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Rapid Review Step 1 > Psychiatry & Behavioral Science > Flashcards

Psychiatry & Behavioral Science Flashcards

1
Q

Neuroleptic malignant syndrome

A

Reaction to antipsychotic medications
- Fever (>40 C common)
- Confusion
- Muscle rigidity (generalized)
- Autonomic instability (abnormal vital signs, sweating)

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2
Q

Wernicke encephalopathy

A

Caused by Vitamin-B1 (Thiamine) deficiency in alcoholics
Confusion, Ophthalmoplegia/Nystagmus, Ataxia (add confabulation/memory loss for Korsakoff syndrome)
Damage to Mamilliary bodies.

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3
Q

Serotonin Syndrome

A

– Neuromuscluar hyperactivity (clonus,hypereflexia, hypertonia, tremors, siezures)
– Autonomic stimulation
(hyperthermia, diaphoresis, diarrhea)
– Agitation

Treatment:
Benzodiazipine (to calm the patient)
Cyproheptadine (serotonin recptor antagonist)

Note: Differentiation point b/w serotonin syndrome and NMS is that only serotonin syndrome has Clonus & Hyperreflexia, NMS has Hyporeflexia and no clonus

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4
Q

Neuroleptic Malignant Syndrome

A

Feared side effect of typical antipsychotics
Progression to EPS
Muscle rigidity, Myoglobinuria
Fever
Enchephalopathy
Unstable vitals
Elevated Liver enzymes

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5
Q

Metabolic Syndrome

A

Wt.gain , Diabetes , Hyperlipidemia
Atypical antipsychotics have highest risk of causing metabolic syndrome (i.e clozapine, olanzipine, quetiapine)

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6
Q

Tourrette syndrome

A

Motor and vocal tics that presist for > 1 year.
Tx: Fluphenazine, Resperidone

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7
Q

Alcohol Intoxication

A

Slurred speech, Mood changes, Horizontal Nystagmus, Lack of coordinated movement.

Delerium tremens: life threatnening alcohol withdrawal symptoms peak 2-4 days after last drink, characterized by autonomic hyperactivity
( Tremors, Anxiety, Siezures, Electrolyte disturbances, Respiratory alkalosis)

Drugs for withdrawal: benzodiazipines (lorazipam, diazepam)

Tx for alcoholism:
Disulfram (to condition the patient to abstain from alcohol use)
Acamprosate, Naltrexone (reduce cravings)
Support group.

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8
Q

Opiod Intoxication

A

Sx of OD:
Euphoria,
Respiratory/CNS depression,
Pupillary constriction (pinpoint pupils)
Tx: Naloxone (Opiod recptor anatgonist)

Sx of Withdrawal:
Flu-like symptoms Sweating
Dilated pupils
Piloerection
Fever, Rhinorhea, Lacrimation
Nauseas, Stomach cramps, Diarrhea
Tx: Naltrexone

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9
Q

Cocaine Intoxication

A

Cocaine blocks Dopamine, Serotonin, NorEpi reuptake.
Sx of intoxication:
Pupillary dilation
Hallucinations (including tactile i.e feeling bugs all over the body aka cocaine crawlies)
Paranoid ideations
Angina, SCD
Perforation of nasal septum
Tx: Alpha blockers (Phenoxybenzamine, Phentolamine) , Benzodiazipines, B-blockers C/I.

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10
Q

MDMA intoxication
Aka Ecstacy

A

Club drug
For social closeness
Distorted sensory and time preception
Teeth clenching
Life threatening effects include:
Tachycardia, HTN, Hyperthermia, Hyponatremia, Serotonin syndrome

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11
Q

Marijuana/ Cannaboid intoxication

A

Euphoria , Anxiety , Paranoid delusions , Preception of slowed time , Impaired judgement , Social withdrawal , Increase Appetite , Dry mouth , conjunctival injection , Hallucination

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12
Q

Phenycyclidine / PCP intoxication

A

Violence , Impulsivity , Psychomotor agitation , Nystagmus , Tachycardia , HTN , Analgesia , Psychosis , Delerium , Siezures

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13
Q

LSD intoxication

A

Action at serotonin receptor
Visual hallucinations
Synesthesia ( seeing sounds as colours )
Pupillary dilation
Paranoia
Psychosis
Possible Flashbacks

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14
Q

Inhalant Abuse

A

Young adult, Teenager
Rapid onset of Bilegerence , Assaultiveness
Apathy , Impaired judgement , Blurred vision ,
Coma.
Resolution can be just as rapid

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15
Q

Rett Syndrome

A

Only in girls
Decreased head growth
Hand wringing
Lose motor skills (Normal until 5 months of age)

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16
Q

Autism

A

Poor eye contact , Repetitive movements, lack verbal skills and bonding, symptoms since birth

17
Q

Major depressive disorder
( M D D )

A

Need 5 of 8 SIGECAPS for over 2 weeks
“ S I G E C A P S “
S = Sleep disturbances
I = Interest/ Lipido loss
G = Gulit
E = Energy loss
C = Concentration loss
A = Appitite loss
P = Psychomotor agitation
S = Suicidal Ideation (hopelessness)

18
Q

Malignant Hyperthermia

A

Widespread muscle rigidity after administration of inhalation anesthetics and/or succinylcholine to genetically susceptible individuals.
Genetic mutation in Rayanodine receptors
Unregulated sarcoplasmic Ca+2 release —> sustained muscle contraction

Symptoms:
- Masseter muscle spasm
- Widespread muscle rigidity
- Hypercarbia
- Rhabdomyolysis —> Hyperkalemia & ARF.
- Hyperthermia (late manifestation)

Dantrolene is used for treatment it directly inhibits intracellular Ca+2 release from abnormal ryanodine receptors (RYR1).

19
Q

Brief psychotic disorder

A

Brief psychotic disorder is characterized by the sudden onset of psychotic symptoms lasting ≥1 day but <1 month.

20
Q

Delirium

A

Delirium is a reversible, acute-onset confusional state characterized by a fluctuating level of consciousness with deficits in attention, memory, and executive function

21
Q

Frontotemporal dementia

A

Frontotemporal dementia presents with early behavior change (eg, disinhibition, apathy), followed later by memory impairments

22
Q

Paranoid Personality Disorder

A

Pervasive pattern of distrust & suspiciousness beginning in early adulthood & occurring in a variety of settings (no clear delusions)
- Believes being exploited & deceived by others
- Interprets benign comments & events as threats; reacts angrily
- Bears grudges
- Questions loyalty of partner without justification

23
Q

Schizophrenia

A
  • Delusions
  • Hallucinations
  • Disorganization
  • Negative symptoms
24
Q

Schizotypal personality disorder

A

Characterized by magical beliefs, social anxiety, eccentric behavior, and odd perceptual experiences.

  • Eccentric behavior & thinking
  • Unusual perceptual experiences
25
Q

Narcissistic personality disorder

A

Consists of a pervasive pattern of grandiosity, need for admiration, sense of entitlement, and lack of empathy.

Behaviors and interactions are often motivated by a need for attention and praise

26
Q

Anorexia nervosa

A
  • BMI <18.5 kg/m2
  • Intense fear of weight gain
  • Distorted views of body weight & shape

Treatment:
- Cognitive-behavioral therapy
- Nutritional rehabilitation
- Olanzapine if no response to first-line treatments

27
Q

Bulimia Nervosa

A
  • Recurrent episodes of binge eating
  • Inappropriate compensatory behavior to prevent weight gain
  • Excessive worrying about body shape & weight

Treatment:
- Cognitive-behavioral therapy
- Nutritional rehabilitation
- SSRI (fluoxetine), often in combination with first-line treatments

28
Q

Binge Eating Disorder

A
  • Recurrent episodes of binge eating
  • No inappropriate compensatory behaviors
  • Lack of control during eating

Treatment:
- Cognitive-behavioral therapy
- Behavioral weight loss therapy
- SSRI Lisdexamfetamine, topiramate

29
Q

Body dysmorphic disorder

A

Characterized by intense preoccupation with a perceived defect in physical appearance leading to significant functional impairment.

It is not diagnosed when weight gain is the preoccupation of an individual who meets the criteria for an eating disorder.

30
Q

Cluster-A Disorders

Odd/eccentric

A
  1. Paranoid: suspicious, distrustful, hypervigilant
  2. Schizoid: prefers to be a loner, detached, unemotional
  3. Schizotypal: unusual thoughts, perceptions & behavior
31
Q

Cluster-B Disorders

Dramatic/erratic

A
  1. Antisocial: disregard & violation of the rights of others
  2. Borderline: chaotic relationships, abandonment fears, labile mood, impulsivity, inner emptiness, self-harm
  3. Histrionic: superficial, theatrical, attention-seeking
  4. Narcissistic: grandiosity, lack of empathy
32
Q

Cluster-C Disorders

Anxious/fearful

A
  1. Avoidant: avoidance due to fears of criticism & rejection
  2. Dependent: submissive, clingy, needs to be taken care of
  3. Obsessive-compulsive: rigid, controlling, perfectionistic
33
Q

Alcohol Withdrawal

A

Alcohol withdrawal symptoms typically start within 8-12 hours after the last drink and include:
- Insomnia
- Tremulousness
- Anxiety
- Autonomic hyperactivity (variable blood pressure, diaphoresis, and tachycardia).

Alcohol withdrawal seizures can occur within 12-48 hours.

Delirium tremens (disorientation, severe agitation, fever) typically begins within 48-96 hours.

Benzodiazepines (eg, lorazepam, diazepam, chlordiazepoxide) are used as first-line therapy

34
Q

Delirium Tremens

A

Alcohol withdrawal complication, typically begins within 48-96 hours of withdrawal, usually seen in the setting of hospitalized patients.

  • Disorientation
  • Severe agitation
  • Fever

Rapid Review Step 1 (24 decks)

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