Psychiatry CQ Flashcards
fainting without palor or sweating
conversion symptom
drug seeking
will refuse NON-narcotic alternatives
somatization criteria
age> 30yo pain symptoms 2+ GI 1 repro/sexual 1 pseudoneuro
de clerambaults described as
MORE than just sexual attraction
smoking stats canada
55% of population mesolimbic reinforcement more common in people with depression persistence a/w genetic influence 2-3% successful in quitting
alcoholic– deciding if in patient or out patient
URINE toxicology
Hemineglect
R parietal lobe
suicide epidemiology
more likely when depressed patient recovering
2/3 successful in first attempt
MEN OLDER THAN 75yo= HIGHEST rate
suicide timing for adolescents
WINTER (girls attempt more, boys more successful)
depression and REM
decrease in REM latency
does warfarin cause depression
NOOOO
HSES = cause of postpartum depression
NOOOOO
depression a/w DM diagnosis
initial adjustment disorder, going onto
MAJOR DEPRESSION
DYSTHMIA
is clonazepam panicogenic
NOOOO, calms you down
trichotilomania
OCD, and conversion
pulse with barbiturate withdrawal
HIGH, not low
% monozygotic twin concordance for schizo
40%
do hallucinogens cause miosis
NOOOOO
males or females more at risk for tardive dyskinesia
FEMALES
tx for tardive dyskinesia
- STOP typical antipsychotic
- tetrabenazine
- quetiapine
NOT haloperidol
tx for neurloeptic malignant syndrome
STOP all antipsychotics; DAB Dantrolene Amantadine Bromocriptine NOT valproic acid
adjunct to PTSD
quetiapine
shortest 1/2 life benzo’s
LAM
- triazolam
- alprazolam
valproate decreases what
decreases CARNITINE– thus increases NH3
is an EKG necessary before lithium
YESSS
how does a depressed child act
ANTISOCIAL kid
decrease side effects of parkinson disease
QUETIAPINE
quetiapine– 2 additional uses
- adjunct for PTSD
2. Parkinsons disease– decrease SE’s
patient with alzheimers and delerium
give risperidone
patient on bupropion– what to give to prevent seizures
VALPROATE
donepezil SE to heart
BRADYCARDIA
Delerium tremens
CONFUSED/OBTUNDED/DELERIUM
seen in 5% of people with alcohol withdrawal
35% mortality rate
hanging self– memory loss
psychogenic amnesia– from cerebral anoxia
what drug not suggested in bulimics
bupropion
weird drug for tourettes
PIMOZIDE
MC side effect of ECT
AMNESIA
increase complications from ECT if…
recent haemorrhage
when to give ECT– 4 HY
- failed two types of SSRI’s
- sucidial in pregnancy
- QUICKEST relief of depression
- major depression with psychotic features
efficacy of psychotherapy vs. pharm in GAD
EQUAL efficacy
efficacy of psychotherapy vs. pharm in dysthymia
PSYCHO> pharm
CBT= okay alternative for
moderate depression
moderate to severe anterograde amnesia
NOOOOOOTTTTTT psychogenic amnesia
concordance of OCD in monozygotic twins
80%
OCD epidemiology
80% concordance of OCD in monozygotic twins
2-3% of the population
MALES= YOUNGER age when present
often secretive regarding extent/nature
delirium quick tx
HALOPERIDOL
narcolepsy a/w (other than big 4)….
delusion LIKE dreams
what drug to prevent alcohol relapse
NALTREXONE
which anti-depressant don’t you want to use in anorexics
PHENELZINE– since have dietary restrictions
tx of social phobias
paroxetine
freud’s sexual development stages
- oral
- anal
- phallic
- latent
- genital
activated charcoal doesn’t work for…
FERROUS SULPHATE
stop lithium for treatment of bipolar….
RECURRENT MANIA IN 6 MONTHS
mum overwhelmed by kids…
family counselling
don’t use bupropion
PANIC DISORER
Hx of SEIZURES
BULIMICS
MAO and random drug gives HTN crisis….
merperidine
fluoxetine
OK in prego
LEAST likely to get discontinuation
fluoxetine given alone ….
TRIGGERS MANIA
first side effect of fluoxetine
LOSS OF APPETITE
hypotension with use of fluoxetine
NOOOOOO
what happens if you stop venlafaxine abruptly….
WITHDRAWAL
MS is NOT associated with…
COMPULSIONS
patient is B.A.D. and is having a manic episode, what would NOT be advised…
STOPPING valproic acid
most sensitive symptom to schizo tx….
PARANOID DELUSIONS
anxiety>depression for feelings of…
dread and apprehensive expectations
psychosis and mania tx…
- LORAZEPAM first
2. antipsychotic
fluvoxamine
SSRI
what drug can lead to falls in elderly
SERTRALINE
most suggestive symptom of depression
WITHDRAWAL from family
ADHD in adults
LESS impulsive
Tx– amphetamines
Depressed elderly
EXCLUDE secondary causes
Alcohol abuse in elderly
BETTER prognosis if late onset drinkers
worst prognosis for anorexic
OLDER
tx responsive depression, how long to continue anti-depressants
6 months
fluoxetine + random drug= serotonin syndrome
dextromethorphan
st. johns wart/ herbal remedies + DO NOT ADD
phenelzine
bipolar with 2 severe manic episodes and family history
= Lithium for LIFETIME
genetic component to bipolar
5-10%
sexually abused patients more likely to have
- PTSD
- Depression
- Suicide
Phases for recovery
ACUTE PHASE - remission -response CONTINUATION PHASE - sustained remission - prevent relapse MAINTENANCE PHASE - recovery - recurrence
holding stilborn baby increases…
PTSD
remission:
of acute symptoms, returning to premorbid functioning
response:
SIGNIFICANT improvement (can occur WITH or WITHOUT remission), 50% decrease baseline level severity
autism brain
increase total brain volume
schizophrenia brain
increase lateral ventricles
panic disorder brain
decrease amygdala
PTSD brain
decrease hippocampus
OCD brain
abnormal orbiofrontal cortex and striatum
mesolimbic dopamine antagonism
anti-psychotics
nigrostriatal dopamine antagonism
PD
EPSE
tuberoinfundibular dopamine antagonism
hyper-PRL