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CV-Step 1 > Psychology > Flashcards

Psychology Flashcards

1
Q

Rx:

Social anxiety DO (SAD)
*Self-med with alcohol prior to social event

A

SSRI
CBT
B-blocker or Benzo = performance-only subtype SAD

*Benzo: 2nd line (avoid in self-med with alc)

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2
Q

Meds that incr methadone (mu-R agonist) effect?

A 
ABx:
\+ -nazole (antifungal - cryptococcal meningitis)
\+ ciprofloxacin, clarithromycin
\+ cimetidine
\+ Fluvoxamine
  • Pinpoint pupils, sluggish rxn, bradypnea, QTc prolongation (torsade de pointes)
  • meta by CYP450, CYP3A4
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3
Q

Diagnosis:
Episodic Psych sx + abd pain + peripheral neuropathy
*onset: midlife

A

acute intermittent porphyria (AIP)

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4
Q

Diagnosis:

Personality changes, social withdrawal *prior to onset of overt psychosis.

A

Prodromal schizophrenia

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5
Q

Diagnosis:

1+ unexplained sx, excessive thoughts, anxiety & behaviors in response to sx.

A

Somatic sx DO

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6
Q

Diagnosis:

Minimal to no sx, preoccupation with idea of having a serious illness

A

illness anxiety DO

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7
Q

Diagnosis:

Neurologic sx incompatible with anatomy or pathophysiology

A 
Conversion DO
(functional neurologic sx DO)
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8
Q

Diagnosis:

Falsification of sx/ inducing inj in the absence of obvious external rewards

A

Factitious DO

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9
Q

Diagnosis:

Falsification of illness for obvious external rewards

A

Malingering

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10
Q

Rx:
Anticonvulsant and mood stabilizer for bipolar

  • Voltage-gated Na channel blocker
  • enhance vail of GABA
A

Valproate (Valproic acid)

*reduce GABA catabolism

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11
Q

Rx:
Anticonvulsant and mood stabilizer for bipolar

*CYP450 inducer

A

Carbamazepine

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12
Q

Rx:
Anticonvulsant and mood stabilizer for bipolar

*SE: skin rash, rare Stevens-Johnson syndrome

A

Lamotrigine

*Stevens Johnson syndrome: life threatening mucocutaneous rxn.

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13
Q

Rx: 2nd Gen antipsychotic

antipsychotic + mood DO

A

Aripiprazole

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14
Q

RX: SSRI

  • Avoided in bipolar DO
  • risk of inducing mania
A

Citalopram

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15
Q

Rx:

Anticonvulsants + epilepsy tx

A

Levetiracetam

Phenytoin

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16
Q

RX

Mood stabilizer, bipolar DO

*2nd messenger signal transduction (AC&raquo_space; PIP)&raquo_space; decr excitatory neurotransmission.

A

Lithium

*Toxicity: n/v/d, neuromuscular signs dev later

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17
Q

Rx:
1st line tx of active seizures, acute anxiety, alc withdrawal

*Benzo, enhance affinity of GABA&raquo_space; incr inh potential.

A

Lorazepam

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18
Q

RX:

generalized anxiety DO (GAD)

  • nonbenzo anxiolytic
  • no risk of dependence
A

Buspirone

  • partial 5HT_1A R agonist
  • no m relaxant, no anticonvulsant (in constrast of GABA-A)
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19
Q

RX:

short acting opioids only for break through pain

A

hydrocodone, oxycodone

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20
Q

Diagnosis:
+Disinhibition: socially inappropriate behavior
+Apathy
+Hyperorality: change sin diets, sweets, binge eating, consume inedible objects
+Compulsive behavior: simple repetitive speech/motions, complex hoarding/ following new religion

A

Frontotemporal dementia
*early 50-60s

  • tau protein inclusions, TDP-43 protein inclusions
  • AD (20-40% of cases)
  • initial neuronal loss in frontotemporal lobes
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21
Q

Diagnosis:

  • 60-70s
  • prominent memory impairment
  • Chr 21 (APP gene)
A

Alzheimer dz

  • mild to moderate generalized brain atrophy
  • initial neuro loss in parietal and temporal lobs
  • tau protein, amyloid plaques
  • chr 21, Apolipoprotein E4
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22
Q

Presenilin (component of gamma-secretase complex)

A

Alzheimer’s disease

involve in cleavage of APP

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23
Q

First line RX for panic DO

A

SSRI/SNRI
CBT
Acute distress: benzo

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24
Q

Psychotic sx <1mo

A

Brief psychotic DO

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25
Q

Which personality DO?

Frantic efforts to avoid abandonment

A

Borderline PD

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26
Q

Tx and Rx:

BMI <18.5 kg/m2
intense fear of weight gain
distorted views of body weight/shape

A

Anorexia nervosa
Tx: CBT, nutritional rehab
Rx: Olanzapine

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27
Q

Tx and Rx:

BMI <18.5 kg/m2
intense fear of weight gain
distorted views of body weight/shape

A

Anorexia nervosa
Tx: CBT, nutritional rehab
Rx: Olanzapine (assoc with WG) if tx dont work

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28
Q

Tx and Rx:

Recurrent ep of binge eating
+inappropriate compensatory behavior to prevent WG
+Excess worrying about body shape/weight

A

Bulimia nervosa
Tx: CBT, nutritional rehab
Rx: SSRI (fluoxetine) + tx
Contraindicate: Bupropion (antidepressant - NE/D reuptake Inh) = risk of seizures

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29
Q

Tx and Rx:

recurrent ep of binge eating
no inappropriate compensatory behaviors
lack of ct during eating

A

Binge-eating DO
Tx: CBT, behavioral weight loss therapy
Rx: SSRI, Lisdexamfetamine

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30
Q

Withdrawal syndromes from which substance?

tremors, agitation, anxiety, delirium*, psychosis

A

Alcohol

PE: seizures, tachC, palpitations

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31
Q

Withdrawal syndromes from which substance?

Tremors, anxiety, perceptual* disturbances, psychosis, insomnia.

A

Benzodiazepines

PE: seizures, tachC, palpitations

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32
Q

Withdrawal syndromes from which substance?

N/v, abd cramping, diarrhea, m aches

A

opioids

PE: dilated pupils, yawning, piloerection, lacrimation, hyperactive bowel sounds

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33
Q

Withdrawal syndromes from which substance?

incr appetite, hypersomnia, intense psychomotor retardation, severe depression (crash)

A

stimulants (cocaine, amphetamines)

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34
Q

Withdrawal syndromes from which substance?

Dysphoria*, irritability, anxiety, incr appetite

A

Nicotine

35
Q

Withdrawal syndromes from which substance?

Irritability, anxiety, depressed mood, insomnia, decr* appetite

A

Cannabis

36
Q

Diagnosis:
manic ep
+/- depressive ep

A

Bipolar I

Manic ep: severe, 1week (unless hosp)

37
Q

Diagnosis:

hypomanic ep
+ 1 or more major depressive ep

A

Bipolar II

38
Q

Diagnosis:

2+ years of fluctuating, mild hypomanic, depressive sx
do not meet criteria for hypomanic or major depressive ep.

A

Cyclothymic DO

39
Q

Diagnosis:

Recurrent major depressive disorder

A

Unipolar major depressive DO

40
Q

Major depressive/manic ep concurrent with sx of schizophrenia

Life time hx of delusions/hallucinations for 2 or more weeks (ABSENCE of Major depressive/ manic ep) - psychotic sx w/o mood sx in between hospitalization

A

Schizoaffective DO

  • in contrast to bipolar/ major depression with psychotic (psychotic sx occur exclusively DURING manic/depressive ep)
  • contrast to schizophrenia: no prominent mood sx that meet manic/depressive ep.
41
Q

Most imp screening before dx/tx of major depressive DO?

A

hx of mania

*Prevent use of antidepressant monotherapy as they carry risk of inducing mania

42
Q

Which medication?

(NMS) Neuroleptic malignant syndrome (hyperthermia, severe muscular rigidity, altered mental status, autonomic dysfx)
*fever, confusion, abn VS, difficulty moving 5 days later

A

FGAs - Haloperadol - Dopamine antagonists
*D/t dysregulation of dopamine

*D2 antagonism in nigrostiatal pathway - lead pipe rigidity

Reversal: Dantrolene

43
Q

serotonin syndrome

A

neuromuscular irritability, hyperreflexia (clonus)

  • rather than generalized muscle rigidity (in neuroleptic malignant syndrome in D antagonists)
    onset: <1 day

+ Altered mental status, symp hyperactivity (hyperthermia, HTN, tachC, diaphoresis)

44
Q

what syndrome?

*Diffuse rigidity (lead pipe), hyporeflexia
onset: 1-3days
Altered mental status, symp hyperactivity (hyperthermia, HTN, tachyC, diaphoresis)

A

Neuroleptic malignant syndrome

D/t dysreg of dopamine antagonist

45
Q

Precipitant?

Acute dystonic rxn

A

Antipsychotic D2 dopamine R antagonism (in nigrostiatal pathway)

*distressing contractions of neck, mouth, tongue

46
Q

Diagnosis:

psychotic do 1day-1mo

A

Brief psychotic DO

47
Q

Diagnosis:

increased D activity in the mesolimbic pathway

A

Schizophrenia

tx: Dopamine antagonist antipsychotic

48
Q

antidepression with no sexual dysfx SE

A

Bupropion

Mirtazapine

49
Q

Rx:
Major depressive DO with atypical features
+ Mood reactivity (mood improves in response to pos events)
+laden paralysis (arms/legs feel extremely heavy)
+rejection sensitivity (overly sensitive to slight criticism)
+vegetative signs: incr sleep & appetite

A

MAOi (phenelzine, tranylpromine)

50
Q

Dx:

Physician’s conscious and unconscious rxn toward a patient that is based on past personal relationships

A

countertransference

51
Q

Dx:

patient redirect emotion from a significant person in the past to physician (immediate sense of comfort/familiarity with a physician who resembles her daughter)

A

transference

52
Q

Tx with rapid response

for psychotic depression (+ suicidal ideation)

A

ECT (electroconvulsive therapy)

*or antipsychotic + antidepressant

53
Q

Adjustment DO vs generalized anxiety DO

A

adjustment = less than 3mo

GAD: 6+ mo

54
Q

acute distress DO vs PTSD

A

acute: 3days - 1mo
PTSD: >6mo

55
Q

Dx of personality DO:

suspicious, distrustful, hypervigilant
*avoid relationships/ socialization

A

paranoid

cluster A: odd/eccentric

56
Q

Dx of personality DO:

prefers to be a loner, detached, unemotional

A

schizoid

cluster A: odd/eccentric

57
Q

Dx of personality DO:

unusual thoughts, perceptions/ behavior

A

schizotypal

cluster A: odd/eccentric

58
Q

Dx of personality DO:

disregard/ violation of rights of others

A

antisocial

cluster B: dramatic/ erratic

59
Q

Dx of personality DO:

chaotic relationships, abandonment fears, labile mood, impulsivity, inner emptiness, self-harm

A

borderline

cluster B: dramatic/ erratic

60
Q

Dx of personality DO:

superficial, theatrical, attention-seeking

A

histrionic

cluster B: dramatic/ erratic

61
Q

Dx of personality DO:

grandiosity, lack of empathy

A

narcissistic

cluster B: dramatic/erratic

62
Q

Dx of personality DO:

avoidance d/t fears of criticism/ rejection

A

avoidant

cluster C: anxious/fearful

63
Q

Dx of personality DO:

submissive, clingy, needs to be taken care of

A

dependent

cluster C: anxious/fearful

64
Q

Dx of personality DO:

rigid, controlling, perfectionistic

A

obsessive compulsive

cluster C: anxious/fearful

65
Q

What age:

children dev understanding of concept of gener

A

3-4 yo

66
Q

What age:

sense of permanence of gender

A

around 5-6yo

67
Q

Dx:

intense feeling of a person’s gender does not match one’s assigned birth sex&raquo_space; cont into puberty
*assoc with significant distress

A

gender dysphoria

*assoc depression, anxiety

68
Q

Intoxication of which drug?

violent behavior, dissociation, hallucinations, amnesia
*nystagmus (horiz/vertical)
ataxia

A

PCP (phencyclidine)
Hallucinogen
*N-methyl-D-aspartate glutamate R antagonist + monoamine reuptake inh

69
Q

Intoxication of which drug?

*visual ahllucinations
euphoria, dysphoria/panic, tachyC/HTN

A

LSD Hallucinogen

70
Q

Intoxication of which drug?

Euphoria, agitation/psychosis
*chest pain, *seizures, *mydriasis
TachyC/HTN, MI, stroke, severe vasoconstriction
*last less than 1hr

A

Cocaine
*stimulant

  • high dose: paranoid delusions (like schizophrenia)
  • auditory, visual, tactile hallucination (insect crawling under skin)
  • grandiosity, euphoria, hyperactivity, agitation
71
Q

Intoxication of which drug?

violent behavior, psychosis, diaphoresis, tachyC/HTN
Choreiform movement
*tooth decay

A

Methamphetamine

stimulant

72
Q

Intoxication of which drug?

incr appetite, euphoria, dysphoria/panic, slow reflexes, impaired time perception, dry mouth
*conjunctival injection

A

Marijuana (THC, cannabis)

Cannabinoid

73
Q

Intoxication of which drug?

Euphoria
*depressed mental status, miosis, resp depression
constipation, decr bowel sound

A

heroin

opioid

74
Q

Intoxication of which drug?

mild amnesia, sedation, slurred speech, resp depression
HypoTN, bradyC

A 
benzodiazepine (diazepam)
CNS depressant (mild euphoria/ relaxation)
75
Q

D-D interaction with lithium:

A 
thiazide diuretics (>> dehydration >> incr lithium/Na reabs)
NSAIDs & ACEi (impaired lithium clearance)
  • chronic tox: decr renal perfusion/ dehydration; lethargy/confusion/agitation, ataxia/tremor/fasciculations/ seizure
    tx: IV hydration, hemodialysis (severe cases)
76
Q

potassium sparing diuretics effect on serum lithium lv

A

decrase

*amiloride

77
Q

Adequate antidepressant trial time

A

4-6 weeks

78
Q

Dx:

cortical hyperexpansion in toddlers

  • regression of speech, stereotypical movement (flapping, clapping)
  • no motor milestone dysfx/regression
A

autism spectrum DO (ASD)

79
Q

Dx:

neonate sx
neuro: irrtability, hypertonia, jittery movement, seizures (rare)
GI: d/v/ feeding intolerance
autonomic: sweating, sneezing, pupillary dilation
*high pitched cry

A

neonatal abstinence syndrome

*heroin, methadone in mother

  • withdrawal from transplacental opiates d/t maternal drug use
  • tx: opioid (morphine, methadone)
80
Q

prenatal exposure to which substance:

jitteriness, excessive sucking, hyperactive moro reflex

A

cocaine

  • neonate withdrawal = not as severe as opiates
  • effects of long term behavior, attention lv, intelligence
81
Q

prenatal exposure to which substance:

neural tube defects
cardiac anomalies
dysmorphic facies: cleft lip, narrow bifrontal diameter, midface hypoplasia, broad/ depressed nasal bridge, long philtrum

A

valproic acid

82
Q

What syndrome:

mental status changes, autonomic instability, neuromuscular hyperactivity

A

serotonin syndrome

83
Q

Withdrawal of which anxiolytic:

rebound anxiety, tremor insomnia, symp hyperactivity (diaphoresis, palpitation) – psychotic (hallucination, delusions), seizures*, death.

A

benzo (-zepam)

  • highest risk of withdrawal = short acting agents, prolonged use, higher dose
  • alprazolam (intermediate)

*rebound hyperactivity d/t incr GABAa Rs during drug use

84
Q

sx of anticholinergic toxicity

A

dry skin, mucous membranes
urinary retention, decr bowel sounds, hyperthermia

*decr parasym effect

CV-Step 1 (12 decks)

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