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Pance Re-Up > Psychology #3 > Flashcards

Psychology #3 Flashcards

1
Q

What is the diagnostic criteria for Bipolar I Disorder?

A

-At least 1 manic episode
–abnormal, elevated, expansive, irritated mood for > 1 week that impairs function
–Thinking: flight of ideas, grandiose, racing thoughts
–Behavior: hyperactivity, pressured speech, no sleep, hypersexuality

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2
Q

What is the first line treatment for Bipolar I disorder?

A

Lithium

-Also decreases suicide risk

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3
Q

For acute mania, what medications are used?

A

Antipsychotics (Risperidone or Olanzipine)

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4
Q

What is another treatment option for Bipolar I, besides Lithium

A

Valproic Acid

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5
Q

What is the diagnostic criteria for Bipolar II Disorder?

A

-History of 1 major depressive episode + 1 hypomanic episode (abnormal, elevated mood < 1 week, doesn’t require hospitalization, no impairment of functioning)

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6
Q

Treatment for Bipolar II Disorder

A

-Lithium or 2nd gen antipsychotic
-Psychotherapy

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7
Q

Lithium MOA

Name some adverse effects of this medication

A

-Alters neuronal sodium transport

-Hypothyroidism
-Nephrogenic Diabetes Insipidus
-Hyperparathyroidism
-Hypercalcemia
-Hypermagnesemia

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8
Q

Lithium has a narrow therapeutic index and prior to starting, you should get a _____, _____ and ______.

How often should you monitor labs in this patient?

What are two contraindications to this medication?

A

ECG, TSH, CBC, beta-HCG

Every 4-8 weeks

Pregnancy, Severe renal disease

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9
Q

What is one CAUTION you should remember when using Lithium?

A

Caution in use with NSAIDs. They increase Lithium levels in the body and can lead to confusion, tremor, slurred speech, vomiting.

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10
Q

Generalized Anxiety Disorder (GAD) is what?

What screening tool can you use to screen for this and what is considered positive

A

Excessive anxiety or worry for at least 6 months in various aspects of life. Anxiety is out of proportion to event. At least 3 of the following
–fatigue, concentration, muscle tension, sleep changes, headaches, shakiness.
–causes impairment, not due to substances

GAD-7 : 10 or more is positive

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11
Q

Treatment for GAD

A

-SSRI

-Buspirone (as adjunct)
-CBT, Psychotherapy
-Benzos for short-term

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12
Q

Buspirone MOA

It does not (2 things)

A

Partial serotonin receptor agonist and dopamine receptor agonist

Does not cause sedation and does not have abuse potential

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13
Q

What is panic disorder?

A

Recurrent, unexpected panic attacks (2 or more)
–often followed by concern about future attacks
–persistent worry about attacks
–maladaptive behavior related to attacks

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14
Q

Treatment for panic disorder

A

-SSRI + CBT

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15
Q

Explain what a panic attack is

A

-Sudden episode of fear or discomfort that peaks within 10 minutes and rarely lasts > 1 hour
-Sympathetic system overdrive
-Needs 4 or more of:
–Sense of impending doom
–sweating, dizziness, SOB, CP, fear of dying
–chills, hot flashes, nausea, abdominal pain
–depersonalization (detached from oneself)
–derealization (feelings of unreality)

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16
Q

What is the first-line treatment for a panic attack?

What should you do first

A

Benzodiazepines

Rule out life threatening conditions (heart attack, thyrotoxicosis)

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17
Q

Agoraphobia is _________

And the treatment is

A

Intense fear of being in places where escape is difficult (bridges, crowds, transport, etc.)
-Symptoms last > 6 months and cause dysfunction

-Treatment: SSRI + CBT

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18
Q

Specific phobias last how long and what is the treatment?

A

At least 6 months

Exposure and desensitization
-Short term Benzos or BB used in some patients

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19
Q

MC type of phobia is

A

Social Anxiety Disorder

-Such as public speaking
-Almost always causes panic attacks

20
Q

Treatment for social anxiety disorder

A

-Psychotherapy (initially)
-SSRI’s
-Situational: BB (Propanolol) 30-60 minutes before performance

21
Q

Regarding obsessive-compulsive disorder, what are obsessions?

What are compulsions?

A

Obsessions: recurrent or persistent thoughts (ego-dystonic and inconsistent with personal beliefs)

Compulsions: repetitive behaviors that cause distress, impairment, or time consuming

22
Q

What is the primary neurotransmitter involved with OCD?

A

Serotonin

23
Q

Treatment for OCD

A

-CBT + Pharmacotherapy (SSRI)

-TCA’s (Clomipramine) can be used

24
Q

With PTSD, the traumatic event occurred when?

What is the treatment?

A

Anytime in the past

SSRI’s
CBT

25
Q

With PTSD, what medications can be used for..

-Insomnia
-Nightmares and hypervigilance

A

-Insomnia: Trazodone

-Nightmares: Prazosin

26
Q

On the other hand, with acute stress disorder, the traumatic event occurred when?

What is the treatment?

A

Occurred < 1 month ago and symptoms last < 1 month

-Treatment: Counseling and psychotherapy

27
Q

If the symptoms last longer than 1 month with acute stress disorder, treat as…

A

PTSD

28
Q

What psych condition has the highest mortality of all psych conditions?

A

Anorexia Nervosa

29
Q

What are symptoms of anorexia nervosa

A

-Behaviors to keep a low weight
-Ego Syntonic: acceptable to them
-Restrictive vs Binge Eating
–Low caloric intake
–Diet pills, dieting
–Vomiting, enema, laxatives

30
Q

Patients with anorexia nervosa have symptoms that are ________, which means they are acceptable to them

A

Ego-Syntonic

31
Q

What are some exam findings of a patient with anorexia nervosa

A

-Lanugo (fine, downy hair)
-Dry Skin
-Salivary gland hypertrophy
-Amenorrhea, Osteopenia
-Hypotension, Bradycardia
-Russell’s Sign: callouses on hand
-BMI 17.5 or less
-Body weight: < 85% of ideal

32
Q

What labs are expected with anorexia nervosa?

A

Hypokalemia
Metabolic Alkalosis

Both, from vomiting

33
Q

Admit the patient with anorexia nervosa if weight is < _______%

Otherwise, the treatment is

A

-< 75%

Psychotherapy and SSRI’s (they lead to weight gain)

34
Q

On the other hand, Bulimia Nervosa is

A

-Binge eating followed by compensatory behaviors

35
Q

Patients with bulimia (explain the weight)

Their symptoms are ego-________

A

Can maintain a normal weight or overweight

Ego-Dystonic: troublesome to patient

36
Q

Exam findings of a patient with Bulimia

A

-Teeth pitting or enamel erosion
-Russell’s Sign
-Parotid Gland Hypertrophy

37
Q

What labs are expected with bulimia nervosa

A

-Hypokalemia
-Metabolic alkalosis
-Increased amylase (parotid glands)

38
Q

Treatment for Bulimia (both initially and pharm)

A

-Psychotherapy
-Fluoxetine (pharm therapy first line)

39
Q

What is refeeding syndrome a result of?

A

Fluid and electrolyte shifts during aggressive nutritional rehabilitation

40
Q

What lab is specific for refeeding syndrome?

A

Hypophosphatemia

41
Q

On the other hand, binge- eating disorder is NOT associated with….

What are the treatment options for this?

A

Not associated with compensatory behaviors

Psychotherapy, diet/exercise, Topiramate

42
Q

Delusional Disorder requires what

A

1 or more delusion lasting > 1 month without other psychotic symptoms and no significant impairment in function

43
Q

Treatment for delusional disorder

A

-2nd gen antipsychotics
-Psychotherapy

44
Q

What is the strongest risk factor for suicide?

Who are at the highest risk?

What are other risks?

A

-Previous attempt of suicide

Elderly white men highest risk in US

-Others: live alone, chronic illness, white, positive family history, household with a gun

45
Q

What two drugs treat suicidality?

A

Lithium and Clozapine

46
Q

What acronym should be used to quantify risk of suicide and what is considered “safe?”

A

-SADPERSONS
-Sex, Age, Depression, Previous Attempt, ETOH, Rational Thinking (Lack of), Support Lacking, Organized Plan, No Spouse, Sickness

4 or less is safe

Pance Re-Up (76 decks)

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