Pysch Flashcards
treatment for anxiety disorder and timeframe
> 6 months, use SSRI and SSNI first line
scale to rate generalized anxiety disorder?
Hamilton >20
timeframe of panic attacks
10mins to 30mins
how do panic attacks and panic disorder differ?
Panic disorder is fear of having attacks. Dx is 4 attack in 4 weeks
tx for panic disorder
benzo in the short term, then switch to SSRI
Is OCD egodytonic or egosyntonic
dytonic
TX for OCD
SSRI at higher dose
timeframe to dx PTSD?
1 month
stress reaction/ acute stress disorder timeframe
1 week to 1 month
Tx PTSD
SSRI, benzo, group therapy
what is the most common mental illness
phobias
what is agoraphobia?
fear of placing self in a situation where problem occurs in a very public space
what other disorder do phobia pt’s have 75-80% of the time?
panic attacks
tx for phobia
exposure therapy, SSRI, benzo
what is the difference between schizoid and schizotypal?
schizoid doesn’t desire relationships, schizotypal is afraid of relationships
schizotypal —
think odd name, odd person, magical & derealization thinking
schizoid
loner, reclusive pleasure
how old must a pt be to be dx with antisocial
18 (evident of conduct disorder before the age of 15
tx for antisocial
lithium, anger management
medical tx of anorexia?
Amitriptyline, SSRI (mirtazapine)
only drug FDA approved for weight loss
Orlistat
Major depressive disorder timeframe to dx
5 symptoms in same 2 week peroid
acronym for depression
SIGECAPS
TX MDD
SSRI, effexor, wellbutrin
how do MDD and dysthymic differ
dysthymic’s timeframe is longer (at least 2 years) symptoms are mild, onset is during childhood
define echolalia
meaningless repetition of another’s speech
Aconym for mania
DIGFAST
difference between mania and hypomania?
mania last at least 1 week, requires hospitalization and has marked dysfunction. hypomania is less symptomatic and lasts 4 days
Bipolar 1
this is the MANIC side (I for manIc)
Bipolar 2
depression + hypomania (never hospitalized)
what is cyclothymic disorder
similar to bipolar 2 but not as severe. 2 years of mild depression and hypomania. no > than 2 month of symptom free. moody, impulsive
tx for cyclothymic disorder
mood stabilzer and antimanic drug
fluoxetine is an ssri, what is the common name
prozac
paroxetine is
paxil
setraline is
zoloft
fluvoxamine is
luvox
citalopram is
celexa
escitalopram is
Lexapro
what type of drug is venlafaxine and duloxetine?
SSNI ( effexor and cymbalta)
side effects of lithium
weight gain, hypothyroidism, and arrhythmia
if bipolar pt continues to have depression on lithium add
lamictal/lamotrigine
TCA name the common drugs
amitriptyline, doxepin, nortriptyline
what population should you avoid TCAs
elder due to anticholinergic affects
MAOI must have a ______ free diet
tyramine free, cheese and wine
dangerous to combine MAOI and SSRI b/c
serotonin syndrome, mental status changes
what disorder is dx has one or more symptom affecting voluntary motor or sensory function?
conversion. these patients will have a la belle indifference to their symptoms
schizoaffective disorder (longest name bc it combines..?)
MDD, manic episode with schizophrenia (must occur for 2 weeks)
what might clozapine cause?
agranulocytosis
is OC personality order distressing to the pt
no. but OCD is the mood disorder is.
what personality disorder is described as unstable, impulsivity that is self damaging, suicidal behavior, and in a state off crisis
borderline
describe avoidant personality disorder
fear of rejection so will avoid situations
schizophrenia is comprised of both negative and positive symptoms explain
positive: delusion, hallucination, disorganized speech, unpredictable mood
negative: social withdrawal, flat affect
tx for schizophrenia
must be multi-drugs.
Tx for positive schizophrenia
haloperidol, chlorpromazine, (antipyschotics with dopamine antagonist)
tx for negative schizophrenia symptoms
risperidone, zyprexa, ziprasidone, quetiaprine (seroquel), aripirprazole (abilify)
atypical antipsycotics carry risk of
metabolic syndrome
define delusion disorder and timeframe
non bizarre delusions for at least one month
most likely cause of psychotic disorder
drug, etoh or medical condition
la belle indifference to neurological complaints, blindness, numbness symptoms is own as what disorder
conversion
munchanusen is part of what personality disorder
factitious
pseudocyesis?
false pregnancy
Etoh hepatitis finding?
mallory bodies
tool to access severity of detox
CIWA
when do DT start? what are they?
clouding of consciousness, delirium, fever, agitation (2-4 days)
difference between wernike and korakoff?
wernike: confusion, ataxia, or nystagmus. Korakoff: psychosis and amnesia due to lack of thiamine (permeant)
CONFABULATION
what liver enzyme is the most sensitive and will be elevated first in alcoholism?
GGT
what’s greater AST or ALT is alcoholism?
AST
most commonly abused opioid?
heroin
withdrawal from what drug includes, anxiety, insomnia yawning, tearing, runny nose, muscle cramping, dilation of pupils, hot flashes
opioids
med used to quickly reverse effects of opioids
naloxone (Narcan)
what drug is a partial agonist of opioid receptors and helps with withdrawal symptoms
subutex (buprenorphine)
difference between naloxone and naltrexone
naloxone - knock all opioid off of receptor, naltrexone softens the blow (naltrexone can be used in ETOH withdrawal)
Disulfiram is used to
Antebuse (make patient’s very ill if they consume ETOH
why should clonidine and bb be avoided in stimulant abuse?
can cause HTN crisis by leaving all alpha receptors unopposed
time in which normal grief should resolve
1 year, first 2 months are the worse
first line med for smoking cessation
Varenicline (chantix) and Bupropion (wellbutrin)
progression of disruptive behavior disorders
oppositional defiant (before 8 years old) –> conduct disorder (18 yo) —> antisocial disorder
pervasive development disorder includes/
autistic, asperger and rhett
lamotrigine/ lamictal may cause what in children?
steven johnson syndrome
dopamine inhibits the release of prolactin, therefore dopamine antagonist increase what?
prolactin leading to galactorrhea
what heart condition is connected to panic disorder
mitral valve prolapse
what psych med causes dystonia (muscle contractions and twisting of the head?
antipsyhotic – phenothiazine
med for dystonia?
use anticholinergic that counteracts acetylcholine. including (benzotropine) muscle relaxants (baclofen) and benzos
how long does a brief psychotic disorder last
1 day to 1 month, if over a month if is a delusion disorder
dissociative or psychogenic fugue
due to stressful event, person moves, changes id and develops amnesia
communication commonly used by autistic children?
echolalia and stereotyped words
many difference between asperger’s and autistic disorder?
lack of language and communication skills
what is the hallmark of a manic episode
the hallmark of mania is irritability
most common SE of MAOI
orthostatic hypotension
Which of the following lab results for LH, FSH and T3 would be most consistently found in a patient with anorexia nervosa?
all would be low.
Which of the following lab results for growth hormone, plasma cortisol, transaminases, and serum cholesterol would be most consistently found in a patient with anorexia nervosa?
all would be elevated
first-generation antipsychotic) is a recommended first-line medication for manic/hypomanic pregnant patients.
haldol
____________usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity. After recovery from fugue, previous memories usually return intact, however there is complete amnesia for the fugue episode.
Dissociative fugue
The symptoms of Schizophrenia are generally listed in which psychiatric Axis?
axis 1
Treatment with which of the following agents can lead to decreased serum lithium levels?
valproic acid
What is the most common presentation for a Manic Episode?
Excessive euphoria
The patient has great difficulty “getting out of bed” in the morning, but is sleeping fine. Which of the following would be the most appropriate pharmacological intervention for this patient?
Sertraline
The Dependent personality would most likely be listed classified as which axis and category?
Axis II (all personality disorders) Group C for dependent
This medication is considered the first line in treating acute schizophrenia.
Risperidone
What type of information is generally recorded on Axis IV?
Psychosocial stressors
what axis includes mental retardation
II
An agitated and seemingly delirious pt presents to the er with muscle rigidity, fever, and autonomic instability. She was recently prescribed a drug to treat symptoms of seeing burning objects and bugs crawling on the walls. only finding is increased creatine phosphokinase levels. what is the disorder
Neuroleptic malignant syndrome (NMS) is a life- threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs
Treatment for Neuroleptic malignant syndrome (NMS) is a life- threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs?
Begin administration of dantrolene
Which drug is used to treat benzodiazepine overdose?
Flumazenil
Which of the following is considered a common physiologic effect of chronic alcohol use?
Downregulation of inhibitory neurotransmitter receptors in the brain. Chronic alcohol use reduces the number of inhibitory neurotransmitter (GABA) receptors in the brain (down-regulation). When alcohol is withdrawn, the loss of inhibitory effects, combined with decreased number of GABA receptors, can lead to overexcitation of the brain, manifesting as the classic alcohol withdrawal syndrome.
Which of the following medications may interact and thus increase serum warfarin levels? Valproic acid or Lithium
Valproic acid
treatment of choice in patients with schizophrenia that is refractory to other treatment methods.
Clozapine
Which of the following antidepressant medications should be avoided in patients with diagnosed anorexia nervosa?
Bupropion (Wellbutrin) is a stimulating antidepressant.
antidepressant that has no sexual side effects nor induced weight gain.
Venlafaxine
43 year old female presents to the emergency department with muscle rigidity, fever, and autonomic instability. She was recently prescribed a drug to treat symptoms of seeing burning objects and bugs crawling on the walls. Toxicology screening is negative, chest radiography reveals that lungs are clear bilaterally, and labs show increased creatine phosphokinase levels. What is the next best step in the management of this patient?
Begin administration of dantrolene
Which of the following pharmacologic agents is reported as causing the most drug-related deaths?
tricyclic antidepressants
This medication is considered the first line in treating acute schizophrenia.
Risperidone
