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PANCE review > Pysch > Flashcards

Pysch Flashcards

1
Q

treatment for anxiety disorder and timeframe

A

> 6 months, use SSRI and SSNI first line

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2
Q

scale to rate generalized anxiety disorder?

A

Hamilton >20

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3
Q

timeframe of panic attacks

A

10mins to 30mins

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4
Q

how do panic attacks and panic disorder differ?

A

Panic disorder is fear of having attacks. Dx is 4 attack in 4 weeks

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5
Q

tx for panic disorder

A

benzo in the short term, then switch to SSRI

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6
Q

Is OCD egodytonic or egosyntonic

A

dytonic

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7
Q

TX for OCD

A

SSRI at higher dose

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8
Q

timeframe to dx PTSD?

A

1 month

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9
Q

stress reaction/ acute stress disorder timeframe

A

1 week to 1 month

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10
Q

Tx PTSD

A

SSRI, benzo, group therapy

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11
Q

what is the most common mental illness

A

phobias

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12
Q

what is agoraphobia?

A

fear of placing self in a situation where problem occurs in a very public space

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13
Q

what other disorder do phobia pt’s have 75-80% of the time?

A

panic attacks

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14
Q

tx for phobia

A

exposure therapy, SSRI, benzo

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15
Q

what is the difference between schizoid and schizotypal?

A

schizoid doesn’t desire relationships, schizotypal is afraid of relationships

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16
Q

schizotypal —

A

think odd name, odd person, magical & derealization thinking

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17
Q

schizoid

A

loner, reclusive pleasure

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18
Q

how old must a pt be to be dx with antisocial

A

18 (evident of conduct disorder before the age of 15

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19
Q

tx for antisocial

A

lithium, anger management

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20
Q

medical tx of anorexia?

A

Amitriptyline, SSRI (mirtazapine)

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21
Q

only drug FDA approved for weight loss

A

Orlistat

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22
Q

Major depressive disorder timeframe to dx

A

5 symptoms in same 2 week peroid

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23
Q

acronym for depression

A

SIGECAPS

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24
Q

TX MDD

A

SSRI, effexor, wellbutrin

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25
Q

how do MDD and dysthymic differ

A

dysthymic’s timeframe is longer (at least 2 years) symptoms are mild, onset is during childhood

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26
Q

define echolalia

A

meaningless repetition of another’s speech

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27
Q

Aconym for mania

A

DIGFAST

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28
Q

difference between mania and hypomania?

A

mania last at least 1 week, requires hospitalization and has marked dysfunction. hypomania is less symptomatic and lasts 4 days

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29
Q

Bipolar 1

A

this is the MANIC side (I for manIc)

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30
Q

Bipolar 2

A

depression + hypomania (never hospitalized)

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31
Q

what is cyclothymic disorder

A

similar to bipolar 2 but not as severe. 2 years of mild depression and hypomania. no > than 2 month of symptom free. moody, impulsive

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32
Q

tx for cyclothymic disorder

A

mood stabilzer and antimanic drug

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33
Q

fluoxetine is an ssri, what is the common name

A

prozac

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34
Q

paroxetine is

A

paxil

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35
Q

setraline is

A

zoloft

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36
Q

fluvoxamine is

A

luvox

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37
Q

citalopram is

A

celexa

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38
Q

escitalopram is

A

Lexapro

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39
Q

what type of drug is venlafaxine and duloxetine?

A

SSNI ( effexor and cymbalta)

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40
Q

side effects of lithium

A

weight gain, hypothyroidism, and arrhythmia

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41
Q

if bipolar pt continues to have depression on lithium add

A

lamictal/lamotrigine

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42
Q

TCA name the common drugs

A

amitriptyline, doxepin, nortriptyline

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43
Q

what population should you avoid TCAs

A

elder due to anticholinergic affects

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44
Q

MAOI must have a ______ free diet

A

tyramine free, cheese and wine

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45
Q

dangerous to combine MAOI and SSRI b/c

A

serotonin syndrome, mental status changes

46
Q

what disorder is dx has one or more symptom affecting voluntary motor or sensory function?

A

conversion. these patients will have a la belle indifference to their symptoms

47
Q

schizoaffective disorder (longest name bc it combines..?)

A

MDD, manic episode with schizophrenia (must occur for 2 weeks)

48
Q

what might clozapine cause?

A

agranulocytosis

49
Q

is OC personality order distressing to the pt

A

no. but OCD is the mood disorder is.

50
Q

what personality disorder is described as unstable, impulsivity that is self damaging, suicidal behavior, and in a state off crisis

A

borderline

51
Q

describe avoidant personality disorder

A

fear of rejection so will avoid situations

52
Q

schizophrenia is comprised of both negative and positive symptoms explain

A

positive: delusion, hallucination, disorganized speech, unpredictable mood
negative: social withdrawal, flat affect

53
Q

tx for schizophrenia

A

must be multi-drugs.

54
Q

Tx for positive schizophrenia

A

haloperidol, chlorpromazine, (antipyschotics with dopamine antagonist)

55
Q

tx for negative schizophrenia symptoms

A

risperidone, zyprexa, ziprasidone, quetiaprine (seroquel), aripirprazole (abilify)

56
Q

atypical antipsycotics carry risk of

A

metabolic syndrome

57
Q

define delusion disorder and timeframe

A

non bizarre delusions for at least one month

58
Q

most likely cause of psychotic disorder

A

drug, etoh or medical condition

59
Q

la belle indifference to neurological complaints, blindness, numbness symptoms is own as what disorder

A

conversion

60
Q

munchanusen is part of what personality disorder

A

factitious

61
Q

pseudocyesis?

A

false pregnancy

62
Q

Etoh hepatitis finding?

A

mallory bodies

63
Q

tool to access severity of detox

A

CIWA

64
Q

when do DT start? what are they?

A

clouding of consciousness, delirium, fever, agitation (2-4 days)

65
Q

difference between wernike and korakoff?

A

wernike: confusion, ataxia, or nystagmus. Korakoff: psychosis and amnesia due to lack of thiamine (permeant)
CONFABULATION

66
Q

what liver enzyme is the most sensitive and will be elevated first in alcoholism?

A

GGT

67
Q

what’s greater AST or ALT is alcoholism?

A

AST

68
Q

most commonly abused opioid?

A

heroin

69
Q

withdrawal from what drug includes, anxiety, insomnia yawning, tearing, runny nose, muscle cramping, dilation of pupils, hot flashes

A

opioids

70
Q

med used to quickly reverse effects of opioids

A

naloxone (Narcan)

71
Q

what drug is a partial agonist of opioid receptors and helps with withdrawal symptoms

A

subutex (buprenorphine)

72
Q

difference between naloxone and naltrexone

A

naloxone - knock all opioid off of receptor, naltrexone softens the blow (naltrexone can be used in ETOH withdrawal)

73
Q

Disulfiram is used to

A

Antebuse (make patient’s very ill if they consume ETOH

74
Q

why should clonidine and bb be avoided in stimulant abuse?

A

can cause HTN crisis by leaving all alpha receptors unopposed

75
Q

time in which normal grief should resolve

A

1 year, first 2 months are the worse

76
Q

first line med for smoking cessation

A

Varenicline (chantix) and Bupropion (wellbutrin)

77
Q

progression of disruptive behavior disorders

A

oppositional defiant (before 8 years old) –> conduct disorder (18 yo) —> antisocial disorder

78
Q

pervasive development disorder includes/

A

autistic, asperger and rhett

79
Q

lamotrigine/ lamictal may cause what in children?

A

steven johnson syndrome

80
Q

dopamine inhibits the release of prolactin, therefore dopamine antagonist increase what?

A

prolactin leading to galactorrhea

81
Q

what heart condition is connected to panic disorder

A

mitral valve prolapse

82
Q

what psych med causes dystonia (muscle contractions and twisting of the head?

A

antipsyhotic – phenothiazine

83
Q

med for dystonia?

A

use anticholinergic that counteracts acetylcholine. including (benzotropine) muscle relaxants (baclofen) and benzos

84
Q

how long does a brief psychotic disorder last

A

1 day to 1 month, if over a month if is a delusion disorder

85
Q

dissociative or psychogenic fugue

A

due to stressful event, person moves, changes id and develops amnesia

86
Q

communication commonly used by autistic children?

A

echolalia and stereotyped words

87
Q

many difference between asperger’s and autistic disorder?

A

lack of language and communication skills

88
Q

what is the hallmark of a manic episode

A

the hallmark of mania is irritability

89
Q

most common SE of MAOI

A

orthostatic hypotension

90
Q

Which of the following lab results for LH, FSH and T3 would be most consistently found in a patient with anorexia nervosa?

A

all would be low.

91
Q

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?

A

all would be elevated

92
Q

first-generation antipsychotic) is a recommended first-line medication for manic/hypomanic pregnant patients.

A

haldol

93
Q

____________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.

A

Dissociative fugue

94
Q

The symptoms of Schizophrenia are generally listed in which psychiatric Axis?

A

axis 1

95
Q

Treatment with which of the following agents can lead to decreased serum lithium levels?

A

valproic acid

96
Q

What is the most common presentation for a Manic Episode?

A

Excessive euphoria

97
Q

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?

A

Sertraline

98
Q

The Dependent personality would most likely be listed classified as which axis and category?

A 
Axis II (all personality disorders) 
Group C for dependent
99
Q

This medication is considered the first line in treating acute schizophrenia.

A

Risperidone

100
Q

What type of information is generally recorded on Axis IV?

A

Psychosocial stressors

101
Q

what axis includes mental retardation

A

II

102
Q

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

A

Neuroleptic malignant syndrome (NMS) is a life- threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs

103
Q

Treatment for Neuroleptic malignant syndrome (NMS) is a life- threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs?

A

Begin administration of dantrolene

104
Q

Which drug is used to treat benzodiazepine overdose?

A

Flumazenil

105
Q

Which of the following is considered a common physiologic effect of chronic alcohol use?

A

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.

106
Q

Which of the following medications may interact and thus increase serum warfarin levels? Valproic acid or Lithium

A

Valproic acid

107
Q

treatment of choice in patients with schizophrenia that is refractory to other treatment methods.

A

Clozapine

108
Q

Which of the following antidepressant medications should be avoided in patients with diagnosed anorexia nervosa?

A

Bupropion (Wellbutrin) is a stimulating antidepressant.

109
Q

antidepressant that has no sexual side effects nor induced weight gain.

A

Venlafaxine

110
Q

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?

A

Begin administration of dantrolene

111
Q

Which of the following pharmacologic agents is reported as causing the most drug-related deaths?

A

tricyclic antidepressants

112
Q

This medication is considered the first line in treating acute schizophrenia.

A

Risperidone

PANCE review (19 decks)

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