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NBME Psych Shelf > Qbank: Psych Extra Review > Flashcards

Qbank: Psych Extra Review Flashcards

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1
Q

What is the tx for MDD after 1st failed trial with an SSRI?

A

After failed trial of SSRI in MDD patient, try 2nd medication from the SAME class of drugs. Only after 2 failed trials in same drug class do you consider a new drug class.

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2
Q

What is a Delusion disorder?

A

Delusion disorder: non-bizarre delusions for at least 1 month

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3
Q

What is Brief psychotic disorder?

A

BPD: positive psychotic sxs for more than 1 day but less than 1 month.

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4
Q

What is the acute vs. long-term tx for Panic disorder?

A

Panic disorder acute tx: Benzos; long-term tx: SSRIs or TCAs

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5
Q

What is the tx for performance anxiety?

A

Beta-blockers (e.g. propanolol)

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6
Q

Compare the dominant feelings in grief vs dominant feelings in major depressive episode.

A

Grief: loss + emptiness
MDD: anhedonia + persistent depressed mood

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7
Q

What is used to tx anti-psychotic induced akathisia?

A

Propanolol

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8
Q

What is the most likely atypical anti-psychotic to cause EPS, especially at high dosages?

A

Risperidone

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9
Q

What are examples of EPS symptoms?

A

Cogwheel rigidity, bradykinesia, tremor, akathisia

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10
Q

What are symptoms of excess dopamine blockade?

A

Bradykinesia, masked facies, micrographia

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11
Q

What medications is used to help reduce EPS symptoms in patient taking anti-psychotics?

A

Benztropine (anticholinergic)

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12
Q

How long does it take for most antidepressants to provide symptomatic relief?

A

4-6 weeks

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13
Q

How long should an antidepressant be used to treat a single episode of major depression?

A

6 months

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14
Q

How long should an antidepressant be used to treat multiple episodes of depression?

A

> 6 months

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15
Q

What is the DSM-5 diagnostic criteria for Conduct disorder?

A

Conduct disorder: at least 3 behaviors (out of 15 problem behaviors grouped into 4 main categories: aggression toward people and animals, destruction of property, serious violation of rules, deceitfulness or theft), have been present w/in previous 12 months, at at least 1 present in the last 6 months. Greatest risk for developing antisocial personality disorder as adults.

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16
Q

What atypical antipsychotic is least likely to cause EPS?

A

Clozapine but it is considered to be a medication of last resort b/c it can cause agranulocytosis.

17
Q

What is akathisia?

A

Akathisia is a subjective feeling of restlessness that compels patients to move around (e.g. repeated leg crossing, weight shifting, stepping in place). Etiology: antipsychotic use
Treatment: beta-blockers provide some relief

18
Q

What is dystonia?

A

Dystonia can occur between 4hrs and 4 days after receiving an antipsychotic medication, characterized by muscle spasms or stiffness, tongue protrusion or twisting, opisthotonus and oculogyric crisis.
Treatment: anticholinergics (e.g. benztropine) or antihistamines (e.g. diphenhydramine)

19
Q

What is the recommended treatment for Hoarding disorder according to DSM 5 criteria?

A

Cognitive behavioral therapy has been shown to improve symptoms, and early trials with SSRIs have demonstrated efficacy.

20
Q

What is the difference between: Dissociative fugue, Dissociative identity disorder, Dissociative amnesia and Depersonalization disorder?

A

Dissociative fugue: characterized by sudden, unexpected travel away from home accompanied by inability to recall one’s identity or one’s past. At times, patients with condition will assume new identities.

Dissociative identity disorder: presence of 2 or more distinct identifies that alternatively assume control of the person’a behavior.

Dissociative amnesia: one or more episodes of inability to recall important personal information.

Depersonalization disorder: persistent or recurrent feelings of detachment from one’s own physical or mental processes in the context of an intact sense of reality.

21
Q

What is first-line treatment for GAD? What is second-line treatment for GAD?

A

First-line: Cognitive behavioral therapy + SSRIs (like escitalopram) or SNRIs

Second-line: Benzodiazepines (used when antidepressants are ineffective or poorly tolerated but should be avoided in patients with a history of substance abuse or comorbid depression) or Buspirone

22
Q

What are the most common withdrawal symptoms experienced in heroin withdrawal?

A

Muscle spasms, joint pain, nausea and vomiting, diarrhea, abdominal cramps, rhinorrhea, lacrimation, sweating , irritable, dilated pupils, HTN (autonomic instability)

23
Q

What are FDA-approved first-line treatments for OCD?

A 
Clomiramine (Anafranil) - - a TCA
Fluoxetine (Prozac) - - SSRI
Fluvoxamine (Luvox) - - only SSRI approved just for OCD
Paroxetine (Paxil) - - SSRI 
Sertraline (Zoloft) - - SSRI
24
Q

What is Folie a deux?

A

Folie a deux: induced psychotic disorder (IPD), involves delusions or hallucinations that are transmitted from on individual to another.

25
Q

What is the difference between Competency vs. Capacity?

A

Competency: is a legal definition determined in court.

Capacity: is used in medical situations to determine if someone has the ability to give informed consent to receive or refuse therapy.

26
Q

What neuroimaging finding is most commonly associated with SCZ?

A

Enlargement of cerebral ventricles

27
Q

What neuroimaging finding is most commonly associated with Autism?

A

Increased total brain volume

28
Q

What neuroimaging finding is most commonly associated with OCD?

A

Abnormalities in orbitofrontal cortex & striatum

29
Q

What neuroimaging finding is most commonly associated with Panic disorder?

A

Decreased volume of amygdala

30
Q

What neuroimaging finding is most commonly associated with PTSD?

A

Decreased hippocampal volume

31
Q

Difference between Somatic symptom disorder vs. Illness anxiety disorder (formally hypochondriasis)?

A

Somatic SD: excessive anxiety & preoccupation with >1 unexplained symptoms

Illness anxiety disorder: fear of having a serious illness despite few or no symptoms & consistently negative evaluations

32
Q

What is Pramipexole?

A

Pramipexole is a DA agonist used to treat symptoms of Parkinson’s disease and restless legs syndrome.

33
Q

What pharmacological treatments are used in Tourette Disorder?

A

Antipsychotics:

  • First Generation Neuroleptics (pimozide, haloperidol, fluphenazine)
  • Second Generation Neuroleptics (risperidone)

Alpha-2-agonists:

  • Clonidine
  • Guanfacine
34
Q

What is the side effect profile of Methylphenidate?

A

Nervousness, decreased appetite, weight loss, insomnia and abdominal pain.

NBME Psych Shelf (4 decks)

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