Random Psych Flashcards

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1
Q

Presents with:
Mild depressive symptoms + hypomanic symptoms
lasting ≥ 2 years

A

cyclothymic disorder

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2
Q

Presents with Diaphoresis, Dilated eyes, Tremors, (hyperreflexia), mental agitation, and even diarrhea

A

Serotonin syndrome

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3
Q

Emotionally triggered loss of muscle tone

A

Cataplexy

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4
Q

REM sleep behavior disorder typically occur during the _____ of the sleep period

A

first third

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5
Q

Anorexia often associated with what 2 illnesses?

A

OCD

MDD

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6
Q

What 2 elements distinguish Anorexia from Bulimia?

A
Low BMI (<18.5)
Caloric Intake Restriction
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7
Q

Cocaine coronary vasospams can cause (3) complications

A

MI
stroke
ischemic colitis

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8
Q

Medication that helps reduce self-mutilation

A

Naltrexone

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9
Q

What is Hypercarotonemia?

A

yellow pigmentation of the skin (xanthoderma) and increased beta-carotene levels in the blood.

(seen in Anorexia; yellowing skin/palms & low T3)

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10
Q

List S/X of antidepressant discontinuation syndrome

A

Fatigue
Insomnia
Muscle Aches
Flu like s/x

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11
Q

First thing when a child shows neuro-developmental problems?

A

Screen for Hearing loss

can cause: Social, Language, Speech delays

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12
Q

Where is Serotonin made?

A

Raphe Nucleus

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13
Q

Agression, Delusions, paranoia, hyperthermia, dilated pupils, Tachycardia &/or HTN
(Not amphetamines/cocaine)

A

Bath Salts (Cathinones)

*NEG Urine Tox screen

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14
Q

What is Vaginismus?

A

involuntary vaginal muscle spasms

*genitopelvic pain disorder

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15
Q

MOA of Tetrabenazine used for Tourettes

A

VMAT2- Inhibitor

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16
Q

Where is Acetylcholine made

A

Basal nucleus of Meynert

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17
Q

Where is GABA made?

A

Nucleus Accumbens

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18
Q

Where is NE made

A

Locus Cereleus

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19
Q

Where is Dopamine made

A

Ventral Tegmentum; Substantia Nigra Pars Compacta

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20
Q

Amantadine MOA

For Parkinsonism

A

weak NMDA receptor

*Orthostatic hypotension/anxiety/ataxia

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21
Q

Cyproheptadine MOA

For Serotonin Syndrome

A

Anti-5HT2

Anti-Histamine

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22
Q

TCA MOA

A

Anti- alpha1
Anti-H1
Anti- Ach (Anti-Cholinergic)
NE & 5HT re-uptake inhibitor

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23
Q

Trazadone MOA

A

Anti-5HT2
Anti- alpha1
Anti-H1

Serotonin re-uptake inhibitor

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24
Q

D2 is linked to what GPCR?

A

Gi

Anti-psychotics inhibit Gi = increase cAMP

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25
Q

Which Antipsychotics have the strongest Anti-Histamine and Alpha1 effects?

A

Low Potency TYPICAL Antipsychotics

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26
Q

Linezolid (antibiotic) has ____ activity

A

MOA-1

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27
Q

Mirtazepine Antidepressant MOA

A

Anti- alpha2 **
Anti-H1
Anti- 5HT2 & 5HT3 **
*

Increase release of NE & Serotonin

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28
Q

Atypical antipsychotics block

A

D2
Seretonin 2A
H1
Alpha1 (orthostatic hypotension)

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29
Q

Oppositional defiant disorder treatment

A

Parent Management Therapy

Behavior mod/ conflict management

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30
Q

Benztropine MOA

A

Inhibition of dopamine transporters
&
antimuscarinic/antihistaminic effects

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31
Q

How can lithium become toxic?

A

Hypovolemia (diuretics) = ↑ Na+ reabsorption = ↑ lithium = danger of toxicity

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32
Q

Akithesia can be caused by (2)

A

Antipsychotics or Parkinson treatment

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33
Q

Asterixis (wrist flapping) associated with (3)

A

Hepatic Encephalopathy
Wilson’s disease
Metabolic Derangements

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34
Q

Athetosis (snake like writhing movements in the fingers especially) seen in what illness?

A

Huntington

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35
Q

Chorea (purposeless jerking involuntary movements) seen in what illness?

A

Huntington

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36
Q

Resting tremor in Parkinson is due to a lesion where in the brain?

A

Substantia Nigra

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37
Q

Restless leg syndrome worsens at night/ with rest and improves with movement associated with (4)

A

Pregnancy
Parkinson
CKD
Iron deficiency

*treat with Pramipexole/Ropinirole D2 agonist

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38
Q

Dementia can be cause by ____ deficiency or ____-thyroidism

A

Vit B12 (Cobalamin)

hypothyroidism

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39
Q

Inhibition of the ____ in the brain causes Parkinson

A

Thalamus

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40
Q

2 Histological findings of Parkinson

A

Depigmentation of Substantia Nigra (loss of dopaminergic neurons)

Lewy bodies (Eosinophilic inclusions of alpha syn)

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41
Q

Can present with Agression, Depression, Dementia

A

Huntington

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42
Q

Huntington is due to a lesion(s) where in the brain?

A

Caudate/ Putamen

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43
Q

Huntington has what imbalance of Neurotransmitters

A

↑ Dopamine
↓ GABA
↓ Ach

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44
Q

List 3 histological findings in Alzheimer’s

A

Hirano bodies (hippocampus- pink rods)

Senile Plaques (amyloid Beta)

Neurofibrillary tangles (Hyper Phosphorylated Tau-microtubules)

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45
Q

List 4 Gross histological findings in Alzheimer’s

A

Cortical Atrophy
Hipocampus Atrophy
Narrowing Gyri
Widening Sulci

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46
Q

List 2 histological findings in Pick’s Frontal-temporal dementia

A

Round silver stain Hyper Phosphorylated Tau protein
(pick bodies)

Ubiquitinated TDP-43

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47
Q

Histological finding associated with HIV dementia?

A

Macrophages (Oligodendrocytes) fuse to make

GIANT CELLS

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48
Q

Brain imaging shows Focal demyelinated plaques, periventricular calcifications, and axonal sparing

A

Multiple Sclerosis

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49
Q

Ataxia, Myoclonus, ↓ school performance

Demyelination, Gliosis, Oligoclonal bands IgG in CSF.

A

Subacute Sclerosing Pan Encephalitis (SSPE)

2/2 Measels (viral capsid accumulates)

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50
Q

Idiopathic cranial HTN (aka Pseudotumor cerebri) is an
↑ICP usually seen in Obese women with recurrent Headaches, Papilledema +/- Recurrent Infections.
Associated with ____

A

Cerebral Venous Sinus Stenosis

*LP puncture relieves HA

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51
Q

NPH presents with NORMAL ICP, magnetic/shuffling gait, incontinence, and Cognitive Impairment (Delirious, Depressed, Psychotic, Memory worsening, etc.) What is a gross finding and why?

A

VENTRICULAR ENLARGEMENT

which distorts corona radiata fibers and compresses arachnoid villi.

52
Q

Ex-Vacuo ventriculomegaly looks like it has an ↑ CSF, but is due to ↓ brain tissue. ICP is NORMAL. This is associated with what diseases (5)?

A
Dementia
Alzheimer's 
Huntington 
Pick's (FTD)
HIV assoc. Dementia
53
Q

Alcoholics and other malnourished people are deficient in what key vitamin?

A

Thiamine (B1)

54
Q

List 3 neurological causing Mental Retardation + Seizures

A

Sturge Weber (Non-hereditary)→ Glaucoma & Port-Wine

Tuberous Sclerosis (9/16)→ Murmur, Nodules, Ash leaf

Neurofimbromatosis I (17)→ Pheochroma, Cafe-au-lait, Lisch eye stains, Nodules (skin)

55
Q

How can Von Hipple Lindau Disease cause psych problems?

A
can cause Pheochromacytoma (5Ps) and/or RCC
Pain- HA
Pressure- HTN
Palpitations- Tachycardia
Perspirations
Panicking- Anxiety
56
Q

Causes of Enurisis in kids

A

Voluntary (kid is purposely acting out)

Involuntary (Regression due to abuse/new sibling.)

Anatomic/ illness/ Meds

57
Q

On the SHELF if you see regression in a kid think of ____

A

abuse

may or may not be the answer though could be stress

58
Q

Management of Enuresis

A

Less than 7 y/o can still be normal if they have been drinking water.

If not, use + reinforcement, water restriction, Desmopressin (not the first line though) or imipramine

If no drinking, stressors, or abuse then get a UA and US.

UA (+) but US (-)
UTI bed wetting
Mostly seen in little girls wiping back to front causing
*If STI is present then it’s probably abuse

UA (-) but US (+) anatomical needs surgery

UA (-) & US (-)
No drinking
REGRESSION think abuse

59
Q

Criminal behavior <18

vs

Teen acting out

A

Conduct disorder

vs

Oppositional Defiant

60
Q

Fights with authority. Gets along with peers

A

Oppositional Defiant

61
Q
*Bullying/ Fist fights
Destruction
Theft
Truancy
Running away from home
Liars
Cheaters
Hurt Animals
Torture
Force Sex
A

Conduct disorder

Treatment is Juvenile Detention

62
Q
Lie
Cheat
Steal
Defiant
NO Bullying
NO Fist Fights
Incongruent parenting
A

Oppositional Defiant

Treatment is Parental Management Training

63
Q

4 types of exposure that can cause PTSD

A

Experienced trauma
Witnessed trauma
Learned of a loved one’s trauma
Witnessed repeated aftermath of trauma (1st responders)

(Trauma not witnessed through media, pictures, television or movies unless work-related)

64
Q

Diagnosing OSA criteria (2)

A

15+ apneas/hr
or
5+ apneas/hr + snoring

can lead to Cor Promonale

65
Q
Central Sleep Apnea increase in serum CO2 
seen in (5)
A

opioid users

COPD w/over oxygenation

Stroke victims

CHF

idiopathic

66
Q

Central Sleep Apnea treatment

A

Bi (level) pap

67
Q

Narcoleptics have rapid ____

A

REM

low REM sleep latency

68
Q

People with Narcolepsy wake up feeling

A

Refreshed due to increased REM sleep

69
Q

sleep study aka

A

polysomnography

70
Q

First line treatment of narcolepsy

A

schedule naps

if fails, stimulants

71
Q

Primary insomnia not secondary to mood disorder is treated via

A
Sleep Hygiene
or
Diphenhydramine
Trazadone
Quetiapine (last)
Zolpidem (last)
72
Q

Paranoid personality disorder uses what ego defense

A

Projection

73
Q

Schizoid personality disorder work what type of jobs

A

alone, night, or distant from others

74
Q

Promiscuous or emotional emptiness

possibly…

A

Boderline

75
Q

attention seeking, superficial, dramatic, not suicidal or unempathetic

A

Histrionic

76
Q

self-centered, wants to talk to the boss only, wants to be prioritized over other people, may dress lavishly because they think they are important

A

Narcissistic

77
Q

inadequate feeling, scared of being rejected, passes up on opportunities like promotions/presentations out of fear for failing. Fearful of making decisions

A

Avoidant

78
Q

Cluster A,B,C are all ego-____

A

systonic

79
Q

one simple question to screen for sleep apnea

A

do you wake up gasping for air or out of breath?

80
Q

Blocking the D2 receptors too fast causes

A

acute dystonia

81
Q

what SSRI is safest for pregnancy?

A

Sertraline

82
Q

an antidepressant that can treat erectile dysfunction

A

Buspirone

83
Q

Most common delusion associated w/ dementia

A

Theft/ Persecution

84
Q

Most common hallucination associated w/parkinson

A

Figures of peoples or animals

85
Q

Parkinson is caused by decreased _____

A

Dopamine

86
Q

Beta 1 selective Beta blockers letters __- __

A

A-M

O-M → B1 & B2 non-selective

87
Q

Competitive inhibition of histamine at H2-receptors of the gastric parietal cells, which inhibits gastric acid secretion, gastric volume, and hydrogen ion concentration are reduced.
Does not affect pepsin secretion, intrinsic factor secretion, or serum gastrin.

A

Ranitidine
(GERD)

*contraindicated in acute porphyria (causes attacks), renal/hepatic disease

88
Q

The first-line treatment for binge eating disorder

A

Psychotherapy (eg, cognitive-behavioral therapy)

  • However, pharmacotherapy may require less time. It is ok to use SSRI as first-line treatment for patients who prefer medication over therapy
  • Additional treatment options for patients who are overweight or OBESE include behavioral weight loss therapy and Lisdexamfetamine (Vyvanse) or Topirimate
89
Q

1st line Treatment of delusional disorder

A

Antipsychotic + adjunctive CBT

90
Q

Presents with:

hepatic problems
Low level of serum ceruloplasmin + splenomegaly

neurologic problems
Dysarthria, Ataxia, Tremors, Drooling, Dystonia, Parkinson

Behavioral and psychiatric problems
Depression, Declining school performance, Personality changes, Irritability, impulsiveness, Labile mood,, Inappropriate behavior, Psychosis

A

Wilson disease

  • Children: more likely to present with hepatic problems
  • Older (mid-teens +): more likely to present with neurologic problems
91
Q

Presents with periods of sudden

Stomach ache/problems

Pain in the extremities + patchy numbness/paresthesias
extremity weakness (upper to lower)

Dark or reddish-brown urine (neg dipstick)
Dysuria, retention, incontinence, bladder distention

Insomnia, anxiety, restlessness, hallucinations, delirium, depression, phobias, altered consciousness

A

Acute Intermittent Porphyria

92
Q

Treatment of Delirium agitation

A

Haloperidol

93
Q

Treatment of anticholinergic induced delirium agitation

A

Benzos

94
Q

Chronic opioid use for pain management can be indicated in certain cases of

A

Acute Intermittent Porphyria

95
Q

QRS >100ms = how many little squares?

A

More than 2 little squares (Wide QRS)

96
Q

Bipolar + agranulocytosis

A

Carbamazepine

97
Q

Bipolar h/x + ↑AFP in a 20wk pregnant woman.

What meds is she using

A

Valproate

Carbamazepine

98
Q

Dexamethasone suppression test = failure to suppress

A

Cushings DZ

99
Q
No psychosis (other than
hearing/seeing loved one)
A

Okay in bereavement or complex bereavement

100
Q

Antipsychotic
Prolonged QTc and
pigmentary retinopathy?

A

Thioridazine

101
Q

Pt wakes up with eyes
“stuck” looking up or head
“stuck” turned to the side.

A

Acute Dystonia

102
Q

Pt reports feeling like they

“always have to move”.

A

Akathesia. (30-90 days).

Tx w/ propranolol (1st line) or benzo

103
Q
Remember that metoclopramide (anti-emetic)
can cause (2)
A

NMS or EPS

104
Q

Weight neutral but increases

akathesia?

A

Aripripazole

105
Q

Antipsychotic causes orthostasis and

cataracts?

A

Quetiapine

106
Q

Patient comes in with panic attack syndromes what labs do you get

A

EKG, cardiac enzymes, echocardiogram,

TSH or T4, urine drug screen

107
Q

Hx of anxiety or insomnia
currently w/ fever
convulsions, confusion and
hypertension. Dx

A

Benzo withdrawal

108
Q

OCD has a high incidence of

A

Tourettes

109
Q
A 54 y/o RN presents w/ a history of
2mo of diarrhea and abd pain. He
has presented to 4 other hospitals
w/ the same complaint.
Colonoscopy reveals pigmentation
in the wall of the colon
A

Laxative abuse

Factitious disorder

110
Q

Malingering associated with what personality disorder

A

Antisocial

111
Q

medications that can help paranoid behavior.

A

Low dose antipsychotics

112
Q

Associated with Histrionic personality d/o

2

A

Eating d/o

SUD

113
Q

Old lady altered mental status (agitation worsens at night, stupor in the day), having visual hallucinations and dysuria. Diagnosis?

A

Delirium 2/2 Cystitis
(fluctuating cognition, hallucination, agitation)

*get a UA, treat infection
give antipsychotic (not benzo) for acute agitation
114
Q

Give ____ for severe disinhibition in FTD

A

Olanzepine

115
Q

DLB treated with

A

AchE inhhibitors

116
Q

Memory loss, Loss of vibration sense, labile
affect. Pupil that accommodates
but doesn’t react. Dx?

A

3 syphilis

117
Q

confusion, ataxia, and nystagmus (gaze fixed to one side)

Dx

A

Wernike’s

118
Q

Pt presents with horizontal
nystagmus, dilated pupils,
ataxia and acute psychosis
Dx/ treatment.

A

PCP

Benzo > Haldol

119
Q

Child w/ Mental retardation, Hypotonia, hypogonadism,

hyperphagia, skin picking, agression.

A

Prader Willi

120
Q

Elfin-appearance, friendly, increased
empathy and verbal reasoning ability.
Deletion on Chr7.

A

Williams

121
Q

ADHD-like sxs, microcephaly, smooth

philtrum.

A

Fetal Alcohol syndrome

122
Q

A newborn baby has decreased tone, oblique
palpebral fissures, singular palmar crease, big tongue,
white spots on his iris

A

Down Syndrome

123
Q

Child w/ abnormal muscle tone, unsteady gait,
seizures, mental retardation or
learning disability.

A

Cerebral palsy (birth asphyxia)

124
Q

Autism spectrum sxs, heart disease,
palate defects, hypopastic thymus,
hypoCa. Possible psychosis/depression/anxiety

A

Digeorge

125
Q

Stops just short of breaking the law or physically harming

others, but still annoying, blames others, defiant, liar, cheater

A
Oppositional defiant
(not conduct d/o)
126
Q

In Rumination Disorder

Check ___ levels

A

lead

127
Q

6y/o stools in her clothes once every 2 weeks.

What must you check next. How to treat?

A

Fecal retention

Behavioral modification that only rewards