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Review Flashcards

1
Q

Nocturnal enursis

A

Desmopressin and imipramine

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2
Q

RLS syndrome

A

Do Iron test

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3
Q

Antidepressant trial

A

> 6 weeks

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4
Q

MDD vs SAD

A
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5
Q

Bipolar I disorder

A

DIGFAST
distractible, irritable, grandiose, flight of ideas/racing thoughts, activity, decreased Sleep, talkative/pressured speech

Need 3 of the above and 1 week

Bipolar II is MDD plus hypomania (at least 4 days).

ANY manic episode, regardless of MDD episode is Bipolar I.

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6
Q

Cyclothymia

A

2 years of mild depression and hypomania (can’t meet criteria for MDD and mania)

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7
Q

Neuroleptic syndrome

A

MUSCLE RIGIDITY
Fever
Autonomic instability

Usually first gen APs like haloperidol. Can be all antipsychotics

Tx: Stop antipsychotics,
Bromocriptine (D2 agonist) or dantrolene (acts on RYR receptor and affects calcium) (but not with a CCB)

https://next.amboss.com/us/article/KH0Urh?utm_medium=chatgpt-plugin&utm_source=chatgpt

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8
Q

Dissociative Disorders

A
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9
Q

Antidepressant breast feeding

A

Sertraline

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10
Q

Malignant Hyperthemia

A
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11
Q

Postpartum period

A
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12
Q

Personality Types

A
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13
Q

Serotonin syndrome vs NMS

A

HYPERREFLEXIA distinguishes SS over NMS

Too many serotonin drugs or serotonin drug + MAOi (e.g., switching without a 2 week washout period.)

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14
Q

Malignant Catatonia

A

Slower, prodrome of motor agitation

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15
Q

Malignant Hyperthermia

A

RAPID, in setting of succinylcholine or other volatile anasthetics
hypercarbia, muscle rigidity, hyperthermia

Treatment Dantrolene

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16
Q

Acute Mania

A
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17
Q

Lamotrigine

A

Effective in bipolar DEPRESSION

Watch for Rash, SJS

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18
Q

Carbemezapine

A

Anticonvulsant, Bipolar, requires titration up so not for acute mania.

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19
Q

Physiologic tremor

A

TCAs, beta blockers, SSRIs can cause.

Fine, high frequency tremor, visible in high sympathetic moment (stress),

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20
Q

Acute dystonia

A

Painful spasms, grimacing, torticullis

Tx: anticholinergic benztropine

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21
Q

Akathesia

A

Restlessness
Tx: Propranolol

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22
Q

Tardive Dyskinesia

A

Switch to second generation AP: quetiapine, clozapine).

Risperidone is higher risk even though second generation.

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23
Q

Suicide risks

A

SAD PERSONS are at risk for suicide:

Sex (male), Age (> 45 years), Depression, Previous suicide attempt, Ethanol/substance use, Rational thinking loss (psychosis), Sick (chronic disease), Organized plan (acquisition of weapons/tools), No spouse or social support, Stated intent.

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24
Q

TCA + SGA can cause _____

A

Anticholinergic toxicity.

E.g., clozapine and Doxepin

Consider when hyperthermia, tachycardia, altered mental status. Do an EKG to evaluate for QTc prolongation.

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25
Q

Medications that can cause anticholinergic toxicity

A
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26
Q

Bupronion

A

First line for MDD
Mild stimulant effects
Helps smoking cessation
Helps with weight loss
Does not cause sexual side effects

Contraindicated in seizures and eating disorders.

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27
Q

Atomoxetine

A

SNRI
Can treat ADHD if someone has stimulant abuse or SUD history

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28
Q

Mirtazapine

A

AD, can increase appetite

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29
Q

Modafinal

A

Promotes WAKEFULNESS
Treats Narcolepsy

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30
Q

Phenelzine

A

Atypical depression
Hyperphagia, hypersomnia, leaden paralysis, rejection sensitivity.
Only treatment resistant cases because MAOi risks

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31
Q

Lamotrigine

A

Use as mood stabilizer in pregnancy

Quetiapine and risperidone can also be used.

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32
Q

Medications in pregnancy

A

All antidepressants EXCEPT paroxetine

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33
Q

Bipolar II

A

Lurasidone, quetiapine, lithium or anticonvulsants like lamotrigine

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34
Q

Extrapyramidal symptoms

A
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35
Q

Substance use management

A
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36
Q

Substance use management 2

A
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37
Q

Schizoaffective disorder

A
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38
Q

Antidepressant medications

A
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39
Q

Serotonin Syndrome

A
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40
Q

Functional tremor

A

Involuntary movement, better with action. Shifting tremor frequency

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41
Q

Opioid use disorder treatment

A
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42
Q

Pediatric antidepressants

A

Fluoxetine

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43
Q

Intellectual disability

A
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44
Q

Delusional Disorder

A
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45
Q

Ropinirole

A

Dopamine agonist used for RLS. May cause bipolar like behaviors

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46
Q

Venlafaxine

A

Associated with increased blood pressure

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47
Q

Huntington Disease

A

Gaba neurons
Caudate nucleus and putamen

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48
Q

Parkinson’s disease

A

Dopamine neurons
Substantia Nigra

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49
Q

Phenelzine

A

MAOi
Treatment resistant depression

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50
Q

Fragile X Syndrome

A
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51
Q

Tramodol + sertraline

A

Can develop serotonin syndrome

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52
Q

Bipolar II

A

Quetiapine or Lurasidone

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53
Q

Defense mechanisms

A
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54
Q

Neuroleptic malignant syndrome

A
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55
Q

Prazosin

A

PTSD nightmares
Alpha 1 adrenergic antagonist

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56
Q

Eating disorders

A
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57
Q

Lithium Toxicity

A
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58
Q

Bipolar I disorder

A
59
Q

Tourette’s syndrome

A
60
Q

Depression + psychosis

A
61
Q

Schizophrenia diagnosis criteria

A
62
Q

Dementia

A
63
Q

Avoid SSRI Citalopram in recent MI patients

A

QT prolongation

64
Q

Venlafaxine side effects

A

Tachycardia
High blood pressure

65
Q

Withdrawal

A
66
Q

Acute Dystonia

A
67
Q

Partial response to MDD

A

Augment with other mechanism (e..g, add bupronion)

Add antipsychotic (second gen like ariprizole or lithium)

ECT

68
Q

Buspirone

A

Antianxiety
Generalized Anxiety

69
Q

Neuroleptic Malignant Syndrome and Serotonin Syndrome

A
70
Q

Catatonia

A
71
Q

Antipsychotics EPS

A
72
Q

Depression

A
73
Q

Opioid withdrawal

A
74
Q

Enlarged ventricles

A

Schizophrenia

75
Q

Atrophy of caudate

A

Huntington’s disease

76
Q

Decreased hippocampus

A

Schizophrenia

77
Q

Citalopram

A

QT prolongation

78
Q

Motivational Interviewing

A
79
Q

Catatonia

A

Benzos like Lorazepam
ECT

80
Q

Severe serotonin syndrome

A

Cryheptadine

81
Q

Bipolar

A

Lithium and Valproate, then quetiapine and lamotrigine

82
Q

Diabetic + Neuropathy + MDD

A

Duloxetine (or venlafaxine)
Can do TCA, prefer SNRI

Then gabapentinoids

83
Q

Second generation AP

A

Quetiapine, Clozapine

84
Q

Mirtazapine

A

Great first line antidepressant for poor sleep, appetite loss.

e.g., MDD due to grief with insomnia and weight loss

85
Q

TCA

A

Not usually first line

Anticholinergic effects, Cardiotoxicity, orthostatic hypotension

86
Q

Therapeutic approaches

A
87
Q

Second generation AP

A

Serotonin and dopamine

D2 effect is antipsychotic

88
Q

Buproprion

A

NE and dopamine reuptake inhibition

89
Q

Antidepressant side effects

A
90
Q

Bipolar disorder

A
91
Q

TCA

A

Serotonin and NE

92
Q

Narcolepsy

A
93
Q

Psychotic disorders

A
94
Q

Lithium

A

Hyperparathyroidism and hypercalcemia

Can cause nephrogenic diabetes inspidus, CKD, hypothyroidism,

95
Q

Second generation antipsychotics

A

Hyperlipidemia and diabetes

96
Q

Carbamezapine and lamotrigine

A

Steven Johnson syndrome rash

97
Q

Valproate

A

Fetal neural tube defects

98
Q

Delusional disorder vs paranoid personality type

A
99
Q

Acute drug intoxication symptoms

A
100
Q

Alprazolam

A

Can cause seizure from sudden discontinuation

101
Q

Bipolar disease

A

Monotherapy: Lithium, valproate, lamotrigine, quetiapine.

Combination therapy: Lithium or valproate PLUS SGA (quetiapine).

102
Q

Tourette syndrome

A

OCD and ADHD most likely to develop

103
Q

Dementia vs Normal aging

A
104
Q

Developmental Milestones

A
105
Q

Brief psychotic disorder

A

Related to an acute stress. e.g, patient’s father dies in car accident and a week later he is disorganized, bizarre behavior and hallucinations.

106
Q

Adjustment disorder

A

Can’t be beyond 6 months from the stressor

107
Q

Cathinone aka bath salts

A

prolonged duration of effect

108
Q

Histrionic personality disorder

A
109
Q

Wilson disease

A
110
Q

Neuroleptic Malignant syndrome

A
111
Q

Clomipramine

A

TCA, second line OCD

112
Q

Hoarding disorder

A

CBT
Don’t use SGA (e.g., quetiapine) not indicated
SSRI not useful unless with OCD, then helpful

113
Q

Conditions that seem like ADHD

A
114
Q

Serotonin syndrome

A

Treated with cryoheptadine (seratonin antagonist)

Hyperreflexia, NMS has lead-pipe rigidity

115
Q

Antipsychotic medication EPS

A

Benztropine

Dystonia

116
Q

Alcohol use

A

Acamprosate, Naltrexone

NOT buprenorphine

117
Q

Naltrexone in AUD

A

contraindicated with liver failure or any liver issues

118
Q

Acamprosate AUD

A

Don’t use in renal impairment

119
Q

Smoking cessation

A

Bupropion (not in eating disorder)
Varenicine

120
Q

ADHD medications

A
121
Q

Clonidine in ADHD

A

Children/adolescents

122
Q

Antipsychotic medication effects

A
123
Q

Increased dopamine activity in mesolimbic

A

drug use
decrease is why antipsychotic medications work

124
Q

Nigrostriatal pathway

A

Substantia nigra to basal ganglia
Coordination of movement

125
Q

Venlafaxine

A

Dose-dependent hypertension
NOREPINEPHRINE

126
Q

BDD

A

Preoccupation with a body part > repetitive behaviors like checking. DISTRESS, not high functioning

127
Q

Schizophrenia

A

At least 2 of the 5
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Disorganized behavior
5. Negative symptoms (flat affect, apathy, alogia/poverty of speech).

128
Q

GAD

A

Requires 6 months or more

129
Q

Narcolepsy

A

Daytime sleepiness
Cataplexy
Hypnagogic hallucinations (hearing music as falling asleep)
Sleep paralysis

Tx: Modafinil

Pathophysiology: Decreased orexins in hypothalamus

130
Q

REM sleep disorder

A

Acting out during REM sleep because of loss of paralysis

131
Q

PCP intoxication

A

Aggression
Rotary nystagmus
Ataxia

132
Q

Anticholinergic toxicity

A

Delerium, sedation, hallucinations
Smooth muscle dysfunction (dry)

Supportive care
Treat with pyridostigmine in severe cases

TCA can cause severe anticholinergic effects

Sleep aid toxicity too, diphenhydramine causes this

133
Q

Lithium toxicity

A

GI symptoms
Cardiac symptoms
Neuro symptoms
Relies on kidney to be excreted, so if you take HCTZ then can affect lithium.

134
Q

Pseudodementia

A

cognitive impairment due to MDD
need depressive symptoms

135
Q

Alprazolam

A

GABA, increase Cl

Can cause rebound anxiety

Can switch to clonazepam which is a longer acting benzodiazepine

136
Q

Prazosin
Clonodine

A

Alpha 1 adrenergic antagonists
can cause orthostatic hypotension

137
Q

Valproic acid

A

Can cause acute pancreatitis
Hepatotoxic - DO NOT USE IN LF
Bone marrow toxicity
Alopecia

138
Q

Lithium

A

DO NOT USE IN RF

139
Q

Chronic alcohol use

A

gynecomastia
palmar erythema

140
Q

Lithium

A

can induce nephrogenic diabetes inspidus
Thyroid dysfunction

141
Q

Toluene inhalation

A

Violent behavior
Redness around mouth
Hallucination, disorientation, agitation

142
Q

MDD

A

2 or more weeks of 5:
1. Depressed mood
2. anhedonia
3. guild or worthlessness
4. difficulty concentrating
5. psychomotor slowing
6. suicidal thoughts

decreased energy, sleep disturbance, appetite disturbance

SIGECAPS

143
Q
A

Pysch Shelf (2 decks)

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