Rosh Material #3 Flashcards
age requirements for dx of antisocial pd
adults >18 w. symptoms occurring since age 15
t/f: pharm is not generally recommended for antisocial pd
t!
categories of EPS
dystonia
parkinsonism
akathisia
TD
compulsive repetitive motions
agitation
akathisia
lip smacking
worm-like tongue movements
fly-catching
TD
pharm for acute dystonias (spasms of tongue, neck, face, back)
diphenhydramine
tx for akathisia
propranolol
tx for parkinsonism EPS
amantadine
parenteral exposure to what agent is associated w. development of ADHD
tobacco
which SSRI is most likely to cause weight gain
paroxetine
which SSRI has the longest half life
fluoxetine
s.e of TCAs
anticholinergic: can’t see, pee, spit, shit
antihistamine: drowsy, weight gain, confusion
cardiac: prolonged QT, orthostatic hypotn, tachy
moa for TCAs
inhibition of reuptake of norepinephrine and serotonin
pscyh comorbidity mc associated w. illness anxiety d.o
gad
which antidepressant is best for neuropathic pain
duloxetine
staging of anorexia
extreme: BMI < 15
severe: BMI 15-15.99
moderate: BMI 16-16.99
mild: BMI > 17
what personality d.o is mc associated w. bulimia nervosa
borderline pd
which SGA is associated w. hyperprolactinemia, amenorrhea, and hypogonadism
risperidone
which SGA has lowest probability of hyperprolactinemia, amenorrhea, and hypogonadism
aripiprazole
t/f: antipsychotics are most effective for treating negative sx of schizophrenia
f!
negative sx don’t respond well to pharm
which pd is associated w. increased risk for suicide
borderline pd
antisocial pd
mc adverse effect of lithium
nephrogenic diabetes insipidus
most effective tx for severe refractory psychiatric conditions
ECT
indications for ECT
-refractory/resistant
-need rapid response - ex pregnant/suicidal intent/food refusal
-contraindications to pharm
-previous response to ECT
psychotic features
-catatonia
-persistent suicidal intent
first line tx for cyclothymic d.o
lithium
what drug produces the metabolite benzoylecgonine
cocaine
criteria used to dx serotonin syndrome
hunter
what are the second gen antidepressants
SSRIs
SNRIs
what are the atypical antidepressants
mirtazapine
bupropion
agomelatine
what are the serotonin modulator antidepressants
nefazodone
trazodone
name 2 MAOIs
phenelzine
isocarboxazid
name 2 SNRIs
duloxetine
venlafaxine
what are the SSRIs
citalopram
escitalopram
sertraline
paroxetine
fluoxetine
fluvoxamine
assessment tool for postpartum dpn
edinburgh postnatal depression scale
mainstay tx of smoking cessation in pregnant women
non pharm: behavioral interventions
what psychiatric condition is mc associated w. panic d.o
mdd
avoidance of occupational activities that may involve criticism
narcissistic pd
self mutilation and increased suicide risk
borderline pd
2 antipsychotics that are best for pt w. hx of substance abuse
risperidone
aripiprazole
name 4 first gen antipsychotics
haldol
chlorpromazine
perhenazine
thiothixene
what distinguishes adjustment d.o from anxiety d.o, mood d.o, and stress d.o
adjustment d.o’s are completely situational
3 red flags for bipolar d.o w. mixed features
agitation
anxiety
irritability
best type of therapy for panic d.o
CBT:
-teaching the pt about nature of d.o and encouraged to keep mood diary and record of attacks
-breathing techniques/muscle relaxation
-address maladaptive thoughts
-exposure in a graduated manner
2 stages of sleep
NREM
REM
divisions of NREM sleep
N1
N2
N3
lightest stage of sleep
theta waves
N1
longest percentage of total sleep is stage
N2
benzos are associated with increased _ stage of sleep
NREM - N2
deep sleep/slow wave sleep
delta waves
NREM - N3
sleep spindles and K complexes
NREM - N2
in what stage of sleep do parasomnias occur
NREM - N3
low voltage
sawtooth waves
atonia
REM sleep
vivid dreaming is associated w. what stage of sleep
REM
moa for stimulants
dopamine and NE reuptake inhibitors
moa for atomoxetine
selective NE reuptake inhibitor
what 2 drugs used for ADHD are alpha 2 adrenergic agonists
guanfacine
clonidine
functional GI d.o in which ingested food regurgitates into the mouth after meals
rumination syndrome
management of rumination syndrome
diaphragmatic breathing
baclofen
what med used for bipolar can cause neural tube defects/spina bifida
carbamazepine
2 serious s.e of carbamazepine
agranulocytosis
SJS/TEN
moa for varenicline
blocks nicotinic Ach receptors -> decreased craving and withdrawal sx
s.e of varenicline
n/v
ha
insomnia
appetite changes
abnormal dreams
altered mood
dpn/suicidality
psychosis
t/f: ketamine has proven efficacy in decreasing suicidal ideation in suicidal pt’s
t!
initial tx for somatic sx d.o and illness anxiety d.o
regularly scheduled visits w. clinician
acute side effects of inhalants
lethargy
confusion
HA
sz
CNS dpn
ventricular tachydysrhythmias
myocarditis
sudden cardiac death
pneumonitis
hypoxia
4 s.e of chronic inhalant use
leukoencephalopathy
myeloneuropathy
sensorimotor peripheral neuropathy
hepatotoxicity
risk of carbamazepine toxicity is increased in pt’s who are _ positive
HLA-B*1502
tx for cannabis withdrawal for patients who are experiencing negative effects in work/school/relationships
donabinol
gabapentin
+/- zolpidem if insomnia
which antidepressant requires discontinuation x 5 weeks before initiating an MAOI
fluoxetine
if you have to use pharm for mood stabilization in pregnancy, what med do you choose
lamotrigine
what mood stabilizer has the highest risk for congenital malformations
valproate
childhood lifetyle behavior that increases the risk of panic d.o as an adult
childhood smoking
moa for bupropion
DA and NE reuptake inhibitor
in order for dx of ASD, what 2 factors must be present
-atypical social communication/interaction
AND
-narrow/restricted/repetitive patterns of interests or activities
which segment of the brain is responsible for processing fear
amygdala
hyperactivity in the amygdala is associated with what 2 psychiatric conditions
specific phobia
PTSD
_ has been associated w. a greater risk of relapse or recurrence of mdd after successful tx
childhood maltreatment
the risk of recurrence of mdd is greatest w.in _ after treatment
the first few months
what do you think when you see a patient who is distressed by violent images of himself driving a vehicle over his partner of 5 years - he has never been violent and is very loving
OCD
obsessions: recurrent and persistent impulses, thoughts, or images
what medication has been shown to aid in weight gain and decrease symptoms of obsesiveness that are commonly associated w. anorexia
olanzapine
general SSRI dosing for gad
half the starting dose that is used for dpn
phobia that results from being involved in a specific situation
direct conditioning
phobia that develops as a result of observing or seeing someone react to a situation
vicarious acquisition
phobia that develops as a result of hearing stories about something happening
informational transmission
3 possible findings of schizophrenia on imaging
excess synaptic pruning
ventricular enlargement
gray matter loss
cyanosis that does not improve w. supplemental O2
methemoglobinemia
management of methemoglobinemia
supportive care
supplemental O2
methylene blue
4 PE findings of methemoglobinemia
ABG O2 sat normal
pulse ox ~85%
chocolate blood
cyanosis
causes of methemoglobinemia
amyl nitrite
dapsone
nitrates
antimalarials
-aines
naphthalene (moth balls)
what rxn mediates the formation of methemoglobinemia from amyl nitrite exposure
oxidation
what differentiates sleep terrors from nocturnal panic attacks
with sleep terrors:
non REM sleep arousal
associated confusion/unresponsiveness
amnesia for the attack
