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Psych Review by Minnie: AH > SAS/Review > Flashcards

SAS/Review Flashcards

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1
Q

Which opioids affect serotonin levels?

Why is this important?

A

Tramadol, fentanyl

Patients on serotoninergic agents should not take!

Can lead to serotonin syndrome

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2
Q

What kind of defense mechanism:

A perosn is angry at their phsysician for cancelling their appointment. They end up cleaning their entire department to avoid thinking about being angry

A

Sublimation

Channeling anger, discomfort, unpleasant thoughts at productive activities

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3
Q

Which side effect of first-generation antipsychotics is likely to present after decades of use?

A

Tardive dyskinesia

Due to long term dopamine blockade

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4
Q

Describe the general timeline of symptoms onset during alcohol withdrawal

A
  • 6-48h: ANS hyperactivity
  • 12-48h: Seizures
  • 12-24h: Hallucinations
  • 3-5+ days: Delirium Tremens
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5
Q

What are the risks associated with MAO inhibitors?

A
  • Serotonin Syndrome
  • Hypertensive crisis
    • Must avoid tyramine-rich foods
  • Severe interaction with meperidine
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6
Q

Which drugs increase serum Lithium levels?

A
  • NSAIDs
  • Diuretics
    • Thiazides, spironalactone, triamterene
  • ACE inhibitors
  • Ca2+ channel blockers
  • Metronidazole
  • Tetracycline
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7
Q

What factors might precipitate delerium?

A

I-WATCH-DEATH

The slides specifically highlight factors in bold

  • Infection - pneumonia
  • Withdrawal
  • Acute metabolic
  • Trauma
  • CNS pathology
  • Hypoxia/hypercarbia - hypoxia
  • Deficiencies
  • Endocrine
  • Acute vascular
  • Toxins - diphenhydramine
  • Heavy metal
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8
Q

What is the difference between schizoaffective disorder and schizophrenia?

A
  • Schizoaffective disorder:
    • Mood symptoms regardless of whether psychotic symptoms are present or absent
  • Schizophrenia:
    • Mood symptoms only present when psychotic symptoms are present

(Thank you @Nathan Shlobin!)

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9
Q

Abnormal eye movements (nystagmus) are characteristic of which drug intoxication?

A

Phencyclidine (PCP)

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10
Q

Which antidepressants are contraindicated in patinets with current or history of anorexia nervosa or bulimia nervosa?

A

Bupropion

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11
Q

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

Serotonin

A

Wakefullness

Raphe nuclei (pons)

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12
Q

Which antipsychotics are most likely to have side effects of involuntary facial movements, restlessness, and dystonia?

A

High-potency first-generation antipsychotics

  • Haloperidol
  • Fluphenazine
  • Trifluoperazine
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13
Q

Hoover’s sign provides evidence for which disorder?

A

Functional Neurological Disorder (aka conversion disorder)

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14
Q

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

Orexin

A

Wakefulness

Lateral hypothalamus

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15
Q

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

Histamine

A

Wakefulness

Tuberomamillary nucleus (hypothalamus)

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16
Q

What differentiates Bipolar I from Bipolar II?

A
  • Bipolar I
    • At least 1 manic episode lasting 1+ weeks
  • Bioplar II
    • Hypomania
      • Different from mania b/c does not cause marked impairment in social/occupational functioning, does not require hospitalization
    • No manic episodes
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17
Q
A

E - All of the above

  • Bupropion = atypical antidepressant (NE and DA reuptake inhibitor)
  • Clonidine, guanfacine = alpha-2 blockers
  • Atomoxetine = selective NE reuptake inhibitor
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18
Q

Rapid withdrawal of what hormone can trigger migraine?

A

Estrogen

  • Rapid withdrawal occurs during the following times:
    • Perimenopause
    • Post-partum
    • Perimenstruation
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19
Q

What is the most consistent but non-specific neuroimaging finding in schizophrenia?

A

Enlarged ventricles

  • Almost always found in patients with schizophrenia
  • Not specific for schizophrenia
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20
Q

Which seizure medications are prefered in women of childbearing age?

A

Lamotrigine, levetiracetam

Sometimes carbamazepine

Avoid valproate, topiramate!!

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21
Q

What is the most effective treatment for insomnia?

A

Cognitive behavioral therapy

Focuses on:

  • Sleep hygeine
  • Sleep restriction
    • Bed is for sleeping and sex only!
    • Wake up at the same time every day
  • Stimulus control
    • Don’t sleep until you’re tired
    • If you can’t fall asleep in 20 min, get out of bed and read
      • Avoid screens
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22
Q

What is the difference between schizotypal and schizoid personality disorders?

A
  • Schizoid
    • Socially withdrawn
    • Desire to be left alone
    • Limited emotional expression
  • Schizotypal
    • Also socially withdrawn
    • Interpersonal awkwardness
    • Magical thinking, eccentricity
23
Q

Which area/circuit of the brain is impaired in semantic aphasia/dementia?

A

Central pathway of vision (temporal lobe)

24
Q

A set of sidely scattered but orchestrated crerebral areas that are activated by a specific task observed on neuroimaging is a…

  1. State network
  2. Attention network
  3. Channel network
  4. Default mode network
A

c. Channel network

25
Q

Schizophrenia is a [developmental/degenerative] disorder

What is the brain pathology?

A

Schizophrenia is a developmental disorder

Results from abnormal neuronal migration during development

26
Q

What are the classic features of MDD, melancholic subtype?

A
  • Anhedonia and/or lack of reactivity
  • Early morning awakening
  • Significant anorexia or weight loss
  • Excessive or inappropriate guilt
27
Q
A

A - Methylphenidate

  • Bupropion can also be used for ADHD, but not first line
  • Guanfacine is an alpha-2 agonist that is 2nd line or ad-junct to the stimulants
  • Tranylcypromine is a MAO inibitor - not indicated for ADHD
28
Q

Which antipsychotic may cause neutropenia?

A

Clozapine

  • Atypical anti-psychotic
  • Blocks serotonin and norepinephrine
  • Used as a 3rd line agent
    • But must register in database
    • Track any neutropenia resulting so it is not prescribed in the future
29
Q

What kind of seizure is associated wtih tongue biting?

A

Generalized tonic/clonic seizure

30
Q

What time period constitutes persistent depressive disorder?

A

2+ years of depressed mood for most of the day, more days than not

31
Q

Which area/circuit of the brain is impaired in Lewy Body Dementia?

A

Dorsal Pathway of Vision (parietal lobe)

32
Q

What syndrome is associated with thamine deficiency?

Which population is at particular risk?

A

Wernicke-Korsakoff Syndrome

People with alcohol-use disorder

  • Wernicke
    • Ataxia, abnormal eye movmement
  • Korsakoff
    • Amnesia, poor judgement, confabulation, spurious answers to questions
33
Q

Automatisms and aura of a funny taste in one’s mouth before a seizure are characteristic of which kind of epilepsy?

A

Temporal lobe epilepsy

Automatism = fumbling with clothing/button, cannot stop

34
Q

Which type of reinforcement schedule has the fastest extinction?

Which types have the slowest extinction?

A

Fastest extinction = continuous (also has fastest learning)

Slowest extinction = variable interval or variable ratio

(Fixed interval and fixed ratio have the fastest conditioning)

35
Q

Which antipsychotics are likely to cause abnormal lactation?

A
  • Low-potency first-generation
    • Chlorpromazine
    • Thioridazine
  • Second-generation - lower risk than FGA, but can still happen
    • Quetiapine
    • Olanzapine
    • Risperidone
    • Aripiprazole
    • Ziprasodone
    • Clozapine
36
Q

List the parts of the Papez circuit, in order

A
  • Entorhinal cortex (anterior part of the parahippocampal gyrus)
    • Via perforant (through dentate) or alvear pathways to the…
  • Hippocampus
  • Fornix
  • Mammillary bodies (hypothalamus)
    • Via mammilothalamic tract to the…
  • Anterior thalamic nuclei
    • Via internal capsule to the…
  • Cingulate
  • Back to the parahippocampal gyrus
37
Q

What kind of medication is cyclobenzaprine?

A

Muscle relaxant

38
Q

Which sleep disorder is associated with low orexin levels in the CSF?

Describe 3 associated symptoms

A

Narcolepsy

  • Cataplexy
    • Knees buckle in response to emotion
  • Vivid dreams
  • Sleep paralysis
39
Q

Which area/circuit of the brain is impaired in frontal type dementia?

A

Frontal cortex

40
Q

What kind of defense mechanism:

A perosn is angry at their psysician for cancelling their appointment. Next time they see their physician, they compliment the physician on their shirt

A

Reaction formation

(Doing the opposite of what you feel)

41
Q

Which class of antidepressants is most likely to have cardiac effects?

What are the effects?

A

TCAs

Long QT -> Torsades (potentially fatal arrhythmia)

  • Amitriptyline
  • Nortriptilyine
  • Desipraime
  • Amoxapine
  • Imipramine
  • Clomipramine
  • Doxepin
42
Q

How is lithium metabolized?

A

Excreted unchanged by the kidney

(No hepatic metabolism)

43
Q

Which cognitive domain will be affected first in Alzheimer’s Disease?

A

Memory

(Limbic system)

44
Q

What are the indications for haloperidol in a patient with delerium?

A
  • Psychosis
  • Hallucinations
  • Agitation

But remember, the focus of the treatment should always be the underlying cause!!

45
Q

What further testing is indicated when a child presents with signs and symptoms of autism spectrum disorder?

A
  • Genetic testing
  • Lead levels (if reasonable environmental risk)
  • EEG
  • Hearing and vision
  • Wood’s lamp (for Tuberous Sclerosis)
46
Q

How are abscence seizures differentiated from focal seiziures without loss of consciousness?

A

No post-ictal period (confusion) after abscence seizure

47
Q

According to Robins and Guze (1970), what 5 steps can help achieve diagnostic validity for psychiatric disorders?

A
  1. Clinical description
  2. Delimitation from other disorders
  3. Follow-up study (including treatment response)
  4. Family study
  5. Laboratory studies
48
Q

Which kind of reinforcement schedule results in the fastest conditioning?

A

Fixed schedules - type of partial reinforcement

(Continuous reinforcement has the fastest learning)

49
Q

What are the classic features of MDD, atypical subtype?

A
  • Mood reactivity
  • Significant weight gain
  • Hypersomnia
  • Leaden paralysis
50
Q

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

Norepinephrine

A

Wakefulness

Locus ceruleus (pons)

51
Q

Which medication can be used to augment the effects of SSRIs and is known for reducing the risk of suicide?

A

Lithium

52
Q

Is this neurotransmitter associated with wakefullness or sleep?

Where is it secreted?

GABA

A

Sleep

Ventrolateral peroptic nucleus (VLPO)

53
Q

What is a “homeopathic” treatment?

A

Like treating like

Ex: using seizures in ECT to help treat patients with seizures

Psych Review by Minnie: AH (35 decks)

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