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MS2 - MBB > Test 4 - Psychiatry, Behavioral Science > Flashcards

Test 4 - Psychiatry, Behavioral Science Flashcards

1
Q

What is it called when a person is lip-smacking or constantly swallowing during a seizure? In what types of seizures is this seen in?

A

Automatism

seen in complex (awareness-impaired) seizures

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2
Q

Seizures that involve the _________ lobe are often preceded by an olfactory aura because…?

A

temporal lobe because the primary olfactory cortex is located in the uncus of the temporal lobe

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3
Q

Antiepileptic pharmacotherapy is indicated if a clinician determines that a patient’s risk of having another seizure is ____% or greater.

A

60%

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4
Q

Describe the steps for treating a patient presenting w/ status epilepticus.

A

1st: ABCs (airway/breathing, circulatory), body temp., O2 sats, blood glucose
2nd: get IV placed and give thiamine + glucose + Lorazepam
3rd: start Phenytoin

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5
Q

What anti-epileptic drug is most commonly used in the pediatric population?

A

Phenobarbital

(see jackhammer cats)

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6
Q

Name 4 drugs that can be used to treat both focal and generalized seizures.

A

Topiramate, valproate, lamotrigine, levatiracetam

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7
Q

Name four side effects of valproate.

A
  1. Hepatotoxicity (can be fatal - seen in children more often)
  2. Teratogenic (neural tube defects)
  3. Acute pancreatitis
  4. Tremor
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8
Q

What are the main indications for phenytoin use? What are the side effects?

A

Focal seizures, status epilepticus

Side effects:

Nystagmus and diplopia

Ataxia

Decreased bone density

Stevens-Johnson Syndrome (esp. in HLA-B1502 Asians)

DRESS syndrome

Teratogenic (cleft palate)

Folate deficiency -> megaloblastic anemia

Drug-induced lupus

Gingival hyperplasia

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9
Q

What are the main indications for carbamazepine use? What are the side effects?

A

Focal seizures (partial epilepsy)

Side effects:

SIADH -> hyponatremia

Teratogenic -> neural tube defects

Agranulocytosis

DRESS syndrome

Ataxia

Diplopia

SJS esp. in HLA-B1502

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10
Q

What are the side effects of Lamotrigine?

A

SJS, diplopia, interactions with CYP450 inducers like valproate

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11
Q

What is the best drug for generalized absence seizures? What are its side effects?

A

Ethosuximide

Side effects: lethargy/fatigue, GI distress

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12
Q

Which dopamine pathway is involved in the manifestation of the positive symptoms of schizophrenia?

A

Mesolimbic dopamine system (increased dopamine causes the positive symptoms)

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13
Q

Which dopamine pathway is involved in the manifestation of the negative symptoms of schizophrenia?

A

Mesocortical (less dopamine in psychosis)

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14
Q

How is the niagrostriatal pathway affected in schizophrenia? How do antipsychotics affect this pathway?

A

Niagrostriatal pathway is involved in motor function (direct, indirect pathways) and is not affected in schizophrenia.

Antipsychotics block the D2 pathway, which turns on the sub-thalamic nucleus –> inhibition of cortical activity.

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15
Q

How is the tuberoinfundibular pathway affected in schizophrenia? How do antipsychotics affect this pathway?

A

Tuberoinfundibular pathway regulates prolactin secretion (via dopamine), antipsychotics block dopamine –> increased prolactin

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16
Q

What symptoms are catatonia characterized by? In what psychiatric conditions is it seen in? How is it treated?

A

Catalepsy (muscle rigidity; waxy flexibility)

Mutism

Echolalia (mimics what people say)

Negativism (resistance to do shit)

Echopraxia (mimics what people do)

Seen in schizophrenia (most commonly) and MDD

Tx: benzodiazepines like lorazepam and electroconvulsive therapy (ECT)

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17
Q

Does clonidine treat Tourette’s/tics?

A

Yeah (puppet at the bottom)

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18
Q

What is the adult version of conduct disorder?

A

Antisocial disorder

antisocial = sociopath

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19
Q

Which two drugs/drug types can treat PTSD?

A

SNRIs/SSRIs and Prazosin (alpha-1 antagonist)

Dude on stage w/ dog tags

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20
Q

What drugs treat acute panic disorder and chronic panic disorder, respectively?

A

Benzodiazepines for acute panics

SSRIs/SNRIs for chronic panic disorder

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21
Q

Name three drugs that can treat trichotillomania.

A

Olanzapine, n-acetylcysteine, and naltrexone (all off label)

22
Q

Which benzo has a quick onset and short duration?

A

Alprazolam

23
Q

What non-pharmacologic treatment is used for specific phobia?

A

Flooding

24
Q

What non-pharmacologic treatment is used for PTSD?

A

Prolonged exposure

25
Q

What non-pharmacologic treatment is used for OCD?

A

Exposure and response prevention

26
Q

What non-pharmacologic treatment is used for panic disorder?

A

CBT

27
Q

Compare and contrast facticious disorder from malingering.

A

Facticious disorder is when someone falsifies disease for primary gain (likes being cared for/being a patient)

Malingering is when someone fakes an illness for the purposes of external gain

28
Q

Bruxism is most commonly seen in ________ intoxication.

A

Ecstasy (MDMA)

29
Q

Which benzos are best for treating alcohol withdrawals in a patient with normal liver function? Why?

A

Chlordiazepoxide and Diazepam cuz they have long half-lives

30
Q

Name three drugs and their MOAs that can be used for prevention of alcohol abuse relapse.

A

Disulfiram (aldehyde DH inhibitor)

Acamproasate (GABA agonist)

Naltrexone (mu antagonist that decreases cravings/reward)

31
Q

Name the cluster A personality disorders

A

Paranoid

Schizoid

Schizotypal

32
Q

Name the cluster B personality disorders

A

Narcissistic

Borderline

Antisocial

Histrionic

33
Q

Name the cluster C personality disorders

A

Avoidant

Dependent

Obsessive-compulsive

34
Q

Name the personality disorder:

Suspicious/mistrusting of others

Frequent hostility

A

Paranoid PD

35
Q

Name the personality disorder:

Detachment from social relationships

Restrictive affective range (blunted emotions)

A

Schizoid PD

36
Q

Name the personality disorder:

Odd, eccentric beliefs and behaviors

Magical thinking

A

Schizotypal PD

37
Q

Name the personality disorder:

Grandiosity, inflated self-importance

Entitled, needs admiration

A

Narcissistic PD

38
Q

Name the personality disorder and how is it treated:

Unstable mood and relationships

Self-mutilation

Suicidality

A

Borderline personality disorder

Treat with dialectical behavioral therapy (DBT)

39
Q

Name the personality disorder:

Disregard for/violation of others’ rights w/ no remorse

Charming and manipulative

A

Antisocial PD

40
Q

Name the personality disorder:

Excessive but superficial emotions

Attention seeking

Seductive/provocative

A

Histrionic PD

41
Q

Name the personality disorder:

Extreme fear of rejection

No friendships despite a strong desire for them

A

Avoidant PD

42
Q

Name the personality disorder:

Excessive need to be cared for

Passivity

Intense self-doubt; difficulty with decision making on their own

A

Dependent PD

43
Q

Name the personality disorder:

Overly preoccupied with rules and organization

Likes the shit out of lists

A

Obsessive-compulsive PD

44
Q

Name three treatments for neurocognitive disorders and the MOAs.

A

Donepezil - acetylcholinesterase inhibitor

Tacrine - acetylcholinesterase inhibitor

Memantine - NMDA antagonist

45
Q

What are the treatments for binge-eating disorder?

A

SSRIs, CBT, lisdexamfetamine

46
Q

What is the treatment for bulimia nervosa?

A

Fluoxetine (SSRI), CBT

47
Q

What is the treatment for anorexia nervosa?

A

Weight restoration and family therapy

48
Q

Fill it in

A
49
Q

After treatment with a 1st gen antipsychotic, someone becomes rigid, febrile, confused, and has unstable vitals. U check CK and its high. What is the Dx? What is the treatment?

A

NMS

Treat with bromocriptine (D2 agonist) or dantrolene (ryanodine receptor antagonist decreases muscle contraction)

50
Q

Name the atypical antipsychotics that have the fewest metabolic side effects.

A

Risperidone, ziprasidone, aripiprazole

51
Q

Which atypical antipsychotic has the fewest extrapyramidal side effects?

A

Aripiprazole

MS2 - MBB (8 decks)

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