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U World Flashcards

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1
Q

Major depressive disorder affects the physiology of the brain how?

A

Hyperactivity of HPA axis

Results in increased cortisol levels

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2
Q

Pt w/bipolar that has elevated Cr should get what Med?

A

Valproic acid

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3
Q

How does Major depressive disorder effect REM sleep latency?

Slow-wave sleep?

A

Decreases

Decreases

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4
Q

What are the MC side effects of Methylphenidate?

A

Dec appetite
Weight loss
Insomnia

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5
Q

Pt that is constantly walking around nonstop after starting new antipsychotic has developed what?

Treat how?

A

akathisia

Dec dose, give Propanolol or benzotropine/Benzo

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6
Q

What is high imminent risk in suicide assessment?

High non-imminent risk?

A

Ideation, intent and plan

Ideation, intent but NO plan

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7
Q

Pt that has depression, fatigue, hypersonic, increased dreaming, hyperplasia, and impaired concentration most likely has what?

A

Cocaine withdrawal

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8
Q

Pt that has been hospitalized 5 times in the last 3 years most likely has what?

Treat how?

A

Relapses d/t noncompliance

Give a long acting injectable

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9
Q

What meds can decrease serum Lithium levels?

A

Theophylline

K+ sparing diuretics - spironalactone

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10
Q

Pts w/Dementia w/LB are extremely sensitive to antipsychotics, what can they cause?

A

Confusion
Parkinsonism - rigidity
ANS dysfunction

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11
Q

What is the most specific indicator of dementia?

A

Getting lost in familiar territory

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12
Q

Pt w/anxiety, irritability, mood swings, grandiosity and psychotic sx w/borderline tachycardia, HTN, diaphoretic, has mild tremors, and dilated pupils has what going on?

A

Cocaine use disorder

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13
Q

Neuroimaging of Schizophrenia shows what findings?

A

Enlargement of cerebral LATERAL ventricles

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14
Q

Panic disorder has what common sx?

A

Cardiorespiratory
GI distress
Parenthesis
Dissociative sx

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15
Q

ECT causes what SEs?

A

Retrograde AND anterograde (2 weeks) amnesia

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16
Q

How do you treat oppositional defiant disorder?

A

Psychotherapy - anger management training and social skills training

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17
Q

What is Schizoaffective disorder?

A

Major depressive or manic episode w/sx of schizophrenia
Lifetime hx of delusions/hallucinations for > 2 weeks in ABSENCE of MD or manic episode
Mood Sx present for majority of illness

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18
Q

Bipolar disorder that is not adequately controlled with mono therapy is treated how?

A

Add a 2nd gen antipsychotic

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19
Q

Performance situation anxiety is a subtype of what?

A

Social anxiety disorder

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20
Q

What is the MAJOR distinguishing feature of Binge-eating disorder?

A

NO compensatory behavior

Recurrent binge eating w/lack of control

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21
Q

Catatonia is treated how?

A

BENZOs or ECT

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22
Q

Pt that has recurrent awakenings from REM sleep associated w/full alertness and dream recall has what?

A

Nightmare disorder

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25
Q

What is the MAJOR distinguishing feature of Bullimia nervosa?

A

Compensatory behavior (vomiting or Exercise) to prevent weight gain

Normal body weight

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26
Q

1st line treatment for anorexia nervosa?

A

CBT

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27
Q

High fever, mental status change, ANS instability, rigidity indicates what?

What causes it?

A

NMS

Antipsychotics —> olanzapine

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28
Q

Pt that suddenly gets dysphoria, insomnia, fatigue, and myalgia after suddenly stopping SSRI has what?

Treatment?

A

Antidepressant discontinuation syndrome

Restart med, then gradually taper

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30
Q

What is it called when there is a dream enactment during REM sleep if muscle Antonia is absent?

A

REM sleep behavior disorder

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31
Q

What non-psychiatric meds can cause psychotic disorder?

What sx?

A

High dose glucocorticoids aka Prednisone

Delusions, hallucinations

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32
Q

What medication is used to treat NMS?

A

Dantrolene or Bromocriptine

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35
Q

1st line treatment for ACUTE mania are what?

A

Antipsychotics - Olanzapine

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36
Q

Pt w/Major depression that fails to respond to initial SSRI at MAX dose should have what done next?

A

Switch to different SSRI

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37
Q

What is persistent complex bereavement disorder?

A

Depressive sx but sadness CENTERS on loss of loved one characterized by intense yearning for deceased

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38
Q

Timeline of Schizoaffective disorder?

A

LIFETIME hx of delusions/hallucinations for > 2 weeks w/no major depression

38
Q

Agranulocytosis = what?

A

Neutropenia

39
Q

Pt w/unexplained ABD pain and new onset neuropsychiatric symptoms including neuropathy, anxiety, mood change, and psychosis may have what?

A

AIP

39
Q

Borderline pts have what common history?

A

Hx of childhood abuse

42
Q

Adjustment disorder defined how?

Treatment?

A

Emotional/behavioral sx that start within 3 months of an Identifiable stressor, ends w/in 6 months

Psychotherapy

43
Q

What is the Major features of antisocial personality disorder?

A

Violating rights of others with NO remorse

PMHx of conduct disorder sx before age 15

44
Q

Pt with new onset of severe GI sx, confusion, ataxia, tremor and eventually seizures due to what medication?

A

Lithium toxicity

45
Q

Li toxicity causes what symptoms?

What drug can interact to cause this?

A

GI distress, confusion, ataxia, tremor/fasciculations

NSAIDs

47
Q

Long term SEs of Li include what?

A

Nephro DI
CKD
Hyperparathyroidism w/hypercalcemia
Thyroid dysfx

48
Q

Structural abnormalities in orbitofrontal cortex and striatum (BG) are found in what disorders?

A

OCD

49
Q

What demographic does REM sleep behavior disorder occur in?

May be a sign of what?

A

Older men

PD or Dementia w/Lewy Bodies

50
Q

Pt w/prolactin level of 70 has what?

If over 200?

A

Risperidone SE

PRLoma

50
Q

Pt that is depressed but also has hallucinations has what?

Can Treat how?

A

Major depression w/psychotic features

ECT or SSIR + anti-psychotic

53
Q

OTC cold and cough meds can cause what in children?

A

Hallucinations and confusion —> psychosis

54
Q

If you are considering PMS/prementrual dysphoria disorder what do you need to do first?

Treat mild how?

Mod to severe?

A

Keep menstrual diary

Exercise and stress-reduction

SSRI

55
Q

How long do you continue SSRI treatment after a pt tells you they feel better and not depressed anymore?

A

6 months

56
Q

Chronic mood disturbance characterized by > 2 years of numerous periods of hypomanic and depressive sx that are subthreshold for Dx major depressive or hypomanic/manic episodes is what?

A

Cyclothymic disorder

57
Q

Postpartum blues occurs when?

Peaks when?

A

WITHIN 2 weeks!!!

Day 5

59
Q

What defines obsessive-compulsive PERSONALITY disorder?

A

Perfectionist, preoccupied with order

Have RIGID rules and details

60
Q

15 y/o boy w/transient euphoria and LOC that lasts only for 15-45 minutes is abusing what?

What other sx?

A

Inhalants

Dermatitis in mouth or nose

62
Q

What are the MC used treatments acute PCP intoxication?

A 
#1 - BENZOs
Haldol
64
Q

What labs/tests do you need prior to starting Lithium?

A

BMP
Ca
Thyroid fx tests
UA

65
Q

What does Pramipexole treat?

A

PD and Restless leg syndrome

65
Q

Serotonin syndrome can occur with what drug drug interaction?

A

SSRI and MAOI

66
Q

Chronic depressed mood for > 2 years and NO sx-free period for > 2 months w/poor appetite, insomnia, low E/self-esteem, hopelessness indicates what?

A

Persistent depressive disorder (dysthymia)

Depressed mood MORE days than not for > 2 years and 2 other depressive sx

67
Q

Sexual assault increases pt’s risk of what?

A

Suicide

70
Q

What is the 1st line treatment for school-aged children w/ADHD?

A

Stimulants - methylphenidate or amphetamines

71
Q

Elderly pts that present w/new onset insomnia with other depressive sx should raise concern for what?

A

Major depressive disorder

72
Q

What is psychodynamic psychotherapy?

A

Used to develop insight into past, unresolved conflicts and change maladaptive defenses

it is NOT THE SAME as CBT

73
Q

What electrolyte abnormalities do bulimics have?

A

HypoK
HypoCl
Metabolic alkalosis

77
Q

How to tell the difference bw PD w/dementia and Dementia w/Lewy body?

A

If Parkinsonism symptoms (TRAP) PREDATES cognitive impairment by > 1 year, then it is PDD

78
Q

What drugs interact with Lithium?

A 
Thiazides diuretics
NSAIDs
ACE-i’s
Tetracycline
Metronidazole
79
Q

Pt with acute psychosis with hallucinations needs to be what?

A

Hospitalized

81
Q

Pt that is on a SSRI for depression and after 2 weeks says he is eating and sleeping better BUT still depressed, what should you do?

A

Continue for 2-4 weeks

Adequate SSRI requires 4-6 week trial

81
Q

Pt that has ADHD with history of substance use disorder treated with what?

A

Atomoxetine

82
Q

What causes an adverse side effect in the elderly which is manifested by recurrent episodes of confusion, aggression, disinhibition and agitation w/in 1 hour after taking the medication?

What is this called?

A

BENZOs

Paradoxical agitation

83
Q

BENZOs are generally not recommended in the elderly bc of what risks?

A

Cognitive impairment
Falls
Paradoxical agitation

84
Q

Treatment for Body dysmorphic disorder?

A

SSRI +/- CBT

85
Q

Pediatric depression presents w/symptom most often?

A

Irritability rather than depressed mood

86
Q

Pt that hears voices and seeing animals when falling asleep and feels weak in face and knees after talking to gf and is experience daytime sleepiness has what?

What are those 2 things called?

A

Narcolepsy

Hypnagogic hallucinations and cataplexy (loss of m. Tone in response to emotion)

87
Q

Guys can also have what personality disorder?

A

Borderline

88
Q

Social anxiety disorder is characterized by what?

A

Anxiety and FEAR of scrutiny in social situations

Results in avoidance, distress, social-occupational dysfx

89
Q

Pt that has failed 2 trials of antidepressants from the same class (ie SSRI) should be started on what?

A

New antidepressant w/different MOA

90
Q

Pt experiencing Acute stress Disorder, what is the best step in management/treatment?

A

Educate the pt about range of rxns to trauma —> CBT

91
Q

Which SSRI has a short half-life?

Long half-life? How long?

A

Paroxetine

Fluoxetine (4-6 days)

94
Q

Recurrent, unexpected panic attacks and FEAR about future attacks or maladaptive behavior related to attacks is what?

Some pts may develop what?

A

Panic disorder

Agoraphobia

95
Q

What medical conditions can cause psychosis in kids?

A

SLE
Thyroid dysfunction
CNS infection
Electrolyte disorder

95
Q

Tardive dyskinesia is a result of what neurotransmitter dysregulation?

A

Dopamine receptor super sensitivity

96
Q

What is agoraphobia?

A

Anxiety and avoidance of >/= 2 situations in which it may be difficult to escape or get help (being outside the home or in enclosed spaces, using transportation) in the event of a panic attack

Psych (8 decks)

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