USMLE Easy 1 Flashcards
Drugs that cause schizophrenia-like symptoms?
PCP
Amphetamines
LSD
Patient in clozapine. Lowering WBC count. Next step (depending on count)?
If 3000-3500, continue clozapine and institute 2x weekly CBCs
If 2000-3000, stop clozapine and restart when WBCs normalize
If agranulocytosis, stop clozapine and place on protective isolation
Four character traits?
#harm avoidance (uncertain, shy worriers) #novelty seeking (impulsive, curious, easily bored) #reward dependence (socially dependent, sociable) #persistence (hard-working, ambitious overachievers)
Social phobia - longest lasting treatment?
CBT
Treatment for narcissism?
Psychodynamic psychotherapy
Abnormal neurotransmitter in OCD?
Serotonin
Patient with cataplexy. Drugs to suppress REM sleep?
Antidepressants (SSRI, TCA, and MAOI)
Seizure with postictal hypertension and tachycardia – suspect?
Alcohol withdrawal
Tarasoff I versus Tarasoff II?
Duty to warn 3rd parties who are in danger from patient versus duty to protect victim from danger
Hormone that is sometimes used in the adjuvant treatment of depression?
Levothyroxine
Patient with benzodiazepine overdose is given flumazenil. Shortly after, patient has seizure – cause of seizure?
Pre-existing seizure disorder (Flumazenil precipitates seizures in patients with seizure disorder)
Initial therapy for panic attacks? Why?
Hyperventilate
Hypocapnia/respiratory alkalosis is reversed, leading to normal cerebral blood flow and normalization of serum calcium
Herbal treatments for depression?
St. John’s wort (antidepressant, sedative, and anxiolytic)
Ginseng (mood elevator)
Melancholic depression?
Variant of major depressive disorder
#Anhedonia #Lack of reactivity (nothing makes the patient feel better) #And neurovegetative symptoms
Double depression? Importance?
Major depressive episode in a patient with dysthymic disorder
#Higher risk for suicide #more severe depressive symptoms #more treatment resistance
Bereavement versus adjustment disorder?
Death of a loved one versus other event
Signs/symptoms that suggests major depressive disorder instead of bereavement?
#Persistace beyond two months #Worthlessness #Suicidal ideation #Psychomotor retardation #psychosis
Most common cause of delirium in old age?
In children?
Multiple medications
Accidental poisoning or hypoxia (from drowning)
Hereditary Alzheimer disease – genes? Chromosomes? Occurs at what ages?
Presinilin 1/2; Apo E
14; 21
40s (Ps1) versus 50s (PS2) versus over 50 (Apo E)
Majority of Alzheimer’s disease is caused by which gene?
Presilin 1 (70-80%)
Huntington’s disease affects which brain region?
Caudate Nucleus
Brain changes in a patient with schizophrenia?
#PET scan – increase in D2 receptors and caudate nucleus #Eye movement Dysfunction #Enlarged lateral and third ventricles (reduction in cortical ) #Decreased alpha waves on EEG, increased Delta and Theta waves
Drug to treat psychosis in delirium?
Haloperidol
Erotomanic delusions?
Belief that someone (usually of higher status, such as a TV star) is in love with you
Undoing?
A compulsive act to negate the consequences of a obsessive fantasized action
Psychotic patient with orthostatic hypotension - best medication?
Haloperidol or fluphenazine (low Anticholinergics side effects and less postural hypotension)
Drugs well tolerated in the elderly?
SSRIs Bupropion Venlafaxine Nefazadone Mirtazapine
Bereavement vs depression. Signs suggestive of depression?
#guilt over actions taken by the survivor #thoughts of death OTHER THAN "I would be better off dead" #worthlessness #psychomotor retardation #hallucinations OTHER THAN hearing the voice of loved one
Yearly tests for patients on Li?
EKG (when 50+)
Cr
Antipsychotic for patient with Parkinson’s?
Clozapine
