Usmle Easy 2 Flashcards
Patient with refractory schizophrenia on clozapine presents with good response but seizures. Management?
Seizures are dose dependent (usually over 400 mg)
#Temporarily stop clozapine and start barbiturates #restart clozapine at 1/2 dose and titrating up
Repression versus suppression?
Expelling idea from consciousness that causes one to lose goals versus postpone goals
Previously-well controlled Bipolar on Valproic acid is not able to sleep and develops mild mania - treatment?
Lack of sleep can cause mania - give long acting benzodiazepine to re-regulate sleep cycle
Depressed patient refusing to eat - treatment?
ECT
Mechanism of action of amphetamines?
release of monoamines (DA and NE) at synaptic cleft)
When to use supportive psychotherapy?
Patient is undergoing acute life crises and is feeing overwhelmed
Van Gogh vision? Can also present with?
Digoxin toxicity
Auditory hallucination and atrial fibrillation.
Organic causes for acute onset OCD?
Same as anxiety (Hyperparathyroidism, Hyperthyroidism, hypercortisolism)
Drug for startle response in PTSD?
Beta-blocker
Lesion to where causes euphoria and joking/puns?
Lesion that causes disinhibition, euphoria, and lack of remorse?
Causes depression and uncontrollable crying?
Fornix
Orbitofrontal cortex
Dorsolateral cortex
Over-the-counter medication that is contraindicated with MAOIs?
Pseudoephedrine
Bipolar patients on lithium experiences depressive symptoms. Treatment?
Stop Li temporarily and start antidepressant temporarily
Ramelteon – Indication? Mechanism? Should not be used in patients with?
Sleep aid
High affinity for melatonin receptors
Liver disease, sleep apnea, COPD
Social phobia versus avoidant personality disorder?
Specific situations cause distress versus interpersonal contact
Bipolar drug that can cause a action tremor?
Lithium
Intoxication with this opioid can cause seizures?
Meperidine
First choice drug for mild to moderate Alzheimer’s disease?
Donepezil
Lesions to the dorsal lateral frontal lobe may cause?
#Deficiencies in planning #Amotivation, Lack of focus/goal-directedness #Tendency to linger on trivial thoughts #Repetition
Intoxication of this drug may cause vertical nystagmus?
PCP
Patient has one seventh episode of psychosis, warranting a diagnosis of schizophrenia. Since starting medication, patient has been symptom-free. What should be done with her medications?
Lower the dose, and if no symptoms recur, can stop medication
Drug that can increase plasma concentration of carbamazepine?
Drugs they can decrease the plasma concentration of carbamazepine?
Erythromycin
Theophylline, cisplatin
Most important for side effect of sildenafil?
Myocardial infarction
Antidepressant (not bupropion) that is not associated with weight gain?
Setraline
Drug that can cause patients to unknowingly sleepwalk, binge eat, have aggressive outbursts and night drive?
Zolpidem
OCD symptoms may be caused by which drug?
Cocaine intoxication
Will have test necessary before starting the patient on carbamazepine? After beginning therapy?
CBC, reticulocyte count, electrolytes, AST, ALT, pregnancy test
Dreams:
- Manifest content?
- Hidden latent content?
- Dream work?
- Condensation?
- Primary process?
- Secondary revision?
- Images and sensations recalled
- Impulses, ideas, and feelings acceptable to the conscious mind
- Process in which the content of the dream is transformed into more acceptable manifest content
- combination of different concept/feelings into one single image
- The logical, bizarre, and incoherent images that make up dreams
- Ego makes manifest content rational and acceptable to the dreamer
Non-antidepressant drug can cause impotence?
Beta Blocker
Inhalant abuse is associated with what symptoms?
#Hearing loss #peripheral neuritis and motor impairment #cerebellar signs
Biofeedback is what type of therapy?
Behavior therapy
