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USMLE > USMLE Rx: Psych > Flashcards

USMLE Rx: Psych Flashcards

1
Q

Tx: Frotteurism

A

SSRIs (Antidepressants) Psychotherapy

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2
Q

Chicken, Wine, cheese can lead to

A

HTN Crisis with MAOis

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2
Q

Somatization Disorder

A

Pain in 4 sites No etiology/physiology

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3
Q

Tx: Panic Disorder

A

CBT/SSRIs (1st line; benzos are addictive)

(Imipramine can treat panic disorder with agoraphobia)

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3
Q

Somatoform Disorder

A

Umbrella term for Somatization, Conversion, Hypochondriasis, Body Dysmorphic, Pain Disorder,

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4
Q

Tx: Suicidal Ideation

A

Hospitalization

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4
Q

Hypochondriasis

A

Fear of disorder w/ no or minimal symptoms

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5
Q

Psychoanalytic Psychotherapy

A

“free assocation”, allows Pt to vent and talk without judgement

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5
Q

Malingering

A

Faking symptoms for secondary gain

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6
Q

Contraindications to Benztropine

A

Acute angle glaucoma

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6
Q

Hyperthyroidism is associated with

A

Anxiety Disorders

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7
Q

Hypersomnolence, anergia, increased appetite, psychomotor retardation

A

Cocaine withdrawal

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7
Q

Suicide Risk Factors

A

Schiz, Bipolar Men Age Death of loved one Substance abuse Copycats

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8
Q

Cluster B Personalities

A

Histrionic Antisocial Narcissistic Borderline

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8
Q

Seizure pts should avoid

A

Buproprion (contraindication)

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9
Q

Insulin Antibodies

A

indicate factitious disorder (they are antibodies to exogenous insulin)

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9
Q

Bupropion MOA

A

NE+ D Reuptake inhibitor

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9
Q

Bulimia/AN Pts should avoid

A

Buproprion lowers seizure threshold

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10
Q

BPD: Men vs. Women

A

Type 1 M=F Type 2 is more common in women

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11
Q

Suicide rate is increased in Pts with

A

Bipolar Disorder, schizo MDD Borderline, Polysubstance abuse/depend

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12
Q

Sx: Refractory Schizophrenia

A

Clozapine

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13
Q

Drugs to discontinue before surgery

A

SSRIs they have antiplatelet effects

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14
Q

Jungian Psychotherapy

A

Personal unconscious Collective unconscious (collective= how humans perceive things; expressed in dreams art and religion)

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15
Q

Interpersonal Psychotherapy

A

Focuses on experiences in one’s life

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16
Q

Cognitive Behavioral Psychotherapy

A

Focuses on understanding negative emotions

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17
Q

Psychodynamic Psychotherapy

A

Personal unconscious motivating behavior. Unconscious emotional memory is formed early on thru personal interactions and needs to be realized

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18
Q

Contraindicated in Cocaine Intoxication

A

B-Blockers (cocaine has a-adrenergic activity which goes unopposed)

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19
Q

Refeeding Syndrome

A

PO4 shifts to intracellular dt ATP synth Leads to Resp fail, cardiac fail, arrh’s, rhabdo, seizures, coma, RBC/WBC dysf

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20
Q

Possible sexual child abuse

A

ALWAYS get reported, regardless of inconclusive evidence

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21
Q

Vascular Dementia Workup

A

CT and MRI (MRI shows better detail and assesses frontotemporal dementia)

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22
Q

Scenarios to break confidentiality

A

-Harm to one’s self -Harm to others -Gun/Knife wounds

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23
Q

Reactive Attachment Disorder

A

Early lack of attachment as baby -child lacks social interactions OR -child clings to all interactions

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24
Q

Anorexia- Thyroid levels

A

Low T3/Thyroxine/TSH High Reverse T3

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25
Q

Haloperidol Reversal

A

Acute Dystonia- Antihistamines NMS- Dantrolene/Bromocriptine

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26
Q

What psych conditions can propanolol?

A

Anxiety, personality disorders

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27
Q

4 D’s of Malpractice

A

Duty Dereliction Damage Direct cause of damage

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28
Q

Echolalia is seen in

A

autism and schizo

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29
Q

Schizophrenic criteria

A

2 of: Delusions Hallucinations, Disorg speech/behavior Flat affect Anhedonia

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30
Q

Torticollis is associated with what med?

A

Typicals (Haloperidol)

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31
Q

Tx: Acute dystonia

A

Dyphenhydramine (antihist) or Benztropine (antichol)

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32
Q

When do you admit anorexics?

A

weigh <20% of their ideal body weight

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33
Q

Sx: TCA Overdose

A

Cardiac- Dysrhyth, PR/QRS/QT widens Severe HoTN Anticholinergic (hyperthem, sinus tachy, constip, ur retent)

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34
Q

Tx: TCA Overdose

A

Fluids for BP NaBicarb for QRS prolongations

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35
Q

Conduct Disorder

A

Child is aggressive and destructive to others before age 15. Turns into Antisocial personality disorder later on

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36
Q

Panic Disorder

A

Palpitations, diaphoresis, CP etc, over 1 month or more

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37
Q

Panic Disorder usually leads to

A

Agoraphobia

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38
Q

Sx: Anorexia Nervosa

A

Ortho HoTN Hypothermia Skin Dryness

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39
Q

Sx: Bulimia

A

Salivary Gland hypertrophy Dental Enamel erosion scars on knuckles (Russell’s)

40
Q

sfx: Prolonged QT

A

Ziprasidone

41
Q

Liver Failure associated

A

Wernicke Korsakoff (Pt will be confabulated as opposed to dec consciousness in hep enceph)

42
Q

MC Complication of PCP intox

A

Trauma (death)

43
Q

Sx: PCP intox

A

Violent Hallucination HTN/HR Nystagmus/Ataxia Rigidity, Dysarthria Seizures/hyperacusis

44
Q

Benzo Dependency is due to

A

doseage and duration

45
Q

Schizoid vs. Schizotypal

A

Typal= Magical thinking, weird, strange Zoid=detached, solitary, doesnt desire social

46
Q

Tx: Specific phobia

A

systemic desensitization

47
Q

Tx: Social phobia

A

B-beta blockers

48
Q

Reaction Formation

A

Pt’s action are opposite to their feelings. (Mom didnt want kid so she becomes overprotective)

49
Q

Bereavement lasts

A

up to 6 months-ish

50
Q

Social Phobia

A

fear of being scrutinized/judged

51
Q

Tx: Social Phobia

A

SSRIs Benzos, occas B-Blockers

52
Q

Cyclomania

A

Alternates between Hypomania + Dysthymia

53
Q

sfx: Olanzapine

A

Dyslipidemia, Hyperglycemia, weight gain

54
Q

sfx: Lamotrigine

A

Steven’s Johnson

55
Q

Antidote: Delirium Tremens

A

Benzos (ie Diazepam)

56
Q

Antidote: Heroine

57
Q

Tx: GAD

A

1L: CBT SSRIs work fast Buspirone- slower

58
Q

Tx: HTN crisis

A

Labetolol (blocks α + β) (Propanolol if resistant)

59
Q

Tx: PTSD

60
Q

Sx: Heroine

A

Pupillary constriction ↓ Breathing

61
Q

Antidote: Cocaine

A

Haldol (psych symptoms)

Diazepam (physio symptoms)

62
Q

Antidote: Organophophates

63
Q

Antidote: Anticholinesterases

64
Q

Antidote: Iron

A

Deferoxamine

65
Q

Antidote: Arsenic

A

Dimercaprol

66
Q

Antidote: Gold

A

Dimercaprol

67
Q

Antidote: Lead

A

Dimercaprol

68
Q

Antidote: Mercury

A

Dimercaprol

69
Q

Antidote: Benzos

A

Flumazenil

70
Q

Antidote: β Blockers

71
Q

Antidote: Carbon monoxide

A

Hyperbaric oxygen

72
Q

Tx: Bipolar Disorder

A

1L: Lithium, Valproate 2L: Carbamazepine, Lamictal

73
Q

Dantrolene MOA

A

blocks Ryanodine rec and ↓Ca(i)

74
Q

PCP MOA

A

blocks NMDA rec

75
Q

Tx: PCP overdose

A

Benzos (sedate)

76
Q

Difference between Normal Grief and Adjustment Disorder

A

Adjustment abandons/withdraws social connections and cant handle basic issues (like paying bills)

77
Q

Timeline for Delirium Tremens

A

48-72 hrs usually (can be up to 7-10 days tho)

78
Q

Sx: Asperger’s

A

lack of eye contact paucity of facial and getural expressions flat/emotionless tone of voice Poor motor control Speech peculiarities Can excel in certain subjects

79
Q

B-Blockers can cause

A

Depression with high sudden dosing

80
Q

Trichotillomania

A

Pulling one’s hair out (Tx: SSRIs)

81
Q

Secure Attachment

A

Normal behavior for children (separated- sad; reunion-happy)

82
Q

Substance Dependence

A

3 or > in 12mos tolerance, w/drawal, larger amts/time than intended, inability to cut down, time obtaining/using/recovering, interfering in important activities, continued use despite knowledge of problem

83
Q

Substance Tolerance

A

1 or > in 12mos fails to fulfill obligs, recurr sunstance in hazard situations, legal problems, interpersonal/social problems

84
Q

Varenicline Tartrate

A

Tablets used for nicotine cessation -Nic agonist w/ additional a4b2 binding to prevent “buzz” if person smokes again

85
Q

Anhedonia, emptiness, mood instability

A

Depression OR Borderline !!!

86
Q

Suicide Risk Factors

A

S: Male sex A: Older age D: Depression P: Previous attempt E: Ethanol abuse R: Rational thinking loss S: Social supports lacking O: Organized plan N: No spouse S: Sickness

87
Q

Predisposers to Antisocial Personality Disorder

A

Conduct, ADHD

88
Q

Tx: Tardive Dyskinesia

A

Lower the dose!

89
Q

NT that modulates aggression

A

Serotonin (inhibits prefontal cortex)

90
Q

Tx: OCD

A

1L: SSRIs (fluvoxamine)

2L: Clomipramine/Imipramine (TCAs)

91
Q

sfx: seizures

A

TCAs, MAOi, Buproprion

92
Q

HTN Crisis

93
Q

sfx: Arrhythmias

A

TCAs, MAOi

94
Q

Tx: Tourette’s

A

Haldol (/fluphenazine), Clonidine, or Pimozide (Haldol least sfx)

95
Q

Dx: ADHD

A

>6mos by 6yoa or younger causes issues in more than one context

96
Q

Gender Identity Disorder

A

can show in adolescence more common in men cant be Dx’d in Pts w ambig genitalia

97
Q

Salicylic Acid Overdose

A

Primary resp alkalosis and eventually anion gap metabolic acidosis w hyperventilation fever and diaphoresis

98
Q

Sx: Amphetamines

A

CNS stim agitation, tachycardia, fever, arrh

99
Q

Sx: Cocaine

A

CNS stim agitation, HTN, tachycardia, angina, hallucinations, euphoria

100
Q

Tx: Akathisia

A

Propanolol Anticholinergics (or reduce/switch the antipsychotic)

101
Q

Pseudodementia

A

Abrupt/quick onset often answers “I don’t know” Focus/concentration are intact (true dementia gives false answers and appear uninterested)

102
Q

Vascular Dementia

A

Often progresses stepwise with each infarct (Hx of HTN +/- Stroke)

103
Q

CAGE

A

anyone ever say you should CUTdown? have you ever gotten ANGRY about someone criticizing your drinking have you ever felt GUILTY about drinking have you drank in the morning- EYE opener

104
Q

Tourettes is more common in

105
Q

What antidepressant can increase the risk of suicide

A

SSRIs; highest risk at 2 weeks

106
Q

Neufibrillary tangles, neuritic plaques and threads

A

Alzheimer’s

107
Q

Subcortical degeneration

A

Parkinson’s

108
Q

Mood stabilizer Rx that causes a rash

A

SJS- Lamotrigine

rash- Carbamazepine (can rarely cause sjs too)

109
Q

Sadism, Masochism

A

Sadism- likes to give pain for sexual satisfaction

Masochism- likes to receive pain for sexual satisfaction

USMLE (4 decks)

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