Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

psychiatry > UW 2 > Flashcards

UW 2 Flashcards

1
Q

switching from fluoxetine to MAIi

A

wait 5 weeks to prevent seretonin syndrome (fluoxetine has long HT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

seretonin syndrome - treatment

A
  1. stop all seretonergic medications
  2. supportive care, sedation with benzo
  3. refractory –> cyproheptadine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

switch to clozapine if extrapyramidal symptoms under antipsychotics

A

only if tardive dyskinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

REM sleep behavior disorder

A

complex motor behaviours that occur during REM

  • dream enactment can occur if the muscle atonia that usually accompanies REM sleep is absent or incomplete
  • latter of the night (higher % of REM)
  • very transient confusion after awake
  • recall heir dreams but not movements
  • older adult men
  • may be prodromal for Parkinson or Lewy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

depression refractory to 1 SSRI - next step

A 
try a 2nd SSRI (then other drugs)
change class if 2 dif medication of the same class do not work
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Best predictor of complication after TCA overdose

A

QRS longer than 100 msec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

best initial therapy for major depression

A

SSRI with CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

gambling disorder diagnosis is based on 4 or more of the following

A
  1. gambling when distressed
  2. depressed or anxious
  3. increased gambling to achieve the desired excitement
  4. frequently returning to gambling to recover past losses
  5. preocppation with gambling
  6. irritability and distress when trying to cut back on gambling
  7. repeated unsuccessful attempts to cut back
  8. trying to conceal the extend behaviors
  9. damaging relationships or jeopardizing employment
  10. relying on others to make up for financial loses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

start SSRI for Major depression - when to stop them

A

if single episode of major depression –> continue for additional 6 months following acute response to reduce the risk of relapse
with chronic, recurrent or severe episodes –> 1-3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

cancer patient with depression - what to say

A 
offer treatment
(don't say it is normal: it will negatively affect the treatment)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

post traumatic stress disorder - treatment

A
  1. trauma focused CBT
  2. SSRI or SNRI
  3. prazosin for nightmares
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

drug of choice in pediatric depression

A

fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pharmacotherapy of psycjosis

A
  1. antipsychotics 2nd generation
  2. adjunctive benzo for agitation
  3. chronic nonadherence: lonsider long actinve injectable
  4. Treatment resistance (2 failed trials): consier clozapine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

oppositional defiant disorder - time

A

at least 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

patient with acute mania and psychosis - best initial treatment

A

antipsychotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

causes of FP amphetamine urine test

A

selegiline, bupropion, decongestant pseudoephedrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

kelptomania - characteristics

A

stolen objects have little value

  • increasing tension prior to theft –> pleasure or relief after
  • guilt or remorse are common
  • stolen objects given away, discharged or returned
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

kleptomania vs shoplifting

A

shoplifting is much more common, theft for personal gain
- In kleptomania, ovewrwhelming fellings of tension r anxiety precede impulses and are releived with the act of theft (guilty and shame)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

kleptomani treatment

A

CBT oreientation focusing on techniques to resist and manage urges and anxiety
medications: SSRI, opiod antagonists, lithium, anticonvulsants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

new onset (childhood) schizo - characteristic

A

poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

schizophreniform vs schizophrenia beside duration

A

only schizophrenia requires functional decline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

antipsychitics vs prolactinoma regarding levels of prolactin

A

prolactinoma: more than 200
medications: 25-100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

medications that decreases lithium levels

A

theophylline

K+ sparing diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

treatment of bipolar in renal failure

A

valproate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Marchiafava-Bgnami disease

A

dementia, motor dysfunction, dyrsarthria
- severe damage to the corpus callosum and surrounding white matter in the contex of chronic alcohol use disorder and malnutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Korsakoff - kind of amnesia / another characteristics)

A

retrograde and anterograde with intact long memory

sometimes develops without Wernicke - normal neurological examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

catatonia?

A

syndrome seen in severe psychiatric and medical illness and is characterized by immobility, mutism, posturing
Lorazepam and electroconvulsive therapy are the treatments of choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

antipsychotics - long QT?

A

only ziprasidone in very high doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

some chronic methammphetamine users can develop

A

persistent psychosis: difficult to distinguish from primary psychiatric disorders –> visual and tactile hallucinations tend to be more common in substance-induced psychotic disorders –> long term management with CBT and antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

narcolepsy - treatment

A
  • sleep hygiene and scheduled naps
  • if leepiness impairs daily functioning na dposes safety risks –> modafinil (nonamemphetamine medication)
  • if significant cateplexy –> antidepressants and sodium oxybat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

immediate treatment of depression with SSRI –>

A

it is not depression –> its bipolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

borderline - treatment

A

1st line: dialectical

  • adjunctive pharmacotherapy to target mood instability + transient psychosis (2nd feneration antipsychotics, mood stabilizers)
  • antidepressants if comorbid mood or anxiety disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

alcohol withdrawal - which benzo

A

lorazepam (intermediate HT and does not metabolized by liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

adjustment disorder

A

emotional or behavioral symptoms that develop within 3 months of exposure to an identifiable stressor and rarely last more than 6 months (no criteria for major depression)
- treatment: psychotheray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

nightmare disorder

A

recurrent episodes of awakening from sleep with recall of highly disturbing and frightening dream content

  • full alert on awakening
  • usually consoled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

another SE of marijuana overdose

A

dry mouth
tachycardia
slow reaction time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

transient global amnesia

A

anterograde amnesia fro time and place that resolve in 24 h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

dissociative amnesia

A

isolated impairment in autobiographical memory

- if the amnesia is accompanied by travel or wandering, the specifier of “with dissociative fugue” is given

39
Q

long acting antipsychotics are administered IM every

A

2-4 wks

40
Q

benzo should be used with extreme caution in the elderly due to

A

increased risk of cognitive imairment, falls, and paradoxical agitation
(be careful –> don’t increase the dose if the patient is agitated)

41
Q

partial response to an antidepressant

A

add an antidepressant with a different mechanism of action, 2nd gen antipsychotic, lithium, T3 or psychoterapy)

42
Q

persecutory delusions m - example

A

being poisoned, harassed, plotted against

43
Q

delusional disorder - treatment

A

antipsychotics

CBT

44
Q

adequate duration of an antidepressant trial is generally considered to be

A

6 wks

45
Q

Dissociative identity disorder - association

A

with childhood trauma –> chronic auditory hallucinations that have venn present since childhood and are perceived as inside the patien;s head (vs psychotice, in which voices seem to come from outside)

46
Q

dissociative identity disorder - treatment

A

long-term focused psychotheray

47
Q

psychiatric drug that can cause liver toxicity

A

valproate
esp the first 6 months
(check Liver enzymes before initiation of treatment and then monitor)

48
Q

in addition to hepatotoxicity, valproate can cause

A

thrombocytopenia, alopecia, tremor

49
Q

normal age related sleep changes

A
  1. decreased total sleep time
  2. increased nighttime awakenings
  3. sleepiness earlier in the evening with earlier morning awaking
  4. increased daytime somnolence (napping)
50
Q

patients with chronic alcohol abuse frequently seep primary care due to

A

sleep disturbance and anxiety from mild withdrawal is in this patient
- use alcohol to fall asleep, but the blood alcohol level drops, CNS hyper-arousal occurs and results in awakening

51
Q

how to differentiate nhistrionic vs narcisistic

A

histrionic have greater capacity for interpersonal relationships and do not display emotional coldness or lack of empathy)

52
Q

neuroleptic malignant symptom - time to happen

A

in the 1st 2 wks

53
Q

hypertnesive crisis after MAOi can results in

A

headache (can present like)

- stroke/intracranial bleeding/death

54
Q

clozapine SE

A
  1. neutropenia
  2. metabolic syndrome
  3. myocarditis
  4. seizures
55
Q

the greatest RF in completing homicide

A

firearms

56
Q

homicide RFs / (strongest)

A
  • young male
  • unemployed
  • impoverished
  • access to firearms (STRONGEST)
  • substance abuse
  • history of violence or criminality
  • impuslivity
  • history of childhood abuse
57
Q

tamoxifen in male

A

in people taking steorids to treat gynecomastia

58
Q

methamphetamine - acne or baldness

A

maybe due to skin picking

59
Q

marijuana - another symptom

A

gynecomastia

60
Q

psychogenic non epileptic seizure?

A

type of conversion disorder commonly misdiagnosed as a seizure disorder
- features suggestive include FORCED EYE CLOSURE, SIDE TO SIDE HEAD OR BODY MOVEMENTS, MEMORY RECALL OF THE EVENT, LACk OF POSTICTAL CONFUSION
gold standard for diagnosis: video electroencephalogram of an event demonstrating lack of epiliptiform activity

61
Q

somatic symptoms disorder - management

A

regularly sceduled vistis with the same provider, avoiding unnecessary diagnostic testing and specialists referrals, exploring the role of psycholosocial stresors, promote stress deuction and healthy behaviors
- refractory: CBT, SSRI

62
Q

alcohol withdrawal syndrome - manifestations per time

A

mild withdrawal: 6-24
seizures: 12-48
alcholic hallucinosis: 12-48
DT: 48-96

63
Q

DT - time + manifestation

A

48-96

- confusion, agitation, fever, tachycardia, hypertension, diaphoresis, hallucinations

64
Q

Delayed sleep-wake phase disorder

A

circadian rhythm disorder characterizedby inability to fall assleep at traditional bedtimes –> sleep-onset insomnia and excessive sleepiness –> sleep normally if allowed to follow their internal circadian rhythm and sleep until late morning

65
Q

special characteristic og bath satls

A

long time effect

- may be toxicology (-)

66
Q

HIV-associated neurocognitive disorder - manifestations

A
  1. Impaired memory + attention/concentration
  2. personality + behavior changes
  3. motor symptoms (eg. ataxia, slowed movement
67
Q

HIV - associated neuroognitive disorder - RFs

A

long standing HIV
older than 50
CD less than 200

68
Q

sleep disturbances are commonly seen in

A

depression (new onset of insomnia in elderly patients with depressed symptoms –> think about major depressive disorder)

69
Q

anorexia nervosa - complications

A
  1. cardiovascular: Myocard atrophy, bradycardia, hypotension, arrhythmias
  2. renal: poor urinary concentration, dehydration
  3. neurological: seizures, cognitive impairment
  4. dermatological: dry skin, lanugo
  5. gynecological: amenorrhea, infertility
  6. GI: gastroparesis, constipation
  7. hematological: cytopenias
  8. other: electrolyte depletion, osteopenia, hypercholesterolemia, hypercarotenemia
70
Q

over the counter cold preparation containing antihistamine in children can cause

A

hallucinations + confusion

71
Q

survicors of sexual assault are at high risk for developing

A

PTSD
depression
suitability

72
Q

social anxiety disorder (social phobia) - diagnosis

A
  1. marked anxiety about 1 or more social situations for 6 or more months
  2. fear
  3. avoid social situations
  4. marked impairment
  5. SUB-TYPE SPECIFIER: Pperformance only
73
Q

Social anxiety disorder (social phobia) - treamtent

A

SSRI/SNRI
CBT
beta blockers or benzo for performance -only subtype

74
Q

dissociative idenntity disorder - treatment

A

trauma-focused psychotherapy

75
Q

2nd generation antipsychotic drug associated with hyperprolactinemia

A

risperidone

76
Q

acute dystonia - treatment

A
  1. benzotropine

2. diphenidramine

77
Q

akathisia - treamtent

A
  1. propranolol
  2. benzotropnine
  3. lorazepame
78
Q

parkinsonism - treatment

A
  1. benzotropine

2. amantadine

79
Q

tardive dyskinesia -ttreatment

A

valdenazine

80
Q

major depression who fail to respond to an initial SSRI trial

A

consider switch to another 1st line antidepressant (SSRI, bupropion, mirtazapin, Seretonin modulators)

81
Q

adeqate duration of SSRI

A

6 wks

82
Q

SSRI - suitability

A

slightly higher risk if under 25

the risk of suicide from depression is higher

83
Q

lamotrigine - rash

A

up to 10% (and steven Johnson in ot Toxic epdiermal necrolysis in 0.1%
- any occurence of rash during lamotrigine –> immediate stop the drug

84
Q

Hoover sign

A

impaired flexion/extension strength of the hip with intact extension on contralateral hip flexion –> incompatible with known nerve pathways -> maybe conversion

85
Q

how long before antidepressnats should be stoped before MAOI

A

2 weeks

- exception is fluoxetine: 5 wks

86
Q

initial apporach to patients presenting with symptoms after a trumatic incident

A

educate them on the range that will normalize their experience
trama focused CBT is indicated if prersistent symptoms

87
Q

panic disorder treatment

A

immediate: benzo

long erm: SSRI/SNRI +/or CBT

88
Q

risperidone - mechanism of action

A

seretonin 2A + dopamine D2 antagonists

- the added seretonin receptor binding reduces the likelihood of extrapyramidal SE

89
Q

benzo withdrawal

A

abrupt discontinuation of benzo can result in a potentially life-threatening withdrawal syndrome: anxiety, insomnia, tremors, psychosis, seizures
- mild withdrawal may be difficult to distinguish from reemergence of the underlying disorder

90
Q

intermittent explosive disorder

A

recurrent episodes of impulsive verbal or physical aggression
- unplanned and out of proportion to the provocation

91
Q

disruptive mood dysregulation disorder

A

disroportionate verbal or physical outbursts

- diagnosis requires onset before 10 and persistent irritability or anger in-between episodes

92
Q

electroconvulsive - indications

A
  1. treatment resistance
  2. psychotic features
  3. emergency conditions (pregnancy, refusal to eat or drink, imminent risk for suicide
93
Q

severe or refractory anorexia nervosa

A

olanzapine

94
Q

contraidication of haloperodol

A

seizure disorder

psychiatry (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions