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Psychiatry > UWorld > Flashcards

UWorld Flashcards

1
Q

tx for generalized social anxiety

A

SSRI/SNRI, CBT

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2
Q

tx for performance type social anxiety

A

propranolol or benzos, CBT

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3
Q

weight loss, behavioral changes, erythema of turbinates and nasal septum

A

cocaine abuse

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4
Q

when treating a single episode of MDD, antidepressant should be continued for _______ following the patient’s response

A

6 months

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5
Q

first line tx for specific phobia

A

behavioral therapy

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6
Q

minors (t require parental consent

A

emancipated: homeless, lives alone, financially independent, married, military
medical circumstances: emergency, contraception, STD, prenatal care, substance abuse tx

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7
Q

survivors of sexual assault are at risk for developing PTSD, ______, and ________

A

depression, suicidality

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8
Q

multiple personality disorder is aka ________

A

dissociative identity disorder

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9
Q

looks like dissociative fugue but without the traveling

A

dissociative amnesia

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10
Q

first line drugs for bipolar

A

depakote, Li, atypical antipsychotics

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11
Q

tourettes dx: multiple ______ tics and at least 1 _____ tic
onset before ______
must exist for at least ______

A

motor, vocal
age 18
1 year

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12
Q

tx for tourettes

A 
antipsychotics (haldol, pimozide, fluphenazine, *risperidone) 
alpha agonists (clonidine, guanfacine) 
behavioral therapy
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13
Q

metabolic side effects of second gen APDs
highest risk:
lowest risk:
how and what to monitor

A

highest risk: olanzapine, clozapine
lowest risk: aripiprazole, ziprasidone
-monitor BMI monthly
-fasting glucose, lipids, BP, waist circumference at baseline, 3 months, and yearly

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14
Q

kidney and thyroid tests for pts taking this mood stabilizer

A

Li

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15
Q

QT prolongation associated with this 2nd gen APD

A

ziprasidone (Geodon)

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16
Q

hyperprolactinemia occurs with first gen APDs and this second gen

A

risperidone

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17
Q

somatic symptom disorder

how to handle these pts

A

one or more sxs that cause distress or significantly disrupt daily life, have excessive thoughts of behaviors related to these sxs, and have persistent sxs for > 6 months
-regularly scheduled appointments intended to reduce their underlying psychological distress

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18
Q

impairment resulting from perfectionism and the need to complete tasks meticulously

A

OCPD

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19
Q

for depression in patients with a short life span, you can give __________ as these take longer to achieve their effect

A

stimulants (methylphenidate, modafinil)

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20
Q

treatment for acute mania

A
  • first and second gen antipsychotics
  • Li (avoid in renal disease)
  • depakote (avoid in liver disease)
  • carbamazepine (can increase metabolism of other drugs)
  • combos (ex. APDs + Li or depakote) in severe mania
  • adjunctive benzos for insomnia, agitation
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21
Q

lamictal is used in bipolar under what circumstance

A

treatment of depression in pts with bipolar

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22
Q

how to tx conversion d/o

A

education and support –> CBT is second line

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23
Q

drugs for OCD

A 
clomipramine (TCA)
fluoxetine
fluvoxamine
paroxetine
sertraline
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24
Q

you must inform the health department about positive HIV and TB tests (T/F)

A

T

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25
Q

imaging finding in autism

A

increased brain volume

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26
Q

imaging finding in OCD

A

abnormalities in orbitofrontal cortex and striatum

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27
Q

imaging finding in panic disorder

A

decreased volume of amygdala

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28
Q

imaging finding in PTSD

A

decreased hippocampal volume

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29
Q

imaging finding in schizophrenia

A

enlargement of cerebral ventricles

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30
Q

if health care proxy disagrees with living will, first do this and then do this if the first thing doesn’t work

A
  1. discuss the situation with the proxy and other family

2. consult hospital ethics committee

31
Q

tx for trichotillomania

A

CBT (habit reversal training)

32
Q

maintenance tx recommendations for bipolar

A

1 episode: therapy for at least 1 year (maybe 2)
2 episodes: long term (year) if not indefinitely, esp if episodes were severe or there is a family history
3: lifetime maintenance therapy

33
Q

nervousness, loss of appetite, nausea, abdominal pain, insomnia, tachycardia are side effects of _____

A

methylphenidate

34
Q

prolonged methylphenidate use for ADHD has shown to cause growth ________

A

retardation or weight loss

35
Q

tx for panic disorder

A

SSRI/SNRI and/or CBT

36
Q

common comorbidities of panic disorder

A

depression, agoraphobia, substance abuse, suicide, bipolar

37
Q

buspirone is used to treat both GAD and social anxiety disorder (T/F)

A

F

it’s only used for GAD

38
Q

visual hallucinations and perceptual intensification are hallmarks of __________ intoxication

A

LSD

39
Q

tx for akathisia

A

propranolol

40
Q

how to tx drug induced parkinsonism

A

anticholinergic or amantadine (DA agonist)

41
Q

bupropion (wellbutrin) should not be given to ppl with ______

A

seizures (epilepsy, alcohol or benzo use, eating disorders)

42
Q

MOA of bupropion

A

inhibits reuptake of NE, DA, and 5-HT

-good for concentration and energy

43
Q

which atypical antipsychotic is most likely to cause EPS?

which is least likely?

A

risperidone

clozapine is the atypical that is least likely to cause EPS

44
Q

parents have the right to refuse life saving treatment for their children (including refusal for religious reasons)
T/F

A

F
parents CANNOT refuse life saving tx for their children
-as the physician, you should get a court order
-if it’s an emergency situation, you can go ahead and tx the child w/o the court order

45
Q

this typical APD is associated with jaundice

A

chlorpromazine

46
Q

cataracts are associated with this atypical APD

A

quetiapine

47
Q

clozapine can cause this neuro disorder

A

lowers the seizure threshold

48
Q

frequent comorbidities of tourette’s

A

ADHD, OCD

49
Q

immediate tx of panic attack

A

benzo

50
Q

tx for anorexia nervosa

A

CBT, nutritional rehab, olanzapine as last resort

51
Q

tx for bulimia

A

CBT, nutritional rehab, SSRI

52
Q

when to hospitalize anorexia patients

A

dehydration, electrolyte distrubances (hypoK, hypophos), bradycardia, severe weight loss

53
Q

when making anorexics eat, watch out for this

A

refeeding syndrome: electrolyte depletion, arrhythmia, heart failure

54
Q

only the patient or a personal representative can request medical records (T/F)

A

T

-the spouse can’t do it… the patient must submit the request herself

55
Q

in alcoholic hallucinosis, ppl hallucinate but ______ and ______ are intact

A

sensorium and vitals

56
Q

SSRIs (4)

A

citalopram
fluoxetine
paroxetine
sertraline

57
Q

SNRIs (3)

A

duloxetine (cymbalta)
venlafaxine (effexor)
desvenlafaxine (pristiq)

58
Q

TCAs (4)

A

amitriptyline (Elavil)
clomipramine (Anafranil)
doxepin (sinequan)
nortriptyline (Pamelor)

59
Q

MAOIs (2)

A

phenelzine (Nardil)

tranylcypromine (Parnate)

60
Q

other antidepressants not SSRI, SNRI, TCA, or MAOI

A

bupropion (wellbutrin)
mirtazapine (remeron)
trazodone (desyrel)

61
Q

if not responsive to one SSRI, what do you do next?

A

try another SSRI

if still doesn’t work, then consider switching classes

62
Q

how to tx hoarding

A

SSRI and CBT

63
Q

tx for narcolepsy

A

maintain proper sleep schedule, avoid alcohol/benzos
*novel stimulants: modafinil, armodafinil <– these are preferred
amphetamine stimulants: methylphenidate
sodium oxybate

64
Q

pramipexole MOA and uses

A

DA agonist

Parkinson’s and RLS

65
Q

pt with anorexia is at risk for what if she wants to have a baby

A

premature or small for gestational age baby
miscarriage
hyperemesia gravidarum
postpartum depression

66
Q

clinical findings in anorexia

A 
osteoporosis
elevated cholesterol and carotene levels
cardiac arrhythmias 
euthyroid sick syndrome
HPA dysfunction
hyponatremia
67
Q

risk of bipolar:

  • in general population
  • father or mother
  • father and mother
  • MZ twin
A

general: 1%
father or mother: 5-10%
father and mother: 60%
MZ twin: 70%

68
Q

introjection defense mechanism

A

assimilating another person’s attitude into one’s own perspective

69
Q

tx response is defined as a _______ reduction in the baseline level of severity

A

50%

70
Q

night terrors occur during REM sleep (T/F)

A

F

71
Q

sleep walking occurs during REM (T/F)

A

F

72
Q

these are important in ADHD dx

A

teacher evaluations

73
Q

tx for kleptomania

A

CBT (meds don’t do much)

Psychiatry (4 decks)

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