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UWorld Flashcards

1
Q

Intoxication

  1. Violent w nystagmus
  2. visual hallucination
  3. chest pain and seizures
  4. tooth decay
  5. increased appetite, impaired time perception, conjunctival injection
  6. depressed mental status, miosis, respiratory depression
A
  1. PCP
  2. LSD
  3. cocaine
  4. meth
  5. cannabis
  6. heroin
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2
Q

Time durations

  1. adjustment disorder
  2. GAD
  3. brief psychotic vs. schizophreniform vs. schizophrenia
  4. schizoaffective
  5. delusional
  6. acute stress
  7. specific phobias
  8. hypomania
  9. mania
  10. depression
  11. selective mutism
  12. hospice
  13. cyclothymic / dysthymic
  14. social anxiety
A
  1. onset within 3 mo
  2. > 6mo
  3. 1mo vs. 6mo
  4. > 2wk of psychosis w/o mood
  5. > 1 mo
  6. 4 wks
  7. 6mo
  8. > 4d
  9. > 7d
  10. > 2wks
  11. 1mo
  12. 2 yrs for adults, >1 yr for children
  13. > 6mo
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3
Q

Personality disorders

  1. Loner
  2. Fantastical
  3. Distrustful
  4. Dramatic
  5. Self-important
  6. Childhood conduct disorder + lacks empathy / problems w the law
  7. Unstable
  8. Perfectionist
  9. hypersensitive to criticism
  10. clingy
A

Cluster A: Weird / Mad

  1. schizoid
  2. schizotypal
  3. paranoid

Cluster B: Wild / Bad

  1. Histrionic
  2. Narcissistic
  3. Antisocial
  4. Borderline

Cluster C: Worried / Sad

  1. obsessive-compulsive
  2. avoidant
  3. dependent
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4
Q

Medication side effects

  1. hyperprolactinemia
  2. nephrogenic DI, thyroid dysfunction, hyperparathyroidism
  3. pigmentary retinopathy
  4. cataracts
A
  1. antipsychotics (2/2 dopamine blockade)
  2. Li
  3. thioridazine
  4. quetiapine
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5
Q

Drug choices

  1. AD
  2. OCD
  3. Tourette
  4. Anorexia nervosa
  5. Bulimia
  6. Acute mania
  7. GAD
  8. performance anxiety
  9. panic
A
  1. cholinesterase inhibitors (donepezil, rivastigmine, galantamine)
  2. SSRIs or clomipramine
  3. antipsychotics, a-adrenergic agonists (clonidine, guanfacine)
  4. Olanzapine
  5. SSRI
  6. risperidone + Li
  7. SSRI
  8. benzo or propranolol
  9. benzo for acute, SSRI for long term
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6
Q

Therapy choices

  1. Relationships / grief (e.g. marriage counselling)
  2. pyschosis / cognitive impairment
  3. high functioning patterns of dysfunction / Neuroticism
  4. substance use
  5. maladaptive thoughts / behavior (e.g. Kleptomania, avoidance)
  6. Borderline / self harm
  7. Somatization
  8. GAD
  9. adjustment disorder
A
  1. interpersonal psychotherapy (current relationships)
  2. Suppottive psychotherapy (build up defense mechanisms)
  3. Pyschodynamic psychotherapy (past relationships, uses transference, break down defense mechanisms)
  4. Motivational interviewing (addresses ambivalence to change)
  5. CBT
  6. DBT
  7. Biofeedback
  8. CBT
  9. pyschodynamic
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7
Q

Defense mechanisms

  1. bad feeling -> bad behavior
  2. pretends badness does not exist
  3. yelled at by boss -> yells at his secretary
  4. disrupted identity
  5. altered perception of reality
  6. substitutes w imaginary scenarios
  7. ruminates over fact details to avoid feelings
  8. separating thought from emotions
  9. covert hostility
  10. attributes own feelings to others
  11. justifying behavior
  12. thought -> opposite action
  13. reverts to earlier development
  14. no conscious recollection of bad feelings
  15. bad feeling -> physical symptoms
  16. seeing others as all good or all bad
  17. bad feeling -> helps others
  18. joking
  19. bad impulse -> acceptable behavior
  20. Ignores bad feelings
A
  1. acting out
  2. denial
  3. displacement
  4. dissociation
  5. distortion
  6. fantasy
  7. intellectualization
  8. isolation of affect
  9. passive aggressive
  10. projection
  11. rationalization
  12. reaction formation
  13. regression
  14. repression
  15. somatization
  16. splitting
  17. altruism
  18. humor
  19. sublimation
  20. suppression
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8
Q

Med side effect reversal

  1. acute dystonic
  2. Parkinsonian
  3. akathisia
  4. NMS
  5. priapism
  6. benzo tox
  7. Li tox
  8. tardive dyskinesia
A
  1. benztropine, diphenhydramine, trihexyphenidyl, biperiden
  2. benztropine, diphenhydramine, amantadine, levodopa
  3. lorazepam, propranolol
  4. Dantrolene, bromocriptine
  5. NE into corpus of penis
  6. flumazenil
  7. dialysis
  8. stop med, switch to clozapine
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9
Q

Med side effects

  1. clozapine
  2. 2nd gen antipsychotics (olanzapine, clozpine, aripiprazole, ziprasidone)
  3. Buproprion
A
  1. agranulocytosis, seizure
  2. metabolic syndrome
  3. seizure
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10
Q

patient on clozapine develops psychotic symptoms -> which substance use?

A

smoking -> induces CYP450 -> lowers clozapine levels

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11
Q

Withdrawal

  1. low energy, hypersomnia, increased appetite
  2. mydriasis, gooseflesh, rhinorrhea, muscle aches
A
  1. cocaine / meth

2. opiod

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12
Q

Neuroimaging findings

  1. Autism
  2. OCD
  3. Panic
  4. PTSD
  5. schizophrenia
A
  1. increase total brain vol
  2. abnormal orbitofrontal cortex & striatum
  3. decreased amygdala
  4. decreased hippocampal vol
  5. enlarged ventricles
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13
Q

conflict between living will and proxy -> ?

A

talk w proxy and family member -> ethics

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14
Q

mgmt of folie a deux?

A

interview separately

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15
Q

duration of tx for 3 episodes of acute mania

A

lifetime

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16
Q

panic disorder associated w?

A

MDD and agoraphobia

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17
Q

Bipolar in general population? In people w first degree family hx?

A

1% vs. 10%

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18
Q

when to up the dose of SSRIs?

A

in 4-6 wks; none before even if they don’t feel better

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19
Q

med effects on DA pathways

  1. mesolimbic
  2. nigrostriatal
  3. tuberoinfundibular
A
  1. antipsychotic
  2. EPS
  3. hyperPRL
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20
Q

serotonin syndrome vs. HTN crisis

A

SSRI + MAOI vs. MAOI + tyramine foods

21
Q

DA pathways for + vs. - sx of schizophrenia

A

mesolimbic (too much DA) vs. mesocrotical (not enough)

22
Q

Pathology buzzwords

  1. NF tnagles, senile plaques
  2. spongiform
  3. neuronal loss in substantia nigra
  4. Lewy bodies
A
  1. AD
  2. CJD
  3. Parkinson’s
  4. Lewdy body dementia, Parkinson’s
23
Q

Imaging buzzwords

  1. bilateral caudate atrophy
  2. periventricular white matter lesions
  3. ventricular enlargement / diffuse cortical atrophy
  4. atrophy of frontotemporal lobes
A
  1. Huntington
  2. MS
  3. schizophrenia
  4. Picks/FTD
24
Q

medical complications of anorexia

A
  1. metabolic derangements esp hypokalemia -> EKG
  2. hypochloremic metabolic alkalosis
  3. low phosphorous w refeeding syndrome
  4. bradycardia and hypothermia
25
Q

confusion, lethargy, constipation, abd pain, polyuria

A

hypercalcemia

26
Q

med causes of hyponatremia

A

carabamazepine and SSRI (SIADH)

27
Q

alcohol withdrawal vs. postop delirium

A

2-3d after op vs. immediately after

28
Q

Medical causes of…

  1. pancreatic cancer
  2. lymphomas
  3. pheochromocytoma
  4. carcinoid
  5. RA
  6. HIV
  7. Wilson’s
  8. Parkinson’s
  9. Cushing’s
  10. acute intermittent porphyria
  11. Left frontal lobe lesions
  12. right frontal lobe
  13. COPD
  14. hypoglycemia
  15. cannabis
  16. long term alcohol
A
  1. depression
  2. depression
  3. anxiety (catecholamine)
  4. anxiety (serotonin)
  5. depression
  6. depression
  7. psychosis
  8. depression
  9. mania
  10. psychosis
  11. depression
  12. mania
  13. anxiety
  14. anxiety
  15. anxiety
  16. anxiety
29
Q

pharm causes of…

  1. IFN
  2. steroids
  3. parkinsonian meds (levodopa, amantadine)
  4. antiemetics (prochlorperazine, metoclopramide)
  5. anticholinergics (diphenhydramine, benztropine, oxybutynin)
  6. b-blockers
A
  1. depression
  2. depression, mania, psychosis
  3. pyschosis
  4. psychosis
  5. delirium
  6. depression
30
Q

indications

  1. buspirone
  2. clomipramine
  3. propranolol
  4. prazosin
  5. bupropion
  6. mirtazapine
A
  1. GAD (after SSRI)
  2. OCD (after SSRI)
  3. situational phobias
  4. PTSD nightmares
  5. smoking, depressed bipolar, sexual side effects from SSRI
  6. for weight gain, sexual side effects from SSRI
31
Q

Contraindications

  1. bupropion
  2. valproic acid
  3. carbamazepine
  4. Li
A
  1. seizure and eating disorder
  2. pregnancy (NT)
  3. pregnancy (NT)
  4. pregnancy, renal disease
32
Q

Labs

  1. pheochromocytoma
  2. Wilson
  3. Cushing
  4. SLE
  5. Carcinoid
  6. porphyria
  7. pseudoseizure
  8. MS
  9. CJD
  10. Guillain Barre
A
  1. urine VMA, metanephrines, catecholamines
  2. CP
  3. cortisol, dex suppression test
  4. ANA, anti-smith, anti-DNA
  5. 5-HIAA
  6. urine porphobilinogens/urobilinogens (includes d-ALA)
  7. PRL 10-20min after -> elevated in real seizures
  8. MRI, oligoclonal bands in CSF
  9. CSF for protein, EEG
  10. protein >45 w normal WBC in CSF
33
Q

differential for catatonia

A

mood, psychosis
encephalitis, seizure
NMS , serotonin

34
Q

agitation cocktails

A

5 haloperidol + 2 lorazepam + 1 benztropine / 50 diphenhydramine

35
Q

opioid u receptor antagonist

A

naloxone (Narcan)

36
Q

how long will urine tox remain + for marijuana?

A

1mo (stored in fat)

37
Q

cocaine vs. amphetamine mech?

A

DA reuptake inhibition vs. direct release of DA

38
Q

1st line tx

  1. MDD
  2. bipolar mania
  3. bipolar depression
  4. bipolar cycling
  5. schizophrenia
  6. delirium
  7. catatonia
  8. GAD
  9. panic
  10. PTSD
A
  1. SSRI + psychotherapy (interpersonal / CBT)
  2. Li; Li+risperidone if severe
  3. Li only
  4. valproic acid only
  5. antipsychotic
  6. high-potency antipsychotic (halo, fluphenazine)
  7. lorazepam
  8. SSRI -> buspirone
  9. Lorazepam + SSRI (then taper lorazepam)
  10. SSRIs
39
Q

postpartum blues vs. depression vs. psychosis

A

does not meet criteria for MDD (30%), resolves within 2 wks vs. MDD vs. psychosis

40
Q

premenstrual dysphoric disorder -> tx?

A

severe PMS -> SSRI during luteal phase

41
Q

Effects on fetus:

  1. Li
  2. Valproate
  3. Carbamazepine
  4. SSRIs
A
  1. ebstein
  2. NT
  3. NT
  4. pulmonary HTN and fussy babies
42
Q

Paraphilias

  1. frotteurism
  2. sadism
  3. masochism
A
  1. rubbing against strangers in crowded places (e.g. trains)
  2. pleasure from inflicting pain
  3. pleasure from receiving pain
43
Q

Sleep disorder

  1. restless legs: tx?
  2. night terrors: tx?
  3. narcolepsy: REM latency?
  4. circadian rhythm d/o: tx?
A
  1. pramipexole, ropinirole (-> pathological gambling and sleep atacks)
  2. no need to treat
  3. much faster onset of REM
  4. sleep hygiene
44
Q

anorexia vs. bulimia

A

low weight vs. normal weight

ego-syntonic vs. ego-dystonic

45
Q

depersonalization vs. derealization

A

self feels alien vs. surroundings feel alien

46
Q

pharm tx for conduct disorder? for conduct disorder w depression?

A

anti-psychotics; antipsychotics + antidepressants

47
Q

how long to achieve neg cocaine tox?

48
Q

tx for loose stools, n/v and muscle aches during opioid withdrawal

A

loperamide, promethazine, ibuprofen

Psych Shelf (4 decks)

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