UWorld Flashcards
Intoxication
- Violent w nystagmus
- visual hallucination
- chest pain and seizures
- tooth decay
- increased appetite, impaired time perception, conjunctival injection
- depressed mental status, miosis, respiratory depression
- PCP
- LSD
- cocaine
- meth
- cannabis
- heroin
Time durations
- adjustment disorder
- GAD
- brief psychotic vs. schizophreniform vs. schizophrenia
- schizoaffective
- delusional
- acute stress
- specific phobias
- hypomania
- mania
- depression
- selective mutism
- hospice
- cyclothymic / dysthymic
- social anxiety
- onset within 3 mo
- > 6mo
- 1mo vs. 6mo
- > 2wk of psychosis w/o mood
- > 1 mo
- 4 wks
- 6mo
- > 4d
- > 7d
- > 2wks
- 1mo
- 2 yrs for adults, >1 yr for children
- > 6mo
Personality disorders
- Loner
- Fantastical
- Distrustful
- Dramatic
- Self-important
- Childhood conduct disorder + lacks empathy / problems w the law
- Unstable
- Perfectionist
- hypersensitive to criticism
- clingy
Cluster A: Weird / Mad
- schizoid
- schizotypal
- paranoid
Cluster B: Wild / Bad
- Histrionic
- Narcissistic
- Antisocial
- Borderline
Cluster C: Worried / Sad
- obsessive-compulsive
- avoidant
- dependent
Medication side effects
- hyperprolactinemia
- nephrogenic DI, thyroid dysfunction, hyperparathyroidism
- pigmentary retinopathy
- cataracts
- antipsychotics (2/2 dopamine blockade)
- Li
- thioridazine
- quetiapine
Drug choices
- AD
- OCD
- Tourette
- Anorexia nervosa
- Bulimia
- Acute mania
- GAD
- performance anxiety
- panic
- cholinesterase inhibitors (donepezil, rivastigmine, galantamine)
- SSRIs or clomipramine
- antipsychotics, a-adrenergic agonists (clonidine, guanfacine)
- Olanzapine
- SSRI
- risperidone + Li
- SSRI
- benzo or propranolol
- benzo for acute, SSRI for long term
Therapy choices
- Relationships / grief (e.g. marriage counselling)
- pyschosis / cognitive impairment
- high functioning patterns of dysfunction / Neuroticism
- substance use
- maladaptive thoughts / behavior (e.g. Kleptomania, avoidance)
- Borderline / self harm
- Somatization
- GAD
- adjustment disorder
- interpersonal psychotherapy (current relationships)
- Suppottive psychotherapy (build up defense mechanisms)
- Pyschodynamic psychotherapy (past relationships, uses transference, break down defense mechanisms)
- Motivational interviewing (addresses ambivalence to change)
- CBT
- DBT
- Biofeedback
- CBT
- pyschodynamic
Defense mechanisms
- bad feeling -> bad behavior
- pretends badness does not exist
- yelled at by boss -> yells at his secretary
- disrupted identity
- altered perception of reality
- substitutes w imaginary scenarios
- ruminates over fact details to avoid feelings
- separating thought from emotions
- covert hostility
- attributes own feelings to others
- justifying behavior
- thought -> opposite action
- reverts to earlier development
- no conscious recollection of bad feelings
- bad feeling -> physical symptoms
- seeing others as all good or all bad
- bad feeling -> helps others
- joking
- bad impulse -> acceptable behavior
- Ignores bad feelings
- acting out
- denial
- displacement
- dissociation
- distortion
- fantasy
- intellectualization
- isolation of affect
- passive aggressive
- projection
- rationalization
- reaction formation
- regression
- repression
- somatization
- splitting
- altruism
- humor
- sublimation
- suppression
Med side effect reversal
- acute dystonic
- Parkinsonian
- akathisia
- NMS
- priapism
- benzo tox
- Li tox
- tardive dyskinesia
- benztropine, diphenhydramine, trihexyphenidyl, biperiden
- benztropine, diphenhydramine, amantadine, levodopa
- lorazepam, propranolol
- Dantrolene, bromocriptine
- NE into corpus of penis
- flumazenil
- dialysis
- stop med, switch to clozapine
Med side effects
- clozapine
- 2nd gen antipsychotics (olanzapine, clozpine, aripiprazole, ziprasidone)
- Buproprion
- agranulocytosis, seizure
- metabolic syndrome
- seizure
patient on clozapine develops psychotic symptoms -> which substance use?
smoking -> induces CYP450 -> lowers clozapine levels
Withdrawal
- low energy, hypersomnia, increased appetite
- mydriasis, gooseflesh, rhinorrhea, muscle aches
- cocaine / meth
2. opiod
Neuroimaging findings
- Autism
- OCD
- Panic
- PTSD
- schizophrenia
- increase total brain vol
- abnormal orbitofrontal cortex & striatum
- decreased amygdala
- decreased hippocampal vol
- enlarged ventricles
conflict between living will and proxy -> ?
talk w proxy and family member -> ethics
mgmt of folie a deux?
interview separately
duration of tx for 3 episodes of acute mania
lifetime
panic disorder associated w?
MDD and agoraphobia
Bipolar in general population? In people w first degree family hx?
1% vs. 10%
when to up the dose of SSRIs?
in 4-6 wks; none before even if they don’t feel better
med effects on DA pathways
- mesolimbic
- nigrostriatal
- tuberoinfundibular
- antipsychotic
- EPS
- hyperPRL