UWorld Flashcards
Rx for antipsychotic-induced Parkinsonism
benztropine (anticholinergic)
Rx of neuroleptic malignant syndrome
dantrolene (muscle relaxant)
Rx of antipsychotic-induced akithisia
propanolol
intentional falsification of disease with the goal of assuming the sick role; when questioned, leave AMA
factitious disorder
motor or sensory neurologic deficits after stressor, not intentionally produced, labelle indifference
conversion disorder
excessive anxiety and preoccupation with the potential of having a serious undiagnosed disease, nonspecific symptoms not produced intentionally
illness anxiety disorder/somatic symptom disorder
intentional production of symptoms motivated by secondary gain
malingering
contraindications to Li use
CKD, heart disease, hyponatremia or diuretic use
baseline studies for Li use
check Ca, renal function, thyroid function, CV function
BUN, creatinine, Ca, urinalysis, TFTs, EKG if coronary risk factors
acute SE of Li
GI, tremor, weight gain, cognitive impairments
chronic SE of Li
nephrogenic DI, thyroid dysfunction, hyperPTH
maintenance therapy for bipolar a/f 1 episode, a/f 2 episodes, a/f 3 episodes
a/f 1 episode at least a year, a/f 2 episodes at least years/lifetime, a/f 3 episodes lifetime
if bipolar maintenance of Li is failing
add an atypical antipsychotic
first line treatment for specific phobia
CBT
fearful of scrutiny of others
social anxiety disorder
eye movement desensitization and retracking is used for
PTSD
Rx of GAD
buspirone
SSRIs used in Rx of anxiety disorders
fluoxetine and venlafaxine
NT most affected in OCD
serotonin
Rx OCD
fluoxetine, fluvoxamine, paroxetine, sertraline (SSRI), clomipramine (TCA)
Rx bipolar disorder
atypical antipsychotics, Li, Valproic Acid
amitriptylene class
TCA
amitriptylene SE
orthostatic hypotension, cardiotoxicity w/ overdose
Rx panic disorder (immediate and long term)
immediate: benzos
long term: SSRI, SNRI, CBT
panic disorder comorbidities
MDD, substance abuse, agoraphobia, bipolar
also higher risk of suicide
indecisive, clingy, fear of being alone, submissive behavior
dependent PD
HA, fatigue, insomnia a/f a big life change and w/ tearfulness
depression
antipsychotic SE of agranulocytosis
clozapine
antipsychotic SE of cataracts
quetiapine
antipsychotic SE of pigmentary retinopathy
thioridazine
antipsychotic SE of jaundice
chlorpromazine
Rx of adjustment disorder
cognitive of psychodynamic psychotherapy
screening tests needed when starting Li
kidney and thyroid function tests
antipsychotic with SE of hyperprolactinemia
risperidone
antipsychotics with worse metabolic SE
olanzapine and clozapine
drug intoxication with nystagmus and ataxia
PCP
acute intoxication with visual hallucinations
LSD
acute intoxication with chest pain and seizures, mydriasis
cocaine
acute intoxication with increased appetite, impaired time perception, conjunctival injection
marijuana
acute intoxication with depressed mental status, miosis, respiratory depression
heroin
chronic marijuana use SE
gynecomastia
respiratory depression, pinpoint pupils, CND depression
opioid overdose
violent behavior, agitation, dissociation, acute intoxication
PCP
a/f administration of haloperidol, fever, rigidity, mental status changes, autonomic instability
Neuroleptic malignant syndrome (NMS)
chronic low grade depression that lasts for at least 2 years
persistent depressive disorder (dysthymia)
Rx of dysthymia
antidepressants and/or therapy
anticholinergic agent used to treat EPS SE of antipsychotics
benztropine
Rx of NMS
dantrolene, amantadine, bromocriptine
Rx opiod overdose
naloxone
Rx SE of akathisia
propanolol
Rx hypochondriasis
discuss emotional stressors, brief psychotherapy
Rx performance social anxiety disorder
propanolol (beta blocker) or benzo (if no substance use issues) or CBT
Rx generalized social anxiety disorder
SSRI/SNRI or CBT
SE dietary restriction, risk of hypertensive crisis
phenelzine (MAOI)
SSRI for moderate-severe depression ineffective, next step
switch to another SSRI
SSRI for moderate-severe depression ineffective, switch to other SSRI also ineffective, next step
switch class of antidepressants
Rx narcolepsy
modafinil, armodafinil, amphetamine stimulants, sodium oxybate
Rx dystonia
benztropine of diphenhydramine
MAOI + tyramine rich foods has a risk of
hypertensive crisis
Rx for treatment-resistant schizophrenia or schizophrenia associated with suicidality
clozapine, must monitor for agranulocytosis
age-related sleep changes
less sleep, frequent awakenings, less stage 4 sleep
anorexia BMI cutoff
Rx anorexia (medicine)
olanzapine
Rx bulimia (med)
SSRI
agitation, irritability, paranoia, delirium, tachy, hypertension, diaphoresis, mydriasis
amphetamine intoxication
mydriasis, hyperthermia, tachy, HTN, dry skin and mucous membranes, myoclonic jerks and tremors, ileus, urinary retention
anticholinergic poisoning