UWORLD Flashcards
anxiety, insomnia, perceptual disturbances, tachycardia, seizures, psychosis - withdrawal from what?
benzos
agitation, tremors, tachycardia, HTN, possible progression to seizure and DT - withdrawal from what?
give what three things?
alcohol withdrawal
benzos, anticonvulsants, thiamine
Diagnosis of ADHD requires what:
presence of symptoms before age of TWELVE and SIX or more inattentive or hyperactive symptoms.
Dx of adjustment disorder with depressed mood.
Within 3 months of identifiable stressor with significant functional impairment and marked distress (v. normal sadness)
Time frame for GAD.
6 or more months
unstable and intense relationships, anger, self-destructive behavior - what personality disorder?
borderline PD
hypomania ad major depression
bipolar 2
dx/criteria od MDD
5+ sx for 2+ weeks: SIG E CAPS - depressed mood, sleep disorder, interst deficient (anhedonia), guilt, eergy-less,
hypotension, tachycardia, dry skin, menstrual irregularities, hypokalemia, elevated pancreatic enzymes
Bulemia Nervosa
tx for AN and BN
CBT, fluoxetine (SSRI), nutritional rehab
prominent mood symptoms and mania
Bipolar 1
treatment of treatment-resistant schizophrenia
clozapine
MOA of PCP
NMDA receptor antagonist, leading to excess release of excitatory neurotransmitters. (hallucinogen)
delusions or halllucinations for more than 2 weeks in absence of major depressive or manic episodes. Mood sx preset for majority of illness.
schizoaffective disorder
schizophrenia has absence of mood sx for most of illness
difference bw schiphrenia and schizoaffective
schizophrenia has NO mood symptoms at any point (no mania or depression)
psychosis and mood together v. delusions and hallucinations WITHOUT mood
bipolar and MAD (w/ mood sx) v. schizoaffective disorder (w/o mood sx for at least 2 weeks - only schizo hallucinations during this time, NO MOOD)
tx of GAD
SSRI (NOT benzos)
define schizophrenia criteria for dx
2 or more sx for 1 or more months (w/o tx) and more than one sx (delusions, hallucinations, disorganized speech)
continual disturbance for 6+ mo
two drugs to slow demenita
donepezil (AChE inhibitor) and memantine (NMDA inhibitor)
Never give elderly what type of drug?
Avoid anticholinergic medications which can impair cognitive function, ESPECIALLY in ELDERLY, (i.e. Benadryl , hydroxyzine***)
Black box warning for what antipsychotics (for dementia + psychosis)
olanzapine (Zyprexa), aripiprazole (Abilify), risperidone (Risperdal), or quetiapine - double risk of death!
Medication examples for tx of med addiction in elderly.
- Naltrexone –opiate antagonist to reduce cravings
- Buprenorphine, Benzodiazepines (i.e. valium/Diazepam taper)
Hill’s DoC for geriatric depression
nortryptaline
CHASE
dysthymia (progressive depressive disorder)
Concentration Hopelessness Appetite SELF ESTEEM Energy
more than 2 years with no more than 2 mo WITHOUT symptoms
SIG E CAPS
Major Depressive Episode
Sleep
I…INTEREST LOSS
Guilt
Energy
Concentration
Appetite
P… PSYCHOMOTOR RETARDATION/AGITATION
Suicide
Episode = more than 2 weeks of 5/9 characteristics
DIG FAST
Mania:
Distractibility
Irresponsibility
Grandiosity - inflamed self esteem
Flight of ideas
Activity
Sleepless
Talkativeness - pressured speech
Episode = 1 or more weeks (BP1 is manic only, BP2 is hypomanic and Major Depressive Episode)
define cyclothymia
greater than two years of mild depression and hypomania sporadically (essentially dysthymia with intermittent hypomania)
tx for OCD (and 2nd line for BN)
fluvoxamine
tx for BN (1st line)
fluoxetine
give what three things for opioid withdrawal (intox = pinpoint pupils)?
buprenorphine, naltrexone, methadone.
Give what three thigns for alcohol addiction?
Naltrexone, acamprosate, disulfram
What drug intoxication is this: illusions, hyperacusis, sensitivity of touch, taste/ smell altered, “oneness with the world”, tearfulness, euphoria, panic, paranoia, impairment judgment
MDMA
Teeth grinding
MDMA - what receptor does it target?
5HT2 receptor agonist
What drug intoxication is this:
Dissociative anesthetic
Similar to Ketamine used in anesthesia
Intoxication: severe dissociative reactions – paranoid delusions, hallucinations, can become very agitated/ violent with decreased awareness of pain.
Cerebellar symptoms - ataxia, dysarthria, nystagmus (vertical and horizontal)
With severe OD - mute, catatonic, muscle rigidity, HTN, hyperthermia, rhabdomyolsis, seizures, coma and death
PCP
PCP - what receptor does it target and what is the overdose treatment?
What is its withdrawal like?
NMDA receptor
benzos or antipsychotics
No tolerance or withdrawal!!!
BMI for AN
less than 18.5
Manic v. hypomanic - defining difference
manic has psychotic features, 1 week
hypomanic does not have psychotic features, greater than four days
