UWorld Psych Flashcards
Reaction formation
Neurotic defense mechanism - transformation of unwanted thought or feeling into its opposite
Atypical antipsychotic most likely to cause EPS?
Risperidone
First line treatment for mania
Antipsychotics and mood stabilizers
What has the greatest efficiacy in treating bipolar depressive episodes?
Lamotrigine
What is the most significant adverse effect of lamotrigine?
SJS
Symptoms must start within how many months in adustment disorder
3 months
Alcohol withdrawal
Starts within 12 and 48 hours after the last drink. Diaphoresis, seizures, tremors and hyperreflexia in the acute stage. Followed by hallucinosis. Followed by DT which usually occurs 2-4 days after last drink.
Heroin withdrawal looks like?
pupillary dilation, rhinorrea, muscle and joint aches, abdominal cramp, nausea and diarrhea. Sx are severe and out of proportion to physical findings. Not life threatening.
Hoarding disorder tx?
CBT and SSRIs have shown to be effective
Kleptomania clinical features
rare IMPULSE CONTROL DISORDER with typical onset at adolescence, repetitive failure to resist impulses to steal, stolen objects have little value, increasing tension prior to theft, pleasure or relief when committing theft, stolen objects given away, discarded or returned.
Kleptomani tx
CBT
What are the two subtypes of social anxiety disorder?
Dx of social anxiety disorder = anxiety about 1 or more social situations for greater than 6 months, fear of scrutiny by others, humiliation or embarassement, social situations avoided or endured with intense distress, marked impairment (social, academic, occupation). GENERALIZED social anxiety disorder = meeting new people, initiating and maintaing conversations, being observed by others, going to party. PERFORMANCE ONLY - public speaking or presentations/performance.
Social anxiety disorder (phobia) tx differences between 1) generalized and 2) performance only
1) SSRI/SNRI and CBT 2) Benzos, propanolol 30 minutes before ppt and CBT
What are the 2 components of an advance directive
1) Living will and 2) Durable power of attorney. If living will and power of attorney conflict and can’t be resolved through discussion, hospital ethics committee consult is then next best step.
Buspirone is used to treat what kind of anxiety disorder
GENERALIZED anxiety disorder and NOT social anxiety disorder
Selective mutism
Verbal and talkative ta home but refuse to speak in specific settings, for example at school
What is the firs tline treatment for bipolar disorder?
Atypical Antipsychotics, lithium, valproate. For mild to moderate - atypical or lithium or valproate as monotherapy. For more severe, atypical + lithium or valproate
% risk of developing bipolar disorder if first degree relative has it?
5-10%
% risk of developing BPAD if 1) both parents have it and 2) if monozygotic twin has it?
60% and 70%. Lifetime risk = 1%
What kind of medication is benztropine
Anti-cholinergic meds. Would help EPS symptoms
Remission
Absence of minimal symptoms with return to patient’s premorbid functioning or wellness. Patient no longer meets diagnostic criteria for illness
Treatment response
Patient demonstrates significant improvement with or without remission, generally definied as 50% reduction in baselien of severity
Recovery
Episode is over. Presents option fo patient either discontinuing medication or continuing maintenance therapy with goal of preventing new episode
What is clonidine
Alpha adrenergic receptor agonists
How is Tourette disorder treated?
Antipsychotics and habit reversal training. Haldol and pimozide are approved by FDA but atypicals increasingly used due to metabolic profile.
How is body dysmorphic disorder best treated?
Psychotherapy and meds (SSRIs)
Common findings in anorexic patients
OSTEOPOROSIS, ELEVATED cholesterol and carotene levels, cardiac arrythmias (prolonged QT interval), hyponatremia secondary to drinking excess water 5) hypothalamic pituitary axis dysfunction =? Amenorhea
Tx for panic attacks
acute treatment: benzos. Long term tx: SSRIs/SNRIs and cognitive therapy
Cannabis intoxication?
Usually euphoria, conjunctival injection, dry mouth, increased appetitie, tachycardia. Can also have dysphoria, panic attacks, psychomotor retardation. Impaired perception of time,
What are the baseline studies needed before lithium initiation?
Urinalysis, calcium, creatinine/kidney function and thyroid function tests, EKG in patients with cardiac risk factors
Contraindications for lithium
Chronic kidney disease, cardiac disease, hyponatremia or diuretic use.
Side effects of lithium
Short term - GI (N/V), weight gain, cognitive impairment, tremor, ataxia, weakness. Chronic: nephrogenic DI, hyperparathyroidism with hypercalcemia, thyroid disfunction
Panic disorder co-morbidities
Agoraphobia, major depression, bipolar disorder, substance abuse. Also linked to higher SI or SA
Cardinal features of NMS
hyperthermia, autonoic instability, muscular ridigity, altered sensorium, elevated CPK. Rhabdomyolysis, followed by myoglobinuria that causes acute renal failure is a known complication.
NMS occurs due to tx with what?
Dopamine antagonists. Therefore can occur with antipsychotics.
Dopamine agonist?
Bromocriptine
Naloxone is used to treat?
Opioid overdose
Physostigmine is used to treat?
Reverse CNS toxic effects caused by anticholinergic drugs
NMS is treated with?
Dantrolene (muscle relaxant) and supportive care
Modafinil is used to treat?
Narcolepsy
Beneficial side effect of bupropion
Smoking cessation
