uworld psychiatry Flashcards
what is the def of delusional disorder
≥1 delusion for ≥1 month
what are the treatments for delusional disorder
antipsychotics or CBT
what is the treatment of neuroleptic malignant syndrome
discontinue the antipsychotic; dantrolene or bromocriptine
can you treat extrapyramidal while simultaneously treating psychotic features with the antipsychotic or do you have to discontinue the antipsychotic
you can treat them simultaneously
what is the treatment for acute dystonia
benztropine and diphenhydramine
what is acute dystonia
sudden sustained contractions of the neck, mouth, tongue, and eye muscles
what is akathisia
subjective restlessness and the inability to sit still
what is the treatment for akathisia
beta blocker (propanolol), benztropine, benzodiazepine (lorazepam)
what is the treatment for Parkinsonism
benztropine and amantidine
what is tardive dyskinesia
gradual onset of dyskinesia of the mouth, face, trunk and extremities
what is the treatment for tardive
valbenazine, deutetrabenazine.
what is illness anxiety disorder
excessively concerned about an illness or general medical condition despite no medical evidence for it
what is somatic symptom disorder
excessive anxiety and thoughts about a serious illness of at least one somatic symptom.
what is the treatment for psychosis induced from antiparkinson meds
reduction of antiparkinson meds, medication substitutes, low-potency antipsychotics such as quetiapine
what antipsychotics would worsen parkinsonism
risperidone and haloperidol
what is the treatment for acute mania with psychotic features
to protect staff lorazepam
what are the SE of lithium
tremor, DI, hypothyroidism/hyperthyroidism
what is schizotypal
magical thinking, suspiciousness, paranoid ideation, but no frank delusion, general paranoia and idiosyncratic thinking.
schizoid personality
loners, detached, often lack close friends, they do not want them. no odd thinking or perceptual distortions
what is an essential feature of antisocial personality disorder
conduct disorder prior to 15
antisocial personality disorder
physically aggressive, impulsive, repeated fights, manipulation for personal gain, illegal activities (theft, illegal drug use), failure to take responsibility, lack of remorse, arrogant self-appraisal
losing semen while urinating is an south asian thing for
Dhat syndrome.
what is a SE of clozapine
seizures, neutropenia and myocarditis
what can be added to antidepressant therapy to increase energy and cause weight loss.
bupropion is safe as adjuvant therapy
postpartum blues resolve within
two week postpartum
when does mild alcohol withdrawal occur and what are the symptoms
perspiration, insomnia, tremors, anxiety, GI upset, palpations
6-24 hours since last drink
when do seizures from alcohol withdrawal occur
12-48 horus
when does alcoholic hallucinosis occur
12-48 hours
when does delirium tremens occur
48-96
what are the symptoms of delirium tremens
confusion, agitation, fever, tachycardia, hypertension, diaphoresis, hallucinations
PTSD
exposure to life threatening trauma, nightmares, flashbacks, intrusive memories, avoidance of reminders, dissociation, emotional detachment, negative mood, decreased interest in activity, sleep disturbance, hypervigilance, duration ≥1 month
treatment for PTSD
SSIRs trauma focused CBT
adjustment disorder
≤6 months after a stressor
treatment for akathisia
reduce the antipsychotic and provide beta blocker, benzotropine, benzodiazepine
binge eating disorder
recurrent episodes of binge eating, no inappropriate compensatory behaviors, lack of control during eating
bulimia nervosa
recurrent episodes of binge eating, with inappropriate compensatory behaviors, excessive worry about body shape and weight.
body dysmorphic disorder
excessive preoccupations with minor or nonexistent defects in physical appearance
what is the treatment of choice for ADHD in adults for non-stimulant meds
atomoxetine
what is a non-stimulant med for ADHD in children and adolescents
clonidine
dissociative identity disorder
discontinuity in identity and loss of personal agency with fragmentation into two distinct personality states. associated with severe trauma or abuse.
dissociative amnesia
inability to recall autobiographical information. localized or selective amnesia typically after sudden and preceded by overwhelming events or intolerable events
transient global amnesia
anterograde amnesia for time and place. There is no loss of identity. typically lasts for 24 hours
depersonalization/derealization disorder
feelings of detachment from or being outside of ones self. experiencing surroundings as unreal. intact reality testing
name two MAOIs
phenelzine and tranylcypromine
reactive attachment disordre
extremem outcome of early childhood abuse which results in lack of emotional responsiveness and the absence of comfort seeking from caregivers
does lithium cause hepatotoxicity
no
what are the SE of valproate
hepatotoxicity, fine tremor, nausea, vomiting. thrombocytopenia and alopecia
what can cause lithium toxicity
dehydration, use of thiazide diuretics, NSAIDs, ACE inhibitors
what are the most common SE of fluoxetine
nausea, insomnia and headache
what lab test is associated with suicidal behavior
low CSF 5-HIAA
treatment for lithium toxicity
dialysis
what parameters require dialysis for lithium toxicity regardless of the symptoms
lithium greater 4, creatinine greater than 2
what are the symptoms of inhalant abuse
nausea/upset stomach, perioral dermatitis, tremor, disorientation, headaches, slurred speech, hallucinations, arrhythmias, wheezing and coughing, irritability, mood swings, aggression, grandiosity, weight loss, anorexia, decreased reflexes, peripheral neuropathy, cerebellar dysfunction
what changes in sleep patterns are found in people with depression
sleep disturbance is a core feature of depression. difficulty falling asleep, interrupted sleep, early morning awakening, hypersomnia, decreased latency to REM, decreased slow wave sleep. increased cortisol levels
are sleep changes in depression normalized with antidepressants
yes
normal grief reaction
normal reaction to loss, sadness with thoughts more specific to the loss person, waves of grief at reminders, self-esteem usually preserved, functional decline not as pronounced as MDD, intensity that decreases over time. thoughts of suicide to join loved one are rare.
what is monitored with olanzipine
fasting blood glucose
what medication treats both depression and diabetic neuropathy
duloxetine SNRIs can treat bothj
rapid eye movement sleep behavior disorder
complex motor behaviors that occur while sleeping. acting out dreams/nightmares.
this is associated with neurodegeneration in older males.
what is cyclothymic disorder
a lesser degree of bipolar, but on the same spectrum. will also share many features of borderline personality disorder, but will not continue the behaviors in that groups either. long persistent issues with fluctuating mood
somatic symptom disorder
excessive anxiety ≥1 unexplained symptom.
conversion disorder
neurological disorder incompatible with known disease
illness anxiety disorder
fear of having a serious illness despite few or no symptoms and consistently negative evaluations
what drug can cause hypercalcemia
lithium can cause hyperparathyroidism and hypercalcemia
what is the presnetation of panic disorder
recurrent unexpected panic attacks worry about additional attacks and avoidance behavior
what is the treatmetn for panic disorder
first line maintenance is SSRI/SNRI or CBT
acute distress is benzodiazepine.
what is the pathophysiology of tardive dyskinesia
dopamine receptor supersensitivity
what is the def of MDD
≥ 2 weeks of symptoms
what does increased sensitivity to lactate infusion indicate
panic attacks
what is the treatment for binge eating disorder
SSRIs
how does cocaine withdrawal present
depression, increased dreaming, hyperphagia, impaired concentration, intense drug craving, fatigue, depression, hypersomnia
what can give a false positive for phencyclidine on drug screening
dextromethrophran
what is the treatment for somatic symptom disorder
reassurance and close follow up
what is the treatment for body dysmorphic disorder
SSRIs
what is the treatment of choice for illness anxiety disorder
reassurance and close follow up
can prednisone induce psychosis
yes
what is the treatment for catatonia
benzodiazepine
what is the treatment for catatonia
benzodiazepine
