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step II > uworld psychiatry > Flashcards

uworld psychiatry Flashcards

1
Q

what is the def of delusional disorder

A

≥1 delusion for ≥1 month

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2
Q

what are the treatments for delusional disorder

A

antipsychotics or CBT

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3
Q

what is the treatment of neuroleptic malignant syndrome

A

discontinue the antipsychotic; dantrolene or bromocriptine

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4
Q

can you treat extrapyramidal while simultaneously treating psychotic features with the antipsychotic or do you have to discontinue the antipsychotic

A

you can treat them simultaneously

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5
Q

what is the treatment for acute dystonia

A

benztropine and diphenhydramine

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6
Q

what is acute dystonia

A

sudden sustained contractions of the neck, mouth, tongue, and eye muscles

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7
Q

what is akathisia

A

subjective restlessness and the inability to sit still

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8
Q

what is the treatment for akathisia

A

beta blocker (propanolol), benztropine, benzodiazepine (lorazepam)

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9
Q

what is the treatment for Parkinsonism

A

benztropine and amantidine

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10
Q

what is tardive dyskinesia

A

gradual onset of dyskinesia of the mouth, face, trunk and extremities

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11
Q

what is the treatment for tardive

A

valbenazine, deutetrabenazine.

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12
Q

what is illness anxiety disorder

A

excessively concerned about an illness or general medical condition despite no medical evidence for it

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13
Q

what is somatic symptom disorder

A

excessive anxiety and thoughts about a serious illness of at least one somatic symptom.

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14
Q

what is the treatment for psychosis induced from antiparkinson meds

A

reduction of antiparkinson meds, medication substitutes, low-potency antipsychotics such as quetiapine

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15
Q

what antipsychotics would worsen parkinsonism

A

risperidone and haloperidol

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16
Q

what is the treatment for acute mania with psychotic features

A

to protect staff lorazepam

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17
Q

what are the SE of lithium

A

tremor, DI, hypothyroidism/hyperthyroidism

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18
Q

what is schizotypal

A

magical thinking, suspiciousness, paranoid ideation, but no frank delusion, general paranoia and idiosyncratic thinking.

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19
Q

schizoid personality

A

loners, detached, often lack close friends, they do not want them. no odd thinking or perceptual distortions

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20
Q

what is an essential feature of antisocial personality disorder

A

conduct disorder prior to 15

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21
Q

antisocial personality disorder

A

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

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22
Q

losing semen while urinating is an south asian thing for

A

Dhat syndrome.

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23
Q

what is a SE of clozapine

A

seizures, neutropenia and myocarditis

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24
Q

what can be added to antidepressant therapy to increase energy and cause weight loss.

A

bupropion is safe as adjuvant therapy

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25
Q

postpartum blues resolve within

A

two week postpartum

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26
Q

when does mild alcohol withdrawal occur and what are the symptoms

A

perspiration, insomnia, tremors, anxiety, GI upset, palpations
6-24 hours since last drink

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27
Q

when do seizures from alcohol withdrawal occur

A

12-48 horus

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28
Q

when does alcoholic hallucinosis occur

A

12-48 hours

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29
Q

when does delirium tremens occur

A

48-96

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30
Q

what are the symptoms of delirium tremens

A

confusion, agitation, fever, tachycardia, hypertension, diaphoresis, hallucinations

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31
Q

PTSD

A

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

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32
Q

treatment for PTSD

A

SSIRs trauma focused CBT

33
Q

adjustment disorder

A

≤6 months after a stressor

34
Q

treatment for akathisia

A

reduce the antipsychotic and provide beta blocker, benzotropine, benzodiazepine

35
Q

binge eating disorder

A

recurrent episodes of binge eating, no inappropriate compensatory behaviors, lack of control during eating

36
Q

bulimia nervosa

A

recurrent episodes of binge eating, with inappropriate compensatory behaviors, excessive worry about body shape and weight.

37
Q

body dysmorphic disorder

A

excessive preoccupations with minor or nonexistent defects in physical appearance

38
Q

what is the treatment of choice for ADHD in adults for non-stimulant meds

A

atomoxetine

39
Q

what is a non-stimulant med for ADHD in children and adolescents

A

clonidine

40
Q

dissociative identity disorder

A

discontinuity in identity and loss of personal agency with fragmentation into two distinct personality states. associated with severe trauma or abuse.

41
Q

dissociative amnesia

A

inability to recall autobiographical information. localized or selective amnesia typically after sudden and preceded by overwhelming events or intolerable events

42
Q

transient global amnesia

A

anterograde amnesia for time and place. There is no loss of identity. typically lasts for 24 hours

43
Q

depersonalization/derealization disorder

A

feelings of detachment from or being outside of ones self. experiencing surroundings as unreal. intact reality testing

44
Q

name two MAOIs

A

phenelzine and tranylcypromine

45
Q

reactive attachment disordre

A

extremem outcome of early childhood abuse which results in lack of emotional responsiveness and the absence of comfort seeking from caregivers

46
Q

does lithium cause hepatotoxicity

A

no

47
Q

what are the SE of valproate

A

hepatotoxicity, fine tremor, nausea, vomiting. thrombocytopenia and alopecia

48
Q

what can cause lithium toxicity

A

dehydration, use of thiazide diuretics, NSAIDs, ACE inhibitors

49
Q

what are the most common SE of fluoxetine

A

nausea, insomnia and headache

50
Q

what lab test is associated with suicidal behavior

A

low CSF 5-HIAA

51
Q

treatment for lithium toxicity

A

dialysis

52
Q

what parameters require dialysis for lithium toxicity regardless of the symptoms

A

lithium greater 4, creatinine greater than 2

53
Q

what are the symptoms of inhalant abuse

A

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

54
Q

what changes in sleep patterns are found in people with depression

A

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

55
Q

are sleep changes in depression normalized with antidepressants

A

yes

56
Q

normal grief reaction

A

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.

57
Q

what is monitored with olanzipine

A

fasting blood glucose

58
Q

what medication treats both depression and diabetic neuropathy

A

duloxetine SNRIs can treat bothj

59
Q

rapid eye movement sleep behavior disorder

A

complex motor behaviors that occur while sleeping. acting out dreams/nightmares.
this is associated with neurodegeneration in older males.

60
Q

what is cyclothymic disorder

A

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

61
Q

somatic symptom disorder

A

excessive anxiety ≥1 unexplained symptom.

62
Q

conversion disorder

A

neurological disorder incompatible with known disease

63
Q

illness anxiety disorder

A

fear of having a serious illness despite few or no symptoms and consistently negative evaluations

64
Q

what drug can cause hypercalcemia

A

lithium can cause hyperparathyroidism and hypercalcemia

65
Q

what is the presnetation of panic disorder

A

recurrent unexpected panic attacks worry about additional attacks and avoidance behavior

66
Q

what is the treatmetn for panic disorder

A

first line maintenance is SSRI/SNRI or CBT

acute distress is benzodiazepine.

67
Q

what is the pathophysiology of tardive dyskinesia

A

dopamine receptor supersensitivity

68
Q

what is the def of MDD

A

≥ 2 weeks of symptoms

69
Q

what does increased sensitivity to lactate infusion indicate

A

panic attacks

70
Q

what is the treatment for binge eating disorder

A

SSRIs

71
Q

how does cocaine withdrawal present

A

depression, increased dreaming, hyperphagia, impaired concentration, intense drug craving, fatigue, depression, hypersomnia

72
Q

what can give a false positive for phencyclidine on drug screening

A

dextromethrophran

73
Q

what is the treatment for somatic symptom disorder

A

reassurance and close follow up

74
Q

what is the treatment for body dysmorphic disorder

A

SSRIs

75
Q

what is the treatment of choice for illness anxiety disorder

A

reassurance and close follow up

76
Q

can prednisone induce psychosis

A

yes

77
Q

what is the treatment for catatonia

A

benzodiazepine

78
Q

what is the treatment for catatonia

A

benzodiazepine

step II (22 decks)

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