UWorld Week 1 Flashcards
1
Q
what vitals can be abnormal in delirium tremens?
A
fever, tachycardia, hypertension, diaphoresis
2
Q
what are two options for treatment of binge eating disorder?
A
lisdexamphetamine and SSRI
3
Q
what is delayed sleep wake phase disorder?
A
sleep onset insomnia and morning sleepiness
4
Q
what is advanced sleep wake phase disorder?
A
early sleep and morning insomnia with tiredness
5
Q
what is the test for CJD?
A
real time quaking induced conversion test
6
Q
what are the symptoms of CJD?
A
dementia, myoclonus, ataxia, UMN signs, mood and sleep disorders
7
Q
doxepin is what class of drug?
A
TCA
8
Q
what is a common GI symptom of anorexia?
A
constipation
9
Q
what is first line option for adult ADHD, meds or CBT?
A
meds first even with addictive history
10
Q
what med can you give to adult with ADHD with addiction history?
A
atomoxetine
11
Q
what is MoA of atomoxetine?
A
NE uptake inhibitor
12
Q
periodic sharp wave complexes on EEG is suggestive of what
A
CJD
13
Q
how does depression often present in young kids?
A
with somatic symptoms like stomach aches and headaches
14
Q
do imaginary friends help or hurt real relationships
A
help
15
Q
what ages are appropriate for imaginary friends?
A
3-6 but any age in childhood is OK
16
Q
what is hyperventilation syndrome?
A
hyperventilation without a cardiac or pulmonary etiology
17
Q
what are signs of hyperventilation syndrome?
A
increased respiratory rate and tidal volume
18
Q
what is treatment for hyperventilation syndrome?
A
reassurance and breathing teaching
19
Q
what are the three key features of Rett syndrome?
A
loss of hand movements, gait abnormalities and loss of speech
20
Q
who gets rett syndrome?
A
mainly girls 6-18 mos
21
Q
what is another feature of Rett syndrome aside from hand movement loss, loss of speech and gait abnormality?
A
seizures
22
Q
what is testing for Rett syndrome?
A
DNA analysis
23
Q
what is treatment for body dysmorphic disorder?
A
SSRI and CBT
24
Q
describe nightmare disorder
A
patient awakes and remembers dream and then can be consoled
25
describe night terror disorder
patient awakes and does not remember dream and cannot be consoled
26
when do nightmares occur? when do night terrors occur?
nightmares are in REM and terrors not in RME
27
what is initial management of serotonin syndrome?
supportive care and sedation with benzos
28
if sedation and support does not work with serotonin syndrome, what can you give?
cyproheptadine
29
what does persistent complex bereavement syndrome center around? how does this differ from MDD?
yearning for the lost...in MDD you dont yearn for the lost
30
what antipsychotics are worst about causing galactorrhea?
high potency first generation
31
when is a functional tremor present?
at rest and with movement
32
what makes a functional tremor stop?
any distractions
33
what age group has slight increased risk for suicidal thoughts on SSRI?
age less than 25 years of age...
34
if a patient with bipolar is stable on lithium and wants off, what can you offer them?
nothing...need to stay on lithium for life
35
when does a physiologic tremor occur? what can make it increase?
anytime..stress and caffeine
36
what four classes of drugs cause a physiologic tremor to increase?
beta agonists
TCAs
SSRI
roids
37
what are the main symptoms of heroin withdrawal?
nausea, diarrhea, vomiting, cramping muscle aches
38
what are the physical findings of heroin withdrawal?
piloerection, dilated pupils, yawning, hyperactive bowel sounds
39
what are the two sleep changes in depression?
decreased REM sleep latency and decreased slow wave sleep
40
what is REM sleep latency?
time from onset of sleep to REM sleep
41
what endocrine abnormality is associated with depression? why?
overactivity of HPA leads to increased levels of cortisol
42
what are two common comorbid diagnoses with tourette syndrome?
ADHD and OCd
43
is NMS or serotonin syndrome rapid onset?
serotonin syndrome is rapid and NMS is slow
44
what does NMS have that serotonin syndrome doesnt?
lead pipe rigidity
45
what does serotonin syndrome have that NMS does not?
hyperreflexia, clonus and nausea vomiting
46
NMS is caused by what kind of drugs?
dopamine antagonist
47
steroids can induce what psychiatric problem?
psychosis
48
what nt is down in huntingtons?
GABA
49
what areas of the brain are affected in Huntingotns?
caudate and putamen
50
what is treatment for adjustment disorder?
psychotherapy
51
what are the two mainstays of treatment of anorexia nervosa?
psychotherapy and nutritional rehabilitation
52
what eating disorder can you give SSRI for?
bulimia nervosa
53
what is a common side effect of venlafaxine?
increased blood pressure...dose dependent
54
what SNRI has increased BP as risk?
venlafaxine
55
what is diagnosis of panic disorder?
recurrent attacks with worry or concern about more attacks or behavior changes due to attacks
56
how long must you have the worry and behavior change related to panic attacks to be diagnosed with panic disordeR?
1 month
57
what med can you give for nightmares in PTSD?
prazosin
58
how long must symptoms last to get diagnosis of cyclothymic disorder?
more than 2 years
59
what are the two criteria for diagnosis of bipolar II?
one MDD and hypomania
60
how long does manic symptoms have to last to be called hypomanic?
more than 4 days
61
what number of MDD episodes is considered chronic? what does this mean for treatment?
3 or more...means treatment for life
62
what number of MDD episodes is considered recurrent? what does this mean for treatment?
2 or more...means eligibile for maintenance therapy
63
how long does maintenance therapy for MDD last?
1-3 years
64
when does adjustment disorder have to onset?
within 3 months of the stressor
65
what are the two main criteria for adjustment disorder?
it doesnt match another DSM V diagnosis and it has an impact on function of patients life
66
what is the initial management of NMS?
supportive care and stop meds
67
if initial management of NMS fails, what two meds can be tried?
bromocriptine and dantrolene
68
how does dantrolene help NMS
it is a muscle relaxant so decreases temperature
69
how does bromocriptine help NMS?
dopamine agonist so helps minimize the blockade
70
what two meds are used in bipolar depression?
quetiapine and lurasidone
71
what SSRI is used in elderly population?
sertraline
72
what SSRI is contraindicated in elderly? why?
citalopram...because can elongate QT
73
2 main side effects of mirtazapine
weight gain and sedation
74
what are the treatment options for body dysmorphic disorder?
SSRI and CBT
75
aside from medication management, what else can be beneficial at reducing hospitalizations in patients with schizophrenia?
family therapy
76
three vital signs for admission with anorexia
bradycardia <40
hypothermic <35
hypotensive <80/60
77
what is indication of bad TCA toxicity?
QRS greater than 100 ms
78
if TCA overdose leads to QRS greater than 100 ms, what is started?
sodium bicarbonate therapy
79
name three indications for ECT in depression
emergency situations, treatment resistant, psychotic features
80
what are some emergency situations in depression that mean you should use ECT?
pregnancy, refusal to eat or drink, and imminent suicide risk
81
what must you use to formally diagnose a specific learning disorder?
standardized testing
82
what is paradoxical agitation? what med is it associated with?
when taking benzos patients actually become agitated and aggressive and confused...common in elderly
83
how do children with language disorder often express themselves?
they get irritated when no t understood and can thrown tantrums
84
what does sulfonyurea do to levels of insulin and c peptide?
increases both
85
what med group that is often used can contribute to memory impairment in elderly?
antihistamines due to anticholinergic effect
86
when should you worry about meds causing cognitive decline in a patient?
if there is an abrupt onset
87
how long to wait between stopping an SSRI and starting an MAO inhibitor to avoid serotonin syndrome?
2 weeks
88
what are the features of reactive attachment disorder
child doesnt respond to comfort, poor social resposiveness, limited positive affect, unexpained irritability and aggressiveness
89
what is cause of reactive attachment disorder?
insufficient care
90
whatis treatment for reactive attachment disorder?
protective nurturing environment and therapy PRN
91
what is difference in reactive attachment disorder and disinhibited social engagement disordeR?
Disinhited is an overfamiliarity with strangers following neglect/lack of care
92
name two medication options for tourette syndrome
second gen antipsychotics and clonidine
93
what is thought to be the mechanism of tardive dyskinesia?
upregulation of dopamine receptors that become super sensitive
94
what two meds in parkinsons disease can be associated with psychosis?
dopamine precursors (carbidopa) and dopamine agonists (pramipexole)
95
what are signs of stimulant intoxication?
irritable restless behavior, insomnia
96
what are physical exam findings of stimulant intoxication? why?
sympathetic overactivity causes hypertension, hyperthermia diaphoresis and tachycardia
97
what is first line med for stimulant intoxication?
benzos
