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Psychiatry Block > Uworld week 3-4 > Flashcards

Uworld week 3-4 Flashcards

1
Q

what are people with dementia with lewy body really sensitive to?

A

antipsychotic side effects

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2
Q

what class of antipsychotics should be avoided in those with lewy body dementia?

A

typical antipsychotics

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3
Q

what is treatment of agitation in PCP use?

A

benzos

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4
Q

what are two favorable side effects of buproprion?

A

stimulant activity and weight gain

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5
Q

what are people with narcissistic personality disorder focused on?

A

a need for praise and admiration

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6
Q

what are people with obsessive compulsive personality disorder focused on?

A

orderliness and control

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7
Q

what are four risk factors for somatic symptom disordeR?

A

low SES
female
chronic illness
childhood neglect and rape

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8
Q

what is negativism in catatonia?

A

resistance to instructions and movement

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9
Q

how does movement change in catatonia?

A

either immobile or excessive purposeless activity

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10
Q

what is treatment of catatonia?

A

benzodiazepines

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11
Q

what can catatonic patients do with their speech?

A

echolalia

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12
Q

what is the treatment for restless leg syndrome?

A

dopamine agonists…like pramipexole

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13
Q

aside from pramipexole, what else can be used for restless leg syndrome?

A

gabapentin

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14
Q

what do you try before meds for restless leg syndrome?

A

supportive measures…heating pad and exercise

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15
Q

what are signs of benzo withdrawal?

A

tremulousness, tachycardic, high BP, hallucinations

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16
Q

PTSD most increases risk for what?

A

depression and suicide

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17
Q

what are synthetic cathinones?

A

bath salts..in family of amphetamines

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18
Q

what are signs of synthetic cathinone intoxication?

A

agitation, combativeness, psychosis, delirium, and rarely seizures

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19
Q

what is abnormal about cathinone intoxication?

A

can last up to a week

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20
Q

what is RBD?

A

rapid eye movement sleep disorder

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21
Q

what happens during RBD?

A

normally in REM sleep you have muscle atonia, but brainstem doesnt do this in RBD and patients start to enact their dreams

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22
Q

when is it more likely for RBD to occur?

A

in the morning hours when REM sleep is occurring more

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23
Q

will patients with RBD recall movements or dreams?

A

will recall dream but not movement

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24
Q

3 SEs of methylphenidate

A

weight loss, loss of appetite and insomnia

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25
Q

what should the first step in management of a patient with postpartum psychosis be?

A

immediate hospitalization to rule out infanticide

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26
Q

what is rx of postpartum psychosis?

A

antipsychotics and treat underlying mood disorder

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27
Q

what are the symptoms of Dhat syndrome?

A

fatigue, weight loss and concern about losing semen during urination

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28
Q

where is Dhat syndrome found?

A

in southeast asia

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29
Q

what is first line treatment for depression with psychotic features?

A

antipsychotic and antidepressant

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30
Q

what can develop in kidney with NMS?

A

AKI…

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31
Q

what labs are abnormal in NMS?

A

leukocytosis, high CK, high creatinine and BUn

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32
Q

what are the three main early side effects of SSRIs?

A

HA, nausea and insomnia

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33
Q

what can happen to patients with akithisia who are made to sit still?

A

they can become severely agitated

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34
Q

what is the MOA of welbutryin?

A

NE and dopamine uptake inhibitor

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35
Q

what psych medication is most commonly associated with hepatotoxicity?

A

valproate

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36
Q

what two antipsychotics can be used in treatment of acute depression of bipolar disorder?

A

quetiapine and lurasidone

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37
Q

what psych disease is an ovarian tumor associated with?

A

NMDA receptor autoimmune encephalitis

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38
Q

describe the progression of NMDA receptor autoimmune encephalitis

A

flu like illness then changes in psych and physical health

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39
Q

what are the symptoms of NMDA receptor autoimmune encephalitis ?

A

psych issues then autonomic instability then rigidity hyperreflexive and seizures

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40
Q

two locations copper deposits in wilson disease

A

basal ganglia and cornea

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41
Q

what are the psychiatric symptoms of wilson disease

A

parkinsonism, psychosis, tremor, personality changes

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42
Q

when is RLS often worse?

A

at night

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43
Q

what helps RLS?

A

moving around

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44
Q

what lab is often abnormal in those with RLS?

A

low iron

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45
Q

name some medical causes of RLS?

A

diabetes, pregnancy, MS, parkinsons, uremia

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46
Q

how long must feelings of gender dysphoria last for diagnosis?

A

6 mos

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47
Q

how long must specific phobia last for diagnosis?

A

6 mos

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48
Q

what is a common side effect of SSRI when used to treat anxiety early?

A

early increase in anxiety

49
Q

how do you manage therapy with SSRI if patient with anxiety has increased anxiety when starting SSRI?

A

decrease the dose

50
Q

what type of opioid is seen on a UDS?

A

natural

51
Q

name the only natural opioids?

A

morphine, heroin and codeine

52
Q

name some opioids that wont show up on a UDS?

A

oxycodone, hydrocodone, fentanyl, methadone, tramadol

53
Q

do eyes dilate or constrict with opioid intoxication?

A

constrict

54
Q

name four drug classes that can decrease lithium clearance?

A

tetracyclines, diuretics, ACE inhibitors, NSAIDs

55
Q

what are the neuro symptoms of lithium toxicity?

A

ataxia, tremor, confusion and SEIZURES

56
Q

what are the GI sx of lithium toxicity

A

nausea, vomiting, diarrhea

57
Q

what is best way to see a patient in learning situation who has borderline?

A

as a whole team

58
Q

three serious SEs of clozapine?

A

agrnulocytosis, seizures, and myocarditis

59
Q

what AP has highest risk of seizure?

A

clozapine

60
Q

what mood stabilizer is associated with a tremor?

A

lithium

61
Q

what type of tremor do you have with lithium?

A

physiologic, bilateral hand tremor

62
Q

what mood stabilizer can lead to an increase in parathyroid hormone?

A

lithium

63
Q

what mood stabilizer is associated with hypercalcemia?

A

lithium

64
Q

what do you use to treat psychosis in parkinsons disease

A

second gen AP

65
Q

does bilateral or unilateral tremor suggest parkinsons?

A

unilateral

66
Q

what are two treatment options for intermittent explosive disorder?

A

CBT and SSRI

67
Q

what is the difference in DMDD and intermittent explosive disorder?

A

DMDD is peds diagnosis

68
Q

what is rx of night terrors?

A

reassurance

69
Q

what pain medication can contribute to serotonin syndrome?

A

tramadol

70
Q

if a patient is on long term opioids how often should they have a follow up visit?

A

every 3 months

71
Q

what should you do as a doctor if a patient is on long term opioids every time you see them?

A

check the drug program system to see if there are co prescriptions

72
Q

two treatment options for tardive dyskinesia?

A

valbenazine and deutatetrabenazine

73
Q

A patient with sleep and anxiety issues abruptly discontinues medication then has seizures, what med was she on?

A

a benzo…

74
Q

what is best SSRI in pediatric depression?

A

fluoxetine

75
Q

what is the first line treatment for social anxiety disorder?

A

SSRI or CBT

76
Q

what is PMDD?

A

premenstrual dysphoric disorder

77
Q

what happens in PMDD?

A

prominent mood symptoms, changes in appetite and physical symptoms that occur before menstruation and leave after

78
Q

what is therapy used for childhood ocd?

A

SSRI and CBT

79
Q

patients with DID often have a history of what?

A

trauma or abuse

80
Q

can patients with DID have auditory hallucinations?

A

yes

81
Q

what are the differences between voices in DID and schizophrenia?

A

voices inside head with DID and outside with schizo

82
Q

what is the treatment of choice for adjustment disorder?

A

psychotherpay

83
Q

refusal for a child to speak at school but everything else being normal is what?

A

selective mutism

84
Q

what is treatment of acute stress disorder?

A

CBT…not evidence for SSRI use

85
Q

when does separation anxiety peak in child development?

A

8-9 months

86
Q

someone recurrently sees images of hurting someone but doesnt want to do it and they count down from 5 to 1 to get rid of it…what is the diagnosis?

A

OCD

87
Q

what is first line med with catatonia?

A

benzo

88
Q

what benzo is used in catatonia?

A

lorazepam

89
Q

how long does it take catatonia to respond to benzos?

A

about a week

90
Q

name four drugs that can be positive for PCP?

A

dextromethorphan
diphenhydramine
ketamine
tramadol

91
Q

name three meds that can be positive for amphetamines

A

propanolol bupropion and nasal decongestants

92
Q

a patient with parkinsons develops psychosis and change in parkinson meds does not work, what should be prescribed?

A

atypical antipsychotics without EPS…quetiapine

93
Q

what is maintenance therapy for someone with bipolar depression?

A

lithium plus second gen AP

94
Q

how long should antidepressant be continued for a patient with a single MDD episode?

A

6 months after optimal dose is achieved

95
Q

what are the cardio features of opioid withdrawal?

A

high BP tachycardic diaphoresis

96
Q

what are GI features of opioid withdrawal?

A

N/V/D

97
Q

what are the two medication options for treatment of opioid withdrawal?

A

non opioid based and opioid based

98
Q

what is the non opioid based therapy for opioid WD?

A

clonidine

99
Q

what are the opioid based therapies for opioid WD?

A

methadone and buprenorphine

100
Q

when can separation anxiety onset?

A

any time…not an age specific diagnosis

101
Q

what are symptoms of acute intermittent porphyria?

A

abdominal and neuropathic pain

102
Q

how is AIP inherited?

A

AD

103
Q

what can occur aside from medical symptoms in AIP?

A

psychosis

104
Q

how do kleptomaniacs feel about stealing things?

A

they are very anxious about it before then feel guilty after they steal it

105
Q

does sleep increase of decrease in cocaine withdrawal?

A

increase

106
Q

does appetite increase or decrease in cocaine withdrawal?

A

increase

107
Q

what should you definitely not do with a cancer survivor when they have depression?

A

normalize the depression

108
Q

what are some physical findings of chronic meth use?

A

poor dentition, skin pickings, psychosis, tactile hallucinations

109
Q

what is rx for premature ejaculation?

A

SSRI

110
Q

what is first line rx for hoarding disorder?

A

CBT

111
Q

what is inheritance of fragile X?

A

X linked dominant

112
Q

what is gene in fragile X?

A

FMR1

113
Q

what is the commob psych dx in MS?

A

depression

114
Q

what are the antidepressant withdrawal symptoms?

A

rhinorrhea, fatigue myalgias chills and HA

115
Q

what is rx for delusion disorder?

A

AP and CBT

116
Q

what are two meds to decrease desire for alcohol?

A

acamprosate and naltrexone

117
Q

what med is used for ethanol or methanol OD

A

fomepizole

118
Q

name some ways tardive dyskinesia looks

A 
facial movements of tongue etc
trunk rocking
foot tapping
chorea
shoulder shrugging

Psychiatry Block (3 decks)

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