Uworld week 3-4 Flashcards
1
Q
what are people with dementia with lewy body really sensitive to?
A
antipsychotic side effects
2
Q
what class of antipsychotics should be avoided in those with lewy body dementia?
A
typical antipsychotics
3
Q
what is treatment of agitation in PCP use?
A
benzos
4
Q
what are two favorable side effects of buproprion?
A
stimulant activity and weight gain
5
Q
what are people with narcissistic personality disorder focused on?
A
a need for praise and admiration
6
Q
what are people with obsessive compulsive personality disorder focused on?
A
orderliness and control
7
Q
what are four risk factors for somatic symptom disordeR?
A
low SES
female
chronic illness
childhood neglect and rape
8
Q
what is negativism in catatonia?
A
resistance to instructions and movement
9
Q
how does movement change in catatonia?
A
either immobile or excessive purposeless activity
10
Q
what is treatment of catatonia?
A
benzodiazepines
11
Q
what can catatonic patients do with their speech?
A
echolalia
12
Q
what is the treatment for restless leg syndrome?
A
dopamine agonists…like pramipexole
13
Q
aside from pramipexole, what else can be used for restless leg syndrome?
A
gabapentin
14
Q
what do you try before meds for restless leg syndrome?
A
supportive measures…heating pad and exercise
15
Q
what are signs of benzo withdrawal?
A
tremulousness, tachycardic, high BP, hallucinations
16
Q
PTSD most increases risk for what?
A
depression and suicide
17
Q
what are synthetic cathinones?
A
bath salts..in family of amphetamines
18
Q
what are signs of synthetic cathinone intoxication?
A
agitation, combativeness, psychosis, delirium, and rarely seizures
19
Q
what is abnormal about cathinone intoxication?
A
can last up to a week
20
Q
what is RBD?
A
rapid eye movement sleep disorder
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
22
Q
when is it more likely for RBD to occur?
A
in the morning hours when REM sleep is occurring more
23
Q
will patients with RBD recall movements or dreams?
A
will recall dream but not movement
24
Q
3 SEs of methylphenidate
A
weight loss, loss of appetite and insomnia
25
what should the first step in management of a patient with postpartum psychosis be?
immediate hospitalization to rule out infanticide
26
what is rx of postpartum psychosis?
antipsychotics and treat underlying mood disorder
27
what are the symptoms of Dhat syndrome?
fatigue, weight loss and concern about losing semen during urination
28
where is Dhat syndrome found?
in southeast asia
29
what is first line treatment for depression with psychotic features?
antipsychotic and antidepressant
30
what can develop in kidney with NMS?
AKI...
31
what labs are abnormal in NMS?
leukocytosis, high CK, high creatinine and BUn
32
what are the three main early side effects of SSRIs?
HA, nausea and insomnia
33
what can happen to patients with akithisia who are made to sit still?
they can become severely agitated
34
what is the MOA of welbutryin?
NE and dopamine uptake inhibitor
35
what psych medication is most commonly associated with hepatotoxicity?
valproate
36
what two antipsychotics can be used in treatment of acute depression of bipolar disorder?
quetiapine and lurasidone
37
what psych disease is an ovarian tumor associated with?
NMDA receptor autoimmune encephalitis
38
describe the progression of NMDA receptor autoimmune encephalitis
flu like illness then changes in psych and physical health
39
what are the symptoms of NMDA receptor autoimmune encephalitis ?
psych issues then autonomic instability then rigidity hyperreflexive and seizures
40
two locations copper deposits in wilson disease
basal ganglia and cornea
41
what are the psychiatric symptoms of wilson disease
parkinsonism, psychosis, tremor, personality changes
42
when is RLS often worse?
at night
43
what helps RLS?
moving around
44
what lab is often abnormal in those with RLS?
low iron
45
name some medical causes of RLS?
diabetes, pregnancy, MS, parkinsons, uremia
46
how long must feelings of gender dysphoria last for diagnosis?
6 mos
47
how long must specific phobia last for diagnosis?
6 mos
48
what is a common side effect of SSRI when used to treat anxiety early?
early increase in anxiety
49
how do you manage therapy with SSRI if patient with anxiety has increased anxiety when starting SSRI?
decrease the dose
50
what type of opioid is seen on a UDS?
natural
51
name the only natural opioids?
morphine, heroin and codeine
52
name some opioids that wont show up on a UDS?
oxycodone, hydrocodone, fentanyl, methadone, tramadol
53
do eyes dilate or constrict with opioid intoxication?
constrict
54
name four drug classes that can decrease lithium clearance?
tetracyclines, diuretics, ACE inhibitors, NSAIDs
55
what are the neuro symptoms of lithium toxicity?
ataxia, tremor, confusion and SEIZURES
56
what are the GI sx of lithium toxicity
nausea, vomiting, diarrhea
57
what is best way to see a patient in learning situation who has borderline?
as a whole team
58
three serious SEs of clozapine?
agrnulocytosis, seizures, and myocarditis
59
what AP has highest risk of seizure?
clozapine
60
what mood stabilizer is associated with a tremor?
lithium
61
what type of tremor do you have with lithium?
physiologic, bilateral hand tremor
62
what mood stabilizer can lead to an increase in parathyroid hormone?
lithium
63
what mood stabilizer is associated with hypercalcemia?
lithium
64
what do you use to treat psychosis in parkinsons disease
second gen AP
65
does bilateral or unilateral tremor suggest parkinsons?
unilateral
66
what are two treatment options for intermittent explosive disorder?
CBT and SSRI
67
what is the difference in DMDD and intermittent explosive disorder?
DMDD is peds diagnosis
68
what is rx of night terrors?
reassurance
69
what pain medication can contribute to serotonin syndrome?
tramadol
70
if a patient is on long term opioids how often should they have a follow up visit?
every 3 months
71
what should you do as a doctor if a patient is on long term opioids every time you see them?
check the drug program system to see if there are co prescriptions
72
two treatment options for tardive dyskinesia?
valbenazine and deutatetrabenazine
73
A patient with sleep and anxiety issues abruptly discontinues medication then has seizures, what med was she on?
a benzo...
74
what is best SSRI in pediatric depression?
fluoxetine
75
what is the first line treatment for social anxiety disorder?
SSRI or CBT
76
what is PMDD?
premenstrual dysphoric disorder
77
what happens in PMDD?
prominent mood symptoms, changes in appetite and physical symptoms that occur before menstruation and leave after
78
what is therapy used for childhood ocd?
SSRI and CBT
79
patients with DID often have a history of what?
trauma or abuse
80
can patients with DID have auditory hallucinations?
yes
81
what are the differences between voices in DID and schizophrenia?
voices inside head with DID and outside with schizo
82
what is the treatment of choice for adjustment disorder?
psychotherpay
83
refusal for a child to speak at school but everything else being normal is what?
selective mutism
84
what is treatment of acute stress disorder?
CBT...not evidence for SSRI use
85
when does separation anxiety peak in child development?
8-9 months
86
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?
OCD
87
what is first line med with catatonia?
benzo
88
what benzo is used in catatonia?
lorazepam
89
how long does it take catatonia to respond to benzos?
about a week
90
name four drugs that can be positive for PCP?
dextromethorphan
diphenhydramine
ketamine
tramadol
91
name three meds that can be positive for amphetamines
propanolol bupropion and nasal decongestants
92
a patient with parkinsons develops psychosis and change in parkinson meds does not work, what should be prescribed?
atypical antipsychotics without EPS...quetiapine
93
what is maintenance therapy for someone with bipolar depression?
lithium plus second gen AP
94
how long should antidepressant be continued for a patient with a single MDD episode?
6 months after optimal dose is achieved
95
what are the cardio features of opioid withdrawal?
high BP tachycardic diaphoresis
96
what are GI features of opioid withdrawal?
N/V/D
97
what are the two medication options for treatment of opioid withdrawal?
non opioid based and opioid based
98
what is the non opioid based therapy for opioid WD?
clonidine
99
what are the opioid based therapies for opioid WD?
methadone and buprenorphine
100
when can separation anxiety onset?
any time...not an age specific diagnosis
101
what are symptoms of acute intermittent porphyria?
abdominal and neuropathic pain
102
how is AIP inherited?
AD
103
what can occur aside from medical symptoms in AIP?
psychosis
104
how do kleptomaniacs feel about stealing things?
they are very anxious about it before then feel guilty after they steal it
105
does sleep increase of decrease in cocaine withdrawal?
increase
106
does appetite increase or decrease in cocaine withdrawal?
increase
107
what should you definitely not do with a cancer survivor when they have depression?
normalize the depression
108
what are some physical findings of chronic meth use?
poor dentition, skin pickings, psychosis, tactile hallucinations
109
what is rx for premature ejaculation?
SSRI
110
what is first line rx for hoarding disorder?
CBT
111
what is inheritance of fragile X?
X linked dominant
112
what is gene in fragile X?
FMR1
113
what is the commob psych dx in MS?
depression
114
what are the antidepressant withdrawal symptoms?
rhinorrhea, fatigue myalgias chills and HA
115
what is rx for delusion disorder?
AP and CBT
116
what are two meds to decrease desire for alcohol?
acamprosate and naltrexone
117
what med is used for ethanol or methanol OD
fomepizole
118
name some ways tardive dyskinesia looks
```
facial movements of tongue etc
trunk rocking
foot tapping
chorea
shoulder shrugging
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