First Aid Psychiatry

Front 1

This is learning in which a natural response (salivation) is elicited by a conditioned or learned, stimulus (bell) that previously was presented in conjunction with an unconditioned stimulus (food)

Back 1

classical conditioning

Front 2

This is learning in which a particular action is elicited because it produces a reward

Back 2

operant conditioning

Front 3

Mouse presses button to get food is an example of ____ reinforcement

Back 3

positive

Front 4

Mouse presses button to avoid shock is an example of ____ reinforcement

Back 4

negative

Front 5

This type of operant conditioning is characterized by application of aversive stimulus extinguishes unwanted behavior

Back 5

punishment

Front 6

This type of operant conditioning is characterized by discontinuation of reinforcement eliminates behavior

Back 6

extinction

Front 7

This term is used to describe when a patient projects feelings about formative or other important persons onto physician

Back 7

transference

Front 8

This term is used when the doctor projects feelings about formative or other important persons onto patient

Back 8

countertransference

Front 9

This is the term used to describe unconscious mental processes used to resolve conflict and prevent undesirable feelings (anxiety, depression)

Back 9

ego defenses

Front 10

Tantrums are this form of immature defenses

Back 10

acting out

Front 11

This is temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress

Back 11

dissociation

Front 12

This type of immature defense is avoidance of awareness of some painful reality. A common reaction in newly diagnosed AIDS and cancer patients

Back 12

denial

Front 13

This is a process whereby avoided ideas and feelings are transferred to some neutral person or object such as mother places blame on child because she is angry at her husband

Back 13

displacement

Front 14

This is partially remaining at a more childish level of development such as men fixating on sports games

Back 14

fixation

Front 15

This is modeling behavior after another person who is more powerful (though not necessarily admired). Ex. abused child identifies himself/herself as an abuser

Back 15

identification

Front 16

This is defined as separation of feeling from ideas and events such as describing murder in graphic detail with no emotional response

Back 16

isolation of affect

Front 17

This is an unacceptable internal impulse that is attributed to an external source, such as when a man who wants another woman thinks his wife is cheating on him

Back 17

projection

Front 18

After getting fired, claiming a job was not important anyway is what form of ego defense?

Back 18

rationalization

Front 19

This type of ego defense is the process whereby a warded off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite such as a patient with libidinous thoughts enters a monastery

Back 19

reaction formation

Front 20

This type of ego defense is turning back the maturational clock and going back to earlier modes of dealing with the world such as seen in children under stress such as illness, punishment, or birth of a new sibling

Back 20

regression

Front 21

This is involuntary withholding of an idea or feeling from conscious awareness such as not remembering a conflictual or traumatic experience; pressing bad thought into the unconscious

Back 21

repression

Front 22

This is the belief that people are either all good or all bad at different times due to intolerance of ambiguity. Seen in borderline personality disorder. For example a patient says that all nurses are cold and insensitive but that the doctors are warm and friendly

Back 22

splitting

Front 23

This is guilty feeling alleviated by unsolicited generosity towards others such as when the mafia boss makes large donations to charity

Back 23

altruism

Front 24

This type of mature defense is appreciating the amusing nature of an anxiety provoking or adverse situation

Back 24

humor

Front 25

This is the process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with one's value system such as when a Teenager's aggression toward his father is redirected to perform well in sports

Back 25

sublimation

Front 26

This is voluntary withholding of an idea or feeling from conscious awareness, such as choosing not to think about the USMLE until the week of the exam

Back 26

suppression

Front 27

Sublimation, alturism, suppression and humor are ____ defenses

Back 27

mature

Front 28

Infant deprivation for more than ____ months can lead to irreversible changes

Back 28

6

Front 29

Anaclitic depression is seen in what population?

Back 29

describes infants who waste away at hospital due to lack of social interaction/care from mother

Front 30

What is the peak age incidence of sexual abuse in a child?

Back 30

9-12 years of age

Front 31

What evidence of physical abuse would suggest the possibility of child abuse?

Back 31

healed fractures on x-ray, cigarette burns, subdural hematomas, multiple bruises, retinal hemorrhage or detachment

Front 32

With physical child abuse, who is most likely to be the abuser?

Back 32

usually female and primary caregiver

Front 33

This is the most common form of child maltreatment. Evidence is poor hygiene, malnutrition, withdrawal, impaired social/emotional development, failure to thrive

Back 33

child neglect

Front 34

Should child neglect be reported to local child protective services?

Back 34

Yes

Front 35

This disorder has an onset before age 7. There is limited attention span and poor impulse control. Characterized by hyperactivity, motor impairment, and emotional lability. Continues into adulthood in as many as 50% of individuals and is associated with decreased frontal lobe volumes

Back 35

attention-deficit hyperactivity disorder

Front 36

Methylphenidate, amphetamines, and atomoxetine are used to treat what disorder?

Back 36

attention-deficit hyperactivity disorder

Front 37

This is a disorder defined by repetitive and pervasive behavior violating social norms (physical aggression, destruction of property, theft). After 18 years of age, diagnosed as antisocial personality disorder

Back 37

conduct disorder

Front 38

This type of disorder is characterized by enduring pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social nomrs?

Back 38

Oppositional defiant disorder

Front 39

Is conduct disorder or oppositional defiant characterized by violation of social norms?

Back 39

conduct disorder

Front 40

This disorder has onset before age 18. Characterized by sudden, rapid, recurrent, nonrhythmic, stereotyped motor movements or vocalizations (tics) that persist for greater than a year. Coprolalia (obscene speech) found in 20% of patients. Associated with OCD. Treatment is with haloperidol

Back 40

Tourette's syndrome

Front 41

This disorder has a common onset at 7-9 years of age. There is an overwhelming fear of separation from home or loss of attachment figure. May lead to factitious physical complaints to avoid going to school

Back 41

separation anxiety disorder

Front 42

This set of disorders is defined by difficulties with language and failure to acquire, or early loss of social skills

Back 42

Pervasive developmental disorders

Front 43

This pervasive developmental disorder is characterized by severe language impairment and poor social interactions. Greater focus on objects than on people. Repetitive behavior and below-normal intelligence. More common in boys

Back 43

Autistic disorder

Front 44

How do you treat autistic disorder?

Back 44

behavioral and supportive therapy to improve communication and social skills

Front 45

This is a milder form of autism that is characterized by all-absorbing interests, repetitive behavior, and problems with social relationships. No language impairment

Back 45

Asperger's disorder

Front 46

This is an X-linked disorder seen almost exclusively in girls. There is loss of development, loss of verbal abilities, mental retardation, ataxia, and stereotyped hand wringing

Back 46

Rett's disorder

Front 47

This disorder has a common age of onset of 3-4 years. Marked by significant loss of expressive or receptive language skills, social skills or adaptive behavior, bowel or bladder control, play, or motor skills. More common in boys

Back 47

childhood disintegrative disorder

Front 48

With schizophrenia there is ____ dopamine

Back 48

increased

Front 49

With Parkinson's disease there is ____ dopamine, ____ serotonin, and ____ AcH

Back 49

decreased, increased, increased

Front 50

This describes the patients ability to know who she or he is, what time and date it is, and what his or her present circumstances are

Back 50

orientation

Front 51

What is the order of loss of orientation?

Back 51

1st - time, 2nd = place, 3rd = person

Front 52

Can hypoglycemia cause loss of orientation?

Back 52

yes

Front 53

This is defined as inability to remember things that occurred before a CNS insult

Back 53

retrograde amnesia

Front 54

This is defined as inability to remember things that occurred after an CNS insult (no new memory)

Back 54

anterograde amnesia

Front 55

This is classic anterograde amnesia caused by thiamine deficiency and the associated destruction of mammillary bodies. May also include some retrograde amnesia. Seen in alcoholics, and associated with confabulations

Back 55

Korsakoff's amnesia

Front 56

This is inability to recall important personal information, usually subsequent to severe trauma or stress

Back 56

dissociative amnesia

Front 57

Delirium and dementia are classified under ____ disorders

Back 57

cognitive

Front 58

____ is characterized by waxing and waning level of consciousness with acute onset, whereas with ____ there is gradual decrease in intellectual ability or cognition without affecting level of consciousness

Back 58

Delirium, dementia

Front 59

This is the most common psychiatric illness on medial and surgical floors. Associated with abnormal EEG. Check for drugs with anti-cholinergic effect

Back 59

delirium

Front 60

In elderly patients, ____ may present like dementia

Back 60

depression

Front 61

This is a distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thinking.

Back 61

psychotic disorder

Front 62

This is perceptions in the absence of external stimuli (seeing a light that is not actually present)

Back 62

hallucination

Front 63

This is perceiving external stimuli as something they are not (seeing a light and thinking that it is the sun)

Back 63

illusion

Front 64

This is the false belief about oneself or others that persist despite the facts (thinking the CIA is spying on you)

Back 64

delusion

Front 65

This is disorders in the form of thought (the way ideas are tied together)

Back 65

loose associations

Front 66

_____ hallucinations are more commonly a feature of medical illness than psychiatric illness

Back 66

Visual

Front 67

_____ hallucinations are more commonly a feature of psychiatric illness (schizophrenia) than medical illness

Back 67

auditory

Front 68

____ hallucinations occur as an aura of psychomotor epilepsy and in brain tumors

Back 68

Olfactory

Front 69

____ hallucinations are common in alcohol withdrawal (the sensation of insects crawling on one's skin) or also seen in cocaine abusers

Back 69

tactile

Front 70

This type of hallucination occurs while going to sleep

Back 70

hypnagogic hallucination

Front 71

THis is a chronic mental disorder with periods of psychosis, disturbed behavior and thought, and decline in functioning that lasts more than 6 months. Associated with increased dopaminergic activity and decreased dendritic branching.

Back 71

schizophrenia

Front 72

____ use is a risk factor for schizophrenia in teens

Back 72

Marijuana

Front 73

How many of these symptoms must one have to be diagnosed with schizophrenia? 1) delusions 2) hallucinations 3)loose associations 4) disorganized or catatonic behavior 5) negative symptoms

Back 73

2

Front 74

In paranoid schizophrenia people are more likely to suffer from ____

Back 74

delusion

Front 75

With schizophrenia are patients at increased risk of suicide?

Back 75

Yes

Front 76

A brief psychotic disorder is less than ____ month and is usually stress related

Back 76

one

Front 77

Schizophreniform disorder is diagnosed when a psychotic episode lasts how long?

Back 77

1-6 months

Front 78

This disorder is at least 2 weeks of stable mood with psychotic symptoms plus a major depressive, manic, or mixed episode. There are 2 subtypes: bipolar or depressive

Back 78

schizoaffective disorder

Front 79

This is a fixed, persistent, nonbizarre belief system lasting for greater than 1 month. Functioning otherwise not impaired. Such as when a woman believes she is married to a celebrity when in fact she is not

Back 79

delusional disorder

Front 80

This is development of delusions in a person in a close relationship with someone with delusional disorder. Often resolves upon separation

Back 80

shared psychotic disorder (folie a deux)

Front 81

This is a disorder defined by the presence of 2 or more distinct identities or personality states. More common in women. Associated with history of sexual abuse

Back 81

dissociative identity disorder

Front 82

This is a disorder defined by persistent feeling of detachment or estrangement from one's own body, a social situation, or the environment

Back 82

depersonalization disorder

Front 83

This is an abrupt change in geographic location with inability to recall past, confusion about personal identity, or assumption of a new identity. Associated with traumatic circumstances. Not the result of substance abuse or general medical condition

Back 83

dissociative fugue

Front 84

A manic episode must last at least _____ to be termed a manic episode

Back 84

a week

Front 85

In a manic episode is there an increased or decreased need for sleep

Back 85

decreased

Front 86

This is like a manic episode except mood disturbance is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. No psychotic features

Back 86

hypomanic episode

Front 87

This disorder is defined by the presence of at least 1 manic (bipolar I) or hypomanic (bipolar II) episode. Depressive symptoms always occur eventually. Patient's mood and functioning usually return to normal between episodes.

Back 87

bipolar disorder

Front 88

Use of antidepressants can lead to increased mania. True or False

Back 88

True

Front 89

Lithium, valproic acid, and carbamazepine are used to treat what psychotic disorder?

Back 89

bipolar

Front 90

In this disorder there is dystheymia and hypomania; milder form of bipolar disorder lasting at least 2 years

Back 90

cyclothymic disorder

Front 91

This is a milder form of depression lasting at least 2 years

Back 91

dysthymia

Front 92

This disorder is associated with winter season; improves in response to full spectrum light exposure

Back 92

seasonal affective disorder

Front 93

This type of depression is characterized by hypersomnia, overeating, and mood reactivity (the ability to experience improved mood in response to positive events vs. persistent sadness). Associated with weight gain and sensitivity to rejection. Most common subtype of depression and can be treated with MAO inhibitors or SSRIs

Back 93

atypical depression

Front 94

THis type of postpartum mood disturbance occurs in 50-85% of women and is characterized by depressed affect, tearfulness, and fatigue. Usually resolves within 10 days. Treatment is supportive

Back 94

Maternal blues

Front 95

This postpartum mood disturbances has a 10-15% incidence rate. Characterized by depressed affect, anxiety and poor concentration. Lasts 2 weeks to 1 year. Treatment is antidepressants and psychotherapy

Back 95

postpartum depression

Front 96

This postpartum mood disturbances has a 0.1 to 0.2% incidence rate and is characterized by delusions, confusion, unusual behavior, and possible homicidal/suicidal ideations or attempts. Usually lasts days to 4-6 weeks

Back 96

postpartum psychosis

Front 97

This is a treatment option for major depressive disorder refractory to other treatment and for pregnant women with major depressive disorder. Produces a painless seizure in an anesthetized patient

Back 97

electroconvulsive therapy (ECT)

Front 98

With suicide ___ try more often, ____ succeed more often

Back 98

women, men

Front 99

This is inappropriate experience of fear/worry and its physical manifestation when the source of the fear/worry is either not real or insufficient to account for the severity of the symptoms. Symptoms interfere with daily functioning. Lifetime prevelance of 30% in women, and 19% in men

Back 99

anxiety disorder

Front 100

Panic disorder, phobias, OCD, and PTSD are under what type of disorders

Back 100

anxiety disorder

Front 101

This is defined by the presence of recurrent periods of intense fear and discomfort peaking in 10 minutes with at least 4 of the following: palpitations, paresthesias, abdominal distress, nausea, intense fear of dying or losing control, light-headedness, chest pain, chills, choking, disconnectednes, sweating, shaking, shortness of breath

Back 101

panic disorder

Front 102

This is an exaggerated fear of embarrassment in social situations and can be treated with SSRIs

Back 102

social phobia (social anxiety disorder)

Front 103

This is recurring intrusive thoughts, feelings, or sensations (obsessions) that cause severe distress; relieved in part by the performance of repetitive actions. This is ego dystonic (behavior inconsistent with one's own beliefs and attitudes). Associated with Tourette's disorder

Back 103

obsessive compulsive disorder (OCD)

Front 104

How does one treat OCD?

Back 104

SSRIs, clomipramine

Front 105

Post traumatic stress disorder disturbances lasts greater than ___ month

Back 105

one

Front 106

Acute stress disorder lasts between ___

Back 106

2 days and 1 month

Front 107

This is a pattern of uncontrolled anxiety for at least 6 months that is unrelated to a specific person, situation, or event. Associated with sleep disturbance, fatigue, GI disturbance, and difficulty concentrating.

Back 107

Generalized anxiety disorder

Front 108

These are emotional symptoms (anxiety, depression) causing impairment following an identifiable psychosocial stressor (divorce, illness) and lasting less than 6 months

Back 108

adjustment disorder

Front 109

Patient consciously fakes or claims to have a disorder in order to attain a specific secondary gain (avoiding work, obtaining drugs). Poor compliance with treatment or follow up of diagnostic tests. Complaints cease after gain

Back 109

malingering

Front 110

Patient consciously creates physical and/or psychological symptoms in order to assume "sick role" and to get medical attention (primary gain)

Back 110

factitious disorder

Front 111

This syndrome is chronic factitious disorder with predominantly physical signs and symptoms. Characterized by a history of multiple hospital admissions and willingness to receive invasive procedures

Back 111

Munchausen's syndrome

Front 112

What is Munchausen's syndrome by proxy?

Back 112

when illness in a child is caused by the caregiver. motivation is to assume a sick role by proxy. form of child abuse

Front 113

This is a category of disorders characterized by physical symptoms with no identifiable physical cause. Both illness production and motivation are unconscious drives. Symptoms not intentionally produced or feigned. More common in women

Back 113

somatoform disorders

Front 114

With this type of disorder there is a variety of complaints in multiple organ systems (at least 4 pain, 2 GI, 1 sexual, and 1 pseudoneurologic) over a period of years

Back 114

somatization disorder

Front 115

This is sudden loss of sensory or motor function often following an acute stressor. Patient is aware of but indifferent toward symptoms. More common in adolescents and young adults

Back 115

Conversion

Front 116

This is preoccupation with and fear of having a serious illness despite medical evaluation and reassurance

Back 116

hypochondriasis

Front 117

This is a preoccupation with minor or imagined defect in appearance leading to significant emotional distress or impaired functioning; patients often seek cosmetic surgery

Back 117

body dysmorphic disorder

Front 118

This is prolonged pain with no physical findings. Pain is the predominant focus of clinical presentation and psychological factors play an important role in severity, exacerbation, or maintenance of the pain

Back 118

pain disorder

Front 119

With personality disorder, is the person usually aware or unaware of the problem?

Back 119

unaware

Front 120

This type of cluster personality disorder is odd or eccentric. There is an inability to develop meaningful social relationships. No psychosis; genetic association with schizophrenia

Back 120

Cluster A

Front 121

With this type of Cluster A personality disorder there is pervasive distrust and suspiciousness; projection is major defense mechanism

Back 121

paranoid

Front 122

With this type of Cluster A personality disorder there is voluntary social withdrawal, limited emotional expression, content with social isolation (vs. avoidant)

Back 122

schizoid

Front 123

With this type of Cluster A personality disorder there is eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

Back 123

schizotypal

Front 124

This type of personality disorder is dramatic, emotional or erratic. Genetic association with mood disorders and substance abuse

Back 124

Cluster B personality disorder

Front 125

This type of Cluster B personality disorder is characterized by a disregard for and violation of rights of others, criminality. Males>females; conduct disorder if less than 18 years

Back 125

antisocial

Front 126

This type of personality disorder is defined by unstable mood and interpersonal relationships, impulsiveness, self-mutilation, boredom, sense of emptiness; females > males; splitting is a major defense mechanism

Back 126

borderline

Front 127

This type of personality disorder is characterized by excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance

Back 127

histrionic

Front 128

This type of personality disorder is characterized by grandiosity, sense of entitlement; lacks empathy and requires excessive admiration; often demands the best and reacts to criticism with rage

Back 128

Narcissistic

Front 129

This category of personality disorder is anxious or fearful; genetic association with anxiety disorders

Back 129

Cluster C personality disorder

Front 130

This type of personality disorder is characterized by hypersensitivity to rejection, socially inhibited, timid, feelings of inadequacy, desires relationships with others

Back 130

avoidant

Front 131

This type of personality disorder is characterized by preoccupation with order, perfectionism, and control. Ego syntonic: behavior consistent with one's own beliefs and attitudes

Back 131

obsessive compulsive

Front 132

This type of personality disorder is submissive and clinging, excessive need to be taken care of, low self-confidence

Back 132

dependent personality disorder

Front 133

Schizoid + odd thinking is termed ____

Back 133

schizotypal

Front 134

1-6 month of symptoms of schizo type disorder is termed ____

Back 134

schizophreniform disorder

Front 135

This is schizophrenic psychotic symptoms + bipolar or depressive mood disorder

Back 135

schizoaffective

Front 136

This type of eating disorder lead to body weight being less than 85% of ideal body weight and commonly coexists with depression

Back 136

anorexia nervosa

Front 137

This type of disorder is associated with parotitis, enamel erosion, electrolyte disturbances, alkalosis, and dorsal hand calluses (Russell's sign)

Back 137

bulimia nervosa

Front 138

This is the desire to live as the opposite sex, often through surgery or hormone replacement

Back 138

transsexualism

Front 139

This is characterized by paraphilia, wearing clothes of the opposite sex

Back 139

transvestism

Front 140

This is a maladaptive pattern leading to clinically significant impairment or distress with recurrent use resulting in failure to fulfill major obligations at work, school, or home. There is recurrent use in physically hazardous situation and continued use in spite of persistent problems caused by use

Back 140

substance abuse

Front 141

In this stage of change in overcoming substance addition one does not yet acknowledge that there is a problem

Back 141

precontemplation

Front 142

In this stage of change in overcoming substance addition one acknowledges that there is a problem, but is not yet ready or willing to make a change

Back 142

contemplation

Front 143

In this stage of change in overcoming substance addition one is getting ready to change behavior

Back 143

preparation/determination

Front 144

In this stage of change in overcoming substance addition one is changing behaviors

Back 144

action/willpower

Front 145

In this stage of change in overcoming substance addition one is maintaining the behavior change

Back 145

maintenance

Front 146

In this stage of change in overcoming substance addition one is returning to old behaviors and abandoning new changes

Back 146

relapse

Front 147

What are the stages of change in overcoming substance addiction?

Back 147

1) precontemplation 2) contemplation 3) preparation/determination 4) action/willpower 5) maintenance 6) relapse

Front 148

Anxiety, tremor, seizures, and insomnia is seen with withdrawl from what substance?

Back 148

depressants

Front 149

What is the treatment for delirium tremens?

Back 149

benzodiazepines

Front 150

Intoxication with these substances cause CNS depression, nausea and vomiting, constipation, pupillary constriction (pinpoint pupils), and seizures (overdose is life-threatening). Treatment is with naloxone and naltrexone

Back 150

opioids

Front 151

Withdrawal from these substances lead to symptoms such as sweating, dilated pupils, piloerection, fever, rhinorrhea, nausea, stomach cramps, and diarrhea

Back 151

opioids

Front 152

This class of drugs has a low safety margin and intoxication leads to marked respiratory depression. Treatment is to assist respiration and increase BP

Back 152

barbiturates

Front 153

Withdrawal from this depressant leads to delirium and life-threatening cardiovascular collapse

Back 153

barbiturates

Front 154

This class of depressants have a greater safety margin. There is ataxia and minor respiratory depression. Treatment is with flumazenil

Back 154

benzodiazepines

Front 155

Intoxication with this substance will lead to impaired judgement, pupillary dilation, prolonged wakefulness and attention, delusions, hallucinations and fever but no paranoid ideations, angina, or sudden cardiac death

Back 155

amphetamines

Front 156

Intoxication with this substance leads to impaired judgment, pupillary dilation, hallucinations such as crawling feeling on skin, paranoid ideations, angina and sudden cardiac death. Treatment is with benzodiazepines

Back 156

cocaine

Front 157

Restlessness, increased diuresis, and muscle twitching can result from the use of what stimulant?

Back 157

caffeine

Front 158

Bupropion/varenicline is used in the withdrawal from what substance?

Back 158

nicotine

Front 159

This type of hallucinogen will lead to belligerence, vertical and horizontal nystagmus, tachycardia, homicidality, psychosis, and delirium (such as the belief one is immortal)

Back 159

PCP

Front 160

This type of hallucinogen will lead to marked anxiety or depression, delusions, visual hallucinations, flashbacks, and pupillary dilation

Back 160

LSD

Front 161

This type of hallucinogen causes euphoria, paranoid delusions, perception of slowed time, impaired judgement and social withdrawal

Back 161

marijuana

Front 162

With marijuana use is there increased or decreased appetite?

Back 162

increased

Front 163

Marijuana can be detected in urine up to ___ month after last use

Back 163

one

Front 164

Users of this substances are at increased risk for hepatitis, abscesses, overdose, hemorrhoids, AIDS, and right sided endocarditis. Look for track marks (needle sticks in veins)

Back 164

heroin addiction

Front 165

This is a long lasting oral opiate; used for heroin detoxification or long term maintenance

Back 165

methadone

Front 166

Naloxone + buprenorphine (partial agonist) together is termed what drug?

Back 166

suboxone

Front 167

This drug is long acting with fewer withdrawal symptoms than methadone. Naloxone (which is part of this drug) is not active when taken orally, so withdrawal symptoms occur only if injected (lower abuse potential)

Back 167

suboxone

Front 168

Wernicke-Korsakoff syndrome is caused by _____ deficiency. Triad of confusion, opthalmoplegia, and ataxia (Wernicke's encepholopathy)

Back 168

thiamine

Front 169

This disease is associated with periventricular hemorrhage/necrosis of mammillary bodies. Treatment is vitamin B1 (thiamine)

Back 169

Wernicke-Korsakoff syndrome

Front 170

This syndrome leads to longitudinal lacerations at the GE junction caused by excessive vomiting. Often presents with hematemesis. Associated with pain (vs. esophageal varices)

Back 170

Mallory-Weiss syndrome

Front 171

What drug can be used to treat alcoholism?

Back 171

disulfiram (to condition the patient to abstain from alcohol use)

Front 172

This is a life-threatening alcohol withdrawal syndrome that peaks 2-5 days after last drink

Back 172

delirium tremens

Front 173

Alcohol withdrawal may lead to this condition which is marked by these symptoms in order of appearance: 1) autonomic system hyperactivity (tachycardia, tremors, anxiety, seizures), psychotic symptoms (hallucinations, delusions), confusion.

Back 173

delirium tremens

Front 174

What class of drugs are used to treat delirium tremens?

Back 174

benzodiazepines

Front 175

What class of drugs are used to treat bulimia?

Back 175

SSRIs

Front 176

What class of drugs are used to treat anxiety?

Back 176

Benzodiazepines, buspirone, SSRIs

Front 177

What drugs are used to treat ADHD?

Back 177

methylphenidate (ritalin), amphetamines (dexedrine)

Front 178

What drugs are used to treat atypical depression?

Back 178

MAO inhibitors, SSRIs

Front 179

What drugs are used to treat bipolar disorder?

Back 179

lithium, valproic acid, carbamezepine as mood stabilizers and atypical antipsychotics

Front 180

What drugs are used for depression?

Back 180

SSRIs, SNRIs, TCAs

Front 181

What drug is used to treat depression with insomnia?

Back 181

Mirtazapine

Front 182

What drugs are used to treat OCD?

Back 182

SSRIs, clomipramine

Front 183

What drugs are used to treat panic disorder?

Back 183

SSRIs, TCAs, benzodiazepines

Front 184

What drugs are used to treat PTSD?

Back 184

SSRIs

Front 185

What drugs are used to treat tourette's syndrome?

Back 185

haloperidol, risperidone

Front 186

What is the mechanism of action of methylphenidate and dextroamphetamine?

Back 186

increase catecholamines at synaptic cleft, especially NE and dopamine

Front 187

What is methylphenidate and dextroamphetamine used to treat?

Back 187

ADHD, narcolepsy, appetite control

Front 188

Drugs that end in -azines are what type of drugs?

Back 188

antipsychotics

Front 189

All typical antipsychotics block ____ receptors increasing cAMP

Back 189

D2

Front 190

Antipsychotics are primarily used to treat the ____ symptoms of schizophrenia

Back 190

positive

Front 191

These antipsychotics have high potency and therefore are more likely to exhibit neurologic side effects such as extrapyramidal symptoms

Back 191

trifluoperazine, fluphenazine, haloperidol

Front 192

These antipsychotics have low potency and have non-neurologic side effects (anti-cholinergic, antihistamine, and alpha blockade effects)

Back 192

chlorpromazine, thioridazine

Front 193

Where does chlorpromazine usually deposit (anti-psychotic)

Back 193

corneal deposits

Front 194

Where does thioridazine usually deposit?

Back 194

retinal deposits

Front 195

Antipsychotics are highly lipid soluable and therefore stored where? Thus they are very slowly removed from body and can cause toxicity

Back 195

stored in body fat

Front 196

What are some endocrine side effects of antipsychotics?

Back 196

since there is dopamine receptor antagonism there is hyperprolactinemia and galactorrhea

Front 197

Side effects of antipsychotics such as dry mouth and constipation occur due to block of ____ receptors, hypotension due to block of ____ receptors, and sedation due to block of ____ receptors

Back 197

muscarinic, alpha, histamine

Front 198

This syndrome is defined by rigidity, myoglobinuria, autonomic instability, hyperprexia. Treatment is with dantrolene or a D2 agonist such as bromocriptine

Back 198

neuroleptic malignant syndrome

Front 199

Use of anti-psychotics can lead to this toxicity such as stereotypic oral-facial movements due to long-term antipsychotic use. Often irreversible

Back 199

tardive dyskinesia

Front 200

Olanzapine is what type of drug?

Back 200

atypical antipsychotic

Front 201

Clozapine is what type of drug?

Back 201

atypical antipsychotic

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Quetiapine is what type of drug?

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atypical antipsychotic

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Riseridone is what type of drug?

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atypical antipsychotic

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Aripiprazole is what type of drug?

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atypical antipsychotic

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Ziprasidone is what type of drug?

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atypical antipsychotic

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This atypical antipsychotic is used to treat OCD, anxiety disorder, depression, mania, and Tourette's syndrome

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olanzapine

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What two atypical antipsychotics can cause significant weight gain?

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olanzapine/clozapine

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This atypical antipsychotic may cause agranulocytosis (requires weekly WBC monitoring)

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clozapine

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This atypical antipsychotic may prolong the QT interval

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ziprasidone

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This drug is a mood stabilizer for bipolar disorders; blocks relapse and acute manic events. Also SIADH

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lithium

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What are some side effects of lithium use?

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movement, nephrogenic diabetes insipidus, hypothyroidism, pregnancy problems

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Toxicity of this drug is hypothyroidism, polyuria, and teratogenesis. Fetal cardiac defects include Ebstein anomaly and malformation of the great vessels.

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lithium

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Does lithium have a big or narrow therapeutic window?

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narrow, requires close monitoring of serum levels

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This drug is almost exclusively excreted by the kidney; most is reabsorbed at the proximal tubules following sodium reabsorption. Can lead to hypothyroidism and nephrogenic diabetes insipidus

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lithium

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This drug stimulates 5HT1A receptors and is used to treat generalized anxiety disorder. Does not cause sedation, addiction or tolerance. Does not interact with alcohol (vs. barbiturates, benzodiazepines)

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buspirone

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_____ end in -iptyline or ipramine except for doxepin and amoxapine

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TCAs

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This class of drugs block reuptake of NE and serotonin

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tricyclic antidepressants

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What TCA is used to treat bedwetting?

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imipramine

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What TCA is used to treat OCD?

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clomipramine

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What TCA is the least sedating and has lower seizure threshold?

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desipramine

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Do TCAs have anticholinergic side effects?

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Yes such as tachycardia, urinary retention

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Do tertiary TCAs such as amitriptyline have more or less anticholinergic effects than do secondary TCAs such as nortriptyline

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tertiary have more side effects

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What are the toxicities of TCAs?

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convulsions, coma, cardiotoxicity (arrhythmias), also respiratory depression, hyperpyrexia. Confusion and hallucinations in elderly due to anti-cholinergic side effects

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What is the treatment for cardiovascular toxicity of tricyclic antidepressants?

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NaHCO3

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It normally takes how long for antidepressants to have an effect?

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4-8 weeks

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Fluoxetine is what class of drug?

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SSRI

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Paroxetine is what class of drug?

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SSRI

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Sertraline is what class of drug?

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SSRI

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Citalopram is what class of drug?

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SSRI

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What are some toxicities of SSRIs?

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fewer than TCAs. GI distress, sexual dysfunction (anorgasmia)

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This syndrome presents with hyperthermia, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures and can be treated with cyproheptadine

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serotonin syndrome

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This 2 drugs are SNRIs that inhibit serotonin and NE reuptake

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venlafaxine, duloxetine

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Does venlafaxine or duloxetine have greater effect on NE?

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duloxetine

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With the SNRIs, _____ is used in generalized anxiety disorder; _____ is indicated for diabetic peripheral neuropathy

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venlafaxine, duloxetine

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What are the toxicities of SNRIs?

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increased BP most common, also stimulant effects, sedation, nausea

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Tranylcypromine is what type of drug?

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monoamine oxidase (MAO) inhibitor

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Phenelzine is what type of drug?

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monoamine oxidase (MAO) inhibitor

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Isocarboxazid is what type of drug?

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monoamine oxidase (MAO) inhibitor

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Selegiline is a selective MAO-B inhibitor and therefore increases the concentration of _______

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dopamine

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Nonselective MAO inhibition increases the levels of what amine neurotransmitters?

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NE, serotonin, dopamine

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With MAO inhibitors hypertensive crisis can occur with ___ ingestion (which can be found in wine and cheese)

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tyramine

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This class of drugs is contraindicated with SSRIs or meperidine to prevent serotonin syndrome

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MAO inhibitors

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This drug is an atypical antidepressant this is also used for smoking cessation. Increase NE and dopamine via unknown mechanism

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bupropion

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This atypical antidepressant can cause seizure in bulimic patients but has no sexual side effects

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bupropion

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This atypical antidepressant is an alpha antagonist (increases release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist. Toxicity: sedation, increased appetite, weight gain, dry mouth

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mirtazapine

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This atypical antidepressant blocks NE reuptake. Toxicity is sedation and orthostatic hypotension

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maprotiline

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This atypical antidepressant inhibits serotonin reuptake. Used for insomnia, as high doses are needed fro antidepressant effects. Toxicity: sedation, nausea, priapism, postural hypotension

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trazedone