Psych Set 3

Front 1

Potential side effect from dopamine blockade by antipsychotics?

Back 1

Increases prolactin concentration, which may lead to galactorrhea, impotence, menstrual dysfunction, and decreased libido.

Front 2

Unique side effect of thioridazine.

Back 2

retinal pigment deposits

Front 3

Unique side effect of clozapine.

Back 3

agranulocytosis
(monitor CBCs weekly)

Front 4

Unique side effect of chlorpromazine.

Back 4

jaundice and photosensitivity

Front 5

Signs and symptoms of mania.

Back 5

DIG FAST:
Distractability, Insomnia, Grandiosity, Flight of ideas, Activities agitation, Sexual indiscretion/Shopping sprees, Talkativeness

Front 6

Classic presentation of bipolar disorder.

Back 6

A history of mania alternating with depression.

Front 7

Age of onset for bipolar disorder

Back 7

Between 16 and 30 years of age

Front 8

First line of treatment for bipolar disorder

Back 8

Lithium and Valproic acid

Front 9

Second line of treatment for bipolar disorder

Back 9

Carbamazepine, olanzapine, and gabapentin

Front 10

Side effects of lithium

Back 10

Think: Brain, Thyroid, Kidneys
Brain: tremor
Thyroid: hypothyroidism, weight gain
Kidneys: nephrogenic diabetes insipidus, thirst

Front 11

Organ dysfunction with valproic acid use

Back 11

Liver disfunction

Front 12

SE of carbamazepine

Back 12

bone marrow depression

Front 13

Bipolar I vs Bipolar II

Back 13

Bipolar I: mania + MDE
Bipolar II: hypomania + MDE

Front 14

Mania vs hypomania

Back 14

Hypomania = mild mania wihtout psychosis that does not cause occupational dysfunction

Front 15

Cyclothymia

Back 15

Hypomania + moderate depression
for > 2 years

Front 16

Bipolar epidemiology:
Prevalence, gender ratio, age of onset, suicide rate

Back 16

prevalence = 1%
male:female ratio = 1:1
age of onset = 20's
suicide rate = 10-15%

Front 17

Signs and symptoms of typical Depression

Back 17

SIG E CAPS
Sleep (decr), Interest (decr), Guilt, Energy (decr), Concentration (decr), Appetite (decr), Psychomotor agitation, Suicidal ideation (2/3 of patients)

Front 18

Pyschiatric disorder that has the greatest risk of suicide

Back 18

Depression

Front 19

Sleep cycle disturbance in depression

Back 19

Decreased REM sleep

Front 20

Feature that worsens the prognosis of depression

Back 20

Psychotic features: typically mood congruent delusions/hallucinations

Front 21

S/S of atypical depresion

Back 21

Weight gain, hypersomnia, rejection sensitivity

Front 22

Treatment of atypical depression

Back 22

MAOI: Phenelzine, Tranylcypromine

Front 23

Dysthymia

Back 23

Depression for > 2 years

Front 24

Adjustment disorder

Back 24

Depression that occurs within 3 months of a stressor (job loss, move) and resolves by 6 months

Front 25

Gender with greater incidence of depression

Back 25

Female

Front 26

Risk of antidepressant use in bipolar patients

Back 26

Antidepressants can trigger mania or hypomania in bipolar patients

Front 27

First line drug treatment of depression

Back 27

SSRI: Fluoxetine, Sertraline, Paroxetine

Front 28

MOA and SE of TCA's

Back 28

MOA: prevents reuptake of NE and serotonin

SE: Tri-A's
Anticholinergic
Antimuscarinic (orthostatic hypotension)
Arrthymia (cardiac, fatal)

Front 29

Second line drug treatment of depression

Back 29

TCA: Nortriptyline, Amitriptyline

Front 30

MOA and SE of SSRI's

Back 30

MOA: prevent reuptake of serotonin

SE: sexual dysfunction, insomnia, anorexia

Front 31

Dietary caution with use of MAOI

Back 31

Foods containing tyramine (red wine and aged cheese) may cause hypertensive crisis.

Same can happen with MAOI and SSRI or meperidine.

Front 32

Unique SE of trazodone

Back 32

Priapism: painful, sustained erection without sexual arousal or desire

Front 33

Unique SE of bupropion

Back 33

Decreased seizure threshold

Front 34

Atypical antidepressants

Back 34

Bupropion, Trazodone

Front 35

Serotonin syndrome

Back 35

Fever, myoclonus, mental status change, cardiovascular collapse

Front 36

Most effective treatment of depression

Back 36

Electroconvulsive therapy; use if immediate treatment is necessary.

Front 37

Grief/bereavement

Back 37

Depression developing after the loss of a loved one, but limited to one year only. S/S for > 1 yr = depression.

Front 38

Can grief include illusion or hallucinations?

Back 38

Yes, but a normal grieving person knows that they are only illusions or hallucinations, whereas a depressed person believes the illusions or hallucinations are real.

Front 39

Signs that grief is actually depression

Back 39

Feelings of worthlessness, psychomotor retardation, and suicidal ideations.

Front 40

Treatment of grief/bereavement

Back 40

Support, pscythotherapy. No drugs needed for grief because it is self-limiting.

Front 41

Cluster A PDs

Back 41

Paranoid
Schizoid
Schizotypal

Front 42

Cluster B PDs

Back 42

Borderline
Antisocial
Histrionic
Narcissistic

Front 43

Cluster C PDs

Back 43

OCPD
Avoidant
Dependent

Front 44

Paranoid PD

Back 44

Axis II
distrustful/suspicious of other people

There are no hallucinations/delusions as seen in paranoid schizophrenia.

Front 45

Schizoid PD

Back 45

Axis II
isolated, "loner"
Patient is content with being alone.

Front 46

Schizotypal PD

Back 46

Axis II
Odd behavior, perception, appearance
Magical thinking, ideas of reference

Front 47

Borderline PD

Back 47

Axis II
Volatile, unstable mood, impulsive
Pts exhibit "splitting": people are either all good or all bad

Front 48

Antisocial PD

Back 48

Axis II
Violate rights of others, social norms, and laws.
Cruel to people and animals.
Strong association with alcoholism and drug abuse as well as somatization disorder.

Must show s/s by age 15, and cannot be diagnosed until age 18. Younger than 18 = conduct d/o.

Front 49

Histrionic PD

Back 49

Axis II
Attention-seeking, overly-dramatic, and inappropriately seductive

Front 50

Narcissistic PD

Back 50

Axis II
Egocentric and lacking empathy; grandiose

Pts react with rage when critisized.

Front 51

OCPD

Back 51

Axis II
Preoccupied with perfectionism, order, and control
anal-retentive, stubborn
very inefficient

Front 52

Avoidant PD

Back 52

Axis II
Socially inhibited, rejection sensitive, fear of being disliked or ridiculed
Pts are loners, but desire to have friends.

Front 53

Dependent PD

Back 53

Axis II
Submissive, clingy, highly dependent of others
Cannot make decisions alone

e.g. a wife who stays with her abusive husband

Front 54

Axis II d/o that most close resembles schizophrenia

Back 54

Schizotypal PD

Schizotypal pts may become psychotic.

Front 55

Axis II d/o that has suicidal ideations

Back 55

Borderline PD