Psych Substance/drugs - Ms3 Part 3

Front 1

labs to order before starting Li2+:

(4)

Back 1

1. TSH

2. chem 7

3. ECG

4. preg/hCG

Front 2

SE's of Li2+:

(7)

Back 2

1. AKI

2. nephrogenic DI

3. hypothy (add synthroid)

4. arrythmias (esp. persistent tachy)

5. GI

6. tremors

7. sez's

Front 3

labs to get before starting valproate:

(3)

Back 3

1. LFT's

2. CBC w/ diff

3. hCG

Front 4

teratogenicity of Valproate =

Back 4

NTD's

(anencephaly, spina bifida, etc.)

- give TONS of folate (4 mg)

Front 5

SE's of valproate use:

(6)

Back 5

1. hepatitis

2. dec. blood cells (leukopenia, etc.)

3. PCOS

4. wt gain

5. (rare) fulminant pancreatitis

6. alopecia

Front 6

labs to get before starting CBZ:

(4)

Back 6

1. LFT's

2. CBC w/ diff

3. chem 7

4. hCG

Front 7

teratogenicity of CBZ =

Back 7

NTD's

(like valproate)

Front 8

SE's of CBZ:

(5)

Back 8

1. aplastic anemia

2. isolated thrombocytopenia

3. agranulocytosis

(BM can't make neutrophils)

4. hyponatremia

5. induces CYP, met. by liver

Front 9

Li2+ won't start working for:

Back 9

1 week

=> Tx for acute mania = antipsychotic, +benzo if agitated

Front 10

anxiety *never* results in:

Back 10

unconsciousness

- think syncope, hypoglycemia, angina, arrythmias, sez

Front 11

most SE's of SSRI's, except libido,

Back 11

go away after a couple mths

Front 12

Tx PCP intox =

Back 12

low-stimulus environment

- if violent and/or psychotic, Tx = antipsychotic + benzo

Front 13

**sudden WD of benzo's, barbs, or alcohol =>

(3)

Back 13

sez's, anxiety, tremors

Front 14

best antipsychotic for delirium =

Back 14

Haldol

Front 15

SSRI's can briefly worsen:

Back 15

insomnia

Front 16

Tx adjustment disorder =

Back 16

psychotherapy

Front 17

mental retardation ~~

Back 17

anger/outbursts when not understanding schoolwork,

difficulties w/ socializing, caring for self

Front 18

borderline intelligence =

Back 18

IQ 71-84

Front 19

sedation SE from clonidine will go away after:

Back 19

several weeks

Front 20

HYPERthyroidism can *also* cause:

Back 20

depression

Front 21

Benadryl is **not**:

Back 21

addictive

Front 22

Tx Tourette's =

(3)

Back 22

1. atypical antipsychotic (esp. Risp)

2. Clonidine or Guanfacine

3. typical antipsychotics only if severe

Front 23

difference b/w adjustment disorder with depressive mood and MDD =

Back 23

adjustment w/ depressive mood does NOT meet the full depression criteria

Front 24

features of anorexia:

(6)

Back 24

1. osteoporosis

2. hypercholesterolemia

3. elevated blood carotene

4. QTc

5. HPA dysfunction => EST deficiency, amenorrhea, anovulation

6. hyponatremia due to excess water intake

Front 25

sexual assault ==>

Back 25

depression and SI

Front 26

2 episodes of acute mania =>

Back 26

years-long Li2+

- 3 episodes => life-long

Front 27

in paranoid PD, there are *no*:

Back 27

persistent delusions or other psychotic symps

Front 28

remember that performance anxiety *requires*:

Back 28

public speaking

- o/w it's (generalized) social anxiety disorder

Front 29

opioid OD ~~

(3)

Back 29

hypotension, hypothermia, brady

(it's a CNS depressant)

Front 30

cholinergic toxicity =>

(6)

Back 30

n/v, brady, sez's, lacrimation, salivation, diarrhea

Front 31

atropine =

Back 31

antimuscarinic

- *blocks* ACH

Front 32

antipsychotics _________ seizure threshold, like:

Back 32

*lower* seizure threshold, like benzo's

Front 33

ADHD: if first stimulant isn't working, try:

Back 33

another stimulant

Front 34

TOC for psychotic during preg =

Back 34

Haldol

Front 35

*smoking* opiates ==>

Back 35

immediate effect

Front 36

nicotine intoxication =>

(4)

Back 36

1. confusion

2. cramps

3. muscle twitching

4. even resp failure and coma

Front 37

best treatment for hypertensive crisis =

Back 37

IV phentolamine (a-blocker)

- better than B-blocker or CCB

Front 38

organic causes of mania:

Back 38

thyrotoxicosis, Cushings syndrome, hypoglycemia, electrolytes, WD, steroids, anticholinergic meds, CNS insults

Front 39

amok =

Back 39

violent or furious outburst w/ homicidal intent

Front 40

Ganser synd. =

Back 40

approximate or outright ridiculous answers

- may include amnesia, conversion disorder, H's

Front 41

Latah =

Back 41

sudden fear + catatonic features

Front 42

**antidepressants in bulimia:**

Back 42

decrease binge-eating and purging

Front 43

DBT ~~

(3)

Back 43

1. advice

2. confrontation

3. HW

Front 44

eye-movement desensitization is used to treat:

Back 44

PTSD

Front 45

Amantadine mechanism and use:

Back 45

Dopa agonist,

3rd-line for EPS (if benztropine or diphenhydramine don't work)

Front 46

NPD defense mechanism =

Back 46

denial

Front 47

saccadic eye movement =

Back 47

voluntary, smooth, *nl* eye movement

Front 48

cold water =>

Back 48

nystagmus w/ fast component *away* from ear

Front 49

catalepsy =

Back 49

assumption of an immobile position that is constantly maintained

- a symptom of catatonia

Front 50

Li2+ toxicity ~~

Back 50

severe CNS and renal impairment

Front 51

**benzo's should be avoided in:**

(3)

Back 51

respiratory conditions and delirium and PTSD

Front 52

MAOI coupled with meperidine =>

Back 52

hypertensive crisis

Front 53

right parietal lobe ~~

Back 53

visual, non-verbal memory

Front 54

MAOI during preg =>

Back 54

HTN

- use SSRI's over ECT

Front 55

inc. CPK indicates:

Back 55

muscle injury

Front 56

NMS ~~

(3)

Back 56

1. muscle rigidity

2. confusion

3. mutism

Front 57

apart form Clozapine, agranulocytosis can also be seen in:

(2)

Back 57

1. CBZ

2. Valproate

Front 58

somatization disorder is often seen w/:

(3)

Back 58

anxiety, depression, and PD's

Front 59

mc PD in somatization disorder =

Back 59

HPD

Front 60

frank hallucinations are *rare* in schizotypal disorder, although:

Back 60

they can pop up during times of stress

Front 61

common comorbidities of factitious disorder:

(5)

Back 61

depression

anxiety

SI

BPD

HPD

Front 62

cocaine hits *both* alpha and Beta r's; if giving B-blocker by itself, =>

Back 62

unopposed alpha action ==> hypertensive urgency

Front 63

venlafaxine at high doses ==>

Back 63

HTN

Front 64

withdrawal synd of SSRI's =

Back 64

flu-like symps, brain zaps, muscle aches

- the shorter the half-life, the more likely

Front 65

SSRI for dysthymic disorder should be taken for:

Back 65

8 weeks before it can be called ineffectual

Front 66

Couvade synd =

Back 66

husband of preg wife experiences same symps

Front 67

copropraxia =

Back 67

obscene gestures

- bruxism = grinding of teeth

Front 68

hemiballismus =

Back 68

uncontrollable, sudden swing of an extremity

Front 69

athetoid ~~

Back 69

snake-like movements of hands

Front 70

thought broadcasting = delusion that:

Back 70

others can read your thoughts

Front 71

1st-line Tx for bipolar =

Back 71

Li2+/Valproate/CBZ or atypical antipsychotic

- the latter more so because they start working faster

Front 72

actus reus =

Back 72

willingness to commit a crime

Front 73

zolpidem (Ambien) DOES have:

Back 73

abuse pot.

Front 74

zaleplon should be avoided in:

Back 74

alcoholics, due to possible liver problems

Front 75

lamotrigine = TOC for:

Back 75

bipolar *depressive* episode

Front 76

Tx Tourette's =

Back 76

atypical antipsychotics,

followed by Clonidine

Front 77

best Tx for enuresis =

Back 77

behavior

- buzzer or pad

Front 78

features of FAS:

(4)

Back 78

1. microcephaly, small jaw

2. flat midface

3. thin upper lip

4. smooth philtrum

Front 79

most delirium in the elderly is due to blocking:

Back 79

ACH

Front 80

if BiPD woman becomes preg, switch from Li2+/CBZ/V to:

Back 80

Haldol

Front 81

type II error =

Back 81

FN

- *says no difference* when in fact there is a difference

Front 82

EPS, TD ~~ which part of the brain?

Back 82

Basal Ganglia

Front 83

TOC for opioid WD =

Back 83

Clonidine

- inhibits autonomic instability

-- naloxone will *worsen* opioid WD; it's best for opioid *OD*

Front 84

paroxetine has some ___________________ effect

Back 84

anticholinergic