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331 Cards in this Set
- Front
- Back
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Psychosis defined by presence of one of the following:
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1. delusional thinking
2. hallucinations 3. diordered thought process |
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olfactory hallucinations often assoc with?
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Auras of epilepsy
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Tactile hallucinations seen in..?
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drug abuse, alcohol withdrawal
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negative symtpoms of schizophrenia?
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5 As:
Anhedonia, affect (flat), alogia, avolition, attention (poor) |
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highest functioning subtype of schizophrenia?
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paranoid
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disorganized type schizophrenia?
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- disorganized speech
- disorganized behavior - flat or inappropriate affect |
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concordance rate of schizophrenia among monozygotic twins?
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50%
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risk of having schizophrenia if one first-degree relative is affected?
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12%
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dopamine pathways affected in schizophrenia?
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Prefrontal cortical - negative symptoms
Mesolimbic - responsible for positive symptoms |
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which drugs excite dopaminergic pathways?
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cocaine, amphetamines
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significant improvement is noted in what % of schizophrenic patients who take an antipsychotic medication?
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70%
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name the typical neuroleptics?
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chlorpromazine, thioridazine, trifluoperazine, haloperidol
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what are the high potency typical antipsychotics?
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haloperidol and trifluoperzine
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Theorist: separation-individuation and early infantile development
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Mahler
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Theorist: stages of psychosocial development throughout the life cycle
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Erikson
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Theorist: psychosexual development and unconscious conflicts
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Freud
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Theorist: stages of cognitive development
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Piaget
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Theorist: uses terms 'shadow' 'archetype' 'animus'
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Jung
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Theorist: stages of moral development
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Kohlberg
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Theorist: self-psychology, resilient sense of self is due to empathic care-giving
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Kohut
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Theorist: object relations and infant-mother interaction
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Klein
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Theorist: defined 'transitional object' as comforting substitute for primary caregiver
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Winnicott
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Theorist: emphasized central importance of interpersonal relationships
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Sullivan
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Where's the satiety center located in the brain?
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Ventromedial nucleus of the hypothalamus
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What do the left and right prefrontal area of the brain do?
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Left = "Lifts" mood
Right = "Reduces" mood |
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What is the orbitofrontal region of the frontal lobe involved in?
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Insight/judgment, remorse, inhibition, stability
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What is the dorsolateral region of the frontal lobe involved in?
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Planning, monitoring, flexibility, motivation
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4 year old girl is noticed to have lost ability ability to play, speak, control bowel movements..
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Childhood disintegrative disorder
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How to distinguish between Rett's and childhood disintegrative disorder?
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Rett's - earlier onset (usually six months after birth), with characteristic hand sterotypies
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Nocturnal enuresis can be diagnosed after age..?
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5
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Which medication can effectively treat sleep terrors?
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Diazepam
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Personality change, preoccupation/perseveration with a single theme, total loss of sex drive, emotional intensity. Otherwise normal physical exam..
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Temporal lobe epilepsy
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Child has a generalized siezure, bloody diarrhea, vomiting, and muscle twitching. What did he eat?
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Arsenic
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A tumor in this part of the brain can present with headache, papilledema, and homonymous hemianopsia...
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Occipital lobe
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Urine vanillymandelic acid (VMA) can be used to diagnose..?
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Pheochromocytoma
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Risk of daughter (with affected father) for developing Huntington's?
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1 in 2
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NMS pharmacologic treatment?
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Bromocriptine or dantrolene
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What is perphenazine?
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High potency typical antipsychotic
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17 year old boy is diagnosed with shizophrenia. What is the risk that one of his siblings will develop the disease?
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10%
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First line drugs for the treatment of akathisia?
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Beta blockers (propranolol) and benzos (lorazepam)
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Benztropine and diphenhydramine are of what class of drugs?
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Anticholingerics
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What % of diagnosed shizophrenics commit suicide?
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10%
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Which drugs can produce psychoses similar to schizophrenia?
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Cocaine, amphetamines, PCP, and LSD
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This syndrome manifests as a visual hallucination of a transparent phantom of one's own body
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Autoscopic psychosis
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Under hypnosis, a woman who was sexually abused pleads "Daddy please don't hurt me." This is an example of?
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Abreaction (aka reenactment)
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Woman is diagnosed with MDD. What is the chance that her identical twin sister will develop the disease?
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70%
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Which medication could cause acne, thirst, and food to taste funny?
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lithium
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Prevalence of clinical depression among patients post-stroke?
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35-45%
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Risk for suicide in patients with mood disorders?
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10-15%
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Craving for sweets is seen in which affective disorder?
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Seasonal affective disorder
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Which medication would you use to augment fluoxetine in the treatment of major depression?
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Lithium
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Which medication would you use to augment fluoxetine in the treatment of major depression?
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Lithium
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What are the contraindications for ECT?
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Recent MI, increased ICP, aneurysms, bleeding disorders, etc.
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What are the contraindications for ECT?
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Recent MI, increased ICP, aneurysms, bleeding disorders, etc.
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Prevalence of alcohlism in patients with MDD?
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35%
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Prevalence of alcohlism in patients with MDD?
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35%
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Memory gaps, significant problems with autobiographical memory, fluctuation in skills, changes in mannerisms/affect, are indicative of...?
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Dissociative identity disorder
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Memory gaps, significant problems with autobiographical memory, fluctuation in skills, changes in mannerisms/affect, are indicative of...?
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Dissociative identity disorder
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Onset of antianxiety effects of Buspirone? More or less sedating than benzos..?
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Three weeks. Less sedating.
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Onset of antianxiety effects of Buspirone? More or less sedating than benzos..?
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Three weeks. Less sedating.
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Vietnam vet startles and hyperventilates whenever he hears a sharp noise. These symptoms of autonomic hyperarousal can be treated with..?
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Beta blockers
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What condition is often associated with Restless Leg?
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Pregnancy
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Vietnam vet startles and hyperventilates whenever he hears a sharp noise. These symptoms of autonomic hyperarousal can be treated with..?
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Beta blockers
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Which class of drugs can have significant effects on sexual function?
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Beta blockers, in specific, propranolol
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What condition is often associated with Restless Leg?
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Pregnancy
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Lifetime prevalence of all personality disorders in the general population?
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10-20%
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Which class of drugs can have significant effects on sexual function?
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Beta blockers, in specific, propranolol
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Restless leg vs periodic limb movement disorder?
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Periodic - (aka nocturnal myoclonus)
Restless leg |
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Lifetime prevalence of all personality disorders in the general population?
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10-20%
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Restless leg vs periodic limb movement disorder?
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Periodic - (aka nocturnal myoclonus)
Restless leg |
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Which medication would you use to augment fluoxetine in the treatment of major depression?
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Lithium
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What are the contraindications for ECT?
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Recent MI, increased ICP, aneurysms, bleeding disorders, etc.
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Prevalence of alcohlism in patients with MDD?
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35%
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Memory gaps, significant problems with autobiographical memory, fluctuation in skills, changes in mannerisms/affect, are indicative of...?
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Dissociative identity disorder
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Onset of antianxiety effects of Buspirone? More or less sedating than benzos..?
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Three weeks. Less sedating.
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Vietnam vet startles and hyperventilates whenever he hears a sharp noise. These symptoms of autonomic hyperarousal can be treated with..?
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Beta blockers
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What condition is often associated with Restless Leg?
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Pregnancy
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Which class of drugs can have significant effects on sexual function?
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Beta blockers, in specific, propranolol
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Lifetime prevalence of all personality disorders in the general population?
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10-20%
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Restless leg vs periodic limb movement disorder?
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Periodic - (aka nocturnal myoclonus)
Restless leg |
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Which medication would you use to augment fluoxetine in the treatment of major depression?
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Lithium
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What are the contraindications for ECT?
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Recent MI, increased ICP, aneurysms, bleeding disorders, etc.
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Prevalence of alcohlism in patients with MDD?
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35%
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Memory gaps, significant problems with autobiographical memory, fluctuation in skills, changes in mannerisms/affect, are indicative of...?
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Dissociative identity disorder
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Onset of antianxiety effects of Buspirone? More or less sedating than benzos..?
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Three weeks. Less sedating.
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Vietnam vet startles and hyperventilates whenever he hears a sharp noise. These symptoms of autonomic hyperarousal can be treated with..?
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Beta blockers
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What condition is often associated with Restless Leg?
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Pregnancy
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Which class of drugs can have significant effects on sexual function?
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Beta blockers, in specific, propranolol
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Lifetime prevalence of all personality disorders in the general population?
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10-20%
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Restless leg vs periodic limb movement disorder?
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Periodic - (aka nocturnal myoclonus)
Restless leg |
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Time till 'peak' of opiate withdrawal symtpoms?
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48 hours
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How long does intoxication with a hallucinogen last?
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8-12 hours
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Treatment for alcohol-withdrawal delirium?
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Benzos such as chlordiazepoxide (librium)
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What can you use to treat some acute symptoms of opioid withdrawal?
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Clonidine (alpha 2 adrenergic agonist)
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This illicit substance can produce vertical nystagmus?
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PCP
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PCP toxicity should be treated with...?
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Benzos or antipsychotics
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If both of your parents are alcoholic, how much greater risk do you have of becoming alcoholic than the general population?
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3 to 4 times higher
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Marijuana impairs the operation of motor vehicles for how long after its use?
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8-12 hours
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Which drug can cause tremors, HTN, tachycardia, mydriasis, hyperthermia, sweating, blurry vision, and false perceptions (ie. of being able to fly)?
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LSD
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Which TCA has been used to treat OCD?
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Clomipramine
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Which adjuvant to an SSRI can be given to resolve sexual side effects?
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Cyproheptadine
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Which drugs can increase lithium levels to toxic levels?
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Several NSAIDs, ie ibuprofen
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High fever, chills, bleeding gums, extreme fatigue, and pallor associated with carbamazepine?
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Acute aplastic anemia
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Which antipsychotic is recommended for treatment-refractory psychosis?
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Clozapine
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How long does lithium take to come to steady state with regular administration?
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5-8 days
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What's the best anticonvulsant for patients taking clozapine who experience seizures?
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Phenobarbitol
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Treatment of PTSD hyperarousal?
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Clonidine, beta blockers
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Elderly man with psychotic depression, prostatic hypertrophy, CAD, orthostatis hypotension - what med...?
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Haldol, fluphenazine - low in anticholinergic side effects
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Which medication reduces/delays REM sleep?
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Desipramine
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Boy with enuresis and ADHD... treatment?
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Imipramine
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Mechanism of typical neuroleptics?
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Dopamine antagonists
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Mechanisms of atypical neuroleptics?
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Antagonize serotonin and dopamine receptors
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Which neuroleptics have a higher incidence of EPS than anticholinergic effects?
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High potency neuroleptics (haldol and trifluoperazine)
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Which neuroleptics have primarily anticholinergic side effects?
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Low potency neuroleptics - chlorpromazine and thioridazine
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Tardivwe dyskinesia occurs most often in....?
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Older women after at least 6 months
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Mortality rate of NMS?
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20%
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Weight gain, sedation, orthostasis, ECG changes, hyperprolactinemia, hematologic effects, and dermatologic conditions can be associated with which class of drugs?
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Antipsychotics
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Schizophreniform duration of symptoms?
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1-6 months
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These are criteria for which disorder: have had delusions or hallucinations for 2 weeks in the absence of mood disorder symptoms, meet criteria for major depressive episode, manic episode, or mixed episode....?
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Schizoaffective disorder
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Delusional disorder?
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Nonbizarre fixed delusions for at least 1 month
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Echopraxia?
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Mimics behavior
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CT scan of patients with schizophrenia?
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Enlargement of the ventricles and diffuse cortical atrophy
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Difference between schizophrenia and delusional disorder?
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Delusional disorder has nonbizarre delusions, daily functioning is not significantly impaired, and does not meet the DSM criteria for schizophrenia
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List some extrapyramidal symptoms?
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Dystonia
Parkinsonism Akathisia |
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Treatment for EPS side effects of antipsychotics?
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Antiparkinsonian agents (benztropine, amantadine) and benzodiazepines
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What are anticholinergic symptoms? Seen with which antibiotics?
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Dry mouth, constipation, blurred vision. Seen with low potency traditional and atypical antipsychotics
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Shared psychotic disorder?
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Folie a deux - patient develops the same delusional symptoms as somone he is in a close relationship with
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What is Koro? Amok? Brain fag?
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Koro - belief of disappearing penis
Amok - sudden unprovoked outbursts of violence of which person has no recollection Brain fag - Headache, fatigue, and visual disturbances |
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To have a MDD, you must have one of which two symptoms (in addition to others...)?
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Depressed mood or anhedonia
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Risk of a patient who has been previously hospitalized for MDD for committing suicide?
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15%
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What % of manic patients have psychotic symptoms?
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75%
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Differences between mania and hypomania?
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Mania lasts at least 7 days (as opposed to 4 days)
Marked social/occupational functioning May require hospitalization May have psychotic features |
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What are potential medical causes of a manic episode?
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Hyperthyroidism, tmeporal lobe seizures, MS, neoplasia, HIV
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What medications can cause mania?
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Corticosteroids
Antidepressants |
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Average age of onset for MDD?
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40
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Triad for seasonal affective disorder?
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Irritability
Carbohydrate drawing Hypersomnia |
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Concordance rate of MDD for monozygotic twins?
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50%
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Symptoms of serotonin syndrome?
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Autonomic instability, hyperthermia, and seizures
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TCA side effects?
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Sedation, weight gain, orthostasis, and anticholinergic side effects
(anti HAM) |
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Which medications are often useful in the treatment of atypical depression?
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MAOIs
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Atypical depression?
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Hypersomnia, hyperphagia, reactive mood, and hypersensitivity to interpersonal rejection
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Bipolar I diagnostic criteria? Lifetime prevalence?
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One manic or mixed episode. 1%
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Concordance rates of bipolar I disorder for monozygotic twins?
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75%
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Bad side effects of lithium
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arrhythmias, seizures, goiter/hypothyroidism, polyuria, polydipsia
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Pharmacotherapy for bipolar
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Lithium, carbamazepine, valproic acid, and olanzapine
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Diagnostic criteria for bipolar II disorder?
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History of one or more MD episodes and at least one hypomanic episode
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Cyclothymia?
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numerous periods with hypomanic symptoms and periods with depressive symptoms for at least 2 years
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Panic attacks may be mistaken by patients for...?
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MI
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DSM criteria for panic disorder
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Recurrent panic attacks with no obvious precipitant
At least 1 month of persistent concern about addtl attacks, worry about implications, change in behavior |
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Effective treatment of anxiety symptoms in pts with panic disorder?
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Benzos
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Maintenance treatment of panic disorder?
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SSRIs
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50-75% of pts with agoraphobia have coexisting..?
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Panic disorder
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Most common mental disorders in the US?
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Phobias
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What disorders are found more commonly in phobic patients/
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Substance related disorders, MDD
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Treatment for social phobia?
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Paroxetine
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Lifetime prevalence of OCD?
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2 to 3%
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OCD is often co-morbid with what..?
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Tourette's
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Onset of OCD is often triggered by..?
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Stressful life event
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Treatment for OCD?
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SSRIs, clomipramine
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Symptoms of PTSD? Criteria?
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Increased arousal, avoidance of stimuli associated with the trauma, persistent reexperiencing, etc. Must be present for at least 1 month
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GAD criteria? Prevalence
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Persistent, excessive anxiety and hyperarousal for at least 6 months
Association with somatic complaints - restlessness, fatigue, muscle tension, sleep disturbance, etc. Prevalence up to 45% |
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Pharm treatment of GAD?
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Buspirone, benzos, SSRIs, venlafaxine XR
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Adjustment disorder is brought on by..? Defined as...?
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Non-life threatening stressful event
Maladaptive behavioral/emotional symptoms within 3 months after a stressful event Severe distress in excess of what would be expected Symptoms resolve within 6 months |
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PD manifests in problems with...?
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Cognition
Affect Personal Relations Impusle control |
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Avoidant PD vs schizoid PD?
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Schizoid PD prefers to be alone
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Which PD is characterized by unstable moods, behaviors, and interpersonal relationships?
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Borderline
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Which PD is characterized by excessive emotionality and attention seeking?
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Histrionic
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Who's more functional: the borderline or the histrionic?
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Histrionic
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What defense mechanism is often used by histrionic patients?
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Regression
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Which PD is marked by poor self-confidence and a fear of separation?
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Dependent PD
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OCPD: ego-syntonic or ego-dystonic?
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Ego syntonic
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Abuse
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failure to fulfill obligations
Use in dangerous situations Recurrent legal problems Continued use despite problems |
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Dependence
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at least 3 of these within a 12 month period
Withdrawal Tolerance Increasing use Desire to cut down Significant time spent Decreased activities Continued use despite physical/psychological problem |
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Lifetime prevalence of substance abuse or dependence?
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17%
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Alcohol activates which receptors?
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GABA and Serotonin
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how many Americans are alcoholics?
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7-10%
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Screen for alcohol abuse?
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CAGE questionnaire
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At which BAL can you start to see the effects of alcohol in a novice drinker?
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20-50 mg/dL
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Metabolic problem with ethanol or methanol intoxication?
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Metabolic acidosis with increased anion gap
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Treatment of acute alcohol intoxication...
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ABCs, glucose level, thiamine, naloxone (for any opioids that may have been ingested), and folate
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Atypical depression?
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Hypersomnia, hyperphagia, reactive mood, and hypersensitivity to interpersonal rejection
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Bipolar I diagnostic criteria? Lifetime prevalence?
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One manic or mixed episode. 1%
|
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Concordance rates of bipolar I disorder for monozygotic twins?
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75%
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Bad side effects of lithium
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arrhythmias, seizures, goiter/hypothyroidism, polyuria, polydipsia
|
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Pharmacotherapy for bipolar
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Lithium, carbamazepine, valproic acid, and olanzapine
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Diagnostic criteria for bipolar II disorder?
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History of one or more MD episodes and at least one hypomanic episode
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Cyclothymia?
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numerous periods with hypomanic symptoms and periods with depressive symptoms for at least 2 years
|
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Panic attacks may be mistaken by patients for...?
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MI
|
|
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DSM criteria for panic disorder
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Recurrent panic attacks with no obvious precipitant
At least 1 month of persistent concern about addtl attacks, worry about implications, change in behavior |
|
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Effective treatment of anxiety symptoms in pts with panic disorder?
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Benzos
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Cocaine intox?
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euphoria, dilated pupils, tactile hallucinations, fight-or-flight response
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Wernicke's?
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ataxia, confusion, and ocular abnormalities
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Korsakoff's?
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Impaired recent memory, anterograde amnesia, +/- confabulation
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Classic amphetamines are used medically in the treatment of?
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Narcolepsy, ADHD, and depressive disorders
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Amphetamine intox looks a lot like what...?
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Cocaine intox
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Rotatory nystagmus is pathognomonic for...?
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PCP
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How to treat benzo OD?
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Maintain ABCs..
Flumazenil |
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Opiate intoxication?
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contstricted pupils, drowsiness, constipation, and respiratory depression
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Treatment of opiate OD?
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Administer naloxone or naltrexone (opiate antagonists).
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Opiate withdrawal?
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Dysphoria, yawning, rhinorrhea, piloerection, muscle ache, dilated pupils
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Treatment of moderate opiate withdrawal?
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clonidine and/or buprenorphine
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Is withdrawal from opiates life-threatening?
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No
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Which drug causes conjunctival injection and dry mouth?
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Marijuana
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Cigarette smoking during pregnancy is associated with...?
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Low birth weight and persistent pulmonary HTN of the newborn
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Perfect score on MMSE?
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30
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Hallmarks of delirium?
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Clouding of consciousness
Acute onset Lasts 3 days to 2 weeks Orientation impaired Immediate/recent memory impaired Visual hallucinations common Symptoms fluctuate Usually reversible Awareness reduced EEG changes |
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Differential for delirium?
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AEIOU TIPS
Alcohol Electrolytes Iatrogenic Oxygen hypoxia Uremia/hepatic encephalopathy Trauma Infection Poisons Seizures (post-ictal) |
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Treatment for catatonic depression?
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Antidepressants and antipsychotics
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Visual Agnosia?
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inability to recognize a previously known object
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Name the cholinesterase inhibitors?
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Tacrine
Donepezil Rivastigmine |
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Which dementia involves intraneuronal inclusion bodies?
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Pick's disease/frontotemporal dementia
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List the subcortical dementias? How do they differ from the cortical dementias?
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Huntington's, Parkinson's, NPH, multi-infarct dementia.
Have more prominent affective and movement symptoms |
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Carbidopa doeWs what?
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Prevents conversion of levodopa to dopamine in the periphery
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Treatment for Parkinson's disease?
|
Levodopa, Carbidopa
Amantadine Anticholinergics Dopamine agonists MOA B-inhibitors |
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What does NPH produce first in terms of symptoms?
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Gait disturbance
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Dementia + cogwheel rigidits + resting tremor =
|
Parkinson's
Lewy body dementia |
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Dementia + diminished position sensation + megaloblasts =
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VB12 deficiency
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Dementia + tremor + abnormal LFTs + Kayser-Fleischer rings =
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Wilson's disease
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Delirium + dilated pupils + tachycardia =
|
drug intox
|
|
|
Delirium + tachycardia + tremor + thyromegaly =
|
Thyrotxicosis
|
|
|
Delirium + elevated BP + papilledema =
|
Hypertensive encephalopathy
|
|
|
T or F? Benzos are good to use in delirious patients...
|
FALSE
|
|
|
What can cause amnestic disorders?
|
Hypoglycemia, hypoxia, trauma, tumor, szs, CVA, MS, HSV encephalitis, substance use
|
|
|
Pseudodementia?
|
presence of apparent cognitive deficits in patients with MDD
|
|
|
Mirtazapine side effects
|
Increased appetite, sedation
|
|
|
How does REM sleep change in the elderly?
|
increased episodes of shorter duration
|
|
|
Which sedative-hypnotics should be used in the elderly?
|
Hydroxyzine and zolpidem --> these are safer than the more sedating benzos
|
|
|
Second most common cause of MR?
|
Fragile X
|
|
|
Conduct disorder conveys what risk of developing ASPD in adulthood?
|
40%
|
|
|
Difference between ODD and conduct disorder?
|
ODD does not involve violation of the basic rights of others
|
|
|
Subtypes of ADHD?
|
Inattentive
Hyperactive-impulsive Combined type |
|
|
Improvement in ADHD patients on Ritalin is seen in what %?
|
75%
|
|
|
ADHD onset is before what age?
|
7
|
|
|
Dextroamphetamine is used to treat..?
|
ADHD
|
|
|
Pemoline was used to treat what? What's the problem with it?
|
ADHD
Liver failure |
|
|
Autism
|
Problems with social interaction
Impairments in communication Repetitive and sterotyped patterns of behavior and activities |
|
|
Autism is often associated with which other medical conditions?
|
Fragile X, tuberous sclerosis, MR, and szs
|
|
|
Rett's disorder is seen only in...? Onset...? How to distinguish from childhood disintegrative?
|
Girls
Between 5-48 months Decreasing rate of head growth Stereotyped hand movements |
|
|
Coprolalia
|
repetitive speaking of obscene words
|
|
|
Tourette's concordance rate in monozygotic twins?
|
50%
|
|
|
amnesia is a prominent symptom in all of the dissociative disorders except...?
|
Depersonalization disorder
|
|
|
If a patient is unable to recall their name or other important information but will remember obscure details, it's likely...?
|
Dissociative amnesia
|
|
|
Difference between dissociative amnesia and dissociative fugue?
|
Fugue - unaware that they have forgotten anything
|
|
|
Dissociative identity disorder?
|
Two or more distinct personalities that alternately control their behaviors and thoughts
|
|
|
Somatization disorder must present before what age...?
|
30
|
|
|
Criteria for conversion disorder?
|
At least one neurological symptom that cannot be explained by a medical disorder, substance abuse
Psych factors associated with initiation of symptom |
|
|
Symptoms of conversion disorder may resolve after what treatment?
|
Sodium amobarbital interview
|
|
|
Fears in hypochondriasis last at least how long?
|
6 months
|
|
|
90% of patients with body dysmorphic disorder have comorbid...?
|
depression
|
|
|
Factitious disorder
|
Intentionally producing medical or psychological symptoms in order to assume the sick role
|
|
|
Munchhausen
|
another name for factitious disorder with primarily physical symptoms
|
|
|
Patients usually feel remorseful after episodes of aggressive behavior in this disorder
|
Intermittent explosive disorder
|
|
|
Impulsiveness and aggression has been associated with low levels of..?
|
Serotonin
|
|
|
One fourth of patients with bulimia nervosa have comorbid...?
|
Kleptomania
|
|
|
Subtypes of anorexia?
|
restrictive - eat little and may vigorously exercise
binge-eating/purging - eat in binges followed by purging/exercise |
|
|
diagnostic criteria for anorexia nervosa
|
Body weight at least 15% below normal
Intense fear of gaining weight Disturbed body image Amenorrhea |
|
|
Mortality of anorexia
|
10%
|
|
|
Which is more ego-dystonic - bulimia or anorexia?
|
Bulimia
|
|
|
Subcategories of bulimia?
|
Purging and nonpurging
|
|
|
Criteria for the binge eating of bulimia?
|
Occurs at least twice a week for 3 months
|
|
|
Electrolyte abnormality in bulimia?
|
Hypochloremic hypokalemic alkalosis
|
|
|
Treatment for anorexia?
|
Antidepressants for adjunctive treatment - paroxetine or pirtazapine
|
|
|
Dyssomnias, parasomnias
|
Dysomnias - disturbances in sleep
Parasomnias - abnormal events in behavior or physiology during sleep |
|
|
Sleep spindles and k-complexes are seen in which type of sleep?
|
Stage 2 - light sleep
|
|
|
Sawtooth waves are seen in what type of sleep?
|
REM
|
|
|
Primary insomnia - time criteria?
|
Disturbance occurs 3+ times per week for at least one month
|
|
|
Zolpidem and zalepon can be used to treat..?
|
primary insomnia
|
|
|
Cataplexy occurs in...?
Treat with...? |
Narcolepsy
Sodium oxalate |
|
|
Small doses of ..... can be effective for treating night terror disorder?
|
diazepam
|
|
|
How do dopamine and serotonin affect libido?
|
Dopamine - enhances
Serotonin - inhibits |
|
|
Dyspareunia
|
Genital pain associated with sexual intercourse
|
|
|
Gender identity usually develops by what age?
|
3
|
|
|
When are the Id, Ego, and Superego formed?
|
Id - birth
Ego - after birth Superego - by age 6 |
|
|
Repression vs suppression?
|
Suppression is a conscious act
|
|
|
Classical conditioning?
Operant conditioning? |
Classical - stimulus evokes a conditioned response - Pavlov
Operant - behaviors are learned when followed by positive or negative reinforcement |
|
|
Linehan developed which type of psychotherapy?
|
Dialectical behavioral therapy - treatment for borderline, teaches coping skills, solution-focused therapy
|
|
|
True or false? - all antidepressants are considered equally effective in treating MDD
|
True
|
|
|
TCAs can be used for which other conditions besides depression?
|
OCD, Enuresis, Migraine headaches, Insomnia
|
|
|
Name the TCAs
|
Imipramine
Amitriptyline Trimipramine Nortriptyline Despramine Clomipramine Doxepin |
|
|
Which TCA is least likely to cause orthostatic hypotension?
|
Nortriptyline
|
|
|
Which TCA is the most serotonin specific and can be used in the treatment of OCD?
|
Clomipramine
|
|
|
Mainstay of treatment for TCA OD?
|
IV Sodium bicarbonate
|
|
|
side effects of TCAs
|
anti-HAM, weight gain, lethal OD
|
|
|
Major complications of TCAs
|
3 Cs
Convulsions, coma, cardiotoxicity |
|
|
name the MAOIs
|
phenelzine, tranylcypromine, isocarboxazid
|
|
|
This condition is initially characterized by lethargy, restlessness, confusion, flushing, diaphoresis, tremor, and myoclonic jerks
|
serotonin syndrome
|
|
|
which SSRI has the longest half life?
|
fluoxetine
|
|
|
Which SSRI has the highest risk for GI involvement?
|
sertraline
|
|
|
which SSRI is most serotonin specific and the most activating?
|
Paroxetine
|
|
|
which SSRI is approved currently only for use in OCD?
|
fluvoxamine
|
|
|
What is Escitalopram?
|
Lexapro - SSRI
|
|
|
Give an example of:
SNRI NDRI SARI |
SNRI - Venlafaxine
NDRI - Bupropion SARI - Nefazodone, and trazodone |
|
|
This drug is used to aid in smoking cessation and seasonal affective disorder and ADHD?
|
Bupropion
|
|
|
Buproprion confers an increased risk of what side effects at high doses?
|
Seizures and psychosis(due to the dopaminergic effect)
|
|
|
Sedation and priapism are potential side effects of..?
|
Trazadone
|
|
|
Which drug is useful in the treatment of refractory MDD in patients who need to gain weight?
|
Mirtazapine
|
|
|
Low potency antipsychotics have a higher incidence of which side effects? Lower?
|
Higher - anticholinergic and antihistaminic side effects
Lower - EPS and NMS |
|
|
Name the low potency antipsychotics?
|
Chlorpromazine
Thioridazine |
|
|
dopamine inhibits secretion of which chemical messengers?
|
Prolactin and acetylcholine
|
|
|
Irreversible retinal pigmentation can be caused by...? Deposits in lens and cornea can be caused by...?
|
Thiroidazine
Chlorpromazine |
|
|
Seizures are more likely to be caused by which potency antipsychotics?
|
Low potency
|
|
|
Clozapine side effects?
|
Agranulocytosis, seizures
|
|
|
Olanzapine side effects?
|
Hyperlipidemia, glucose intolerance, weight gain, and liver toxicity
|
|
|
onset of action of lithium takes how long?
|
5 to 7 days
|
|
|
Toxic range of lithium?
|
> 1.5
|
|
|
important high yield side effects of lithium?
|
Hypothyroidism and nephrogenic diabetes insipidus
|
|
|
Carbamazepine is useful in treating what types of mood disorders? What neuro condition?
|
Mixed episodes and rapid-cycling bipolar disorder.
Trigeminal neuralgia |
|
|
Which medication can cause leukopenia, nyponatremia, aplastic anemia, and agranulocytosis?
|
Carbamazepine
|
|
|
How do NSAIDs affect Lithium levels? impaired renal function?
|
NSAIDs - increase
Impaired renal function - increase |
|
|
What drug can cause hepatotoxicity, thrombocytopenia, and neural tube defects during pregnancy?
|
Valproic acid
|
|
|
First line anxiolytics?
|
Benzos
|
|
|
Chlordiazepoxide and diazepam are what types of benzos?
|
Long acting
|
|
|
Olanzapine side effects?
|
Hyperlipidemia, glucose intolerance, weight gain, and liver toxicity
|
|
|
onset of action of lithium takes how long?
|
5 to 7 days
|
|
|
Toxic range of lithium?
|
> 1.5
|
|
|
important high yield side effects of lithium?
|
Hypothyroidism and nephrogenic diabetes insipidus
|
|
|
Carbamazepine is useful in treating what types of mood disorders? What neuro condition?
|
Mixed episodes and rapid-cycling bipolar disorder.
Trigeminal neuralgia |
|
|
Which medication can cause leukopenia, nyponatremia, aplastic anemia, and agranulocytosis?
|
Carbamazepine
|
|
|
How do NSAIDs affect Lithium levels? impaired renal function?
|
NSAIDs - increase
Impaired renal function - increase |
|
|
What drug can cause hepatotoxicity, thrombocytopenia, and neural tube defects during pregnancy?
|
Valproic acid
|
|
|
First line anxiolytics?
|
Benzos
|
|
|
Chlordiazepoxide and diazepam are what types of benzos?
|
Long acting
|
|
|
HAM side effects can be caused by...?
|
TCAs and low-potency antipsychotics
|
|
|
Hyperprolactinemia can be caused by...?
|
High potency traditional antipsychotics
|
|
|
Isoniazid can cause which psychiatric symptom?
|
Psychosis
|
|
|
Criteria for involuntary admission?
|
Patient is found by two staff physicians to be potentially harmful or unable to care for self.
Principle of parens patriae |
|
|
Competence vs capacity?
|
Competence - legal term decided by a judge
Capacity - clinical term |
|
|
The most important factor in assessing a patient's risk of violence is....?
|
History of violence
|
|
|
M'Naghten?
|
Stringent test of statutory criteria for being declared 'insane'
|
|
|
To successfully argue a case of malpractice, a patient must prove which conditions?
|
1. there is an established standard of care
2. the physician breached his responsibility to the plaintiff 3. this breach caused injury or damage to the plaintiff |
|
|
4Ds of malpractice?
|
Dereliction of a Duty that led Directly to Damages
|
