Psychiatry: High Yield For Step 2 Ck

Front 1

CAGE questionaire for suspected EtOH abuse.

Back 1

felt a need to Cut down?
ever been Annoyed at someone for criticizing your drinking?
feel Guilty about your drinking?
ever have an Eye-opener drink to get you going in the morning?

Front 2

EtOH withdrawal: these sx start 6-12 hours after last drink

Back 2

Minor withdrawal symptoms: tremulousness is most tested; others: insomnia, mildanxiety, gastrointestinal upset, headache, diaphoresis, palpitations, anorexia

Front 3

EtOH withdrawal: these sx start 12-24 hours after last drink (generally resolve within 48 hours).

Back 3

Alcoholic hallucinosis: visual, auditory, or tactile hallucinations

Front 4

EtOH withdrawal: these sx usually start 24-48 hours after last drink (can start earlier)

Back 4

Withdrawal seizures: generalized tonic-clonic seizures

Front 5

EtOH withdrawal: these sx start 48-72 hours after last drink (peak at day 5)

Back 5

Alcohol withdrawal delirium (delirium tremens): hallucinations accompanied by disorientation; other sx: tachycardia, hypertension, low-grade fever, agitation, diaphoresis

Front 6

EtOH intoxication (remember 4 sx: SAND mnemonic)

Back 6

slurred speech
ataxia
nystagmus
disinhibition

Front 7

EtOH intoxication in ER: 3 labs to aid treatment.

Back 7

Blood Glucose, Thiamine, Folate

Front 8

EtOH withdrawal treatment.

Back 8

Benzo taper: can use Chlordiazepoxide (Librium), but generally use Lorazepam (Ativan) 2/2 liver disease risk

Front 9

Most feared complication in cocaine intoxication/overdose.

Back 9

sudden cardiac death due to arrhythmias and vasospasm

Front 10

Cocaine withdrawal "crash:" what is the biggest concern?

Back 10

depression and suicidality

Front 11

Amphetamine, Meth, or Ecstasy intoxication: remember 4 things.

Back 11

agitation, tachycardia, delusions, pupil dilation

Front 12

Methamphetamine intoxication pearl in Step 2 questions.

Back 12

psychosis

Front 13

PCP intoxication (3 things to remember)

Back 13

remember it's always a WEIRD presentation: combative, psychosis, STRANGE BEHAVIOR

Front 14

Most important Barbiturate and Benzo overdose sx.

Back 14

respiratory depression

Front 15

Opiate intoxication vs withdrawal: pupil size.

Back 15

INtoxicated=pIN-point
withDrawal=Dilated

Front 16

Opiate withdrawal sx.

Back 16

cold turkey with diarrhea: sweating, dilated pupils, piloerection, rhinorrhea, N/V, cramps, diarrhea

Front 17

Other drug besides Benzos that can cause respiratory depression in overdose.

Back 17

Opiates (common post-op)

Front 18

Marijuana/Spice addiction/intoxication symptoms.

Back 18

social withdrawal, increased appetite (munchies), dry mouth, CONJUNCTIVAL INJECTION

Front 19

Caffeine withdrawal sx pearl in Step 2 questions.

Back 19

headache

Front 20

Nicotine withdrawal craving (addiction) treatment.

Back 20

Nicotine patch or gum, Zyban (Wellbutrin), Clonidine, Chantix, counseling, hypnosis

Front 21

What are "cocaine bugs"?

Back 21

intoxication hallucinations are usually tactile and feel like bugs crawling on skin

Front 22

Very important treatment in EtOH detox (besides benzos via CIWA)?

Back 22

Thiamine, Folate, and nutrition

Front 23

Schizophrenia DSMIV criteria (DOWNSHIfT mnemonic).

Back 23

Delusion
Odd Behavior
W/out mood sx
Negative sx
Speech disorganized
Hallucinations
If = Impaired Function
Time > 6 months

Front 24

Schizophrenia negative sx (5 A's)

Back 24

Affect flat
Anhedonia
Apathy
Alogia
Attention

Front 25

Major Depressive Episode DSMIV criteria (2 weeks or more of these sx: D-SIGECAPS mnemonic).

Back 25

Sleep changes
Interest decreased (anhedonia) or Depressed
Guilt
Energy down
Concentration down
Appetite changes
Psychomotor retardation
Suicidality

Front 26

Manic Episode DSMIV criteria (DIG-FAST mnemonic sx)

Back 26

Distracted
Insomnia
Grandiose
Flight of Ideas
Activity/Agitation
Speech pressured
Thoughtless (impulsive)

Front 27

Panic Attack DSMIV criteria (PANICS mnemonic)

Back 27

Palpitations
Abdominal distress
No-control/No known cause
Impending doom/fear of death
Chest pain
Sweating, shaking, SOB

Front 28

OCD mnemonic

Back 28

Obsessions and Compulsions AND DISTRESSED ABOUT THEM (OCPD is egosyntonic, OCD is egodystonic)

Front 29

PTSD criteria from DSMIV (TRAUMA mnemonic)

Back 29

Traumatic experience in past
Re-experiencing it (flashbacks etc.)
Avoiding triggers like social anxiety
Unable to function
More than 1 month
Arousal (easily startled)

Front 30

General Anxiety Disorder (GAD) sx from DSMIV criteria (CANTREST mnemonic)

Back 30

Concentration decreased
Agitated
No control
Time more than 6 months
Restless
Energy down
Sleep changes
Tense muscles

Front 31

Borderline sx from DSMIV criteria (AM-SUICIDE mnemonic)

Back 31

Abondonment (fear of)
Mood instability
Suicidal or Self-mutilating behavior
Unstable relationships
Impulive
Control of anger lacking
Identity disturbed
Dissociative thinking (splitting)
Emptiness (chronic feeling of)

Front 32

Cluster A personality disorders (weird)

Back 32

paranoid
schizoid
schizotypal

Front 33

Cluster B personality disorders (wild)

Back 33

Borderline
Histrionic
Narcissistic
Antisocial

Front 34

Cluster C personality disorders (wimpy)

Back 34

Obsessive/Compulsive (OCPD)
Avoidant
Dependant

Front 35

Schizoid vs. Schizotypal Personality Disorder

Back 35

Schizoid: loner
Schizotypal: magical thinking/odd

Front 36

What disorder leads to Antisocial Personality Disorder?

Back 36

Conduct disorder in children (remember torchering animals is pathognomonic)

Front 37

Dementia vs. Delirium acute or gradual?

Back 37

Dementia: gradual
Delirium: acute

Front 38

Assessment of dementia: Activity of Daily Living (ADL) mnemonic ABCDEF

Back 38

Ambulates
Bathes
Continent (toilets)
Dresses/undresses
Eats
Functional transfers (OOB etc.)

Front 39

Assessment of dementia: Independent Activities of Daily Living (IADLs) mnemonic SCUM

Back 39

Shopping
Cook and Clean
Use telephone and transportation
Manage Money and Medication

Front 40

DEMENTIAS mnemonic for causes of Dementia.

Back 40

Degenerative diseases (PD, Huntington's)
Endocrine (thyroid, adrenal, etc.)
Metabolic (alcohol, electrolytes, B12, hepatic, renal, etc.)
Exogenous (heavy metals, CO, drugs)
Neoplasm
Trauma (subdural)
Infection (meningitis, encephalitis, HIV, prion, etc.)
Affective (psuedodementia of depression)
Stroke/Structure (ischemia, NPH, etc.)

Front 41

2 most common causes of dementia.

Back 41

Alzhiemer's (50%)
Multi-Infarct Dementia (25%)

Front 42

Abuse vs Dependence.

Back 42

Abuse messes up your life
Dependence messes up your body

Front 43

Most common reason to discontinue SSRI's

Back 43

sexual dysfunction

Front 44

Avoid Bupropion (Wellbutrin) in these individuals.

Back 44

Bulimics, Anorexics, Epilepsy

Front 45

Buspar is good anxiety med especially in this cohort.

Back 45

Alcoholic

Front 46

Use for performance anxiety

Back 46

Beta blocker

Front 47

Why is Xanax not the best med for anxiety?

Back 47

short half-life (withdrawal anxiety every day)

Front 48

Antidote to Benzo intoxication/overdose.

Back 48

Flumazenil

Front 49

Agorophobia vs Social Phobia

Back 49

Agorophobia: fear of being trapped in a crowd
Social Phobia: fear of being embarassed in a crowd

Front 50

Mental Status Exam (MSE) ASEPTIC mnemonic

Back 50

Appearance
Speech
Emotion (mood and affect)
Perceptions (hallucinations?)
Thought process and content
Insight/Judgment
Cognition (MMSE)

Front 51

IWATCHDEATH mnemonic for causes of delirium

Back 51

Infection
Withdrawal
Acute metabolic or subtance Abuse
Trauma
CNS pathology
Hypoxia
Deficiencies
Endocrine
Acute vascular/MI
Toxins/drugs
Heavy metals

Front 52

Lithium side effects (4 to remember)

Back 52

Diabetes Insipidus, Teratogen (Ebstein's anomaly), Renal Failure, Cardiac Conduction defects

Front 53

Neuroleptic Malignant syndrome.

Back 53

MUSCLE RIGIDITY, HIGH FEVER, autonomic instability, AMS

Front 54

Treatment for Neuroleptic Malignant syndrome

Back 54

stop med and give dantrolene or bromocriptine (anticholinergics)

Front 55

TCA overdose.

Back 55

can be lethal 2/2 arrhythmias (don't give if h/o suicide attempts by overdose)

Front 56

Use this TCA for enuresis (bed-wetting).

Back 56

Imipramine

Front 57

What MOAI side-effect necessitates avoidance of tyramine in diet (e.g. cheese)?

Back 57

Hypertensive crisis

Front 58

After discontinuing MAOI, how long to wait before starting a new anti-depressant?

Back 58

2 weeks (wait for MAO enzyme to regenerate)

Front 59

Thing to remember about discontinuing Paroxetine (Paxil).

Back 59

brisk discontinuation symptoms (taper to d/c)

Front 60

1st major depressive episode: treat how long?

Back 60

6 months

Front 61

SSRI doesn't seem to be working after 4 weeks. How long to try before switching to a new med?

Back 61

6 weeks (2 more weeks)

Front 62

Anti-depressant with least sexual side effects?

Back 62

Bupropion (Wellbutrin)

Front 63

Serotonin Syndrome

Back 63

Siezures, clonus, diarrhea, cramps, fever, autonomic instability, AMS

Front 64

What syndrome: Siezures, diarrhea, cramps, fever, autonomic instability, AMS

Back 64

serotonin syndrome (2/2 SSRIs etc)

Front 65

What syndrome: MUSCLE RIGIDITY, HIGH FEVER, autonomic instability, AMS

Back 65

neuroleptic malignant syndrome (2/2 antipsychotics)

Front 66

Duloxetine (Cymbalta), besides psych indications, is also used for . . .

Back 66

chronic/neuropathic pain

Front 67

Valproic Acid and Carbemazepine in pregnant woman. What teratogenic defect?

Back 67

neural tube defects

Front 68

Treatment for antipsychotics induced dystonia (2)

Back 68

dephenhydramine (Benadryl) and Benztropine (anticholinergics)

Front 69

Treatment for parkinsonism induced by antipsychotics.

Back 69

Benztropine (anticholinergic)

Front 70

Antipsychotic meds good for non-compliant patients (3).

Back 70

Haloperidol decanoate qMonth
Fluphenazine decanoate q2wks
Risperidone CONSTA q2ks

Front 71

Clozapine (Clozaril) is the most efficacious antipsychotic, but is seldom used because. . .

Back 71

risk of agranulocytosis (monitor weekly CBC if using)

Front 72

Risperidone effect on the endocrine axis.

Back 72

elevates prolactin

Front 73

Olanzapine (Zyprexa) is this side effect most of all the antipsychotics.

Back 73

weight gain

Front 74

Quetiapine (Seroquel) has the least of which side-effects amoung antipsychotics?

Back 74

least ExtraPyramidal Sympoms (EPS)

Front 75

Treatment for akathisia induced by antipsychotics.

Back 75

Propranolol

Front 76

Management of Tardive Diskinesia induced by antipsychotics

Back 76

discontinue med

Front 77

Which 2 antipsychotics don't have weight gain as a side-effect?

Back 77

Ziprasidone (Geodon) and Aripiprazole (Abilify)

Front 78

1st line class for mood and anxiety disorders.

Back 78

SSRIs (guess SSRI if you are guessing in a psych question)

Front 79

Which antipsychotic in a pregnant woman?

Back 79

Haldol

Front 80

Benzo teratogenicity 1st trimester vs 3rd trimester.

Back 80

1st trim: cleft palate
3rd trim: floppy baby

Front 81

ANOREXIA mnemonic

Back 81

*Amenorrhea
No other cause of weight loss
Obviously thin, but feels fat
*Refusal to maintain nl body wt (BMI under 19)
Epigastric discomfor
X-symptoms (peculiar symptoms)
*Intense fear of gaining wt
Always thinking about food

Front 82

Anorexia vs Bulimia: egosyntonic or egodystonic?

Back 82

Anorexia: egosyntonic
Bulimia: egodystonic

Front 83

BULIMIA mnemonic

Back 83

*Binge eating
Under strict diet
*Lacks control over eating
Induces *vomiting
*Minimum of 2 episodes/wk for 3 mo
Increased concern of body size
Abuse of diuretics/*laxatives

Front 84

Bupropion (Wellbutrin) is a good anti-depression med in this cohort.

Back 84

Smokers

Front 85

The most concerning side-effect of Lamotragine (Lamictal).

Back 85

Stevens Johnson Syndrome (rash)

Front 86

Teacher complains kid has poor concentration. 1st question to mom before diagnosing ADHD.

Back 86

symptoms at home too? (dx requires 2 settings)

Front 87

Memorize these 4 signs of autism (age 2 mo, 12 mo, 16 mo, and 24 mo).

Back 87

no eye contact by 2 mo
no babbling by 12 mo
no single words by 16 mo
no 2-word phrases by 24 mo

Front 88

Treatment for Tourette's.

Back 88

Dopamine receptor antagonists (Haloperidol, pimozide) or Clonidine

Front 89

Lanugo. Diagnosis?

Back 89

Anorexia (lanugo is fine hair all over)

Front 90

Scar on dorsal hand surface (DIP). Diagnosis?

Back 90

Bulimia

Front 91

Osteoporosis/Stress Fractures in female college athlete. Diagnosis?

Back 91

Anorexia

Front 92

Good sleep hygiene advice (SLEEP mnemonic).

Back 92

Schedule sleep time
Limit caffeine
Exercise early in the day
Eating prohibited just before bedtime
Prevent daytime naPs

Front 93

Morning headaches. Suspected diagnosis?

Back 93

OSA

Front 94

Narcolepsy meds.

Back 94

Modafinil, Methylphenidate

Front 95

Likes the sick role. Diagnosis?

Back 95

Factitious

Front 96

Malingering vs. Factitious: how to differentiate.

Back 96

Malingering patients have a secondary gain MORE than the sick-role empathy.

Front 97

Somatization Disorder vs. Conversion disorder: extent of symptoms.

Back 97

Somatization: multiple organ systems
Conversion: "neuro" sx

Front 98

SADPERSONS mnemonic for suicide risk.

Back 98

Sex (male)
Age (elderly)
Depression
Previous attempt
EtOH or Drug abuse
Rational thought (can plan)
Sickness (e.g. chronic pain)
Organized plan
No spouse
Social support lacking

Front 99

Most common complication of a Somatoform disorder.

Back 99

Iatrogenic complications from repeated invasive work-up.

Front 100

How long before bereavement can be called depression?

Back 100

1 year