Psychiatry Shelf

Front 1

IQ tests

Back 1

Wechsler Adult Intelligence Scale (WAIS) - ages 16-75
Stanford-Binet - ages 2-18

Front 2

Objective personality test

Back 2

Minnesota Multiphasic Personality Inventory (MMPI-2)

Front 3

DSM-IV Schizophrenia

Back 3

A)Two+ for at least 1 month:
1) Delusions
2) Hallucinations
3) Disorganized speech
4) Grossly disorganized or catatonic behavior
5) Negative symptoms
B) Causes social/occupational deterioration
C) At least six months (incl. prodromal or residual)
D) Not due to medical, neuro, substance

Front 4

Schizophrenia subtypes

Back 4

1) Paranoid
2) Disorganized
3) Catatonic
4) Undifferentiated
5) Residual

Front 5

Criteria for Paranoid Type Schizophrenia

Back 5

A) Preoccupation with 1+ delusions or frequent AH
B) No predominance of disorganized speech, disorganized or catatonic behavior, or inappropriate affect

Front 6

Criteria for Disorganized Type Schizophrenia

Back 6

A) Disorganized speech
B) Disorganized behavior
C) Flat/inappropriate affect

Front 7

Criteria for Catatonic Type Schizophrenia

Back 7

At least 2 of:
A) Motor immobility
B) Excessive purposeless motor activity
C) Extreme negativism or mutism
D) Peculiar voluntary movements/posturing
E) Echolalia or echopraxia

Front 8

Schizophrenia:
1) Monozygotic concordance rate
2) Inheritance w/ 2 parents
3) Inheritance w/ one 1st degree relative

Back 8

1) 50%
2) 40%
3) 12%

Front 9

Dopamine pathways

Back 9

1) Prefrontal cortical - negative sx
2) Mesolimbic - positive sx
3) Tuberoinfundibular - prolactin
4) Nigrostriatal - EPS when blocked

Front 10

Neurotransmitter abnormalities in schizophrenia (non-dopamine)

Back 10

1) ↑ serotonin
2) ↑ NE
3) ↓ GABA

Front 11

Serotonin-antigonizing antipsychotics

Back 11

risperidone
clozapine

Front 12

In schizophrenia:
___ sx & ___ onset associated w/ better prognosis; ___ sx & ___ onset w/ worse.

Back 12

Mood sx & acute onset associated w/ better prognosis; negative sx & gradual onset w/ worse.

Front 13

SE of high potency neuroleptics
SE of low potency neuroleptics

Back 13

High: EPS
Low: anticholinergic

Front 14

EPS SE in order of onset

Back 14

1) Dystonia
2) Akathisia
3) Parkinsonism
4) Tardive dyskinesia

Front 15

Tx of EPS (except TD)

Back 15

Anticholinergics (benztropine, amantadine)
Benzos

Front 16

Tx of TD

Back 16

Cholinomimetics
Benzos
Beta-blockers

Front 17

Most likely to cause NMS

Back 17

High-potency

Front 18

Sx of NMS

Back 18

Confusion
High fever
HTN
Tachycardia
Lead pipe rigidity
Sweating
Elevated CPK

Front 19

Which antipsychotic can cause irreversible retinal pigmentation?

Back 19

Clozapine

Front 20

Which antipsychotic can cause deposits in lens and cornea?

Back 20

Chlorpromazine

Front 21

DSM-IV for schizoaffective d/o

Back 21

A) Meet criteria for MDD, manic episode, or mixed episode, during which criteria for schizophrenia also met
B) Delusions/hall for 2 weeks WITHOUT mood sx
C) Mood sx for substantial portion of psychotic illness
D) Not due to medical condition or drugs

Front 22

DSM-IV for Major Depressive Episode

Back 22

A) At least five (incl. 1 or 2) for at least 2 weeks:
1) Depressed mood
2) Anhedonia
3) Change in appetite or weight
4) Worthlessness/guilt
5) Insomnia/hypersomnia
6) ↓ concentration
7) PMA/PMR
8) Fatigue/↓ energy
9) Recurrent thoughts of death/suicide

Front 23

DSM-IV for Manic Episode

Back 23

A) At least 1 week of abnormally and persistently elevated, expansive, or irritable mood w/ 3 (4 if irritable):
1) Distractibility
2) Inflated self-esteem/grandiosity
3) ↑ goal-directed activity
4) ↓ need for sleep
5) Flight of ideas/racing thoughts
6) Pressured speech/talkative
7) Risky activites

Front 24

DSM-IV for Mixed Episode

Back 24

Criteria met for both manic and major depressive episode, nearly every day for at least 1 week.

Front 25

Hypomanic Episode

Back 25

-At least 4 days
-No marked social/occupational impairment
-Does not require hospitalization
-No psychotic features

Front 26

Sleep problems in MDD

Back 26

1) Multiple awakenings
2) Initial & terminal insomnia
3) Hypersomnia
4) REM earlier in night
5) ↓ 3&4

Front 27

Neuroendocrine abnormalities in MDD

Back 27

1) High cortisol; failure to suppress in dexamethasone suppression test
2) Abnormal thyroid axis; blunted TSH response to TRH

Front 28

Monozygotic and dizygotic concordance for MDD

Back 28

50% and 10-25%

Front 29

DSM-IV for Bipolar I

Back 29

One manic or mixed episode

Front 30

Monozygotic and dizygotic concordance for Bipolar I

Back 30

75% and 5-25%

Front 31

DSM-IV for Bipolar II

Back 31

One+ MDE and 1+ hypomanic episode

Front 32

DSM-IV for Dysthymic Disorder

Back 32

A) Depressed mood most of the time on most days for at least 2 years (1 in chilren)
B) 2+ of:
1) Poor concentration/decision-making
2) Hopelessness
3) Poor appetite or overeating
4) Insomnia/hypersomnia
5) Low energy/fatigue
6) Low self-esteem
C) During the 2-year period:
1) Not without the sx for >2 months at a time
2) No MDE

Front 33

DSM-IV for Cyclothymic Disorder

Back 33

A) Numerous periods w/ hypomanic sx and periods w/ depressive sx for at least 2 years
B) Never sx-free for >2 months
C) No hx of MDE or manic episode

Front 34

Neurotransmitter changes in anxiety

Back 34

-↑ NE
-↓ GABA
-↓ serotonin

Front 35

DSM-IV for panic attacks

Back 35

Discrete period of intense fear and discomfort with at least 4 of:
-Palpitations
-Sweating
-Shaking
-Shortness of breath
-Choking sensation
-Chest pain
-Nausea
-Light-headedness
-Depersonalization
-Fear of losing control/going crazy
-Fear of dying
-Numbness or tingling
-Chills or hot flushes

Front 36

DSM-IV for Panic Disorder

Back 36

1) Spontaneous recurrent panic attacks
2) At least one followed by at least one month of:
-Persistent concern about having further attacks
-Worry about implications of attack
-Significant change in behavior

Front 37

Pharm tx for Panic Disorder w/w/o Agoraphobia

Back 37

SSRIs first-line

Front 38

DSM-IV for Specific and Social Phobias

Back 38

1) Persistent excessive fear
2) Exposure causes immediate anxiety response
3) Pt recognizes fear is excessive
4) Situation avoided or tolerated w/ intense anxiety
5) If under 18, lasts at least 6 months

Front 39

Pharm tx for social phobia

Back 39

Paroxetine, beta-blockers

Front 40

DSM-IV for OCD

Back 40

1) Either obsessions or compulsions
2) Pt is aware are unreasonable/excessive
3) Obsessions cause marked distress, are time consuming, or interfere w/ ADLs

Front 41

Pharm & behavioral tx for OCD

Back 41

Pharm: SSRIs, clomipramine
Behav: Exposure and response prevention (ERP)

Front 42

DSM-IV PTSD

Back 42

-Traumatic, potentially harmful or fatal event; initial reaction intense fear or horror
-Persistent re-experiencing
-Avoidance of stimuli associated w/ the trauma
-Numbing of responsiveness
-Persistent sx of increased arousal
-At least one month

Front 43

Pharm tx for PTSD

Back 43

TCAs (imipramine, doxepin); SSRIs; MAOIs; anticonvulsants (for flashbacks and nightmares)

Front 44

Time lengths in acute stress disorder

Back 44

Event occurred <1 month ago
Symptoms last <1 month

Front 45

DSM-IV for GAD

Back 45

1) Excessive anxiety & worry for at least 6 months
2) Difficult to control the worry
3) At least three of:
-Restlessness
-Fatigue
-Difficulty concentrating
-Irritability
-Muscle tension
-Sleep disturbance

Front 46

Pharm tx of GAD

Back 46

Buspirone; short course of benzos (clonazepam, diazepam); SSRIs; venlafaxine ER

Front 47

DSM-IV of Adjustment Disorder

Back 47

1) Development of emotional or behavioral sx w/in 3 months of a stressful (not life-threatening) event, producing either
-Severe distress
-Significant impairment in daily fx
2) Sx are not those of bereavement
3) Sx resolve w/in 6 months

Front 48

DSM-IV for personality d/o

Back 48

1) Pattern of behavior/inner experience manifested in 2+ of:
-Cognition
-Affect
-Personal relations
-Impulse control
2) The pattern:
-Is pervasive & inflexible in a broad range of situations
-Is stable; onset no later than adolescence/early adulthood
-Causes sig. distress in fx
-Not accounted for otherwise

Front 49

Cluster A
-Types
-Family assoc

Back 49

-Types: schizoid, schizotypal, paranoid
-Assoc: psychotic d/os

Front 50

Cluster B
-Types
-Family assoc

Back 50

-Types: antisocial, borderline, histrionic, narcissistic
-Assoc: mood d/os

Front 51

Cluster C
-Types
-Family assoc

Back 51

-Types: avoidant, dependent, obsessive compulsive
-Assoc: anxiety d/os

Front 52

DSM-IV for substance abuse

Back 52

1+ year w/ 1+ of:
1) Failure to fulfill obligations
2) Use in dangerous situations
3) Recurrent substance-related legal problems
4) Continued use despite social or interpersonal problems due to the substance use

Front 53

DSM-IV for substance dependence

Back 53

W/in a 12-month period, 3+ of:
1) Tolerance
2) Withdrawal
3) Using more than originally intended
4) Persistent desire or unsuccessful efforts to cut down
5) Significant time spent getting, using or recovering
6) Decreased social, occupational, recreational activities

Front 54

Legal limit for intoxication in most states

Back 54

BAL 80-100 mg/dL

Front 55

Tx of acute EtOH intoxication

Back 55

1) ABCs, electrolytes & acid-base
2) FSBG
3) Thiamine, naloxone, folate

Front 56

Pharm tx for EtOH dependence

Back 56

Disulfiram, SSRIs, naltrexone (reduces cravings)

Front 57

Tx of EtOH withdrawal

Back 57

1) Tapering benzo
2) Thiamine, folic acid, MVI
3) MgSulfate for postwithdrawal sz

Front 58

Sx of Wernicke's encephalopathy

Back 58

1) Ataxia
2) Confusion
3) Ocular abnormalities (nystagmus, gaze palsies)

Front 59

Sx of Korsakoff's syndrome

Back 59

1) Impaired recent memory
2) Anterograde amnesia
3) +/- confabulation

Front 60

Order of nutrients in Wernicke-Korsakoff

Back 60

Thiamine BEFORE glucose

Front 61

Effect of cocaine

Back 61

Blocks dopamine reuptake

Front 62

Pharm tx of
-Cocaine intoxication
-Cocaine dependence

Back 62

-Intox: benzos, Haldol, sx tx
-Dependence: TCAs, dopamine agonists (amantadine, bromocriptine)

Front 63

-Classic amphetamines
-Substituted ("designer") amphetamines

Back 63

-Dextroamphetamine (Dexedrine), methylphenidate (Ritalin), methamphetamine (crystal meth)
-MDMA (ecstasy), MDEA (eve)

Front 64

Effect of
-Classic amphetamines
-Substituted amphetamines

Back 64

-Release dopamine from nerve endings
-Release dopamine and serotonin from nerve endings; stimulant & hallucinogenic

Front 65

How long is urine drug screen + after cocaine use?

Back 65

3 days; longer in heavy users

Front 66

How long is urine drug screen + after amphetamine use?

Back 66

1-2 days

Front 67

Effects of PCP

Back 67

-Antagonizes NMDA glutamate receptors
-Activates dopaminergic neurons

Front 68

Drug similar to PCP

Back 68

Ketamine

Front 69

Pathognomonic sx of PCP intox

Back 69

Rotatory nystagmus

Front 70

How long is urine drug screen + after PCP use, and what else is often elevated?

Back 70

>1 week; CPK & AST

Front 71

Effect of
-benzos
-barbiturates

Back 71

-Increase frequency of Cl channel opening
-Increase duration of Cl channel opening

Front 72

How long is urine drug screen + after sedative-hypnotic use?

Back 72

1 week

Front 73

Tx of barbiturate intoxication

Back 73

Alkalinize urine w/ sodium bicarb to promote renal excretion

Front 74

Tx for benzo intoxication

Back 74

Flumazenil

Front 75

What is the date rape drug?

Back 75

GHB (gamma-hydroxybutyrate)

Front 76

What is dextromethorphan?

Back 76

An opiate

Front 77

What can meperidine + MAOIs together cause?

Back 77

Serotonin syndrome

Front 78

How long is urine test + after opiate use?

Back 78

12-36 hours

Front 79

Sx of opiate withdrawal include

Back 79

-Dysphoria
-Lacrimation, rhinorrhea
-Yawning
-Piloerection
-Muscle ache

Front 80

Which opiate does not cause miosis?

Back 80

Meperidine

Front 81

How long is urine test + after MJ use?

Back 81

Up to 4 weeks in heavy users

Front 82

How long is serum test + after inhalant use?

Back 82

4-10 hours

Front 83

Effect of caffeine

Back 83

-Adenosine antagonist → ↑ cAMP
-Stimulant effect (dopaminergic)

Front 84

Pharm tx for smoking cessation

Back 84

Zyban (bupropion), clonidine