Step 2: First Aid Rapid Review (Psychiatry)

Front 1

first line pharmacotherapy for depression

Back 1

SSRIs

Front 2

antidepressants associated with hypertensive crisis

Back 2

MAOIs

Front 3

galactorrhea, impotence, menstrual dysfunction, and lower libido. these are side effects of what type of medication?

Back 3

pt on dopamine agonist

Front 4

17yo F has left arm paralysis after boyfriend dies in a car crash. no medical cause is found.

Back 4

conversion d/o

Front 5

mom who is angry at her husband yells at her child. defense mech.?

Back 5

displacement

Front 6

pedophile who enters a monastery. defense mech.?

Back 6

reaction formation

Front 7

woman calmly describes a grisly murder. defense mech.?

Back 7

isolation

Front 8

hospitalized 10yo begins to wet his bed. defense mech.?

Back 8

regression

Front 9

life-threatening muscle rigidity, fever, and rhabdomyolysis

Back 9

neuroleptic malignant syndrome

Front 10

amenorrhea, bradycardia, and abnormal body image in a young female

Back 10

anorexia

Front 11

a 35yo M has recurrent episodes of palpitations, diaphoresis, and a fear of going crazy

Back 11

panic d/o

Front 12

most serious side effect of clozapine?

Back 12

agranulocytosis

Front 13

21yo male has 3 mos of social withdrawal, worsening grades, flattened affect, and concrete thinking

Back 13

schizophreniform d/o (dx of schizophrenia requires >= 6mos of sx)

Front 14

key side effects of atypical antipsychotics

Back 14

wt gain
type 2 DM
QT prolongation

Front 15

a young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. dx? tx?

Back 15

acute dystonia (oculogyric crisis)

treat with benztropine (anti-cholinergic) or diphenhydramine (Benadryl = antihistamine and sedative)

Front 16

meds to avoid in pts c hx of alcohol w/d seizures

Back 16

neuroleptics

Front 17

13yo M has a hx of theft, vandalism, and violence toward family pets

Back 17

conduct d/o

Front 18

5mo old F has decr. head growth, truncal dyscoordination, and decr. social interaction

Back 18

Rett's d/o

Front 19

a pt hasn't slept for days, lost $20,000 gambling, is agitated, and has pressured speech. dx? tx?

Back 19

acute mania. start a mood stabilizer (eg. lithium or valproic acid)

Front 20

after a minor fender bender, a man wears a neck brace and requests permanent disability pmts.

Back 20

malingering

Front 21

a nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide

Back 21

factitious d/o (Munchausen syndrome)

Front 22

a pt continues to use cocaine after being in jail, losing his job, and not paying child support

Back 22

substance abuse

Front 23

a violent pt has vertical and horizontal nystagmus

Back 23

phencyclidine hydrochloride (PCP) intoxication

Front 24

a woman who was abused as a child frequently feels outside of or detached from her body

Back 24

depersonalization d/o

Front 25

a man has repeated, intense urges to rub his body against unsuspecting passengers on the bus

Back 25

Frotteurism (a paraphilia)

Front 26

a schizophrenic pt takes haloperidol for 1yr and develops uncontrollable tongue movements. dx? tx?

Back 26

tardive dyskinesia; decrease or d/c haloperidol and consider another antipsychotic (eg. risperidone, clozapine)

Front 27

a man unexpectedly flies across the country, takes a new name, and has no memory of his prior life

Back 27

dissociative fugue

Front 28

Name 5 SSRI's. When are they indicated?

Back 28

Citalopram
Escitalopram
Fluoxetine
Paroxetine
Sertraline

Indications: first-line therapy for depression and anxiety d/o

Front 29

What are side effects of the SSRI's?

Back 29

sexual side effects, decreased appetite, insomnia, HA, tremor

Front 30

what can happen if SSRI's are combined with MAOI's?

Back 30

serotonin syndrome: fever, myoclonus, mental status changes, CV collapse

Front 31

what are the signs and sx of serotonin syndrome?

Back 31

fever, myoclonus, mental status changes, CV collapse

Front 32

how do you remember TCA toxicity?

Back 32

"Three C's and A"

Convulsions
Coma
Cardiac arrhythmias
Anti-cholinergic effects (dry mouth, constipation, urinary retention)

Front 33

what are 2 side effects of chronic lithium use?

Back 33

hypothyroidism and nephrotoxicity

Front 34

what mood stabilizer can cause a life-threatening rash, aka Stevens-Johnson syndrome?

Back 34

lamotrigine

Front 35

what can happen if cheese and red wine are consumed while taking MAOI's?

Back 35

hypertensive crisis

Front 36

Name 5 atypical antidepressants.

Back 36

bupropion
mirtazapine
nefazodone
trazodone
venlafaxine

Front 37

what class of drugs may be used to treat OCD, chronic pain and migraines?

Back 37

atypical antidepressants.

Front 38

which atypical antidepressant is also used as a sleep aid and for erectile dysfunction?

Back 38

trazodone

"trampy and trance on trazodone"

Front 39

what antidepressants are used as first line therapy especially because they lack sexual side effects?

Back 39

atypicals:
bupropion
mirtazapine
nefazodone
trazodone
venlafaxine

Front 40

bupropion: drug class and SE?

Back 40

atypical antidepressant

lowers seizure threshold

Front 41

venlafaxine: drug class and SE?

Back 41

atypical antidepressant

diastolic hypertension

Front 42

mirtazapine: drug class and SE?

Back 42

atypical antidepressant

weight gain and sedation

Front 43

nefazodone: drug class and SE?

Back 43

atypical antidepressant

sedation, HA, dry mouth

Front 44

trazodone: drug class and SE?

Back 44

atypical antidepressant

highly sedating, priapism

Front 45

name 4 TCA's.

Back 45

amitriptyline
nortriptyline
imipramine
desipramine

Front 46

how can TCA's become lethal?

Back 46

overdose leading to cardiac conduction abnormalities

Front 47

do MAOI's have sexual side effects?

Back 47

yes

Front 48

list the symptoms of mania.

Back 48

DIG FAST

Distractibility
Insomnia
Grandiosity and Goals
Flight of ideas
Agitated psychomotor
Sexual indiscretions
Talkativeness

Front 49

what are the characteristics of personality disorders?

Back 49

MEDIC

Maladaptive
Enduring
Don't follow cultural norms
Inflexible
Causes impairment in social functioning

Front 50

name 4 mood stabilizers.

Back 50

lithium
carbamazepine
valproic acid
lamotrigine

Front 51

what drug is used as a mood stabilizer in treatment refractory pts?

Back 51

lamotrigine

Front 52

this drug, also used for acute mania, is the most widely used bipolar d/o drug.

Back 52

valproic acid

Front 53

what second-line mood stabilizer is also an anti-convulsant?

Back 53

carbamazepine

Front 54

what are the 4 indications for lithium?

Back 54

1. 1* mood stabilizer
2. acute mania (combine with antipsychotics)
3. prophylaxis of mania and depression in bipolar d/o
4. augment depression tx

Front 55

what are the side effects from taking a dopamine agonist?

Back 55

galactorrhea
impotence
menstrual dysfunction
lower libido