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221 Cards in this Set
- Front
- Back
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one of the most common and troubling potential side effects of SSRI
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sexual dysfunction, impotence
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patients have the legal right to obtain copies of their medical records
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**
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serious side effect of clozapine
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agranulocytosis
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when is clozapine indicated in patients with schizophrenia
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when both typical and other atypical antipsychotics fail
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contrast pts with anorexia vs. bulimia
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anorexia - amenorrhea and body weight below normal
bulimia - normal menses and body weight |
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what other condition is most commonly associated with panic attacks
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depression
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common side effects of PCP use
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nystagmus, hypertension, tachycardia, ataxia, muscle rigidity, seizures, psychosis, hallucinations
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how can antipsychotics lead to hyperprolactinemia
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by blocking dopamine in the tuberoinfundibular pathway
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what adverse effect is associated with olanzapine
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weight gain
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rare developmental disorder that occurs more commonly in males in which there is normal development at first followed by a loss of previously acquired skills
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childhood disintegrative disorder
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schizophrenic patient who presents with fever, rigidity, and altered mental status most likely takes which medication
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haloperidol
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differentiate between malingering and factitious disorder
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malingering - always associated with secondary gain
factitious disorder - assume the sick role |
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patient taking an antipsychotic develops a sustained neck contraction should be treated with what medication
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benztropine or diphenhydramine
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the stressor in adjustment disorder cannot be the death of a loved one
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**
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what is the timeline for normal bereavement
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rarely lasts longer than two months
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treatment for narcolepsy
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psychostimulants - modafinil or methylphenidate
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altered levels of which neurotransmitter play a role in OCD
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5-HT
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passive-agressive behavior
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defense mechanism in which an individual expresses his agression toward another person after repeated, failed passive attempts
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what should be done if child abuse is suspected
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1. complete physical exam
2. x-rays 3. coagulation profile 4. report to CPS |
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depressive symptoms not meeting full criteria for MDD that lasts two years or more
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dysthymic disorder
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differentiate schizotypical and schizoid personality disorder
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schizotypical - odd behavior, magical thinking, lack of close friends
schizoid - lack close friends and restricted range of emotional expression; no eccentric behavior |
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distinguish between MDD with psychotic features and schizoaffective disorder
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MDD w/ psychosis - patient's psychotic symptoms occur during times of depression
schizoaffective - time periods in which psychotic symptoms are present without mood symptoms |
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schizoaffective disorder
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characterized by presence of both psychotic and mood symptoms with time periods of psychotic symptoms with and without mood symptoms
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adjustment disorder
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development of emotional or behavioral symptoms in response to an identifiable stressor that occurred within the past 3 months
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excessive worry over many aspects of one's life that causes significant impairment in functioning for longer than 6 months
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GAD
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treatment of choice for social phobia
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assertiveness training, a component of CBT and an SSRI
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look for MDD symptoms in patients with cancer; depression, guilt, feelings of hopeless, or suicidal thoughts.
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prescribe an SSRI
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first-line treatment for patients with schizophrenia
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atypical antipsychotics - risperidone
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differentiate the side-effect profile between typical and atypical antipsychotics
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typical - extrapyramidal symptoms, neuroleptic malignant syndrome
atypical - weight gain |
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first-line drug for treating GAD
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buspirone
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drug of choice for treating performance-related anxiety
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propanolol
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treatment of choice for specific phobias
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short-acting benzos
*alprazolam |
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3 medications suitable for long-term treatment of bipolar disorder
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lithium
valproic acid carbamazepine |
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when should lithium not be administered to a pt with bipolar disorder
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renal dysfunction
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differentiate circumstantial and tangential thought process
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circumstantial - deviate from the subject but eventually return
tangential - drift away without ever returning to the subject |
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abrupt cessation of what medication used to treat panic disorder can lead to a generalized seizure
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alprazolam
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antidepressant of choice in patients suffering from sexual dysfunction
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bupropion
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lithium exposure during the first trimester of pregnancy is associated with what
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Ebstein's anomy, a cardiac malformation consisting of: ASD, enlarged RA, and malformed tricuspid valve
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reaction formation
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defense mechanism consisting of transformation of an unwanted thought or feeling into its opposite
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treatment of choice for schizophrenic patients who suffer relapses due to treatment noncompliance
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depot antipsychotics (IV or IM typical)
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diagnosis of MDD
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patients have at least 5/8 depressive symptoms (SIGECAPS) for at least two weeks
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what two things should be obtained in a pt presenting with refractory mania despite therapy with a mood stabilizer (lithium)
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UDS
lithium blood levels |
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severe symptoms of of tourette syndrome are best treated with what
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typical antipsychotics such as haloperidol or pimozide
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differentiate medications used for acute vs. long-term symptom relief for panic attacks
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short - benzo
long - SSRI |
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treatment of choice for adjustment disorder (symptoms develop within three months of exposure that rarely last more than six months)
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cognitive or psychodynamic psychotherapy
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what are complications that could arise for fetuses born to women with anorexia
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intrauterine growth retardation (small for gestational age)
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how can one treat extrapyramidal side effects of antipsychotics
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anticholinergic medications like benztropine
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what can be seen on head CTs of patients with schizophrenia
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increased ventricular size
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pregnant woman who is competent has the right to refuse treatment even if it places her fetus at risk
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**
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contraindications to bupropion use
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seizure disorder
eating disorder |
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diagnoses of schizophreniform disorder
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schizophrenic-like symptoms lsat for more than one month but less than six months
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when can patients with bipolar disorder taper and discontinue their mood stabilizer
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if they only had a single manic episode and they received medications for at least a year
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what labs should be ordered on a patient taking olanzapine
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fasting glucose and lipids
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delusional disorder
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involved one or more non-bizarre delusions in an otherwise high-functioning individual
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when should a person undergoing normal bereavement be considered for medication and psychotherapy
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patients with at least 2 weeks of depressive symptoms 6-8 weeks after a major loss
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treatment for patients with acute mania
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hospitalized and stabilized with antipsychotics
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first-line treatment for patients with psychotic disorders
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atypical antipsychotics
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differentiate avoidant and schizoid personality disorders
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avoidant - hypersensitivity to criticism, social inhibition, and feelings of inadequacy
schizoid - social detachment and restricted range of expressed emotion |
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only dissociative disorder associated with travel
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dissociative fugue
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pt presents to ED with pupillary dilation, rhinorrhea, muscle aches, abdominal cramping most likely has withdrawal to what
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heroin
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one of the most common side effects associated with ECT
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amnesia
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physiological defense mechanism in which unacceptable feelings about one object or person are put onto another "safer" option
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displacement
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diagnosis of somatization disorder
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four pain symptoms including: two GI, one sexual, one neurological
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person characterized by need for perfection, over-attention to detail and a need to strictly follow rules
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obsessive-compulsive personality disorder
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involuntary spasm of the perineal musculature that interferes with sexual intercourse
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vaginismus
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greatest risk factor for committing suicide
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past history of suicide attempts
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first-line treatment for patients with psychotic disorders
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atypical antipsychotics
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differentiate avoidant and schizoid personality disorders
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avoidant - hypersensitivity to criticism, social inhibition, and feelings of inadequacy
schizoid - social detachment and restricted range of expressed emotion |
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only dissociative disorder associated with travel
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dissociative fugue
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pt presents to ED with pupillary dilation, rhinorrhea, muscle aches, abdominal cramping most likely has withdrawal to what
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heroin
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one of the most common side effects associated with ECT
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amnesia
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physiological defense mechanism in which unacceptable feelings about one object or person are put onto another "safer" option
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displacement
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diagnosis of somatization disorder
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four pain symptoms including: two GI, one sexual, one neurological
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person characterized by need for perfection, over-attention to detail and a need to strictly follow rules
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obsessive-compulsive personality disorder
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involuntary spasm of the perineal musculature that interferes with sexual intercourse
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vaginismus
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greatest risk factor for committing suicide
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past history of suicide attempts
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patients with tourette syndrome have a significantly increased risk of developing what disorders
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ADHD
OCD |
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first-line treatment for patients with OCD
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SSRI
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what can result in a patient taking MAOI and eating soft cheeses and wine
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hypertensive crisis
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side effects associated with lithium
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nephrogenic diabetes insipidus
hypothyroidism ebstein's anomy in the fetus |
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what is suspected in a patient presenting with weight loss, behavioral changes, and erythema in the turbinates of the nasal septum
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cocaine abuse
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long should medication treatment be continued in a patient with a single episode of major depression
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six months following the patient's response
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absolute contraindication for the use of bupropion
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epilepsy
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depressed modd lasting the majority of days for at least two years
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dysthymia
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first-line medication treatment for enuresis if behavioral techniques fail
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desmopressin
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acid-base findings in a patient that induces vomiting daily
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hypokalemic-hypochloremic metabolic alkalosis
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most likely adverse effect of desmopressin
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headache
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medication treatment for child that presents with enuresis that has not responded to behavior interventions
|
intranasal desmopressin
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percent chance that a identical twin sister will develop Rett disorder after her twin is diagnosed
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100%
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what distinguishes MDD from adjustment disorder
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symptoms do NOT persist for more than 6 months following termination of the stressor in adjustment disorder
*both can develop within 3 months of a stressor and both do not represent normal bereavement |
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what percent of children with type I DM develop adjustment disorder following their diagnosis
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33%
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first-line treatment for tourette disorder
|
clonidine
*atypical antipsychotics are also used but are not first-line |
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define tourette disorder
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both multiple motor tics with at least one vocal tic present sometime during their illness for 1 year without 3 consecutive months tic-free
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which medications is associated with development of tics
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stimulants for ADHD
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what percentage of children with learning disorders have a comorbid psychiatric disorder
|
50%
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percentage of children that benefit from stimulant for ADHD
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70%
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parent of ADHD child does not want to start child on stimulant-type medication, what is the next best treatment
|
atomoxetine - nonstimulant NE reuptake inhibitor
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lab findings in an anorexic patient
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hypercholesterolemia
hypokalemia leukopenia normal TSH with decreased T3 |
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what complications is associated with indication for admitting an anorexic patient
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arrhythmia
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which cluster A personality disorder is associated with schizophrenia
|
schizotypal personality disorder
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adverse effect of clonidine seen in children prescribed for Tourette disorder
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sedation
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treatment of choice for panic disorder
|
SSRI
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percentage change an identical twin will develop schizophrenia is one twin is already diagnosed
|
50%
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delusion that the world has been reduced to nothingness, there is no world
|
Cotard syndrome
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delusion that people have been replaced by imposter aliens
|
Capgras syndrome
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that common mood disorder that develops into postpartum psychosis
|
bipolar disorder
|
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what defense mechanism does a patient that intense mood swings, avoid abandonment, empitness, anger, impulsivity use
|
splitting
*borderline personality disorder |
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what symptoms of schizophrenia portends a better prognosis
|
good premorbid functioning (functioning before onset of schizophrenia)
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treatment of choice for patient with catatonic subtype of MDD
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lorazepam
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a patient presents with catatonic type of schizophrenia, you start lorazepam after vitals are stabilized. pt is not responding to treatment, what is the next step in management
|
ECT
|
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what is a contraindication for ECT
|
intracranial brain mass and recent MI
|
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what hormone do you expect to be increased in a patient with depression
|
cortisol
|
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what type of medication should be discontinued in a pt that is showing signs of mania that was previously depressed
|
SSRI
*can worsen mania |
|
|
sublinical depression + hypomania
|
cyclothymic disorder
|
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what benzodiazepines are ideal for treating delirium
|
lorazepam and oxazepam because they are not dependent on liver function for liver metabolism
|
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percent chance of mortality in a pt not treated for delirium tremens
|
30%
|
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pt presents with large appetite, compulsitivity, sexual disinhibition, and is docile
|
kluber-bucy syndrome
|
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what part of the brain is damaged in kluver-bucy syndrome
|
amygdala
|
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for how long can symptoms last for in adjustment disorder
|
up to 6 months
|
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treatment of choice for heroin addiction in a pregnant patient
|
methadone
|
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is physiologic dependence needed for substance dependence to be diagnosed
|
NO
|
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what separates substance abuse from substance dependence
|
inability to stop drinking despite knowing the harmful effects
|
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differentiate acute stress disorder vs PTSD
|
acute stress disorder happens within 4 weeks of a trauma
PTSD has persistent symptoms after 4 weeks of the trauma |
|
|
treatment for OCD
|
SSRI
|
|
|
how to manage a patient in delirium that is agitated
|
haloperidol
|
|
|
percentage of patients taking an SSRI vs. placebo are expected to improve after 4-6 weeks
|
placebo - 30%
SSRI - 70% |
|
|
treatment of choice for narcolepsy
|
stimulants
|
|
|
treatment of choice for Tourette disorder
|
antipsychotic
|
|
|
average untreated depressive episode in a patient with MDD vs. treated
|
untreated - 6-13 months
treated - ~3 months |
|
|
treatment of choice for PTSD
|
SSRI
|
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are patients with factitious disorder doing so consciously vs. unconsciously
|
unconsciously
|
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what medication can cause a psychotic disorder used in the hospital
|
high-dose corticosteroids
*substance-induced psychotic disorder |
|
|
what percentage of impotence in age 30-50 is psychological etiology
|
90%
|
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what disorder is associated with sensory gating deficits, short-term memory difficulties, and abnormalities in smooth-pursuit eye movements
|
schizophrenia
|
|
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which type of antidepressant is associated with also used for migraine headaches
|
TCA
|
|
|
differentiate cataplexy vs. catalepsy
|
catalepsy - state of immobility sometime seen in catatonic states
cataplexy - transient loss of motor tone associated with narcolepsy |
|
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akathisia
|
subjective sensation of motor and mental restlessness
|
|
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type is tactile hallucination in which one has the sensation of bugs crawling on or under the skin associated with cocaine intoxication
|
formication
|
|
|
which parts of the brain are affected in patients with OCD
|
caudate nucleus, frontal lobes, and cingulum
|
|
|
substitution of a word or description for a ward that cannot be recalled or spoken
|
circumlocution
|
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|
delusion that penis is shrinking into abdomen
|
koro
|
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delusional belief that one's body is offensive
|
taijin-kyofusho
|
|
|
delusional belief of possession by a spirit
|
zar
|
|
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what type of affect is seen in a patient who is current manic
|
expansive and irritable
|
|
|
differentiate mild, moderate, sever, and profound mental retardation
|
mild - 50-69
moderate - 35-49 severe - 21-34 profound - <20 |
|
|
treatment of choice for atypical depression
|
MAOI
|
|
|
how long is considered minimal adequate trial for SSRI
|
6 week trial
|
|
|
drug of choice for agitated patient 36 hours after admission in a patient with history of alcohol dependence
|
benzodiazepine - preferably lorazepam, oxazepam, tomazepam
|
|
|
treatment of choice for MDD with psychotic features
|
SSRI and an atypical antipsychotic
|
|
|
treatment of choice for akathisia, restlessness seen in use of atypical antipsychotics
|
propanolol
|
|
|
treatment of choice for EPS symptoms seen in typical antipsychotics
|
benztropine
|
|
|
treatment of choice for acute dystonias seen in use of antipsychotics
|
diphenhydramine
|
|
|
three first-line agents used to treat bipolar disorder with depression currently
|
lithium
lamotrigin quetiapine |
|
|
long-term side effect associated with hioridazine
|
retinal pigmentation
|
|
|
treatment of choice for panic disorder
|
SSRI
|
|
|
which medication should be used for pain in patients taking lithium for their mood
|
aspirin or sulindac, NOT NSAIDS
|
|
|
what can be exacerbated by stimulant medication used for ADHD
|
tics
|
|
|
treatment for tourette disorder
|
antipsychotic
|
|
|
treatment of choice for tardive dyskinesia
|
clozapine
|
|
|
adverse effect associated with SSRI use during pregnancy
|
persistent pulmonary HTN of the newborn
|
|
|
patient become acute irritable with body aches, chills, and general lethargy 3 days after abruptly withdrawing his SSRI medication
|
SSRI discontinuation syndrome
*need to taper off the medication |
|
|
treatment of choice for patient with depression and insomnia
|
trazodone
|
|
|
adverse effect associated with trazodone
|
priapism
|
|
|
EKG finding associated with lithium
|
T-wave depression
|
|
|
treatment of choice for OCD
|
clomipramine
|
|
|
next step in management of a patient with OCD already on clomipramine that still has significant distress
|
add risperidone
|
|
|
what receptor does cloazpine mainly act on
|
D4
|
|
|
type of antidepressant associated with orthostatic hypotension in the elderly
|
TCA
|
|
|
first-line treatment for bipolar disorder with mani currently
|
lithium
valproic acid |
|
|
adverse effect associated with lithium
|
increases risk of cardiac malformation
*Ebstein's anomaly |
|
|
treatment of choice for nightmares
|
prazosin
|
|
|
treatment of choice for patient with both depression and pain
|
duloxetine
*less side-effects than a TCA |
|
|
most likely side effect of risperidone
|
orthostatic hypotension
|
|
|
anticonvulsant used to treat binge eating disorder
|
topiramate
|
|
|
most common side effect of transcranial magnetic stimulation
|
headache
|
|
|
treatment of choice that is safest for bipolar patient that is pregnant
|
ECT
|
|
|
which mood stabilizer is associated with increased risk of pancreatitis
|
valproic acid
|
|
|
which symptom of depression takes the most time to improve after starting an SSRI
|
suicidality
|
|
|
benzos of choice in a patient with liver problems
|
LOT
|
|
|
adverse effect associated with lamotrigine
|
stevens-johnson syndrome
|
|
|
spasm of the back and neck that causes the patient to arch forward, seen in typical antipsychotics
|
opisthotonos
|
|
|
adverse effect associated with topiramate
|
renal stones
|
|
|
delirium tremens occurs most often during which time frame
|
within 72 hours
|
|
|
adverse effect associated with oxcarbazepine
|
hyponatremia
|
|
|
side effect associated with mirtazapine
|
weight gain
|
|
|
side effect associated with venlafaxine
|
hypertension
|
|
|
mood stabilizer associated with spina bifida in pregnant patient
|
valproic acid
|
|
|
treatment of choice for NMS in patient taking typical antipsychotic
|
dantrolene
|
|
|
what is the brown-peterson task used to evaluation
|
short-term memory
|
|
|
what does nicotine do to the levels of antipsychotics
|
nicotine lowers medication levels, if a person decides to quit smoking their medication level would increase
|
|
|
what is the folstein mini-mental state examination used to assess
|
used a screening for dementia
|
|
|
what is the wisconsin card sorting test used to determine
|
person's ability to reason abstractly and solve problems
|
|
|
what is the draw-a-person test used for
|
determine is someone has brain damage
|
|
|
what part of the brain does the wisconsin card sorting test measure
|
frontal lobes
|
|
|
percent risk a child has of having schizophrenia is one parent is diagnosed
|
as high as 12%
|
|
|
it is unethical to engage in therapy to change the sexual orientation of a patient
|
**
|
|
|
malaysian origin that refers to a violent or furious outburst with homicidal intent
|
amok
|
|
|
indian term referring to anxiety regarding the discharge of semen
|
dhat
|
|
|
characterized by a patient who responds to question by giving approximate or outright ridiculous answers
|
ganser syndrome
|
|
|
a non anti-cholinergic medication used to alleviate EPS symptoms in patients taking typical antipsychotics
|
amantadine
|
|
|
projective tests lack structure and allow for a variety of responses
|
examples include: Rorschach, thematic apperception test, sentence completion, and draw-a-person test
|
|
|
what type of personality disorder uses denial as a defense mechanism
|
narcissistic
|
|
|
how do you calculate IQ
|
mental age/chronological age x 100
|
|
|
what does the rey-osterrieth test assess
|
visual nonverbal memory
*right parietal lobe |
|
|
patient taking benztropine due to EPS side effects of antipsychotics develops decreased secretions, agitation, dry skin, flushing, tachycardia, dilated pupils
|
anticholinergic toxicity
|
|
|
treatment for anticholinergic toxicity
|
AChE
|
|
|
which mood stabilizer is associated with reversible hair loss
|
dialproex (valproic acid)
|
|
|
treatment for kleptomania
|
SSRI
*anxiety-related disorder |
|
|
what other anxiety disorders are related to kleptomania
|
OCD
Bulemia |
|
|
dysthmymia + hypomania
|
cyclomania
|
|
|
differentiate treatment of OCD vs. tourettes
|
OCD - SSRI
Tourette's - clonidine/atypical antipsychotics |
|
|
drug of choice for cocaine intoxication
|
alpha blockade > beta blockade
|
|
|
neurotransmitter associated with sleep
|
serotonin
|
|
|
what medication can reduce stage III/IV sleep
|
benzodiazepines
|
|
|
which stage of sleep is associated atony
|
REM
|
|
|
which atypical antipsychotics does NOT cause weight gain
|
ziprasidone
aripiprazole |
|
|
what must be ruled out before reassuring patients with a panic attack
|
medical problems with hear and lungs
|
|
|
how long is an adequate therapeutic trial for SSRI medication a patient with dysthymia
|
8 weeks
|
|
|
test used to determine hemispheric dominance
|
Wada test
|
|
|
drug of choice for bipolar patient who is pregnant if ECT is not available
|
haloperidol
|
|
|
treatment used to control symptoms of opioid withdrawal
|
clonidine
|
