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71 Cards in this Set

  • Front
  • Back
Age of onset of schizophrenia
Men 15-25
Women 25-35
Prevalance of schizoprenia
1% in most cultures
List the differences between psychotic disorders
<1 mo=brief psychotic episode
1-6 months = schizophreniform disorder
> 6 month = schizophrenia
Why are atypical antipsychotics preferred for maintainence therapy in psychotic disorders?
less EPS and better effect on negative symptoms
Onset of dystonia if EPS reaction?
hours to days
Treatment of acute dystonia
- anithistamines (diphenhyd)
- anitcholinergics (benztropine, trihexyphenidyl)
Onset of akathisia if EPS reaction
within days
Treatment of akathisia
can try b-blockers
Onset of parkinsonism if EPS reaction
within months of treatment
Parkinsonism from EPS most common in
older women
Acute dystonia from EPS most common in
young men
Onset of tardive dyskinesia if EPS reaction
after years of treatment
Treatment of tardive dyskinesia
- none
- likely stop antipscyhotic and switch to atypical
Features of neuroleptic malignant syndrome
- rigidity
- high fever (up to 107)
- high CPK
- sweating
- myoglobinuria
- mutism
- altered mental status (agitated of obtunded)
Treatment of neuroleptic malignant syndrome
- stop antipsychotic
- supportive care for fever and renal
- consider giving dantrolene
classic side effect of thorazine
retinal pigment deposits
classic side effect of clozapine
Classic side effects of chlorpromazine
- jaundice
- photosensitivity
3 classic side effects of SSRIs
- insomnia
- anorexia
- sexual dysfunction
Firs line treatment of depression
therapy and SSRIs
Mechanism of action of TCAs
- NE reuptake block
- serotonin reuptake block
- a-adrenergic block
- AchM block
Why do TCAs cause orthostatic hypotension?
a-adrenergic block
MAOIs may be good for
atypical depression (eating and sleeping more)
TCA overdose most concerning for
cardiac arrhythmias
MAOIs + tyramine =
HTN crisis
Age of onset of bipolar disorder
16-30 years old
1st line agents for bipolar disorder
- lithium
- valproic acid
(carbamezapine 2nd line)
What is bipolar II?
hypomania with major depression
What is cyclothymia
2 years of hypomania with depressed mood without major episodes of either
4 classic side effects of lithium
- renal (DI)
- thyroid
- tremor
- CNS effects
Classic side effect of valproic acid
liver dysfunction
Classic side effect of carbamazepine
bone marrow depression
10 major risk factors for suicide
- age above 45
- substance use
- h/o violence
- prior attempts
- male
- psych history
- recent loss
- loss of health
- unemployment/retirement
- not married/partnered
Greatest age risk for suicide
over 65 (15-24 also high)
Normal grief can last up to
1 year
Typical age for panic disorder
Treatment of panic disorder
SSRIs (fluoxetine)
Panic disorder is associated with
Describe conversion discorder
- ppt event
- unexplanable neuro symptoms
Key features of somatization disorder
multiple complaints in multiple organ systems with negative workup
Treatment of somatoform disorders
- frequent clinic visits and/or therapy
Difference between factitious disorder and malingering
factitious disorder the patient wants to assume role of the patient. It's intentional but no monetary or other gain.
Key features of paranoid personality disorder
- everyone's out to get them
- law suits
Key features of schizoid personality disorder
- loner and not interested in having friends
Key features of schizotypal personality disorder
- bizarre beliefs
- bizarre way of talking but no psychosis
Key features of avoidant personality disorder
- inferiority complex
- has no friends but wants them
Key features of histrionic personality disorder
- center of attention
- seductive
- dramatic and attention seeking
Key features of narcissistic personality disorder
- no empathy
- use others for own gain
- sense of entitlement
Key features of antisocial personality disorder
* must have had conduct disorder
- criminal
- male
- alcohol and drugs
- somatization
Key features of borderline personality disorder
- unstable in every realm
- splitting
- 2 minutes of psychosis
- impulsive
- constant crisis
Key features of dependent personality disorder
- cannot be alone
- cannot do anything alone
Key features of obsessive-compulsive personality disorder
* different than OCD
- restricted affect
- rules are more important than objectives
What is a dissociative fugue?
patients have amnesia, travel, assume new identity
Dissociative identity disorder most likely assoicated with
childhood sexual abuse
Usually onset of OCD
adolescents or early adulthood
Treatment of OCD
- SSRIs (fluvoxamine
- clomipramine
- behavioral therapy
Features of narcolepsy
* decreased REM latency (enter REM as soon as fall asleep)
- cataplexy
- hypnopompic or phynagogic hallucinations
Treatment of narcolepsy
modafinil or amphetamines
Formications are associated with
Cocaine withdrawl features
- sleepy
- hungry
- irritable/depressed
amphetamines are classically associated with ____ symptoms
Likely drug intoxication if vertical and horizontal nystagmus
Phencyclidine (PCP)
Treatment of PCP overdose
- urine acidification
Is PCP toxic in overdose
yes. can cause dealth from consulsions, coma, respiratory arrest.
Are there withdrawl symptoms from PCP?
Are withdrawl symptoms from opiods dangerous?
Typical age for use of inhalants
11-15 years
Serious effects of inhalants
- respiratory depression
- arrhythmia
- asphyxiation
- nervous system toxic
- nephrotoxic
Is benzo withdrawl dangerous?
yes, like alcohol
3 classic syptoms of caffeine withdrawl
- headache
- irritability
- fatigue
6 times when ok to break confidentiality
- patient's request
- child abuse
- court mandate
- duty to warn/protect
- reportable disease
- danger to other