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EOR: Behavioral Health > Rosh Material #2 > Flashcards

Rosh Material #2 Flashcards

1
Q

substanc mc abused by schizophrenic pt’s

A

tobacco

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2
Q

primary feature of illness anxiety d.o

A

fear of a serious underlying medical condition

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3
Q

drug that reduces frequency of inappropriate fantasies and sex drive (ex for pedophilic d.)

A

leuprolide acetate

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4
Q

indications for hospitalization in depressed pt who expresses suicidal ideation (8)

A

recent suicide attempt
detailed suicide plan
inability to discuss safety planning
comorbid psychiatric d.o
agitation
impulsivity
severe hopelessness
poor social support

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5
Q

3 comorbid psychiatric conditions that indicate hospitalization for depressed suicidal pt

A

borderline pd
schizophrenia
bipolar

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6
Q

rf for suicide

A

> 70 yo
male
poor health
hx mental illness
feeling hopeless/helpless
isolation
unemployment/stressful work situation
poor finances
previous suicide attempt
fam hx suicide/attempt
LBGTQ+

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7
Q

what do you think when you see: acute brain syndrome

A

mc major symptom of PCP

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8
Q

what is acute brain syndrome

A

disorientation combined w. confusion, lack of judgment, inappropriate affect, or memory loss

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9
Q

common PE finding of acute brain syndrome

A

nystagmus: horizontal, vertical, or rotary

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10
Q

standard drug urine test can detect (7)

A

cocaine
amphetamines
benzos
barbs
natural opioids
cannabis
PCP

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11
Q

what are the synthetic opioids (can not be detected on urine drug screen)

A

fentanyl
methadone
+/- oxycodone (semisynthetic)

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12
Q

3 causes of false positives for opioids on urine drug test

A

poppy seeds
rifampin
fluoroquinolones

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13
Q

which medications increase lithium levels (5)

A

ACEI
NSAIDs
thiazides
TCAs
metronidazole

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14
Q

weekly weight gain goal for inpatient anorexia pt

A

2-3 lb/week

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15
Q

weekly wt gain goal for anorexia pt with partial hospital tx

A

1-2 lb/week

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16
Q

weekly outpatient weight gain goal for anorexia pt

A

0.5-1 lb/week

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17
Q

indications for hospitalization for anorexia pt (8)

A

HR < 40 bpm
bp < 80/60
orthostatic increase in pulse
decrease in SBP
cardiac dysrhythmia
BMI < 15
< 75% IBW
medical complications 2/2 malnutrition

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18
Q

pharm for refractory anorexia that does not respond to 1st line tx

A

SGA - ex olanzapine

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19
Q

what dietary deficiencies have been linked to ADHD

A

iron
zinc
omega 3

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20
Q

erections require increased vascular flow into the _ (2)
and reduced _

A

corpora cavernosa
corpus spongiousum

reduced venous outflow

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21
Q

what intrapenile substance increases during an erection

what substance is produced as a result

A

nitric oxide promotes generation of cyclic guianosine monophosphate

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22
Q

nitric oxide and cyclic guanosine monophosphate lead to _
which leads to erection

A

vasodilation

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23
Q

6 classes of medications associated w. decreased libido and sexual dysfxn

A

SSRIs
antiandrogens
5ARI’s
thiazides
spironolactone
opioids

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24
Q

what personality d.o is mc associated w. anorexia

A

ocd personality d.o

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25
Q

what lab test is most definitive in determining chronic AUD

A

carbohydrate deficient transferrin

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26
Q

first line tx for conduct d.o

A

multisystemic:
family therapy, parent training, CBT, community consultation

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27
Q

besides multisystemic tx, what other non pharm tx are used for conduct d.o (4)

A

positive parenting program
fast track
therapeutic foster homes
multidimensional foster care

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28
Q

malingering is associated w. _ incentinves

factitious d.o is associated with _ incentives

A

malingering: external inventives
factitious: non external incentives

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29
Q

what is required for dx of complicated grief rxn

A

extreme yearning for deceased at 12 mo after their death

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30
Q

what instrument is used to measure severity of GAD

A

hospital anxiety and dpn scale

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31
Q

t/f: most children w. conduct d.o will later develop antisocial pd

A

f!

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32
Q

what 3 antiepileptic drugs are associated w. sexual dysfxn

A

lamotrigine
gabapentin
topiramate

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33
Q

antipsychotic highly associated w. TD

A

quetiapine

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34
Q

mc manifestations of TD

A

oral
facial
lingual

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35
Q

2 drugs associated w. TD

A

antipsychotics
metoclopramide

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36
Q

tx for mild TD

A

benzo

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37
Q

tx for localized and severe TD

A

botox

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38
Q

pathology of TD

A

hyperkinetic movements due to prolonged use of dopamine receptor blocking agents

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39
Q

t/f: TD is irreversible

A

f!

remission may occur months-years later

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40
Q

first line tx for ADHD in peds:
first line tx for ADHD in adults:

A

peds: behavior mods
adults: stimulants

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41
Q

life threatening adverse effect of methadone

A

qt prolongation

42
Q

3 features associated w. paranoid pd

A

feeling of exploitation/deception
holding grudges
interpret benign remarks as threatening

43
Q

risk of lamotrigine if it is titrated up rapidly

A

SJS

44
Q

moa for first gen antipsychotics

A

D2 antagonists
also antagonists of M1, H1, and alpha 1 receptors

45
Q

moa for second gen antipsychotics

A

5HT2a an D2 antagonists
rapid D2 dissociation
5H1a agonists

also antagonists of M1, H1, and alpha 1 receptors

46
Q

mc type of hallucination in schizophrenia pt

A

auditory

47
Q

3 red flags for factitious d.o

A

hx of multiple hospital admits
willingness to undergo procedures
deceptive behavior: ex forging/falsifying /exaggerating

48
Q

spectrum of postpartum dpn

A

blues: 2-3 days postpartum
dpn: first few months
psychosis: days to 4-6 weeks

49
Q

tx for postpartum blues

A

reassurance
watchful waiting for dpn

50
Q

pharm for postpartum dpn

A

sertraline
paroxetine

51
Q

tx for postpartum psychosis

A

antipsychotics
inpatient

52
Q

brief psychotic episode involves one or more psychotic symptoms that have a sudden onset and last at least _
and resolve within _

A

1 day
1 month

53
Q

first line tx for brief psychotic episode

A

SGAs

54
Q

gs assessment tool used for panic d.o

A

panic disorder severity scale

55
Q

what classes of meds are associated w. neuroleptic malignant syndrome

A

FGA: haldol, fluphenazine - mc
SGA: clozapine, risperidone, olanzapine
antiemetics:metocopramide, promethazine
withdrawal of dopamine agonists

56
Q

quadrad of neuroleptic malignant syndrome

A

AMS
hyperthermia
lead pipe rigidity
autonomic instability

57
Q

lab finding of neuroleptic malignant syndrome

A

elevated CK

58
Q

pharm for neuroleptic malignant syndrome

A

benzos

59
Q

neuroleptic malignant syndrome rarely presents with _
which is one way it can be distinguished from serotonin syndrome

A

hyperreflexia

60
Q

EKG finding of neuroleptic malignant syndrome

A

generalized slow wave activity

61
Q

disorders of arousal from NREM sleep in peds

A

confusional arousals
sleep walking
sleep terrors

62
Q

parasomnias associated w. REM sleep in peds

A

nightmares
sleep paralysis
REM sleep behavior d.o
parasomnia overlap d.o

63
Q

what insomnia drug is best for sleep maintenance
what is its MOA

A

doxepin
H1 receptor antagonist

64
Q

what insomnia drug is best for sleep onset
what is its MOA

A

ramelteon
melatonin agonist

65
Q

what insomnia drugs are used for sleep onset AND sleep maintenance

what are their MOAs

A

lemborexant - orexin antagonist
suvorexant - orexin antagonist
trazadone - 5HT, alpha-1, H1 antagonist

66
Q

what OTC supplement is used to induce vomiting

what complication is associated w. it

A

syrup of ipecac

ipecac induced myopathy/cardiomyopathy

67
Q

long tangent of unrelated conversation before arriving at an answer

A

circumstantial speech

68
Q

long tangent of unrelated conversation without arriving at an answer

A

tangential speech

69
Q

disorganized speech with repetitive words

A

verbigeration

70
Q

words strung together without making sense

A

word salad

71
Q

rapidly shifting between topics that have no connection

A

loose association

72
Q

gad typically begins in what age group

A

early adulthood

73
Q

pharm for binge eating d.o (3)

A

lisdexamfetamine
topiramate
SSRIs

74
Q

what phobia is mc associated w. binge eating d.o

A

specific phobia

75
Q

major differentiation btw somatic sx d.o and illness anxiety d.o

A

somatic sx d.o: genuine sx w.o an identifiable cause

illness anxiety d.o: obsession w. illness +/- somatic sx

76
Q

what 2 antipsychotics are mc associated w. weight gain

A

SGAs:
clozapine
olanzapine

77
Q

SGA’s have fewer EPS s.e, but higher incidence of (4)

A

wt gain -> metabolic syndrome
qt prolongation
hyperprolactinemia
drowsy

78
Q

3 subgroups of sx associated w. schizotypal pd

A

cognitive-perceptual
odd/disorganized
interpersonal

79
Q

cognitive perceptual sx associated w. schizotypal pd

A

odd beliefs
unusual perceptual experiences
ideas of reference
paranoia

80
Q

what odd beliefs are associated w. schizotypal pd

A

magical thinking
mind reading
thought transfer

81
Q

how long shold women w. postpartum dpn continue medication after sx resolution

A

6-9 months

82
Q

_ are associated w. poor prognosis in schizophrenia

A

negative sx
< 20 yo at onset
coexisting OCD
unstable employment
insidious onset
slow rate of dz progression
male
SUD
low socioeconomic status
fam hx schizophrenia

83
Q

factors associated w. better prognosis in schizophrenia

A

dx > 20 yo
catatonic
paranoid
stable employment
acute onset
rapid progression
female
no SUD
middle/high socioeconomic status
early intervention

84
Q

order of tx for serotonin syndrome

A
  1. benzos
  2. cryptoheptadine
85
Q

what do you think when you see a pt who smoked something bad at a party and presents w.: paranoia, avoidance of eye contact, sedation, diahoresis, vomiting, bradycardia, hypotn, and extreme muscle pain

UA is negative

A

synthetic cannabinoids

86
Q

street names for synthetic cannabinoids

A

K2/K3
spice
crazy clown
krypton
aztec fire
happy tiger incense

87
Q

first and 2nd line tx for bipolar 1 mania

A
  1. lithium PLUS antipsychotic
  2. valproate PLUS antipsychotic - if contraindication for lithium
88
Q

black box warning for valproate

A

hepatotoxicity

89
Q

rf for PTSD

A

young age at time of trauma
adverse childhood events
female
widowed/separated/divorced
lower socioeconomic status/education
fam hx
poor social support
severe stress rxn to event

90
Q

rf for schizophrenia

A

brith during late winter/spring
living further from the equator
living in an urban area/industrialized country
immigration
advanced paternal age
perinatal obstetric complications
childhood trauma
CNS infxns
cannabis use

91
Q

female athlete triad

A

low energy availability
low bone mineral density
amenorrhea

92
Q

pathophys behind dystonias related to first gen antipsychotics

A

dopamine receptor blockade

93
Q

tx for acute dystonic rxn related to first gen antipsychotics

A

anticholinergics:
diphenhydramine
benztropine

94
Q

what pharm is first line tx for adult pt w. ADHD who has a hx of substance use disorder

A

atomoxetine

95
Q

piloerection, diaphoresis, yawning restlessness, dysphoria, myalgia, arthralgia, rhinorrhea, lacrimation, n/v, diarrhea, palpitations

A

acute opioid withdrawal

96
Q

acute opioid withdrawal is associated w. _

A

abrupt cessation of short acting opioids

heroin

97
Q

tx for acute opioid withdrawal

A

opioid agonists:
methadone
buprenorphine

98
Q

6 specifiers for delusional d.o

A

ertomanic
grandiose
jealous
persecutory
somatic
bizarre content

99
Q

tx for schizotypal pd

A

quetapine
+/- stimulants

100
Q

belief that irrelevant and innocuous things in teh world have great personal significance

A

ideas of reference

EOR: Behavioral Health (13 decks)

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