Psych - morning of exam Flashcards

1
Q

How many days does PCP stay in your system

A

4-7 days urine

Think: opioid = 3 days. P comes right after O and is 3 letters. So 4 + 3 = 7

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2
Q

How many days do benzos stay in your system

A

Short acting = 5 days

Long acting = 30 days

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3
Q

How many days do barbs stay in your system

A

Short acting = 24 hours

Long acting = 3 weeks

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4
Q

What psych issues is Propranolol used for

A

Non-selective beta antagonist
• Useful in treating the autonomic effects of panic attacks or social phobia, such as palpitations, sweating, and tachycardia

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5
Q

How long do opioids stay in your system

A

1-3 days urine

think of the 3 vowels in opIOId

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6
Q

What can be used for tx of heroin withdrawal sx

A

Clonidine (a2 agonist) to treat autonomic signs and symptoms of withdrawal

Methadone or Buprenoprhine to cause detox

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7
Q

MOA of PCP

A

activation of NMDA receptors

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8
Q

What drugs can be used to treat nicotine dependence

A

Varenicline
Bupropion
Nicotine replacement therapy

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9
Q

Give important BAL

A

20-30 = first signs of intoxication

100-200 = impairment of motor and mental performance

200-300 = blackouts

400+ = respiratory depression, death possible

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10
Q

Presentation of inhalant intoxication

A

Perceptual disturbances, paranoia, lethargy, dizziness, N/V, HA nystagmus, tremor, muscle weakness, ataxia, slurred speech

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11
Q

Describe partial complex seizure

A

Altered state of consciousness, usually manifested by staring, is accompanied by hallucinations (olfactory are common), automatisms (buttoning and unbuttoning, masticatory movements, speech automatisms), perceptual alterations (objects changing shape or size), complex verbalizations

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12
Q

Cushing syndrome (from exogenous corticosteroids), often manifests in which psychiatric disorders?

A

Depression and mixed anxiety and depressive state

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13
Q

Presentation of temporal lobe epilepsy

A
  • Bizarre behavior, often without classic grand mal shaking movements
  • Characterized by hypo-sexuality, emotional intensity and a perseverative approach to interactions, termed viscosity
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14
Q

Presentation of Wernicke vs. Korsakoff syndrome

A

♣ Due to Thiamine deficiency

Wernicke = ataxia, confusion, ocular abnormalities (nystagmus, gaze palsies)

Korsakoff = anterograde and retrograde amnesia, compensatory confabulation

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15
Q

Drug treatment of akithisia

A

Beta blockers (Propranolol) are most effective

Benzos and anticholinergics may be somewhat effective

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16
Q

Tx of shift work sleep disorder

A

Modafinil is the only approved medication

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17
Q

Preferred drug to treat psychotic sx in patients with Parkinsons

A

Quetiapine - due to sedative quality and lack of EPS

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18
Q

What is the half-life of Lithium / how long does it take to reach steady state

A

Half life = 20 hours

Takes 5 half-lives to reach steady state. 5 x 20 = 100 hours = about 8 days

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19
Q

What is clang association

A

Thoughts that come out in a rhyming pattern, whether or not the verbalized sentence means anything logical

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20
Q

Time frame and number of symptoms needed for GAD

A

At least 3 symptoms for at least 6 months

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21
Q

What is Nihilism

A

Belief that oneself, other, or the world are either nonexistant or are coming to an end

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22
Q

What is the primary metabolite of dopamine

A

Homovanillic acid

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23
Q

At what stage of sleep does dreaming occur

A

REM

24
Q

Most common gene mutation in Alzheimers

A

Presenilin 1 (70-80%)

Presenilin 2 (20-30%)
APP (2-3%)
25
Q

Time frame of bulimia

A

Binge eating and compensatory behaviors occur at least once a week for 3 months

26
Q

Time frame of binge eating disorder

A

Binge eating occurs at least once a week for 3 months

27
Q

DSM criteria and time frame for hypersomnolence disorder

A

o Excessive sleepiness despite at least 7 hours of sleep, with at least one of the following:
♣ Recurrent periods of sleep within the same day
♣ Prolonged, nonrestorative sleep > 9 hours
♣ Difficulty being fully awake after awakening
o Occurs at least 3 times per week for at least 3 months

28
Q

Tx of hypersomnolence disorder

A

Modafinil or stimulants

Amphetamine-like antidepressants such as atomoxetine are second line

29
Q

Time frame for narcolepsy

A

Recurrent lapses into sleep or naps

♣ Minimum 3x per week for 3 months

30
Q

What substance can be used to test for narcolepsy

A

Low CSF levels of hypocretin

31
Q

2 components of ADHD

A

Inattention + hyperactivity/impulsivity

32
Q

Time frame for ADHD

A

Sx > 6 months in at least 2 settings

33
Q

2 components of ASD

A

Impairments in social communication/interaction + restrictive, repetitive behaviors/interests

34
Q

Diagnostic criteria for Tourette disorder

A

o Multiple motor tics and at least one vocal tic for > 1 year

• Vs. Chronic tic disorder
o Either motor or verbal tics (but not both) for > 1 year

35
Q

• Sexual arousal from touching or rubbing against a nonconsenting person

A

♣ Frotteuristic disorder

36
Q

Recurrent defecation into inappropriate places

A

Encopresis

37
Q

Tx for Tourette

A

o Behavioral intervention – habit reversal therapy
o Medications:
♣ Alpha-2 agonists – Guanficine, Clonidin
♣ Antipsychotics

38
Q

Time frame for selective mutism

A

> 1 month

THINK: You SELECT a single (1) choice

39
Q

Time frame (onset and duration) of Acute Stress Disorder

A

Trauma occurred < 1 month ago

Symptoms last < 1 month

40
Q

Tx for catatonia

A

Benzo or ECT

41
Q

At what time of alcohol withdrawal do seizures occur

A

12-48 hours

42
Q

At what time of alcohol withdrawal does delirium tremens occur?

A

48-96 hours

43
Q

First line tx for alcohol use disorder

A

Naltrexone

44
Q

Dangers of PCP overdose

A

Seizures, delirium, coma, death

45
Q

When you think of psych liver enzymes think…

A

2D6

46
Q

Smoking is an inducer of what liver enzyme

A

1A2

47
Q

Meds that can be used to treat delirium

A

Avoid unnecessary meds

Low dose Haldol (0.25-0.5) if agitated - scheduled BID IV for as short amount of time

Make sure to have plan to discontinue

48
Q

What dementia is characterized by personality changes

A

FTD

49
Q

Features of Lewy Body dementia

A

THINK: Creepy Lewy. Is not right in the head (early dementia). Staring at everyone (visual hallucinations). With darty eyes (rapid eye movement disorders - REM)

Core Features:
• Waxing and waning of cognition, especially in the areas of attention and alertness
o Early onset dementia (vs. Parkinson’s which has later onset)
• Visual hallucinations (syntonic – the hallucinations are not disturbing to the patient)
• Development of extrapyramidal signs (Parkinsonism) at least one year after cognitive decline becomes evident

Suggestive Features:
• Rapid eye movement (REM) sleep behavior disorder – violent movements during sleep in response to dreams, often of fighting
• Pronounced antipsychotic sensitivity

50
Q

Tx of akathisia

A

Lorazepam, Propanolol or Diphenhydramine

51
Q

Which antipsychotics are available as long acting injectables

A

THINK: How Ridiculous, Paying For A hOle

H = Haloperidol
R = Risperidone
P = Paliperidole
F = Fluphenazine
A = Aripiprazole
O = Olanzapine
52
Q

Toxicity of what bipolar drug causes tremor, confusion, ataxia, and diarrhea

A

Lithium

53
Q

Describe flight of ideas

A

The patient is not able to answer your original questions, and she switches rapidly from one
topic to another. However, there is still a loose connection between sentences.

54
Q

Describe tangentiality

A

logical thought

processing that does not answer the original question.

55
Q

Describe word salad

A

severe breakdown in thought process in

which no meaning is conveyed and speech consists of a string of words that do not form sentences

56
Q

Cataplexy vs. Catatonia

A

Catatonia requires
two or more of the following criteria to be met: motor immobility, excessive motor activity, negativism or mutism,
odd voluntary movements, and echolalia or echopraxia. This patient exhibits motor immobility with waxy
flexibility (maintaining a pose he is placed in), mutism, odd voluntary movements with gegenhalten (increasing
resistance through a range of motion), and automatic obedience (obeying your command to allow you to put a pin
through his tongue).

Cataplexy is sudden loss of muscle tone in response to strong emotion and is seen in
narcolepsy