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Flashcards in Behavioral Health UWorld Deck (40)
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1

Side effects of first generation antipsychotics

Low potency: chlorpromazine and thioridazine
Antihistamine: sedation
Anticholinergic
Alpha-blocking: orthostasis

High potency: haloperidol and fluphenazine
EPS

2

Causes of new onset lithium toxicity

Thiazide diuretics: reduced Na+ reabsorption at the DCT results in increased Na+ and Li+ reabsorption at the PCT
NSAIDs (not ASA)
Reduced GFR: CHF, cirrhosis increase Na and Li uptake at proximal tubule
ACE-I

3

Drugs that can cause Parkinsonian like symptoms

Anti-psychotics (1st generation > 2nd generation)
Anti-emetics: prochlorperazine
Motility agents: metoclopramide

4

Treatment for drug-induced Parkinsonism

Anticholinergics (benztropine or trihexyphenidyl)

5

A mom feels depressed after her daughter leaves for college; however, she does not exhibit any social or occupational impairment as a result. What is your diagnosis?

Normal sadness. DSM-V diagnoses require significant occupational or social impairment for diagnosis.

6

Most common cause of death in patients intoxicated with PCP?

Trauma from violent behavior.

7

Strongest single risk factor for suicide

Prior attempts

8

Conditioning involved in an officer writing a speeding ticket

Positive punishment (punishment decreases behavior)

9

Conditioning involved in parents taking keys away from their teenager for disobedience.

Negative punishment (reward removal decreases behavior)

10

Conditioning involved in paying kids for good grades

Positive reinforcement (giving reward increases behavior)

11

Conditioning involved in deciding to use sunscreen after getting a bad sunburn last time at the beach

Negative reinforcement (removal of punishment increases behavior)

12

Conditioning involved in white coat hypertension

Classical: past doctor visits (unconditioned stimulus) that made patients feel anxious (unconditioned response) are associated with blood pressure cuffs (neutral stimulus). Repeated associated of the unconditioned stimulus with the neutral stimulus results in anxiety in the face of the neutral stimulus by itself (conditioned stimulus and conditioned response)

13

Expressing unacceptable feelings through actions

Acting out - immature

14

Behaving as if an aspect of reality does not exist

Denial - immature

15

Transferring feelings to an unrelated object

Displacement - immature

16

Using intellect to avoid uncomfortable feelings

Intellectualization - immature

17

Avoiding conflict by expressing hostility covertly

Passive-aggression - immature

18

Attributing one's feelings to others

Projection - immature

19

Justifying behavior to avoid difficult truths

Rationalization - immature

20

Responding in a manner opposite to one's actual feelings

Reaction formation - immature

21

Reverting to earlier developmental stages

Regression - immature

22

Seeing others as all bad or all good

Splitting - immature

23

Channeling impulses into socially acceptable behaviors

Sublimation - mature

24

Consciously putting unwanted feelings aside to cope with reality

Suppression - mature

25

What property of barbiturates make them more dangerous to use than benzodiazepines?

Benzodiazepines allosterically bind the GABAa receptor and increase the frequency at which the receptor opens, hyper polarizing the cell by Cl- influx.

Barbiturates act similarly, but increase the duration the channel is open, and at high concentrations can open the channels in the absence of GABA.

26

What happens when GABAb receptors are activated? GABAc?

GABAb = binds G-protein in brain -> K+ efflux, reduced Ca influx and inhibition of adenylate cyclase.

GABAc = Cl- channel in retina

27

Timeline of alcohol withdrawal symptoms

8 - 12 hours: autonomic hyperactivity, insomnia, tremors and anxiety

12 - 48 hours: withdrawal seizures

48 - 96 hours: delirium tremens (fever, disorientation and severe agitation)

28

Benzos to use in patients with alcohol withdrawal and liver disease

"LOT": lorazepam, oxazepam and temazepam do not have active metabolites that need liver metabolism

29

When can patient confidentiality be breeched?

Stab/gunshot wounds, reportable communicable diseases, abuse and harm to self or others.

30

Disulfiram mechanism of action

Inhibits aldehyde dehydrogenase, resulting in accumulation of aldehyde and sickness if the patient drinks