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Flashcards in Board Exam Deck (53):
1

What are the extrapyramidal side effects of neuroleptics?

Parkinsonism; dystonia; akathisia

2

What is used to treat akathisia?

Benzodiazepines and beta blockers (propranolol)

3

How is tardive dyskinesia treated?

D/c or lower antipsychotic and switch to a different antipsychotic

4

What are the typical antipsychotics? High and low potency?

High potency: haldol, fluphenazine, trifluoperazine, pimozide; Low potency: chlorpromazine and thioridazine

5

How are panic attacks treated?

CBT and pharmacotherapy (SSRIs first-line, can use TCAs if ineffective)

6

Up to 65% of patients with panic attacks have what comorbid disorder?

Major depression; other comorbid conditions: anxiety disorders (esp agoraphobia), bipolar disorder, alcohol use disorder

7

What medication is FDA approved for bulimia nervosa?

Fluoxetine

8

How is GAD treated?

Psychotherapy (CBT) and pharmacotherapy (SSRI, SNRI)

9

What is thought to be the cause of tardive dyskinesia?

Increased sensitivity of the dopamine receptors

10

What is seen on polysomnography in narcolepsy?

Decreased REM latency

11

What is deficient in the CSF of patients with narcolepsy?

Hypocretin

12

What is the drug of choice in treatment of cataplexy?

Sodium oxybate

13

Which TCA could be used to treat OCD?

Clomipramine (most serotonin selective)

14

What factors can increase Lithium levels?

Dehydration, NSAIDs, ASA, decreased kidney function, thiazide diuretics, salt deprivation, sweating (salt loss)

15

What symptoms are seen in lithium toxicity?

Course tremor, altered mental status, convulsions, delirium, coma, death

16

What ECG rhythm can be seen in lithium toxicity?

2nd degree AV heart block

17

What is the treatment for PTSD?

First-line is antidepressant; can us prazosin (alpha 1 antagonist) targets nightmares

18

What is the most effective treatment for adjustment disorder with depressed mood?

Supportive psychotherapy

19

What is the treatment of serotonin syndrome?

Stop offending agent; supportive; benzodiazepines. Can use cyproheptadine (serotonin antagonist)

20

52 year old homeless man with alcoholism is brought to the emergency departmetn by polic after being found agitated and confused. He feels nervous and could use a drink. Temp 37, HR 120, RR 20, BP 138/86. He is trembling. Hct 30%. Urinalysis shows 7 WBC/hpf and many oxalate crystals. What is the most likely cause?

Ethylene glycol toxicity

21

How is gambling disorder treated?

CBT and self help groups; SSRIs and naltrexone have been used to help

22

What is the MOA of buproprion?

Inhibits reuptake of NE and DA

23

What is buspirone used to treat?

FDA-approved non-benzo anxiolytic; used to treat GAD w/o comorbid depression or panic sxs

24

What is the first line treatment of GAD?

SSRIs or SNRIs

25

Patient with new medication to treat asthma develops psychosis, what is the likely cause?

Glucocorticoid-induced psychosis = med-induced psychotic disorder

26

What is the drug category of clozapine?

Second generation antipsychotic

27

What drugs can cause lithium toxicity due to drug interaction?

Thiazide diuretics, NSAIDs, ACE inhibitors, tetracyclines, metronidazole

28

What medications can cause a decrease in serum lithium levels?

Theophylline and potassium sparing diuretics (spironolactone)

29

If a patient uncharacteristically has a rapid response to venlafaxine, what psychiatric diagnosis should you consider?

Bipolar; typical response to venlafaxine is 2 weeks

30

What is the treatment of neuroleptic malignant syndrome?

Stop neuroleptics, start fluids, administer dantrolene or bromocriptine if refractory

31

What is a distinguishing factor between neuroleptic malignant syndrome and serotonin syndrome?

NMS - has lead pipe rigidity; Serotonin syndrome has GI sxs, hyperreflexia and myoclonus

32

What is the most consistently replicated neuroimaging finding in schizophrenia?

Enlargement of lateral cerebral ventricles

33

What type of therapy is helpful in borderline PD?

DBT

34

What are the indications for hospitalization in patients with anorexia nervoas?

Dehydration, unstable VS (hypotension, bradycardia HR <40, hypothermia), cardiac dysrhythmias, electrolyte disturbances, organ involvement, very low weight

35

What is the primary pharmacotherapy treatment of bulimia nervosa?

Fluoxetine

36

What is the primary pharmacotherapy treatment for anorexia nervosa?

Olanzapine

37

What is the treatment for anorexia nervosa?

CBT, Nutritional rehab, olanzapine for severe cases

38

What labs need to be monitored with valproate?

CBC (for platelets) and LFTs

39

What medication is used to treat PMS/PMDD?

Fluoxetine

40

What is the defense mechanism reaction formation?

Responding in a manner opposite to one’s actual feelings

41

What are non-stimulant options to treat ADHD?

Atomoxetine (NE reuptake inhibitor); buproprion and TCAs

42

QRS duration of >100 msec in TCA toxicity is an indication for what treatment?

Sodium bicarbonate

43

What is the MOA of buproprion?

NE and DA reuptake inhibitor

44

What are common adverse effects of mirtazapine?

Sedation and weight gain

45

What antipsychotics have the highest potential for increasing prolactin?

High potency 1st gen (haloperidol and fluphenazine) and risperidone and paliperidone

46

What are the key features of illness anxiety disorder?

Fear of having a serious illness despite few or no symptoms and consistently negative evaluations

47

During what phase of sleep do nightmares occur?

REM sleep

48

What is nightmare disorder?

Recurrent awakenings due to highly disturbing and frightening dream content; patients are able to recall dreams, awaken from dreams, and are able to be consoled (compared to sleep terror disorder)

49

During what phase of sleep do sleep terrors occur?

Non-REM

50

How is kleptomania treated?

CBT, SSRIs, opioid antagonist, lithium, anticonvulsants

51

What is the first line treatment for panic disorder and agoraphobia?

SSRI and CBT

52

What is the treatment for postpartum depression?

SSRIs (sertraline for breast feeding)

53

What is social anxiety disorder?

Anxiety restricted to social and performance situations, fear of scrutiny and embarrassment.