Gilks Deck 2: childhood milestones, repro etc Flashcards
(108 cards)
1
Q
at what age should a child be able to do the following:
walk
A
1 year
2
Q
at what age should a child be able to do the following:
draw a cross and a rectangle
A
4 years
3
Q
at what age should a child be able to do the following:
draw a circle
A
3 years
4
Q
at what age should a child be able to do the following:
sit
A
6 months
5
Q
at what age should a child be able to do the following:
say 10 words
A
1 year
6
Q
at what age should a child be able to do the following:
kick a ball
A
1 year
7
Q
at what age should a child be able to do the following:
draw a line
A
2 years
8
Q
at what age should a child be able to do the following:
stack 6 cubes
A
2 years
9
Q
at what age should a child be able to do the following:
tell stories, use past tense
A
4 years
10
Q
at what age should a child be able to do the following:
gender identity
A
3 years
11
Q
at what age should a child be able to do the following:
2 word sentences
A
2 years
12
Q
at what age should a child be able to do the following:
parallel play
A
1 year
13
Q
at what age should a child be able to do the following:
stack 3-4 cubes
A
1 year
14
Q
at what age should a child be able to do the following:
babble
A
6 months
15
Q
at what age should a child be able to do the following:
object permanence
A
1 year
16
Q
at what age should a child be able to do the following:
run
A
2 years
17
Q
at what age should a child be able to do the following:
stack 9 cubes
A
3 years
18
Q
at what age should a child be able to do the following:
ride a tricycle
A
3 years
19
Q
at what age should a child be able to do the following:
saying “no;” can be aggressive, egocentric
A
2 years
20
Q
at what age should a child be able to do the following:
bowel and bladder control
A
3 years
21
Q
at what age should a child be able to do the following:
complete sentences, strangers can understand
A
3 years
22
Q
at what age should a child be able to do the following:
imaginary friends
A
4 years
23
Q
at what age should a child be able to do the following:
hop on one foot
A
4 years
24
Q
at what age should a child be able to do the following:
immitate adults
A
4 years
25
what milestones are associated with a 4 year old
o draw a cross and a rectangle
o hop on one foot
o immitate adults
o imaginary friends
o tell stories, use past tense
26
what milestones are associated with a 3 year old
o draw a circle
o stack 9 cubes
o ride tricycle
o bowel and bladder control
o gender identity
o complete sentences, strangers can understand
27
what milestones are associated wiht a 2 year old
o draw a line
o stack 6 cubes
o run
o “no”, can be aggressive, egocentric
o 2 word sentences
28
what milestones are associated wiht a 1 year old
o stack 3-4 cubes
o walk
o kick ball
o parallel play
o object permanence
o 10 words
29
what milestones are associate wiht a 6 month old
o sit
o babble
30
list 9 risk factors for torsades
female
older age
low potassium
low magnesium
structural cardiac disease
hepatic dysfunction
hypothyroid
other meds that increase QTc
stroke
infection
obesity
EtOH/illicit drugs
31
by how much does rising QTc increase risk for torsades
risk for torsades increases by 5-7% with each 10ms QTC rises (but still very very rare)
32
what is considered prolonged QTc in women
above 460-470 ms
33
what is considered prolonged QTc in men
above 450
34
when do we really start to worry abotu QTC
above 500ms
35
which antipsychotics have minimal effect on QTc
quetiapine
olanzapine
clozapine
36
which antipsychotics have minimal to no effect on QTc
lurasidone
aripiprazole
37
which antipsychotics have significant effect on QTc
haldol IV (PO/IM has moderate effect)
pimozide
ziprasidone
chlorpromazine
38
what does Parkinsonism look like
mask like facies
resting tremor
cogwheel rigidity
shuffling gait
bradykinesia
39
list 4 symptoms of hyperprolactinemia
galactorrhea
amenorrhea
gynecomastia
impotence/reduced libido
40
how are pupils affected in NMS
NORMAL
41
why do you get myoglobinuria in NMS
due to rhabdo
42
do you get myoclonus, hyperreflexia in serotonin syndrome, or in NMS
in serotinin syndrome
43
how might NMS present clinically
HYPERSALIVATION, pallor, mutism, fever, LEAD-PIPE rigidity, mental status changes, AUTONOMIC INSTABILTY, elevated creatine phosphokinase, myoglobinuria (rhabdomyolysis), AKI, NORMAL pupils
44
how might serotonin syndrome present clinically
anxiety, agitation, delirium, DIAPHORESIS, tachycardia, hypertension, hyperthermia, gastrointestinal distress,TREMOR, muscle rigidity, MYOCLONUS, HYPERREFLEXIA
45
how might anticholinergic toxidrome present clinically
blurred vision, dilated pupils, constipation, dry mouth (which may chronically lead to dental caries), urinary retention, tachycardia, anhidrosis, hyperthermia, sedation, confusion/delirium
46
how might lithium toxicity present clinically
PERSISTENT N/V, abdominal pain, coarse TREMOR, ATAXIA, NYSTAGMUS, blurred vision, hyperreflexia, fasciculations, CHOREATHETOID movements, RENAL failure, seizure, stupor/coma, death (tx of severe toxicity is dialysis)
47
how might SSRI discontinuation syndrome present clinically
flu like symptoms
dysphoria, dizziness, gastrointestinal distress, fatigue, chills, myalgias, runny nose, sore eyes (flu-like symptoms)
48
how would you rank the following medications in terms of risk of manic switch:
SSRI / Venlafaxine / TCA / MAOi / Buproprion
TCA > MAOi > venlafaxine > SSRI > buproprion
*conflicting evidence with venlafaxine; some studies show no increased risk of mania/hypomania with ADs--> UNCLEAR (sobs)
49
what is the risk of lithium in pregnancy
ebsteins anomaly (1/1000)
50
what is the risk of the following medication in pregnancy:
atypical antipsychotics
basically SAFE but small risk of PRETERM BIRTH, EPS, tremor, abnormal muscle tone, breathing/feeding difficulties, sedation
51
what is the safest mood stabilizer in pregnancy
lamotrigine
52
what is the risk of the following medication in pregnancy:
lamotrigine
small risk of cleft palate
53
what is the risk of the following medication in pregnancy:
benzos
neonatal withdrawal
decreased motor tone (floppy baby syndrome)
small risk of cleft palate
excreted in breast milk
54
what is the risk of the following medication in pregnancy:
imipramine
withdrawal symptoms
55
what is the risk of the following medication in pregnancy:
valrproate
neural tube defects (5-10%)
fetal valproate syndrome
lower IQ in fetus
autism
56
what is the risk of the following medication in pregnancy:
topiramate
small risk of cleft palate
57
what is the risk of the following medication in pregnancy:
carbamazepine
cleft palate
neural tube defects
fetal carbamazepine syndrome
58
what is the risk of the following medication in pregnancy:
SSRIs, SNRIs
30% of infants experience neonatal adaptation syndrome --> non specific symptoms (see other card)
small increased risk of PPH (2-6/1000)
59
what is the risk of the following medication in pregnancy:
paroxetine
highest risk of CV defects of all SSRIs
higher risk compared to other SSRIs of NAS
60
what is the risk of the following medication in pregnancy:
stimulants
basically SAFE
small increased risk of preterm birth, miscarriage, pre eclampsie, placental abruption
61
which medication should be avoided in breastfeeding
lithium
62
which medications can cause cleft palate if taken during pregnancy
benzos
lamotrigine
topiramate
carbamazepine
63
which medications are associated with neural tube defects if taken in pregnancy
valproic acid > carbamazepine
64
what is the risk of NTDs in mothers taking valproic acid
5-10%
65
what is the risk of NTDs in mothers taking carbamazepine
1%
66
which medications are associated with neonatal adaptation syndrome if taken in pregnancy
SSRIs, SNRIs
67
which SSRI has highest risk of CV defects of all SSRIs
paroxetine
also higher risk of NAS
68
what are the symptoms of neonatal adaptaion syndrome
non specific sx--> poor feeding, jitteriness, respiratory distress, temperature instability
69
which medications are associated with persistent pulmonary hypertention if taken in pregnancy
SSRIs, SNRIs--> small risk (2-6/1000)
70
which medications are associated with placental abruption/preeclampsia if taken in pregnancy
stimulants
71
which medications are associated with floppy baby syndrome if taken in pregnancy
benzos
72
which medications are associated with autism if taken in pregnancy
valproic acid
73
which medications are associated with lower IQ in infants if taken in pregnancy
valproic acid
74
is valproic acid considered safe in breastfeeding
yes
75
are antidepressants considered safe in breastfeeding
yes
76
is lithium considered safe in breastfeeding
no
77
are stimulants considered safe in breastfeeding
yes
78
are benzos considered safe in breastfeeding
can cause sedation in newborn--> are excreted in breastmilk
if need them, use short acting and use infrequently
79
what are the most common adverse effects of ECT in pregnancy
premature contractions and labor in the mother
bradyarrhythmias in the fetus
NO risk of malformation
considered safe and effective in pregnancy
80
what meds are first line for ADHD
VAC-B
Vyvanse (lisdexamphetamine)--prodrug, metabolized to make dextroamphetamine
Adderall (dextroamphetamine)
Concerta (OROS methylphenidate)
Biphentin (methylphenidate)
81
what is the short acting methylphenidate
ritalin
82
how long does the following ADHD medication last:
concerta
about 12 hours
83
how long does the following ADHD medication last:
ritalin SR
8 hours
84
how long does the following ADHD medication last:
ritalin IR
3-4 hours
85
how long does the following ADHD medication last:
adderall XR
12 hours
86
how long does the following ADHD medication last:
vyvanse
13-14 hours
87
how long does the following ADHD medication last:
foquest
13-16 hours
88
how long does the following ADHD medication last:
dexedrine spansules
6-8 hours
89
how long does the following ADHD medication last:
dexedrine tablets
4 hours
90
how long does the following ADHD medication last:
biphentin
10-12 hours
91
rank the following ADHD meds from shortest to longest acting:
ritalin (IR and SR), vyvanse, adderall XR, biphentin, foquest, concerta, vyvanse, dexedrine (tablets and spansules)
ritalin/methylphenidate short acting (3-4 hours)
dexedrine tablets (4 hours)
dexedrine spansules (6-8 hours)
Ritalin SR (8 hours)
Biphentin (10-12 hours)
Adderall XR = Concerta (12 hours)
Vyvanse (13-14 hours)
Foquest (13-16 hours)
92
smoking induces which CYP enzyme
1A2
93
smoking REDUCES levels of which important medications (by inducing 1A2)
clozapine
olanzapine
TCAs
94
fluvoxamine inhibits which CYP enzyme
1A2
(caffeine also)
95
which medications inhibit 2D6
buproprion
paroxetine
fluoxetine
96
which medications are metabolized by 2D6
abilify
risperidone
venlafaxine
vortioxetine
atomoxetine
TCAs
(expect levels to go up if also Rx buproprion, paroxetine or fluoxetine)
97
which medications should not be Rx with tamoxifen
buproprion, paroxetine, fluoxetine--> block 2D6 which is needed to convert tamoxifen into its active metabolite
98
why is carbamazepine so annoying as a drug
induces 3A4--> which decreases levels of a bunch of relevant psych meds including ADs, APs, benzos, zopiclone, synthetic opioids, and OCP
99
fluvoxamine INHIBITS which cyp enzymes
1A2, 3A4, 2C19
100
thiamine is reduced in which populations
AUD
starvation
bariatric surgery
101
vitamin B3/niacin is reduced in which populations
AUD
vegan/veggie
starvation
102
vitamin B2/riboflavin is reduced in which populations
AUD
starvation
103
vitamin B6/pyridoxine is reduced in which populations
MAOis
isoniazid
levodopa
104
vitamin B12/cobalamin is reduced in which populations
vegan/veggie
105
vitamin B3/niacin deficiency causes what clinical presentation
pellagra --> the 5 Ds: dermatitis, diarrhea, delirium, dementia, death
*delirium responds to replacement, dementia slower to recover
106
what psych syndrome is associated with vitamin B12/cobalamin deficiency
panic attacks
mood disturbance
cognitive slowing
rare psychosis
visual hallucinations
107
what psych syndrome is associated with vitamin B6/pyridoxine deficiency
confusion
irritability
depression
108
memory deficits in wernickes are due to damage to what brain structure
mamillary bodies
