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Psychiatry MOC Review > MOC Exam#3 > Flashcards

MOC Exam#3 Flashcards

(50 cards)

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1
Q

Which medications decrease VALPROIC ACID blood levels/concentrations?

A
  • Carbamzepine
  • Phenytoin
  • Cholestyramine
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2
Q

What does it mean that medication A can reduce, or decrease, blood concentrations of medication B?

A
  • That Drug A increases elimination of Drug B

- That Drug A can decreased absorption of Drug B

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3
Q

Which medication can increase VALPROIC ACID blood concentration?

A

-ASA

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4
Q

How does CHOLESTYRAMINE decrease VALPROIC ACID levels?

A

-By decreasing intestinal absorption

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5
Q

Best approach to treatment of Factitious Disorder Imposed on Self

A

-symptom management and avoiding un-necessary procedures

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6
Q

Percentage of patients with bulimia that are male

A

-10%

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7
Q

Which P450 system metabolizes MODAFANIL?

A

-2D6

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8
Q

Name 2 SSRI inhibitors of 2D6

A
  • Fluoxetine

- Paroxetine

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9
Q

Symptoms of MODAFANIL overdose

A
  • dizziness
  • sedation
  • dry mouth
  • tachycardia
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10
Q

What is the genetics of Rhett syndrome?

A
  • spontaneous mutation on X chromosome gene (MECP2)

- almost exclusively in females (males don’t survive gestation due to only 1 copy of X chromosome

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11
Q

What is the initial presentation of infant with Rhett Syndrome?

A
  • normal prenatal and perinatal development
  • normal psychomotor development for at least the first 5 months
  • normal head circumference at birth
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12
Q

What is the progression of symptoms for infant with Rhett Syndrome?

A
  • decelerating head growth between 5-48 months
  • loss of previously acquired purposeful hand movements and skills
  • sterotyped hand movements (hand wringing)
  • poorly coordinated gait and trunk movememnts
  • severe psychomotor retardation
  • loss of social engagement
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13
Q

Which opioids are also weak SSRI’s?

A
  • meperidine
  • tramadol
  • methadone
  • dextromethorphan
  • propoxyphene
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14
Q

What is the risk of combining meperidine and MAOI?

A
  • serotonin syndrome

- DEATH!!

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15
Q

Name the two age peaks for panic disorder, panic attack, onset

A
  • males late teens to early 20’s

- females mid-30’s to 40’s

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16
Q

What percentage of patients have onset of panic attacks/disorder after age 40 y?

A

~15%

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17
Q

The total prevalence of panic attacks/disorder is the greatest for which age range?

A

15y-24y

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18
Q

What is a proven regimen for maintenance treatment of MDD after completion of course of ECT?

A

Nortriptyline and Lithium

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19
Q

ADHD treated with stimulants does not increase risk of developing substance use disorder in adolescents. TRUE or FALSE

A

TRUE

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20
Q

Which disorders in adolescents increase risk of developing substance use disorders?

A
  • Untreated ADHD
  • Undiagnosed ADHD
  • Conduct Disorder
  • Impulse Control Disorders
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21
Q

What is the clinical triad of Serotonin Syndrome

Study These Flashcards
A
  • Cognitive Effects
  • Somatic Effects
  • Autonomic Effects
22
Q

List the Cognitive Effects of Serotonin Syndrome

Study These Flashcards
A
  • headache
  • confusion
  • agitation
  • hypomania
  • hallucinations
  • coma
23
Q

List the Somatic Effects of Serotonin Syndrome

Study These Flashcards
A
  • Myoclonus
  • muscle twitching
  • hyperreflexia
  • tremor
24
Q

List the Autonomic Effects of Serotonin Syndrome

Study These Flashcards
A

All hypers

  • hypertension
  • tachycardia
  • nausea
  • sweating
25
How often should AIMS testing be done for pt who is not high risk?
- every 6 months for FGAs | - every 12 months for SGAs
26
How often should AIMS testing be done for pts at high risk for dyskinesia
- every 3 months for FGAs | - every 6 months for SGAs
27
Which pts are at increased risk for dyskinesias and Parkinsonism?
- elderly patients | - pts who have experienced acute dystonic reactions or EPS or akathisa
28
The single most predictive factor for successful adoption:
-young age of adoptive child
29
Other factors that predict successful adoption:
- short time in foster care - older age of adoptive parents - child without mental illness
30
Cell body nuclei and major neurotransmitters:
- Raphe nucleus: Serotonin - Locus Coeruleus: NE - VTA: Dopamine
31
Name the features of schizoid personality disorder
- social distance/withdrawal - discomfort with human interaction - introversion - bland and constricted affect - latent fearfulness
32
Best treatment for schizoid personality disorder
-supportive psychotherapy
33
Feature that distinguishes serious rash due to lamotrigine from benign rash
-lymphadenopathy (suggests systemic rash)
34
Risk of death from ECT
1/10,000 - 1/50,000
35
What is the mortality rate for ECT?
- 0.002% per treatment - 0.01% per patient - safer than child birth - safer than getting struck by lightening
36
Annual relapse rate for patients with schizophrenia who are compliant with antipsychotics:
30%
37
# Define the following cognitive distortions: - Mindreading - Catastrophizing - All or nothing thinking - Over inclusion - Essentializing
- "jumping to conclusions" - assuming the worst possible outcome or that the worst will happen - no nuances allowed "it's either this or that" - inability to maintain boundaries between concepts (seen in schizophrenia) - inappropriate reduction of complex situation to obvious details
38
Signs and symptoms of Wernicke's Encephalopathy
- gait ataxia - oculomotor abnormalities - confusion - vestibular dysfunction
39
What is permanent alcohol amnestic syndrome?
Korsakoff's syndrome
40
Findings in patients with pyromania
- lower than average IQ - significantly low CSF levels of 5-HIAA and MHPG - absent fathers - no remorse for actions - intense curiosity about effects of fire
41
Most common form of competed suicide by teens in the US
FIREARMS
42
# Define the following: - Efficacy - Effectiveness - Potency - Therapeutic Index
- ability of a drug to treat the condition it is supposed to treat - how well a drug works in the real world setting (including ease of use, tolerability) - amount of drug needed to produce effect - Therapeutic dose/Toxic dose
43
The 2 antipsychotics approved by the FDA for treatment of Tourette's Disorder
HALOPERIDOL & PIMIZODE
44
What is the Flynn Effect?
- increase in average IT test scores since 1936 | - 3 IQ points per decade since 1936
45
Risk factors for alcohol use disorder
- white race - male gender - family history of alcohol use disorder - psychiatric disorder (depression/anxiety)
46
Clinical features of Lewy Body Disease
- fluctuating consciousness - visual hallucinations - Parkinsonism motor symptoms - sensitivity to dopamine antagonists (antipsychotic medications)
47
What are the safest and most effective medications for LBD?
Cholinesterase inhibitors (90% LBD pts report decrease in visual hallucinations
48
Which antipsychotics should be AVOIDED in pts with LBD?
- Risperdal | - Haloperidol
49
Which antipsychotic is considered safest and most tolerable for parkinsonian sx in pts with LBD?
QUETIAPINE
50
What is Charles-Bonnet Syndrome?
- macular degeneration with visual hallucinations | - Diabetes is a risk factor

Psychiatry MOC Review (60 decks)

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