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9 Psychiatry > NBME - Psych > Flashcards

NBME - Psych Flashcards

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1
Q

Lewy body demential vs Frontotemporal dementia

A

Lewy body dementia is associated with visual hallucinations.

Frontotemporal dementia is associated with behavior change (eg hypersexuality)

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2
Q

Intoxication with which drug causes hyperreflexia?

A

Amphetamines

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3
Q

Some association between this cardiac drug and depression.

A

Beta blockers

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4
Q

Intoxication with what drug causes papillary dilation?

A

Cocaine

Amphetamines

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5
Q

1st line treatments for Obsessive Compulsive Disorder

A

CBT
SSRI
Venlafaxine
Clomipramine (Serotonin Selective TCA)

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6
Q

3 Hz spike on EEG. What type of seizure is this?

A

Absence seizure

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7
Q

EEG: Focal spikes localized to the temporal lobe. What type of seizure is this? Symptoms?

A

Complex partial seizure

  • impaired consciousness
  • automatisms
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8
Q

Benzoylecgonine on urinanalysis - tests for?

A

Cocaine

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9
Q

Treatment of cocaine toxicity.

A

Alpha blocker

Benzodiazepines

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10
Q

At what age does separation anxiety become abnormal?

A

4 years old

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11
Q

Hypocretin deficiency in CSF. Dx?

A

Narcolepsy

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12
Q

Low levels of 5-hydroxyindolacetic acid (5-HIAA) in CSF. Dx?

A

Major Depressive Disorder

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13
Q

Meperidine. Drug class? Side effect

A

Opioid
Side effect: Seratonin Syndrome
and mydriasis (unlike other opioids which cause miosis)

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14
Q

Aripiprazole - drug class.

A

Atypical (2nd gen) antipsychotic

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15
Q

Hallucinogen affect on pupil size.

A

Dilate pupils.

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16
Q

Ziprasidone - drug class.

A

Atypical (2nd gen) anti-psychotic

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17
Q

Hydroxyzine - mechanism? use?

A

Hydroxyzine is an antihistamine.

It is used as a quick acting anxiolytic when benzodiazepines cannot be used.

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18
Q

Somatic Symptoms Disorder
vs
Conversion Disorder

A

Both have unconscious symptoms and unconscious motivation. Somatic symptoms disorder is a variety of bodily complaints. Conversion disorder is loss of sensory or motor function with “la belle indifference”.

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19
Q

Define: athetosis

A

Abnormal muscle contractions

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20
Q

Acute stress disorder can develop into _______ after __(period of time)__

A

Post-traumatic stress disorder

- after 1 month

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21
Q

Adjustment disorder can develop into _______ after __(period of time)__

A

Generalized Anxiety Disorder

- after 6 months

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22
Q

Brief psychotic disorder can develop into _______ after __(period of time)__

A

Schizophreniform disorder
- after 1 month
Schizophrenia
- after 6 months

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23
Q

Major Depressive Disorder can develop into _______ after __(period of time)__

A 
Dysthymic disorder (Persistent Depressive Disorder)
- after 2 years
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24
Q

Cyclothymic disorder is defined as numerous periods of hypomanic symptoms (But not full hypomanic episode) and periods of depressive symptoms (But not full Major depressive episode) lasting at least (period of time)

A

2 years

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25
Treatment for oppositional defiant disorder.
Parent Management Training
26
Prominant Epicanthal folds. Dx?
Down's Syndrome
27
Almond-shaped eyes. Dx?
Prader-Willi Syndrome
28
Timetable of adjustment disorder.
Anxiety within 3 months of stressor. Resolves withing 6 months of stressor. If it does not resolve after 6 months then = GAD
29
What test is used to confirm diagnosis of narcolepsy?
Polysomnography
30
Acute temporary management of anxiety until a patient can be bridged to long-term medications.
Benzodiazepine
31
Methimazole mechanism? use?
Methimazole inhibits thyroid peroxidase, inhibiting thyroid hormone synthesis. Used to treat hyperthyroidism.
32
Rapidly progressive cognitive decline with myoclonus. Dx?
Creutzfeldt-Jakob disease
33
Agitation, hyperthermia, nystagmus. Dx?
PCP intoxication
34
Agitation, hyperthermia, no nystagmus. Dx?
Amphetamine intoxication
35
Despiramine. Drug class?
TCA
36
Rotatory nystagmus. Dx?
PCP intoxication
37
Region of brain affected in Alzheimer's disease?
Basal nucleus of Meynert, decreased ACh
38
Pupils when pt has LSD intoxication.
Dilated pupils
39
Pupils when pt has alcohol intoxication.
Normal pupils
40
Pupils when pt has amphetamine intoxication.
Dilated pupils
41
Pupils when pt has cocaine intoxication.
Dilated pupils
42
Pupils when pt has heroin intoxication.
Constricted pupils
43
Drowsiness and nystagmus. Intoxication with?
Benzodiazepines or Barbituates.
44
Intellectual disability and hand wringing in female toddler. Dx?
Rett syndrome
45
Smooth philtrum. Dx?
Fetal alcohol syndrome
46
Inappropriate laughter, seizures, ataxia and severe intellectual disability. Dx?
Angelman Syndrome
47
Large jaw, big ears, intellectual disability. Dx?
Fragile X
48
Lysch-Nyhan Syndrome. Mechanism? Findings?
``` Absent HGPRT (hypoxanthine phosphoribosyltransferase) Findings = Mn* HGPRT Hyperuricemia Gout Pissed off (aggression, self mutilation) Retardation (intellectual disability) dysTonia ```
49
Hypogonadism and intellectual disability Dx?
Klinfelter syndrome (XXY)
50
Macroorchidism and intellectual disability. Dx?
Fragile X
51
Hydroxyzine. Mechanism? Use?
Hydrozxyzine is an antihistamine. | Quick-acting, short-term anxiolytic (PRN use) for patients who do not want to take benzodiazepines.
52
Tourette's Disorder. Tx?
1st line = alpha-2 agonists: guanafacine (1st choice), clonidine (more sedating) For severe cases use: atypical (risperidone) or typical (pimozide) antipsychotic.
53
Perphenazine. Drug class?
1st gen antipsychotic (like Fluphenazine)
54
What is the heart rate like in marijuana intoxication?
Mild tachycardia
55
What is the effect of major depressive disorder on serum cortisol? Mechanism? Test?
``` MDD = High serum cortisol Mechanism = hyperactivity of hypothalamic-pituitary-adrenal axis Test = failure to suppress cortisol levels in the dexamethasone suppression test ```
56
Eye finding in Down's syndrome
Prominent Epicanthal Folds
57
Eye finding in Fetal Alcohol syndrome
Small Palpebral Fissure
58
Treatment of MAOI toxicity due to ingestion of tyramine.
Phentolamine (nonselective alpha blocker) OR Nitroprusside (NO release --> Increase cGMP)
59
What psychiatric emergency is Bromocriptine used for? What is the mechanism?
Psych Emergency Tx for Neuroleptic Malignant Syndrome. | Mechanism = Dopamine Agonist
60
What psychiatric emergency is Dantrolene used for? Mechanism?
Psych Emergency = Neuroleptic Malignant Syndrome | Dantrolene = Binds to ryanodine receptor, preventing Calcium release from sarcoplasmic reticulum of skeletal muscle
61
What Psych Emergency is Diazepam used for?
Psych emergency = Delerium Tremens
62
What Psych Emergency is Diphenhydramine used for? Mechanism
Psych emergency = Acute Dystonia | Diphenhydramine = H1 blocker
63
What is Fluvoxamine?
SSRI
64
What medication is used for opioid intoxication?
Naloxone
65
When is physostigmine used? Mechanism?
``` Use = anticholinergic toxicity Mechanism = Indirect Acetylcholine Agonist ```
66
What Psych Emergency is Phentolamine used for? Mechanism?
Psych Emergency = MAO inhibitor hypertensive crisis | Mechanism = Nonselective alpha blocker
67
Lab findings for Bulemia Nervosa.
``` Hypochloremia Hypokalemia High Bicarbonate (compensation) High BUN High Amylase ```
68
Medication used for Bulemia Nervosa
SSRI
69
Thin upper lip. Dx?
Fetal alcohol syndrome
70
What cause of intellectual disability is also associated with growth retardation?
Fetal alcohol syndrome
71
Symptoms of Vit B1 deficiency.
Vit B1 = Thiamine Deficiency = Wernicke-Korsakoff syndrome Triad of: - Ataxia - Confusion - Ophthalmoplegia (paralysis of eye muscles) Eventually = memory loss --> confabulation
72
Symptoms of Vit B3 deficiency.
Vit B3 = Niacin | Deficiency = Diarrhea, Dermatitis, Dementia (+ hallucinations)
73
Symptoms of Vit B6 deficiency.
Vit B6 = Pyridoxine | Deficiency = Convulsions, Hyperirritability, Peripheral Neuropathy
74
Symptoms of Vit B12 deficiency
Vit B12 = Cobalamin Deficiency = Ataxic gait, paresthesia, impaired position/vibration sense + pernicious anemia
75
Agitation, confusion and oxalate crystals in urine. Dx? Tx?
``` Dx = Ethylene glycol toxicity Tx = Fomepizole (alcohol dehydrogenase inhibitor) ```
76
What medication is used to discourage alcohol drinking? Mechanism?
Disulfiram | inhibits Acetaldehyde Dehydrogenase
77
In what condition are mammillary bodies affected?
Wernicke-Korsakoff syndrome
78
Hydralazine vs Hydroxyzine
Hydralazine increases cGMP, causing smooth muscle relaxation, thus dilating arterioles. Hydralazine is used in severe Hypertension, safe in pregnancy. Hydroxyzine is an antihistamine used to treat anxiety.

9 Psychiatry (6 decks)

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