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OME Flashcards

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1
Q

1st line treatment for anorexia?

A

CBT + Antipsychotic

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2
Q

What is the best treatment for OCD?

What else?

A

CBT

SSRI or clomipramine (TCA)

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3
Q

Patient that has insomnia, what is the next step to assess the reason?
What does that mean?

A

of hours sleep greater or less than 6 hours

< 6 hours = fix sleep hygiene, treat underlying disease, try BENZOs

> 6 hours means adjust sleep schedule

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4
Q

What defines Bipolar II?

A

Hypomania AND major depression

Less than 4 days of duration

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5
Q

How do BENZOs affect sleep?

A

Shorten REM -> less restful sleep

Eliminate dreams

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6
Q

What is Gender Dysphoria definition?

A

> 6 months AND distress d/t 1 of 4 things:

Incongruence
Desire to be other gender
Wanting to rid of self sex char
Believe they are opp sex

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8
Q

Treatment for GAD?

A

1st line: Psychotherapy is best

2nd line: SSRI, buspirone

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10
Q

Psychiatric illness w/a patient on no medications that has rigidity, increase temp, and ANS instability what do they have?

A

Malignant catatonia

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11
Q

Pt that has a SBO and is missing hair most likely has what?

Need to r/o what?

A

Trichobezoar

Fungus

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12
Q

Night terrors occur in what stage?

Memory?

Tone?

Treatment?

A

Stage 3

No

Yes

Reassurance

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13
Q

What are the cluster C personality disorders?

A

ADO —> fear, shy
Avoidant
Dependent
Obsessive-Compulsive

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14
Q

What is Wernicke’s encephalopathy?

Symptoms?

A

Reversible lesion of cerebellum bc No B1

causes confusion, ATAXIA, ophthalmoplegia

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15
Q

What defines Autism spectrum disorder?

What else do they have?

A

Dec social communication
Restricted repetitive behaviors

Dec language
IQ impaired

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16
Q

ADHD defined by what timeline?

A

Before age 12, last > 6 months

Must occur in 2 settings or more

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17
Q

What is the loss of muscle tone while conscious called?

A

Cataplexy

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18
Q

What defines GAD?

A

Constant anxiety about almost everything

Most days >/= 6 months and have >/= 3 somatic sx

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19
Q

What are the nt’s of sleep and what stages do they occur?

A 
SAND
Serotonin - inc sleep
ACh - Dream
NorEpi - Dream
Dopamine - inc awake
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21
Q

What are the 5 categories of PTSD?

A 
Intrusion - nightmares, flashbacks
Mood changes - Negative
Dissociation 
Avoidance
Arousal - hypervigilance
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23
Q

Treatment for Bulimia Nervosa?

Never use what?

A

Fluoxetine + CBT

Bupropion

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24
Q

What involves regurgitation of food for at least a month?

MC in whom?

A

Rumination disorder

Infants, retards

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25
Q

What are the MC sx of GAD?

A 
Irritability
Somatic pain
Weight change
Sleep change
Concentration
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27
Q

What is intermittent explosive disorder?

Treat how?

A

Stressor that induces anxiety which causes person to violently act out at people or property

No benefit to SSRI or therapy therefore:

JAIL if severe

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29
Q

What defines insomnia?

A

Difficult falling asleep or waking up too early w/out falling back asleep 3 nights/wk for 3 months

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30
Q

Baby blues occurs with which baby?

Timing?

Depression?

Psychosis?

Treatment?

A

1, cares about baby

Onset and duration w/in 2 weeks

Dysthymic

None

None

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31
What med is long acting and used for long term maintenance of opioid dependence?
Naltrexone
32
A girl that regresses after a period of normal development until about 6 months most likely has what?
Rett syndrome
33
How is Tourette’s treated? Like what?
Antipsychotics Risperidone (dopamine antagonist)
34
What defines schizophrenia?
Greater than 6 months AND 2 of 5, ONE must be 1-3 1) bizarre delusions 2) hallucinations 3) Disorganized speech 4) disorganized behavior 5) flat affect, cognitive defects, poverty of speech, anhedonia
35
What does SIGECAPS stand for?
``` Sleep - dec Interest - dec Guilt - inc Energy - dec Concentration - dec Appetite - dec Psychomotor - dec Suicide - inc ```
36
The object stolen in kleptomania is described how?
Little to no value Pt CAN afford Unplanned, w/OUT help
37
What is Tourette’s associated w/?
OCD
39
Paradoxical behavior, appearance changes, memory gaps (blackouts) is what? Treat how?
DID Psychotherapy
40
PCBD timeline?
Started after 6 months, lasts greater than 12 months
41
What defines Panic Disorder?
SOB, trembling, unsteadiness, depersonalization, excessive HR, numbness, tingling, sweating, palpitations, ABD distress, N, intense fear of losing control/dying, chest pain
41
What are the 2 treatment techniques to overcome specific phobias? Describe
Systemic desensitization - start w/small amount and build up —> works best but takes longer Flooding - anxiety response burns out —> best for time-sensitive need
42
What defines narcolepsy? Dx how? Treat how?
Rapidly plunged to REM sleep at least 3x / wk for 3 months Low CSF hypocretin-1, polysomnography Schedule naps, stimulants
44
What meds can treat enuresis? Without meds?
Desmopressin Oxybutynin Imipramine Positive reinforcement
46
Adjustment disorder timeline? D/t what? Treat how?
> 3 months, less than 6 months Less severe stressor No treatment needed
47
What are the 2 types of IED? MC in whom?
Mild: 2x / week in 3 months w/out harm Severe: 3x / year WITH harm MEN
48
What is the key feature of schizotypal personality disorder?
Magical thinking
49
What are the 5 Kubler-Ross states of death and dying?
DABAD ``` Denial Anger Bargaining Acceptance Depression ```
51
What does DIGFASTER stand for?
``` Distractibility Insomnia Grandiosity Flight of Ideas Agitation, Activities Sexual Exploits Talkative Elevated Mood Racing thoughts ```
52
Moderate autism occurs when? Presents how?
2-4 Plateau
53
Side effects of TCAs?
``` TCCAS tachycardia, HoTN cardiac conduction delay (QRS) Change in mental status AntiAch Seizures ```
54
What are the cluster A personality disorders?
PSS Paranoid Schizoid Shizotypal
55
Definition of enuresis? Wetting the bed is normal up until when?
2 or more times / wk for 3 months in 5 yrs or older 7
56
Acute stress disorder defined how? PTSD?
Less than 4 weeks from the event Older than 4 weeks
56
Pt that has Disinhibited Social Engagement Disorder has what sx? Must r/o what?
PAIRS too much Autism
58
DBT is used for treating what?
Borderline personality disorder
59
What are the 5 stages of substance abuse?
``` Pre-contemplative Contemplative Preparation Action Maintenance ```
60
What defines encopresis? What is it?
1x or more / Month for 3 months Shitting in public
61
What defines MDD?
5 SIGECAPS w/depressed mood/anhedonia for at least 2 weeks
61
Haldol is the BEST medicine for a pt w/acute severe mania w/psychosis except when it is contraindicated in what pts?
Prolonged QT
62
What are atypical features of MDD?
Increased sleep | Increased appetite/weight
65
Nightmares occur in what stage? Memory? Tone? Treatment?
REM YES, awake easily No Address stressor
66
When starting an SSRI, how long is an adequate trial?
1-2 months of MAX dosing
67
Pt that was once dry but now has bed wetting with negative UA and negative US what is the cause? D/t what?
Regression New sibling, sexual abuse
68
What defines Bipolar I?
Elevated mood + 3 sx of DIGFASTR for at least 1 week
69
What is anxiety in response to a mild stressor that leads to anxiety about 1 specific thing which leads to a loss of function w/out psychosis?
Adjustment disorder
70
Respiratory depression + mitosis in a pt indicates what?
Opiate OD
71
Bupropion is used for what?
Smoking | Has NO weight gain
72
What defines pyromania? What is their motivation?
Fire setting 2x or more + fascination/gratification To decrease anxiety or Increase sexual arousal —> THEY LIKE IT
73
ADHD characterized how?
Impulsivity Inattention Ex. Poor grades and bad behavior
74
Amnesic-Confabulatory syndrome is known as what? What symptoms? Pathology?
Korsakoff’s syndrome Retrograde and anterograde amnesia, confabulation IRREVERSIBLE B1 Deficiency for too long
75
Pt that is presenting with panic disorder, what must be ruled out first? MC pt?
ACS - troponin, EKG Hyperthyroid = TSH Asthma = wheezing Female in their 20s w/no PMHx
75
Schizophreniform timeline? Treat how long?
> 1 month, less than 6 month 3-6 months
75
Anorexia Nervosa severe signs?
Bradycardia Leukopenia HoTN
76
IDD pt w/6th grade level is what severity? 6 y/o (3rd grade)? Age 3? Age 1?
Mild Mod Severe Profound
78
How long should you treat with a SSRI? Treat for how long before changing meds? How long for washout?
6 weeks at MAX Dose 6 months 3 weeks or more
79
FRAMES is used for what? Means what?
Motivational interviewing ``` F - offer Feedback R - emphasize personal Responsibility A - give Advice M - Menu of option E - use Empathy S - support Self-efficacy ```
80
Describe the classic Kleptomaniac
WOMAN, object causes increased anxiety, only stealing it reduces anxiety Feels remorse, therefore gifts, hoards, or returns item
81
What are the cluster B personality disorders?
``` BANH Borderline Antisocial Narcissistic Histrionic ```
82
What drug can be used to help opiate withdrawal? Helps what symptoms?
Clonidine Lacrimation, diarrhea, sweating, nausea
83
What is cataplexy assoc w/?
Narcolepsy
84
What personality disorder is characterized by being a loner, happy in isolation?
Schizoid
85
What is agoraphobia?
Fear and avoidance of public areas, crowds, public transportation, going outside alone
86
Mild autism occurs when? Presents how?
Age 4-6 Regression
87
What psychotherapy treatment for panic disorder?
CBT
88
Grief timeline? Features?
Less than 12 months Waxes and wanes Can be happy IS insight to psychosis
89
People w/IED described how after the act?
Calm, relaxed, without Remorse
89
What is the timing for acute stress disorder? PTSD?
> 3 days but less than 1 month >/= 1 month
89
Treatment for RAD/DSED?
Find a caregiver —> parent better
89
What is the treatment ladder for Bipolar I?
1 - Lithium 2 - Valproic Acid 3 - Carbamazepine/lamatrogine 4 - Quietapine
89
Post-Partum psychosis occurs with which baby? Timing? Depression? Psychosis? Treatment?
After 1st, fears baby and will kill it Onset w/in 1 month None Yes Mood stabilizer, antipsychotic
89
Travel + amnesia = what?
Fugue
89
What defines intellectual disability disorder?
Dec cognitive skill | Dec adoptive function
90
What is depersonalization disorder? Derealization?
Dissociation from your BODY From the environment
91
What is the stressor for reactive attachment disorder? Evident when? What is impaired?
Neglect or abuse Less than 5 y/o Ability to PAIR/bond
91
Depression (MDD) in the setting of death of a loved one has what timeline? What features
Duration greater than 12 months Hallucinations Hopeless, NEG self
91
Anorexia nervosa is categorized by what? What are they?
Weight Mild - BMI > 17 Mod - 16 - 16.9 Severe/Extreme —> < 16
91
Catatonia is treated how? Refractory cases treated how? Pts at risk for what?
Lorazepam ECT DVT, Rhabdo (Inc CK)
93
Dysthymia defined how? Treat how? Rule out what?
Depressed mood for > 2 years but w/out symptoms > 2 months at a time SSRI Thyroid - get TSH
94
MC social phobia? Treat how?
Public urination, public speaking Beta blockers, CBT
94
Brief psychotic disorder timeline?
> 1 day, less than 1 month
95
What is Cataplesy associated w/?
Catatonia
95
What are the stages of sleep with wave forms?
BATS Drink Blood ``` Beta - awake Alpha - drowsy Theta - Stage 1 Spindles and K complexes - Stage 2 Delta - Stage 3 Beta - REM ```
96
Treatment for PTSD or ASD?
Group therapy is the BEST Then use SSRI/SNRI
96
What defines cyclothymia?
At least 2 years of hypomania and a MDE
97
Acute opioid overdose use what medicine?
Naloxone
99
What medication is useful in treating nightmares and sleep disruption in PTSD? MOA?
Prazosin Alpha-1 blocker that blocks adrenaline receptors
100
What is Flumazenil used for?
Benzo OD
101
At what stage is it hardest to arouse?
3
104
What does GABA do to sleep?
Decrease Stage 3 | Decrease Sleep latency
105
OSA can lead to what health complications? Treatment?
Pulm HTN —> RHF CPAP, lose weight
106
For pts w/IDD what IQ score is no disability? What adaptive fxns? Mild? Mod? Severe? Profound?
> 70 no restriction 50-70 no advanced life skills 35-49 no advanced life skills, cannot work 20-34 no ADLs < 20 total care
107
Binge-Eating Disorder patients are described how?
Overweight, NO purge
108
Post-Partum depression occurs with which baby? Timing? Depression? Psychosis? Treatment?
After 1st, doesn’t care about baby, may hurt Onset w/in 1 month MDE None SSRI
110
What causes central sleep apnea? Look for what? Treat how?
Opiates, COPD, idiopathic, CVA Cheyenne-Stokes breathing BiPAP

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