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AANP Study Cards > Psych > Flashcards

Psych Flashcards

1
Q

What are risk factors for suicide?

A
  • Older adult who has recently lost a spouse
  • plan involving a gun or lethal weapon
  • history of attempted suicide or family hx of suicide
  • mental illness
  • history of abuse
  • terminal illness or chronic pain
  • ETOH/Drug abuse
  • Age 15-24 years and >60
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2
Q

Who is at highest risk of suicide according to LEIK

A

-elderly males who recently lost a partner

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3
Q

The hunter toxicity criteria decision rules state regarding Serotonin toxicity the patient must

A

have taken a serotonergic agent and meet 1 of the following criteria

  • spontaneous clonus
  • inducable clonus + agitation and diaphoresis
  • ocular clonus + agitation and diaphoresis
  • tremor + hyperreflexia
  • hypertonia + temperatur >100.4
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4
Q

Higher risk of serotonin syndrome occurs when

A

combining 2 or more drugs that block serotonin

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5
Q

What is malignant neuroleptic syndrome

A
  • A rare life threatening idopathic reaction from typical or atypical antipsychotic
  • Can also be seen in parkinsons with removal or reduction in L-dopa or dopamine agoinist therapy
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6
Q

What are sx of malignant neuroleptic syndrome

A
  • high fever
  • muscle rigidity
  • mental status change
  • dysautonomia (fluctuating BP and urinary incontinence)
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7
Q

A questionnaire used to evaluate an individual for confusion and dementia

A

-Folstein MMSE

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8
Q

Orientation is tested by asking questions like

A

What day it is

What location the patient is in

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9
Q

Immediate recall is assessed by

A

instructing patient that you will be testing their memory ; say 3 unrelated words and ask the patient to repeat

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10
Q

Attention and calculation is assessed by

A

serial 7’s

spell a word backward

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11
Q

Writing and copying

A

-as a patient to copy a figure or write sentence

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12
Q

What is the max score of an MMSE

A

30

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13
Q

A score of ___ on the MMSE indicates impairment

A

19 or less

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14
Q

What are the adverse effects of atypical antipsychotics and therefore what should you monitor

A
  • obesity and T2DM

- All can cause weight gain so assess BMI/weight every 3 months

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15
Q

SSRIs are first line for what conditions

A
  • depression
  • OCD
  • GAD
  • Panic
  • social anxiety
  • Premenstrual dysphoric disorder
  • PTSD
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16
Q

What are the adverse effects of typical antipsychotics

and what do you need to monitor

A
  • elevates triglyceride/lipids
  • extrapyramidal side effects
  • tardive dyskinesia
  • QT prolongation
  • sudden death
  • Malignant neuroleptic syndrome

labs: blood glucose and lipid profiles

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17
Q

What are adverse effects of anticonvulsants and what needs to be monitored

A
  • AE: Steven-Johnson Syndrome

- Must monitor: Serum concentrations in valproic acid and carbamezapine

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18
Q

What is an AE of Bupropion and when is it contraindicated

A
  • seizures

- CI: seizure disorder, anorexia, bulimia

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19
Q

What mental health medications can precipitate acute narrow angle glaucoma

A

-venlafaxine and duloxetine

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20
Q

What mental health medications can have anticholinergics side effects

A

-TCAs

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21
Q

What SSRI has the longest 1/2 life

A

Prozac (Fluoxetine)

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22
Q

What SSRI has the shortest 1/2 life

A

Paxil (Paroxetine)

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23
Q

What SSRI has the least drug interactions

A

Celexa

24
Q

MAOIs are rarely used due to _____

A

serious food (high tyramine content) and drug interactions

25
Q

What are examples of high tyramine foods

A

-beer, wine aged cheese, fava beans

26
Q

Abrupt discontinuation of benzodiazepines can increase risk of

A

seizure

27
Q

Symptoms of Depression

A

SIGECAPS

  • Sleep: Insomnia or hypersomnia
  • Interest: Reduced, loss of pleasure
  • Guilt: Feelings of worthlessness
  • Energy: Fatigued or loss of energy
  • Concentration: Diminshed
  • Appetite changes
  • Psychomotor retardation
  • Suicidal ideations
28
Q

What lab tests should you order in a patient presenting with sx of depression

A
  • CBC
  • Chem profile
  • TSH
  • Folate and Vit B12
  • US
29
Q

It may take ____ to achieve antidepressant effects from SSRIs

A

4-8 weeks

30
Q

You must continue SSRI therapy for at least ___ months post initiation

A

4-9 months

31
Q

What are extrapyramidal side effects

A
  • Akinesia: inability to initiate movement
  • Akathsia: inability to stay still
  • bradykinesia: slow movement
  • tardive dyskinesia: involuntary movements of the lops, tongue, face, and extremities
32
Q

What are the side effects of anticholinergics SAD CUB

A
  • Sedation
  • Anorexia
  • Dry Mouth
  • Confusion and Constipation
  • Urinary Retention
  • BPH
33
Q

What is the difference between major and minor depression

A

-minor depression is a milder form; the criteria is the same as major depression except there are fewer symptoms (at least 2 but less than 5)

34
Q

Antipsychotic medications increase risk for

A

obesity, T2DM, hyperlipidmia, metabolic syndrome, hypothyroid

35
Q

The FDA has a black box warning for SSRIs that includes

A

Increased risk of suicidal thinking and behaviour in younger adults in the first 2 months of treatment

36
Q

What is a standard drink sizes

A
  • beer 12oz
  • malt liquor 8-9oz
  • wine 5oz
  • liquor/spirits 1.5oz
37
Q

What are recommended drink guidelines

A
  • women: 1 drink/day

- men: 2 drinks/day

38
Q

What is considered binge drinking?

A
  • males: 5+ drinks in a single occasions

- females: 4+ drinks in a single occasion

39
Q

what is korsakoff’s syndrome

A
  • a complication from chronic alcohol abuse
  • caused by chronic thiamine deficiency
  • a neurologic disorder with sx that include hypotension, visual impairment and coma
40
Q

What are sx of korsakoff’s syndrome

A
  • mental confusion
  • ataxia
  • stupor
  • coma
  • hypotension
41
Q

What are risk factors for insomnia

A
  • depression
  • anxiety
  • GERD
  • female gender
  • Illicit drug use
  • MSK illness
  • pain
  • chronic health problems
  • shift work
  • ETOH
  • Caffeine
  • Nicotine
  • certain meds
42
Q

What is the 1st line treatment for insomnia

A

-sleep hygiene: maintain regular sleep, nighttime rituals, avoid caffeine, tobacco/heavy meals before bed, use bed only for sleep and sex, avoid media

43
Q

The gold standard to dx sleep apnea is

A

Polysomnography

44
Q

A lone ___ can be a sign of occult ETOH abuse

A

GGT

45
Q

AST/ALT ratio of ___ of higher is likely alcoholism

A

2

46
Q

These natural supplements are used for insomnia and anxiety. You cannot mix them with benzos, hypnotics or CNS depressants

A

Kava-Kava

Valerian root

47
Q

Bipolar disorder presentation

A
  • mood instability
  • alternating cycles of mania and depression
  • manic episodes are increased energy/activity, grandiosity, less need for sleep, disinhibition, talkative, euphoric mood
48
Q

What is the management of bipolar disorder

A
  • Lithium
  • Anticonvulsants
  • Second generation antipsychotics
49
Q

Antipsychotics require the following lab tests

A
  • A1C
  • Lipids
  • EKG
50
Q

Antipsychotics can _____ the QT interval and cause

A

prolong QT interval and cause torsade de points

51
Q

What is the presentation of anorexia nervosa

A
  • intense fear of gaining weight along with distortion of body shape and weight
  • severe food intake
  • BMI <18.5
  • lanugo
  • amenorrhea for 3 mths or longer
52
Q

What are complications of anorexia

A
  • osteopenia/osteoporosis
  • peripheral edema r/t low albumin
  • cardiac complication (arrhythmias, cardiomyopathy, atrophy of cardiac muscles, bradycardia)
  • Hypotension
53
Q

What is motivational intereviewing

A

-a counselling method used to help an individual resolve a state of indecision into finding the internal motivation to make positive healthier behaviors

54
Q

The most common psychiatric disorder is

A

Depression

55
Q

It can take ___ to see improvement in depression symptoms and ___ for releif

A

2-4 weeks; 6-12 weeks

56
Q

Bipolar ___ is more common that Bipolar ___

A

2; 1

AANP Study Cards (20 decks)

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