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Psych Flashcards

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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

24
Q

MAOIs are rarely used due to _____

Study These Flashcards
A

serious food (high tyramine content) and drug interactions

25
What are examples of high tyramine foods
-beer, wine aged cheese, fava beans
26
Abrupt discontinuation of benzodiazepines can increase risk of
seizure
27
Symptoms of Depression
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
What lab tests should you order in a patient presenting with sx of depression
- CBC - Chem profile - TSH - Folate and Vit B12 - US
29
It may take ____ to achieve antidepressant effects from SSRIs
4-8 weeks
30
You must continue SSRI therapy for at least ___ months post initiation
4-9 months
31
What are extrapyramidal side effects
- 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
What are the side effects of anticholinergics SAD CUB
- Sedation - Anorexia - Dry Mouth - Confusion and Constipation - Urinary Retention - BPH
33
What is the difference between major and minor depression
-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
Antipsychotic medications increase risk for
obesity, T2DM, hyperlipidmia, metabolic syndrome, hypothyroid
35
The FDA has a black box warning for SSRIs that includes
Increased risk of suicidal thinking and behaviour in younger adults in the first 2 months of treatment
36
What is a standard drink sizes
- beer 12oz - malt liquor 8-9oz - wine 5oz - liquor/spirits 1.5oz
37
What are recommended drink guidelines
- women: 1 drink/day | - men: 2 drinks/day
38
What is considered binge drinking?
- males: 5+ drinks in a single occasions | - females: 4+ drinks in a single occasion
39
what is korsakoff's syndrome
- a complication from chronic alcohol abuse - caused by chronic thiamine deficiency - a neurologic disorder with sx that include hypotension, visual impairment and coma
40
What are sx of korsakoff's syndrome
- mental confusion - ataxia - stupor - coma - hypotension
41
What are risk factors for insomnia
- depression - anxiety - GERD - female gender - Illicit drug use - MSK illness - pain - chronic health problems - shift work - ETOH - Caffeine - Nicotine - certain meds
42
What is the 1st line treatment for insomnia
-sleep hygiene: maintain regular sleep, nighttime rituals, avoid caffeine, tobacco/heavy meals before bed, use bed only for sleep and sex, avoid media
43
The gold standard to dx sleep apnea is
Polysomnography
44
A lone ___ can be a sign of occult ETOH abuse
GGT
45
AST/ALT ratio of ___ of higher is likely alcoholism
2
46
These natural supplements are used for insomnia and anxiety. You cannot mix them with benzos, hypnotics or CNS depressants
Kava-Kava | Valerian root
47
Bipolar disorder presentation
- mood instability - alternating cycles of mania and depression - manic episodes are increased energy/activity, grandiosity, less need for sleep, disinhibition, talkative, euphoric mood
48
What is the management of bipolar disorder
- Lithium - Anticonvulsants - Second generation antipsychotics
49
Antipsychotics require the following lab tests
- A1C - Lipids - EKG
50
Antipsychotics can _____ the QT interval and cause
prolong QT interval and cause torsade de points
51
What is the presentation of anorexia nervosa
- 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
What are complications of anorexia
- osteopenia/osteoporosis - peripheral edema r/t low albumin - cardiac complication (arrhythmias, cardiomyopathy, atrophy of cardiac muscles, bradycardia) - Hypotension
53
What is motivational intereviewing
-a counselling method used to help an individual resolve a state of indecision into finding the internal motivation to make positive healthier behaviors
54
The most common psychiatric disorder is
Depression
55
It can take ___ to see improvement in depression symptoms and ___ for releif
2-4 weeks; 6-12 weeks
56
Bipolar ___ is more common that Bipolar ___
2; 1

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