Psych Flashcards
(131 cards)
1
Q
SNRI
A
venlafaxine
duloxetine
desvenlafaxine
2
Q
SNRI AE
A
anxiety and insomnia
3
Q
TCA
A
doxepin
amitriptyline
4
Q
TCA AE
A
increased QTc interval
5
Q
buspirone AE
A
weaker, slower onset of action
do not use in anorexia or bulemia –> lowers seizure threshold
6
Q
benzo AE
A
cognitive impairment
ataxia
withdrawal
abuse
7
Q
GAD time criteria
A
> 6mo
8
Q
panic disorder time criteria
A
3 panic attack episodes w/in 3wks
9
Q
specific phobia time criteria
A
> 6mo
10
Q
specific phobia tx
A
CBT w/ exposure therapy
11
Q
social phobia time criteria
A
> 6mo
12
Q
bipolar 1 criteria
A
manic at least 1wk
13
Q
bipolar disorder 2 criteria
A
hypomanic, milder version of bipolar
4 days
14
Q
lithium AE
A
check renal function (nephrotoxic)
nephrogenic DI, DMT2
hypothyroidism, tremor
Epstein’s anomoly (tricuspid valve abnormality)
15
Q
if patient on lithium and pregnant, switch to
A
lamotrigine
16
Q
valproate MOA and AE
A
increase GABA in brain
liver failure, pancreatitis
teratogenic neural tube defects
17
Q
lamotrigine AE
A
SJS
18
Q
carbamazepine AE
A
asplastic anemia
SIADH
teratogenic neural tube defect
19
Q
bipolar tx
A
lithium
anticonvulsants: valproate, lamotrigine, carbamazepine
antipsychotics: quetiapine, lurasidone, olanzapine
benzo
20
Q
quetiapine AE
A
increase mortality in elderly w/ demential related psychosis
suidical thoughts and behaviors
21
Q
lursidone AE
A
increase mortality in elderly w/ demential related psychosis
suidical thoughts and behaviors
22
Q
olanzapine AE
A
weight gain, DMT2
increase mortality in elderly w/ demential related psychosis
post injection delirium/sedation
23
Q
strongest factor of bipolar disorder
A
FHx
24
Q
depression screen
A
start in adolescents 12-18yo
25
cyclothymic disorder time criteria
at least 2y
not full hypomanic episode
26
MDD time criteria
>5sx for at least 2wks
27
persistent depressive disorder (dysthymia) time criteria
at least 2yrs
28
PMDD time criteria
luteal phase
>5sx final week before menses
29
suicide risk factors
Sex male
Age (YA/elderly)
Depression
Previous attempt
Ethanol/drug use
Rational thinking loss (psychosis)
Sickness (medical illness)
Organized plan
No spouse or social support
Stated future intent
30
suicide highest RF
previous attempt
31
conduct disorder criteria
under 18yo
at least 3 behaviors over the past year and at least 1 occurring w/in past 6mo
32
oppositional defiant disorder criteria
at least 4 sx present > 6mo
33
oppositional defiant disorder tx
behavior mod
parent management training
rx if ADHD
34
Dissociative fugue
abrupt change in geographic location w/ inability to recall past, loss of identify
35
anorexia nervosa BMI
<17.5 or body weight <85% of ideal weight
36
anorexia nervosa labs
hyponatremia, hypokalemic
alkalosis if vomiting, arrhythmias (QT prolongation)
dec LH/FSH, dec estrogen/testosterone
hypothyroidism, hypoglycemia
osteopenia, anemia, inc BUN
37
anorexia indications for hospitalization
pulse <40, BP <80/60 or light headedness
orthostatic changes, hypothermia
refeeding syndrome
<70% expected weight or BMI <15
acute food refusal, suicidality, psychosis
38
refeeding syndrome sx
hypophosphatemia
dysrhythmia
severe edema
39
russels sign
bulimia
calluses on back of hands d/t induced vomiting
40
bulemia nervosa labs
hypochloremic
hypokalemic
metabolic alkalosis d/t vomiting
41
bulemia FDA approved tx
fluoxetine
42
binge eating disorder criteria
sx 1x/wk for 3mo
43
female sexual interest/arousal disorder criteria
3+ sx for 6mo that cause distress
44
impotence test
r/o med and rx causes
BIT: check for night time erections (postage stamp test)
if + night time erections = psych cause
45
tx impotence
PDE5 inhibitors (sildenafil)
vacuum device prosthetic
psychotherapy
46
paraphilia disorder criteria
sx for 6mo
47
OCD associated disorders
tourettes
tx w/ risperidone
48
ADD/ADHD criteria
at least 6 inattentive sx and/or at least 6 hyperactivity/impulsivity sx
sx present for >6mo in 2+ settings
onset usually <12yo
49
MC single genetic cause autism
fragile X syndrome
50
cluster A personality disorder
"weird"
schizoid
schizotypal
paranoid
51
cluster B personality disorder
"wild"
antisocial
borderline
histrionic
narcissistic
52
cluster C personality disorder
"wimpy"
avoidant
dependent
obsessive compulsive
53
brief psychotic disorder criteria
>1 psychotic sx for <1mo
54
schizophrenia criteria
2+ sx present for at least 1mo
continuous impairment for >6mo
significant functional decline
55
tx schizophrenia
1st line: olanzapine, quetiapine, ziprazidone, risperidone
urine tox
refractory: clozapine
acute episode: hospitalization
56
schizophreniform criteria
schizophrenia for >1mo and <6mo
57
schizoaffective criteria
schizophrenia 2wks + mood disorder (MDD or manic)
58
delusional disorder criteria
1+ delusions for at least 1mo
function not significantly impaired
does not meet criteria for schizophrenia
59
cataplexy
loss of muscle tone following strong emotional stimulus
60
narcolepsy sx
excessive daytime sleepiness
hallucination just before sleep or just before awakening
sleep paralysis
61
narcolepsy test
polysomnography
62
narcolepsy tx
first line: modafinil
scheduled naps
63
restless leg disease test
polysomnography
nerve conduction studies
64
restless leg disease tx
lifestyle
D/C offending meds
supplemental iron
1st line: dopamine agonist: pramipexole, ropinerole
benzo as adjunct
gabapentin
65
somatic sx disorder criteria
1+ somatic sx (pain), distressing or resulting in significant disruption
no physical cause
>6mo
66
somatic sx tx
regular visits w/ 1 PCP
67
illness anxiety disorder sx and criteria
anxiety about health, hypochondriac
>6mo
68
illness anxiety disorder tx
regular visits w/ 1 PCP
69
factitious disorder sx
falsification of physical or psychological sx absence of obvious external rewards
repeated and long term hospitalization common
70
malingering vs factitious disorder
malingering: external reward or secondary gain. not a mental illness
factitious: no obvious external reward
71
alcohol use disorder tx
naltrexone: dec craving
acamprosate: for pts w/ liver dz or opioid use
disulfiram: 2nd line for highly motivated pts
thiamine, Mg (before dextrose), multivitamin, haloperidol if aggression
72
disulfiram CI
CV dz, DM, epilepsy, hypothyroidism, kidney problems
can cause N/V
73
alcohol withdrawal sx
6h
trembling, irritability
anxiety, HA, tachycardia
74
alcohol withdrawal tx
IV thiamine w/ mg (before dextrose)
multivitamin, folate
IV fluids
75
alcohol withdrawal seizure
48h, tonic clonic seizures
tx w/ benzo w/ taper (lorazepam)
head CT
76
delirium tremens
48-96h
autonomic instability, disorientation, hallucination, agitation
77
delirium tremens tx
thiamine --> glucose --> folate --> haloperidol (if psychosis)
78
opioids
morphine
heroin
methadone
oxycodone
codeine
79
opioids sx
pupil constriction (miosis)
euphoria and sedation
constipation, bradycardia, hypotension
respiratory depression, seizures, slurred speech
80
opioid intoxication tx
naloxone
81
opioid withdrawal sx
not fatal, anxiety, insomnia, anorexia, sweating
dilated pupils, piloerection
F, N/V, rhinorrhea, stomach cramps, diarrhea
flu-like sx
82
opioid withdrawal tx
methadone, buprenorphine + naloxone
naltrexone (block cravings)
clonidine, loperamide, NSAID
83
barbiturates sx
respiratory/CNS depression
depression, impaired memory, poor concentration
drowsiness
84
barbiturates tx
sx management b
84
barbiturates tx
sx management
85
barbiturates withdrawal
anxiety, seizures, delirium
tx: long acting Benz w/ taper or phenobarbital
86
benzo intoxication sx
amnesia, depression
ataxia, stupor, somnolence
minor respiratory depression
87
benzo intoxication tx
flumazenil
88
benzo withdrawal sx
rebound anxiety
seizures, tremor, insomnia
89
benzo withdrawal tx
long acting benzo w/ taper (clonazepam/diazepam)
90
amphetamines intoxication sx
AMS, euphoria, impaired judgement
delusion, hallucination, prolonged wakefulness/attention
agitaiton, pupil dilation, HTN, tachycardia, F, arrhythmia
violent behavior, psychosis, diaphoresis, choreiform movement, tooth decay
91
amphetamines tx
haloperidol, bezo, vitC
propranolol for rate control
92
MDMA (ecstacy) sx
hyperthermia, social closeness
"club drug", hyponatremia
93
MDMA tx
CCB
94
do not give to MDMA intoxication
BB: cause coronary artery vasospasm
95
cocaine intoxication sx
AMS, euphoria, agitaiton, hallucination, paranoid ideations
dec appetite, tachycardia, pupil dilation, HTN
angina (MI/CVA)
repetitive motions
96
cocaine OD tx
haloperidol
benzo, vitC
labetalol
97
cocaine withdrawal sx
severe depression, hyperphagia, hyper somnolence, fatigue
malaise, severe psychological craving
98
cocaine withdrawal tx
bupropion, bromocriptine
SSRI for depression
99
wernickes encephalopathy
triad: ataxia, confusion, oculomotor palsy (d/t thiamine deficiency)
from chronic ethanol or benzo intoxication
100
Korsakoff syndrome
amnesia, hepatomegaly, palmar erythema
cirrhosis, dupuytrens contracture, gynecomastia
testicular atrophy
from chronic ethanol and benzo intox
101
PCP intoxication sx
belligerence, impulsiveness, fear, homicidality
psychosis, delirium, seizures
nystagmus, tachycardia, ataxia
102
PCP intoxication tx
benzos
haloperidol
103
PCP withdrawal sx
depression, anxiety, irritability, restlessness
anergia, thought/sleep disturbances
104
PCP withdrawal tx
sx tx
105
LSD intoxication sx
visual hallucinations, seeing sound as color
anxiety/depression, delusions
pupil dilation, "bad trip panic"
106
LSD intoxication tx
haloperidol
benzo
107
cannabis sx
slowed perception, conjunctival injection
increased appetite, dry mouth
108
cannabis withdrawal sx
peak in 48h, lasts 5-7d
irritability, depression, insomnia, N, anorexia, hyperemesis syndrome
109
inhalants intoxication sx
belligerence, assertive, impaired judgement
apathy, blurred vision, coma
110
inhalant intoxication tx
haloperidol
111
anticholinergic toxicity sx
Hot as a hare: inc body temp
dry as a bone: dec secretions
red as a beet: flushed skin
blind as a bat: cycloplegia, mydriasis
mad as a hatter: AMS
full as a flask: urinary retention, constipation
fast as a fiddle: tachycardia
112
adjustment disorder criteria
onset w/in 3mo
<6mo following termination of stressor
113
PTSD criteria
sx >1mo
114
acute stress disorder criteria
sx <1mo
115
PTSD tx
CBT, SSRI
prazosin to reduce nightmares
116
antipsychotics that have greatest risk of QTc prolongation
thioridazine
pimozide
droperidol
ziprasidone
117
clozapine AE
agranulocytosis
118
neuroleptic malignant syndorme sx
fever, confusion, muscle rigidity
rhabdo, autonomic instability (abn vitals, sweating)
119
neuroleptic malignant syndrome tx
stop meds, supportive
dantrolene or bromocriptine (if refractory)
120
tardive dyskinesia can be caused by
haloperidol
typical antipsychotic drugs (prolonged use)
121
acute dystonia caused by
haloperidol
typical antipsychotic drugs
122
acute dystonia sx
intermittent involuntary and uncoordinated hyperkinetic movements
spasm of tongue, neck, face, and back
sustained spasm
123
acute dystonia tx
IM/IV benztropine or diphenhydramine
124
serotonin syndrome sx
AMS, autonomic dysregulation (diaphoresis, tachycardia, HTN, hyperthermia),
neuromuscular hyperactivity (hyperreflexia, tremor, rigidity, babinski)
hyperactive bowel sounds, diarrhea
125
serotonin syndrome tx
d/c drugs, supportive
cyproheptadine for severe cases
sedation w/ benzos
126
meds that increase lithium levels
thiazide (HCTZ)
ACE (lisinopril)
NSAIDS
tetracyclines
metronidazole
127
neonatal abstinence syndrome
withdrawal from opiates due to maternal drug use
neuro: irritability, hypertonia, jittery, seizures
GI: diarrhea, vomiting, feed intolerance
autonomic: sweat, sneeze, pupil dilation
tx w/ opioid therapy (morphine, methadone)
128
normal grief
resolves w/in 1yr
129
abnormal grief
severe sx
>1yr continued sx
positive suicide ideation
130
persistent complex bereavement disorder
severe grief reaction >1yr (6mo in children) after death of bereaved
