Psych

Question 0

Worse than blues, also has sleep disturbances and change in appetite. Lasts months after giving birth.

Answer 0

Postpartum depression

Question 1

Common in 50-70% of women after birth. Starts in first few days and resolves in 2 wks. Increased tearfulness, restlessness and anxiety. Tx is support and reassure

Answer 1

Postpartum blues

Question 2

Severe anxiety after giving birth with agitation, disordered thoughts, confusion and may harm child. Hospitalize.

Answer 2

Postpartum mania or psychosis

Question 3

PMDD

Answer 3

PMS with more sever sx. Treatment with SSRI

Question 4

What is the initial assessment for a suspected antifreeze ingestion?

Answer 4

Examine urine with woods lamp.

Question 5

Withdrawal characterized with dysphoric mood, n/ v, muscle aches, yawning, diarrhea, lacrimation, rhinorrhea, sweating, fever and insomnia

Answer 5

Opioid withdrawal

Question 6

Withdrawal with autonomic hyperactivity, hand tremor, insomnia, hallucinations, psychomotor agitation, seizures and anxiety

Answer 6

Xanax withdrawal (benzo)

Question 7

Withdrawal with fatigue, unpleasant dreams, insomnia, hypersomnia, increased appetite, psychomotor retardation, anxiety

Answer 7

Amphetamine withdrawal

Question 8

Withdrawal with fatigue, unpleasant dreams, insomnia, increased appetite, psychomotor retardation, anxiety

Answer 8

Amphetamine or cocaine withdrawal

Question 9

Atypical antipsychotic used in resistant schizophrenia. Can cause agranulocytosis, seizures, myocarditis, and psychosis.

Answer 9

Clozapine

Question 10

Disorder when Physical sx are constant with true illness but are under voluntary control of the patient. May have secondary gains.

Answer 10

Fictitious disorder

Question 11

First line med in depression?

Answer 11

SSRI

Question 12

MAOI (phenelzine) contraindicated in patients who take () because it may cause delirium, hyperpyrexia, convulsions and HTN.

Answer 12

Meperidine (Demerol)

Question 13

Causes microcephaly, short palprable fissure, cardiac defects, large ears, under sized jaw and small eyes.

Answer 13

Fetal alcohol syndrome

Question 14

Panic disorder treatment.

Answer 14

Cognitive behavior therapy (exposing patient to offending stimuli) along with SSRI

Question 15

Institutionalized patient presents with polyuria, vomiting, diarrhea, difficulty concentrating, confusion and lethargy. What could this be?

Answer 15

Psychogenic polydipsia.

Question 16

What is acute dystonic reactions!

Answer 16

Occur as a result of taking antipsychotics or raglan for over 12 wks. Patients often given an anti cholinergic with the antipsychotic to decrease side effects.

Question 17

What are they extra pyramidal side effects?

Answer 17

Tremor, slurred speech, akathesia, dystonia, anxiety, distress, paranoia, bradyphrenia.

Question 18

Best treatment for depression after stroke?

Answer 18

SSRI

Question 19

Side effects of lithium?

Answer 19

Nephrogenic diabetes insipidus, thyroid suppression, leukocytosis

Question 20

Withdrawal causing tremors, diaphoresis, hyper reflexes, elevated vital signs and anxiety

Answer 20

Alcohol

Question 21

Excessive altered mental status, hallucinations, autonomic instability, seizures and death are all sx of excessive withdrawal from?

Answer 21

Alcohol, delirium tremens

Question 22

Use and side effects of respiridone?

Answer 22

Atypical antipsychotic for tx of schizophrenia . Extrapyrimdial effects, tardive dyskinesia, neuroleptic sx.

Question 23

What is tardive dyskinesia?

Answer 23

Sudden uncontrollable movements of voluntary muscles. Usually mouth tongue cheeks and jaw. Lip smacking, puffing checks, protruding tongue etc.

Question 24

Akathisia

Answer 24

Restlessness and psychomotor agitation from taking antipsychotics or reglan

Question 25

Persistent pattern of negative, hostile, defiant behavior towards adults.

Answer 25

Oppositional defiant disorder

Question 26

Drug that causes aggression, distortion of body image, ataxia, nystagmus, mid dilated pupils, fever, hyper salivation. Treatment?

Answer 26

PCP is drug. Treat with diazepam initially.... May need haldol.

Question 27

Most common side effect of zyprexa, an atypical antipsychotic?

Answer 27

Weight gain contributing to DM2

Question 28

What do you give for someone going through heroin withdrawal?

Answer 28

Benadryl

Question 29

Disorder when patient develop somatic sx that are not explained by other disorders, usually after a traumatic experience

Answer 29

Conversion disorder

Question 30

Disorder common in hospitalized elderly. Rapid onset of impaired cognition, changes in LOC, disturbances in attention and psychomotor activity.

Answer 30

Delirium

Question 31

Luvox/fluvoxamine

Answer 31

SSRI

Question 32

Side effects of TCA?

Answer 32

Blurred vision, mydriasis, dry mouth, ortho static hypotension, weight gain, urinary retention, prolonged t wave

Question 33

Personality disorder described as instability in personal relationships, poor self image, impulsivity, recurrent suicidal behavior, chronic feelings of emptiness, paranoid ideation, cutting, substance abuse and sexual promiscuity.

Answer 33

Borderline personality

Question 34

Personality disorder who is distrustful or suspicious, fear of confiding in others, perceive threats everywhere, socially isolated, avoids intimacy, prides on being rational and objective but appears unemotional and hyper vigilant.

Answer 34

Paranoid personality disorder

Question 35

Personality: detached with limited emotional expression, indifferent and little interest in sex, works alone with no friends, enjoys solitary pursuits, can't deal with strong emotion,

Answer 35

Schizoid personality disorder, schizoid/avoid

Question 36

Personality with magical thinking, believes in ESP, behavioral eccentricities, discomfort with close relationships, unusual beliefs outside of the norm, may talk to self in public or have vague speech

Answer 36

Schizotypal personality disorder, typal/magical

Question 37

Personality: disregard for others, behavior violates others, lack of remorse or empathy, law breakers, lying, must be over 18, hostile, may appear charming

Answer 37

Antisocial personality disorder (serial killers)

Question 38

Personality disorder with unstable self image, unstable relationships, rage, despair. Have difficulty knowing between fantasy and reality, rapid mood swings, impulsivity, usually substance abuse

Answer 38

Borderline personality disorder (think crazy fan)

Question 39

Personality with excessive attention seeking, center of attention, influenced easily, provocative. Overly concerned with appearance and may be perceived as vain. Threatened by anything that threatens sense of physical attractiveness.

Answer 39

Histrionic personality disorder

Question 40

Personality that needs praise or admiration. Entitled, conceited, arrogant with a lack of empathy. Self important, blind ambition, fantasy of unlimited success, they are special

Answer 40

Narcissistic personality disorder

Question 41

Personality that is submissive and has an excessive need to be cared for. Will not initiate anything, fear that illness leads to abandonment, clingy, may agree with everyone, right or wrong

Answer 41

Dependent personality disorder

Question 42

Personality that desires close relationships but avoids them, intense feelings of inadequacy, sensitive to criticism, fears rejection and humiliation,

Answer 42

Avoidant personality disorder

Question 43

Personality who is a perfectionist. Require order and control. Attentions to detail impairs ability to finish projects. * patient thinks that obsessions or compulsions are NORMAL.

Answer 43

Obsessive compulsive personality disorder

Question 44

How long must one have sx before a dx of schizophrenia can be given?

Answer 44

6 months

Question 45

Disease associated with auditory hallucinations, bizarre delusions, disorganized speech, catatonic behavior, social withdrawal, lack of emotion, lack of communication and lack of reactivity.... Must have functional decline

Answer 45

Schizophrenia

Question 46

This type of schizophrenia had delusions of persecution or grand urge, is tense suspicious and guarded

Answer 46

Paranoid schizophrenia

Question 47

This type of schizophrenia is when one regresses to a primitive state, has unorganized behavior, and inappropriate emotional response

Answer 47

Disorganized schizophrenia

Question 48

This schizophrenia is rare and has marked decrease in motor function, stupor, rigidity and posture.

Answer 48

Catatonic

Question 49

How do you treat schizophrenia?

Answer 49

Psychosocial rehab and antipsychotics.

Question 50

Haloperidol

Answer 50

First gen antipsychotic, can cause extrapyrimidal side effects.

Question 51

Clozapine

Answer 51

2nd gen atypical antipsychotic, can cause agranulocytosis

Question 52

Risperidone

Answer 52

2nd gen atypical antipsychotic, can cause increase in prolactin levels

Question 53

Olanzapine

Answer 53

2nd gen atypical antipsychotic, can cause weight gain

Question 54

Disorder that can cause multiple issues and multiple sx. Poly surgery is a feature, multiple physical complaints that MUST cause significant role impairment. 4 pain, 2 GI, 1 sexual, 1 pseudo neurological complaint.

Answer 54

Somatization disorder

Question 55

Disorder resulting in a loss or change in sensory or motor function. Suggestive of physical disorder but caused by psychological factors. Usually have depression/anxiety disorder. NOT intentional. Rule out medical causes first.

Answer 55

Conversion disorder

Question 56

Disorder with long hx of severe pain not consistent with clinical findings. Pain is the cause of all life troubles. Women more than men, poor prognosis.

Answer 56

Pain disorder (somatoform pain disorder)

Question 57

A fear or belief that one had a serious undisguised dz, patients doctor shop when they get the "wrong" diagnosis of normal.

Answer 57

Hypochondriasis

Question 58

Self induced sx or false lab or physical exam results, usually women with medical background

Answer 58

Fictitious disorder

Question 59

Parent creates illness in child to maintain relationship with clinician

Answer 59

Munchausen by proxy

Question 60

Disorder with refusal to maintain a normal weight. Loses weight, introverted, feels in control with food, abuses laxatives.

Answer 60

Anorexia

Question 61

A binge eater followed by behavior to prevent weight gain. Minor weight changes, extroverted, shame, feels out of control with food.

Answer 61

Bulemia

Question 62

Treatment of eating disorder?

Answer 62

Psychotherapy and cognitive behavior therapy, fluoxetine for bulimia, NO Wellbutrin!

Question 63

Childhood disorder with impairment in areas of development and social skills, communication skills,

Answer 63

Autism, refer to specialty care

Question 64

Distractibility, short attention span, hyperactive and impulsive. Must be present in greater than 1 setting, l,onager than 6 months and onset before age 7.

Answer 64

ADHD with behavior modification and stimulant drugs

Question 65

A persistent patter of negative, hostile, defiant behaviors toward adults. Arguments, temper, deliberate annoyance, hx of school and family conflict, low self esteem, mood lability

Answer 65

Oppositional defiant disorder, tx with behavior therapy

Question 66

Hx of social and academic difficulty, defies authority, fights, throws tantrums, fails in ,school, sets fires, steals, cruel to animals and people. Sexually aggressive, no guilt or remorse. Poor prognosis and must be under 18.

Answer 66

Conduct disorder

Question 67

Inherited disorder with onset in childhood, unknown cause of tics or vocal tics

Answer 67

Tourette syndrome, tx with atypical neuroleptics like respiridone, haldol and clonadine

Question 68

How do antipsychotics work.

Answer 68

Block dopamine receptors, effective in treating positive sx.

Question 69

Side effects of antipsychotics?

Answer 69

Restlessness, weight gain, anti cholinergic (dry mouth, constipation, urinary retention)

Question 70

How does an SSRI work?

Answer 70

Binds to serotonin reputable proteins inhibiting the reuptake, onset up to 6 wks.

Question 71

SNRI mechanism of action?

Answer 71

Inhibits the reuptake of serotonin and norepinephrine, treats major depression, mod disorders, OCD, use with caution I. HTN and with St. John's wort. Effexor, cymbalta, pristiq

Question 72

What is the MAOI mechanism of action?

Answer 72

Inhibits presynaptic mono amine oxidase which catabolizes norepinephrine dopamine and serotonin

Question 73

What do you avoid eating when taking an MAOI?

Answer 73

Aged cheese, beer, red wine,

Question 74

What is the mechanism of action of bupropion?

Answer 74

Inhibits the uptake of dopamine and norepinephrine

Question 75

Bupropion is contraindicated when?

Answer 75

In patients with seizure risk, decreases the seizure threshold.

Question 76

When do you use benzodiazepines?

Answer 76

Used for anxiety, agitation, insomnia, augments the GABA function in the lymbic system.side effects are drowsiness and respiratory depression.

Question 77

What is the use of buspirone (buSpar)?

Answer 77

Tx for generalized anxiety disorder, takes weeks to not improvement, side effects are dizziness, nervousness and nausea

Question 78

Use for lithium?

Answer 78

Mood stabilizer, must monitor levels on a regular basis, adjust dose with renal decline

Question 79

Side effects of lithium?

Answer 79

Minor- tremor, wt gain, polyuria, GI distress, acne | Major- ataxia, confusion, course tremor, coma, sinus arrhythmia, teratogenicity, death

Question 80

Chronic mental illness with psychosis, disorganized speech, auditory hallucinations, thought disorder, delusions for over 6 months, function decline, begins in 20's

Answer 80

Schizophrenia

Question 81

Bipolar 1 disorder

Answer 81

At least one manic episode, a period of elevate or irritable mood with grandiosity, flight of ideas, racing thoughts, decreased need for sleep, excessive pleasurable activity

Question 82

Brief psychotic disorder

Answer 82

Psychotic sx last greater than 1 day and less than one month, may follow a stressor

Question 83

Delusional disorder

Answer 83

Non bizarre delusions for at least one month

Question 84

Schizophreniform disorder

Answer 84

Schizophrenia lasting more than one month but less than 6 months

Question 85

What lab tests are required during long term lithium treatment?

Answer 85

TSH every 6 months

Question 86

Describe PCP intoxication

Answer 86

Nystagmus, flushing, sweating, distortions of body image, disorganized thinking, irritability, anger

Question 87

Common drug that causes depression

Answer 87

Propranolol

Question 88

Side effects of captropril?

Answer 88

Cough, rash, fever, hyperkalemia

Question 89

Captopril contraindications?

Answer 89

Bilateral renal artery stenosis

Question 90

Side effects of furosemide?

Answer 90

Potassium depletion hyperglycemia , hyperuremicemia, ypocalcemis

Question 91

Furosemide contraindicated in?

Answer 91

Hyperuricemia, gout, primary aldosteronism

Question 92

Side effects of minoxidil?

Answer 92

Hair growth, tachycardia, fluid retention

Question 93

Minoxidil contraindications?

Answer 93

Patients with severe coronary artery disease.

Question 94

Overdose of benzo? (Valium, lorazepam, diazepam)

Answer 94

Give flumazemil 0.2mg IV