PSYCH Flashcards
(37 cards)
TCA overdose symptoms
CV: palpitation, chest pain, hypotension
CNS: convulsion, decr mental status, resp depress, drowsiness, coma
Autonomic: dry mouth, dry skin, urinary retention, blurred vision
TCA overdose physical findings
tachycardia, hypotension/orthostasis, fever, altered mental state, ileus, absent bowel sounds, rigidity, mydriasis
(consistent with anticholinergic toxidrome)
Antidepressants with lowest rate of sexual side effects.
buproprion (Wellbutrin), mirtazapine (Remeron), vilazodone (Viibryd)
typical vs atypical antipsychotics
typical blocks dopamine, atypical (2nd gen) blocks dopamine and decreases serotonin levels
4 dopamine pathways
mesolimbic, mesocortical, nigrostriatal, tuberoinfindibular
Which symptoms of schizophrenia is the mesolimbic pathway responsible for?
Positive symptoms (e.g. hallucinations).
Which symptoms of schizophrenia is the mesocortical pathway responsible for?
Negative symptoms (e.g. avolition, lack of spontaneity)
What symptoms do you get when you block dopamine function in the nigrostriatal pathway?
Parkinsonism (e.g. tremors, rigidity, postural instability)
What symptoms do you get when you block dopamine function in the tubuloinfindibular pathway?
Prolactinemia
How do typical antipsychotics works?
Block D2 receptors to reduce positive symptoms of schizophrenia but subsequently incr negative symptoms.
Major signs/symptoms of NMS (neuroleptic malignant syndrome).
delirium, muscle rigidity, elevated CK, myoglobinuria, fever
NMS treatment
aggressive cooling, dantrolene +/- bromocriptine
What medication can be used to reverse extrapyramidal symptom side effects?
anticholinergics (blocking acetylcholine)
ODD diagnostic criteria
pattern of negativistic, hostile, defiant behavior lasting at least 6 months, during which >= 4 are present:
- often loses temper
- often argues with adults
- actively defies or refuses to comply with adult instructions
- deliberately annoys people
- blames others for his or her mistakes/behaviour
- touchy or easily annoyed
- angry and resentful
- spiteful or vindictive
CD diagnostic criteria
repetitive, persistent pattern of behavior in which basic rights of others or major age-appropriate rules are violated with >= 3 of the following in the past 12 months and at least 1 in the past 6:
- aggression to people or animals
- destruction of property
- deceitfulness or theft
- serious violations of rules
Similarities between autism and ADHD.
inattention, hyperactivity, impulsivity, sensory processing difficulty, behavior problems, impaired social skills
Differences between autism and ADHD.
- communication usually more impaired with autism
- lack of “theory of mind” in autism (e.g. lack of empathy)
- ADHD usually better able to engage and connect with others
- ADHD would obviously respond better to stimulant medication
1st line ADHD treatment (two classes)
methylphenidate and dextroamphetamine
What is Zopiclone and what is it used for?
Zopiclone is a nonbenzo hypnotic agent used in the treatment of insomnia. It is a cyclopyrrolone, which increases the normal transmission of the neurotransmitter GABA in the CNS.
SAD PERSONS scale is for suicide risk assessment. What does the mnemonic stand for?
S: male sex A: age D: depression P: previous attempt E: excess EtOH/substance R: rational thinking loss S: social supports lacking O: organized plan N: no spouse S: sickness
alcohol abuse vs. dependence
Abuse is “harmful use” of alcohol whereas dependence is that plus a pattern of behaviors seeking alcohol (e.g. attending social functions only if alcohol is being served).
Treatment of mild to moderate dementia (AD).
cholinesterase inhibition (ChEI) (prevent breakdown of acetylcholine) e.g. donepezil, rivastigmine, galantamine
NPH vs. AD
NPH: magnetic gait (feet stuck to ground), dementia (more rapid onset), urinary incontinence
AD: don’t normally have balance problems, and incontinence
What is pedophilia?
Adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children, generally 11 or younger.
