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Flashcards in Psych Deck (67):
1

Hallucinations of recently deceased relatives is:

Normal for children

2

Discontinuation of MAOi (washout period)

Give 2 weeks of discontinuing MAOi before giving an SSRI to allow for MAO regeneration to prevent serotonin syndrome

3

Kleine Levin

sleeping beauty syndrome, hypersomnia, hyperphagia, hypersexuality

4

Kluver Bucy

hyperphagia, hypersexuality

5

Neuroleptic Malignant Syndrome

- Hyperthermia, muscle rigidity, rhabdomyolisis, mental status changes, muscle rigidity, and autonomic dysfunction
- Antipsychotics that block D2 (dopamine) receptors

6

Antidepressant Intoxication

MC cause of death is arrhythmia (sodium channel inhibition)

7

Treat Serotonin Syndrome w/

Cyproheptadine

8

Lithium Toxicity

w/ thiazide diuretics (not loop), ACE inhibitors, and NSAIDs
- Increased proximal tubular resorption of Lithium and Sodium
- Lithium can cause hypothyroidism and nephrogenic DI

9

TCA Toxicity

can cause arrhythmias → treat with NaHCO3

10

MAO inhibitors used for:

atypical depression (mood reactivity) and treatment resistant depression

11

Schizoaffective DIsorder

Psychotic episodes NOT during mood disturbances
- DIFFERENT from bipolar with psychotic symptoms (where psychotic sx only during mood episodes)

12

Tremors, agitation, anxiety, delirium, psychosis, seizures, tachycardia, palpitations,

Alcohol Withdrawal

13

Tremor, anxiety, perceptual disturbances, insomnia

Benzodiazapine Withdrawal

14

Dilated pupils, yawning, lacrimation, nausea, vomiting, abdominal pain, muscle aches

Heroin Withdrawal

15

Increased appetite, hypersomnia, intense psychomotor retardation, "crash"

Cocaine or Amphetamine Withdrawal

16

Increased appetite, irritable, anxious

Nicotine withdrawal

17

Respiratory and Cardiac depression, miosis, sedation, reduced GI motiliy

Opioid intoxication

18

Low Potency vs High Potency Typical Antipsychotics

High: Haloperidol, Fluphenazine, Trifluoperizine
- more extrapyramidal Sx
Low: Thioridazine, Chlorpromazine
- sedation, orthostatic hypotension, and antichol effects

19

Classical vs Operant Conditioning

Classical: involuntary response
Operant: voluntary response

20

ADHD

Before age 12
Tx: methylphenidate (ritalin), amphetamines, atomoxetine

21

Tourette's

Usually age 7-9 (Onset before age 18 usually)
motor and vocal tics > 1 yr
(coprolalia is if its obscene speech)
- aw/ OCD and ADHD
- Tx: antipsychotics (haloperidol), pimozide

22

Separation Anxiety Disorder

7-9 yrs
SSRIs, or relaxation techniques/behavioral interventions

23

Rett Disorder

Almost exclusively girls (1-4 yrs) [males die in utero]
X-linked
regression and stereotyped hand wringing

24

Orientation: Order of loss

Time then Place then Person

25

Manic Episode

at least 1 week

26

Hypomania Episode

at least 4 consecutive days

27

Bipolar I

1 manic +/- a hypomanic or depressive episode

28

Bipolar II

hypomanic + depressive
- use of antidepressants may cause increased mania

29

Cyclothymic Disorder

dysthymia + hypomania
at least 2 yrs

30

Dysthymia

at least 2 years

31

Major Depressive Disorder

at least 2 weeks

32

Sleep in Depression

Increased total REM (decreased REM latency)
Early morning awakenings
Less slow wave sleep

33

Postpartum Blues vs Postpartum Depression

Blues should resolve within 10 days
PPD lasts over 2 weeks (hopeless, guilty, etc)
[Postpartum psychosis may last 4-6 weeks]

34

Normal Bereavement

up to 6-12 months

35

Electroconvulsive Therapy

Safe for treating depression in pregnant women
- temporary headache and partial amnesia that resolves in 6 months

36

Risks of Suicide

Male, teen or elderly, depression, previous attempt, access to firearms, chronic illness/meds, organized plan, unmarried or no social support

37

Panic Disorder

Attack followed by 1 month or more of:
- persistent concern about additional attacks
- worry about consequences of attack
- behavioral changes related to attack

38

Generalized Anxiety Disorder vs Adjustment Disorder

GAD >6 months
Adjustment:

39

Acute Stress Disorder

Less than one month

40

PTSD

> 1 month

41

Tx: OCD

SSRI, Clomipramine

42

Conversion Disorder

La belle indifference
sudden loss of sensory or motor function (paralysis, blindness, mutism, seizure) after an acute stressor

43

Personality Disorders

A: Eccentric
B: Dramatic
C: Anxious

44

Suboxone= Naloxone + Buprenorphine

Naloxone is not active orally (prevents withdrawal if injected)
Buprenorphine: partial agonist

45

Naltrexone

Long acting opioid antagonists to prevent relapse once detoxified

46

Disulfiram

Inhibits acetaldehyde dehydrogenase --> increasing hangover sx

47

Chlorpromazine: specific side effect

corneal deposits

48

Thioridazine: specific side effect

retinal deposits

49

Haloperidol, Trifluoperizine, fluphenazine thioridazine, chlorpromazine

Typical Antipsychotics (neuroleptics) (block D2 receptors)

50

Olanzapine, Clozapine, Quetiapine, Risperidone, Aripiprazole, Ziprasidone

Atypical Antipsychotics (block DA and 5HT receptors)

51

Adjuncts for depression

Clozapine, quetiapine, aripiprazole

52

Weight gain

Olanzapine and Clozapine (also agranulocytosis)

53

Lithium Toxicity

Increased with thiazide diuretics, ACE inhibitors and ARBs
Follows Na+

54

Buspirone

5HT1A partial agonist (no sedation, addition, or tolerance)
2 weeks for effect
no interaction with alcohol

55

Fluoxetine, Paroxetine, Sertraline, Citalopram

SSRIs (5HT reuptake inhibitors)
4-8 weeks for effect

56

Venlafaxine and Duloxetine

SNRI (5HT and NE reuptake inhibitors)
Venlafaxine: depression, GAD, panic disorders
Duloxetine: depression and also diabetic neuropathy

57

Amitriptyline, nortriptylne, imipramine, desipramine, clomipramine, doxepine, amoxapine

TCAs (5HT and NE reuptake inhibitors)
- major depression, OCD (clomipramine), fibromyalgia

58

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline

MAOi
atypical depression, anxiety, hypochondriasis
- side effect: hypertensive crisis w/ tyramine ingestion
- Contraindicated w/: SSRI, TCA, St Johns Wort, Meperidine, and dextromethorophan to prevent serotonin syndrome

59

Bupropion, Mirtazapine, Trazodone

Atypical Antidepressants
Bupropion: also for smoking (increased NE and DA); no sexual side effects
Mirtazapine: helps w/ insomnia (a2-antagonist/ increased NE and 5HT)
Trazodone: insomnia also (blocks 5HT2 and a1-adrenergic receptors); side effect: priapism

60

Aggression, Nystagmus, ataxia, dissociation

PCP

61

Visual hallucination, euphoria, tachycardia, panic

LSD

62

Chest pain, seizures, mydriasis, agitation, euphoria

Cocaine

63

Conjunctival injection, increased appetite, tachycardia, dry mouth,

Marijuana

64

Tooth decay, violent, psychosis, diaphoresis

Methamphetamine

65

Tx for TCA Overdose

Sodium Bicarbonate
- corrects cardiac problems caused by TCAs

66

6 Year Olds idea of Death

- typically understand the finality of death
[Infants have no understanding, whereas preschool age children often think of deaths in reversible or metaphorical terms]

67

Tx of Acute Anxiety

Benzodiazepines (including alprazolam aka Xanax) are effective at treating anxiety conditions
- use should be limited to bridge therapy awaiting the efficacy of safer less habit-forming maintenance medications like SSRIs and buspirone