Psych Flashcards Preview

Step 2 > Psych > Flashcards

Flashcards in Psych Deck (40):
1

A patient has had a depressed mood more often than not for the last 2yrs, but has not had any major depressive episodes. What is the likely diagnosis? What is the concern?

Dysthymic disorder

Develop MDD (76%)
Develop bipolar disorder (13%)

2

What are examples of SSRIs?

Fluoxetine
Sertraline
Paroxetine
Citalopram
Escitalopram

3

What significant side effects are associated with SSRIs?

Sexual dysfunction
Decreased platelet aggregation
Blackbox warning

4

What are examples of SNRIs? When are they used? What are significant side effects?

Venlafaxine and duloxetine

First-line for depression + comorbid neurologic pain
Second-line for depression that doesn't respond to SSRI

Nausea, dizziness, insomnia, sedation, constipation, HTN...more benign than TCAs

5

What are examples of TCAs?

Imipramine
Amitriptyline
Desipramine
Nortriptyline

6

What are significant side effects of TCAs?

Easy to OD...causes prolonged QT
sedation, wt. gain, sexual dysfunction, anticholinergic symptoms

7

What are examples of MAOIs?

Phenelzine
Isocarboxazid
Tranylcypromine
Selegiline

8

What are significant side effects of MAOIs?

Dry mouth, indegestion, dizziness
Tyramine (cheese, aged meats, beer) --> HTN crisis

9

How does bupropion work? What is nice about it?

Inhibits uptake of dopamine and NE

Doesn't cause sexual dysfunction

10

What can be used to treat depression with significant insomnia?

Trazodone...does something with serotonin
Mirtazapine...blocks alpha2-receptors and serotonin receptors --> increaseed adrenergic neurotransmission

11

What is the major difference between 'manic' and 'hypomanic'?

Manic --> significant impairment of ability to function
Hypomanic --> no significant impairment of ability to function

12

What is cyclothymia?

Rapid cycling of hypomania and mild depression lasting longer than 2 years with no normal mood lasting longer than 2 months

13

What is a big difference between 'bereavement' and 'adjustment disorder'?

Bereavement does not impair one's ability to function
Adjustment disorder causes a significant impairment of ability to function

14

What psychotic disorder is increased in patients with mitral valve prolapse?

Panic disorder

15

What drug is used for anxiety disorders when abuse or sedation is a concern?

Buspirone...does something with dopamine and serotonin receptors

16

What is a potential concern for the kid of a woman who was malnourished or ill during pregnancy?

Schizophrenia

17

What is necessary to diagnose schizophrenia?

2 or more of the following for at least 1 month in the last 6 + impaired social function for at least 6 months

Delusions, hallucinations (auditory), disorganized speech, disorganized or catatonic behavior...these make up the "positive symptoms"
Or negative symptoms: social withdrawal, flat affect, apathy, anhedonia, or lack of motivation

18

What are examples of atypical antipsychotics?

Clozapine, olanzapine, quetiapine
Risperidone, ziprasidone, paliperidone
Sertindole
Aripiprazole

19

How do Atypical antipsychotics work? What are significant side effects?

Block dopamine and serotonin receptors

Anticholinergic effects, weight gain, arrhythmias, seizures

20

Which atypical antipsychotic is most effective?

Clozapine...but causes agranulocytosis...so only for refractory psychosis

21

What are examples of high-potency neuroleptics?

Haloperidol, droperidol
Fluphenzine, perphenazine, trifluoperazine
Loxapine
Thiothixene

22

How do high-potency neuroleptics work? When are they used? What are significant side effects?

Block D2 dopamine receptors

Emergency control of psychosis or agitation
Strong positive symptoms

Extrapyramidal effects
Tardive dyskinesia
Neuroleptic malignant syndrome

23

What are the low-potency neuroleptics? What significant side effects do they have?

Thioridazine, chlorpromazine

Anticholinergic effects...some is seen with high-potency, but not as much

24

What is schizophreniform?

Symptoms of schizophrenia, but has lasted longer than 1 month and less than 6 months

Return to normal after psychotic episode...often develop true schizophrenia later

25

What is schizoaffective disorder?

Presence of mood disorder an psychotic symptoms...but does not meet criteria for either diagnosis alone

Psychotic symptoms happen during normal mood for longer than 2 weeks

Treat both disorders

26

What is delusional disorder?

One or more distinct realistic delusions lasting longer than 1 month

If it is an unrealistic delusion, then it is either schizophreniform or schizophrenia

27

What is it called when psychotic symptoms last less than a month?

Brief psychotic disorder

28

A patient has signs of a personality disorder, but can function normally in society. What does this person have?

Personality trait

29

There are three clusters of personality disorders. How are they broadly classified?

A = weird
B = wild
C = wimpy/worried

30

What are the three cluster A disorders?

Paranoid
Schizoid- negative symptoms of schizophrenia
Schiotypal- paranoia, eccentric and inappropriate behavior, social anxiety, odd beliefs

31

What are the four cluster B disorders?

Antisocial- aggressive to people/animals; no remorse; men
Borderline- fear of abandonment; splitting (all good or all bad); women
Histrionic- Dire need for attention; believes relationships are more intimate than they are
Narcissistic

32

What are the three cluster C disorders?

Avoidant
Dependent
Obsessive-compulsive- perfectionist

33

How long does a person have to have a preoccupation with fear of having a serious illness before being diagnosed with hypochondriasis?

6 months

34

How does fibromyalgia differ from conversion disorder and pain disorder?

Conversion disorder and pain disorder are related to stressful events

35

A patient develops a pain after a stressful situation, but no specific injury. Are analgesics likely to help?

Not if it is true pain disorder

36

What should NOT be used to treat delirium or dementia related agitation?

Benzos or anticholinergics

37

What is required to diagnose ADHD?

6 inattentive symptoms OR 6 hyperactivity or impulsivity symptoms BEFORE 7yo that limit ability to function

38

What is required to diagnose Conduct Disorder?

Aggressive behavior to people or animals
Destruction of property
Deceitfulness/theft
Violation of serious rules

1+ above if less than 10yo
3+ above if more than 10yo

39

What is difference between Conduct Disorder and Oppositional Defiant Disorder?

ODD does NOT have illegal or destructive activity

40

What is required to diagnose Tourette Syndrome?

Tics last longer than 1 yr and start before 21yo

Coprolalia (obscene tics) is seen in 40% of cases