Psych

Question 1

Parkinsonian Disease Dementia

Answer 1

similar to Lewy Body Dementia, BUT parkinson symptoms of tremor and rigidity >1 yr precede the cognitive impairment

Question 2

Lewy Body Dementia

Answer 2

has to have >2 of the following 
visual hallucination 
parkinsonism (at the same time as dementia!) 
sleep disorder
fluctuating cognition

Question 3

progressive supranuclear palsy

Answer 3

falls
impaired gaze
parkinsonism
**very rare

Question 4

best treatment for ACUTE bipolar mania

Answer 4

1st of 2nd gen antipsychotics

olanzapine can be given IM and acts rapidly

Question 5

best treatment for ACUTE bipolar depression

Answer 5

Lamotrigine

DO NOT do an antidepressant in BPD

Question 6

delusion disorder

Answer 6

> /=1 delusion for >/= 1 month
there is lack of any other psychosis
aka pt is functioning normally otherwise

Question 7

Schitzophreniform vs Schitzophrenia

Answer 7

phreniform is >1 mo <6 mo

phrenia is >6 mo

Question 8

smoking cessation drugs

Answer 8

Varencycline
Buproprion
Nicotine aids

Question 9

PCP

Answer 9

= phencyclidine
side effects are hypertension, hyperthermia, muscle rigidity
causes hallucinations, nystagmus, and lack of pain sensation

Question 10

ADHD

Answer 10

inattention
and hyperactive/impulse symptoms
in >1 place

Question 11

whats dialectical behavioral therapy for?

Answer 11

BPD

Question 12

whats biofeedback therapy?

Answer 12

• therapy to get attuned to the physical symptoms like BP and HR and learn how to respond and control physiologic reactions

Question 13

psychodynamic psychotherapy

Answer 13

gain insight into past events and see how that effects events of today

Question 14

Aripripazole MOA

Answer 14

partial agonist and antagonist of D2.

Question 15

what drugs increase Lithium levels?

Answer 15

thiazides, ACEinhibitors, NSAIDs, metronidazole, tetracyclines

Question 16

Lithium toxicity symptoms?

Answer 16

GI distress 
tremor 
ataxia
agitation 
confusion

Question 17

serotonin syndrome vs NMS symptoms

Answer 17

serotonin- GI distress, muscular hyperactivity/reflexivity, low grade fever
NMS- muscular rigidity with low reflexes, HIGH fever

Question 18

Bipolar long term treatment

Answer 18

Lithium
Valproate
Qietapine
Lamotrigine

Question 19

how does Risperidone work?

Answer 19

antagonist of D2 and serotonin

Question 20

T/F Buproprion 1st line antidepressant?

Answer 20

YES

Question 21

catatonia treatment?

Answer 21

Benzodiazepine, then ECT if that doesnt work in one week

Question 22

schitzophrenia vs schitzoaffective vs Bipolar disorder

Answer 22

phrenia: psychotic features mainly with only few instances of psychotic w mood
affective: psychotic with mood disorder
BPD: never any psychotic features without mood

Question 23

bipolar disease long term pharmacotherapy

Answer 23

lithium or valproate

Question 24

olanzapine precautions

Answer 24

metabolic syndrome concern (similar to Clozapine)

check lipids, triglycerides, weight

Question 25

which psych med req close cbc monitoring

Answer 25

Clozapine | - concern for agranulocytosis

Question 26

treatment for acute dystonia

Answer 26

benzotropine | antihistamine

Question 27

treatment for akathesia

Answer 27

benzotropine lorazepam B Blocker

Question 28

treatment for drug induced parkinsonism

Answer 28

benzotropine | amantidine

Question 29

treatment for TD

Answer 29

Valbenazine

Question 30

schitzophrenia vs schitzophreniform

Answer 30

< 6 mo vs >6 mo

Question 31

to treat psychotic symptoms secondary to parkinson's drugs give what?

Answer 31

quietapine or clozapine or pimavanserin

Question 32

what is progresssive supranuclear palsy

Answer 32

falls, impaired vertical gaze, parkinsonism

Question 33

how to tell apart Lewy Body Dementia and PD Dementia

Answer 33

PD Dementia- the parkinsonian symptoms come before the dementia (>1 yr before) Lewy Body Dementia: both dementia and Parkinson sx without time gap in betwen

Question 34

somatic symptom vs illness anxiety

Answer 34

somatic symptom is concern and worry about 1+ unconcerning nonspecific sx illness anx is concern you are ILL even though you have minima sx

Question 35

OCD vs OCPD

Answer 35

OCD: true obsessions followed by compulsion which are distressing to pt OCPD: perfectionism to the point of ineffectiveness which are non distressing

Question 36

drinking cut offs for alcoholism

Answer 36

women or elderly men who drink >7 a week and >3 in a day | men <65 who drink >14 a week and >4 day

Question 37

nightmare disorder vs sleep terror disorder

Answer 37

nightmare happens in REM, pt remembers the dream, and is consolable sleep terror happens in Non-REM, pt does not remember the dream and is not consolable

Question 38

pediatric depression treatment

Answer 38

SSRI- fluoexetine | Buproprion is not first line or used frequently in pediatrics

Question 39

oppositional disorder vs conduct disorder

Answer 39

oppositional can PRECEDE conduct and is less severe. Conduct involves violating the rights of OTHERS

Question 40

seizure vs DT timeline in alc withdrawal

Answer 40

seizures in 24-48 hr | DT in 2-4 days

Question 41

why is Lorazepam preferred for stopping seizures over Diazepam and Chordiazepoxide

Answer 41

it is intermediate acting the others are long acting | it does not get metabolized by the liver

Question 42

abnormalities related to anorexia nervosa

Answer 42

hypercholesterolemia, hypercarotenemia, decreased bone mineral density, decreased HPO axis,

Question 43

acute bipolar depression tx

Answer 43

lurasidone, qeitiapine, lamotrigine

Question 44

patient on long term opioids must be seen how often

Answer 44

every 3 mo

Question 45

tx for post partum depression in breastfeeding mom

Answer 45

sertraline

Question 46

NMS pharm tx

Answer 46

stop antipsychotic | give amantidine or bromocriptine or dantrolene

Question 47

acute stress disorder vs PTSD timeframe

Answer 47

3 d-1 mo vs >1 mo

Question 48

SSRI with lowest cardiac risk

Answer 48

sertraline and escitalopram

Question 49

how long should someone be on ssri

Answer 49

if single episode of MDD, do 6 mo after acute phase if multiple episodes etc do 1-3 yrs if v serious with multiple suicide attemps to indefinitely

Question 50

what are the signs and symptoms of Li toxicity

Answer 50

GI distress tremor and fasciculation confusion and ataxia (nte the risk of this is increased with NSAIDs, ACEi, ibuprofen)

Question 51

which antidepressants can cause hypertension

Answer 51

SNRIs like Venlafaxine can cause DOSE dependent hypertension. at low doses serotonin affects predominate but as the dose increases norepinephrine effects increase

Question 52

how do you switch from an SSRI to an MAOi

Answer 52

stop SSRi for 2 wks minimum before starting MAOi reason being is that MAOi can inhibit the ox deamination of serotonin and increase its levels and cause serotonin syndrome

Question 53

symptoms of serotonin syndrome?

Answer 53

tachycardia, hyperreflexia, dilated pupils, tremor, hyperthermia, tremor

Question 54

MDD physiology

Answer 54

increased cortisol levels due to HPA hyperactivity

Question 55

lactate infusion sensitivity assn w what psych dx

Answer 55

Panic disorder

Question 56

medication tx for OCD

Answer 56

SSRI clomipramine

Question 57

what is anxiety re public speaking

Answer 57

it is a SOCIAL phobia not a specific phobia

Question 58

after what age is bedwetting pathological

Answer 58

>5 yo