Psych - Case Files, UW, etc. Flashcards Preview

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Flashcards in Psych - Case Files, UW, etc. Deck (102)
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1

What is the risk of recurrence of a major depressive episode if SSRIs or other treatments are discontinued?

50-85%

2

What are the major side effects of SSRIs?

GI sx (pain, nausea, diarrhea), sleep disturb (sedation or insomnia), tremor, dizzy, sex dysfunction

3

What is retinitis pigmentosa, and which psychiatric medication can cause this disorder?

Pigmentation of retina that may cause poor night vision

Side effect of first generation AP Thioridazine

4

What is an appropriate treatment of priapism from Trazadone?

Epinephrine injection into corpus of penis

5

What are contraindications for using bupropion?

Patients with eating or seizure disorder

6

What are symptoms of life threatening lithium overdose, and how do you best treat?

Seizures and coma

Dialysis to treat

7

What can be useful for excessive daytime sleepiness in shift workers?

Modafinil

8

What must be ruled out to make a diagnosis of schizophrenia?

Psychosis secondary to substance abuse and or general medical conditions

Schizoaffective DO and mood DO must be R/O

9

What symptom is most specific to a diagnosis of schizophrenia?

Bizarre delusions

10

What symptom is most specific to a diagnosis of schizophrenia?

Bizarre delusions

11

What is the immediate treatment for panic attacks? Long term treatment for panic disorder?

1. Short acting benzo (alprazolam) - discontinue after initial few weeks
2. SSRI + CBT

12

What is the definition of agoraphobia?

Anxiety about being in situations or places from which escape will be difficult, or in which help may not come if panic attack occurs

13

What differentiates social phobia vs. specific phobia?

Social phobia involves social or performance situations while specific involves a specific object or situation

14

How can ADHD be differentiated from hypo mania?

ADHD has distractibility, impulsivity and hyperactivity present on daily basis since age 7 (also look for preschool age sx)

And often oppositional defiant disorder and conduct disorder present

15

What needs to be monitored closely in patients taking lithium or carbamazepine?

Li - thyroid and kidney fxn

Carba - aplastic anemia or agranulocytosis

16

What mood stabilizers are a better option in young women of child bearing age?

Atypical APs - olanzapine risperidone seroquel

17

How can one differentiate schizoid PD from avoidant?

Avoidant find loneliness as ego-dystonic and strongly wish for relationships with others

Schizoid do not feel need for relationships at all

18

What defense mechanism is frequently seen in schizoid PD?

Intellectualization

19

What is the best course of therapy for major depression with psychotic features? (Especially in elderly with SI)

ECT

20

What medical conditions should raise caution before doing ECT?

Raised ICP, unstable angina, recent MI, electrolyte imbalance

21

What pharma tx can be given for anxiety associated with performance situation just before the feared situation?

Beta blockers - atenolol and propranolol

22

What are typical exam findings of PCP intoxication?

Angry, belligerent, dysarthria, vertical nystagmus

23

How does treatment for PCP intoxication vary based on the symptoms?

Benzodiazepines if psychotic symptoms not present

Haldol if severe psychosis but this may worsen anti-cholinergic side effects, hyperthermia, dystonia

24

What should be avoided in patients with generalized anxiety disorder?

Benzodiazepines, because habit forming and will make buspirone and to lesser extent SSRIs less effective

25

What are PANDAS?

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections

Include OCD and other disorders

26

What is the triad of wernicke encephalopathy?

Acute reversible triad of delirium, 6th nerve palsy, ataxia, caused by thiamine deficiency

27

What are the CAGE questions?

Have you attempted to Cut down on drinking, Annoyed by criticism, Guilty for drinking,Eye opener

Yes to 2 or more is sensitive for EtOh dependence

28

What is the most sensitive test for delirium and what will it show?

EEG, generalized slowing

If delirium by EtOH or sedative hypnotic withdrawal, can show fast low voltage activity

Hepatic encephalopathy - triphasic delta waves

29

How do depressed youth often present to their pediatrician?

Sudden onset anger and irritability, lack of interest in fun activities, low E, poor grades

30

What are the key features of OCPD and how do you differentiate from OCD?

INFLEXIBLE THINKING AND BEHAVIOR - Difficulty making decisions and finishing work, blames others for problems (egosyntonic), rigid and stubborn manner

w/ OCPD there are no intrusive repetitive thoughts or ritualistic behaviors as with OCD