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Flashcards in Psych + Derm Deck (24):
1

GAD
- time criteria
- trx

- >6 months
- SSRIs, CBT

2

Panic disorder
- sx, time criteria
- trx

- panic attacks, dread of future attacks, avoidance of >1 month
- abortive: benzos; longterm: SSRIs+CBT

3

OCD trx

High dose SSRI + CBT
- Clomipramine gold std but not freq used bc SEs

4

PTSD time criteria

> 1 month, if less = acute stress disorder

5

Major depressive disorder
- Criteria
- Trxq

- Low mood or anhedonia + 4 SAGECAPS
- Suicidal ideation; anhedonia; guilt; energy low; concentration low; appetite changes; psychomotor agitation or retardations; sleep changes
- Sx > 2 weeks
Trx: SSRIs + CBT

6

SSRIs
- SEs

- fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine
- SE: sexual dysfn, headache, nausea, diarrhea

7

SNRIs

- venlafaxine, desvenlafaxine, duloxetine, levomilancipam
- SE: similar to SSRIs, increased sweating and BP

8

TCAs

- pramines, tryptilines, doxepin
- SEs: anticholingergic, inc cardiac conduction time, orthostasis, sedation
- OD:convulsions, coma, cardiotoxicity --> give sodium bicarb

9

MAOIs

- phenlzine, isocarboxizid, tranylcypromine, selegeline
- SEs: weight gain, orthostasis, insomnia, hypertensive crisis with tyramine

10

Buproprion
- acts on
- Do not use with
- Sexual dysfn?

- NE and DA
- bulimics --> lowers seizure threshold
- low incidence of sexual dysfn

11

Mirtazipine
- acts on
- SEs
- good for

- serotonin and NE
- increased appetite and sleep
- cancer pts, palliative

12

Bipolar I

1 manic episode; maybe depressive episode
Mania = elevated mood + 3 DIGFAST (or 4 if only irritable) for >1 week

13

Bipolar II

hypomania + depressive episodes, >4 days

14

Acute reversal of benzos

flumazenil

15

Dysruptive Mood Dysregulation

Temper tantrums >12 months; doesn't make sense for age
Dx between 6 and 18 years old, sx have to start before age 10
Does not fit criteria for bipolar

16

Separation anxiety
- time

At least 4 weeks in kids, 6 months for adults
Normal up to age 6

17

Selective mutism
- time

>1 month

18

Oppositional defiant disorder

Angry/irritable mood and defiant/vindictive behavior vs authority figures for greater than 6 months

19

Schizophrenia
- criteria
- timeframe

2 or more of following:
1) delusions
2) hallucinations
3) disorganized speech
4) disorganized or catatonic behavior
5) negative sx (avolition, diminished emotions)

- <1 month = brief psychotic disorder
- 1-6 month = schizophreniform
- >6 months = schizophrenia

20

1st line trx for absence seizures

Ethosuximide

21

Side effects for
- phenytoin
- levetiracetam
- topiramate

- Phenytoin = gingival hyperplasia, midline cerebellar atrophy, drug-induced SLE
- Levetiracetam = rage, aggression "levetiragetam"
- Topiramate = fatigue and psychomotor slowing ("dope"iramate), kidney stones, weight loss

22

AIDS OIs
- CD4+ 200-500
- <200
- <50

- 200-500: Candida (oral thrush), EBV & papovavirus (oral hairy leukoplakia, herpes zoster, bartonella, HHV-8 (kaposi)
- <200: Toxoplasma, P.jiroveci, candida esophagitis
- <50: CMV (retinitis, esophagitis, colitis), MAC (cough+ fever+ fatigue, weight loss, pneumonia), PML (JC virus)

23

AIDS OI prophylaxis and trx

Prophlx
- <200: TMP-SMX for Toxo and PCP
- <50: azithromycin for MAC

Trx
- start restart HAART
- systemic antifungals (fluconazole) for candidiasis
- CMV: foscarnet, valganciclovir, ganciclovir

24

HIV trx

HAART/ART/cART = 2 NRTIs, and 1 NNRTI/Protease inhibitor/Integrase Inhibitor
- Protease inhibitors: ritonavir boosts effectiveness bc p450 inhibition; most have gluocorticoid SEs
- NRTIs: zidovudine for pregnant moms and general proph
- NNRTIs: all can cause rash and hepatotoxicity; efavirenz weird dreams
- integrase inhib
- fusion inhib