Psych JB

Question 1

ADHD sx

Answer 1

sx before age 12 and present for at least 6mo
sx occur in 2 settings

Question 2

ADHD tx

Answer 2

behavior modification
stimulants TOC (Ritalin, adrenal, Focalin)
non stimulants: Strattera, SNRI

Question 3

Electroconvulsive therapy AE

Answer 3

short term memory loss
increased HR and BP during procedure
HA, N, muscle aches, disorientation, confusion, fatigue

Question 4

agoraphobia tx

Answer 4

SSRI
SNRI
psychotherapy: combo of exposure therapy, relaxation, and breathing training

Question 5

alcohol withdrawal tx

Answer 5

IV benzo, IV fluids
IV thiamine and mg (before glucose)
multivitamin (+ B12 and folate)
dextrose
avoid meds that decrease seizure threshold (buproprion, haloperidol, anticonvulsants, clonidine, BB)

Question 6

anorexia nervosa dx and labs

Answer 6

BMI <17.5 or body weight <85 the ideal weight
labs: leukopenia, leukocytosis, anemia, hypoK, increased BUN (dehydration), hypothyroidism, osteopenia, osteoporosis

Question 7

anorexia nervosa tx

Answer 7

hospitalization for <75 expected weight or complications
psychotherapy: CBT, supervised meals, weight monitoring

Question 8

anorexia nervosa tx

Answer 8

depression: SSRI, atypical antipsychotics
no buproprion w/ eating disorders or seizures
calcium, vit D, estrogen

Question 9

antisocial personality disorder sx

Answer 9

> 18yo
may commit criminal acts without regard to laws
lack of empathy

Question 10

bipolar disorder I criteria

Answer 10

> 1 manic (1w) or mixed episode with often cycles depressive episodes.

Question 11

bipolar disorder II criteria

Answer 11

> 1 hypomanic episode (4d) + >1 major depressive episode. mania or mixed episodes absent

Question 12

strongest risk factor in bipolar disorder

Answer 12

family hx, first degree relative

Question 13

bipolar disorder tx

Answer 13

mood stabilizer: lithium 1st line
valpropc acid, carbamazepine, olanzapine,
haloperidol, benzo for psychosis or agitation
ECT

Question 14

brief psychotic disorder

Answer 14

> 1 psychotic sx w/ onset and remission <1mo

Question 15

bulimia nervosa labs

Answer 15

hypoK
hypoMg
normal/overweight
metabolic alkalosis (from vomiting)

Question 16

bulimia nervosa PE

Answer 16

Russel’s sign: calluses on dorsum of hands
teeth pitting/enamel erosion

Question 17

bulimia nervosa tx

Answer 17

CBT and fluoxetine

Question 18

cocaine abuse tx

Answer 18

benzo +/- antipsychotics (halperidol) for agitation

Question 19

dissociative fugue tx

Answer 19

psychotherapy

Question 20

analgesics overdose sx

Answer 20

respiratory depression, miosis
stupor, hepatic injury, hypoxemia

Question 21

illness anxiety disorder sx

Answer 21

hypochondriasis
fear or belief that one has or will contract a serious undiagnosed disease
>6mo sx, somatic sx not present

Question 22

Major depressive disorder sx

Answer 22

> 5 almost every day for most days for at least 2 weeks
Sleep disturbances
Interests
Guilt
Energy
Concentration
Appetite
Psychomotor
Suicide

Question 23

major depressive disorder tx

Answer 23

CBT
SSRI

Question 24

nicotine dependence tx

Answer 24

CBT + OTC gum, nasal spray, patch
buproprion
varencicline

Question 25

OCD sx

Answer 25

obsessions: recurrent and persistent thoughts and images compulsions: repetitive behaviors that they feel driven to perform

Question 26

OCD tx

Answer 26

CBT SSRI (fluoxetine), SNRI (venlafaxine)

Question 27

panic disorder sx

Answer 27

recurrent unexpected panic attacks + 1mo of persistent worry for another panic attack

Question 28

panic disorder tx

Answer 28

long term: SSRI 1st line, CBT Acute attack: benzo

Question 29

postoperative psychosis sx

Answer 29

patient w/ recent hx of surgery that needed anesthesia

Question 30

postpartum depression tx

Answer 30

SSRI brexanolone (FDA approved)

Question 31

psychogenic polydipsia labs

Answer 31

urine specific gravity 1.005 low sodium

Question 32

psychosis tx

Answer 32

2nd gen antipsychotics 1st line (risperidone, olanzapine, quetiapine) clozapine for refractory cases 1st gen antipsychotics for + sx but associated with extrapyramidal sx

Question 33

schizoaffective disorder sx

Answer 33

schizophrenia + mood disturbance (MMD/manic episode)

Question 34

schizophrenia criteria

Answer 34

>6mo w/ 1mo of acute sx along with functional decline

Question 35

schizophrenia tx

Answer 35

hospital for acute psychotic episodes 2nd gen antipsychotics 1st line (risperidone, olanzapine, quetiapine) clozapine for refractory cases 1st gen antipsychotics better for + sx

Question 36

schizophreniform disorder sx

Answer 36

criteria for schizophrenia but <6mo

Question 37

shaken baby syndrome sx

Answer 37

bilateral retinal hemorrhage, failure to thrive diffuse brain injury, poor feeding blunt head trauma seizure

Question 38

somatic symptom disorder sx

Answer 38

patient has physical symptoms involving >1 part of the body but no physical cause can be found

Question 39

ecstasy abuse sx

Answer 39

HTN, tachycardia, hyperthermia, hyponatriemia (increased fluid intake) neuro sx (confusion, seizure, cerebral edema) hepatotoxicity (jaundice, abd pain, N/V, increased bill, increased AST/ALT)

Question 40

nicotine substance disorder sx

Answer 40

yellowing of fingers/nails smell of nicotine on hair and clothes agitation to withdraw weight gain if attempting to stop

Question 41

tardive dyskinesia tx

Answer 41

switch to 2nd gen antipsychotic deutetrabenazine valbenazine