Psych personality disorders and more

Question 1

Todds paralysis?

Answer 1

Postictal hemiparesis lasting 15 hours but no longer than 24

Question 2

Personality trait vs disorder?

Answer 2

Trait, means you still work well in society and able to function

Question 3

Cluster A?

Answer 3

NO PSYCHOSES!

Paranoid, Schizoid, Schizotypal

Question 4

Schizotypal?

Answer 4

Schizotypal goes to work dressed like a pickle

Eccentric odd beliefs/magical thinking

Question 5

Avoidant vs schizoid?

Answer 5

Avoidant want to relate to others but don’t know how.

Schizoid don’t care

Question 6

Cluster A tx?

Answer 6

Low dose antipsychotics if psychotherapy

Question 7

Treatment of personality disorder?

Answer 7

Psychotherapy

Question 8

DT symptoms?

Answer 8

Nihgtmares, agitation, disorientation, hallucinations, fever, htn…. EVENTUALLY SEIZURES or AUTONOMIC HYPERACTIVITY

Question 9

Wernicke korsakoff from what?

Answer 9

B1 thiamine deficiency. alcoholics. Mammallary bodies

Wernicke: confusion, ataxia and coma and DEATH

Korsakoff: Amnesia. Confabulation. Hallucinations

Question 10

How many do you need in CAGE questionnaire?

Answer 10

more than 1

Cut down. Annoyance. Guilt. Eye opener

Question 11

Intoxication of amp or cocaine intoxication?

WHAT DONT YOU GIVE?

Answer 11

Benzo and haloperidol if psychosis

Phentolamine is alpha 1 blocker can be used for htn.

DO NOT GIVE BETA BLOCKERS b/c beta 2 actually vasodilator a bit and beta blockers cause unopposed Alpha constriction

Question 12

Patient with nystagmus who is super violent is on what?

Answer 12

PCP

CALM THEN DOWN!!! bento and haloperidol

Question 13

Phentolamine is what?

Answer 13

Alpha blocker for cocaine

Question 14

Anorexia tx?

What is contraindicated?

Answer 14

Psychotherapy is tx

If depressed give SSRI, NO BUPRORPRIONe

Question 15

OCD tx?

Answer 15

CBT and ssri

Question 16

PTSD dirsturbance must last how long?

Answer 16

1 month!

Question 17

Tx of ptsd?

Nightmares?

Answer 17

PSYCHOTHERAPY and SSRI is only to work for it!!!

prazosin may improve sleep (alpha antagonist)

Bezos are abused! so don’t give them

Question 18

Acute stress disorder is different than PTSD how?

Answer 18

less than one month!

Question 19

What is adjustment disorder? Timeline?

Answer 19

emotional response to stressor.

MUST BEGIN WITHIN 3 months then must resolve within 6 months

Must be start within 3 months of stressor and gone after 6 months of the disappearance of the stressor

Question 20

Conversion disorder?

Answer 20

V for Voltage

Motor symptoms or sensory symptoms without neuro or medical cause

Question 21

What is somatic symptom disorder?

Answer 21

Some symptoms possible but SUPER WORRIED ABOUT IT AND WAYYYY PREOCCUPIED about it

patients bring detailed notes

Question 22

factitious vs malingering

Answer 22

factitcious may be hurting themselves!

malingering is for a reward!

Question 23

ADHD dx

Answer 23

6 inattention or 6 hyperactivity before age 12 with questionnaires from parents and 2 other people

Question 24

Tx if stimulants failed in ADHD?

Answer 24

TCA Bupropion or CLONIDINE alpha 2 antagonist

Question 25

Stimulants for ADHD effect on height?

Answer 25

Growth delayed, but adult height not affected

Question 26

Risk with atomoxetine?

Answer 26

Risk of suicidality

Question 27

Tx for tourette?

Answer 27

Counseling to adjust fluphenazine, pimozide, tetrabenazine (dopa antagonists, haloperidol not tolerated well) SSRI or clonidine helps impulses

Question 28

learning disability is different than intellectual disability

Answer 28

Intellectual is with all, learning is specific things

Question 29

Autism signs early on?

Answer 29

"Living in their own world. Lack of responsiveness to others with poor eye contact and absence of social smile...) repititions

Question 30

DT is what vitally?

Answer 30

vital signs unstable!!! Alcoholic hallucination is vitally stable

Question 31

How do you remember DPP4 inhibitors?

Answer 31

Only ones with p's in them consistently GLIPTINS!

Question 32

Other Metformin mechanism?

Answer 32

Increased sensitivity to insulin kinda!

Question 33

KUSSMAUL breathing associated with DKA

Answer 33

Deep labored breathing to blow off CO2

Question 34

Potassium status in DKA?

Answer 34

Serum level measured high, but total level is actually low (dehydrated and extracellular shift) K and H+ shift b/c acidosis

Question 35

DKA tx? What do you do about KCl?

Answer 35

``` ICU IV fluids! Lots of it, 2 X IV amount IV insulin KCl IV glucose if needed ``` DO NOT STOP just b/c glucose is normal

Question 36

When do you stop insulin drip in DKA?

Answer 36

When anion gap back to 10-12

Question 37

HHNS is what?

Answer 37

Hyperosmolar hyperglycemic nonketotic state. from not enough insulin, but enough to prevent ketoacidosis Hyperosmolar and dehydrated

Question 38

Workup for cause of DKA includes what?

Answer 38

Infectin: Culture, UA, CXR To screen Pancreatitis: amylase or lipase Evaluate for MI

Question 39

TCA overdose symptoms?

Answer 39

Cardiotox: wide QRS or tacky CNS toxicity Anticholinergic

Question 40

Anterior 2/3 of tongue taste? Monitors chemo and baroreceptors?

Answer 40

VII CN IX

Question 41

2 types of diabetic retinopathy. | Findings? Which is worse.

Answer 41

Nonprolif has cotton wool spots/exudates. (MORE COMMON, LESS SEVERE) Proliferative has proliferation of vascularization. Can see hemmorhages which causes blindness

Question 42

Tx for proliferative retinopathy?

Answer 42

Laser photocoag to stop hemorrhage of neovascularture

Question 43

Diabetic nephropathy is what? WHAT IS ON biopsy? How do you screen?

Answer 43

glomerular sclerosis b/c expansion of mesangial matrix See kimmelstiel wilson nodules Screen for microablumin in urine

Question 44

Most common neuropathies with DM?

Answer 44

Sensory, then motor and then autonomic

Question 45

Charcot joint?

Answer 45

Arthropathy from chronic repetitive trauma. Think DM or tabes dorsalis