Psych Shelf Flashcards
(222 cards)
1
Q
Screening tool for dementia
A
Folstein MMSE
2
Q
Test that acts friends and relatives to report individual’s function
A
Blessed rating scale
3
Q
Test to assess executive function
A
WCST (wisc card sorting test)
4
Q
Executive functions are localized to this lobe in the brain and are often affected in individuals with —
A
Frontal, schizophrenia
5
Q
IQ calcuation
A
mental age/chronological age x100
6
Q
test to assess visual nonverbal memory
A
rey-osterrieth test that asks pt to copy complex figure with it in front of them and then from memory
7
Q
rey-osterrieth test result: pt can’t copy figure correctly
A
R parietal lobe lesion – L visual field neglect
8
Q
rey-osterrieth test result: pt can’t copy figure from memory
A
R temporal lobe lesion
9
Q
Transference vs countertrans
A
Transferring emotions from one’s past onto another. For trans it’s patient onto therapist and other way around for counter
10
Q
akathisia
A
motor and mental restlessness; SE of FGA
11
Q
dystonia
A
musc rigidity and spasticity; SE of FGA
12
Q
tests for concentration
A
serial 7s, spelling world backwards, random letter test
13
Q
Repetition of obscene words sometimes in Tourette
A
coprolalia
14
Q
What’s most common psych emergency in kids and adolescents?
A
suicidal behavior
15
Q
What’s most common way kids/teens attempt suicide?
A
drug OD
16
Q
What’s most common way kids/teens commit suicide?
A
firearms
17
Q
What med is used to treat enuresis?
A
DDVAP
18
Q
Side effects of DDVAP
A
HA and nausea
19
Q
SEs of fluoxetine
A
GI, insomnia, agitation, HAs
20
Q
Condition with deceleration of head growth, loss of coordination, and developmental delay starting after 5 months
A
Rett’s
21
Q
First line medication for tourette
A
Alpha 2 agonist: guanfacine, clonidine
22
Q
Most common initial sx’s for tourettes
A
Eye tics
23
Q
type of tics in tourettes
A
Must have motor and verbal although not necessarily simultaneously
24
Q
What’s most common predisposing factor for mental retardation?
A
Early alterations in embyronic development (can be due to chrom changes or toxins)
25
Axis I
psych disorders exc Axis II ones
26
Axis II
intellec disab and personality do's
27
Axis III
medical dos
28
Axis IV
psychosocial and envi probs
29
Axis V
global assessment functioning
30
What meds can increase risk of tics?
stimulants
31
Enuresis is more common
in boys than girls that are otherwise healthy
32
At what age can normal child copy circle?
2
33
At what age can normal child copy square?
5
34
At what age can normal child tell you age and gender?
3
35
At what age can normal child ride tricycle?
3
36
At what age can normal child ID left hand?
5
37
Treatment for NMS
Dantrolene and bromocriptine or amantadine
38
Catatonia sx's
stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerism stereotypy, agitation, grimacing, echolalia (repeats words), echopraxia (repeats behavior)
39
delusion that familiar ppl have been replaced by impostors
capgras
40
antipsychotics available in long acting injectable form
haloperidol and fluphenazine
41
Factors favoring good outcome in schizophrenia
Age onset 20-25, married, good premorbid social and work hx, triggering event, rapid onset
42
Factors favoring poor outcome in schizophrena
Age<20, insidious onset, lack of precipt factors, poor premorbid hx, negative sx's, social isolation, fam hx of schizophrenia
43
Drugs that induce psychosis
amphetamines, PCP, LSD
44
Prevalence of schizophrenia
0.3-0.7%
45
Malingering
feigning sx's for personal gain with external motivation (like avoiding legal issues, getting room and board, receiving monetary compensation)
46
Factitious disorder
feigning sx's for personal gain with internal motivation to assume sick role
47
hallucination of transparent phantom of one's body
autoscopic psychosis
48
delusion that you're a werewolf or other animal
lycanthropy
49
false perception of having lost everything ie money, strength, health, organs
cotard syndrome
50
one person develops psychotic sx's similar to one that partner has
folie a deux
51
First line med for mania
valproic acid
52
In what time range does pt develop depression after stroke?
Usually within 6 mos
53
cyclothymic disorder
recurrent periods of mild depression and hypomania present for at least 2 years
54
Tests to monitor lithium
plasma levels, thyroid, creatinine, urinalysis, CBC, electrolytes
55
Treatment for premenstrual dysphoric disorder
SSRIs and OCPs
56
phobia desensitization by pairing feared stimulus with anti-anxiety behavior
reciprocal inhibition
57
operant conditioning
learning through rewards and punishments (Skinner)
58
polysymptomatic syndrome in which pts are chronically sick and get several surgeries but no organic cause
somatic sx disorder
59
interpretation, clarification, and confrontation are used in what type of therapy
psychoanalytic psychother
60
patient presents acutely with blindness with no explainable cause
conversion disorder
61
pt is intensely afraid of getting sick and has distorted interpretation of sx
illness anxiety disorder
62
med to treat narcoplepsy
modafinil
63
pt has lots of time and memory gaps including autobio details
dissociative identity
64
pharm treatment for OCD
clomipramine (TCA), SSRIs (high dose)--fluvoxamine
65
treatment for PTSD
CBT, SSRIs, prazosin for nightmares
66
pharm for panic do
SSRI + benzo initially until SSRI effect sets in
67
sudden onset of REM sleep
narcolepsy
68
REM sleep behavior disorder vs narcolepsy
pts act out dreams as opposed to paralysis in narc
69
med to treat narcoplepsy
modafinil
70
patient is unaware that they move legs at night
periodic limb movement disorder
71
patient feels pain and need to move legs
restless leg syndrome
72
treatment for PTSD
CBT, SSRIs, prazosin for nightmares
73
Pharm to treat tardive dyskin
valbenazine
74
drugs abused that lead to brief euphoria, loss of consciousness, perioral skin changes
inhalants
75
treatment for GAD
CBT and SSRIs (buspirone is also an option)
76
EPS: dyskinesia of mouth, tongue, extremities that develops months after starting meds
tardive dyskinesia
77
antidepressant assoc with dose depend HTN
venlafaxine
78
Pharm to treat akathisia
beta block (propanolol), benzo, benztropine
79
narcolepsy sx's
cataplexy (loss of musc tone), shortened REM phases, hypnagogic (falling asleep) and pompic (waking up) halluc
80
Pharm to treat tardive dyskin
valbenazine
81
drugs abused that lead to brief euphoria, loss of consciousness, perioral skin changes
inhalants
82
withdrawal sx's of irritability and incr appetite
nicotine
83
drug intox that presents with agitation, aggression, psychosis, nystagmus, ataxia
PCP
84
antidepressant assoc with dose depend HTN
venlafaxine
85
long term treatment for panic disorder
CBT and SSRIs
86
narcolepsy sx's
cataplexy (loss of musc tone), shortened REM phases, hypnagogic and pompic halluc
87
withdrawal sx's incl seizure
alc and benzos
88
withdrawal sx's of pyschomotor retardation and severe depr
stimulants
89
withdrawal sx's of irritability and incr appetite
nicotine
90
abnormal cortico-striato-thalamo-cortical circuits in which disorder
OCD
91
hypercortisol seen in
MDD (hyperact of HPA axis)
92
pharm for panic d/o
SSRI + benzo (use initially until SSRI kicks in)
93
decreased hippocampal and frontal lobe volumes seen in
MDD
94
patient presents acutely with blindness with no explainable cause
conversion d/o
95
pt is intensely afraid of getting sick and has distorted interpretation of sx
illness anxiety d/o
96
polysymptomatic syndrome in which pts are chronically sick and get several surgeries but no organic cause
somatic symptom d/o
97
pt has lots of time and memory gaps including autobio details
dissociative identity
98
lithium toxicity
GI, confusion, ataxia, tremor
99
pharm for panic d/o
SSRI + benzo (use initially until SSRI kicks in)
100
NMS
fever, musc rigidity, autonom instability, delirium
101
antichol effects
dilated pupils, hyperthermia, flushed, dry skin, intestinal ileus
102
new onset neuropsych sx's and unexplained ab pain
acute intermittent porphyria
103
effect of tuberoinfundibular
control of prolactin; antag leads to galac and sex dysfunc
104
length of time for major depr episode
>2 weeksli
105
cocaine withdrawal
depression, hypersomnia, hyperphagia, fatigue, impaired conc, incr dreaming
106
lithium clearance
renal
107
NMS
fever, musc rigidity, autonom instability, delirium
108
effect of mesolimbic pathway
psychosis
109
effect of nigostriatal pathway
movement; antag leads to EPS
110
effect of tuberoinfundibular
control of prolactin; antag leads to galac and sex dysfunc
111
risk factors for suicide
SAD PERSONS: sex, age, depr, previous attempt, EtOH, rational thought loss, social support lack, organized plan, no spouse, sickness
112
cocaine withdrawal
depression, hypersomnia, hyperphagia, fatigue, impaired conc, incr dreaming
113
nightmare d/o vs sleep terrors
nightmare: recurrent awakenings from REM with alertness and recall; terror: non-REM with partial arousal, unresponsiveness and no recall
114
meds to treat NMS
dantrolene, dopa agonists (bromocriptine, amantadine) and benzos
115
first line treatment for atypical depr
MAOIs
116
Long acting BDZ
diazepam (valium) and clonazepam
117
Intermed acting BDZ
alprazolam (xanax), lorazepam, oxazepam, temazepam
118
Short acting BDZ
triazolam, midazolam
119
BDZs not met'd by liver
LOT: loraz, oxaze, temaze
120
sexual se of SSRIs in women
anorgasmia
121
first and second line treat for tourette's
1) haloperidol 2) alpha2ag
122
pharm for bulimia
fluoxetine
123
ECG changes with lithium
flattening or inversion of T wave
124
class of antidepressant that has orthostat hypotens as SE
TCAs
125
antidepressant that can cause withdrawal symptom in 2 days
paroxetine
126
antipsych available in depot form
haloperidol and risperidone
127
amantadine can be used to treat
NMS and parkinsonism
128
relative contrainds for ECT
MI within 6 months and intracranial space occupying lesion
129
What drug reduces suicidality in pts with schiz?
clozapine
130
What drug reduces suicidality in pts with bipolar?
lithium
131
spasm of neck and back that causes pt to arch
opisthotonos
132
neck spasm that brings neck to one side
torticollis
133
feeling of bugs crawling on your skin
formication
134
drugs that cause agranulocytosis
clozapine and chlorpromazine
135
side effect assoc with thioridizaine
pigmented retinopathy
136
del tremens occurs within how many hours
96
137
mental status changes, autonomic dysreg, neuromusc hyperactivity
serotonin syndrome
138
Management of serotonin syndrome
Supportive care, sedation with benzos, serotonin antag (cyproheptadine)
139
What's the time frame for post partum blues?
Onset 2-3 days and resolves within 14
140
Symptoms of post partum depression
At least 2 weeks of mod to severe depr
141
First line treatment for ADHD
stims: methylphenidate and amphet
142
Second line treat for ADHD
atomoxetine (NE reuptake inhib) or alpha 2 ags (guanfacine, clonidine)
143
persistent complex bereavement syndrome
persistent yearning for deceases and prolonged emotional pain with ruminative thoughts and dysfunc behavior
144
brain changes in schizophrenia
lat ventricle enlargement, decr volume of hippocampus and amygdala
145
struc abnormalities in orbitofrontal cortex and basal ganglia assoc with
OCD
146
personality changes, disinhibition, apathy, compulsions
frontotemporal dementia
147
memory, executive, and visuospatial deficits
alzheimers
148
dementia with parkinsonism and hallucinations
dementia with lewy bodies
149
wet, wacky, wobbly
NPH
150
mild memory impairment, major exec dysfunc and focal neuro deficits
vasc dementia
151
treatment for major depression with psychotic features
ECT
152
treatment for severely depressed elderly patients
ECT
153
meds for social anxiety
SSRI and SNRI
154
treatment for ADHD in someone with substance abuse
atomoxetine (nonaddictive)
155
most common sleep disturbance in MDD
early morning awakening
156
double depression
MDD imposed on dysthymia
157
anorexia lab findings
Incr BUN, cortisol, growth hormone, anemia, leukopenia, reduced gonadotropins
158
% of pts with messed up cortisol response in MDD
50% ; incr cortisol
159
full list of Li SEs
weight gain, tremor, GI probs, fatigue, cardiac arrhyth, seizures, goiter/hypothyr, coma, polyuria and dipsia, alopecia
160
Risk of schizophrenia in 1) child, 2) identical twin, 3) frat twin, 4) sibling of pt with it
1) 12%; 2) 50%; 3) 12%; 4) 8%
161
loss of motor tone in narcolepsy
cataplexy (catalepsy is in catatonia)
162
anterograde amnesia
loss of short term memory
163
retrograde amnesia
loss of remote or previously formed memories
164
subbing a word or descr for a word that can't be found/spoken
circumlocution
165
can't perform previously learned motor skills
apraxia
166
prodromal schizophrenia
incr negative sx's without pos sx's
167
general psych d/o that carries greatest risk of suicide
mood disorder
168
What's the most predictive variable for suicide?
Older age >45
169
iatrogenic cause of psych sx's like depr or psychosis
glucocorticoids
170
treatment for pt with bipolar and kidney probs
valproate
171
med that can result in liver failure
valproate
172
med that can cause renal disease
lithium
173
spasm of extraoc muscles as dystonic reac
oculogyric crisis
174
spasm of jaw musc as dystonic reac
trismus
175
physio effects of bulimia
hypokal, hypochloremic alkalosis, hypomag, high serum amylase, enlargement of salivary and parotid glands and pancreas, Normal thyroid func
176
Why the concern for discontinuing antianxiolytic (benzo or barb)
Risk of seizures
177
Drug used to manage agitated or confused patient with delirium
haloperidol
178
Tourette often co-occurs with
OCD and ADD
179
Withdrawal sx's severe with drugs with what?
short half lives
180
What makes drugs of abuse more addictive?
short onset of action
181
Wernicke triad
ataxia, confusion, eye movement (nystagmus)
182
What's deficient in Wernike
B1, thiamine
183
Korsakoff lesions found
mamillary bodies and thalamus
184
Korsakoff sx's
memory impairment, confusion, confabulation, personlaity changes
185
What meds are good for depressed phase of bipolar?
atypical antipsych (quetiapine, lurasidone)
186
pharm to treat acute dystonia EPS
diphenhydramine, benztropine (have antichol effects)
187
pharm to parkinsonism EPS
benztropine, amantadine
188
treatment for moderate to severe premenstrual dysphoric
SSRIs
189
MDMA intoxication
HTN, tachycardia, hyperthermia, serotonin syndrome, hyponatremia
190
BMI cutoff for anorexia
18.5
191
erythema of nasal mucosa
cocaine abuse --> also see weight loss and behav changes
192
meds that cause hyperprolactinemia
typical antipsych (haloperidol, fluphenazine), risperidone
193
treatment for anorexia
nutritional rehab and CBT (or other therapy)
194
Domains of ASD
social communication and stereotyped, repetitive behavs
195
drug intox that can cause psychosis
amphetamine
196
physical findings of amphet intox
tooth decay, acne, skin excoriations
197
drug for schizophrenia with sucidality
clozapine
198
AEs of clozapine
agranulocytosis, myocarditis, seizures, metab syndrome
199
drug to treat tyramine crisis
alpha blocker phentolamine
200
medical causes of mania
thyrotoxicosis, Cushing, hypoglycemia, substance use and withdrawal, steroids, antichol
201
depression with atypical features
mood reactivity, rejection sensitivity, leaden paralysis, hypersomnia, weight gain
202
depression with melancholic features
loss of interest and pleasure in all activities or lack of reactivity to pleasurable stimuli
203
antidepressant that can be used in pregnancy
fluoxetine
204
Risk of lith in pregnancy
Ebstein's anomaly
205
Meds assoc with neural tube defects
valproic acid and carbamazepine
206
drugs to use in alc withdrawal for those with liver disease
loraz, oxaz, temaz
207
What pain med has dangerous interactions with MAO-I?
meperidine (demerol)
208
score on MMSE indicative of dementia
<24
209
NMS vs serotonin syndrome
rigidity in NMS vs hyperreflexia/tremor in SS
210
normal MOCA score
>=26/30
211
seizures, QRS prolong, and antichol effects are OD of what type drug
TCAs (triptyline)
212
pathophys of tardive dyskinesia
dopamine recep supersens/upreg
213
first line med for alc use disorder
naltrexone
214
real scary SE of lamotrigine
Stevens-Johnson or toxic epidermal necrolysis
215
low levels of hypocretin
narcolepsy
216
tooth decay and skin excoriations can be sign of chronic use of what drug
meth
217
propanolol used for what type anxiety disorder
performance anxiety
218
first line treatment for MDD with psychotic features (2 options)
1) antidep + antipsych 2) ECT if need results faster
219
illicits assoc with serotonin syndrome
ecstasy and bath salts
220
antipsych w/ highest risk of metab syndrome
clozapine and olanzapine
221
fevers higher in SS or NMS?
NMS
222
time frame for dysthymia
depressed mood >2 years w/o 2 mo symptom free
