psychiatry Flashcards Preview

Step 2 CK > psychiatry > Flashcards

Flashcards in psychiatry Deck (128):
1

bipolar 1 vs 2

1 - manic
2 = hypomanic (not as severe; not interfereing w/life)

2

perseveration

repetition of thoughts or ideas during conversation

3

tangentiality

an abrupt deviation of thought/ideas and never returns to original idea

4

circumstantial thought process

drift away from current topic, then come back to it
common in schizophrenia

5

definition somatic symptom disorder

obsession about one or more somatic symptoms (worked up and -) for 6 or more months

(formerly hypochondriasis)

6

drug class for tx of dystonia from antipsychotics

anticholinergics (benztropine or benadryl)

7

tx of neuroleptic malignant syndrome

a dopamine agonist like dantrolene, amantadine, or bromocriptine

8

head CT finding in schizophrenia

enlargement of the ventricles

9

head CT finding in OCD (2) (where are abnormalities fount)

orbitofrontal cortex
basal ganglia

10

timeline after initial SSRI start to increase dose

4-6 weeks

11

timeline for GAD

over 6 mos

12

trihexyphenidyl, class and use

anticholinergic for Parkinson's

13

difference between schizoaffective disorder and MDD or bipolar with psychotic features

in schizoaffective, psychosis is present MOST of the time, and also in the absence of mood disorders

14

side effect ziprasidone

prolongs QT

15

tx of serotonin syndrome

cyproheptadine

16

MDD timeline (sx present for how long before dx)

2 weeks

17

kleptomania associations (2)

OCD
bulimia

18

time for dysthymia

At least 2 years
this is Eore

19

cyclothymia (s)

hypomania
dysthymia

No loss of function

20

tx of cyclothymia

mood stabilizers

21

normal bereavement
time and function

6-12 mos. no loss of function

22

following death:
adjustment disorder vs persistent complex bereavement disorder

timing and function

both have mild loss of function

adjustment 6-12 months
PCBD greater than 1 yr

23

psychosis for:
less than 1 mo.
1-6 months

acute psychotic disorder
schizophreniform disorder

24

psychosis with mood disorders

schizoaffective disorder

25

antidepressant absolutely contraindicated in bulimia

buproprion
-increased seizures

26

dissociative fugue
dx?

amnesia of an "old life" - usually move and start new life
amital interview

27

tx of cocaine OD htn

Phentolamine, alpha blockade


If beta blocker only later!!!!!!THEN beta blockade

28

length of time for SSRI washout

3 weeks

29

venlafaxine side effect

diastolic htn

30

mandatory test prior to TCA rx

ECG
due to QT elongation of TCAs

31

B52 (3)

lorazepam
haloperidol
benadryl

32

tx of Neuroleptic malignant syndrome

dantrolene

33

class to tx acute dystonia

anticholinergics
for example, benztopine or benadryl

34

neuroleptic malignant syndrome test (if suspected)

CK

35

Clang associations

Come out in rhyming pattern

36

Jarvis hearing

Court order for neuroleptic Meds

37

Price sheppard

Court order for ect

38

Tarasoff decision

Duty to warn

39

Derealization

Sense environment not real.

40

dementia with little people

lewy body dementia
lillepucian hallucinations

41

dementia with Personality changes in 50s
oral/sexual fixation

fronto-temporal dementia

42

dementia with depression symptoms

pseudodementia

43

8 yo who falls off growth chart.
Picky eater

Arfid

Avoidant/restrictive food intake disorder

44

Phenelzine class

MAOI

45

Dementia pugilistica

Punchdrunk syndrome

Dementia following chronic trauma like boxing.

46

Delusions in delusional disorder vs a psychotic disorder

In delusional, they are believable

47

Ideal target receptor for antipsychotics

D2

48

2 receptors affected less by atypical antipsychotics

Less d1
Antagonism 5ht against negative sx

49

Ziprasidone side effect

Qt prolongation

Eat with fat!

50

Aripriprazole MOA

Agonist antagonist d2

Can tx gynecomastia

51

Receptor that clozapine blocks

D4

52

Feelings by a clinician that the patient provoked

Countertransferance

53

Fluvoxamine class (Luvox)

Ssri

54

3 month mortality of a delirium pt

33%

55

Response rate of ssri

70%

56

Frotteurism

Sexually rubbing up against nonconsenting others

57

Masochism

Being sexually dominated

58

Sadism

Dominating others sexually

59

PMDD vs PMS

PMDD disrupts life more

60

Duration of mdd with tx

3 months

61

Indication for EMDR therapy

PTSD

62

Class of antidepressants most likely to induce mania

Tc a

63

Idea of reference

Idea that something relates to you but it doesn't.

Example of someone who thinks the tv is talking to them

64

Mesolimbic pathway

Positive symptoms

65

Mesocortical pathway

Negative sx

66

formication

tactile hallucination of bugs crawling on skin. Cocaine intox, ETOH w/d

67

synesthesia

secondary sensation of a perception.
ex: tasting a "color" while using LSD

68

scanning speech

irregular pauses in speech

69

palinopsia

persistence of visual image after the stimulus has been removed

70

circumlocution

substitution of descriptors for words. common in Alzheimer's

71

projection

one's unacceptable ideas are seen as coming from another
ex: a cheating husband blames accuses his wife of cheating

72

projective identification

someone's thoughts become true in a defence mechanism

ex: a person thinks "all people hate me"
and does stuff to make people break off relationships with her.

73

3 benzoes not metabolized by liver (good for DTs)

LOT
lorazepam
oxazepam
temazepam

74

tx for neuroleptic-induced akathisia

propanolol or other beta blocker

75

tx for neuroleptic induced dystonia or parkinsonism

anticholinergic (ex: benztropine)

76

tx for an acute dystonia

antihistamine like benadryl

77

classic side effect of thioridazine

retinal pigmentation

78

most potent benzo

clonazepam (klonopin)

79

mood stabilizer that IS NOT anti-manic

lamotrigine

80

Eps (3)

Akathisia
Parkinsonism
Dystonia

81

2 Meds that reduce si

Clozapine, lithium

82

Asenapine unique (2)

Sublingual
Rapid onset

83

Ssri with shortest half life

Paroxetine

84

Teratogenic ssri

Paroxetine. Heart effects

85

Duloxetine also treats

Pain

86

Desipramine unique

Bed wetting

87

1st line tx of bulimia

Ssri

88

2nd line tx bulimia

Topirimate

89

Most common side effect transcranial magnetic stimulation (rTMS)

HA

90

Mood stabilizer that causes pancreatitis

Valproic acid

91

Tx for sialorrhea

Clonidine

92

Zaleplon unique

Short half life for middle insomnia

93

Opisthotonos

Arching forward. Spasm of back and neck, a type of Dystonia

94

Topirimate side effect

Renal stones

95

Rate of dementia in 65+

1 in9

96

Timeline for mania

Greater than 1 week

97

Timeline for hypomania

4 days, greater than

98

Antipsychotic that also treats bipolar depression

Queitiapin

99

Capgras syndrome

Humans have been replaced by imposters

100

abreaction

a pt relives an emotional experience to get rid of megative emotions and move on.

101

probabability of sibling getting schizophrenia

10%

102

anti-psychotic where person gets purple-grey metallic rash over sun-exposed areas and jaundice

chlorpromazine

103

anti-psychotic that gives prolonged QT and pigmentary retinopathy

thioridazine

104

1st line tx Tourette

Clonidine

105

Most common PD associated with somatization disorder. Females? Males?

Females histrionic
Males antisocial

106

Tx of hypertensive crisis

Phentolamine (alpha blocker)

107

Classic side effect of clozapine besides agranulocytosis

Seizure

108

atypical antipsychotic that causes cataracts and orthostasis

quietiapine

109

classic side effect aripriprazole

akathisia (A,A)

110

2 changes in depressed polysomnogram

less REM latency
more REM

111

SSRI with most drug-drug interactions

paroxetine

112

serotonin discontinuation classic with

sertraline

113

possible psychiatric sx of R MCA stroke

mania

114

possible psychiatric sx of L MCA stroke

depression

115

meds that precipitate lithium toxicity

NSAIDS

116

"gold standard" drug for OCD

clomipramine

117

Gander syndrome

Giving approximate or ridiculous answers. Most common in prisoners

118

Catalepsy

Maintaining an immobile position. A type of catatonia

119

tx narcolepsy (2)

naps
modafinil

120

EEG in delirium vs psychosis

slow waves in delirium
normal in psychosis

121

contraindicated class in Lewy Body Dementia

anti-psychotics (paradoxical effect)

122

EEG of Creutzfeld-Jakob

triphasic bursts

123

tx for autonomic sx (htn, etc) from heroin w/d

clonidine

124

1st line tx (2 classes) vs most effective tx tourette's

1st line = Clonidine or atypical antipsychotic
most effective = haloperidol

125

Risk of recurrent mdd

50%

126

2 agents for bipolar depression

Quietiapine
Lamotrigine

127

Timeline of normal development in pdd vs rett

Pdd is normal fist two years
Rett is normal first 5 mos

128

Ssri that is the most anticholinergic and should be avoided in old people

Paroxetine