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Flashcards in Psychiatry Deck (58)
1

Transference

Patient projects feelings about formative or other important persons onto physician

2

Reaction formation

Replaced a problematic idea or feeling with its opposite

3

Mature defenses (4)

Altruism, humor, sublimation (replacing unacceptable wish with one that does not conflict with value system), suppression

4

Retts disorder

X-linked seen almost exclusively in girls. Regression characterized by loss of development, loss of verbal abilities, MR, ataxia, sterotype hand-wringing

5

Time frame form postpartum blues and postpartum depression respectively

Blues - resolves within 10 days. Depression - 2 weeks to 1 year or more

6

Conversion disorder

Sudden loss of sensory or motor function (eg paralysis, blindness, mutism) following an acute stressor. Patient is aware of but indifferent towards symptoms

7

Somatization disorder

Variety of complaints in multiple organ systems over a period of years

8

Schizoid personality

Social withdrawal, limited emotional expression, content with social isolation (unlike avoidant)

9

Schizotypal personality

Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

10

Schizophreniform vs schizophrenia

Schiphreniform is 1-6 months, schizophrenia is 6 months or more

11

What two effects of opioids do you typically not develop tolerance to?

Constipation and miosis

12

Intoxication with what substance is typically associated with belligerence and what are the other findings?

PCP. Impulsiveness, fever, psychomotor agitation, nystagmus, tachycardia, homicidality, psychosis, delirum

13

What makes methadone useful in heroin treatment

It has an extremely long half life

14

Treatment for alcohol withdrawal

Benzos

15

Treatment for bulimia

SSRIs

16

Treatment for anxiety

Benzos, buspirone, SSRIs

17

Treatment for atypical depression

MAOIs, SSRIs

18

Treatment for bipolar

Lithium, valproic acid, carbamazepine, atypical antipsychotics

19

Treatment for depression

SSRIs, SNRIs, TCAs

20

Treatment for depression with insomnia

mirtazapine

21

Treatment for OCD

SSRIs, clomipramine

22

Treatment for panic disorder

SSRIs, TCAs, Benzos

23

Treatment for PTSD

SSRIs

24

Treatment for tourettes

Antipsychotics (haloperidol, risperidone)

25

Treatment for social phobias

SSRIs

26

Typical antipsychotics (5)

Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine

27

Mechanism of typical antipsychotics

Block D2 receptors

28

High potency typical antipsychotics

Trifluoperazine, fluphenazine, haloperidol

29

Neuroleptic malignant syndrome

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Seen with typical antipsychotics. Treatment is dantrolene or D2 agonists (bromocriptine)

30

Atypical antipsychotics (6)

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone

31

What symptoms of schizophrenia do typical and atypical antipsychotics respectively treat?

Typicals - mostly positive symptoms, atypicals - positive and negative symptoms

32

Side effects of chlorpromazine and thiordazine

Chlorpromazine - corneal deposits, thioridazine - retinal deposits

33

Time course of EPS side effects

4 h - acute dystonia, 4 d - akinesia (parkinsonian symptoms), 4 wk - akathisia, 4 mo - tardive dyskinesia

34

Risperidone side effects

Hyperprolactinemia. May cause amenorrhea

35

Low potency typical antipsychotics

Chlorpromazine and thioridazine

36

Lithium side effects

MNOP. Movement (tremor), Nephrogenic DI, hypOthyroidism, Pregnancy problems

37

Buspirone

Stimulates 5-HT-1A receptors. Use in GAD. Does not cause sedation, addiction, or tolerance or interact with alcohol

38

Tricyclic antidepressants (7)

Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine

39

Mechanism of TCAs

Block reuptake of NE and serotonin

40

What is the main cause of death in TCA overdose

TCAs inhibit cardiac fast sodium channels

41

Uses of TCAs

MDD. Bedwetting (imipramine), OCD (clomipramine), fibromyalgia

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Side effects of TCAs

Sedation, alpha block, anticholinergic effects

43

Toxicity of TCAs

Convulsions, Coma, Cardiotoxicity. Also respiratory depression, hyperpyrexia, hypotension, confusion, hallucinations

44

SSRIs (4)

Fluoxetine, paroxetine, sertraline, citalopram

45

Uses of SSRIs

Depression, OCD, bulimia, social phobia, PTSD

46

Toxicities of SSRIs

GI distress, sexual dysfunction, serotonin syndrome (hyperthermia, myoclonus, CV collapse, flushing, diarrhea, seizures)

47

Treatment for serotonin syndrome

Cyproheptadine (5-HT-2 antagonist)

48

SNRIs (2)

Venlafaxine, duloxetine

49

Uses of SNRIs

Depression, GAD (venlafaxine), diabetic peripheral neuropathy (duloxetine)

50

Toxicities of SNRIs

Increased BP

51

MAOIs (4)

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B inhibitor)

52

MAOIs lead to increased levels of what NTs?

Amines (NE, serotonin, dopamine)

53

Uses of MAOIs

Atypical depression (depression with hyperphagia or weight gain), anxiety, hypochondriasis

54

Toxicities of MAOIs

Hypertensive crisis with tyramine ingestion and b-agonists. Serotonin syndrome if given with SSRIs or meperidine

55

Bupropion

Increases NE and dopamine by unknown mechanism. Depression and smoking cessation. Causes CNS stimulation, headache, and seizure in bulimic patients. No sexual side effects

56

Mirtazapine

Alpha-2 antagonist (increases NE and serotonin) and antagonist of 5-HT-2 and 5-HT-3. Causes sedation, increased appetite, weight gain, and dry mouth

57

Maprotiline

Blocks NE reuptake. Causes sedation and orthostatic hypotension

58

Trazodone

Inhibits serotonin reuptake. Used for insomnia. Causes sedation, nausea, priapism, postural hypotension