Psychiatry Flashcards
(124 cards)
1
Q
2 types of bipolar?
A
Bipolar 1 and Bipolar 2
2
Q
Age of onset of bipolar?
A
20-30
3
Q
Mania in BP1 or BP2?
A
BP1.
BP2 is hypomania.
4
Q
Define mania
A
Abnormal and persistently elevated, expansive, or or inappropriate mood at least 1 week with marked impairment of social/occupational function. Sometimes psychotic features.
5
Q
Abnormal and persistently elevated, expansive, or or inappropriate mood at least 1 week with marked impairment of social/occupational function. Sometimes psychotic features.
A
Mania
6
Q
Define Hypomania
A
Like mania but no market impairment and no psychotic features
7
Q
Hypomania in BP1 or BP2?
A
BP2
8
Q
Which BP has manic or mixed episodes?
A
BP1 only!
9
Q
Which BP has NO mania or mixed episodes?
A
BP2
10
Q
Which BP has mania but no marked impairment and no psychotic features?
A
BP2
11
Q
Define “mixed episodes”
A
Simultaneous occurrance of ≥3 manic or hypomanic sx plus depresson
12
Q
1st line tx for BP1 and BP2?
A
Lithium
13
Q
Tx for mania?
A
Haldol or BZD
14
Q
≥1 HYPOmanic episode + ≥1 major depressive episode
A
BP2
15
Q
Similar to BP2 but less severe
A
Cyclothymic Disorder
16
Q
Cyclothymic Disorder for how long?
A
At least 2 y
17
Q
Cyclothymic Disorder describe
A
Hypomanic symptoms cycling with relative mild depressive episodes for at least 2 years
18
Q
Cyclothymic Disorder tx?
A
Similar to BP1. Mood stabilizers and neuroleptics (aka antipsychotics)
19
Q
Persistend Depressive Disorder (Dysthymia) for how long?
A
≥1 year children/adolescents
≥2 years adults
20
Q
Persistend Depressive Disorder (Dysthymia) milder or more severe than Major Depressive Disorder?
A
Milder than MDD
21
Q
Persistend Depressive Disorder (Dysthymia) tx?
A
Psychotherapy and SSRIs
22
Q
Major Depressive Disorder for how long?
A
≥2 weeks
23
Q
How many Sx for Major Depressive Disorder?
A
≥5 symptoms
24
Q
Major Depressive Disorder tx?
A
Psychotherapy and SSRIs
25
How long to let SSRIs work?
3-6 weeks minimum
26
When to consider ECT in Major Depressive Disorder?
If other tx fail
27
How long goes General Anxiety Disorder have to last for?
≥6 months
28
Excessive worry or excessive anxiety about various aspects of life for a majority of days for more than ≥6 months
General Anxiety Disorder
29
General Anxiety Disorder TX?
SSRIs (ex paroxetine/Paxil, escitalopram/Lexapro)
Buspar
psychotherapy
30
Panic Disorder definition
≥2 Recurrent and unexpected panic attacks, last <60 min, peak at about 10 min
31
When to panic attacks often occur?
Followed by concern for future attacks
32
Panic Disorder tx
SSRIs, CBT, BZDs for acute attacks
33
PTSD in who?
MC young adults who have experienced trauma (war, sex abuse)
34
PTSD is when you re-experience the trauma for how long?
More than 1 month (less than 1 month is acute stress disorder)
35
PTSD tx?
SSRI, CBT
36
Tobacco withdrawal sx?
Restlessness, anxiety, irritabiity, sleep abnormalities, depression, nicotine craving
37
Mainstay of tobacco withdrawal?
Nicotine tapering therapy
38
Anti-depressant used with tobacco withdrawal?
Bupropion (Zyban)
39
Which med blocks nicotine receptors and reduces anxiety from tobacco withdrawal?
Chantix
40
Opioid intoxication sx?
Euphoria, sedation, pupils constrict (miotic), resp depression, bradycardia, hypotension
41
Opioid withdrawal sx?
Pupila dilate (mydriasis), piloerection (goosebumps), flu-like sx, rhinorrhea
42
Opioid intoxication tx?
Narcan
43
Opioid withdrawal tx?
Clonidine, loperamide, NSAIDS, Suboxone, Methadone taper
44
Alcohol intoxication sx
Disinhbition, depression, labile mood
45
Alcohol intoxication tx?
Observe. Haldol for psychosis or severe aggression. IV Thiamine and Folate.
46
Alcohol withdrawal begins how long after the last drink?
6-24h
47
Alcohol withdrawal does what to CNS activity?
INCREASES it
48
Alcohol withdrawal sx?
Tremors, anxiety, diaphoresis, palpitations
49
When can seizures occur from Alcohol withdrawal?
6-48h
50
When can DT occur from Alcohol withdrawal?
2-5 days after last drink
51
DT in Alcohol withdrawal sx?
Delerium, tachycardia, hypertension, diaphoresis
52
Alcohol withdrawal tx?
IV BZS, fluids, thiamine, magnesium, B12, and Folate IV
53
Korsakoff’s Syndrome due to what?
Major thiamine deficiency during alcohol withdrawal
54
Describe Korsakoff’s Syndrome?
Amnesia
55
Korsakoff’s can happen when what is given before Thiamine?
Glucose given before Thiamine (no real proof of this but it can show up on tests)
56
Schizophreniform Disorder lasts how long?
<6 months
57
Schizophrenia lasts how long?
≥6 months
58
Schizophrenia lasts how long and what declines?
≥6 months with functional decline
59
Define hallucination
Sensory perception w/o physical stimuli
60
Define delusion
Fixed belief with strong conviction despite evidence to contrary
61
What is Schizoaffective Disorder?
Schizophrenia + mood disturbance (mania, major depressive)
62
Schizphrenia requires which of the following: hallucinations, delusions, or disorganized speech
At least one of them
63
Which generation anti-psychotics first-line for psychotic disorders like schizophrenia
Second-line. Does D4 and 5-HT2 antagonism.
64
Which generation anti-psychotic better for positive symtpoms of psychotic disorder?
1st gen (Haldol, Thorazine) but many extra-pyramidal symptoms (D2 receptor antagonist)
65
Schizophreniform vs Schizophrenia
Less than 6 months in duraiton, more than 6 months in duration
66
What happens to brain gray matter in schizophrenia?
Less of it
67
What happens to brain ventricles in schizophrenia?
Enlarge
68
What happens to CNS dopamine receptors in schizophrenia?
Many more
69
How long does Delusional Disorder last for?
≥1 month
70
How many delusions in Delusional Disorder
≥1
71
Does Delusional Disorder have other psychotic symptoms?
NO!
72
Delusional Disorder delusions likely?
Possible but highly unlikely
73
Delusional Disorder has impairment of function
Nope!
74
Facitious Disorder
Falsified general medical or psych symptoms uwsually after psychosocial stress
75
ADHD dx before what age?
12
76
ADHD in how many settings?
≥2
77
ADHD sx?
Hyperactive/impulsive/inattentiveness
78
Tx of choice for ADHD?
Sympathomimetic meds (Ritalin, Adderall)
79
Difficult social interactions, impaired communication, restricted/repetitive behaviors in which condition?
Autism spectrum disorder
80
Conduct Disorder most common in who?
Boys
81
What percent Conduct Disorder develops into Antisocial Personality Disorder?
40%
82
Behavior that deviates sharpy from age-appropriate norms and violates the rights of others
Conduct Disorder
83
Violations of law, cruel to animals, defeitculness, destruction of property in which childhood condition?
Conduct Disorder
84
Oppositional Defiant Disorder can progress into what other disorder?
Conduct Disorder
85
Defiant behavior toward adults in which disorder?
Oppositional Defiant Disorder
86
How many months for Oppositional Defiant Disorder?
>6 months
87
Angry/ittirable mood, argumentative/defiant behavior, vindictiveness in which childhood disorder?
Oppositional Defiant Disorder
88
Aneroxia Nervosa in which sex 90% of time?
female
89
Aneroxia Nervosa is when person refuses to do what?
Maintain minimally normal body weight
90
What sort of behaviors in Aneroxia Nervosa?
Behaviors toward maintaining low weight
91
Aneroxia Nervosa when BMI below what?
≤17.5
92
Aneroxia Nervosa when Ideal Body Weight below what?
≤85%
93
What ideal weight to hospitalize Aneroxia Nervosa?
<75%
94
Tx for Aneroxia Nervosa?
CBT, weight monitoring, monitored meals. SSRIs, atypical anti-psychotics.
95
Bulemia Nervosa weight normal?
Normal weight. Sometimes even overweight.
96
Bulemia Nervosa binge eating when?
Weekly for 3 months+
97
Bulemia Nervosa binge eat when?
Stress/mood changes
98
Bulemia Nervosa compensate for binge eating how?
Vomiting (aka purging)
99
What happens to teeth in Bulemia Nervosa?
Teeth pitting and enamel erosion
100
Electrolytes in Bulemia Nervosa?
HypoK
| HypoMg
101
What kind of acidosis from vomiting in Bulemia Nervosa?
Metabolic acidosis
102
Tx for Bulemia Nervosa?
CBT, SSRIs
103
Which SSRI helps with purging in Bulemia Nervosa?
Fluoxetine but my have cardiac problems
104
Illness Anxiety Disorder aka?
Hypochondriac
105
Fear or belief one has or will contract serious disease or has undiagnosed disease?
Illness Anxiety Disorder
106
Illness Anxiety Disorder definition
Fear or belief one has or will contract serious disease or has undiagnosed disease
107
Are somatic symptoms usually present in Illness Anxiety Disorder?
No
108
Tx for Illness Anxiety Disorder?
Regularly scheduled appointments with provider for reassurance
109
Somatic Symptoms Disorder most commonly in which sex?
Females
110
Somatic Symptoms Disorder describe
Physical symptoms involving ≥1 part of body but NO PHYSICAL CAUSES FOUND
111
Facitious Disorder aka
Munchausen Syndrome
112
Intentional falsification or exaggeration of s/sx of medical or psych illness for primary gain is which disorder?
Facitious Disorder
113
Facitious Disorder patient is trying to get which gain?
Primary Gain (being sick/injured for their benefit such as sympathy)
114
OCD made up of what two parts?
1. Thoughts (obsessions)
| 2. Behaviors (compulsions)
115
Define Obsessions in OCD?
Recurrent or persistent thoughts/images which are inappropriate and unwanted
116
Define Compulsions in OCD?
Repetitive behavior which person feels compellet to perfrm
117
Which SSRI for OCD?
Fluoxetine
118
Describe Obsessive Compulsive Personality Disorder?
Perfectionist who required ORDER AND CONTROL. Preoccupied with minute details.
119
Overly emotional, dramatic, seductive, sexually inappropriate
Histrionic Personality Disorder
120
TOC for Histrionic Personality Disorder?
Psychotherapy
121
When to use activated charcoal in anticholinergic intox?
<1hr since ingestion
122
Antidode for anticholinergic?
Physostigmine
123
When to use sodium bicarb in TCA overdose? (hint: EKG)
QRS above 100ms
124
When to use charcoal in TCA OD?
If less than 2h since ingestion
