Psychiatry Flashcards
(258 cards)
1
Q
Young female BMI 16bcoming to you with 1ry amenorrhea first inv…
A
US
2
Q
Female BMI 16 with bony pain first inv
A
DEXA scan ..osteoporosis
3
Q
Priority in anorexia nervosa
A
electrolytes (hypo K)
4
Q
Most common:
Effect of anorexia nervosa on pregnancy
A
…Low birth weight
5
Q
Effect of malaria on pregnancy
A
.low birth weight
6
Q
Effect of cocaine on pregnancy
A
low birth weight
7
Q
Effect of smoking on pregnancy
A
low birth weight
8
Q
Main difference bet bulimia and anorexia nervosa
A
…normal weigh
9
Q
Long term prognosis of bulimia nervosa
A
depression
10
Q
Long term prognosis of OCD
A
..PSYCHOSIS
11
Q
Long term prognosis of borderline personality disorder…
A
PSYCHOSIS
12
Q
Long term prognosis of generalized anxiety
A
depression
13
Q
Long term prognosis of panic attack……
A
depression
14
Q
Psychiatric disorder causing highest rate of death
A
anorexia nervosa
15
Q
Female always feel that she is overweight although normal BMI
A
.body dysmorphic disorder
16
Q
Causes of body dysmorphic disorder?
A
2-anorexia nervosa
3-amputated limb
4-acromegaly
5- neglect syndrome
17
Q
Distrustful suspicious person
A
paranoid
18
Q
Female with history of crimes, drug abuse, sexual troubles, left her family and lives alone
A
borderline
19
Q
Male with history of crimes, drug abuse, sexual troubles, left his family and lives alone more than 18 yrs
A
antisocial
20
Q
Most risk with borderline
A
…suicide
21
Q
Psychotherapy for borderline
A
dialectal
22
Q
Psychotherapy for trichillomania
A
…..aversion
23
Q
Male lives alone does not care about people
A
…schizoid
24
Q
Male lives alone feels being rejected
A
..avoidant
25
Male lives alone with ideas of reference
…schizotypal
26
Male with high self esteem does not show empathy
.narcissitic
27
Female being abused by her boy friend but still feels as if she can never live without him…
dependent
28
Female gives great care to the order of furniture in her home and has a strict schedule of her life routine.
Obsessive compulsive
29
Female during interview wear sexy clothes and tries to seduce the employer to get the job
…histrionic
30
Child 5 yrs his mother complains of his overactivity and that he does not listen to what she says
.ADHD
31
First step to confirm ADHD
call the teacher and ask for his grades
32
Drug of choice for ADHD
.methyphenidate
33
Most imp test for ADHD………
..hearing test
34
Boy 4 yrs old with low IQ limited social activity, limited language development , fascinating with certain toys…..
AUTISM
35
Boy 4 ys old with normal IQ , limited social activity, normal language development , fascinating with certaing toys
.asperger
36
8 yrs child doing recurrent grimacing and recurrent strange sounds….
.Tourret's
37
Most common association with Tourret's……
OCD
38
Drug of choice for tourret's
…antipsychotic
39
Child 14 yrs with history of drinking alcohol and recurrent fighting with his peers in school
Conduct
40
Is masturbation normal act?
..yesssssss
41
Is being Gay or lesbian normal act ?....
yesssssss
42
TTT of choice for :
| Anorgasm
.self stimulation
43
Premature ejaculation, what to do?
….squeeze technique
44
Vaginismus
…vaginal dilators
45
Male feels orgasm by wearing his girlfriend underwear
.transvestism
46
Male feels orgasm by rubbing his body against clothed females in crowded places
……frotteurism
47
Male feels orgasm by having sex with kids….
pedophilia
48
Male feels that he is a woman in male's body and asking for plastic surgeries to change his sex
transsexualism
49
Young females with recurrent attacks of hyperventilation, palpitations and feeling as if she will die…
panic
50
Long term prognosis of panic
depression
51
Most common association with panic
…agoraphobia
52
TTT of acute attack of panic……
benzodiazepine
53
Lab of panic
alkalosis, hypocapnia and increased O2
54
Woman with marked fear each time she has to give public speaking
social phobia
55
Best ttt for specific phobia
gradual exposure
56
Imp test for dementia
MMSE test|( less than 24)
There is no definitive investigation for Alzheimer
Alzheimer is not preventable nor curable
57
First to be affected in Alzheimer
memory
58
Least likely to be affected with Alzheimer is?
face recognition
59
Psychiatric illness increases in incidence
dementia
60
Memory affection with normal aging sometimes very similar to Alzheimer except that there is no impairment of normal function
he lives independently
61
CT of Alzheimer
brain atrophy with ventricular enlargement
62
Drug of choice for alzheimer
donepezil, tacrine
63
Best drug for alzheimer with heart disease
memantine
64
Dementia + visual hallucinations + parkinsonism
.lewy body
65
Dementia+personality changes+abnormal movements
Huntington
66
Dementia+urine incontinence+abnormal gait
normal pressure hydrocephalus
67
Dementia+young aged male with uncontrolled HTN
Vascular
68
Short history of dementia+sleeping troubles
depression
69
Old age in the hospital sleeping during the day, agitated
delirium
70
Most imp inv for delirium
urine analysis
71
Most imp drug to control agitation in delerium
.antipsychotic
72
Agitation in admitted person
think of alcohol withdrawal
73
TTT of alcohol withdrawal
diazepam
74
Female being raped now complains of flashbacks and troubles in sleeping
PTSD
75
Most effective ttt in PTSD
group counseling
76
Drug of choice for PTSD
SSRI
77
Drug of choice for OCD
SSRI
78
Drug of choice for depression
SSRI
79
Drug of choice for GAD
SSRI
80
Long term ttt for panic
.SSRI
81
Female patients with a long history of hospital admissions with many procedures and surgeries done
factitious
82
Kid admitted hospital becomes sick only when his mom visits him
munchausen syndrome by proxy
83
Male patient comes to the clinic with severe renal colic asking for strong analgesics, his investigations normal
malingering
84
First step in this patient of malingering
urine sampling in front of you
85
Male patient alcoholic now complains of nystagmus, gait instability and drowsy
wernicke's encephalopathy
86
Main cause of wernicke's encephalopathy
thiamine deficiency
87
TTT of wernicke's encephalopathy
THIAMINE then GLUCOSE
88
Police brings to you male confused doesn't know his name , you found airline ticket in his pocket….
dissociative fugue
89
Causes of IMPULSE CONTROL DISORDER?
1-KLEPTOMANIA
2-PYROMANIA
3-TRICHOTILLOMANIA
4-PATHOLOGICAL GAMBLING
90
Female patient with recurrent acts of stealing of stuff she does not really needs
KLEPTOMANIA
91
Main ttt of kleptomania
aversion
92
Male patient with recurrent episodes of doing firing in home and school
pyromania
93
Why pyromaniacs do firing……
satisfaction
94
Female patient with no hair on half of her scalp
TRICHOTILLOMANIA
95
Main ttt of grief
support
96
TTT of grief and depression
SSRI
97
Most imp to depression with grief
suicidal ideation
98
Grief + visual hallucination
abnormal grief
99
Imp question to patient with postpartum
if she has any feeling of hurting herself or her baby
100
Main risk factor for postpartum psychosis
….primipara
101
Important steps for mild postpartum blue
family involvement and continue breastfeeding
102
Treatment of cases of postpartum psychosis
…involuntary admission and .ECT
103
Inability to answer a question without giving excessive, unnecessary detail.. but eventually will answer the question
.Circumstantiality
104
if does not answer the question
tangentiality
105
feeling that you saw this situation before
.deja vu
106
Female patient told you that a very famous celebrity loves her
…delusion of erotomania
107
Male patient came to told shouting that he is God and should be followed
..delusion of grandiosity
108
Old age patient anxious telling you his neighbors trying to kill him by putting poisons in his food
.delusion of persecution
109
Patient feels that the people are talking about him
.delusions of reference
110
2 sisters sharing the same psychotic symptoms
folie a deux
111
Female patient with recurrent thoughts of cleaning her hands
OCD
112
Long term prognosis of OCD
……psychosis
113
Female patient worries about her financial condition and also about her husband's work ……
GAD
114
Main ttt of GAD
.SSRI
115
Long term prognosis of GAD……
depression
116
Female patient with recurrent thoughts of washing her hands
OCD
117
Young boy taking more than 10 showers per day…
OCD
118
Drug of choice for OCD in kids……
SSRI
119
Young male with recurrent attacks of sleeping per day that are accompanied with hallucinations
…narcolepsy
120
Main ttt of narcolepsy
…psychostimulant
121
Middle age male obese with recurrent attacks of sleeping and his wife complains of his snoring
…Obstructive sleep apnea
122
Inv of choic for OSA….
polysomonography
123
First advice for this patient OSA
loss weight
124
TTT of choice of OSA
…CPAP
125
What does insomnia means
…bad quality of sleep
126
Main ttt of insomnia
……non pharmacological
127
Drug of choice for insomnia
.short acting benzodiazepine
128
Duration to diagnose depression
2 weeks
129
Duration to diagnose schizophrenia……
6 months
130
Duration to diagnose schizophreniform
.1-6 months
131
Duration to diagnose brief psychotic disorder.
less than I month
132
Duration to diagnose PTSD
.more than 1 month
133
Drug of choice for depression
SSRI
134
No effect after usage of SSRI for 1 week….
just continue
135
Effect of SSRI appears after……
2-6 weeks
136
When to shift to another drug…..
no effect after 2 months
137
How long to use SSRI
at least 6 months
138
How long to use SSRI in suicidal patient….
2 YEARS
139
ld age + severe depression
ECT
140
Depression+smoker
…..bupropion
141
Depression+insomnia……..
mirtazapine
142
Depression + decreased appetite……….
mirtazapine
143
Most common season for depression
Winter
144
Most common season for suicide……………
Spring
145
Most common season for SIDS
Winter
146
Depression memory impairement
……pseudodementia
147
Depression and suicide
when is the Highest risk of suicide
first two weeks after leaving hospital
148
Most important question to depressed patient……..
suicidal thoughts
149
Highest probability of suicide
..history of previous suicidal attempt
150
Once you discover suicidal thoughts
…involuntary admission
151
Most risky patients
have a plan of suicide
152
SSRI + Ecstasy…….lead to?
serotonin syndrome
153
First step in serotonin syndrome
..stop both drugs
154
Food should be avoided in patient taking MAOI….
cheese and wine
155
What should be screened in patient taking MAOI
.blood pressure
156
Patient on SSRI comes back to you complaining that there is no improvement………
….just.continue the medications
157
how to stop SSRI ?
.TAPPERING SHOULD BE DONE FOR 2_4 WEEKs
158
Effect of overdose of TCA
…arrhythmia
159
Most imp Inv in TCA overdose?
ECG
160
How to assess severitty of TCA overdose
…….duration of QRS complex
161
Antidote for TCA overdose……
NaHco3
162
Tests should be done in patient on lithium
.TSH and RFTs (thyroid and Kidneys)
163
Main SE of lithium toxicity…..
ataxia, dysarthria delirium
164
TTT of lithium toxicity
…dialysis
165
Main SE of carbamazepine
……leucopenia
166
Main SE of lamotrigine
…rash
167
Patient coming to ER with neck contracted to one side
…dystonia
168
TTT of acute dystonia
…diphenhydramine and benztropine
169
Main 2 categories of drugs causing extrapyramidal symptoms
…antipsychotic and anti emetics drugs
170
Patient on antipsychotic with continuous urge to move around the room……
akathisia
171
Patient on antipsychotic with twitching of his face, tongue and hand
.tardive dyskinesia
172
Patient on antipsychotic coming to ER with high fever, high blood pressure…….
neuroleptic malignant syndrome
173
Risk with neuroleptic malignant syndrome
…rhabdomyolosis….acute renal failure
174
TTT of choice for neuroleptic malignant syndrome…
dantrolene or bromocriptine
175
Monitor of clozapine for? with?
CBC( AGRANULOCYTOSIS)
176
Monitor of olanzapine
…FBS and lipid profile
177
First line therapy for schizophrenia
olanzapine
178
schizophrenia + insomnia
olanzapine
179
drug with the least side effects
quitiapine
180
schizophrenia+ oversleeping…
respiridone
181
Most important step in psychotherapy
establish good relationship with the patient
182
Main SE of ECT
Transient memory disturbance
183
Schizophrenic patient taking marijuana first step
.stop marijuana
184
Duration of usage of SSRI in suicidal patients……
2 yrs
185
Type of SSRI in kids
.fluvoxamine
186
Most imp to monitor in venalfaxine
…blood pressure
187
Patient with pin point pupil and RR 6/min
.morphine toxicity
188
TTT of morphine toxicity,…… (opiod)
naloxone
189
Patient with pinpoint pupil, diarrhea and marked crepitation heared on the lung……
organophosphorus poisoning
190
TTT organophosphorus….
atropine and oxime
191
Patient with piloerection, yawning, rhinorrhea and myalgia…
.morphine withdrawal
192
TTT of morphine withdrawal…..
methadone
193
Main SE of benzodiazepine withdrawal….
agitation
194
Type of benzodiazepine causing withdrawal symptoms…
short acting
195
TTT of benzodiazepine overdose
Flumazenil
196
Effect of cocaine on brain
stroke
197
Effect of cocaine on nose
septal perforation
198
Effect of cocaine on heart
MI
199
Effect of cocaine on skin
bugs under skin
200
Effect of cocaine on placenta
.abruptio placenta
201
Effect of cocaine on fetus
low birth weight.
202
Effect of cocaine on fetus
teratogenic
203
Most common teratogenic substance
alcohol followed by cocaine
204
Main SE of cocaine withdrawal
skin bugs
205
Main SE of PCP toxicity
vertical/horizontal nystagmus
206
Main SE of LSD toxicity…
hallucination
207
Main SE of cannabis toxicity
increased appetite, dry mouth, conjunctival injection
208
Active form of cannabis
etra hydro cannabinoid
209
Main TTT to help patient stop smoking
nicotine patch
210
alcohol questionnaire
CAGE
1. Have you ever felt the need to Cut down on your drinking?
2. Have you ever felt Annoyed by criticism of your drinking?
3. Have you ever felt Guilty about drinking?
4. Have you ever had to take a morning Eye opener?
211
Most imp question to detect alcohol addiction
….morning eye opener
212
Most important risk factor for:
| Anorexia nervosa.
family history of athleticism
213
Bulimia nervosa
history of child abuse
214
Binge eating
family history of obesity
215
Weight loss in young female without others symptoms except psychic problems
drug or alcohol abuse
216
Drug of choice for catatonic schizophrenia
..benzodiazepine
217
Most common drug used in parties
Ecstasy (MDMA)
218
Most important sign of amphetamine withdrawal
paranoia
219
Most important sign of amphetamine toxicity
…psychosis followed by hallucinations
220
Drug of choice for agitation of drugs
antipsychotic
221
Patient on SSRI comes back to you complaining that there is no improvement
just continue the medications
222
Patient on SSRI still have symptoms first step
increase dose
223
Patient on SSRI developed side effects
..shift to another SSRI
224
Most common side effect of SSRI
.abdominal pain and agitation
225
Patient on SSRI after taking tramadol developed serotonin syndromes first step
….stop both of them
| Donepezil and SSRIs
226
Synergistic effect
| First step
.stop both of them
227
Police brings to you homeless psychotic patient :
| First step
.collateral history from the police
228
If agitated
…antipsychotic then admission
229
If not agitated……
admission
230
Where to admit
.psychiatric unit
231
DD of sudden withdrawal manifestation in teenagers??
1-drug abuse……..need to be excluded first
2-depression…..associated with decreased appetite, enegery, sleep and suicisal thoughts
3-prodrome of schizophrenia……associated with delusions and hallucinations
232
Delusion with pregnancy…………
clozapine
233
Drug causing teratogenicity in first trimester
..anticonvulsant
234
Drug causing teratogenicity in last trimester
..antipsychotic
235
First step if mom complains of behaviouir of her son …..
interview with the son
236
Currently ttt of choice in agitated person if:
| Psychotic patient
..antipsychotic medications
237
Delirious patient
..antipsychotic medications
238
Postoperative……………..
antipsychotic medications
239
Amphetamine toxicity…………………
antipsychotics
240
Alcoholic………
diazepam
241
Alcoholic and liver impairment…….
.lorazepam
242
Selective Mutism
where children will speak freely in somesettings (usually at home) but not in others
243
Patient with dementia needs urgent surgery first step
.ask for advanced directive
244
Serious complication of amphetamine poisioning?
MI
245
Least common side effect of lithium?
Renal impairment
246
Motor restlessness of feet and legs is termed?
Akathisia
247
Muscle spasm of neck, face tongue and trunk is termed?
Dystonia
248
Tx of Hoarding disorder?
CBT
249
what is LESS common presentation in bipolar vs unipolar depression?
Decreased appetite
250
In eating disorder, expect family history of what?
Obesity
251
What is not a key diagnostic feature of eating disorder?
Hirsutism
252
Believes that someone replaces your loved one is called?
Capgrass syndrome (dilusional misidentifivation syndrome)
253
MCC of death in TCA overdose?
Arrhythmias
254
Pt develops lethergy while on long term Lithium therapy, Check what?
Thyroid function
255
flight of ideas is a feature of?
| not?
Bipolar
| not schizophrenia
256
What is clock drawing test used for?
Access severity of dementia
257
which antipsychotics protect against depression in a pt with Bipolar disorder?
Olanzapine and quetiepine
258
only effective ssri for kids?
fluoexetine
