Psychiatry Flashcards
(38 cards)
Treatment options in patient presenting with catatonia
1st line = lorazepam and/or ECT
2nd line= ECT (if patient doesn’t improve)
Muscular rigidity, delirium, autonomic instability and high fever.. dx?
NMS (neruoleptic malignant syndrome)
NMS is due to dysregulation of which neurotransmitter?
Dopamine
1st line treatment for a patient presenting with MDD with psychotic features.
Antidepressant plus antipsychotic (ECT is also 1st line however it is reserved for patients who require rapid response due to refusal to eat or drink or suicidality)
1st line treatment for acute bipolar depression
2nd generation anti psychotics quetiapine and lurasidone
Social awkwardness, intense interest in and restricted focus on a single topic and unusual sensory interest… Dx?
Autism spectrum disorder
first-line pharmacological therapy for restless leg syndrome.(RLS)
Pramipexole (dopamine agonist)
other include ropinirole apomorphine and rotigotine
Diagnostic tests indicated for restless leg syndrome
Iron studies, Polysomnogram
1st line therapy for RLS
Lifestyle changes: abstinence from coffee, nicotine, and alcohol
Discontinue offending agent (e.g., dopamine antagonists)
Supplemental iron if serum ferritin < 50 ng/mL
Passive aggression
expressing negative feelings toward someone in a non-confrontational way. (e.g. Rather than confront his boss about feeling overworked and undervalued, he feigns illness and thereby forces his boss to take over his workload)
Individuals with panic disorder are at increased risk of developing?
MDD (. Approximately 50% of patients with panic disorder have at least one episode of MDD in their lifetime)
The best management in patients on MMT ( methadone maintenance therapy) who require opioid analgesic
scheduled short-acting opioid administration such as morphine given every 3–4 hours in addition to methadone.
1st line treatment for generalized anxiety disorder (GAD) with sexual dysfunction
Buspirone
What psychiatric disorder predisposes a pregnant patient to IUGR?
Patients with a history of anorexia nervosa are at increased risk for intrauterine growth restriction due to chronic malnutrition and low pregnancy weight.
What is the difference in a child with temporal lobe epilepsy and absence seizure
absence have episodes are typically shorter (5–10 seconds) compared to epilepsy (1-2 mins) and are not followed by a postictal phase
What deficiency is a complication of carcinoid syndrome
Pellagra, or niacin deficiency
Initial treatment in a patient that is terminally ill with severe acute depression and a very limited life expectancy
Methylphenidate and other psychostimulants (can be combined with SSRI)
What is a relative contraindication for ECT in a patient with breast cancer
Metastasis to the brain
Difficulty with vaginal penetration, vulvovaginal or pelvic pain during intercourse, anticipatory anxiety, and pronounced tightening of the pelvic floor muscles during attempted vaginal penetration.. dx?
Genitopelvic pain/penetration disorder (penetration disorder)
Individuals with a persistent fear of having or developing an illness despite having no physical symptoms
Illness anxiety disorder
Individuals with this disorder show a preoccupation with their health and develop significant distress and fear of severe illness over benign symptoms.
somatic symptom disorder. (anxiety is caused by physical symptoms)
What is Advanced sleep phase disorder
circadian rhythm sleep-wake disorder in which the sleep-wake cycle begins and ends earlier than normal. This causes individuals to feel the need to go to bed early and to wake up early in the morning irrespective of when they go to bed.
What is Advanced sleep phase disorder treatment?
Timed bright light phototherapy
Pathophysiology of refeeding syndrome
An increase in insulin levels, which causes an intracellular shift of glucose, potassium, phosphate, and magnesium.
