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Flashcards in Psychiatry Deck (86)
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1

who is a candidate for lifelong antidepressant treatment

patient with more than 3 lifetime depressive episodes, suicide attempts, or episodes lasting more than 2 years

2

blockage of what receptor causes extrapyramidal symptoms

D2 (antipsychotics and metoclopramide)

3

what is not detected by a standard urine drug screen

semisynthetic opioids
-hydrocodone
-hydromorphone
-oxycodone

synthetic opioids
-fentanyl
-meperidine
-methadone
-tramadol

4

man with bipolar comes in with fatigue, myalgias, constipation, and bradycardia ... what do you think

lithium induced hypothyroidism (this happens in 25% of pts on lithium)
-all pts on lithium need TSH monitoring every 6-12 months
-treat with T4 supplementation (dont discontinue lithium)

5

if ssri doesnt work for a pt who is suffering from weight gain and sexual side effects, what do you give them?

bupropion (NDRI)

6

what do you give to someone who has an addictive past but is diagnosed with ADHD

Atomoxetine, nonstimulant norepinephrine reuptake inhibitor

7

TCA overdose

convulsions
coma
cardiotoxicity

-respiratory depression, hyperpyrexia, prolonged QT

8

neuroimaging in a pt with schizophrenia

larger lateral ventricles

9

what is the first line treatment for narcolepsy

modafinil
-nonamphetamine
-promotes wakefulness

10

MAOI and you drink or eat cheese

hypertensive crisis due to excess tyramine

11

preferred treatment for adjustment disorder (symptoms develop w/i 3 months of major stressor and cause significant impairment) and borderline personality disorder

psychotherapy
-specifically dialectical behavioral therapy for borderline personality disorder

12

how long do postpartum blues last

usually 2 weeks

13

how to treat acute opioid intoxication

naloxone

14

unstable mood, recurrent suicidal behavior, impulsivity, intense anger, chaotic interpersonal relationships

borderline personality disorder

15

what CSF findings are associated with increased risk of suicidal behavior

low concentrations of 5-HIAA in CSF

16

valproate side effect

hepatotoxicity

17

irritability, agitation, psychosis, tachycardia, hypertension, hyperthermia, diaphoresis, mydriasis

amphetamine toxicity

18

how to treat catatonia (when pt doesnt move even if you move their arm against gravity they will just leave it there)

benzodiazepine and/or ECT

19

signs of and how to treat lithium toxicity

signs --> neurologic (altered mental status, seizure, fasciculations, tremor) and gi (vomiting and diarrhea) symptoms

mild --> hydration and monitoring
prominent --> hemodyalsis

20

what do you think of in a pt with hand abrasions and parotid gland enlargement

bulemia nervosa
-expect to see metabolic alkalosis with hypokalemia
-also hypochloremia

21

3 FDA-approved first line treatments for smoking cessation

1. nicotine replacement therapy
2. varenicline
3. bupropion

22

second generation antipsychotics that cause metabolic side effects

olanzapine and clozapine

23

what medication at high doses can cause psychosis

glucocorticoids

24

first line treatment for alcohol use disorders

naltrexone --> mu opioid receptor antagonist
acamprostate --> glutamate modulator

25

what are three chemical differences in someone with MDD

1. hyperactivity of hypothalamic-pituitary-adrenal axis causing increased cortisol levels
2. decreased REM latency
3. decreased slow wave sleep

26

mirtazapine

atypical antidepressant
-a2 antagonist
-increases NE and serotonin

27

if pt on antipsychotic starts experiencing tardive dyskinesia refractory to valbenazine and deutetrabenazine then what do you do...

-discontinue causative medication if feasible
-switch to either quetiapine or clozapine if continued antipsychotic is required

28

what type of therapy has been shown to decrease relapse in pts with schizophrenia

family therapy

29

first line treatments for acute mania

1. antipsychotics (1st and 2nd generation)
2. lithium
3. anticonvulsant mood stabilizers (valproate)

30

dhat syndrome

-somatic symptoms (fatigue, weight loss), anxiety, cultural background, and belief of losing semen during urination
-usually in south asian men
-pt mentions any type of concern of losing semen

-use a pt centered approach and ask open ended questions about what they think is going on