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Flashcards in Pysch Deck (112):
1

treatment for anxiety disorder and timeframe

> 6 months, use SSRI and SSNI first line

2

scale to rate generalized anxiety disorder?

Hamilton >20

3

timeframe of panic attacks

10mins to 30mins

4

how do panic attacks and panic disorder differ?

Panic disorder is fear of having attacks. Dx is 4 attack in 4 weeks

5

tx for panic disorder

benzo in the short term, then switch to SSRI

6

Is OCD egodytonic or egosyntonic

dytonic

7

TX for OCD

SSRI at higher dose

8

timeframe to dx PTSD?

1 month

9

stress reaction/ acute stress disorder timeframe

1 week to 1 month

10

Tx PTSD

SSRI, benzo, group therapy

11

what is the most common mental illness

phobias

12

what is agoraphobia?

fear of placing self in a situation where problem occurs in a very public space

13

what other disorder do phobia pt's have 75-80% of the time?

panic attacks

14

tx for phobia

exposure therapy, SSRI, benzo

15

what is the difference between schizoid and schizotypal?

schizoid doesn't desire relationships, schizotypal is afraid of relationships

16

schizotypal ---

think odd name, odd person, magical & derealization thinking

17

schizoid

loner, reclusive pleasure

18

how old must a pt be to be dx with antisocial

18 (evident of conduct disorder before the age of 15

19

tx for antisocial

lithium, anger management

20

medical tx of anorexia?

Amitriptyline, SSRI (mirtazapine)

21

only drug FDA approved for weight loss

Orlistat

22

Major depressive disorder timeframe to dx

5 symptoms in same 2 week peroid

23

acronym for depression

SIGECAPS

24

TX MDD

SSRI, effexor, wellbutrin

25

how do MDD and dysthymic differ

dysthymic's timeframe is longer (at least 2 years) symptoms are mild, onset is during childhood

26

define echolalia

meaningless repetition of another's speech

27

Aconym for mania

DIGFAST

28

difference between mania and hypomania?

mania last at least 1 week, requires hospitalization and has marked dysfunction. hypomania is less symptomatic and lasts 4 days

29

Bipolar 1

this is the MANIC side (I for manIc)

30

Bipolar 2

depression + hypomania (never hospitalized)

31

what is cyclothymic disorder

similar to bipolar 2 but not as severe. 2 years of mild depression and hypomania. no > than 2 month of symptom free. moody, impulsive

32

tx for cyclothymic disorder

mood stabilzer and antimanic drug

33

fluoxetine is an ssri, what is the common name

prozac

34

paroxetine is

paxil

35

setraline is

zoloft

36

fluvoxamine is

luvox

37

citalopram is

celexa

38

escitalopram is

Lexapro

39

what type of drug is venlafaxine and duloxetine?

SSNI ( effexor and cymbalta)

40

side effects of lithium

weight gain, hypothyroidism, and arrhythmia

41

if bipolar pt continues to have depression on lithium add

lamictal/lamotrigine

42

TCA name the common drugs

amitriptyline, doxepin, nortriptyline

43

what population should you avoid TCAs

elder due to anticholinergic affects

44

MAOI must have a ______ free diet

tyramine free, cheese and wine

45

dangerous to combine MAOI and SSRI b/c

serotonin syndrome, mental status changes

46

what disorder is dx has one or more symptom affecting voluntary motor or sensory function?

conversion. these patients will have a la belle indifference to their symptoms

47

schizoaffective disorder (longest name bc it combines..?)

MDD, manic episode with schizophrenia (must occur for 2 weeks)

48

what might clozapine cause?

agranulocytosis

49

is OC personality order distressing to the pt

no. but OCD is the mood disorder is.

50

what personality disorder is described as unstable, impulsivity that is self damaging, suicidal behavior, and in a state off crisis

borderline

51

describe avoidant personality disorder

fear of rejection so will avoid situations

52

schizophrenia is comprised of both negative and positive symptoms explain

positive: delusion, hallucination, disorganized speech, unpredictable mood
negative: social withdrawal, flat affect

53

tx for schizophrenia

must be multi-drugs.

54

Tx for positive schizophrenia

haloperidol, chlorpromazine, (antipyschotics with dopamine antagonist)

55

tx for negative schizophrenia symptoms

risperidone, zyprexa, ziprasidone, quetiaprine (seroquel), aripirprazole (abilify)

56

atypical antipsycotics carry risk of

metabolic syndrome

57

define delusion disorder and timeframe

non bizarre delusions for at least one month

58

most likely cause of psychotic disorder

drug, etoh or medical condition

59

la belle indifference to neurological complaints, blindness, numbness symptoms is own as what disorder

conversion

60

munchanusen is part of what personality disorder

factitious

61

pseudocyesis?

false pregnancy

62

Etoh hepatitis finding?

mallory bodies

63

tool to access severity of detox

CIWA

64

when do DT start? what are they?

clouding of consciousness, delirium, fever, agitation (2-4 days)

65

difference between wernike and korakoff?

wernike: confusion, ataxia, or nystagmus. Korakoff: psychosis and amnesia due to lack of thiamine (permeant)
CONFABULATION

66

what liver enzyme is the most sensitive and will be elevated first in alcoholism?

GGT

67

what's greater AST or ALT is alcoholism?

AST

68

most commonly abused opioid?

heroin

69

withdrawal from what drug includes, anxiety, insomnia yawning, tearing, runny nose, muscle cramping, dilation of pupils, hot flashes

opioids

70

med used to quickly reverse effects of opioids

naloxone (Narcan)

71

what drug is a partial agonist of opioid receptors and helps with withdrawal symptoms

subutex (buprenorphine)

72

difference between naloxone and naltrexone

naloxone - knock all opioid off of receptor, naltrexone softens the blow (naltrexone can be used in ETOH withdrawal)

73

Disulfiram is used to

Antebuse (make patient's very ill if they consume ETOH

74

why should clonidine and bb be avoided in stimulant abuse?

can cause HTN crisis by leaving all alpha receptors unopposed

75

time in which normal grief should resolve

1 year, first 2 months are the worse

76

first line med for smoking cessation

Varenicline (chantix) and Bupropion (wellbutrin)

77

progression of disruptive behavior disorders

oppositional defiant (before 8 years old) --> conduct disorder (18 yo) ---> antisocial disorder

78

pervasive development disorder includes/

autistic, asperger and rhett

79

lamotrigine/ lamictal may cause what in children?

steven johnson syndrome

80

dopamine inhibits the release of prolactin, therefore dopamine antagonist increase what?

prolactin leading to galactorrhea

81

what heart condition is connected to panic disorder

mitral valve prolapse

82

what psych med causes dystonia (muscle contractions and twisting of the head?

antipsyhotic -- phenothiazine

83

med for dystonia?

use anticholinergic that counteracts acetylcholine. including (benzotropine) muscle relaxants (baclofen) and benzos

84

how long does a brief psychotic disorder last

1 day to 1 month, if over a month if is a delusion disorder

85

dissociative or psychogenic fugue

due to stressful event, person moves, changes id and develops amnesia

86

communication commonly used by autistic children?

echolalia and stereotyped words

87

many difference between asperger's and autistic disorder?

lack of language and communication skills

88

what is the hallmark of a manic episode

the hallmark of mania is irritability

89

most common SE of MAOI

orthostatic hypotension

90

Which of the following lab results for LH, FSH and T3 would be most consistently found in a patient with anorexia nervosa?

all would be low.

91

Which of the following lab results for growth hormone, plasma cortisol, transaminases, and serum cholesterol would be most consistently found in a patient with anorexia nervosa?

all would be elevated

92

first-generation antipsychotic) is a recommended first-line medication for manic/hypomanic pregnant patients.

haldol

93

____________usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity. After recovery from fugue, previous memories usually return intact, however there is complete amnesia for the fugue episode.

Dissociative fugue

94

The symptoms of Schizophrenia are generally listed in which psychiatric Axis?

axis 1

95

Treatment with which of the following agents can lead to decreased serum lithium levels?

valproic acid

96

What is the most common presentation for a Manic Episode?

Excessive euphoria

97

The patient has great difficulty "getting out of bed" in the morning, but is sleeping fine. Which of the following would be the most appropriate pharmacological intervention for this patient?

Sertraline

98

The Dependent personality would most likely be listed classified as which axis and category?

Axis II (all personality disorders)
Group C for dependent

99

This medication is considered the first line in treating acute schizophrenia.

Risperidone

100

What type of information is generally recorded on Axis IV?

Psychosocial stressors

101

what axis includes mental retardation

II

102

An agitated and seemingly delirious pt presents to the er with muscle rigidity, fever, and autonomic instability. She was recently prescribed a drug to treat symptoms of seeing burning objects and bugs crawling on the walls. only finding is increased creatine phosphokinase levels. what is the disorder

Neuroleptic malignant syndrome (NMS) is a life- threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs

103

Treatment for Neuroleptic malignant syndrome (NMS) is a life- threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs?

Begin administration of dantrolene

104

Which drug is used to treat benzodiazepine overdose?

Flumazenil

105

Which of the following is considered a common physiologic effect of chronic alcohol use?

Downregulation of inhibitory neurotransmitter receptors in the brain. Chronic alcohol use reduces the number of inhibitory neurotransmitter (GABA) receptors in the brain (down-regulation). When alcohol is withdrawn, the loss of inhibitory effects, combined with decreased number of GABA receptors, can lead to overexcitation of the brain, manifesting as the classic alcohol withdrawal syndrome.

106

Which of the following medications may interact and thus increase serum warfarin levels? Valproic acid or Lithium

Valproic acid

107

treatment of choice in patients with schizophrenia that is refractory to other treatment methods.

Clozapine

108

Which of the following antidepressant medications should be avoided in patients with diagnosed anorexia nervosa?

Bupropion (Wellbutrin) is a stimulating antidepressant.

109

antidepressant that has no sexual side effects nor induced weight gain.

Venlafaxine

110

43 year old female presents to the emergency department with muscle rigidity, fever, and autonomic instability. She was recently prescribed a drug to treat symptoms of seeing burning objects and bugs crawling on the walls. Toxicology screening is negative, chest radiography reveals that lungs are clear bilaterally, and labs show increased creatine phosphokinase levels. What is the next best step in the management of this patient?

Begin administration of dantrolene

111

Which of the following pharmacologic agents is reported as causing the most drug-related deaths?

tricyclic antidepressants

112

This medication is considered the first line in treating acute schizophrenia.

Risperidone