Qbank: Psych Extra Review Flashcards
(34 cards)
What is the tx for MDD after 1st failed trial with an SSRI?
After failed trial of SSRI in MDD patient, try 2nd medication from the SAME class of drugs. Only after 2 failed trials in same drug class do you consider a new drug class.
What is a Delusion disorder?
Delusion disorder: non-bizarre delusions for at least 1 month
What is Brief psychotic disorder?
BPD: positive psychotic sxs for more than 1 day but less than 1 month.
What is the acute vs. long-term tx for Panic disorder?
Panic disorder acute tx: Benzos; long-term tx: SSRIs or TCAs
What is the tx for performance anxiety?
Beta-blockers (e.g. propanolol)
Compare the dominant feelings in grief vs dominant feelings in major depressive episode.
Grief: loss + emptiness
MDD: anhedonia + persistent depressed mood
What is used to tx anti-psychotic induced akathisia?
Propanolol
What is the most likely atypical anti-psychotic to cause EPS, especially at high dosages?
Risperidone
What are examples of EPS symptoms?
Cogwheel rigidity, bradykinesia, tremor, akathisia
What are symptoms of excess dopamine blockade?
Bradykinesia, masked facies, micrographia
What medications is used to help reduce EPS symptoms in patient taking anti-psychotics?
Benztropine (anticholinergic)
How long does it take for most antidepressants to provide symptomatic relief?
4-6 weeks
How long should an antidepressant be used to treat a single episode of major depression?
6 months
How long should an antidepressant be used to treat multiple episodes of depression?
> 6 months
What is the DSM-5 diagnostic criteria for Conduct disorder?
Conduct disorder: at least 3 behaviors (out of 15 problem behaviors grouped into 4 main categories: aggression toward people and animals, destruction of property, serious violation of rules, deceitfulness or theft), have been present w/in previous 12 months, at at least 1 present in the last 6 months. Greatest risk for developing antisocial personality disorder as adults.
What atypical antipsychotic is least likely to cause EPS?
Clozapine but it is considered to be a medication of last resort b/c it can cause agranulocytosis.
What is akathisia?
Akathisia is a subjective feeling of restlessness that compels patients to move around (e.g. repeated leg crossing, weight shifting, stepping in place). Etiology: antipsychotic use
Treatment: beta-blockers provide some relief
What is dystonia?
Dystonia can occur between 4hrs and 4 days after receiving an antipsychotic medication, characterized by muscle spasms or stiffness, tongue protrusion or twisting, opisthotonus and oculogyric crisis.
Treatment: anticholinergics (e.g. benztropine) or antihistamines (e.g. diphenhydramine)
What is the recommended treatment for Hoarding disorder according to DSM 5 criteria?
Cognitive behavioral therapy has been shown to improve symptoms, and early trials with SSRIs have demonstrated efficacy.
What is the difference between: Dissociative fugue, Dissociative identity disorder, Dissociative amnesia and Depersonalization disorder?
Dissociative fugue: characterized by sudden, unexpected travel away from home accompanied by inability to recall one’s identity or one’s past. At times, patients with condition will assume new identities.
Dissociative identity disorder: presence of 2 or more distinct identifies that alternatively assume control of the person’a behavior.
Dissociative amnesia: one or more episodes of inability to recall important personal information.
Depersonalization disorder: persistent or recurrent feelings of detachment from one’s own physical or mental processes in the context of an intact sense of reality.
What is first-line treatment for GAD? What is second-line treatment for GAD?
First-line: Cognitive behavioral therapy + SSRIs (like escitalopram) or SNRIs
Second-line: Benzodiazepines (used when antidepressants are ineffective or poorly tolerated but should be avoided in patients with a history of substance abuse or comorbid depression) or Buspirone
What are the most common withdrawal symptoms experienced in heroin withdrawal?
Muscle spasms, joint pain, nausea and vomiting, diarrhea, abdominal cramps, rhinorrhea, lacrimation, sweating , irritable, dilated pupils, HTN (autonomic instability)
What are FDA-approved first-line treatments for OCD?
Clomiramine (Anafranil) - - a TCA Fluoxetine (Prozac) - - SSRI Fluvoxamine (Luvox) - - only SSRI approved just for OCD Paroxetine (Paxil) - - SSRI Sertraline (Zoloft) - - SSRI
What is Folie a deux?
Folie a deux: induced psychotic disorder (IPD), involves delusions or hallucinations that are transmitted from on individual to another.
