Random Psych Flashcards
(127 cards)
1
Q
Presents with:
Mild depressive symptoms + hypomanic symptoms
lasting ≥ 2 years
A
cyclothymic disorder
2
Q
Presents with Diaphoresis, Dilated eyes, Tremors, (hyperreflexia), mental agitation, and even diarrhea
A
Serotonin syndrome
3
Q
Emotionally triggered loss of muscle tone
A
Cataplexy
4
Q
REM sleep behavior disorder typically occur during the _____ of the sleep period
A
first third
5
Q
Anorexia often associated with what 2 illnesses?
A
OCD
MDD
6
Q
What 2 elements distinguish Anorexia from Bulimia?
A
Low BMI (<18.5) Caloric Intake Restriction
7
Q
Cocaine coronary vasospams can cause (3) complications
A
MI
stroke
ischemic colitis
8
Q
Medication that helps reduce self-mutilation
A
Naltrexone
9
Q
What is Hypercarotonemia?
A
yellow pigmentation of the skin (xanthoderma) and increased beta-carotene levels in the blood.
(seen in Anorexia; yellowing skin/palms & low T3)
10
Q
List S/X of antidepressant discontinuation syndrome
A
Fatigue
Insomnia
Muscle Aches
Flu like s/x
11
Q
First thing when a child shows neuro-developmental problems?
A
Screen for Hearing loss
can cause: Social, Language, Speech delays
12
Q
Where is Serotonin made?
A
Raphe Nucleus
13
Q
Agression, Delusions, paranoia, hyperthermia, dilated pupils, Tachycardia &/or HTN
(Not amphetamines/cocaine)
A
Bath Salts (Cathinones)
*NEG Urine Tox screen
14
Q
What is Vaginismus?
A
involuntary vaginal muscle spasms
*genitopelvic pain disorder
15
Q
MOA of Tetrabenazine used for Tourettes
A
VMAT2- Inhibitor
16
Q
Where is Acetylcholine made
A
Basal nucleus of Meynert
17
Q
Where is GABA made?
A
Nucleus Accumbens
18
Q
Where is NE made
A
Locus Cereleus
19
Q
Where is Dopamine made
A
Ventral Tegmentum; Substantia Nigra Pars Compacta
20
Q
Amantadine MOA
For Parkinsonism
A
weak NMDA receptor
*Orthostatic hypotension/anxiety/ataxia
21
Q
Cyproheptadine MOA
For Serotonin Syndrome
A
Anti-5HT2
Anti-Histamine
22
Q
TCA MOA
A
Anti- alpha1
Anti-H1
Anti- Ach (Anti-Cholinergic)
NE & 5HT re-uptake inhibitor
23
Q
Trazadone MOA
A
Anti-5HT2
Anti- alpha1
Anti-H1
Serotonin re-uptake inhibitor
24
Q
D2 is linked to what GPCR?
A
Gi
Anti-psychotics inhibit Gi = increase cAMP
25
Which Antipsychotics have the strongest Anti-Histamine and Alpha1 effects?
Low Potency TYPICAL Antipsychotics
26
Linezolid (antibiotic) has ____ activity
MOA-1
27
Mirtazepine Antidepressant MOA
Anti- alpha2 ********
Anti-H1
Anti- 5HT2 & 5HT3 *****
Increase release of NE & Serotonin
28
Atypical antipsychotics block
D2
Seretonin 2A
H1
Alpha1 (orthostatic hypotension)
29
Oppositional defiant disorder treatment
Parent Management Therapy
| Behavior mod/ conflict management
30
Benztropine MOA
Inhibition of dopamine transporters
&
antimuscarinic/antihistaminic effects
31
How can lithium become toxic?
Hypovolemia (diuretics) = ↑ Na+ reabsorption = ↑ lithium = danger of toxicity
32
Akithesia can be caused by (2)
Antipsychotics or Parkinson treatment
33
Asterixis (wrist flapping) associated with (3)
Hepatic Encephalopathy
Wilson's disease
Metabolic Derangements
34
Athetosis (snake like writhing movements in the fingers especially) seen in what illness?
Huntington
35
Chorea (purposeless jerking involuntary movements) seen in what illness?
Huntington
36
Resting tremor in Parkinson is due to a lesion where in the brain?
Substantia Nigra
37
Restless leg syndrome worsens at night/ with rest and improves with movement associated with (4)
Pregnancy
Parkinson
CKD
Iron deficiency
*treat with Pramipexole/Ropinirole D2 agonist
38
Dementia can be cause by ____ deficiency or ____-thyroidism
Vit B12 (Cobalamin)
hypothyroidism
39
Inhibition of the ____ in the brain causes Parkinson
Thalamus
40
2 Histological findings of Parkinson
Depigmentation of Substantia Nigra (loss of dopaminergic neurons)
Lewy bodies (Eosinophilic inclusions of alpha syn)
41
Can present with Agression, Depression, Dementia
Huntington
42
Huntington is due to a lesion(s) where in the brain?
Caudate/ Putamen
43
Huntington has what imbalance of Neurotransmitters
↑ Dopamine
↓ GABA
↓ Ach
44
List 3 histological findings in Alzheimer's
Hirano bodies (hippocampus- pink rods)
Senile Plaques (amyloid Beta)
Neurofibrillary tangles (Hyper Phosphorylated Tau-microtubules)
45
List 4 Gross histological findings in Alzheimer's
Cortical Atrophy
Hipocampus Atrophy
Narrowing Gyri
Widening Sulci
46
List 2 histological findings in Pick's Frontal-temporal dementia
Round silver stain Hyper Phosphorylated Tau protein
(pick bodies)
Ubiquitinated TDP-43
47
Histological finding associated with HIV dementia?
Macrophages (Oligodendrocytes) fuse to make
| GIANT CELLS
48
Brain imaging shows Focal demyelinated plaques, periventricular calcifications, and axonal sparing
Multiple Sclerosis
49
Ataxia, Myoclonus, ↓ school performance
Demyelination, Gliosis, Oligoclonal bands IgG in CSF.
Subacute Sclerosing Pan Encephalitis (SSPE)
| 2/2 Measels (viral capsid accumulates)
50
Idiopathic cranial HTN (aka Pseudotumor cerebri) is an
↑ICP usually seen in Obese women with recurrent Headaches, Papilledema +/- Recurrent Infections.
Associated with ____
Cerebral Venous Sinus Stenosis
| *LP puncture relieves HA
51
NPH presents with NORMAL ICP, magnetic/shuffling gait, incontinence, and Cognitive Impairment (Delirious, Depressed, Psychotic, Memory worsening, etc.) What is a gross finding and why?
VENTRICULAR ENLARGEMENT
| which distorts corona radiata fibers and compresses arachnoid villi.
52
Ex-Vacuo ventriculomegaly looks like it has an ↑ CSF, but is due to ↓ brain tissue. ICP is NORMAL. This is associated with what diseases (5)?
```
Dementia
Alzheimer's
Huntington
Pick's (FTD)
HIV assoc. Dementia
```
53
Alcoholics and other malnourished people are deficient in what key vitamin?
Thiamine (B1)
54
List 3 neurological causing Mental Retardation + Seizures
Sturge Weber (Non-hereditary)→ Glaucoma & Port-Wine
Tuberous Sclerosis (9/16)→ Murmur, Nodules, Ash leaf
Neurofimbromatosis I (17)→ Pheochroma, Cafe-au-lait, Lisch eye stains, Nodules (skin)
55
How can Von Hipple Lindau Disease cause psych problems?
```
can cause Pheochromacytoma (5Ps) and/or RCC
Pain- HA
Pressure- HTN
Palpitations- Tachycardia
Perspirations
Panicking- Anxiety
```
56
Causes of Enurisis in kids
Voluntary (kid is purposely acting out)
Involuntary (Regression due to abuse/new sibling.)
Anatomic/ illness/ Meds
57
On the SHELF if you see regression in a kid think of ____
abuse
| may or may not be the answer though could be stress
58
Management of Enuresis
Less than 7 y/o can still be normal if they have been drinking water.
If not, use + reinforcement, water restriction, Desmopressin (not the first line though) or imipramine
If no drinking, stressors, or abuse then get a UA and US.
UA (+) but US (-)
UTI bed wetting
Mostly seen in little girls wiping back to front causing
*If STI is present then it's probably abuse
UA (-) but US (+) anatomical needs surgery
UA (-) & US (-)
No drinking
REGRESSION think abuse
59
Criminal behavior <18
vs
Teen acting out
Conduct disorder
vs
Oppositional Defiant
60
Fights with authority. Gets along with peers
Oppositional Defiant
61
```
*Bullying/ Fist fights
Destruction
Theft
Truancy
Running away from home
Liars
Cheaters
Hurt Animals
Torture
Force Sex
```
Conduct disorder
Treatment is Juvenile Detention
62
```
Lie
Cheat
Steal
Defiant
NO Bullying
NO Fist Fights
Incongruent parenting
```
Oppositional Defiant
Treatment is Parental Management Training
63
4 types of exposure that can cause PTSD
Experienced trauma
Witnessed trauma
Learned of a loved one's trauma
Witnessed repeated aftermath of trauma (1st responders)
(Trauma not witnessed through media, pictures, television or movies unless work-related)
64
Diagnosing OSA criteria (2)
15+ apneas/hr
or
5+ apneas/hr + snoring
can lead to Cor Promonale
65
```
Central Sleep Apnea increase in serum CO2
seen in (5)
```
opioid users
COPD w/over oxygenation
Stroke victims
CHF
idiopathic
66
Central Sleep Apnea treatment
Bi (level) pap
67
Narcoleptics have rapid ____
REM
| low REM sleep latency
68
People with Narcolepsy wake up feeling
Refreshed due to increased REM sleep
69
sleep study aka
polysomnography
70
First line treatment of narcolepsy
schedule naps
if fails, stimulants
71
Primary insomnia not secondary to mood disorder is treated via
```
Sleep Hygiene
or
Diphenhydramine
Trazadone
Quetiapine (last)
Zolpidem (last)
```
72
Paranoid personality disorder uses what ego defense
Projection
73
Schizoid personality disorder work what type of jobs
alone, night, or distant from others
74
Promiscuous or emotional emptiness
| possibly...
Boderline
75
attention seeking, superficial, dramatic, not suicidal or unempathetic
Histrionic
76
self-centered, wants to talk to the boss only, wants to be prioritized over other people, may dress lavishly because they think they are important
Narcissistic
77
inadequate feeling, scared of being rejected, passes up on opportunities like promotions/presentations out of fear for failing. Fearful of making decisions
Avoidant
78
Cluster A,B,C are all ego-____
systonic
79
one simple question to screen for sleep apnea
do you wake up gasping for air or out of breath?
80
Blocking the D2 receptors too fast causes
acute dystonia
81
what SSRI is safest for pregnancy?
Sertraline
82
an antidepressant that can treat erectile dysfunction
Buspirone
83
Most common delusion associated w/ dementia
Theft/ Persecution
84
Most common hallucination associated w/parkinson
Figures of peoples or animals
85
Parkinson is caused by decreased _____
Dopamine
86
Beta 1 selective Beta blockers letters __- __
A-M
O-M → B1 & B2 non-selective
87
Competitive inhibition of histamine at H2-receptors of the gastric parietal cells, which inhibits gastric acid secretion, gastric volume, and hydrogen ion concentration are reduced.
Does not affect pepsin secretion, intrinsic factor secretion, or serum gastrin.
Ranitidine
(GERD)
*contraindicated in acute porphyria (causes attacks), renal/hepatic disease
88
The first-line treatment for binge eating disorder
Psychotherapy (eg, cognitive-behavioral therapy)
* However, pharmacotherapy may require less time. It is ok to use SSRI as first-line treatment for patients who prefer medication over therapy
* Additional treatment options for patients who are overweight or OBESE include behavioral weight loss therapy and Lisdexamfetamine (Vyvanse) or Topirimate
89
1st line Treatment of delusional disorder
Antipsychotic + adjunctive CBT
90
Presents with:
hepatic problems
Low level of serum ceruloplasmin + splenomegaly
neurologic problems
Dysarthria, Ataxia, Tremors, Drooling, Dystonia, Parkinson
Behavioral and psychiatric problems
Depression, Declining school performance, Personality changes, Irritability, impulsiveness, Labile mood,, Inappropriate behavior, Psychosis
Wilson disease
* Children: more likely to present with hepatic problems
* Older (mid-teens +): more likely to present with neurologic problems
91
Presents with periods of sudden
Stomach ache/problems
```
Pain in the extremities + patchy numbness/paresthesias
extremity weakness (upper to lower)
```
Dark or reddish-brown urine (neg dipstick)
Dysuria, retention, incontinence, bladder distention
Insomnia, anxiety, restlessness, hallucinations, delirium, depression, phobias, altered consciousness
Acute Intermittent Porphyria
92
Treatment of Delirium agitation
Haloperidol
93
Treatment of anticholinergic induced delirium agitation
Benzos
94
Chronic opioid use for pain management can be indicated in certain cases of
Acute Intermittent Porphyria
95
QRS >100ms = how many little squares?
More than 2 little squares (Wide QRS)
96
Bipolar + agranulocytosis
Carbamazepine
97
Bipolar h/x + ↑AFP in a 20wk pregnant woman.
| What meds is she using
Valproate
| Carbamazepine
98
Dexamethasone suppression test = failure to suppress
Cushings DZ
99
```
No psychosis (other than
hearing/seeing loved one)
```
Okay in bereavement or complex bereavement
100
Antipsychotic
Prolonged QTc and
pigmentary retinopathy?
Thioridazine
101
Pt wakes up with eyes
“stuck” looking up or head
“stuck” turned to the side.
Acute Dystonia
102
Pt reports feeling like they
| “always have to move”.
Akathesia. (30-90 days).
| Tx w/ propranolol (1st line) or benzo
103
```
Remember that metoclopramide (anti-emetic)
can cause (2)
```
NMS or EPS
104
Weight neutral but increases
| akathesia?
Aripripazole
105
Antipsychotic causes orthostasis and
| cataracts?
Quetiapine
106
Patient comes in with panic attack syndromes what labs do you get
EKG, cardiac enzymes, echocardiogram,
| TSH or T4, urine drug screen
107
Hx of anxiety or insomnia
currently w/ fever
convulsions, confusion and
hypertension. Dx
Benzo withdrawal
108
OCD has a high incidence of
Tourettes
109
```
A 54 y/o RN presents w/ a history of
2mo of diarrhea and abd pain. He
has presented to 4 other hospitals
w/ the same complaint.
Colonoscopy reveals pigmentation
in the wall of the colon
```
Laxative abuse
| Factitious disorder
110
Malingering associated with what personality disorder
Antisocial
111
medications that can help paranoid behavior.
Low dose antipsychotics
112
Associated with Histrionic personality d/o
| 2
Eating d/o
| SUD
113
Old lady altered mental status (agitation worsens at night, stupor in the day), having visual hallucinations and dysuria. Diagnosis?
Delirium 2/2 Cystitis
(fluctuating cognition, hallucination, agitation)
```
*get a UA, treat infection
give antipsychotic (not benzo) for acute agitation
```
114
Give ____ for severe disinhibition in FTD
Olanzepine
115
DLB treated with
AchE inhhibitors
116
Memory loss, Loss of vibration sense, labile
affect. Pupil that accommodates
but doesn’t react. Dx?
3 syphilis
117
confusion, ataxia, and nystagmus (gaze fixed to one side)
| Dx
Wernike's
118
Pt presents with horizontal
nystagmus, dilated pupils,
ataxia and acute psychosis
Dx/ treatment.
PCP
| Benzo > Haldol
119
Child w/ Mental retardation, Hypotonia, hypogonadism,
| hyperphagia, skin picking, agression.
Prader Willi
120
Elfin-appearance, friendly, increased
empathy and verbal reasoning ability.
Deletion on Chr7.
Williams
121
ADHD-like sxs, microcephaly, smooth
| philtrum.
Fetal Alcohol syndrome
122
A newborn baby has decreased tone, oblique
palpebral fissures, singular palmar crease, big tongue,
white spots on his iris
Down Syndrome
123
Child w/ abnormal muscle tone, unsteady gait,
seizures, mental retardation or
learning disability.
Cerebral palsy (birth asphyxia)
124
Autism spectrum sxs, heart disease,
palate defects, hypopastic thymus,
hypoCa. Possible psychosis/depression/anxiety
Digeorge
125
Stops just short of breaking the law or physically harming
| others, but still annoying, blames others, defiant, liar, cheater
```
Oppositional defiant
(not conduct d/o)
```
126
In Rumination Disorder
| Check ___ levels
lead
127
6y/o stools in her clothes once every 2 weeks.
| What must you check next. How to treat?
Fecal retention
| Behavioral modification that only rewards
