Rosh Material #1 Flashcards
(100 cards)
1
Q
wernicke encephalopathy triad
A
encephalopathy
oculomotor dysfxn
gait ataxia
2
Q
oculomotor dysfxn associated w. wernicke encephalopathy
A
horizontal nystagmus - mc
lateral rectus palsy
conjugate gaze palsies
3
Q
tx for wernicke’s
A
- thiamine
- glucose
must give thamine before glucose
4
Q
consequence of wernicke’s that involes irreversible memory loss
A
korsakoff
5
Q
in order for dx of mania, episodes must last a minimum of
A
1 week
6
Q
in order for dx of hypomania, sx must last a minimum of
A
4 days
7
Q
2 risks associated w. quetiapine
A
parkinsonism
qt prolongation
8
Q
3 risks associated w. valproate
A
weight gain
tremor
liver failure
9
Q
3 risks associated w. lithium
A
diabetes insipidus
hypothyroidism
tremor
10
Q
risk associated w. lamotrigine
A
skin rash
SJS
11
Q
tx for acute mania
A
mood stabilizers:
lithium
valproate
+/- antipsychotics (haldol)
12
Q
tx for acute dpn in bipolar
A
lithium
lamotrigine
quetiapine
+/- antidepressant add on
13
Q
maintenance therapy for bipolar
A
1st line: whichever drug relieved acute symptoms
2. lithium, lamotrigine, valproate, quetiapine
14
Q
2 mc s.e of SGA’s
A
sedation
weight gain
15
Q
how to remember SGA’s (atypical)
A
pines: olanzapine, quetiapine, asenapine, clozapine
dones: lurasidone, resperidone, paliperidone, iloperidone
pips: aripiprazole, brexpiprazole
rip: cariprazine
16
Q
2 indications for bupropion as 1st line tx for dpn
A
to avoid sexual dysfxn
concomitant tobacco use
17
Q
indication for trazadone as first line tx for dpn
A
dpn w. insomnia
18
Q
major s.e of clozapine
A
neutropenia
19
Q
when does mdd w. peripartum onset occur
A
during pregnancy or w.in 4 weeks of delivery
20
Q
recommended age to screen for autism spectrum disorder
A
18-24 mo
dx is typically made prior to 3 yo
21
Q
5 a’s of tobacco cessation
A
- ask
- advise
- assess
- assist
- arrange
22
Q
stages of change for tobacco smoking/cessation
A
- precontemplation
- contemplation
- preparation
- action
- maintenance
23
Q
which stage of change is associated w. smokers who are ready to quit
A
contemplation
24
Q
mc comorbid mental health illness associated w. delusional d.o
A
dpn
25
specifiers for delusional d.o (6)
erotomanic
grandiose
jealous
persecutory
somatic
bizarre content
26
belief that a stranger removed one's internal organs and replaced them with other organs without leaving a scar
delusional d.o w. bizarre content
27
order of tx for gad
1. SSRI or SNRI
2. different SSRI or SNRI
28
2 add on options if pt w. gad had partial response to SSRI or SNRI
buspirone
pregabalin
29
6 established adverse effects of SSRIs
sexual dysfxn
drowsy
insomnia
wt gain
HA
dizzy
30
5 common s.e of SNRIs
nausea
dizziness
insomnia
sedation
constipation
31
3 common s.e of buspirone
insomnia
agitation
nausea
32
2 common s.e of pregabalin
sedation
dizziness
33
what is pagophagia
craving for ice
34
what deficiency does pagophagia make you think of
iron
35
3 sx of severe ida
koilonychia
atrophic glossitis
angular cheilosis
36
7 risk factors for dpn
1st degree fam hx
low socioeconomic status
divorced/separated/widowed
lack of interpersonal relationships
recent difficult life events
early childhood trauma
postpartum
37
what US ancestry is associated w. dpn
american indian
38
what ancestry has lowest prevalence of dpn
asian
39
6 common fetishes
underpants
bras
shoes
feet
toes
hair
40
medications for dpn should be continued for how long after symptoms resolve
6-12 months
41
first line tx for bipolar major dpn (2)
quetiapine
lurasidone
42
tx for benzo withdrawal for pt who uses benzos chronically
IV long acting benzo (ex diazepam) taper
43
PE finding of refeeding syndrome
peripheral edema
seizure
44
lab findings of refeeding syndrome
hypophosphatemia
hypokalemia
hypomagnesemia
45
primary cause of clinical findings of refeeding syndrome
hypophosphatemia
46
indication for hospitalization for refeeding syndrome
edema
seizures
serum phos < 2 mg/dL
47
refeeding syndrome is associated with low _ (2) and elevated _ (2)
low: glucose, insulin
high: glucagon, gluconeogenesis
48
broadband assessment tool for ADHD
child behavior checklist/teacher report form
*also assesses anxiety, dpn, aggression, withdrawal, somatic complaints*
49
narrow band assessment tools for ADHD (2)
conners 3rd edition
vanderbilt
50
what assessment tools for ADHD are most sensitive/specific
narrowband:
conners
vanderbilt
51
increased serotnergic activity from therapeutic medication drug interactions or self poisoning
serotonin syndrome
52
sx of serotonin syndrome
-AMS
-autonomic instability: tachy, diarrhea, shivering, diaphoresis, mydriasis
-neuromuscular abnormalities: clonus, hyperreflexia, tremor, seizure
53
tx for serotonin syndrome
benzos
hydration/cooling
cyproheptadine
54
what drug is associated w. malignant hyperthermia
muscle relaxants
55
2 risk factors for serotonin syndrome
2 or more serotoning agonists
dosage changes
56
t/f: there is a strong link btw suicidal ideation and OCD
t!
57
what assessment tool is used for OCD
yale-brown obsessive-compulsive scale
58
common historical finding in pt w. borderline pd
childhood trauma
59
7 environmental factors associated w. oppositional defiant disorder
insecure attachment
unresponsive parents
maternal aggression
abuse
community violence
parental psychopathology
peer rejection
60
what differentiates mild vs mod vs severe oppositional defiant d.o
number of settings where symptoms take place (1 vs 2 vs 3)
61
3 comorbidities mc associated w. PTSD
anxiety
dpn
SUD
62
mc rf for schizophrenia
positive fam hx
63
which 2 personality d.o's are associated w. lack of empathy for others
narcissistic
antisocial
64
1st line pharm for social anxiety d.o (aka social phobia)
SSRI or SNRI
65
for dx of social anxiety d.o (social phobia) in children, anxiety must occur in _ settings rather than exclusively w. adults
peer
66
5 symptoms of irritable/expansive mood in cyclothymia
increased goal-directed behavior
decreased need for sleep
inflated self-esteem
talkative
distractibility
67
6 symptoms of depressed mood in cyclothymic d.o
lack of interest
increased/decreased sleep
increased/decreased appetite
poor self esteem
guilt
sadness
67
6 symptoms of depressed mood in cyclothymic d.o
lack of interest
increased/decreased sleep
increased/decreased appetite
poor self esteem
guilt
sadness
68
t/f: for dx of cyclothymic d.o, pt must have both hypomanic and depressive symptoms
t!
69
for dx of cyclothymic d.o in children, symptoms must be present for _
a full year
*2 years for adults*
70
what type of anemia is assocaited w. AUD
macrocytic (MCV > 96 fL)
71
3 causes of macrocytic anemia
etoh
folate deficiency
B12 deficiency
72
which ion channel is associated with benzo MOA
Cl
73
which 3 SGAs cause the least amt of weight gain
ziprasidone
aripiprazole
lurasidone
74
5 types of specific phobias
animal
natural environment
blood-injection-injury
situational
other: choking/vomiting/loud sounds/clowns
75
3 examples of situational phobias
airplanes
elevators
enclosed spaces
76
t/f: most youths have multiple specific phobias
t!
77
5 sx of cannabinoid hyperemesis syndrome
n/v
abdominal pain
bloating
diaphoresis
wt loss
78
what relieves sx of cannabinoid hyperemesis syndrome and can aid in the diagnosis
relief of symptoms w. hot showers
79
4 complications of cannabinoid hyperemesis syndrome
mallory-weiss tear
AKI
hypovolemia
rhabdo
80
tx for cannabinoid hyperemesis syndrome
rehydration
bowel rest
haldol
capsaicin
81
what differentiates cyclic vomiting syndrome from cannabinoid hyperemesis syndrome
presence of a psychological stressor as trigger
82
common s.e of first gen antipsychotics
extrapyramidal
TD
83
management of RLS (4)
iron replacement
behavior mod
pramipexole/ripinirole
gabapentin
84
exacerbations of RLS (3)
antihistamines
dopamine antagonists
antidepressants
85
5 common symptoms of conversion d.o
weakness/paralysis
visual
speech
globus sensation
abnormal movement
nonepileptic sz
86
4 known triggers for conversion d.o
traumatic injury
neurologic illness
interpersonal conflict
life stress
87
major way in which conversion d.o is differentiated from factitious d.o and malingering
conversion d.o symptoms are unconsciously produced
88
cannabis can be detected for up to _ days in non chronic users
30
89
rf for ASD
male
advanced parental age
fam hx
genetics
brain abnormalities
90
most sedating SSRI
paroxetine
91
SSRI most associated w. GI sx
fluvoxamine
92
what 2 medications are appropraite for etoh dependence
disulfram
naltrexone
93
delirium tremens may start after _ hr of etoh withdrawal
48 hr
94
sympathomimetic toxidrome is associated w. what 2 substances
cocaine
amphetamines
95
drug to avoid for bp control in sympathomimetic toxidrome
bb
*due to unopposed alpha receptor stimulation*
96
what drug is used for bp control in sympathomimetic toxidrome
lorazepam
97
what do you think when you see: mydriasis, diaphoresis, hyperthermia, htn, tachy, increased bowel sounds
sympathomimetic toxidrome
98
how does sympathomimetic toxidrome differ from anticholinergic toxidrome (2)
anticholinergic toxidrome has:
dry skin
decreased bowel sounds
99
what psychiatric med is contraindicated in eating disorders
bupropion
*lowers sz threshold*
