Step 2 Flashcards
(51 cards)
treatment for acute dystonia
Anticholinergics i.e. Benztropine (antimuscarinic, antihistamine + inhibits dopamine transporters) or Diphenhydramine (antihistamine)
treatment for tardive dyskinesia
1st line: reduce dose of antipsychotic or change to alternative
2nd line: VMAT2 i.e. valbenazine, deutetrabenazine
treatment for akathisia
1st line: reduce dose or alternative antipsychotic
2nd line: anticholinergic i.e. benztropine or benzodiazepines i.e. lorazepam
treatment for neuroleptic malignant syndrome
discontinue medication
supportive care
dantrolene
treatment for dyskinesia (parkinsonsim induced by antipsychotics)
1st line: reduce dose or alternative
2nd line: anticholinergic (benztropine) or dopamine agonist (amantadine)
serotonin syndrome vs neuroleptic malignant syndrome
21-year-old man has 3 months of social withdrawal, worsening
grades, flattened affect, and concrete thinking
schizophreniform disorder
schizophrenia requires 6 months
atamoxetine mode of action
norepinephrine reuptake inhibitor
stimulants side effects
decreased appetite (weight loss)
irritability
insomnia
anxiety
headache
tic exacerbation
decreased growth velocity
mode of action of clonidine and guanfacine
alpha agonist
used 3rd line in ADHD
inheritence of Rett syndrome
X linked
differential diagnoses to autism
intellectual disability, global developmental delay
selective mutism
hearing impairment
Rett syndrome (usually female, characteristic hand wriggling)
Fragile X (X linked prominant, long face, high arched palate, macro-orchidism etc)
treatment for autism
- education
- behaviour management (applied behavioural analysis therapy)
- medications to treat symptoms i.e. neuroleptics for aggression and mood instability, stimulants or alpha agonists for ADHD, SSRI for behaviour, anxiety and mood
what is disrupted mood dysregulated disorder
A pattern of severe, recurrent verbal or behavioral outbursts that are out of proportion to the situation and a persistently irritable or angry mood between outbursts.
■ Symptoms must occur for ≥1 year; they may progress to depression in
adulthood.
■ DMDD should not be diagnosed before 6 years of age or after 18 years
of age.
most common chromosomal cause of intellectual disability
trisomy 21
most common inherited cause of intellectual disability
fragile X
most common preventable cause of intellectual disability
foetal alcohol syndrome
how is the severity of intellectual disability categorised
based on level of support needed with ADL’s
IQ score not used in new DSM-5
diagnostic criteria for tourettes
multiple motor tics
one or more vocal tic
present for > 1 year
persistent (occur almost every day/multiple times per day)
best initial treatment for tourettes
behavioural therapy - habit reversal therapy
vocal tic only lasting > 1 year - diagnosis?
persistent tic disorder
medication management for tourettes syndrome
1st line: dopamine depleting - VMAT2 i.e. tetrabenzaine
2nd line: dopamine blocking - antipsychotics i.e. fluphenazine, risperidone
3rd line: typical antipsychotics i.e. haloperadol, pimozide
Alpha agonists (clonidine, guanfacine) better side effect profile but not as effective
what is caprolalia
seen in tourettes syndrome
repetition of obscene words
diagnosis of schizophrenia
2 or more of the following symptoms for > 6 months. At least one symptom must be hallucination, delusion or disorganised speech
hallucination
delusions
disorganised speech
dysfunctional or catatonic behaviour
negative symptoms (anhedonia, avolition, flattened affect, social withdrawal)
