Test 4 - Psychiatry, Behavioral Science Flashcards Preview

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Flashcards in Test 4 - Psychiatry, Behavioral Science Deck (51)
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1

What is it called when a person is lip-smacking or constantly swallowing during a seizure? In what types of seizures is this seen in?

Automatism

seen in complex (awareness-impaired) seizures

2

Seizures that involve the _________ lobe are often preceded by an olfactory aura because...?

temporal lobe because the primary olfactory cortex is located in the uncus of the temporal lobe

3

Antiepileptic pharmacotherapy is indicated if a clinician determines that a patient's risk of having another seizure is ____% or greater.

60%

4

Describe the steps for treating a patient presenting w/ status epilepticus.

1st: ABCs (airway/breathing, circulatory), body temp., O2 sats, blood glucose

2nd: get IV placed and give thiamine + glucose + Lorazepam

3rd: start Phenytoin

5

What anti-epileptic drug is most commonly used in the pediatric population?

Phenobarbital

(see jackhammer cats)

6

Name 4 drugs that can be used to treat both focal and generalized seizures.

Topiramate, valproate, lamotrigine, levatiracetam

7

Name four side effects of valproate.

1. Hepatotoxicity (can be fatal - seen in children more often)

2. Teratogenic (neural tube defects)

3. Acute pancreatitis

4. Tremor

8

What are the main indications for phenytoin use? What are the side effects?

Focal seizures, status epilepticus

Side effects:

Nystagmus and diplopia

Ataxia

Decreased bone density

Stevens-Johnson Syndrome (esp. in HLA-B1502 Asians)

DRESS syndrome

Teratogenic (cleft palate)

Folate deficiency -> megaloblastic anemia

Drug-induced lupus

Gingival hyperplasia

9

What are the main indications for carbamazepine use? What are the side effects?

Focal seizures (partial epilepsy)

Side effects:

SIADH -> hyponatremia

Teratogenic -> neural tube defects

Agranulocytosis

DRESS syndrome

Ataxia

Diplopia

SJS esp. in HLA-B1502

10

What are the side effects of Lamotrigine?

SJS, diplopia, interactions with CYP450 inducers like valproate

11

What is the best drug for generalized absence seizures? What are its side effects?

Ethosuximide

Side effects: lethargy/fatigue, GI distress

12

Which dopamine pathway is involved in the manifestation of the positive symptoms of schizophrenia?

Mesolimbic dopamine system (increased dopamine causes the positive symptoms)

13

Which dopamine pathway is involved in the manifestation of the negative symptoms of schizophrenia?

Mesocortical (less dopamine in psychosis)

14

How is the niagrostriatal pathway affected in schizophrenia? How do antipsychotics affect this pathway?

Niagrostriatal pathway is involved in motor function (direct, indirect pathways) and is not affected in schizophrenia.

Antipsychotics block the D2 pathway, which turns on the sub-thalamic nucleus --> inhibition of cortical activity.

15

How is the tuberoinfundibular pathway affected in schizophrenia? How do antipsychotics affect this pathway?

Tuberoinfundibular pathway regulates prolactin secretion (via dopamine), antipsychotics block dopamine --> increased prolactin

16

What symptoms are catatonia characterized by? In what psychiatric conditions is it seen in? How is it treated?

Catalepsy (muscle rigidity; waxy flexibility)

Mutism

Echolalia (mimics what people say)

Negativism (resistance to do shit)

Echopraxia (mimics what people do)

Seen in schizophrenia (most commonly) and MDD

Tx: benzodiazepines like lorazepam and electroconvulsive therapy (ECT)

 

17

Does clonidine treat Tourette's/tics?

Yeah (puppet at the bottom)

18

What is the adult version of conduct disorder?

Antisocial disorder

antisocial = sociopath

19

Which two drugs/drug types can treat PTSD?

SNRIs/SSRIs and Prazosin (alpha-1 antagonist) 

Dude on stage w/ dog tags

20

What drugs treat acute panic disorder and chronic panic disorder, respectively?

Benzodiazepines for acute panics

SSRIs/SNRIs for chronic panic disorder

21

Name three drugs that can treat trichotillomania.

Olanzapine, n-acetylcysteine, and naltrexone (all off label)

22

Which benzo has a quick onset and short duration?

Alprazolam

23

What non-pharmacologic treatment is used for specific phobia?

Flooding

24

What non-pharmacologic treatment is used for PTSD?

Prolonged exposure

25

What non-pharmacologic treatment is used for OCD?

Exposure and response prevention

26

What non-pharmacologic treatment is used for panic disorder?

CBT

27

Compare and contrast facticious disorder from malingering.

Facticious disorder is when someone falsifies disease for primary gain (likes being cared for/being a patient)

Malingering is when someone fakes an illness for the purposes of external gain

28

Bruxism is most commonly seen in ________ intoxication.

Ecstasy (MDMA)

29

Which benzos are best for treating alcohol withdrawals in a patient with normal liver function? Why?

Chlordiazepoxide and Diazepam cuz they have long half-lives

30

Name three drugs and their MOAs that can be used for prevention of alcohol abuse relapse.

Disulfiram (aldehyde DH inhibitor)

Acamproasate (GABA agonist)

Naltrexone (mu antagonist that decreases cravings/reward)

31

Name the cluster A personality disorders

Paranoid

Schizoid

Schizotypal

32

Name the cluster B personality disorders

Narcissistic

Borderline

Antisocial

Histrionic

33

Name the cluster C personality disorders

Avoidant

Dependent

Obsessive-compulsive

34

Name the personality disorder:

Suspicious/mistrusting of others

Frequent hostility

Paranoid PD

35

Name the personality disorder:

Detachment from social relationships

Restrictive affective range (blunted emotions)

Schizoid PD

36

Name the personality disorder:

Odd, eccentric beliefs and behaviors

Magical thinking

 

Schizotypal PD

37

Name the personality disorder:

Grandiosity, inflated self-importance

Entitled, needs admiration

Narcissistic PD

38

Name the personality disorder and how is it treated:

Unstable mood and relationships

Self-mutilation

Suicidality

Borderline personality disorder

Treat with dialectical behavioral therapy (DBT)

39

Name the personality disorder:

Disregard for/violation of others' rights w/ no remorse

Charming and manipulative

Antisocial PD

40

Name the personality disorder:

Excessive but superficial emotions

Attention seeking

Seductive/provocative

Histrionic PD

41

Name the personality disorder:

Extreme fear of rejection

No friendships despite a strong desire for them

Avoidant PD

42

Name the personality disorder:

Excessive need to be cared for

Passivity

Intense self-doubt; difficulty with decision making on their own

Dependent PD

43

Name the personality disorder:

Overly preoccupied with rules and organization

Likes the shit out of lists

Obsessive-compulsive PD

44

Name three treatments for neurocognitive disorders and the MOAs.

Donepezil - acetylcholinesterase inhibitor

Tacrine - acetylcholinesterase inhibitor

Memantine - NMDA antagonist

45

What are the treatments for binge-eating disorder?

SSRIs, CBT, lisdexamfetamine

46

What is the treatment for bulimia nervosa?

Fluoxetine (SSRI), CBT

47

What is the treatment for anorexia nervosa?

Weight restoration and family therapy

48

Fill it in

49

After treatment with a 1st gen antipsychotic, someone becomes rigid, febrile, confused, and has unstable vitals. U check CK and its high. What is the Dx? What is the treatment?

NMS

Treat with bromocriptine (D2 agonist) or dantrolene (ryanodine receptor antagonist decreases muscle contraction)

50

Name the atypical antipsychotics that have the fewest metabolic side effects.

Risperidone, ziprasidone, aripiprazole

51

Which atypical antipsychotic has the fewest extrapyramidal side effects?

Aripiprazole