U World

Question 1

Major depressive disorder affects the physiology of the brain how?

Answer 1

Hyperactivity of HPA axis

Results in increased cortisol levels

Question 2

Pt w/bipolar that has elevated Cr should get what Med?

Answer 2

Valproic acid

Question 3

How does Major depressive disorder effect REM sleep latency?

Slow-wave sleep?

Answer 3

Decreases

Decreases

Question 4

What are the MC side effects of Methylphenidate?

Answer 4

Dec appetite
Weight loss
Insomnia

Question 5

Pt that is constantly walking around nonstop after starting new antipsychotic has developed what?

Treat how?

Answer 5

akathisia

Dec dose, give Propanolol or benzotropine/Benzo

Question 6

What is high imminent risk in suicide assessment?

High non-imminent risk?

Answer 6

Ideation, intent and plan

Ideation, intent but NO plan

Question 7

Pt that has depression, fatigue, hypersonic, increased dreaming, hyperplasia, and impaired concentration most likely has what?

Answer 7

Cocaine withdrawal

Question 8

Pt that has been hospitalized 5 times in the last 3 years most likely has what?

Treat how?

Answer 8

Relapses d/t noncompliance

Give a long acting injectable

Question 9

What meds can decrease serum Lithium levels?

Answer 9

Theophylline

K+ sparing diuretics - spironalactone

Question 10

Pts w/Dementia w/LB are extremely sensitive to antipsychotics, what can they cause?

Answer 10

Confusion
Parkinsonism - rigidity
ANS dysfunction

Question 11

What is the most specific indicator of dementia?

Answer 11

Getting lost in familiar territory

Question 12

Pt w/anxiety, irritability, mood swings, grandiosity and psychotic sx w/borderline tachycardia, HTN, diaphoretic, has mild tremors, and dilated pupils has what going on?

Answer 12

Cocaine use disorder

Question 13

Neuroimaging of Schizophrenia shows what findings?

Answer 13

Enlargement of cerebral LATERAL ventricles

Question 14

Panic disorder has what common sx?

Answer 14

Cardiorespiratory
GI distress
Parenthesis
Dissociative sx

Question 15

ECT causes what SEs?

Answer 15

Retrograde AND anterograde (2 weeks) amnesia

Question 16

How do you treat oppositional defiant disorder?

Answer 16

Psychotherapy - anger management training and social skills training

Question 17

What is Schizoaffective disorder?

Answer 17

Major depressive or manic episode w/sx of schizophrenia
Lifetime hx of delusions/hallucinations for > 2 weeks in ABSENCE of MD or manic episode
Mood Sx present for majority of illness

Question 18

Bipolar disorder that is not adequately controlled with mono therapy is treated how?

Answer 18

Add a 2nd gen antipsychotic

Question 19

Performance situation anxiety is a subtype of what?

Answer 19

Social anxiety disorder

Question 20

What is the MAJOR distinguishing feature of Binge-eating disorder?

Answer 20

NO compensatory behavior

Recurrent binge eating w/lack of control

Question 21

Catatonia is treated how?

Answer 21

BENZOs or ECT

Question 22

Pt that has recurrent awakenings from REM sleep associated w/full alertness and dream recall has what?

Answer 22

Nightmare disorder

Question 25

What is the MAJOR distinguishing feature of Bullimia nervosa?

Answer 25

Compensatory behavior (vomiting or Exercise) to prevent weight gain

Normal body weight

Question 26

1st line treatment for anorexia nervosa?

Answer 26

CBT

Question 27

High fever, mental status change, ANS instability, rigidity indicates what? What causes it?

Answer 27

NMS Antipsychotics —> olanzapine

Question 28

Pt that suddenly gets dysphoria, insomnia, fatigue, and myalgia after suddenly stopping SSRI has what? Treatment?

Answer 28

Antidepressant discontinuation syndrome Restart med, then gradually taper

Question 30

What is it called when there is a dream enactment during REM sleep if muscle Antonia is absent?

Answer 30

REM sleep behavior disorder

Question 31

What non-psychiatric meds can cause psychotic disorder? What sx?

Answer 31

High dose glucocorticoids aka Prednisone Delusions, hallucinations

Question 32

What medication is used to treat NMS?

Answer 32

Dantrolene or Bromocriptine

Question 35

1st line treatment for ACUTE mania are what?

Answer 35

Antipsychotics - Olanzapine

Question 36

Pt w/Major depression that fails to respond to initial SSRI at MAX dose should have what done next?

Answer 36

Switch to different SSRI

Question 37

What is persistent complex bereavement disorder?

Answer 37

Depressive sx but sadness CENTERS on loss of loved one characterized by intense yearning for deceased

Question 38

Timeline of Schizoaffective disorder?

Answer 38

LIFETIME hx of delusions/hallucinations for > 2 weeks w/no major depression

Question 38

Agranulocytosis = what?

Answer 38

Neutropenia

Question 39

Pt w/unexplained ABD pain and new onset neuropsychiatric symptoms including neuropathy, anxiety, mood change, and psychosis may have what?

Answer 39

AIP

Question 39

Borderline pts have what common history?

Answer 39

Hx of childhood abuse

Question 42

Adjustment disorder defined how? Treatment?

Answer 42

Emotional/behavioral sx that start within 3 months of an Identifiable stressor, ends w/in 6 months Psychotherapy

Question 43

What is the Major features of antisocial personality disorder?

Answer 43

Violating rights of others with NO remorse | PMHx of conduct disorder sx before age 15

Question 44

Pt with new onset of severe GI sx, confusion, ataxia, tremor and eventually seizures due to what medication?

Answer 44

Lithium toxicity

Question 45

Li toxicity causes what symptoms? What drug can interact to cause this?

Answer 45

GI distress, confusion, ataxia, tremor/fasciculations NSAIDs

Question 47

Long term SEs of Li include what?

Answer 47

Nephro DI CKD Hyperparathyroidism w/hypercalcemia Thyroid dysfx

Question 48

Structural abnormalities in orbitofrontal cortex and striatum (BG) are found in what disorders?

Answer 48

OCD

Question 49

What demographic does REM sleep behavior disorder occur in? May be a sign of what?

Answer 49

Older men PD or Dementia w/Lewy Bodies

Question 50

Pt w/prolactin level of 70 has what? If over 200?

Answer 50

Risperidone SE PRLoma

Question 50

Pt that is depressed but also has hallucinations has what? Can Treat how?

Answer 50

Major depression w/psychotic features ECT or SSIR + anti-psychotic

Question 53

OTC cold and cough meds can cause what in children?

Answer 53

Hallucinations and confusion —> psychosis

Question 54

If you are considering PMS/prementrual dysphoria disorder what do you need to do first? Treat mild how? Mod to severe?

Answer 54

Keep menstrual diary Exercise and stress-reduction SSRI

Question 55

How long do you continue SSRI treatment after a pt tells you they feel better and not depressed anymore?

Answer 55

6 months

Question 56

Chronic mood disturbance characterized by > 2 years of numerous periods of hypomanic and depressive sx that are subthreshold for Dx major depressive or hypomanic/manic episodes is what?

Answer 56

Cyclothymic disorder

Question 57

Postpartum blues occurs when? Peaks when?

Answer 57

WITHIN 2 weeks!!! Day 5

Question 59

What defines obsessive-compulsive PERSONALITY disorder?

Answer 59

Perfectionist, preoccupied with order | Have RIGID rules and details

Question 60

15 y/o boy w/transient euphoria and LOC that lasts only for 15-45 minutes is abusing what? What other sx?

Answer 60

Inhalants Dermatitis in mouth or nose

Question 62

What are the MC used treatments acute PCP intoxication?

Answer 62

``` #1 - BENZOs Haldol ```

Question 64

What labs/tests do you need prior to starting Lithium?

Answer 64

BMP Ca Thyroid fx tests UA

Question 65

What does Pramipexole treat?

Answer 65

PD and Restless leg syndrome

Question 65

Serotonin syndrome can occur with what drug drug interaction?

Answer 65

SSRI and MAOI

Question 66

Chronic depressed mood for > 2 years and NO sx-free period for > 2 months w/poor appetite, insomnia, low E/self-esteem, hopelessness indicates what?

Answer 66

Persistent depressive disorder (dysthymia) Depressed mood MORE days than not for > 2 years and 2 other depressive sx

Question 67

Sexual assault increases pt’s risk of what?

Answer 67

Suicide

Question 70

What is the 1st line treatment for school-aged children w/ADHD?

Answer 70

Stimulants - methylphenidate or amphetamines

Question 71

Elderly pts that present w/new onset insomnia with other depressive sx should raise concern for what?

Answer 71

Major depressive disorder

Question 72

What is psychodynamic psychotherapy?

Answer 72

Used to develop insight into past, unresolved conflicts and change maladaptive defenses it is NOT THE SAME as CBT

Question 73

What electrolyte abnormalities do bulimics have?

Answer 73

HypoK HypoCl Metabolic alkalosis

Question 77

How to tell the difference bw PD w/dementia and Dementia w/Lewy body?

Answer 77

If Parkinsonism symptoms (TRAP) PREDATES cognitive impairment by > 1 year, then it is PDD

Question 78

What drugs interact with Lithium?

Answer 78

``` Thiazides diuretics NSAIDs ACE-i’s Tetracycline Metronidazole ```

Question 79

Pt with acute psychosis with hallucinations needs to be what?

Answer 79

Hospitalized

Question 81

Pt that is on a SSRI for depression and after 2 weeks says he is eating and sleeping better BUT still depressed, what should you do?

Answer 81

Continue for 2-4 weeks Adequate SSRI requires 4-6 week trial

Question 81

Pt that has ADHD with history of substance use disorder treated with what?

Answer 81

Atomoxetine

Question 82

What causes an adverse side effect in the elderly which is manifested by recurrent episodes of confusion, aggression, disinhibition and agitation w/in 1 hour after taking the medication? What is this called?

Answer 82

BENZOs Paradoxical agitation

Question 83

BENZOs are generally not recommended in the elderly bc of what risks?

Answer 83

Cognitive impairment Falls Paradoxical agitation

Question 84

Treatment for Body dysmorphic disorder?

Answer 84

SSRI +/- CBT

Question 85

Pediatric depression presents w/symptom most often?

Answer 85

Irritability rather than depressed mood

Question 86

Pt that hears voices and seeing animals when falling asleep and feels weak in face and knees after talking to gf and is experience daytime sleepiness has what? What are those 2 things called?

Answer 86

Narcolepsy Hypnagogic hallucinations and cataplexy (loss of m. Tone in response to emotion)

Question 87

Guys can also have what personality disorder?

Answer 87

Borderline

Question 88

Social anxiety disorder is characterized by what?

Answer 88

Anxiety and FEAR of scrutiny in social situations | Results in avoidance, distress, social-occupational dysfx

Question 89

Pt that has failed 2 trials of antidepressants from the same class (ie SSRI) should be started on what?

Answer 89

New antidepressant w/different MOA

Question 90

Pt experiencing Acute stress Disorder, what is the best step in management/treatment?

Answer 90

Educate the pt about range of rxns to trauma —> CBT

Question 91

Which SSRI has a short half-life? Long half-life? How long?

Answer 91

Paroxetine Fluoxetine (4-6 days)

Question 94

Recurrent, unexpected panic attacks and FEAR about future attacks or maladaptive behavior related to attacks is what? Some pts may develop what?

Answer 94

Panic disorder Agoraphobia

Question 95

What medical conditions can cause psychosis in kids?

Answer 95

SLE Thyroid dysfunction CNS infection Electrolyte disorder

Question 95

Tardive dyskinesia is a result of what neurotransmitter dysregulation?

Answer 95

Dopamine receptor super sensitivity

Question 96

What is agoraphobia?

Answer 96

Anxiety and avoidance of >/= 2 situations in which it may be difficult to escape or get help (being outside the home or in enclosed spaces, using transportation) in the event of a panic attack