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UW3 (2020) > UW3 (02 Psych) > Flashcards

UW3 (02 Psych) Flashcards

1
Q

Extrapyramidal

Sudden contraction
Neck / Tongue / Eye
Torticollis + Ocullogyric crisis

Diagnosis?
Treatment? 2

A

Acute Dystonia

DiphenHydramine
Benztropine

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2
Q

Extrapyramidal
Restlessness
Diagnosis?
Treatment? 3

A

Akathisia

Propranolol
Lorazepam
Benztropine

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3
Q

Extrapyramidal

Gradual onset
Tremor
Rigidity
Bradykinesia

Diagnosis?
Treatment? 2

A

Benztropine

Amantadine

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4
Q

Extrapyramidal

Gradual onset
Dyskinesia
Mouth / Face
Trunk / Extremities

Diagnosis?
Treatment? 2

A

Tardive Dyskinesia

Valbenazine
Deuterabenazine

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5
Q

Major depression - diagnosis

Duration?
What complications if no treatment?

A

> 2 weeks

CV disease risk increase

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6
Q

Depression > 2y

Diagnosis?

A

Persistent depressive disorder

= Dysthymia

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7
Q

Adjustment disorder

Timeline criteria?

A

Functional dysfunction onset < 3m after stressor

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8
Q

Depression

Treatment indication?
If responsive to SSRI but has side effects?
What should be added in addition to medication for moderate/severe?
Is it safe to use at CV disease?

A

symptom > 6m

Different SSRI type

Add therapy

Safe with CV disease

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9
Q

Insomnia at elderly
First line treatment?
Others? 4

A

Cognitive Behavioral therapy

Sleep hygiene
Sleep restriction
Stimuli control
Relaxation techniques

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10
Q

Schizophrenia with depression or mania
Delusion or hallucination > 2 weeks without depression or mania

Diagnosis?

A

Schizoaffective disorder

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11
Q

Acute stress
Timing?
When is it considered PTSD?
1st line therapy?

A

Duration 3d-1m
PTSD if > 1y
CBT + medications @ insomnia or anxiety

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12
Q

Lithium toxicity

Risks / Trigger? 3
Management? 3
When is dialysis required?

A

AKI
Hypovolemia (Thiazide / ACE-I)
NSAID

Li check q24h
IVF
Bowel irrigation

Dialysis

  1. Li > 4
  2. Li > 2 with symptom or AKI
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13
Q

Personality disorder:
Excessive emotion
Attention seeking

Histrionic vs Borderline difference?

A

Histrionic
Inappropriate social behavior
Suggestiveness

Borderline
Manipulative
Self injury / SI
Identity disturbance

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14
Q

Schizophrenia treatment

for positive symptoms? (general)
for negative symptoms?

A

Anti-psychotics

Pyschosocial:
social skills
employment service

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15
Q

Androgenic steroid abuse - symptoms

Typical at Male? 1
Typical at Female? 4
Common for both? 1

A

Aggression

Eating disorder
Clitoromegaly
Hair loss
Deep voice

Mood disorder

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16
Q

Diagnosis criteria

Provisioal tic?
Chronic tic?
Tourette? - complications? 2

A

Tic < 1y

Motor / Vocal tic > 1y

Multiple motor + Vocal tic > 1y
OCD / ADHD

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17
Q

Tourette

Treatment? 4

A

CBT (habit reversal)

Antipsychotic
1 - fluphenazine / Pinozide / Haloparidol
2 - Risperidone / Aripiprazole

Alpha blocker (clonidine / guanfacine)

Dopamine deplete (tetrabenazine)

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18
Q

Bipolar treatment:

Hypo/Mania episode while on anti depressant? 2
Severe mania? If worsen?

A

Stop: anti depressant
Start: mood stabilizer or Anti psychotic g2

Start: Lithium / Mood stabilizer / Valproate
Add: anti-psychotics

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19
Q

ADHD

1st management?
Medication Indication?

A

Behavioral therapy

Age > 6y
Failed behavior therapy
Severe impairment

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20
Q

ADHD medication

What organ system HPI & PE is needed?
What test is NOT needed?
Does it increase risk for substance abuse?

A

Cardiac
Monitor weight & VS
NO EKG needed
Not increase subspace abuse risk

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21
Q

Smoking withdrawal symptoms? 5

Smoking cessation treatment? 4

A 
Restlessness
Anxiety / Restlessness
Reduced concentration
Insomnia
Depression

Behavioral
Nicotine replacement
Varenicline
Bupropion

22
Q

Bupropion

Effects on weight?
Avoid at? 2

A

Decrease weight

Avoid at seizure & eating disorder

23
Q

Sleep Terror

Initial management?
Typical course?
When does it require medication? which one?

A

Reassurance & Education only

Spontaneous resolution within 1-2y

Benzo @ high freq or sig impaired function

24
Q

Parkinson medication therapy

Mechanism of causing psychosis?
3 management steps?

A

Elevated Dopamine

Stop/Reduce: adjunct meds
Reduce: Levo/Carbi dopa
Add: quetiapine / clozapine / pimavanserin

25
Q

Treatment resistant depression
(with partial response)

Management? 5

A 
Augment (add)
Anti depressant
Anti Psychotics g2
Lithium
Thyroid hormone
Psychotherapy
26
Q

Treatment resistant depression
(with NO response)

Management?

A

1 - Switch anti depressant
2 - psychotherapy
3 - ECT
4 - transcranial magnetic stimulation

27
Q

Benzodiazepine

Withdrawal symptoms? 10

A 
Tachycardia
Hypertension
Hyperthermia
Restless / Irritable
Anxiety / Panic
Insomnia
Tremor
Psychosis
Seizure
Death
28
Q

Lithium

Medication types that increases Li? 4
Medication types that decreases Li? 2
Medications types that caused mixed Li changes? 2

A

Thiazide
NSAID (∅ Aspirin)
ACE-I / ARB
Anti-Biotics

K sparing diuretics
Theophylline

Loop Diuretic
CCB

29
Q 
Anorexia
Hospitalization criteria (10)
A 
Hemodynamic instability
HR < 40
BP < 80/60
Dizziness / Syncope
Orthostatic change
Hypothermia
Refeeding
BMI < 15
Refusal to eat
Suicidal
Psychosis
30
Q

OCD

Treatment? 4

A
  1. Exposure & Response therapy
  2. SSRI
  3. Clomipramine (TCA)
  4. Anti psychotics
31
Q

Behavioral therapy for conditions:

  1. Borderline
  2. OCD
  3. Depression
  4. Childhood problems
  5. Stress / Coping
A
  1. Dialectical
  2. Exposure & Response
  3. InterPersonal
  4. PsychoDynamic
  5. Supportive
32
Q

Alcohol abuse

1st line treatment

A

Psycho/Social

33
Q

Alcohol treatment:

  1. Naltrexone (mechanism, effects & indication, contraindication 2)
  2. Acamprosate (mechanism)
  3. Disulfiram (use indication)
A
  1. Mu antagonist
    Reduce craving & drinking (start while drinking)
    CI @ opioid / hepatitis or liver failure
  2. Glutamate modulator
  3. highly motivated & not drinking
34
Q

Steroid induced psychiatric symptoms? 6

A 
Mood symptoms
Psychosis
Anxiety
Sleep disturbance
Restlessness
Memory loss
35
Q

Panic attack

  1. Initial treatment
  2. medication for acute episode?
A
  1. SSRI/SNRI + CBT

2. Benzo

36
Q

SLE - labs

General & findings? 5
Serology? 4

A

Hemolytic Anemia
Plt ↓ / WBC ↓ / Cr ↑
ProteinUria

C3 ↓ / C4 ↓
ANA
Anti-dsDNA
Anti-Smith

37
Q

Somatic Symptom

  1. Timing criteria?
  2. Main management?
  3. 4 goals?
A
  1. Distress or Impairment > 6m
  2. Regular office visits
  3. Functional improvement
    Stress reduction
    Coping strategy
    Mental health referral
38
Q

Anti psychotics at dementia

Increased mortality cause 3

A

CV event
Fall
Aspiration pneumonia

39
Q

Catatonia

Treatment? 2

A

Lorazepam

ECT

40
Q

Alcohol withdrawal symptom / timing

  1. 6-24h (4)
  2. 12-48h (2)
  3. 48-96h (7)
  4. Is Benzo safe to use at liver disease?
A
  1. Anxiety / Insomnia / Tremor / Sweat
  2. Hallucination / Seizure
  3. Delirium / Confusion / Hallucination / Agitation / T ↑ / HR ↑ / BP ↑
  4. Yes
41
Q

PCP intoxication treatment

For mild? 1
For severe or violence? 2

A

Reduce stimuli

Benzo / Lorazepam
Haloperidol

42
Q

Serotonin syndrome vs Neuroleptic malignant

Medication causes? 5 / 1
Presentation differences? 3 / 2
Management? 3 / 1

A 
SSRI / SNRI
TCA
Tramadol
MAOI / Linezolid
MDMA

Tremor / MyoClonus / HyperReflexia

BradyKinesia / Muscle Rigidty
--------------------------------------------------
Strop Medications / Support 
Benzo
Cyproheptadine
(serotonin antagonist)

Dantrolene

43
Q

Anxiety / Agitation / Delirium
Diaphoresis / BP ↑ / HR ↑ / T ↑
Nausea / Vomiting / Diarrhea
On psychiatric medication

Differential Diagnosis? 2

A

Serotonin syndrome

Neuroleptic Malignant Syndrome

44
Q

Tobacco effect at pregnancy:

Maternal effects? 5
Fetal effects? 7

A 
Pre-Eclampsia
Placenta previa
Placental abruption
PPROM
Spontaneous abortion
Congenital defects
SGA
Fetal demise
DM
Asthma
Obesity
Sudden infant death
45
Q

Schizophrenia
Good prognosis factors:

Timing?
Gender?
Onset / Trigger ?
Symptom types?
FH?
Duration?
A 
Late onset
Female
Acute onset / Trigger
Positive >> Negative
No FH
Short duration
46
Q

Believe death is:

Temporary
Reversible
Disbelief

age group?

A

Age < 6y

47
Q

Sexual dysfunction @ SSRI

Management? 4

A
  1. r/o medical cause
  2. Switch to bupropion / mirtazapine
  3. Add: sildenafil / bupropion
  4. Reduce SSRI dosage & monitor
48
Q

St. John’s Wort

Common uses? 3
Medication interactions? 7

A

Anti-depressant
Anti-inflammatory
Wound healing

OCP
Anti-RetroViral
ImmunoSuppressant
Narcotics
Anti-Fungal
Anti-Coag
Serotonin syndrome risk ↑ @ SSRI/SNRI
49
Q

Substance abuse referral

Indication for OP? 3
Indication for IP? 6

A

Highly functioning
Highly motivated
Has Good support system

Severe
Intoxication / Withdrawal
Comorbidities
Poorly functioning
Low motivation
Poor support
50
Q

PTSD

Diagnosis?
Treatment? 2
Medication for nightmare?

A

Nightmare / Flash back > 1m

CBT
SSRI / SNRI

Prazosin @ nightmare

51
Q

Varenicline

Psychiatric side effects? 3
Treatment?

A

Agitation
Depression
Suicidal

Bupropion

UW3 (2020) (19 decks)

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