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Psychiatry > UWorld > Flashcards

UWorld Flashcards

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1
Q

tx for generalized social anxiety

A

SSRI/SNRI, CBT

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2
Q

tx for performance type social anxiety

A

propranolol or benzos, CBT

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3
Q

weight loss, behavioral changes, erythema of turbinates and nasal septum

A

cocaine abuse

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4
Q

when treating a single episode of MDD, antidepressant should be continued for _______ following the patient’s response

A

6 months

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5
Q

first line tx for specific phobia

A

behavioral therapy

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6
Q

minors (t require parental consent

A

emancipated: homeless, lives alone, financially independent, married, military
medical circumstances: emergency, contraception, STD, prenatal care, substance abuse tx

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7
Q

survivors of sexual assault are at risk for developing PTSD, ______, and ________

A

depression, suicidality

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8
Q

multiple personality disorder is aka ________

A

dissociative identity disorder

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9
Q

looks like dissociative fugue but without the traveling

A

dissociative amnesia

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10
Q

first line drugs for bipolar

A

depakote, Li, atypical antipsychotics

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11
Q

tourettes dx: multiple ______ tics and at least 1 _____ tic
onset before ______
must exist for at least ______

A

motor, vocal
age 18
1 year

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12
Q

tx for tourettes

A 
antipsychotics (haldol, pimozide, fluphenazine, *risperidone) 
alpha agonists (clonidine, guanfacine) 
behavioral therapy
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13
Q

metabolic side effects of second gen APDs
highest risk:
lowest risk:
how and what to monitor

A

highest risk: olanzapine, clozapine
lowest risk: aripiprazole, ziprasidone
-monitor BMI monthly
-fasting glucose, lipids, BP, waist circumference at baseline, 3 months, and yearly

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14
Q

kidney and thyroid tests for pts taking this mood stabilizer

A

Li

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15
Q

QT prolongation associated with this 2nd gen APD

A

ziprasidone (Geodon)

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16
Q

hyperprolactinemia occurs with first gen APDs and this second gen

A

risperidone

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17
Q

somatic symptom disorder

how to handle these pts

A

one or more sxs that cause distress or significantly disrupt daily life, have excessive thoughts of behaviors related to these sxs, and have persistent sxs for > 6 months
-regularly scheduled appointments intended to reduce their underlying psychological distress

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18
Q

impairment resulting from perfectionism and the need to complete tasks meticulously

A

OCPD

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19
Q

for depression in patients with a short life span, you can give __________ as these take longer to achieve their effect

A

stimulants (methylphenidate, modafinil)

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20
Q

treatment for acute mania

A
  • first and second gen antipsychotics
  • Li (avoid in renal disease)
  • depakote (avoid in liver disease)
  • carbamazepine (can increase metabolism of other drugs)
  • combos (ex. APDs + Li or depakote) in severe mania
  • adjunctive benzos for insomnia, agitation
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21
Q

lamictal is used in bipolar under what circumstance

A

treatment of depression in pts with bipolar

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22
Q

how to tx conversion d/o

A

education and support –> CBT is second line

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23
Q

drugs for OCD

A 
clomipramine (TCA)
fluoxetine
fluvoxamine
paroxetine
sertraline
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24
Q

you must inform the health department about positive HIV and TB tests (T/F)

A

T

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25
imaging finding in autism
increased brain volume
26
imaging finding in OCD
abnormalities in orbitofrontal cortex and striatum
27
imaging finding in panic disorder
decreased volume of amygdala
28
imaging finding in PTSD
decreased hippocampal volume
29
imaging finding in schizophrenia
enlargement of cerebral ventricles
30
if health care proxy disagrees with living will, first do this and then do this if the first thing doesn't work
1. discuss the situation with the proxy and other family | 2. consult hospital ethics committee
31
tx for trichotillomania
CBT (habit reversal training)
32
maintenance tx recommendations for bipolar
1 episode: therapy for at least 1 year (maybe 2) 2 episodes: long term (year) if not indefinitely, esp if episodes were severe or there is a family history 3: lifetime maintenance therapy
33
nervousness, loss of appetite, nausea, abdominal pain, insomnia, tachycardia are side effects of _____
methylphenidate
34
prolonged methylphenidate use for ADHD has shown to cause growth ________
retardation or weight loss
35
tx for panic disorder
SSRI/SNRI and/or CBT
36
common comorbidities of panic disorder
depression, agoraphobia, substance abuse, suicide, bipolar
37
buspirone is used to treat both GAD and social anxiety disorder (T/F)
F | it's only used for GAD
38
visual hallucinations and perceptual intensification are hallmarks of __________ intoxication
LSD
39
tx for akathisia
propranolol
40
how to tx drug induced parkinsonism
anticholinergic or amantadine (DA agonist)
41
bupropion (wellbutrin) should not be given to ppl with ______
seizures (epilepsy, alcohol or benzo use, eating disorders)
42
MOA of bupropion
inhibits reuptake of NE, DA, and 5-HT | -good for concentration and energy
43
which atypical antipsychotic is most likely to cause EPS? | which is least likely?
risperidone | clozapine is the atypical that is least likely to cause EPS
44
parents have the right to refuse life saving treatment for their children (including refusal for religious reasons) T/F
F parents CANNOT refuse life saving tx for their children -as the physician, you should get a court order -if it's an emergency situation, you can go ahead and tx the child w/o the court order
45
this typical APD is associated with jaundice
chlorpromazine
46
cataracts are associated with this atypical APD
quetiapine
47
clozapine can cause this neuro disorder
lowers the seizure threshold
48
frequent comorbidities of tourette's
ADHD, OCD
49
immediate tx of panic attack
benzo
50
tx for anorexia nervosa
CBT, nutritional rehab, olanzapine as last resort
51
tx for bulimia
CBT, nutritional rehab, SSRI
52
when to hospitalize anorexia patients
dehydration, electrolyte distrubances (hypoK, hypophos), bradycardia, severe weight loss
53
when making anorexics eat, watch out for this
refeeding syndrome: electrolyte depletion, arrhythmia, heart failure
54
only the patient or a personal representative can request medical records (T/F)
T | -the spouse can't do it... the patient must submit the request herself
55
in alcoholic hallucinosis, ppl hallucinate but ______ and ______ are intact
sensorium and vitals
56
SSRIs (4)
citalopram fluoxetine paroxetine sertraline
57
SNRIs (3)
duloxetine (cymbalta) venlafaxine (effexor) desvenlafaxine (pristiq)
58
TCAs (4)
amitriptyline (Elavil) clomipramine (Anafranil) doxepin (sinequan) nortriptyline (Pamelor)
59
MAOIs (2)
phenelzine (Nardil) | tranylcypromine (Parnate)
60
other antidepressants not SSRI, SNRI, TCA, or MAOI
bupropion (wellbutrin) mirtazapine (remeron) trazodone (desyrel)
61
if not responsive to one SSRI, what do you do next?
try another SSRI | if still doesn't work, then consider switching classes
62
how to tx hoarding
SSRI and CBT
63
tx for narcolepsy
maintain proper sleep schedule, avoid alcohol/benzos *novel stimulants: modafinil, armodafinil <-- these are preferred amphetamine stimulants: methylphenidate sodium oxybate
64
pramipexole MOA and uses
DA agonist | Parkinson's and RLS
65
pt with anorexia is at risk for what if she wants to have a baby
premature or small for gestational age baby miscarriage hyperemesia gravidarum postpartum depression
66
clinical findings in anorexia
``` osteoporosis elevated cholesterol and carotene levels cardiac arrhythmias euthyroid sick syndrome HPA dysfunction hyponatremia ```
67
risk of bipolar: - in general population - father or mother - father and mother - MZ twin
general: 1% father or mother: 5-10% father and mother: 60% MZ twin: 70%
68
introjection defense mechanism
assimilating another person's attitude into one's own perspective
69
tx response is defined as a _______ reduction in the baseline level of severity
50%
70
night terrors occur during REM sleep (T/F)
F
71
sleep walking occurs during REM (T/F)
F
72
these are important in ADHD dx
teacher evaluations
73
tx for kleptomania
CBT (meds don't do much)

Psychiatry (4 decks)

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