question

define classical conditioning

answer

PAVLOVS DOGGY DOGS (SNOOP DOGS) natrual response is elicited by a conditioned or learned stimulus(bell) that was previously presented in conjunction with an unconditioned stimulus(food)

question

1. define operant conditioning ~different types of operant conditioning below: 2. positive reinforcement 3. negative reinforcement 4. punishment 5. extinction

answer

1. learning in which a particular action is elicited because it produces a particular result 2. desired reward prouces action 3. removal of averse timulus eliminates shock (mouse button prevents shock) 4. application of averse stimulus extinguishes unwanted behavior 5. disconntinuation of reinforcement eliminates behavior

question

1. define transference 2. define coutertransference

answer

1. patient projects feeling about formative or another important person onto the physician (ex. psychiatrist = parent) 2. docotr projects feeling about formative or other important person onto patient

question

defense mechanisms (psychiatry) 1. acting out 2. dissociation 3. denial 4. displacement 5. the above ^^ defense mechanisms are what level of maturity

answer

1. unacceptable feelings expressed through actions (tantrums) 2. temporary drastic change in personality, memory, consciousness, motor behavior to avoid stress 3. avoidance of awarness of some painful reality (ex. new AIDS or cancer dx) 4. avoided ideas or feelings are transferd to a neutral person or object (ex. angry mom blames innocent kid) 5. IMMATURE DEFENSES

question

defense mechanisms (psychiatry) 1. fixation 2. identification 3. isolation of affect 4. projection 5. the above ^^ defense mechanisms are what level of maturity

answer

1. partially remaining at a more childish level of development (ex. SUNDAY FOOTBALL YEA YEA YEA) 2. modeling behavior after another person who is more powerful (ex. child pretends to get ready for work when mom is leaving the house) 3. seperating feelings from ideas and events (describe a murder with no emotional response) 4. unacceptable internal impulse is attributed to an external source (man who wants divorce blames his wife for cheating) 5. IMMATURE DEFENSES

question

defense mechanisms (psychiatry) 1. rationalization 2. reaction formation 3. regression 4. the above ^^ defense mechanisms are what level of maturity

answer

1. proclaiming logical reasons for actions actually performed for other reasons to avoid self blame (after being fired saying that the job was not important) 2. warded off idea or feeling is replaced by an emphasis on its oppsite (libidinous patient enters a monestary) 3. turning black maturational clock and going to earlier modes of dealing with the world (toilet trained children under stress will begin to bedwet again) 4. IMMATURE DEFENSES

question

defense mechanisms (psychiatry) 1. repression 2. splitting 3. the above ^^ defense mechanisms are what level of maturity

answer

1. involuntary witholding of an idea of feeling from consious awareness (not remembering a traumatic event) 2. belief that people are all good or all bad at different times 3. IMMATURE DEFENSES

question

defense mechanisms (psychiatry) 1. alturism 2. humor 3. sublimation 4. suppression 5. the above ^^ defense mechanisms are what level of maturity

answer

1. guilty feelings alleviated by unsolicited generosity to others (mafia boss makes donation) 2. appreciating amusing nature of adverse situation (med student jokes about boards) 3. replace unacceptable wish with a course of action that is similar to the wish but does not conflict with ones values (teenagers aggression toward father is used to accel in sports) 4. voluntary withholding of an idea or feeling from conscious awarness (wait until one week before USMLE to study) 5. MATURE MECHANSIMS - MATURE WOMEN WEAR A SASH (MNEUMONIC)

question

1. what is the result of long term deprevation of affection 2. what happens if deprevation of affection lasts more than 6 months

answer

1. WWWW- weak, wordless, wanting (socially), wary - poor muscle tone, dec. language, no basic trust, anaclitic depression, weight loss, physcial illness 2. irreversible changes, in infants can result in death

question

what are the signs of child abuse- phsical vs sexual

answer

physical - healed fractures, cigareete burns, subdural hematomas, multiple bruises, retinal hemorrhage/detachment sexual - genital trauma, STD, UTI

question

who is most likely the abuser in child abuse + peak age of incidence of child abuse

answer

1' caregiver, female 9-12 years of age

question

what is the evidence of child neglect, what must doctors do when they recognize this

answer

malnourished, withdrawl, social impairment, failure to thrive- report to CPS

question

Attention defecit hyperactivity disorder 1. age of onset + % progression to adulthood 2. clinical characteristics 3. neuroanatomical changes 4. treatment*

answer

1. BEFORE AGE 7, 50% progress to adulthood 2.normal intelligence, hyperactivity, motor impairment, emotional lability 3. decreased FRONTAL LOBE volume 4. methylphenidate, amphetamines , atomoxetine (non stimulant SNRI)

question

conduct disorder 1. age of onset ( 18) 2. clinical characteristics

answer

1. 18 = ANTISOCIAL PERSONALITY DISORDER 2. repetative violation of social norms (physical aggression destruction of property, theft)

question

oppositional defiant disorder 1. clinical characteristics

answer

1. enduring pattern of hostile, defiant behavior toward AUTHORITY FIGURES in teh absense of serious violations of social norms

question

tourettes syndrome 1. age of onset 2. clinical characteristics 3. treatment

answer

1. before age 18 2. rapid recurrent non rhythmic motor movements, associated with OCD 3. antipsychotics - (halperidol)

question

separation anxiety disorder (not seperation anxiety) 1.age of onset 2. clinical characteristics

answer

1. 7-9 years of age 2. fear of seperation from home or attachment figure, may lead to factitious physical complaints to avoid going to school

question

pervasive developmental disorders (definition)

answer

difficulties with language and failure to acquire/loss of social skills

question

autistic disorder 1. clinical presentation 2. tretament

answer

1. severe language disorder, repetative behavior, BELOW NORMAL INTELLIGENCE, unusual abilities, focus on objects more than people 2. behavioral and supportive therapy

question

aspergers disorder 1. clinical presentation *make sure understand differences between aspergers and autism

answer

1. more mild than autism, NORMAL INTELLIGENCE NO LANGUAGE IMPAIRMENT, all absorbing interests, problems with social relationships

question

Retts disorder 1. inheritance 2. clinical presentation (age of onset important)

answer

1. X linked disorder seen in GIRLS, fatal in boys 2. age of onset 1-4, loss of development, loss of verbal abilityies, mental retardation, ataxia, hand wringing

question

Childhood disintegrative disorder 1. clinical presentation (age of onset important)

answer

1. onset age 3-4, loss of language skills, loss of social skills, loss of bowel/bladder control, male predominance

question

neurotransmitter level changes in psychiatric disorders 1. anxiety 2. depression 3. alzheimers disease 4. Huntingtons disease 5. schizophrenia 6. parkinsons disease

answer

1. inc. NE, dec GABA, dec 5-HT 2. dec NE, dec 5-HT, dec DA 3. dec Ach 4. dec. GABA, dec. 5. inc. DA 6. dec. DA, inc. SA, inc. Ach

question

1. what is loss of orientation 2. common causes of loss of orientation

answer

1. loss of knowledge of time, place, person 2. alchohol, drugs, fluid/electrolyte, head trauma, hypoglycemia, nutritional deficiecy

question

1. retrograde amnesia 2. anterograde amnesia

answer

1. cannot remember what happened before an insult 2. cannot remember what happened after an insul

question

korsakoff amnesia 1. pathogensis 2. clinical presentation

answer

1. caused by thiamine deficiency (ALCHOHOLICS) and destruction of mammillary bodies 2. anterograde/retrograde amnesia, confabulation

question

dissociative amnesia 1. pathogenesis 2. clinical presentation

answer

1. trauma or stress 2. cannot recall important personal information

question

cognitive disorders 1. what are the two cognitive disorders 2. delirium clinical presentation 3. delirium causes 4. EEG (normal or abnormal)

answer

1. delirium and dementia 2. waxing and waning change in level of consiousness; ACUTE ONSET rapid dec. in attention span/arousal, disorganized thinking change in sensorium; hallucinations, misperceptions 3. secondary to other illnesses, CNS/infection/trauma/abuse 4. normal

question

dementia 1. clinical presentation 2. delirium causes 3. can a person with dementia develop delirium 4. EEG

answer

1. GRADUAL decline in intellectual ability or cognition with NO CHANGE IN LEVEL OF CONSCIOUSNESS memory loss**, aphasia, apraxia, agnosia, personality/behavioral changes 2. alzheimers, cerebral infarcts, HIV, picks disease, chronic susbstance abuse, CJD 3. YES - ex. person with alzheimers gets pneumonia 4. NORMAL

question

what is pseudodementia

answer

depression that presents like dementia in elderly patients

question

define psychotic disorder

answer

distorted perception of reality (psychosis), characterized by delusions, hallucinations, disorganized thinking

question

what are the four signs of psychosis

answer

hallucinations - perceptions in the absense of stimuli illusions- percieving external stimuli as something it is not delusions - false believes about oneself or others (the CIA is after me) loose associations - disorders in the form of thought (how ideas are tied together)

question

hallucination subtypes - what underlying conditions do they occur in 1. visual 2. auditory 3. olfactory 4. tactile 5. hypnagogic 6. hypnopompic

answer

1. medical illness (ex. drug interaction) 2. psychiatric illness (ex. schizophrenia) 3. part of aura of epilepsy, brain tumors 4. alcohol withdrawl (formication- sensation of insects) 5. while going to sleep 6. while waking up from sleep

question

schizophrenia 1. clinical diagnositc criteria*** 2. neurotransmitter changes 3. 5 subtypes

answer

1. psychosis/disturbed behavior and thought >6 months 2 positive symptoms: delusions, hallucinations, disorganized speech, disorganized or cationic behavior negative symptoms- flat affect, social withdrawl, lack of motivation/speech/thought 2. increased dopamine, dec. dendritic branching 3. paranoid, disorganized, catatonic, undifferentiated, residual (after tx)

question

1. brief psychotic disorder- dx criteria 2. schizophrenifom disorder - dx criteria 3. schizoaffective disorder -dx criteria

answer

1. <1 month psychotic disorder, assc. with stress 2. 1-6 months of positve and negative sx 3. 2 wk psychotic sx w/o mood disturbance + major depressive manic or mixed episode

question

1. delusional disorder - dx criteria 2. folie a deux

answer

1. fixed persistant NONBIZARRE belive system >1month, functioning otherwise normal 2. shared delusion between two people in a close relationship

question

1. dissociative identity disorder - clinical presentation+ demographics 2. depersonalization disorder clinical presentation

answer

1. multiple personality disorder- two or more distinct identities or personality states --- more common in women, assc with sexual abuse 2. persistent feelings of estrangement from ones body, social situation, environment

question

1. dissociative fugue - clinical presentation

answer

1. change in geographic location causes inability to recall past, confusion about personal identity **include depression, bipolar, dysthymia, cyclothimia +/- psychotic sx

question

1. list the mood disorders (4)

answer

1. major depressive disorder, bipoar disorder, dysthymic disorder, cyclothymic disorder

question

1. manic episode - dx criteria

answer

>1 week persistently elevated, expansive, or irritable mood with marked impairment of social/occupational functioning + 3 criteria: ( maniacs DIG FAST) distractibility irresponsibility grandiosity flight of ideas increased goal directed activity decreased sleep talkativeness or pressured speech

question

hypomanic episode - dx criteria

answer

similar to manic episode, but NO marked impairment in social or occupational functioning, no psychotic features

question

1. Bipolar 1 and Bipolar 2 - dx criteria 2. bipolar treatment

answer

Bipolar 1; > 1 manic episode +//- depressive symptoms Bipoar 2; >1 hypomanic episode + major depressive episode 2. mood stabilizers- lithium, valproic acid, carbamazepine, atypical antipsychotics

question

cyclothymic disorder- dx criteria

answer

> 2 years of dysthymia and hypomania --- milder form of bipolar disorder

question

major depressive disorder - dx criteria

answer

self limited 6-12 months in duration + 5/9 of SIG E CAPS Sleep disturbance loss of Interest Guilt or feeling of worthlessness loss of Energy loss of Concentration Appetite/weight changes Psychomotor retardation or agitation Suicidal ideation Depressed mood

question

1. dysthymia - dx criteria 2. seasonal affective disorder -dx criteria

answer

1. same as major depressive disorder but more mild and lasts > 2 years 2. same as dysthymia, assc with winter season, improves with full spectrum light exposure

question

1. atypical depression - dx criteria 2. treatment of atypical depression

answer

1. hypersomnia, overeating, mood reactivity, weight gain, sensitivity to rejection 2. MAOI, SSRI

question

post partum mood disturbances 1. maternal "blues" 2. post partum depression + tx 3. post partum psychosis + tx

answer

1. 50-85% ~ 10 days of depressed affect , tearfulness, fatigue, resolves by itself or progresses to post partum depression 2.10-15% ~depressed affect, anxity, poor concentration 2 weeks-2 months- tx antidepressants/psychotherapy 3. 0.1-0.2% ~ delusions, confusion, homiciadal/suicidal, 4-6 weeks - tx = antipsychotics, antidepressants, inpatient hospitalization

question

ECT therapy 1. indications 2. mechanism 3. side effects

answer

1. major depression, pregnant women with major depression 2. painless seizure in anesthesized pt 3. disorientation, temporary amnesia, resolves after 6 months

question

risk factors for suicide

answer

male teenager or elderly ethanol use loss of rational thinking sickness organized plan no spouse social support lacking men>women in succeeding women>men in trying

question

1. anxiety disorder general characteristics 2. list the anxiety disorders

answer

1. inappropriate fear/worry and anxiety when the source of fear is insufficient to account for the severity of sx 2. panic disoder, phobias, OCD, PTSD, generalized anxiety disorder

question

1. panic disorder - diagnostic criteria 2. treatment

answer

1. reccurent periods of intense fear/discomfort peaking in 10 minutes. Patients have persistent fear of having another attack PANICS (specific symptoms) Palpitations, paresthesias, abdominal distress, nausea, intense fear of dying, light headedness, Chest pain, chills, choking, sweating, shaking, shortness of breath 2. CBT, SSRI, TCA, benzodiazepines

question

1. specific phobia - diagnostic criteria 2. treatment

answer

1. unreasonable fear cued by presence of a specific object or situation - person realizes fear is excessive 2. systematic desensitization

question

1. social phobia -diagnositic criteria 2. treatment

answer

1. exaggerated fear of embarrassment in social situations 2. SSRI

question

Obsessive compulsive disorder 1. diagnostic criteria 2. associated disorder 3. treatmnet

answer

1. recurring intrusive thoughts, feelings, or obsessions that cause distress- relieved by performance of repetitive actions 2. tourettes disorder 3. SSRIs, clomipramine (TCA)

question

Ego dystonic disorder - dx criteria

answer

behavior that is inconsistent with one's own beliefs and attitudes (compare to OCD)

question

Post traumatic stress disoder 1. dx criteria 2. treatment 3. acute stress disorder

answer

1. Disturbance >1 month after traumatic event (nightmares, intense fear, flashbacks), causes impaired functioning 2. psychotherapy, SSRI 3. lasts 2 days to 1 month

question

Generalized anxiety disorder 1. dx criteria 2. treatment 3. adjustment disorder - dx criteria

answer

1. uncontrollable anxiety for >6 months unrelated to specific situation, event or person- fatigue, GI disturbance, difficulty concentrating 2. benzodiazepine, buspirone, SSRI 3. anxiety/depression after an IDENTIFIABLE psychosocial stressor , lasts <6 months

question

1. malingering - dx criteria (compare to factitious disorder and somatiform disorders)

answer

pt consciously fakes claims of having a disorder to get drugs or avoid work- often has poor compliance - complaints STOP AFTER GAIN

question

factitious disorder 1. dx criteria 2. munchausen's syndrome 3. munchausens syndrome by proxy (compare to factitious disorder and somatiform disorders)

answer

1. patient creates physical or psychological symptoms to assume the sick role and get medical attention (1' gain) (DOES NOT STOP AFTER GAIN) 2. chronic factitious disorder with physical signs/symptoms- willing to receive invasive procedures 3. illness in child is caused by the caregiver, motivation is to assume sick role by proxy - this is CHILD ABUSE

question

1. somatoform disorders general features 2. list the different somatoform disorders

answer

1. physical symptoms with no identifiable physical cause, illness is caused by entirely unconsious drives, symptoms not intentionally created (compare to factitious and malingering) 2. somatization disorder, conversion, hypochondriasis, body dysmorphic, pain disorder

question

somatoform disorders 1. somatization disorder 2. conversion disorder 3. hypochondriasis 4. body dysmorphic disorder 5. pain disorder

answer

1. multiple organ systme complaints (4 pain, 2 GI, 1 sexual, 1 pseudoneurologic) over several years 2. sudden loss of sensory or motor function following an acute stressor, patient aware but indifferent to sx (blindness, paralysis, mutism) 3. preoccupation with fear of having illness despity medical evalulation 4. preoccupation with appearance, leads to emotional distress, seek cosmetic surgery 5. prolong pain with no physical findings

question

1. define personality trait 2. define personality disorder

answer

1. enduring repetitive pattern of percieving, relating to and thinking about the environment and oneself 2. infelexible maladaptive behavior pattern that causes stress and impaired functioning

question

Cluster A personality disorders 1. cluster A personality disorders general characteristics 2. paranoid disorder (+defense mech) 3. schizoid disorder 4. schizotypal disorder

answer

1. Accusatory Aloof Awkward: odd and eccentric, cannot develop meaningful social relationships, NO psychosis 2. distrust, suspicion, use of projection as defense mechanism 3. social withdrawl, limited emotional expression, social isolation 4. MAGICAL thinking, eccentric appearance, interpersonal awkwardness

question

Cluster B personality disorders 1. Cluster B personality disorders general characteristics 2. antisocial disorder 3. borderline disorder (+defense mech) 4. histrionic disorder 5. narcissistic disorder

answer

1. dramatic, emotional, erratic, assc with substance abuse 2. violation of rights of others, criminality (conduct disorder if males 4. excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with apperance 5. grandiosity, entitilement, lacks empathy, requires admiration, reacts to criticism with rage

question

Cluster C personality disorders 1. Cluster C personality disorders general characteristics 2. avoidant disorder 3. obsessive compulsive personality disorder 4. dependent disorder

answer

1. anxious or fearful 2. hypersensitive to rejection, socially inhibited, feels inadequate, desires relationships with others (vs schizoid) 3. preoccupied with order, perfectionism, control, behavior consistent with ones own beliefs (vs OCD****) 4. submissive, clinging, needs to be taken care of, low confidence

question

1. schizoid 2. schizotypal 3. schizophrenic 4. schizoaffective 5. schizophreniform (*_*)

answer

1. socially withdrawn, content with isolation 2. schizoid + odd or magical thinking 3. >6 months delusions/hallucinations/cationic or disorganized behaviror + negative sx 4. 2 weeks psychosis + major depression, or manic episode (schizophrenia + mood episodes) 5. schizophrenia that occurs for <6 months

question

1. anorexia nervosa - clinical signs 2. anorexia nervosa - clinical symptoms

answer

1. excessive dieting +/- purging, body weight <85% of ideal, dec. bone density, amenorrhea, anemia, electrolyte disturbances 2. fear of gaining weight, body image distortion, depression

question

1. buleimia nervosa -clinical signs

answer

1. binge eating +/- purging, laxitive, diuretics, emetics body weight NORMAL RANGE, parotitis, enamel erosion, electrolyte disturbances alkalosis, russels sign (marks on back of the hand from vomitting)

question

gender identity disorders 1. transexualism 2. transvestism

answer

1. desire to live as opposite sex through surgery or hormone treatments 2. paraphilia- wearing cloths of the opposite sex

question

substance dependence- diagnostic criteria (7)

answer

>3 in one year tolerance withdrawl increasing dose desire and unsuccess to dec use significant time/energy recovering from drug use social/job/recreational impairments continued use despite knowing problems with use

question

substance abuse - diagnostic criteria (4)

answer

recurrent use resulting in failure at work/school/home use in hazardous situations substance related legal problems use despite continuous problesm

question

stages of change in overcoming substance addiction (6)

answer

1. precontemplation - dont know there is problem 2. contemplation - know there is problem but no action 3. preparation/determination - getting ready to change 4. action/willpower - changing behavior 5. maintainence - maintaining behavior change 6. relapse - returning to old behaviors

question

Depressants (general) 1.intoxication 2. withdrawal 3. what drugs are depressants (4)

answer

1. mood elevation, dec. anxiety, sedation, behavioral disinhibition, respiraotry depression 2. anxiety, tremor, seizures, insomnia 3. alchohol, opiods, barbiturates, benzodiazepines

question

alchohol (depressant) 1. intoxication 2. withdrawal 3. treatment for alcohol withdrawal 3. blood markers of alcoholism****

answer

1. slurred speech, ataxia, emotional lability 2. mild = anxiety, tremor, seizures, insomnia severe= delirium tremens 3. benzodiazepines 4. gamma-glutamyltransferase, AST 2x> ALT****

question

opioids (depressant) 1. intoxication 2. withdrawal 3. treatment of intoxication 4. treatment of withdrawal

answer

1. CNS depression, N/V, constipation, pinpoint pupils, seizures 2. sweating, dilated pupils, piloerection, fever, rhinorrhea, craps, diarrhea 3. naloxone/naltrexone 4. symptomatic

question

barbiturates (depressant) 1. intoxication 2. withdrawal 3. treatment of intoxication

answer

1. major respiratory depression (low safety margin) 2. delierium, life threatening cardiovascular collapse 3. artificial ventilation, increase BP

question

benzodiazepines (depressant) 1. intoxication 2. treatment of intoxication

answer

1. ataxia, minor respiratory depression (compre to barbiturates) (greater safety margin) 2. flumazenil (GABA antagonist)

question

stimulants (general) 1. intoxication 2. withdrawal 3. what drugs are stimulants (4)

answer

1. mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias,tachycardia, anxiety 2. "crash" depression, lethargy, weight gain, headache 3. amphetamines, cocaine, caffeine, nicotine

question

amphetamines (stimulant) 1. intoxication 2. withdrawal

answer

1. pupil dilation, insomnia, prolonged wakefulness/attention, delusions, hallucinations, fever 2. stomach cramps, hunger, hypersomnolence

question

cocaine (stimulant) 1. intoxication 2. withdrawal 3. treatment for withdrawl

answer

1. sudden cardiac death *pupillary dilation, hallucinations, paranoid ideations 2. suicidality, hypersomnolence, malaies, psychological craving 3. benzodiazepines

question

caffeine (stimulant) 1. intoxication

answer

1. restlessness, diuresis, muscle twitching

question

nicotine (stimulant) 1. intoxication 2. withdrawal 3. treatment of withdrawal

answer

1. restlessness 2. anxiety, craving, irritability 3. bupropion, varenicline, patch, gum

question

PCP (hallucinogen) 1. intoxication 2. withdrawal

answer

1. belligerence, impulsiveness, NYSTAGMUS, tachycardia, homicidality, psychosis, delirium 2. depression, anxiety, irritability, restlessness, anergia

question

LSD 1. intoxication

answer

1. anxiety, depression, delusions, FLASHBACKS, pupillary dilation

question

marijuana 1. intoxication 2. withdrawal + urine testing

answer

1. euphoria, anxiety, paranoid delusions, impaired judgment, social withdrawal, increased appetite, conjunctival injection, hallucinations 2. irritability, depression, insomnia, anorexia, sx peak 48 hours last ~1 week, detectable in the urine for up to one month

question

heroin 1. medical complications of heroin addiction 2. methadone 3. suboxone

answer

1. right sided endocarditis, hepatitis, AIDS, abscesses 2. oral opiate used for heroin detox/maintenance 3. naloxone (only active if injected**) + buprenorphine (partial agonist) long acting with less withdrawal compared to methadone

question

alcoholism 1. medical complications of alcoholism 2. wernicke korsakoff syndrome 3. treatment of wernicke korsakoff syndrome

answer

1. alcoholic cirrhosis, hepatitis, pancreatitis, peripheral neuropathy, testicular atrophy 2. thiamine deficiency - necrosis of mamillary bodies Wernicke= Triad: confusion, ophthalmoplegia, ataxia Korsakoff = memory loss, confabulation, personality change 3. parenteral B1

question

Mallory weiss syndrome

answer

longitudinal lacerations at gastroesophageal junction caused by excessive vomiting, presents with meatemesis

question

treatment of alchoholism

answer

disulfiram support groups

question

1. delirium tremens 2. treatment of delirium tremens

answer

1. alcohol withdrawal syndrome 2-5 days after last drink autonomic hyperactivity, (tachycardia, tremors, anxiety), hallucinations/delusions, confusion 2. benzodiazepines

question

psychiatric disorder treatments 1. alcohol withdrawal 2. bulimia 3. anxiety 4. ADHD 5. atypical depression

answer

1. benzodiazepines 2. SSRI 3. benzodiazepines, buspirone, SSRIs 4. methylphenidate, amphetamines 5. MAOI, SSRI

question

psychiatric disorder treatments 1. bipolar disorder 2. depression 3. depression with insomnia 4. OCD 5. panic disorder

answer

1. lithium, valproate, carbamazepine (mood stabilizers), atypical antipsychotics 2. SSRI, SNRI, TCA 3. mirtazapine 4. SSRIs, clomipramine 5. SSRIs, TCAs, benzodiazepines

question

psychiatric disorder treatments 1. PTSD 2. schizophrenia 3. tourettes syndrome 4. social phobias

answer

1. SSRI 2. antipsychotics 3. antipsychotics 4. SSRI

question

methylphenidate, dextroamphetamine 1. mechanism 2. clinical use

answer

1. increase catecholamines (NE/DA) in the synaptic cleft 2. ADHD, narcolepsy, appetite control

question

antipsychotics (typical) 1. high potency (3) 2. low potency (2) 3. mechanism 4. clinical use

answer

1. Try to Fly High - trifluoperazine, fluphenazine, haloperidol 2. Cheating Thieves - chlorpromazine, thioridazine 3. block D2 receptors (increasing cAMP) 4. schizophrenia (+ symptoms), psychosis, mania, tourettes syndrome

question

antipsychotics (typical) 1. side effects 2. neuroleptic malignant syndrome 3. treatment of NMS 4. tardive dyskinesia

answer

1. EPS, hyperprolactinemia/galactorrhea (b/c blocks D2), antimuscarinic side effects (dry mouth/constipation), alpha blocking (hypotension), histamine (sedation) 2. FEVER - fever, encephalopathy, vitals unstable, elevated enzymes, rigidity of muscles 3. dantrolene 4. stereotypic oral facial movements due to long term antipsychotic use

question

antipsychotics (typical) 1. chlorpromazine (low potency)/thioridazine(high potency ocular side effects

answer

1. chlorpromazine - corneal deposits thioridazine - retinal deposits

question

antipsychotics (typical) 1. evolution of EPS for pt on typical antipsychotics

answer

rule of 4's 4 hours - acute dystonic -spasms/stiffness/oculogyric crisis 4 days - akinesia (parkinsonism) 4 weeks - akathisia (restlessness) 4 months - tardive dyskinesia

question

atypical antipsychotics 1. drug names 2. mechanism 3. clinical use

answer

1. olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone 2. 5HT2, DA, alpha, H1 receptor modulation not completely understood 3. schizophrenia (BOTH +/- symptoms)

question

atypical antipsychotics 1. which atypical for OCD, anxiety, depression, mania, tourettes 2. SE compared to typicals 3. which atypicals cause weight gain 4. which atypical causes agranulocytosis 5. which atypical causes long QT

answer

1. olanzapine 2. less EPS, no tardive dyskinesia 3. olanzapine, clozapine 4. clozapine (MOST WATCH CLOZAPINE CLOZLY with WBC counts every week) 5. ziprasidone

question

lithium (mood stabilizer) 1. mechanism 2. clinical use 3.side effects 4. renal effects

answer

1. not known, possibly inhibits phosphatidylinositol cascade 2. mood stabilizer for bipolar disorder, blocks relapse and acute manic events, SIADH 3. tremor, nephrogenic DI (ADH antagonist), hypothyroidism, ebstein abnormality, narrow therapeutic window 4. nephrogenic DI, reabsorbed in PCT with Na+

question

buspirone 1. mechanism 2. clinical use 3. advantage compared to benzodiazepine/barbiturates

answer

1. 5HT1a agonist 2. generalized anxiety disorder 3. does not interact with alcohol

question

TCA 1. drugs 2. mechanism 3. clinical uses

answer

1. amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine, *-iptyiline, *-ipramine 2. NE/5HT reuptake inhibitors 3. depression, bedwetting (imipramine), OCD (clomipramine), fibromyalgia

question

treatments for OCD (3)

answer

clomipramine (TCA) olanzapine (atypical) SSRIs

question

TCA 1. side effects 2. which TCA has more anticholinergic SE 3. which TCA has less sedation + less seizure 4. signs of toxicity 5. treatment of toxicity

answer

1. alpha blocking (hypotension), anticholinergic (tachycardia, urinary retention) 2. amitriptyline (3') > nortriptyline (2') 3. desipramine 4. convulsions, coma, cardiotoxicity(arrhythmia) (3 Cs) respiratory suppression, hyperpyrexia, confusion, hallucinations 5. NaHCO3- to protect the heart

question

SSRIs 1. drug list 2. mechanism 3. clinical uses 4. toxicity 5. treatment of toxicity

answer

1. fluoxetine, paroxetine, sertraline, citalopram 2. 3. depression, OCD, bulimia, social phobias, PTSD 4. serotonin syndrome (if used with MAOIs or other drugs that inc. serotonin hyperthermia, myoclonus, cardiovascular collapse, diarrhea, flushing, seizure 5. cyproheptadine (5HT2 antagonist)

question

SNRI 1. drug list 2. clinical uses 3. toxicity

answer

1. venlafaxine, duloxetine 2. depression, generalized anxiety disorder (venlafaxine), diabetic peripheral neuropathy (duloxetine) 3. increaesd BP, sedation, nausea

question

MAOI 1. drug list 2. mechanism 3. clinical use 4. toxicity

answer

1. tranylcypromine, phenelzine, isocarboxazid, selegiline 2. MAO inhibitor, increases NE/5HT/DA 3. atypical depression, anxiety, hypochondriasis 4. hypertensive crisis with tyramine ingestion and beta agonists, contraindicated with SSRI or merperidine

question

buproprion 1. mechanism 2. clinical use 3. side effects

answer

1. increases NE/DA by unknown mechanism 2. atypical antidepressant, smoking cessation 3. stimulant effects, seizure, no sexual side effects** (compare to other SSRIs)

question

mirtazapine 1. mechanism 2. clinical use 3. side effects

answer

1. alpha 2 antagonist - increases release NE/serotonin, 5HT antagonist 2. atypical antidepressant 3. sedation, inc. appetite, weight gain, dry mouth

question

maprotiline 1. mechanism 2. clinical use 3. side effects

answer

1. blocks NE reuptake 2. atypical anti-depressant 3. orthostatic hypotension, sedation

question

trazadone 1. mechanism 2. clinical use 3. side effects

answer

1. inhibits seratonin reuptake 2. insomnia 3. PRIAPISM, sedation, postural hypotension

USMLE Psychiatry – Flashcards

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