Quick Psych Review

laracrystalo's version from 2016-07-20 13:56

Section 1

Question Answer
prolonged QRSTCA overdose
tx TCA overdosesodium bicarb
tx touretterisperidone
nightmares happen in ...REM sleep
night terrors happen in ...stage IV sleep
overwhelming anxiety that precedes action, with relief afterwards, then guiltimpulse control disorder
tx impulse control disorderCBT, SSRI
main difference between bulimia and anorexialow BMI in anorexia
conversion disorderfunctional neuro sx that are non physiologic. La belle indifference
somatic sx disorderone more physical sx with disproportionate anxiety, concern, energy about it
tx somatic sx disorder?lots of regular visits with single provider
tx conversion disorder?educations, encouragement, CBT
tx acute dystoniabenztropine, diphenhydramine, trihexyphenidyl
tx tardive dyskinesiadc med and change to clozapine
check before starting lithium?baseline BUN, Cr, UA, thyroid function, EKG, Ca++
large heart in neonatelithium toxicity (ebstein) anomaly
how long should lithium be taken in bipolar pt?recommend indeffinitely
metabolic effectsolanzapine and clozapine
prolactinemia and amenorrhearisperidone
EPS haloperidol
schizoid vs avoidantavoidant has social anxiety but desired relationships despite fear of rejection and no eccentric behavior. Schizoid are loners and lack close friends and aren't interested in them.
tx treatment resistant schizophrenia with suicidality?clozapine
circumstantialitydisorganized thought/speech common to schizophrenics -- detailed answers that deviate from the topic but eventually return to subject
tangential permanent deviation
loose associationmore severe tangentiality bc even less related to topic
12-24 hours from last drink?alcoholic hallucinosis. intact sensorium. stable vitals
48 hrs from last drink? delirium tremens. disorientation, global confusion, unstable vitals, life threatening

Section 2

Question Answer
tx social anxiety disorderSSRI/SNRI, or CBT
tx panic disorder short term?benzos
tx panic disorder long term?SSRI, CBT
tx acute bipolar depression?quetiapine, lurasidone, lithium, valproate. If renal disease, use valproate
tx acute mania?lithium, valproate
if agitated in mania tx?risperidone
SNRIsvenlafaxine, duloxetine
if + response to tx for single MDD episode, how long should you stay on?additional 4-9 months (continuation phase)
schizoaffective vs bipolar or MDD + psychotic featurespsychotic sx only occur DURING the mood episodes in the psychotic features dx. in schizoaffective, the delusions/hallucinations occur >2wk in absence of major mood episode (MDD or bipolar)
tx for postpartum psychosis?hospitalize to ensure safety
how do you treat paradoxical agitationdc medication
bath saltsamphetamine analogs that cause agitation, combative psychosis, delirium, myoclonus, seizures, increase BP and HR, PROLONGED DURATION not on Utox
PCP vs bath saltsPCP shorter duration and on Utox. Bath salts longer duration and not on Utox
new onset psychosis in kids?think SLE, get ANA
tx delirium?haloperidol
tx akathisia?reduce dose and add propranolol or benzo
ECT indicationstreatment resistant, pregnancy, refusal to drink or eat in geriatrics
slurred speech, unsteady gait, drowsy, only mild respiratory depressionbenzo overdose
teenage boy with brief transient euphoria, LOC, CNS depression, dermatitis around lips and nostrilsGlue sniffing (toluene, NO, amyl nitrate) negative Utox
labs in glue sniffingincreased LFTs and dilated pupils
MDMA with SSRI?serotonin syndrome (high fever, AMS, seizures, hyponatremia, death)
myoclonus and hyperreflexiathink serotonin syndrome
HTN crisis?MAOi plus tyramine rich foods
normal bereavement length?2 months
projectionattributing your feelings to someone else
displacementtransferring emotions associated with an upsetting person/thing to a safer alternative person/thing
avoid in diabeticsolanzapine
greatest incidence of EPSrisperidone
give to someone who has an existing mvmt disorderquetiapine
increased risk prolonged QTziprasidone
avoid in conduction defectsziprasidone
adjunct treatment for MDDaripiprazole
antipsychotic in pregnancy?lurasidone