NBME Psychiatry Shelf Exam

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Antisocial PD - Must be > ___ years old

15

___ side-effect (long-term tx): hypothyroidism

lithium

Acute stress disorder: ___ days - __ weeks after life is in jeopardy.

2, 4

Adjustment disorder: Within ___ months of life stressor, dissipating at ___ months.

3, 6

Akathisia is a s/e of neuroleptics or prochlorperazine. Prevented by concurrent administration of ___

IV benzo

Rett syndrome: Age-appropriate development for 1st ___ months (at least).

5

3 long-lasting (depot) antipsychotics:

haloperidol, fluphenazine, risperidone

Narcolepsy: sleep attacks occuring DAILY for at least ___ months

3

Tx for Intermittent Explosive Disorder =

carbamazepine

Of the TCAs, _____ is the most serotinergic, so it is used in OCD.

clomipramine

Prochlorperazine = ____. S/e = _____.

anti-emetic, akathisia

Brief psychotic disorder: time =

< 1 month

Delusional disorder: time =

at least 1 month (Function is not impaired. Delusion = non-bizarre. Hallucinations may be present.)

Bulimia tx =

SSRI

Presence of an affective disorder (along with schizophrenia) ____ risk for tardive dyskinesia.

increases

Antipsychotics: ACUTE DYSTONIA is a side-effect. Tx =

anticholinergics

3 anticholinergics

diphenhydramine, benztropine, trihexyphenidyl (tx acute dystonia caused by neuroleptics)

2 lab results in Neuroleptic Malignant Syndrome:

increased CPK, leukocytosis

3 S/Es of TCAs (e.g. imipramine):

blurred vision / pupillary dilation (antimuscarinic effect), dry mouth (anticholinergic effect), orthostatic hypotension (a1-adrenergic effect)

Nortriptyline: class =

TCA

Imipramine: class =

TCA

Leading cause of overdose-related deaths in psychiatric population

Nortriptyline (TCA. causes QT prolongation, cardiac arrhythmia, then death).

TCA that causes QT prolongation

nortriptyline

Pseudoseizures vs. real seizures: If real, within ______ [prolactin] will double.

1 hour

PTSD tx =

sertraline

Prochlorperazine: S/e = ____ Tx = ____

akathisia, anticholinergics (i.e. benztropine) (PREVENTION = concurrent admin of IV benzo)

Hallucinations, insomnia, tremor, GI distress, seizures.

benzo withdrawal

Dysphoria, psychomotor agitation or retardation, fatigue.

Cocaine withdrawal

Abdominal pain, chills, myalgias, NVD, piloerection

Heroin withdrawal

Worst antipsychotic S/Es: Ziprasidone =

QT prolongation

Worst antipsychotic S/Es: Clozapine =

neutropenia, myocarditis

Antipsychotic LEAST associated with movement problems =

clozapine

Weight-neutral antipsychotic =

ziprasidone

Worst lamotrigine S/E =

stevens-johnson syndrome (if titrated up too quickly. A rash is fairly normal, though... usually...)

Tx to relieve the autonomic sx of heroine withdrawal =

anticholinergic (benztropine, diphenhydramine, trihexyphenidyl)

Tx for PCP intoxication =

midazolam

Nystagmus, HTN, coma, hyperacusis, agitation, psychosis

PCP intoxication (tx = midazolam)

Tx for ACUTE (acute!) mania =

haloperidol

___ withdrawal includes elevated temperature

benzo

If an antipsychotic (anticholinergic) ---> urinary S/Es, tx =

bethanechol (cholinergic)

Enuresis: 1st-line tx =

DDAVP (S/E = water intoxication, so watch out. Technically behavior therapy should be tried first.)

Enuresis: 2nd-line tx =

Imipramine

____ = most common drug cause of depression

propranolol

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