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Psychiatry

Terms in this set (137)

First generation

First generation

First generation

First generation

Second generation

Second generation

Second generation

Second generation

Second generation

Second generation

Second generation

Hyperprolactinemia (amenorrhea, galactorrhea, gynecomastia)

QT prolongation

(less wt gain than other 2nd gen)

Olanzapine and quetiapine SE

Weight gain, diabetes, sedating

Aripiprazole SE

First generation SE

Tremors, tardive dyskinesia, dystonia

Second generation SE

Weight gain, hyperlipidemia, hyperglycemia (risk DM), increased appetite

Benztropine, diphenhydramine

Tx tardive dyskinesia

1. Agranulocytosis
2. Myocarditis
3. Metabolic effects

Vanderbilts ADHD criteria

6-9 in either inattentive or hyperactive sx category, sx need to be present in >1 setting

1st line treatment ADHD

Methylphenidate

2nd line treatment ADHD

Methylphenidate medications

Ritalin, concerta

Amphetamine medications

Adderall, vyvanse

3rd line treatment ADHD

Atomoxetine

Alpha-agonists (clonidine)
Bupropion

SSRI with longest half life

SSRI with shortest half life

SSRI with highest rate QTc prolongation

SSRI often associated with discontinuation syndrome

Length of time for adequate SSRI trial

6-8 weeks at dose

Mood disorders (4)

1. MDD
2. Bipolar
3. Cyclothymia
4. Dysthymia

Psychotic disorders (4)

1. Brief psychotic episode
2. Schizophreniform
3. Schizophrenia
4. Delusional disorder

Length of time for brief psychotic episode

Length of time for delusional disorder

Length of time for acute stress disorder

Length of time for schizophreniform disorder

Length of time for mania

at least 1 week

or hospitalization

Length of time for hypomania

at least 4 days

Mixed mood/psychotic disorder (1)

Schizoaffective

Psychotic features greater/= 2 weeks without mood disturbance

Features overlap ~50% of time

Mood disorder with psychotic features (2)

1. MDD with psychotic features
2. Bipolar disorder with psychotic features

Labs for patient on lithium

"q6 months: TSH, q1 year: BUN, T3RU"

Lithium toxicity treatment

"mild (< 3): IV fluids, monitor urine and lithium levels, evere: emergency dialysis"

Labs for patient on carbamazepine

"1st 2 months: SGOT/SGPT/LDP monthly, q3 months: SGOT/SGPT/LDP"

Valproic acid pregnancy category

Lithium pregnancy category

Carbamazepine ADR

Aplastic anemia, Stevens Johnson

Treatment of tardive dyskinesia

"1. Lower or stop antipsych dose, 2. Clozapine"

Preferred treatment for psychotic sx in Parkinson patient

Drugs that increase carbamazepine levels

Drugs that lower carbamazepine levels

Theophylline, cisplatin

Carbamazepine can lower the levels of what drugs

Time until lithium at steady state

Treatment hyperarousal PTSD

Clonidine, beta-blockers

Seizures during clozapine treatment are related to

Treatment of cataplexy

Pt with hyperthermia, muscular rigidity, autonomic instability, AMS, increased CPK/LFT/leukocytes

Treatment of NMS

"1. Stop antipsych, 2. Treat EPS with antiparkinson meds, 3. If severe, dantrolene/bromocriptine/amantidine"

Imipramine uses

ADHD, nocturnal eneuresis

Lithium level to treat acute mania

Treatment lithium-induced tremor

"1. Reduce dose, 2. Stop caffeine, 3. Slow release lithium preparation, 4. Beta-blocker"

Eriksonian Stage birth-1year

basic trust v mistrust

Eriksonian Stage 1-3year

autonomy v shame

Eriksonian Stage 3-5year

initiative v guilt

Eriksonian Stage 5-13year

industry v inferiority

Eriksonian Stage 13-21year

identity v role confusion

Eriksonian Stage 21-40year

initimacy v isolation

Eriksonian Stage 40-60year

generativity v stagnation

Eriksonian Stage 60year-death

integrity v despair

Infant development phase 1st two months

Infant development phase 2-6month

Infant development phase 6-10month

differentiation

Infant development phase 10-16month

Infant development phase 16-24month

Infant development phase 3year

object constancy

Instinctual drives

Balance id and superego

Internalized parental / society

Primary process thinking

Nonlogical, primitive, denies the existence of negatives (operational style of id, manifested in dreams)

Primitive/Narcissistic defense mechanisms

Denial, projection, distortion

Immature defense mechanisms

Acting out, introjection, passive aggressive, somatization

Neurotic defense mechanisms

Displacement, externalization, inhibition, reaction formation, repression, intellectualization, rationalization

Mature defense mechanisms

Sublimation, altruism, asceticism, anticipation, suppression, humor

3 psychological defense mechanisms in OCD

1. Undoing 2. Isolation 3. Reaction formation

Phases of separation in infant

Protest —> despair —> detachment

Freud psychosexual development first 18 months

Freud psychosexual development 18-36 months

Freud psychosexual development age 3

Freud psychosexual development 3-5

Freud psychosexual development 5-11/13

Freud psychosexual development puberty-young adulthood

Primary metabolite of dopamine

Homovanillic acid

Temporal lobe epilepsy sx

Hyposexuality, emotional intensity, viscosity

EEG in REM sleep

Random, fast, sawtoothed, low-voltage waves

Mesial frontal lobe lesion

"slowing of motor function, speech, emotional reaction (at worst, mute and akinetic)"

Orbitofrontal lobe lesion

Abnormal social behvavior, good opinion of slef, jocularity, sexual disinhibition, lack of remorse or concern for others

Sumatriptan acts on

Atypical antipsychotics act on what two receptors

Circadian rhythms affect what receptor

Anxiolytics affect what serotonin receptor

Typical antipsychotics act on what receptor

Antiparkinson drugs act on

M4 (cholinergic)

Diphenhydramine acts on

Central achromatopsia

Inability to perceive color

Simultanagnosia

Inability to integrate visual scene + perceive it as a whole

Gerstmann syndrome (4)

"Agraphia, Acalculia, R/L disorientation, Finger agnosia"

Gerstmann syndrome is a lesion of the

Dominant parietal lobe

Apperceptive visual agnosia

Inability to identify/draw items using visual cues

Oculomotor apraxia

Inability to direct gaze rapidly

Inability to recognize faces

Inability to recognize color (but able to match it)

Balint syndrome (3)

"Optic ataxia, Oculomotor apraxia, Simutanagnosia"

Balint syndrome is a lesion of the

bilateral parieto-occipital lobes

failure to acknowledge blindness

Anton syndrome is a lesion of the

bilateral occipital lobes

Associative visual agnosia

Inability to name/use objects, but able to draw them

Associative visual agnosia is a lesion of the

bilateral medical occipitotemporal lobes

What disorder causes decreased latency of REM sleep

Most common gene implicated in hereditary Alzheimer's

"Presenilin 1 (70-80%), Presenilin 2 (20-30%), APP (2-3%)"

Presenilin 1 is found on

Presenilin 2 is found on

APP is found on

Partial complex seizures originate in the

aura of odor (brain region)

Uncus (area at tip of temporal lobe)

Night terrors occur during

Increased BP, HR, erection, dreaming occur during

Serotonin metabolite

OCD involves ____ pathways

What NT is most commonly associated with Alzheimer

Stimulates appetite

Huntington disease involves damage to what brain structure

Caudate nucleus

R prefrontal lesion

Laughter, euphoria, tendency to joke and make puns

L prefrontal lesion

Depression, uncontrollable crying

Dorsolateral frontal lesion

Decreased planning + motivation (pt is inattentive, echoes examiner's questions)

Amygdala lesion

Impaired ability to recognize fear/anger from external cues (voice, facial expression)

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