Psych forever Flashcards

1
Q

when does bereavement become MDD

A

major depressive disorder in these circumstances requires the presence of marked functional impairment, morbid preoccupations with unrealistic guilt or worthlessness, SI, marked psychomotor retardation, and psychotic symptoms

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2
Q

How long does healthy bereavement last

A

2 months

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3
Q

1st line rx for mania

A

valporate- better tolerated vs Li

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4
Q

_______________- are generally believed to be the treatments of choice for persistent depressive disorder

A

Venlafaxine and bupropion

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5
Q

Onset 6 months post stroke. This disorder may occur in about 33% of stroke victims.

A

Post stroke depression

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6
Q

____________ is not seen in postpartum blues, but is

common in postpartum depressions.

A

Anhedonia

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7
Q

s/s must be present for _____ time to ddx cyclothymia

A

2 years

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8
Q

The most common complaints after ECT include

A

HA, nausea, and muscle soreness.

Memory impairment (both retrograde and anterograde) does occur but less frequently

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9
Q

Positron emission tomography (PET) scan has

consistently demonstrated _______________ in depressed patient

A

a decrease in blood flow and metabolism in the frontal lobe

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10
Q

In major depressive disorder, the REM sleep latency (the period of time between falling asleep and the
first period of REM sleep) is ___________

A

shortened

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11
Q

characterized by loss of pleasure in all activities (anhedonia), lack of reactivity (nothing can make the
patient feel better), intense guilt, significant weight loss, early morning awakening, and marked psychomotor retardation

A

Major depressive disorder with melancholic features

TCAs work well here

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12
Q

__________ is diagnosed when a major depressive episode develops in a patient with dysthymic disorder

A

Double depression

Approximately 40% of patients with a major depressive disorder also meet the criteria for persistent depressive disorder (dysthymia).

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13
Q

________ are considered to be more effective than other classes of antidepressants in atypical depression

A

MAOIs

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14
Q

four Ds of malpractice:

A

(1) a duty existed toward the patient on the part of the psychiatrist
(2) a deviation from the standard of practice occurred (3) this deviation bore a direct causal relationship to the untoward outcome
4) damages occurred as a result

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15
Q

five elements that make up what is
considered a reasonable standard of care for disclosing information needed to obtain informed
consent are

A
diagnosis
treatment
consequences
prognosis
alternatives to the proposed treatment (including risks and benefits)
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16
Q

The Tarasoff decision was a landmark case in determining that psychotherapists have an obligation to

A

warn third parties who are in danger

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17
Q

__________ is the most common reason for malpractice claims in psychiatry, accounting for 33% of all claims.

A

Improper treatment

This is followed by attempted/ completed SI, which at 20%

18
Q

The principle of _____________ refers to preventing or removing harm and promoting well-being.

A

beneficence

19
Q

Tarasoff II stated that once a therapist has reasonably determined that a patient poses a serious danger of violence to others, the therapist must

A

“bears a duty to exercise reasonable care to protect the foreseeable victim of that danger.”

Tarasoff II

20
Q

Anti- depressents for the elderly

A
The SSRIs:  
fluoxetine
 paroxetine,
sertraline
 fluvoxamine
citalopram 

unique agents such as bupropion, venlafaxine, nefazodone, and mirtazapine.

21
Q

Name the SSRIs

A
fluoxetine
paroxetine,
sertraline
fluvoxamine
citalopram
22
Q

citalopram is

A

SSRI

23
Q

fluvoxamine is

A

SSRI

24
Q

The tricyclic drugs include

A

imipramine
desipramine
amitriptyline
nortriptyline.

25
Q

TCAs treat?

A

They are effective in the treatment of depression;

panic disorder, generalized anxiety disorder, and separation anxiety; enuresis; and ADHD

26
Q

Phenelzine and tranylcypromine are both ______,

A

MAO inhibitors

major s/e: hypotension

27
Q

tranylcypromine is?

A

MAOi

28
Q

Clozapine w/ WBC = 2000 to 3000 should cause psychiatrists to

A

get daily CBCs and stop the clozapine. It may be reinstituted after the WBCs normalize.

29
Q

Clozapine w/ wbc 3000-3500 with or without clinical symptoms should cause the psychiatrist to

A

monitor the patient closely and institute a minimum of twice-weekly CBC tests with differentials included.

30
Q

With an uncomplicated agranulocytosis (no signs of infection) on clozapine, the patient should be

A

placed in protective isolation
d/c clozapine
bone marrow specimen to see if progenitor cells are being suppressed.

Clozapine must not be restarted

31
Q

In Li overdose, __________ makes dialysis necessary

A

Li levels >2.5 nEq/L

32
Q

Ramelteon use and s/e

A

Ramelteon reduces time to sleep onset

s/es headache.

do not use in severe hepatic impairment, severe sleep apnea, or severe COPD

33
Q

Carbamazepine warnings

A

can cause aplastic anemia, agranulocytosis, thrombocytopenia, and leukopenia.
risk of hepatotoxicity.

benign rash–> drug should be discontinued if this occurs because progression to a severe rash is unpredictable

34
Q

________ antidepressant is associated with a great tendency to gain weight

A

Amitriptyline

35
Q

All women of child-bearing potential who must take valproic acid should be given _____ supplementation.

A

folic acid

36
Q

neuroepileptic dystonia rx in ER

A

benztropine or diphenhydramine IM in an emergency room setting

37
Q

RX for neuroleptic akathesia

A

beta-adrenergic receptor antagonists ie propranolol, though benzodiazepines and anticholinergics may also be somewhat effective

38
Q

ECT anesthesia

A

Methohexital is commonly used for ECT

lower cardiac risks than other barbiturates

39
Q

The only medication approved for shift work

sleep disorder is ________

A

modafinil

40
Q

disulfiram moa

A

Acetaldehyde dehydrogenase inhibition

41
Q

_______ is the preferred treatment

for psychotic symptoms in patients with Parkinson disease because?

A

Quetiapine due to its sedative quality and relative lack of extrapyramidal effects.

42
Q

____________ is considered the safest and the best-tolerated anticonvulsant for patients taking clozapine who experience seizures

A

Valproate