Step 3 - Psychiatry

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Step 3 cards Flashcards on Step 3 - Psychiatry, created by Jaimie Shah on 03/11/2013.
Jaimie Shah
Flashcards by Jaimie Shah, updated more than 1 year ago
Jaimie Shah
Created by Jaimie Shah over 10 years ago
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Question Answer
negative symptoms flattened affect, social WD, anhedonia, apathy, poverty of thought (atypical antipsychotics are most effective here)
positive symptoms delusions, disorganized speech/behavior, hallucinations, agitation
greatest risk factor for preogression to schizophrenia schizophreniform disorder
schizophrenia has poor prognosis with the following early age onset, negative symps, poor premorbid function, family hx, disorganized or deficit subtype
review antipsych med chart pg. 461
what do you need to check with clozapine therapy baseline CBC and weekly after due to risk of agranulocytosis
Tioridazine SE prolong QT and arrythmia; always get EKG if pt describes CP/SOB/Palpitations; assoc with abnormal retinal pigmentation
low pot antipsychotic SE ortho hypothension, impotence (alpha block); acute urinary ret, dry mouth, blurry vision, and delirium (anti ach effect)
best antipsychotics if there is insomnia quetiapine, ziparsidone, aprpiprazole
antipsychotic used to avoid sedation risperidone
review SE profile chart p. 463
antimetics that cause tardive metoclopramide, prochlorperazine
review medication chart for anxiety d/o pg 467
post partum spectrum chart p 472
TCA toxicity antiach effect and alpha block- perp vasodilate and low BP; effect NA channels so prolont QRS, QT, PR can lead to VT or Vfib; tx with Na HCO3
antidepressants that causes seizures TCA and bupropion
SSRI with most severe anti-ach effects amitryptiline (otherwise SSRI have little of this effect)
SE of lithium acne, weight gain, dose related tremors/GI stress/HA, hypothyroid, Polyuria 2/2 DI, dont use in first trimester of pregnancy
when is divalproex used when Li doesnt work and in rapid cycling bipolar
second line therapy for bipolar carbimazepine
elderly who takes Li with RF now with low Na has N/V, disoriented, tremors, increased DTRs, and seizures Li toxicity (needs dialysis)
high fever, tachy, muscle rigidity, altered conciousness and autonomic dys; unrelated to dosage or prior exposure NMS
NMS tx transfer to ICU, discontinue antipsychotic, bromocriptine to overcome dopamine receptor blockade, dantrolene needed and diazepam for rigidity
SSRI plus triptan or MAOI use; agitation, hyperreflexia, hyperthermia, rigidity and vol contraction due to sweating Serotonin syndrome (fluids cyproheptadine to dec serotonin prod, BDZ for rigidity)
acute HTN with use of MAOI and antihistamine/nasal decongestants/ or tyramine rich foods; or with MAO + TCA MAOI induced hypertensive crisis (tx as hypertensive crisis)
what do you check before starting a pt on antidepressants check if have SI (first two weeks on meds can increase this to start)
olanzapine helps with weight gain in anorexia true
SSRI will help prevent relapses of anorexia true
Alcohol abuse table p. 486
List of abuse substances chart pg 487 and 488
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