Day 3 Flashcards

What are the two most common causes of dementia in the elderly?

_____ disease (most common)
_____ dementia

What is the likely diagnosis for an adult with a history of chronic alcohol consumption who is exhibiting anterograde amnesia and confabulation in the emergency department?

What type of amnesia is present in a patient who sustained a head injury and is unable to recall anything that occurred from the time that the injury occurred?

What type of amnesia is present in a patient who cannot recall anything that occurred before they sustained a head injury but can still make new memories?

Korsakoff syndrome is a late neuropsychiatric manifestation of what disease?

What is the definition of an anxiety disorder?

When a patient experiences inappropriate ____ and ____

Which three other conditions must be ruled out to make a diagnosis of anxiety disorder?

Another ____ disorder
____ use
____ condition

In a person with bipolar disorder, what mood can you expect between episodes of mania/hypomania and depression?

Mood generally returns to ______

What disorder is present in a patient who has mild dysthymia and has been experiencing hypomanic episodes for 3 years?

What class of drugs are used most commonly to treat bipolar disorder?

____ ____

____ ____

How does bipolar I disorder differ from bipolar II disorder?

Bipolar I disorder includes _____ episodes with or without a _____ or _____ episode
Bipolar II disoder includes a _____ episode and a _____ episode, but no _____ episodes

What class of drugs can cause mania and increase suicide risk in patients with bipolar disorder?

______

How long are symptoms required to be present for a diagnosis of cyclothymic disorder?

____ or more years with symptoms present at least ____% of the time, with any remission lasting for ____ months or less

What additional disorder do patients with selective mutism usually have?

How do you treat selective mutism?

____, ____, and ____ therapies with or without ____

What is selective mutism?

____ disorder that involves refraining from ____ in specific situations for less than or equal to ____ month in a child older than ____ years who has no impairment in speech/language development

Selective mutism interferes with performance of what kinds of tasks?

____ tasks
____ tasks
____ tasks

In _____ disorder, the basic rights of others or social norms are violated
In _____ _____ disorder, the basic rights of others or social norms are not violated

What is the treatment for conduct disorder?

How do you treat a child with oppositional defiant disorder?

Up to what age is separation anxiety considered a normal phenomenon?

___ to ___ years

An episode of separation anxiety in older children must last how long for it to be considered a disorder?

____ weeks or more

What can be used to treat a child with separation anxiety disorder?

____ ____ therapy
____ therapy
____ therapy

What modalities are used to treat intractable tics in a patient with Tourette syndrome?

High-potency____, ____-agonists, ________

Tourette syndrome presents with what symptoms and at what age?

Sudden, rapid, recurrent, [rhythmic/nonrhythmic] stereotyped vocal and motor ____ that are present > ____ year(s) before the age of ____ years

What is the first-line therapy for Tourette syndrome?

_____ therapy
_____education

What features and associated disorders may be seen in a patient with Tourette syndrome?

Vocal and motor ____
C____
____-____ ____
____-____ ____ ____

____ is the medical term for the involuntary outburst of obscene words, slurs, or socially inappropriate remarks.

How long do symptoms need to be present for Tourette syndrome to be diagnosed?

More than __ year(s)

ADHD symptoms must last for how long before diagnosis?

What three traits characterize attention-deficit hyperactivity disorder?

I____
I____
H____

ADHD symptoms must be found in ____ or more settings

What are the treatment options for attention-deficit hyperactivity disorder?

______ with or without ______ ______ therapy
______ alternatives

You suspect that a child who does poorly in school has attention-deficit hyperactivity disorder. Does this disorder affect intelligence?

What classes of drugs are used to treat disruptive mood dysregulation disorder?

_____

_____

How does disruptive mood dysregulation disorder present?

Severe, recurrent _____ outbursts incongruent to situation

How long must symptoms be present before a diagnosis of disruptive mood dysregulation can be made?

Autism must present in [early/late] childhood and is more common in [boys/girls]

At what age would you diagnose a patient with conduct disorder?

Before the age of ____ years

After age 18, conduct disorder is reclassified as _____ _____ disorder.

A child with autism may have an intellectual _______ or _______ abilities or specific skills. Size of head and/or brain may be _______.

Which childhood disorder is characterized by poor social interactions, communication deficits, ritualized or repetitive behavior, and restricted interests?

_____ _____ disorder

What is intellectual disability?

______ cognitive deficits that affect memory, reasoning, judgment, abstract thinking, language, and learning

Why do patients with intellectual disability have difficulties in socialization, education, employment, and independence?

_____ functioning is impaired due to _____ cognitive deficits

How do you treat a patient with intellectual disability?

By providing ______ support to improve global functioning

A child is unable to read near the level of proficiency for his or her age even after working with a tutor 7 months. What is the most likely diagnosis?

_____ _____ disorder

What happens to general functioning and intelligence in an individual with specific learning disorder?

How long must symptoms persist for a diagnosis of specific learning childhood disorder?

> ___ months

How do you treat a patient with specific learning disorder?

_____ support
C_____
_____ activities

How do you treat delirium?

Treatment of delirium is aimed at identifying and addressing the _____ _____

_____ may be used as needed for acute episodes of delirium

What classes of medication should be avoided in the treatment of delirium?

_____
_____
_____

What could be the cause of sudden waning of consciousness in hospitalized older patients?

You suspect that your patient with altered mental status has delirium. What test may help to confirm the diagnosis?

_____

EEG may reveal _____ _____ _____ slowing, a finding associated with delirium.

Define delirium.

Acute, [reversible/irreversible], onset of waxing/waning _____ with rapidly decreasing _____ span and level of _____

How do you begin management of delirium before considering medication?

Identifying/treating underlying _____
Providing cognitive _____
Keeping a clock or calendar nearby for _____ purposes
Reducing _____ disturbances

What is the treatment for atypical depression?
_____
_____ _____ therapy
_____ (not first-line)

What symptoms differentiate atypical depression from classical depression?

_____ reactivity
[Hypersomnia/Hyposomnia]
[Overeating/Undereating]
_____ paralysis
_____ to rejection

Heavy feeling in legs and arms is called what?

Transient improvement in mood in response to a positive event is called what?

What is the most common subtype of depression?

How long must symptoms be present for a diagnosis of delusional disorder to be made?

> [...] month(s)

How long must symptoms persist for a diagnosis of brief psychotic disorder?

< [...] month(s)

Symptoms of major depressive disorder last ≥ [...] weeks
Dysthymia and cyclothymia are diagnosed in adults after symptoms last > [...] years

After how many months of anxiety-related symptoms can the diagnosis of generalized anxiety disorder be made?

> [...] months

After how many months of symptoms can the diagnosis of panic disorder be made?

> [...] month(s)

How many months of symptoms are necessary for a narcolepsy diagnosis?

> [...] month(s)

How long must symptoms be present in a child for a diagnosis of oppositional defiant disorder to be made?

> [...] months

How long must symptoms be present for the diagnosis of tic disorder be made?

> [...] year(s)

How long must symptoms be present for the diagnosis of a phobia be made?

> [...] months

Symptoms persisting ____ than ____ months indicate adjustment disorder

Symptoms persisting ____ than ____ months indicate generalized anxiety disorder

Compare the duration of symptoms in acute stress disorder versus post-traumatic stress disorder.

Acute stress disorder → Symptoms persist ____ than ____ month(s)
Post-traumatic stress disorder → Symptoms persist ____ than ____ month(s)

How long must symptoms be present for a diagnosis of schizophreniform disorder to be made?

Symptoms must be present for [...] to [...] months

How long must symptoms be present for a diagnosis of schizophrenia to be made?

Name six psychiatric conditions associated with dissociative identity disorder.

____-____ ____ disorder
______
______ personality disorder
______ use disorder
______ disorders
History of ______ abuse

Dissociative identity disorder is more common in which sex?

Depersonalization → Feelings of detachment/estrangement from one's ____
Derealization → Feelings of detachment/estrangement from one's ____

A man often feels estranged from his surroundings and from himself, almost as if he is merely an observer. What could this condition be?

________/________ disorder

If a patient has two or more distinct personality states or identities, what is the diagnosis?

Due to the severe trauma of child abuse, a woman is unable to recall her date of birth. What type of amnesia is this?

_____ amnesia

A man abruptly travels to the other side of the country and is found wandering on the streets there. What is the most likely diagnosis?

Dissociative _____

Dissociative fugue occurs during a period of dissociative amnesia, which is often associated with _____ circumstances.

Which eating disorder involves dieting, fasting, and/or exercising excessively without purging or binge eating for ≥ 3 months?

Which eating disorder involves recurrent purging behaviors or binge eating for ≥ 3 months?

What three treatment options are available for patients with anorexia nervosa?

_____
_____ rehabilitation
_____

What is the definition of anorexia nervosa?

Intense fear of [gaining/losing] weight, distortion of body image, and overvaluation of ____ → Calorie ____, extreme weight [gain/loss], and inappropriately [high/low] BMI

Name three electrolyte disturbances that occur in refeeding syndrome in patients with anorexia.

[Hyperkalemia/Hypokalemia]
[Hyperphosphatemia/Hypophosphatemia]
[Hypermagnesemia/Hypomagnesemia]

In anorexia nervosa, what three symptoms or diseases may present due to disruption of the endocrine symptom?

[Hyperthyroidism/Hypothyroidism]
_____
_____

How may body hair be altered in anorexia nervosa?

Development of ____ hair on the arms and legs

Compare the body weight profiles of patients with anorexia nervosa and bulimia nervosa.

Anorexia nervosa → _____ BMI
Bulimia nervosa → _____ or _____ BMI

What four findings may be seen in a patient with bulimia nervosa?

____ of enamel on teeth
Metabolic [acidosis/alkalosis]
____ disturbances
[Ventral/Dorsal] hand ____ caused by induction of vomiting

What is the definition of pica?

Recurring consumption of _____ items, not considered normal for an individual's culture or developmental stage, for _____ month(s) or longer

What is the treatment for pica?

First-line treatment → _____ rehabilitation and _____
Second-line treatment → _____

What population of patients does pica typically affect?

_____
_____ women

What four comorbidities is pica associated with?

______ deficiency anemia
______ disabilities
______
______ trauma

Describe the mechanism of refeeding syndrome and three potential complications in a patient with anorexia.

Sudden increase in calorie intake → Increase in ____ → [Hyperphosphatemia/Hypophosphatemia], [hyperkalemia/hypokalemia], and [hypermagnesemia/hypomagnesemia] → Rhabdomyolysis, seizures, and cardiac complications

What treatment options are available for binge-eating disorder?

_____ (first-line treatment)
_____
_____

Why is bupropion contraindicated for patients with bulimia nervosa?

Elevated risk of ______

Why might a doctor order an endoscopy for a patient with bulimia nervosa?

To check for _____ in the [upper/lower] part of the esophagus

Which enzyme would increase as a result of parotid gland hypertrophy in patients with bulimia nervosa?

Serum _____

What is the treatment for bulimia nervosa?

_____
_____ rehabilitation
_____

Is electroconvulsive therapy safe for pregnant patients and elderly patients?

Name four clinical indications for electroconvulsive therapy.

Acute _____
_____ with psychosis
_____ depression
C_____

What is the mechanism of electroconvulsive therapy?

Electroconvulsive therapy induces ____-____ seizures in patients under anesthesia and neuromuscular blockade

What are the adverse effects of electroconvulsive therapy?

_____
_____
_____/_____ amnesia that usually resolves within _____ months

What is the first-line treatment for someone diagnosed with enuresis?

______ modifications
[Positive/Negative] reinforcement

For nocturnal urinary incontinence refractory to behavioral modifications, what are two treatment options?

Bedwetting ______
Oral ______

How long must symptoms of nighttime incontinence last for a diagnosis of enuresis to be made?

≥ [...] times per week for ≥ [...] months

How old does a person have to be for a diagnosis of enuresis to be made?

> [...] years

A caregiver—usually a parent—intentionally fabricates, exaggerates, or induces physical or psychological symptoms in a dependent (often a child) to deceive others and gain attention or sympathy.

_____ disorder imposed on [self/another]

Patients with factitious disorder imposed on self are _____ to undergo tests and procedures

Patients with malingering often _____ treatment

What is the primary goal of a patient with a factitious disorder?

To get _____ and medical _____ by means of the sick role

In which two population groups is factitous disorder imposed on self more common?

_____ workers
[Men/Women]

What is the definition of gambling disorder?

Persistent, recurrent, problematic gambling that cannot be better explained as a _____ episode

What is the treatment of gambling disorder?

______

What is the definition of transgender?

When a patient lives their life as a [similar/different] gender than what was assigned at _____

What is definition of gender dysphoria?

A difference between the way an individual ______ gender and the gender assigned at ______

gender dysphoria lasts for over ______ months and causes persistent ______.

Is gender nonconformity a mental disorder?

At what age does gender identity develop?

What are seven of the most common symptoms associated with generalized anxiety disorder?

Excessive _____
_____ problems
_____
_____
Difficulty _____
_____
Muscle _____

By definition, the symptoms of generalized anxiety disorder must be present for how long to be clinically significant?

On most days for [...] months or longer

What are three first-line treatment options available for generalized anxiety disorder?

____ ____ therapy
____
____

What are three second-line treatment options for generalized anxiety disorder?

____
____
____

How do the criteria for a diagnosis of generalized anxiety disorder in adults compare with the criteria for a diagnosis of generalized anxiety disorder in children?

Adults → ≥ [...] symptoms of generalized anxiety
Children → ≥ [...] symptoms of generalized anxiety

Compare hypomanic and manic episodes in terms of severity.

Hypomanic episodes are [more/less] intense
Hypomanic episodes do not impair ____ or feature ____
Hypomanic episodes do not require ____
Hypomanic episodes last for ≥ ____ consecutive days

What treatment options are first line for major depressive disorder?

_____ _____ _____
_____

What are the features of major depressive disorder?

_____ disturbance
Decreased interest in _____ activities
_____
[Increased/Decreased] energy
[Increased/Decreased] concentration
_____ /_____ changes
_____ agitation
_____ ideation

For major depressive episode: Symptoms must have been present for most days for a period of ____ ____ or longer

Which disorder is often milder than major depressive disorder with at least 2 depressive symptoms lasting at least 2 years and with remission of 2 months or less?

_____ _____ disorder AKA _____

In which depressive disorder do episodes occur only during a particular season in 2 or more consecutive years?

_____ _____ disorder with _____ _____

What are the treatment options for major depressive disorder with seasonal pattern?

______ ______ therapy
______
______ therapy

Psychotic features occur only ______ the major depressive episode in a patient with major depressive disorder with psychotic features

A patient with schizoaffective disorder will have psychotic symptoms [dependent/independent] of a depressive episode

What is the treatment for major depressive disorder with psychotic features?

A(n) ______ combined with a(n) ______ ______ or ______ therapy

Define major depressive disorder with psychotic features.

Major depressive disorder accompanied by _____ or _____

In major depressive disorder with psychotic features, hallucinations and delusions typically have what overlying theme?

They are typically mood ______ with depressed mood

Which disorder is intentional and the patient's complaints stop after something is gained?

Which disorder occurs when a patient consciously fakes, exaggerates, or reports a disorder with goal of attaining a secondary gain?

How does malingering affect a patient's compliance with treatment and follow-up?

Compliance with treatment or follow-up is often _____

What are the seven symptoms of a manic episode?

_____
_____/_____
_____
Flight of _____
[Increased/Decreased] activity/agitation
[Increased/Decreased] sleep needs
_____

For diagnosis of a manic episode, how many manic symptoms must be present and for how long?

At least ___ symptoms for at least ___ ___

Define mood disorders: disorders in which an abnormal range of internal emotions/moods and loss of ____ over them cause distress and impairment in ____ function

Give four examples of disorders that are classified as mood disorders.

____ ____ disorder
____ disorder
____ disorder
____ disorder

Can a patient with a mood disorder experience symptoms of psychosis, such as hallucinations or delusions?

List the order in which a person loses his or her components of orientation.

First → ______
Second → ______
Third → ______

What is orientation in the context of the psychiatric exam?

An individual’s ability to know ____ he/she is, ____ he/she is, and the ____ and ____

What are the common causes of loss of orientation?

____ injury
Fluid/electrolyte ____
____
____
Hypo_____
Hypo_____
_____
_____ deficiencies

What are the criteria for a diagnosis of panic disorder?

____ ____ followed by history of ≥ ____ month of ____ or more of the following criteria:

____ of new attacks
____ about consequences of attacks
Changed ____ due to attacks

What is the treatment for panic disorder?

_____ _____ therapy
_____
_____

For panic disorder, what drug class may be used for acute episodes?

Is panic disorder genetic?

What disorder causes recurrent episodes of intense fear, nausea, paresthesias, and depersonalization for short periods?

How does panic disorder affect the risk for suicide?

What are risk factors for postpartum psychosis?

_____ disorder
_____ disorder
[First/Second] pregnancy
_____ history
Recent discontinuation of _____ medication

Which of the peripartum mood disturbances is the only one that does not usually warrant pharmacologic therapy?

_____ _____

What postpartum mental disorder could cause a woman to have delusions and threaten to kill herself and the baby?

_____ _____

What is the treatment for major depressive disorder with peripartum onset?

____
____ ____ therapy

When will the symptoms of postpartum blues likely resolve?

Within ____ ____

What are three peripartum mood disturbances that new mothers may experience in order from highest to lowest incidence rate?

____ ____ (50% to 85%)
____ ____ disorder with ____ ____ (10% to 15%)
____ ____ (0.1% to 0.2%)

What is the treatment for postpartum psychosis?

Admission to inpatient _____ unit

Administration of _____ _____ or _____ therapy if drug therapy is ineffective

What is the definition of personality disorder?

[Flexible/Inflexible] and ______ pattern of behavior that is pervasive in their life → Distress and/or impaired function

What is the definition of personality trait?

A personality trait is an enduring pattern in which a person processes and relates to his/her _____ and his/her _____ in it

In what age group do personality disorders usually present?

Before or during early ______

What are the three clusters of personality disorders?

Cluster A → "____"
Cluster B → "____"
Cluster C → "____"

What are the three cluster A personality disorders?

____ personality disorder
____ personality disorder
____ personality disorder

Cluster A personality disorders have a genetic association with which other psychiatric disorder?

_______

What common characteristics could be observed in an individual with paranoid personality disorder?

Pervasive _____
[Hypervigilance/Hypovigilance]
_____
Very _____ view of the world

What are four common characteristics of schizotypal personality disorder?

_____ beliefs
Interpersonal _____
_____ thinking
_____ appearance

What three characteristics are common with schizoid personality disorder?

Limited _____ expression
Indifferent to the _____ of others
Prefers _____ activities

What are the four cluster B personality disorders?

____ personality disorder
____ personality disorder
____ personality disorder
____ personality disorder

What three characteristics do cluster B personality disorders share?

D_____ behavior
E_____ behavior
E_____ behavior

Cluster B personality disorders are genetically associated with what two other disorders?

____ abuse
____ disorders

What personality disorder could cause a person who has fragile self-esteem to demonstrate entitlement, grandiosity, and defensiveness and lack empathy?

______ personality disorder

What personality disorder could cause a person to engage in impulsive and self-mutilating behavior, express emotional emptiness, and have unstable moods and relationships?

______ personality disorder

What is the treatment for borderline personality disorder?

_____ _____ therapy

What is a major defense mechanism for a patient with borderline personality disorder?

What personality disorder could cause a person to be shallow and sexually provocative, seek attention, and use dramatic speech and emotional expression?

______ personality disorder

What personality disorder could cause individuals to be hostile, impulsive, manipulative, and unremorseful when they disregard the rights of others?

______ personality disorder

Is antisocial personality disorder more common in males or females?

What are the three cluster C personality disorders?

____ personality disorder
____-____ personality disorder
____ personality disorder

What category of disorders is cluster C personality disorders associated with?

_____ disorders

What personality disorder could cause an individual to have low self-confidence, often remain in abusive relationships, and constantly seek support from others?

_____ personality disorder

What personality disorder could cause a person to be preoccupied with perfectionism, order, and control and experience pleasure in doing so?

_____-_____ personality disorder

What personality disorder could cause a person to be hypersensitive to rejection, timid, and socially inhibited and express feelings of inadequacy yet desire relationships?

[...] personality disorder

What are the three hallmarks of serotonin syndrome?

[Increased/Decreased] activity
____ instability
Altered ____ status

What are two methods of preventing serotonin syndrome?

Allow for a ______ period between serotonergic drugs
Avoid using ______ serotonergic drugs at the same time

Which medication can be used in the treatment of serotonin syndrome, and what is its mechanism?

_____ , which is a _____ receptor antagonist

What condition can develop in a patient on a MAOI who consumes tyramine-rich foods?

______ ______

What is the treatment for a patient prescribed MAOIs undergoing a hypertensive crisis?

______

Tyramine foods include _____ and _____

How long should a patient wait after discontinuation of an MAO inhibitor to begin taking another serotonergic drug or stop dietary restrictions?

[...] weeks

What are 3 clinical uses of MAO inhibitors?

[Typical/Atypical] ______
______ disease
______

How does eating tyramine-rich foods while taking MAOIs result in hypertensive crisis?

Tyramine displaces ______ in the synaptic cleft → Increased ______ → Stimulation of the ______ nervous system

What are six manifestations of neuroleptic malignant syndrome?

M________
F________
E________
________ unstable
[Increased/Decreased] enzyme levels
Muscle ________

What class of drugs should not be prescribed for a patient with a known family history of neuroleptic malignant syndrome?

What drugs can be used to treat neuroleptic malignant syndrome?
_____
_____
_____ agonists

In a patient experiencing alcohol withdrawal, when does delirium tremens typically arise?

____ to ____ days after the last drink

What is the treatment for a patient undergoing alcohol withdrawal with seizures?

Longer-acting _______

What is the likely cause of laryngospasm requiring intubation in a patient who has started taking an antipsychotic medication?

Acute _____

Which three drugs/drug classes can cause acute dystonia?

_______

_______

_______

What two drugs can be used to treat acute dystonia?
_______

_______

What three symptoms may be present in a patient with acute dystonia?

Muscle _____
Muscle _____
_____ crisis

acute dystonia symptoms can begin hours to days after use of a _____ _____.

An oculogyric crisis is an acute, involuntary neurological condition characterized by a sustained, ______ deviation of the eyeballs.

What is the treatment for lithium toxicity?

______ of lithium

Hydrating aggressively with ______ ______ solution

______ can be considered

What is the treatment for a TCA overdose?

_____ treatment

Activated _____

_____

_____ monitoring

What are three potential causes of lithium toxicity?

[Increase/Decrease] in lithium dosage
[Increase/Decrease] in renal clearance
Drugs that affect _____

Lithium is a ______ ______ commonly used to treat bipolar disorder.

Lithium is the drug of choice for _____ _____ in bipolar patients. It commonly causes an action _____ that is exacerbated by caffeine.

What is the treatment for alcohol withdrawal?

Longer-acting _______

What are these symptoms of?

Altered mental status
Autonomic hyperactivity
Hallucinations
Anxiety
Tremors
Seizures
Psychomotor agitation
Insomnia
Nausea

Which can contribute to serotonin syndrome?

A. Metoclopramide
B. Ondansetron
C. Prochlorperazine
D. Promethazine

Which can contribute to serotonin syndrome?

A. Melatonin
B. Ginkgo biloba
C. St. John’s wort
D. Valerian root

Which can contribute to serotonin syndrome?

A. Cocaine
B. MDMA
C. Alcohol
D. Ketamine

Which can contribute to serotonin syndrome?

A. Triptans
B. NSAIDs
C. Beta-blockers
D. Calcium channel blockers

Which can contribute to serotonin syndrome?

A. Guaifenesin
B. Benzonatate
C. Dextromethorphan
D. Pseudoephedrine

Which can contribute to serotonin syndrome?

A. Morphine
B. Tramadol
C. Oxycodone
D. Hydromorphone

Which can contribute to serotonin syndrome?

A. Vancomycin
B. Doxycycline
C. Ceftriaxone
D. Linezolid

Which can contribute to serotonin syndrome?

A. Fentanyl
B. Meperidine
C. Codeine
D. Methadone

What are five life-threatening effects of ecstasy intoxication?

[Tachycardia/Bradycardia]
[Hyperthermia/Hypothermia]
[Hypernatremia/Hyponatremia]
[Hypertension/Hypotension]
[...] syndrome

How do you treat opioid withdrawal?

______ management
______
______

What are three treatment options for smoking cessation?

_____ replacement
_____
_____

What pupillary changes can be seen with both cocaine and amphetamine toxicity?

Pupillary [dilation/constriction]

What may be present on the physical examination of a patient with chronic cocaine use?

______ nasal septum secondary to vasoconstriction
______ necrosis

What are two cardiac manifestations of cocaine overdose?

______
Sudden cardiac ______

What are two cardiovascular manifestations of amphetamine toxicity?

[Hypertension/Hypotension]
Cardiac ______ in severe intoxication

What is the treatment for a cocaine overdose?

______

Do barbiturates or benzodiazepines have a higher safety margin?

What life-threatening condition may develop in a patient with alcohol use disorder who has consumed no alcohol for 48 hours?

What are the symptoms of barbiturate withdrawal?

______
______ collapse

What is the treatment for a benzodiazepine overdose?

______

Flumazenil is a competitive ______ ______ that binds to ______, which is rarely used because it can precipitate ______.

What two symptoms can be present with benzodiazepine intoxication?

_______ depression
_______

What are three symptoms of withdrawal from benzodiazepines?

_______ disturbance
_______
_______

Intoxication with what substance may cause slurred speech, emotional lability, ataxia, coma, blackouts, and high serum GGT?

What is the expected ratio of AST to ALT for a patient that recently consumed alcohol?

What kind of intoxication could cause acute slurred speech, disorientation, drowsiness, abnormal gait, and a perioral rash?

______ intoxication

Which intoxicant is the most likely cause of hyperalertness, fever, fractured teeth, and skin excoriations?

What are three common symptoms of caffeine withdrawal?

_____-like symptoms
_____
Lack of _____

What is the treatment for agitation and seizures secondary to methamphetamine use?

What is the treatment for marked respiratory depression for a patient taking barbituates?

Provide ______ and increase ______ ______ as needed.

What class of drugs is responsible for the most drug-overdose–related deaths?

What is the treatment for opioid overdose?

What is the most common presentation of acute nicotine intoxication?

The following signs and symptoms may be present in a patient intoxicated by which psychoactive drug?

Agitation/violent behavior + psychosis — hallucinations, paranoia, delirium.

Nystagmus — especially horizontal, but can be vertical/rotary.

Sympathetic activation — hypertension + tachycardia.

The following signs and symptoms may be present in a patient intoxicated by which psychoactive drug?

Conjunctival injection
Euphoria
Social withdrawal
Dry mouth
Hallucinations
Paranoia
Slowed time preception
Increased appetite
Worsened judgement

The following signs and symptoms may be present in a patient intoxicatied by which psychoactive drug?

Auditory/visual hallucination
Anxiety
Paranoia
Flashbacks that are not disturbing
Mydriasis
Depersonalization

The following nonspecific symptoms may be present in a patient with withdrawal from which class of psychoactive drugs?

Depression / dysphoria / anhedonia

Fatigue + hypersomnia

Increased appetite

________ is a stimulant that can lead to diaphoresis, hypertension, tachycardia, severe agitation, and psychosis.

The following nonspecific symptoms may be present in a patient with withdrawal from which class of psychoactive drugs?

Anxiety
Tremor
Insomnia
Seizures

The following symptoms may be present in a patient with withdrawal from which psychoactive drug?

Restlessness
Increased appetite/weight
Anxiety
Irritability

The following symptoms may be present in a patient with withdrawal from which psychoactive drug?

Hunger
Sleep disturbances
Severe depression
Restlessness

The following presentations may be present in a patient intoxicated by which psychoactive drug?

Paranoia
Hallucinations (including tactile)
Impaired judgment
Diaphoresis

The following psychiatric symptoms may be present in a patient intoxicated by which psychoactive drug?

Euphoria
Grandiosity
Prolonged wakefulness/attention
Paranoia

The following physical findings may be present in a patient with withdrawal from which psychoactive drug?

Yawning
Sweating
Rhinorrhea
Nausea
Stomach cramps
Diarrhea
Lacrimation
Piloerection
Dilated pupils

The following symptoms may be present in a patient with withdrawal from which psychoactive drug?

Depression
Anxiety
Fatigue
Appetite changes
Difficulty concentrating

The following signs may be present in a patient intoxicated by which psychoactive drug?

Euphoria
Mydriasis
Hallucinations
Bruxism
Disinhibition
Increased thirst
Distorted sensory and time perception

The following symptoms may be present in a patient with withdrawal from which psychoactive drug?

Dysphoria
Irritability
Sleep disturbance
Headaches

The following signs and symptoms may be present in a patient intoxicated by which psychoactive drug?

Decreased respiratory and central nervous system function
Decreased gag reflex
Seizures
Decreased gastrointestinal motility
Euphoria
Pinpoint pupils

The following symptoms may be present in a patient with withdrawal from which psychoactive drug?

Depression
Insomnia
Vivid dreams
Decreased appetite
Weight loss

The following general signs and symptoms may be present in a patient intoxicated by which class of psychoactive drugs?

Decreased appetite
Anxiety
Fast heart rate
Insomnia
Psychomotor agitation
Elevated mood
Cardiac arrhythmias

The following general signs and symptoms may be present in a patient intoxicated by which class of psychoactive drugs?

Respiratory depression
Disinhibition
Sedation
Decreased anxiety
Elevated mood

How can a Pancoast tumor cause sensorimotor deficits in the upper extremity?

By compression of the ______ ______

How can a Pancoast tumor cause hoarseness?

By compression of the ______ ______ nerve

What three symptoms are typically seen if a Pancoast tumor disrupts the cervical sympathetic plexus at the stellate ganglion?

What three neurologic structures are commonly compressed by a Pancoast tumor?

____ ____ nerve
____ ganglion
____ ____

What two vascular structures are commonly compressed by a Pancoast tumor?

______ ______ ______
______ vein

brachiocephalic syndrome (caused by compression of a brachiocephalic vein, for example due to Pancoast tumor) can cause ______ ______ of the upper arm, neck, and face.

superior vena cava syndrome can cause ______, ______ distention, and ______ of the ______ upper extremities, head, and neck

CT shows _____ tumor, AKA _____ _____ tumor

Why might a patient with Pancoast tumor have hemidiaphragm elevation on a chest X-ray?

The tumor is compressing the ______ nerve

Pancoast tumors can cause a brachial plexopathy primarily affecting the _____ nerve distribution, and they may also affect the T2 nerve root.

What is indicated by the red arrow in the electron micrograph showing an axon in cross-section?

What does myelin do to an axon's space constant, conduction velocity, membrane resistance, and membrane capacitance?

[Increases/Decreases] space constant
[Increases/Decreases] conduction velocity
[Increases/Decreases] membrane resistance
[Increases/Decreases] membrane capacitance

What role does myelin play in neuronal activity?

Myelin forms an ______ sheath around a neuron's axon to [increase/decrease] conduction velocity of action potentials

How does myelin increase conduction velocity down an axon?

It promotes ____ conduction at the ____ of ____ where concentrations of ____ channels are high

Which cranial nerves are myelinated as part of the central nervous system and peripheral nervous system?

Central nervous system → Cranial nerve _____
Peripheral nervous system → Cranial nerves _____ to _____

What could cause a person to always use more drugs than intended despite knowing the dangers and trying to cut down on use?

Aside from the dangerous effects on health, how can a substance use disorder harm a person and their social life?

Recurrent use in _____ dangerous situations
Significant _____ expended in obtaining/using/recovering from the substance
Problems with _____/_____

What five causes should you include in the differential for any sexual dysfunction disorder?

_____
_____
_____
Insufficient _____ _____
_____

What 3 symptoms are classically associated with normal pressure hydrocephalus?

Urinary ______
______ apraxia
______ dysfunction

A patient presents with the brain MRI shown. He has symptoms related to stretching of the corona radiata. What is the diagnosis?

A patient with advanced Alzheimer disease presents with the MRI findings shown.

What do you think you are seeing here?

What will a measurement of the patient's ICP reveal?

What does this patient have

What kind of hydrocephalus is likely with the brain MRI finding shown in the image?

What is the classic gait pattern seen in a patient with enlarged ventricles on brain imaging, urinary incontinence, and cognitive impairment?

_____ gait

What conditions are associated with ex vacuo ventriculomegaly?

______ disorders that cause brain ______

Aqueductal stenosis causes what type of hydrocephalus?

_____ _____

Noncommunicating hydrocephalus due to aqueductal stenosis is caused by a structural blockage of cerebrospinal fluid circulation within the _____ system.

In a patient with normal pressure hydrocephalus, on lumbar puncture, what will the opening pressure measurement be?

_____, however it may be _____ episodically

What will a head CT show in an older adult who presents with urinary incontinence, cognitive dysfunction, and gait apraxia?

_____ expansion → Distortion of the fibers of the _____ _____ without an increase in _____ space volume

What is the mechanism by which meningitis can cause a communicating hydrocephalus and subsequent papilledema, herniation, and increased ICP?

Arachnoid ______ after meningitis → Limited CSF ______ via arachnoid ______

How can the symptoms of normal pressure hydrocephalus be reversed?

CSF drainage via _____ _____
CSF _____ placement

What are the 3 common causes of noncommunicating hydrocephalus?

Blockage of the _____ of _____ by a colloid cyst
Stenosis of the _____ of _____
_____

What is hydrocephalus?

[Increased/Decreased] CSF volume → Ventricular _____ with/without [increased/decreased] ICP

What are three common triggers for sleep terror disorders?

______
______ stress
Lack of ______

What waveform is seen on an EEG performed for a patient with sleep terror disorder?

______ waves

Slow waves indicate ____ sleep, stage ____

What is the definition of sleep terror disorder?

Episodes of inconsolable ______ accompanied by ______ in the middle of the night

In which population are sleep terror disorders most common?

Is a patient with sleep terror disorder likely to remember the arousal episodes the next morning?

In Pavlov's classical conditioning experiment, when you ring a bell, a dog salivates. What is the unconditioned stimulus?

In Pavlov's classical conditioning experiment, when you ring a bell, a dog salivates. What is the learned/conditioned stimulus?

What condition is associated with gustatory hallucinations?

______

What type of hallucination is associated with waking from sleep?

What type of hallucination is associated with falling asleep?

What two substances, which are frequently abused, are associated with tactile hallucination?

_____

_____

What two conditions are associated with olfactory hallucinations?

____ tumors
____ ____ epilepsy

What kind of speech consists of words and ideas strung together based on sounds, puns, or loose associations?

_____ speech

Define psychosis.

______ perception of reality marked by hallucinations, delusions, and/or disorganized thought and/or speech

Define delusion.

A fixed, untrue, _____ belief, persisting despite evidence against it, that is not typical of an individual's _____ or _____

[Men/Women] attempt suicide more often.

[Men/Women] complete suicide more often.

What is the greatest risk factor for suicide?

Previous _____

What is the most common method of suicide in the United States?

_____

Does family history of suicide completion affect a person's risk of suicide completion?

What are some of the protective factors for patients at risk for suicide completion?

Effective treatment of _______
Sense of _______ with others
Religious/cultural beliefs directed toward self-_______
Strong ____-____ skills

What is the first-line treatment for schizophrenia?

schizophrenia's positive and negative symptoms stop with management?

How does schizophrenia affect dopaminergic activity and dendritic branching?

[Increases/Decreases] dopaminergic activity
[Increases/Decreases] dendritic branching

Is schizophrenia more likely to be diagnosed in males or females?

What could be the cause of delusions, hallucinations, and catatonia lasting for 6 months with symptoms of a mood disorder?

_____ disorder

Name five positive symptoms of schizophrenia.

_____
_____
_____ speech
Evidence of _____ thought processes
_____ behavior

What is the most likely cause of hallucinations and delusions lasting between 1 day and 1 month?

______ ______ disorder

List the five negative symptoms of schizophrenia.

______/______ affect
______from social activity
______
______
______

how long do brief psychotic disorder, schizophreniform disorder, and schizophrenia each last?

How many symptoms are required to diagnose brief psychotic disorder, schizophreniform disorder, and schizophrenia?

Brief psychotic disorder → [...] or more positive symptoms for < [...] month
Schizophreniform disorder → [...] or more symptoms
Schizophrenia → [...] or more symptoms

For a diagnosis of schizophrenia to be made, periods of psychosis and disturbed behavior/thought leading to functional decline must last for how long?

At least [...] month(s) during the past [...] months or longer

Is general function impaired in a patient with delusional disorder?

Heavy use of which drug in adolescence is associated with incidence and worsened course of psychotic, mood, and anxiety disorders?

What would you expect to find on brain imaging performed for a patient with schizophrenia?

Which personality disorder is included on the schizophrenia spectrum?

_____ personality disorder

What are the cognitive symptoms of schizophrenia spectrum disorders?
______
Decreased ______ memory
Reduced ability to comprehend or create ______

What neurochemical changes are associated with schizophrenia?

[Increased/Decreased] dopaminergic activity
[Increased/Decreased] serotonergic activity

What criteria are required for a diagnosis of schizophrenia?

≥ 2 of the following active symptoms, including ≥ 1 from the first 3 symptoms:

_____
_____
_____ speech
_____/_____ behavior
[Positive/Negative] symptoms

What are the criteria for a diagnosis of schizophreniform disorder?
≥ 2 of the following symptoms:
______
______
______ speech
______/______ behavior
[Positive/Negative] symptoms lasting for [...] to [...] months

In patients with schizophrenia, how does age at onset compare in males and females?

Schizophrenia presents at a(n) [older/younger] age in males when compared with females

In what disorder is "la belle indifférence" seen?

______ disorder

What is a somatic symptom disorder?

One or more _____ complaints that last for _____ month(s) to _____ years

Patients with what disorder demonstrate anxiety about having a disease, despite lack of symptoms, multiple evaluations showing no evidence, and many attempts at reassurance?

_____ _____ disorder

What form of somatic symptoms and related disorders presents with unexplained loss of motor or sensory function following an acute stressor?

______ disorder

Identify the three groups in which conversion disorder is most common.

[Males/Females]
_____
[Older/Younger] adults

What treatment options are available for somatic symptom disorder?

_____ visits with the same _____ along with _____

What is another name for conversion disorder?

_____ _____ symptom disorder

Somatic symptom disorder → ≥ ___ bodily complaint lasting from ___ to ___
Illness anxiety disorder → ___ or ___ somatic symptoms

What are three motivational strategies for the precontemplation stage of the transtheoretical model of change?

Remind the patient that the ____ is available for them
Remind the patient of their own ____ when explaining risks
Encourage the patient to be ____

What are two motivational strategies for the contemplation stage of the transtheoretical model of change?

Suggest different ways to _____ behavioral change
Discuss the _____ and _____ of behavior change to support the healthy behavior

What are three motivational strategies for the preparation/determination stage of the transtheoretical model of change?

_____ the first steps of change
Promote _____ for good results
Ensure the patient is aware of _____ to help planning

What are two motivational strategies for the action/willpower stage of the transtheoretical model of change?

Assist with strategies to ____ with situations that trigger old behaviors
Promote ____-____

What are three motivational strategies for the maintenance stage of the transtheoretical model of change?

_____ good habits
[Positive/Negative] reinforcement for good behavior
Decrease _____ risk

What are two motivational strategies for the relapse stage of the transtheoretical model of change?

_____ the patient to return to good habits
Provide _____ that goals are achievable

What four symptoms would you expect in a patient with post-traumatic stress disorder?

Persistent [hyperarousal/hypoarousal]
_____ of trauma-related stimuli
_____ of event
Distress lasting > [...] month(s)

What is the treatment for acute stress disorder?

What are the three first-line treatments for post-traumatic stress disorder?
_____ _____ therapy

_____

_____

What is the definition of adjustment disorder?

A patient experiences emotional and/or behavioral symptoms within ____ months of an identified ____ stressor with symptoms lasting less than ____ months

What is the treatment for adjustment disorder?

What is the medication treatment for nightmares in a patient with post-traumatic stress disorder?

Exposure to what types of experiences may result in post-traumatic stress disorder?

_____ experience
Discovering that a loved one has experienced _____ events

What is the mechanism of action of mirtazapine?

Mirtazapine inhibits the ____-adrenergic receptor

What are 4 common side effects of mirtazapine?

Weight ______
Increased ______
______
______ ______

does α₂-adrenergic receptors increase or decrease nori?

What changes in neurotransmitter levels are expected when a patient takes a MAOI?

Blockage of _____ _____ → Increased levels of _____, _____, and _____

What are the 4 MAO inhibitors? (PITS)

_____
_____
_____
_____

_____ _____ breaks down serotonin, norepinephrine, and dopamine into metabolites.

Which three classes of antidepressants act by inhibiting norepinephrine reuptake?

[...]
[...]
[...]

Which four classes of antidepressants act by inhibiting the reuptake of serotonin?

[...]
[...]
[...]
[...]

Name two high-potency typical antipsychotics that don't have the suffix trick!

________, ________

What types of meds are these?

Trifluoperazine, Fluphenazine, Thioridazine, Chlorpromazine

What are the adverse effects of higher potency antipsychotics such as haloperidol, trifluoperazine, and fluphenazine?

_____ effects

What are the ophthalmologic adverse effects of chlorpromazine?

____ deposits

What are the ophthalmologic adverse effects of thioridazine?

____ deposits

Which two typical antipsychotics are considered low-potency drugs?

_____azine
_____azine

What adverse effects are more common with low-potency typical antipsychotics?

______ effects
Anti-______-adrenergic effects
______ effects

What could be the cause of a prolonged QT interval in a patient treated for schizophrenia?

The use of ______ or ______ ______

What is the reason for the long half-life of antipsychotics?

They are ______ soluble and stored in ______

Put the following extrapyramidal symptoms in the order in which they occur.

Tardive dyskinesia
Akathisia
Dystonia
Bradykinesia

Hours to days → [...]
Days to months → [...] and/or [...]
Months to years → [...]

A patient treated with antipsychotics develops difficulty sitting still and paces frequently. What is the adverse effect?

Through what mechanism do atypical antipsychotics cause dry mouth, constipation, and sedation?

______ effects
______ effects

By what mechanism do typical antipsychotics cause hypotension?

_____-blockade

What extrapyramidal adverse effect of antipsychotics is irreversible?

______ ______

What adverse effect of antipsychotic medications involves sluggishness in initiating purposeful movement days to months after the drug is taken?

Describe the mechanism by which antipsychotics cause galactorrhea.

Antipsychotics antagonize ____ receptors → Disinhibition of ____ → Hyperprolactinemia and galactorrhea

In what two scenarios can treatment with clozapine be considered?

Treatment-resistant ______ disorders
Persistent ______

Which two antipsychotic medications have the highest risk for metabolic disturbances?

______

______

What blood test should be ordered when a patient is given a new prescription for clozapine?

Clozapine CBC: This is to monitor absolute neutrophil count because clozapine can cause _________.

What are four clinical uses for antipsychotics apart form schizophrenia?

______ disorder
______ ______ disorder
______ disease
______ syndrome

[Typical/Atypical] antipsychotics treat positive symptoms
[Typical/Atypical] antipsychotics can treat both positive and negative symptoms

How is the mechanism of action of aripiprazole unique in comparison with other antipsychotics?

Aripiprazole is a _____ partial agonist

What major receptors are affected by antipsychotic medications?

_____ receptors are blocked by antipsychotics → Increased _____

What is the treatment for akathisia?

_____-blockers
_____
_____

Between typical and atypical antipsychotics, which class has a greater affinity for the dopamine receptor?

What are four treatments for tardive dyskinesia?

_____
_____ toxin injections
_____
_____

What are the 4 side effects vortioxetine (atypical antidepressant)?

_____ (common)
_____ effects
_____ disturbances
_____ dysfunction

What is the mechanism of action of vortioxetine?

___-___ reuptake inhibitor
___-___ receptor antagonist
___-___ receptor agonist

What is the major adverse effect of varenicline?

______ disturbance

What is the mechanism of action of varenicline?

Partial agonist at the ______ ______ receptor

Varenicline helps nicotine ______ decline.

Which atypical antidepressant has stimulant properties and a lower risk of sexual side effects and weight gain?

______

What is the mechanism of action of bupropion?

Inhibits reuptake of ______
Inhibits reuptake of ______

Why is trazodone primarily used for insomnia and not depression?

Trazodone causes ______, which is desirable in the treatment of insomnia

What is the mechanism of action of trazodone?

Trazadone blocks [...], [...], and [...] receptors
Weakly inhibits _____ reuptake

What are the 4 major side effects of trazodone?

Postural ______
______
______
______

Lyonization (also called X-chromosome inactivation) is a natural genetic process in female mammals where one of their two X chromosomes is randomly _____ in _____ cell during _____ development.

What is the main function of the pineal gland?

_____ secretion

What is the mechanism of action of vilazodone?

Partial agonist at [...] receptors
[...] receptor antagonist

Which 2 atypical antidepressants are used for smoking cessation?

_____

_____

Which atypical antidepressant may be suitable for an underweight patient?

_____

What is the primary clinical indication for prescribing buspirone?

What is the mechanism of action of buspirone?

[...] receptor partial agoinst

How long after a patient starts taking buspirone does it begin to take effect?

___ to ___ weeks

What is the advantage of buspirone when compared with other anti-anxiety medications such as benzodiazepines and barbiturates?

Buspirone does not cause _____, _____, or _____
Buspirone does not interact with _____

What three conditions can central nervous system stimulants be used to treat?

______-______ disorder
______-______ ______ disorder
______

What is the mechanism of action of central nervous system stimulants?

They increase ______ release at the synaptic cleft

What are four central nervous system stimulants?

________
________
________
________

Why does lithium require close monitoring of serum levels?

Lithium has a [wide/narrow] therapeutic window

What are four common side effects of lithium use?

[Hyperthyroidism/Hypothyroidism]
_____ anomaly
_____ _____ _____
_____

What is the mechanism of lithium reabsorption in the kidney?

It is reabsorbed at the proximal convoluted tubule along with _____ through _____ channels

How does lithium adversely affect the thyroid?

_____
_____

What is the mechanism by which lithium causes polyuria?

Lithium inhibits _____ function at the level of the kidney → _____ _____ _____

What three drug classes are often implicated in affecting lithium clearance?

_____ inhibitors
_____ diuretics
_____

Which organ almost exclusively excretes lithium? _____

How does lithium affect calcium levels?

Lithium causes mild [hypercalcemia/hypocalcemia]

Intravenous drug use increases a patient's risk for which diseases?

Infectious diseases including ____, ____, and ____
____
Right-sided infective ____
____

How is methadone used in the treatment of patients with substance use disorder?

Methadone is a long-acting _____ that is used for _____ from heroin and long-term _____ therapy

How is naltrexone used in the treatment of patients with substance use disorder and what is its mechanism of action?

It is used to prevent _____ after _____ _____
It is a long-acting oral _____ _____

What is the mechanism of action of buprenorphine and how is it used in the treatment of patients with substance use disorder?

Partial ______ agonist
It is administered in the form of a sublingual film for ______ therapy and suppression of ______

What adverse effect may occur when buprenorphine is taken shortly after a full opioid agonist by an opioid-dependent individual?

Precipitation of ______ symptoms

Apart from opioid detoxification, what are the other uses for naltrexone?

Weight _____
Cessation of _____ or _____ use

Which adverse effects can be caused by nicotine replacement therapy?

Oral _____
_____

Which smoking cessation drug acts as a partial agonist at nicotinic acetylcholine receptors to decrease withdrawal and effects on the reward system?

Name two common side effects of varenicline.

_____ disturbances
_____ discomfort