treatment of rhabdomyolysis and crush syndrome☆IV fluid administration
Monitor fluid output and electrolyte levels
Correct electrolyte imbalances as necessary (see treatment of hypocalcemia and hyperkalemia)
In the case of renal failure: consider hemodialysis pharmacologypsychiatry国試 HirotoShishido
State trait anxiety inventoryinventory based on a 4-point Likert scale and consists of 40 questions on a ☆self-report basis. The STAI measures two types of anxiety – state anxiety, or anxiety about an event, and trait anxiety, or anxiety level as a personal characteristic.
自記式（被験者が記入）
●☆Minnesota（ミネソタ）多面人格検査（MMPI）
●矢田部-Guilford性格テスト（Y-Gテスト）
●文章完成テスト
●☆Beck（ベック）のうつ病自己評価尺度
Beck Depression Inventory (BDI)
●気分プロフィール検査（POMS）
Profile of Mood States
●状態特性不安検査（STAI） psychiatry国試過去3年 HirotoShishido
the most common psychological disorder complicated with multiple sclerosis★Depression has been found in up to two-thirds of patients with MS and is the most common psychiatric complication. Depression can occur at any time and is likely caused by a combination of factors, including inflammatory changes in the brain, immune system changes, and psychological reactions to neurological deficits and the challenges of living with MS. neurologypsychiatryUWorld step2CK HirotoShishido
management of Tourette syndrome・Behavioral therapy (habit reversal training)
・Antidopaminergic agents
Tetrabenazine（Nitoman®）(dopamine depleter= ★Vesicular monoamine transporter type 2 (VMAT2) inhibitors→日本ではコレアジン®→ハンチントンのみ適応)
Antipsychotics (receptor blockers)
(second generations are preferred(eg ★risperidone, aripiprazole(abilify®))
SSRI dose adjustment for the patient with anxiety disorder(worsening anxiety, with jitteriness, insomnia, and new-onset anxiety in nonsocial situations, most likely reflects the stimulating effects of fluoxetine)
The most appropriate step is a temporary dose reduction with the goal of improving tolerability; dose increases may subsequently be reattempted. psychiatryUWorld step2CK HirotoShishido
intoxication treated with benzodiazepinealcohol withdrawal, cocaine intoxication psychiatry HirotoShishido
diagnosis of selective mutismonset before age 5
lasting ≥ 1 month involving refraining from speech in certain situations despite speaking in other, usually more comfortable situations
other psychiatric disorder whose diagnostic criteria requires at least 1 month duration
→ separation anxiety disorder, ☆panic disorder, schizophreniform disorder(<6months), delusional disorder psychiatry HirotoShishido
the reason why TCA toxicity is treated with bicarbonateto overcome the sodium channel-blocking activity of TCAs, but not for accelerating drug elimination. pharmacologypsychiatryUWorld step2CK HirotoShishido
intoxication of benzodiazepines and opioidsbenzodiazepines→ sedation with ☆normal vital signs (☆antidote= flumazenil)
globus sensationGlobus sensation (also called globus hystericus and globus pharyngeus) is a common abnormal sensation of a foreign body, tightness, or fullness in the throat.
It is often worse when swallowing saliva and may be alleviated with food or liquid. Globus is a ☆functional disorder of the esophagus and by definition is not due to a structural abnormality or motility disorder. psychiatryUWorld SIM1 HirotoShishido
restless leg syndrome
cause, treatmentworse at rest/nighttime
relieved by movement
idiopathic, 国試iron deficiency, uremia, diabetes(especially with neuropathy), ★multiple sclerosis
Avoidance of aggravating factors (eg, alcohol, sleep deprivation, antipsychotics)
agoraphobiairrational fear/anxiety while facing more than 2 specific situations(eg open/closed spaces, lines, crowds, public transport)
symptoms present over a period of >=6months
¥panic attack symptoms such as dyspnea, chest tightness, palpitations, dizziness, diaphoresis and feeling of impending doom psychiatryAmboss level4 HirotoShishido
diagnosis of obsessive-compulsive disordertime consuming(>1hr/day), or cause significant distress or impairment
eating/ grooming rituals are driven by a symmetry obsession and the need to prevemt a feared event ⇔ body dysmorphic disorder(preoccupation with defects in physical appearance)
parasomniasREM(beta waves)→ nightmare disorder, REM sleep behavior(patients remember the dream)(more common in adults)
☆↑Ach
NREM(N3, ☆delta waves)→ ☆sleepwalking, ★night terrors(no memory of the dream)(more common in children)
★Reassurance
Administer low-dose benzodiazepine at bedtime if episodes are frequent, persistent & distressing
