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 Jan 6, 2021, 11:18 PM 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 Oct 13, 2020, 8:34 PM 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 Sep 22, 2020, 7:49 AM 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 Sep 21, 2020, 12:33 AM HirotoShishido
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 Jul 7, 2020, 5:23 AM 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 Jun 26, 2020, 4:55 AM 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 May 25, 2020, 1:53 AM 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 May 8, 2020, 8:42 PM 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)
inconsistent with one's beliefs and attitude ⇔ obsessive-compulsive personality disorder psychiatryUWorld Apr 30, 2020, 8:36 PM HirotoShishido
the difference between illness anxiety disorder and somatic symptom disorderIAD(hypochondriasis)→ minimal to no somatic symptoms
somatic symptom disorder→ prominent and typically multiple somatic symptoms psychiatryUWorld Apr 30, 2020, 8:26 PM HirotoShishido
disruptive mood dysregulation disorder
onsetchild is constantly angry and irritable between outbursts
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
