pathophysiology of tardive dyskinesia(antipsychotic side effects)
repetitive involuntary movements
orofacial dyskinesia(e.g. ☆facial grimacing, tongue movements, lip smacking and puckering)
caused by long-term (months to years)blockade of dopamine receptors in the nitrostriatal dopamine pathway, causing ☆receptor upregulation
(dystonia, akathisia, and parkinsonism tend to resolve after discontinuation of the offending agent, but TD usually continue despite discontinuation of medication) psychiatrypharmacologyUWorld SIM2 HirotoShishido
ADHD(attention-deficit hyperactivity disorder) diagnosisonset before age 12
☆diagnosis cannot be given before age 4-5
stages of change in overcoming addictionprecontemplation(denying)
contemplation(acknowledging, but unwilling)
preparation
action
maintenance
relapse psychiatryUWorld HirotoShishido
opioid detoxification and relapse preventionmethadone→ full agonist, ☆☆longer half time
(codeine, fentanyl, hydromorphone, meperidine are also full agonist)
buprenorphine→ partial agonists, ☆can
precipitate withdrawal in patients on long term opioid therapy
naloxone→ ☆short acting opioid antagonist (frequent redosing is necessary)
naltrexone→ long acting opioid antagonist, ☆first line pharmacotherapy for moderate to severe alcohol use disorder(second line→disulfiram) psychiatrypharmacologyUWorld HirotoShishido
management for acute distress of panic disorderbenzodiazepines
the disease whose symptoms are similar to PTSD but lasts between 3 days to 1 month(PTSD is HHARD→ Hypervigilance/increased startle response (eg, when nearby door slams), Hyperarousal, Avoidance of associated stimuli, Re experiencing of the event, ditress (eg, (★)feeling overwhelmed))
acute distress disorder
Life-threatening medical events, such as ★acute MI, may be experienced as traumatic and result in PTSD in some patients. psychiatryUWorld step2CK HirotoShishido
treatment for phencyclidine, cocainePCP→benzodiazepine
which test should be used to evaluate executive functionclock drawing test, an element of MoCA(Montreal Cognitive Assessment) neurologypsychiatry HirotoShishido
nonbenzodiazepine hypnotics
medication,
difference from benzodiazepinethese ZZZs put you to sleep
Zolpidem, Zaleplon, esZopiclone
the difference between
conduct disorder, antisocial personality disorder, and oppositinal defiant disorderconduct diorder→ presents with behaviors that represent pervasive violations of the rights of others and/or of societal norms before the age of 18
antisocial personality disorder→ the diagnosis of conduct disorder in patients ★>18 years old
oppositinal difiant disorder→ disobedience towards authority figures in the absence of serious violation of societal norms psychiatryUWorld step2CK HirotoShishido
ego defense which is frequently seen ln the patient with borderline personality syndromesplitting
the act of characterizing actions, ideas, people, or things as either “all good” or “all bad" psychiatry HirotoShishido
the difference between repression and supressionrepression→ unconsciously holding back inappropriate thoughts(immature ego defense)
difference between delusional disorder (jealous) and paranoid personality disorderdelusional disorder→ does not markedly impair the person’s functioning in daily activities, and the ramifications are limited to the delusional content
(schizoid→aloof, schizotypal→ awkwardness ≒ odd belief, magical thinking)
paranoid personality disorder→ have pervasive, long-standing distrust of ☆many people,
☆but do not have fixed, specific delusions psychiatryUWorld HirotoShishido
how long does anxiety last in the patient with generalized anxiety disorder(GAD)
other characteristicsmore than 6 months(=schizophrenia)
