Psychiatry Intro MSE Personality disorders 2024

Too much dopamine can cause 1. ______ (psychiatric disorder). Too little dopamine can cause 2. ______ (neurological disorder).

1. schizophrenia

2. Parkinson’s disease

Which class of drugs that are strong dopamine-2 blockers can cause motor ADRs (dystonia, pseudoparkinson's symptoms)?

Antipsychotics

Too much dopamine can cause 1. ______ (psychiatric disorder). Too little dopamine can cause 2. ______ (neurological disorder).

1. schizophrenia

2. Parkinson’s disease

Which class of drugs that are strong dopamine-2 blockers can cause motor ADRs (dystonia, pseudoparkinson's symptoms)?

Antipsychotics

Insufficient serotonin can lead to what types of psychiatric disorders?

Depression and anxiety

Blocking serotonin reuptake into platelets can increase risk of

bleeding

What is serotonin syndrome?

a condition in which there is excessive serotonin caused by taking two or more serotonergic agents.

Zoloft (sertraline) can increase 5-HT3. What is a common initial ADR? How can we manage the ADR?

The common initial ADR is N/V. We can manage the ADR by starting at a low dose and taking the medication with food.

GABA is an ______ (inhibitory or excitatory) neurotransmitter.

inhibitory

Diphenhydramine is in many OTC sleep aids. What is the MOA for the sedative effects?

Histamine blocker

Diphenhydramine inhibits acetylcholine. Daily use of an anticholinergic medication can cause what common ADRs?

Anti-SLUD effects (dry mouth, constipation, urinary retention, blurred vision)

Why should OTC diphenhydramine or doxylamine (found in sleep aids) should be avoided in Alzheimer’s patients?

Inhibition of ACh production

List the 6 major classes of psychotropic medications used in psychiatry.

Antidepressants, mood stabilizers, antipsychotics, anxiolytics, hypnotics, psychostimulants

What are the 3 most common psychiatric disorders?

Anxiety, personality, and depressive disorders

What are the 2 FDA-indications for the most serotonergic antidepressants?

depression and anxiety

What is gabapentin FDA-approved for? What is it used off label for in addiction medicine and psychiatry?

Indicated for nerve pain and epilepsy, used off-label for anxiety

Which antidepressant can be used for chronic musculoskeletal pain?

Duloxetine (Cymbalta)

> 90% of serotonin is made from _______________ the (GI track or brain)

GI track

Withdrawing from which class of drugs can lead to depression?

long term use of stimulants such as cocaine or amphetamines

Withdrawing from benzodiazepines can lead to what symptoms? How should BZDs be properly stopped?

May lead to anxiety, insomnia, muscle tension, and seizures, need to taper to properly stop

1. ______ (endocrine condition) can cause dépression. 2. What labs should be drawn?

1. Hypothyroidism

2. TSH (high levels)

What 3 main neurotransmitters do antidepressants (AD) increase?

Serotonin, norepinephrine, dopamine

What is the effect of AD on BDNF and neurogenesis?

Increased BDNF after 4-6 weeks of use

What is a treatment option that is as effective as AD to treat mild-to-moderate depression?

Psychotherapy

What AD is contraindicated in patients with hx of seizure disorders or eating disorders?

Bupropion (Wellbutrin)

Lithium is used to treat ______ ______. Lithium, CBZ and TCAs have narrow therapeutic index.

bipolar disorder

Explain the difference between mental status exam (MSE) vs. mini mental status exam (MMSE).

An MSE (appearance, behavior, perception, cognitive function) is more in depth, extensive, and geared towards diagnosing psychiatric disorders while an MMSE is not as detailed and is for diagnosing cognitive impairment.

In the MSE, what are the medical terms used to describe mood?

depressed, dysthymic, euthymic, elated and euphoric.

What is the most common type of hallucinations in patients with schizophrenia?

Auditory

What is the type of hallucination experienced by methamphetamine abusers? This often cause feelings of “meth mites” and multiple sores from picking their skin.

Formication (tactile)

(T/F): The gold standard to treat personality disorders long term is antipsychotics.

False

For the orientation in MSE, your patient was able to state he/she name, where he/she is, and what is happening but is unable to say the correct month and year. What is the correct level of orientation?

a. Ox1

b. Ox2

c. Ox3

d. Ox4

Ox2

Deficiency in which vitamins and/or electrolytes can lead to psychosis?

Sodium

(T/F): Personality disorder is the least common psychiatric disorder in the US.

False

What are the clusters and types of personality disorders?