Psychiatry APEA 3P Exam Study Guide Flashcards

Vocabulary flashcards covering clinical assessment, pathophysiology, and pharmacological management of psychiatric disorders from the APEA 3P Exam Study Guide.

Depression Diagnostic Criteria

Five or more symptoms present for 2 weeks, including low mood or anhedonia, remembered by the SIGECAPS mnemonic.

SIGECAPS

Mnemonic for depression symptoms: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidality.

SSRIs (Selective Serotonin Reuptake Inhibitors)

Antidepressants that block serotonin reuptake. Side effects include GI upset, sexual dysfunction, and hyponatremia in older adults. Takes 4 to 6 weeks for full effect, carries a suicidality warning up to age 24, and requires tapering to avoid discontinuation syndrome.

SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)

Antidepressants such as venlafaxine and duloxetine that can raise blood pressure.

Bupropion

Antidepressant with no sexual side effects that lowers the seizure threshold; contraindicated in patients with seizure and eating disorders.

Mirtazapine

Antidepressant known for causing sedation and weight gain.

TCAs (Tricyclic Antidepressants)

Antidepressant class causing anticholinergic side effects and fatal arrhythmia in overdose.

MAOIs (Monoamine Oxidase Inhibitors)

Antidepressants associated with tyramine-induced hypertensive crisis; require a 14-day washout period when switching medications.

Generalized Anxiety Disorder (GAD)

Dysregulation of GABA, serotonin, and norepinephrine leading to excess worry on most days for 6 months plus three associated symptoms (restlessness, fatigue, poor concentration, irritability, muscle tension, poor sleep).

Buspirone

A 5-HT1A partial agonist used for anxiety; takes 2 to 4 weeks to work and carries no risk of dependence.

Benzodiazepines

Anxiolytics that enhance GABA-A; intended for short-term use only due to risks of dependence, falls, and withdrawal seizures. Reversed by flumazenil.

Flumazenil

Pharmacological reversal agent for benzodiazepines.

Bipolar I Disorder

Mood disorder characterized by mania lasting for at least 1 week.

DIG FAST

Mnemonic for manic symptoms: Distractible, Impulsive, Grandiose, Flight of ideas, Activity up, Sleep need down, Talkative.

Bipolar II Disorder

Mood disorder characterized by hypomania lasting for 4 days plus major depression.

Lithium

Mood stabilizer with a narrow therapeutic range of $0.6$ to $1.2\,\text{mEq/L}$. Causes tremor, polyuria, and hypothyroidism. Drug levels are elevated by NSAIDs, thiazides, ACE inhibitors, and dehydration.

Lamotrigine

Medication used for the treatment of bipolar depression.

Quetiapine and Olanzapine

Second-generation antipsychotics used in bipolar disorder that carry side effects of weight gain, high glucose, and high lipids.

Serotonin Syndrome

Condition caused by excess serotonin activity (such as combining SSRIs/SNRIs with MAOIs, triptans, tramadol, linezolid, St. John's wort, or dextromethorphan). Features rapid onset within hours with agitation, fever, tachycardia, sweating, diarrhea, clonus, hyperreflexia, and tremor.

Cyproheptadine

Serotonin blocker used in the treatment of serotonin syndrome.

Neuroleptic Malignant Syndrome (NMS)

Antipsychotic-induced reaction characterized by lead-pipe rigidity and a slower onset compared to serotonin syndrome.

Alcohol Withdrawal Timeline

Tremors occur at 6 to 24 hours, seizures at 12 to 48 hours, and delirium tremens at 48 to 96 hours following alcohol cessation.

Opioid Intoxication vs. Withdrawal Findings

Intoxication features pinpoint pupils and slow breathing. Withdrawal features dilated pupils, yawning, gooseflesh, and diarrhea.

Alcohol Abuse Lab Markers

Laboratory findings including elevated GGT, elevated MCV, and an AST:ALT ratio of 2:1.

Naltrexone

Medication for alcohol use disorder that requires the patient to be completely opioid-free prior to initiation.

Thiamine Administration Rule

Clinical protocol requiring thiamine to be administered before glucose in patients with alcohol withdrawal or dependency.

Methadone

Opioid treatment agent associated with the risk of QT prolongation.

Varenicline

Tobacco cessation agent known to cause side effects of nausea and vivid dreams.

Bulimia

Eating disorder characterized by binge eating with compensatory purging at least weekly for 3 months; body weight is usually normal.

Russell Sign

Knuckle calluses caused by self-induced vomiting in bulimia.

Fluoxetine

The only FDA-approved drug for the treatment of bulimia.

Munchausen by Proxy

Factitious disorder imposed on another, wherein a caregiver invents or causes illness in a child to gain attention rather than primary/secondary financial reward; managed by reporting to child protective services.