OMSB Psychiatry (OEPSY) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Delirium Diagnostic Hallmark

Acute onset with fluctuating course, inattention, and altered cognition or perception, not better explained by a pre-existing neurocognitive disorder; usually secondary to a medical, toxic, or metabolic cause.

Major Depressive Episode Criteria

At least five of nine symptoms present for two or more weeks, with depressed mood or anhedonia required; causes clinically significant distress or impairment and is not attributable to a substance or medical condition.

Serotonin Syndrome Features

Mental status change, autonomic hyperactivity, and neuromuscular hyperactivity such as clonus and hyperreflexia, typically arising within 24 hours of starting or increasing a serotonergic agent.

Neuroleptic Malignant Syndrome

Life-threatening reaction to dopamine antagonists with lead-pipe rigidity, hyperthermia, autonomic instability, elevated creatine kinase. Stop the offending drug, provide supportive care, and consider dantrolene or bromocriptine.

Lithium Therapeutic Range

Serum level of 0.6 to 1.0 mmol/L for maintenance, with lower target in older adults. Monitor renal and thyroid function regularly; avoid NSAIDs, thiazides, and ACE inhibitors, which raise levels.

Acute Dystonia Management

Sustained muscle spasm of neck, jaw, or eyes arising hours to days after starting a dopamine antagonist; treat with an anticholinergic such as benztropine or with diphenhydramine.

Tardive Dyskinesia

Involuntary choreoathetoid movements, often of the tongue, lips, and face, appearing after months to years of dopamine antagonist exposure; VMAT2 inhibitors such as valbenazine are approved treatments.

Alcohol Withdrawal Timeline

Tremor and autonomic symptoms begin 6 to 24 hours after the last drink, seizures occur at 6 to 48 hours, and delirium tremens typically peaks at 48 to 96 hours; benzodiazepines are first-line treatment.

Wernicke Encephalopathy Triad

Confusion, ophthalmoplegia or nystagmus, and ataxia due to thiamine deficiency; give parenteral thiamine before glucose to avoid precipitating or worsening the syndrome.

Four Abilities of Capacity

A patient must be able to communicate a choice, understand relevant information, appreciate the situation and consequences, and reason about options; capacity is decision-specific rather than global.

Suicide Risk Assessment Elements

Assess ideation, plan, intent, means access, prior attempts, substance use, and protective factors; risk is highest shortly after psychiatric discharge and in older men.

Panic Attack Definition

Abrupt surge of intense fear peaking within minutes, with at least four symptoms such as palpitations, dyspnea, chest pain, derealization, or fear of dying; rule out cardiac and thyroid causes.

Generalized Anxiety Disorder Criteria

Excessive, difficult-to-control worry across multiple domains for at least six months, with at least three of six symptoms such as restlessness, fatigue, poor concentration, irritability, muscle tension, or sleep disturbance.

OCD First-Line Treatment

Cognitive behavioral therapy with exposure and response prevention plus an SSRI; SSRIs often require higher doses and 8 to 12 weeks before benefit is judged. Clomipramine is an alternative.

PTSD Core Symptom Clusters

Intrusion symptoms, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity persisting more than one month after trauma exposure.

First-Line PTSD Psychotherapy

Trauma-focused therapies, particularly prolonged exposure and cognitive processing therapy, are first-line; SSRIs such as sertraline and paroxetine are first-line pharmacologic options.

Schizophrenia Positive Symptoms

Hallucinations, delusions, disorganized speech, and disorganized or catatonic behavior; these typically respond to dopamine D2 receptor blockade with antipsychotic medication.

Clozapine Indications and Monitoring

Indicated for treatment-resistant schizophrenia; requires regular absolute neutrophil counts because of agranulocytosis risk, plus monitoring for myocarditis and seizures. Smoking cessation raises clozapine levels.

Bipolar I Disorder Definition

At least one manic episode lasting a week or requiring hospitalization, with or without depressive episodes; mania includes elevated mood, decreased need for sleep, grandiosity, and risky behavior.

Bipolar Mania First-Line Agents

Lithium, valproate, or an atypical antipsychotic such as quetiapine, olanzapine, or aripiprazole; antidepressant monotherapy risks inducing mania or rapid cycling and is avoided.

Neuroleptic-Induced Akathisia

Subjective inner restlessness with inability to sit still, emerging days to weeks after starting or increasing a dopamine antagonist; manage by lowering dose, adding a beta-blocker, or a benzodiazepine.

Anorexia Nervosa Features

Restriction of energy intake leading to significantly low body weight, intense fear of gaining weight, and disturbed body image; medical risks include bradycardia, hypokalemia, and refeeding syndrome.

Bulimia Nervosa Features

Recurrent binge eating with compensatory behaviors such as vomiting or laxative use at least weekly for three months, with self-evaluation unduly influenced by shape and weight; first-line psychotherapy is CBT.

Postpartum Psychosis

Psychiatric emergency with onset typically within two weeks of delivery, featuring mood lability, confusion, and delusions; carries high suicide and infanticide risk and requires urgent hospitalization.

SSRI Use in Pregnancy

Generally continued when benefits outweigh risks; paroxetine carries signals for cardiac defects, and persistent neonatal adaptation syndrome may occur after third-trimester exposure. Decisions are individualized.

ADHD Diagnostic Criteria

At least six inattentive or hyperactive-impulsive symptoms (five if age 17 or older), present before age 12, in two or more settings, causing impairment and not better explained by another disorder.

Autism Spectrum Disorder Core Domains

Persistent deficits in social communication and interaction plus restricted, repetitive patterns of behavior, interests, or activities, with onset in the early developmental period.

Opioid Use Disorder Treatment

Buprenorphine or methadone maintenance is first-line and reduces mortality; naltrexone requires full detoxification. Naloxone reverses overdose. Withdrawal alone is not adequate treatment.

Benzodiazepine Withdrawal Risk

Abrupt cessation after long-term use can cause anxiety, insomnia, tremor, seizures, and delirium; taper gradually and consider substituting a long-acting agent such as diazepam.

Electroconvulsive Therapy Indications

Highly effective for severe major depression, treatment-resistant depression, catatonia, and life-threatening conditions such as severe self-neglect or psychotic depression; usual course is 6 to 12 sessions.

Antidepressant Onset of Action

Therapeutic benefit typically emerges over two to four weeks, with full response by six to eight weeks; monitor for activation, suicidality, and serotonin-related adverse effects in the early weeks.

Tricyclic Overdose Toxicity

Cardiotoxicity with QRS widening, arrhythmia, hypotension, seizures, and anticholinergic signs; sodium bicarbonate is the key treatment for widened QRS. Check ECG and continuous cardiac monitoring.