PA PSYCHIATRY EOR 2024 LATEST ACTUAL
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Borderline Personality Disorder - ANSWER-Mood swings & impulsive behavior Unstable personal relationships Poor impulse control - *splitting* *Always in Crisis Mode* Substance Abuse *Stress-induced paranoia/psychosis*
Tx:
1st Line: *Dialectical Behavioral Therapy*
2nd Line: SSRIs (fluoxetine)
Narcissistic Personality Disorder - ANSWER-Exhibitionist Grandiose Preoccupied w/ power and lack empathy Excessive demands for attention *Lying * is an integral part of the behavior Sense of *entitlement*
Tx: 1 / 4
1st Line: *Long-term psychodynamic therapy*
2nd Line: SSRIs
Histrionic Personality Disorder - ANSWER-Center of attention - egocentric Temper tantrums -immature, emotionally labile Inappropriately seductive or provocative Dependent Substance abuse
Tx:
1st Line: *Psychotherapy*
2nd Line: SSRIs
Avoidant Personality Disorder - ANSWER-Fear of rejection Hypersensitive to rejection or failure Low self-esteem Poor social-skills
Tx:
1st line: *Psychotherapy*
2nd line: Paroxetine (Paxil)
3rd line: Clonazepam (Klonopin) or BB for performance anxiety
*SIGECAPS* of Depression - ANSWER-*S*leep disturbances *I*nterests are ↓ 2 / 4
*G*uilt *E*nergy is ↓ *C*oncentration is ↓ *A*ppetite is ↓ *P*sychomotor Agitation *S*uicidal thoughts
Major depressive disorder - ANSWER-Depressed Mood or Anhedonia
Dx: 5 or more of the SIGECAPS Sxs for *> 2 wks* effecting normal function
Tx:
*SSRI* or *SNRI* > TCA/MAOi > ECT
S/Es of SSRIs - ANSWER-*Sexual Dysfunction* Wt gain Anxiety Nausea
*SHIVERS* of Serotonin Syndrome - ANSWER-*S*hivering *H*yperreflexia *I*ncreased temp (fever) *V*itals, unstable *E*ncephalopathy *R*estless 3 / 4
*S*weating
Tx: Cyproheptadine
1st line Tx of depression in children - ANSWER-Fluoxetine (Prozac)
- Longest Half-life of all SSRIs
- Caution ↑ SI in the 1st 2 weeks of use
SSRI known to cause QT interval prolongation - ANSWER-Citalopram (Celexa)
Screening tool or questionnaire used in clinic for:
Bipolar Disorder
Major Depression Disorder - ANSWER-BPD: The Mood Disorder Questionaire
MDD: Beck Depression Inventory
Atypical Antidepressant which inhibits DA reuptake, has less sexual and wt-related side effects, but decreases *seizure* threshold - ANSWER-Bupropion *smoking cessation*
*SNRI Trade Names* Effexor Pristiq Cymbalta Fetzima - ANSWER-*SNRI Drug Names*
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