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NMSK Exam 1 > 19. Psychosomatic Disorders > Flashcards

19. Psychosomatic Disorders Flashcards

1
Q

What is the concept of Psychosomatic Medicine?

A
  • Approach medicine hollistically: Body and mind are a unit. In all diseases, consider psychological factors.
    • ​Keep in mind complimentary and alternative medicine too.
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2
Q

Depression is a RF for what?

A
  1. Coronary heart disease
  2. Stroke
  3. Diabetes (# of depressive sx is related to # of diabetic sx)
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3
Q

Anxiety can make what diseases worse?

A
  1. Coronary artery disease
  2. Asthma
  3. Specific phobias
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4
Q

What is stress?

A

A circumstance that distrubs/can disturb NL physiological/psychological fx => stimulates ANS (sympathetic NS) => tachycardia, HTN, increased CO => stress.

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5
Q

How does the body respond to stress?

A

Responses to decrease impact of stressor and restore homeostasis.

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6
Q

NT responses to stress

A
  • 1. Release catecholamines
  • 2. Increase 5HT
  • 3. Glucocorticoids
  • 4. Increase DA
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7
Q

Immune responses to stress

A

inhibits immune functioning

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8
Q

SLE

  1. Medical sx
  2. Psychiatric sx
A
  1. Fever, HA, photosensitivity, butterfly rash, joint pain
  2. Depression, mood distrubances, psychosis, delusions, hallucinations
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9
Q

Multiple Sclerosis (MS)

  • Medical sx
  • Psychiatric sx
A
  • MS: motor/sensory disturbances, impaired vision, neurosigns with resmissions and exacervations, slurred speech
  • PS: anxiety and mania
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10
Q

RF for develpoment of coronary disease

A
  1. Depression
  2. Anxiety
  3. Type A behavior
  4. Hostility
  5. Anger
  6. Acute mental stress
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11
Q

What psychiatric symptoms do you experience when going through heart transplantation?

A
  1. Anxiety
  2. Depression
  3. Elation
  4. Coping with grief
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12
Q

30% of asthmatics meet criteria for

A
  1. Panic disorder
  2. Agoraphobia
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13
Q

Fear of dyspnea/SOB can trigger what?

A
  1. Asthma attacks
  2. Anxiety
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14
Q

What psychiatric illnesses are common in COPD?

A
  1. Anxiety disorder
  2. Panic disorder
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15
Q

Hypothyroidism

  • Medical Sx
  • Psychiatric Sx
A
  • Medical sx: cold intolerance, dry skin, constipated, WG
  • Psychiatric sx: Depressed, lethargy and paranoia
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16
Q

Hyperthyroidism

  • Medical sx
  • Psychiatric sx
A
  • Medical sx: heat intolerance, sweatting, N/V/D, WL, tachycardia, palpiations,
  • Psychiatric sx: nervous, excitable, irritable, pressured speech, insomnia, psychosis, visual hallucination
17
Q

Diabetes Mellitus

  • Medical sx:
  • Psychiatric sx:
A
  • Medical sx: ↑ urination/thirst, high glucose levels
  • Psych: Depression, lonely, dejeection, frustation
18
Q

Hyponatremia

  • Medical sx
  • Psychiatric sx
A
  • medical sx: excessive thirst, polydipsia, stupor, coma, szrs
  • psych: confusion, lethargy, personality changes
19
Q

Thiamine deficiency

  • Medical sx:
  • Psychaitric sx:
A
  1. Neuropathy, cardiomyopathy, Wernicke-Korsakoff, malaise, common in alcoholics
  2. Psych: poor concentration, confusion, confabulation (making things up; not purposely lying)
20
Q

Cobalamin (vit B12) deficiency

  • Medical sx:
  • Psychaitric sx:
A
  • Medical sx: pallor, dizziness, peripheral neuropathy/tingling, dorsal column signs, ataxia
  • Psych sx: irritable, inattentive, psychosis, demenitia
21
Q
  1. Most common SE of antidepressants?
  2. Which antidepressants cause the highest rate of GI problems. Why?
  3. Whcih antidepressants have SE due to anticholingergic effects (constipation/dry mouth?
A
  1. GI problems
  2. SSRIs; bc alot of 5HT in the GI tract
  3. TCAs
22
Q

Pancreatic cancer sx

A
  • WL, abdominal pain, depression (lethargy, anhedonia, apathy, decreased NRG)
23
Q

Patient has

  • Abdominal pain, fever, N/V, peripheral neuropathy
  • Psychosis (paranoia, visual hallucination), acute depression
A

Abdominal pain + psychosis = Acute Intermittent Porphyria

24
Q

Hepatic encephalopthy

Medical sx:

Psychaitric sx:

A
  • Asterexis, hyperreflexia, spider angioma, palamar erythema, enlarge liver
  • Eurphoria, psychosis, depression
25
Q

Sx of frontal lobe tumor

A
  1. Mood changes (irritable)
  2. Impaired memory
  3. Delirium
  4. Loss of speech/smell
  5. Facetious
26
Q

Treatments for how to manage stress?

A
  1. Self-observation: daily diary to keep track of stressors and reactions
  2. Cognitive restructing: CBR to replace negative thoughts with (+)
  3. Relaxation techniques: muscles
  4. Mindfulness: focus on present
27
Q

what is delirium?

A

medically induced confusion; you can be delirious with or w/o psychosis.

28
Q

MCC of confision/disorientation in the hospital

A

delirium

29
Q

Never give _______ to delirius elderly patients

A

benzos

30
Q

Psyciatric sx of PCP

A
  1. Agitation with blank stare/Aggressive
  2. Anxiety
  3. Stupor
  4. Panic
  5. Bizarre behavior
31
Q

Pt is on “IV corticosteroids”, what psychotic sx might they have?

A
  1. Steroid-induced psychosis (hallucinations)
  2. Mania
32
Q

Why should antidepressants NOT be given to bipolar patients?

A

Cause mania

NMSK Exam 1 (22 decks)

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