2ndyear Reviews Flashcards
loosening of associations
unrelated/unconnected
disorder in the logical progression of thoughts
no train of thought
flight of idea
rapid succession of fragmentary thoughts or speech
abrupt change in content, speech is incoherent
mania
psychotic
loss of reality
delusions, hallucinations
neurotic
no loss of reality
real, intraspyschic conflicts that cause anxiety
obsession, phobia, compulsion
functional
no known structural damage
tangentially
digressive, irrelevant manner of speech where central idea is never communicated
** goes on a tangent**
circumstantiality
disturbance in associative thought in which patients digress into unnecessary thoughts before getting to central idea
schizophrenia, obsessional disturbance, dementia
thought blocking
interruption in train of thinking before idea is finished and patient completely forgets what is said
word salad
incoherent mixture of words and phrases (no connection at all)
seen in severe schizophrenia
hallucinations
false sensory perception occurring in absence of external stimuli
delusions
false belief
based on incorrect inferences about external reality
maintained despite being told it is false
orientation
awareness of oneself and surroundings
A and O x 3 (person, place, time) (+ situation)
insight
conscious recognition of one’s condition
8 main topics of MSE
Appearance/behavior Speech Mood Thought Perception Cognitive behavior Insight Judgement
what medication causes agranulocytosis?
clozapine
types of psychotherapy (6)
psychoanalysis group therapy family therapy marital therapy biofeedback cognitive therapy
group therapy
goal is to change behavior
variety of disease in group is good
works for almost every disease
psychoanalysis
brings suppressed memories into present personality
free association
access the unconscious
sigmund freud
family therapy focus
improving relationships in the family structure
marital therapy
alleviate emotional distress and disability
promote well being but can still lead to divorce
biofeedback
autonomic nervous system under voluntary control
see emotions
relaxation techniques and EMG used
cognitive therapy assumes
patient problem is based on perception of environment
cognitive triad of depression
- negative self thought
- negative view of world
- believe that world will not change
SOME signs of anxiety disorder
trembling, shaking, tachycardia, sweating, diarrhea
parathesia (pins and needles)
dread, insomnia, upset stomach
drugs (categories) used to treat anxiety
- Benzos
- SSRI
- TCA
- MOI
s.e. are worse at higher doses
types of anxiety disorders
- GAD
- Panic Disorder (agoraphobia)
- Phobic disorders
- OCD
- Social Anxiety disorder
- Acute Stress Disorder
- PTSD
generalized anxiety disorder
fear, worry, tension with out panic attacks (>6 months)
benzos + SSRIs
agoraphobia
fear of leaving home, somewhat specific (spaces)
afraid of getting a panic attack in public
panic disorder
SUDDEn
may be triggered by thought, person, situation
patient is quick to freak out
treated with SSRI + Benzo
physical symptoms of panic disorder
tachycardia, hyperventilation, SOB, can pass out
feel scared, out of control
no psychotic ideation
are benzos good for anxiety disorders
NO
they will mellow you so you calm down but doesn’t treat the persistent fear
social anxiety disorder
afraid of humiliation, won’t answer questions
fear of being ridiculed or making mistakes
treat with CBT
obsession
a repetitive thought
eats at you inside
compassion
action that is taken to reduce the obsession
OCD
obsessions and compulsions
patient is aware this is a problem
Fluvoxamine -Treatment
acute stress disorder
witness, participate, know someone who has been thru traumatic event
onset of anxiety secondary to event
short (less than one month)
PTSD
exposure to some sort of event, functionally impaired for more than one month
SSRI treatment, symptom specific (wolters), trauma focused CBT
positive symptoms
gain of function
hallucinations, delusions
negative symptoms
loss of function
abnormal affect
avolition,
alogia…
neologism
creating new words
paranoid delusions
persecutory delusions
control grandeur
ideas of reference
everything is referring to them
clang association
rhyming and punning but the associations don’t make sense
how is schizo diagnosed
from the history
look for hallucinations
s/s change overtime
treatment of schizo
antipsychotics
esp. haldo and geodon + atypical
side effects of antipsychotics
EPS
TD
EPS symptoms
Dystonia Akanthesia Parkinsonism Akinesia Occulolytic (eyes roll back)
tardive diskenesia
lip smacking
comes
BMI levels for anorexia
mild: >17
moderate: 16-17
severe: 15-16
extreme: <15
physical exam findings of anorexia
brittle nails, thin hair, langue, no periods, continual fractures
diagnostic labs for anorexia
cholesterol thyroid dehydration leukopenia TSH - could be hyperthyroidism
anorexia treatment
no meds
SSRI can help depression
atypical antipsychotics
CBT, psychotherapy, family
bulimia nervosa
no lab test but will have electrolyte abnormalities
normal weight but cycles of purging
bulimia physical findings
perimylolysis (dental erosion) parotid enlargement oral damage gastric tears electrolyte imbalance (K+)
normal weight
SIG E CAPS + M
Sleep Irritability Guilt Energy Concentration Appetite loss Psychomotor retardation Suicide Mood
dysthymic disorder
aka persistent depressive disorder
depressed for over 2 years
similar symptoms but not as extreme as MDD
insidious onset (up and down)
treatment of PDD
can use SSRI, SNRI but side effects
typically CBT is best
MDD
discrete onset but not insidious
depressed mood and loss of interest for 2+ weeks
personality disorders
engrained in you
genetic aspect and environmental aspect
pattern of behavior that deviates markedly from set expectation of culture
cluster a
paranoid
schizotypical
shizoid
cluster b
antisocial
borderline
histrionic
narcissistic
cluster c
OCD
dependent
avoidant
paranoid personality
excessive suspiciousness
distrust of other
no basis
precursor of schizophrenia
schizoid PD
will not look you in the eye
detached from social groups, solitary `
schizotypical
development to schizophrenia
odd beliefs and magical thinking
antisocial PD
always in trouble with no remote
disregard for feelings of others
popular in prison population
narcissistic personality disorder
think they are special, unique
no empathy, no cure
grandiose, excessive admiration
borderline personality disorder
self mutilation, threats, impulsive
instability
psychotherapy and pharmacotherapy (SSRI and SNRI)
avoidant
people who tend to stay away from everyone
can’t take criticism
dependent personality disorder
needs other to make decisions
OCPD
everything has to be in place, lined up,
don’t think they are irrational
no obsessions or compulsions
DIGFAST
bipolar disorder - mania
Distractibility Increased goal activity Grandiose Flight of ideas Activity Sleep disturbance Talkative
mania main symptom
flight of ideas
ALSO abnormally elevated mood and increased goal activity
bipolar I
manic episode (1 week) + depressive episode
in a manic phase what might someone do>
promiscuity
waste money
drive like maniac
req. hospitalization
bipolar II
hypomanic episode with depressive episode
best drug given for bipolar disorder?`
lithium
also valproate
lithium concentration is increased by which drugs
NSAIDs ARBS Prozac Ace Thiazides (hydrochlorothiazide)
lithium concentration is decreased by
pregnancy
theophyllanine
diuretics
somatic symptoms disorders (SSD)
multiple systems
early onset
normal tests
disorders that violate clinical tests but there is no intent to deceive
somatic symptom disorder
conversion disorder
disorders where there is an intent to deceive
malingering
factitious
conversion disorder
sensory problem with no clinical diagnosis
typically blind, deaf, paralyzed
la belle indifference
1 s/s abnormal
la belle indifference
lack of concern for severity of symptoms
conversion disorder
body dimorphic disorder
barbie syndrome
obsessed with perceived flaws
repetitive actions to check appearance
multiple plastic surgeries, form of OCD
factitious disorder
purposefully making yourself sick or faking sick for attention
can be munhausen by proxy
what drug is given to patients with NMS
dantrolene
muscle relaxant (decreases CK levels)
which drug requires continual WBC (CBC_
clozapine
bc agranulocytosis
serotonin syndrome
3 maj. effects
cognitive effects (HA, confusion, coma, hallucinations)
autonomic (hyperthermia vasoconstriction, tachycardia)
somatic (muscle twitching, tremors)
NMS
super high fever
stiff rigid muscles
HTN and death
