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ICM - Psychiatry > Autism and Somatic Disorders > Flashcards

Autism and Somatic Disorders Flashcards

1
Q

DSM 5 criteria for autism diagnosis

A
  1. Persistent deficits in social communication and interaction
  2. Restricted, repetitive patterns of behavior, interests of activities
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2
Q

At what point to autism symptoms tend to manifest

A

Six months-two years old.

Symptoms present in early development, often when social demands exceed limited capacities.

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3
Q

Describe the language of an autistic patient

A

Delays in expressive and/or receptive (following commands) language

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4
Q

Describe the social communication and interaction of an autistic patient

A

Lack of reciprocity (play alone)
Deficit in joint attention (parallel play)
Impaired nonverbal communication
Impaired social relationships

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5
Q

Restricted, repetitive behaviors of autistic patients often include (6)…

A 
Repetitive behaviors (hand flapping)
Insistence on sameness (difficulty with schedule changes)
Restricted interests
Sensory perception issues
Motor delays
Savant Skills
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6
Q

How do you scan for autism?

A

M-CHAT questionnaire

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7
Q

Name of the mercury containing preservative associated with vaccines

A

Thimerosal

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8
Q

Physical diagnosis findings associated with Autism

A 
Growth Parameters (Head circumference)
Skin exam (Woods Lamp)
Neurological Exam (Focal neuro signs)
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9
Q

Treatment for autism

A

Psychosocial therapy

Behavioral Training

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10
Q

Difference between illness and disease

A

Illness – response of individual/family to symptoms

Disease – Pathophysiologic process associated with documentable physical lesions

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11
Q

What is Somatization?

A

Tendency to experience and communicate psychological or emotional distress as somatic (physical) symptoms

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12
Q

What is a Somatoform illness?

A

Somatization that produces significant dysfunction in a patient’s life

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13
Q

What is a factitious disorder?

A

Symptoms are produced or feigned in order to appear ill, with no perceivable benefit to the patient

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14
Q

What is malingering?

A

Symptoms are produced or feigned in response to an external incentive

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15
Q

Somatic Symptom and Related Disorders include

A 
Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder
Factitious Disorder
Psychological Factors affecting other medical Conditions
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16
Q

The fancy name for conversion disorder

A

Functional Neurological Symptom Disorder

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17
Q

What are somatic disorder patients a difficult patient population to treat?

A

Chronic, difficult to treat

High utilizers of the medical systems

18
Q

Three common risks of somatic system disorder diagnosis

A

Repetitive, unnecessary testing
Invasive medical and surgical workups
Medically induced illness

19
Q

Gender most commonly afflicted with somatic disorders

A

Female

20
Q

Criteria for somatic symptom disorder (4)?

A
  • Chronic somatic symptom(s) about which people are excessively concerned, preoccupied, or fearful
  • Significant distress and dysfunction
  • Patients are rarely reassured and often find care inadequate
  • Lasts for more than 6 months
21
Q

Important tenant of management or somatic symptom disorder

A

Set realistic goals for reduced (not absent) pain

Increase function

22
Q

Two diseases commonly comorbid with somatic symptom disorder?

A

Anxiety and Depression

23
Q

Illness anxiety disorder was previously referred to as…

A

hypochondriasis

24
Q

Symptoms seen in Illness Anxiety Disorder

A

4 Ds (Disease Fear, Disease Preoccupation, Disease Conviction, Disability)

25
Q

What gender tends to get Illness Anxiety Disorder

A

Equal Prevalence

26
Q

Major risk in Illness Anxiety Disorder patients…

A

Missing medical diagnoses due to symptoms being assumed to be IAD related

Iatrogenic complications

27
Q

Treatment for illness anxiety disorder

A

Cognitive Behavioral Therapy
Relaxation and Supportive Psychotherapy
SSRIs

28
Q

Functional neurological symptom disorder criteria…

A

Symptom(s) of altered voluntary motor or sensory fxn
Incompatibility of symptoms with recognized syndromes
Not better explained by another disorder
Distress and Impairment

29
Q

Examples of motor symptoms seen in functional neurological symptom disorder

A

Weakness, Paralysis
Tremors
Dystonic Movements
Pseudoseizures

30
Q

Examples of sensory symptoms seen in functional neurological symptom disorder

A

Distractibility
Sensory symptoms split at midline
Gap between tested strength and fxn
La belle indifference

31
Q

What does la belle indifference refer to

A

When patients are very chill about symptoms they should be freaking out about

32
Q

What gender is more prone to functional neurological symptom disorder?

A

Females

33
Q

At what age do conversion disorder symptoms tend to develop?

A

Adolescence and early adulthood

34
Q

How is functional neurological symptom disorder treated?

A

Treat anxiety/depression
Hypnosis
Frame to patient as “stress related”

35
Q

Key criteria for psychological factors affecting other medical conditions?

A

Factors have influenced course of medical condition
Factors interfere with treatment of condition (adherance)
Factors constitute well-established health risks for the individual

36
Q

Give two examples of psychological factors affecting other medical conditions

A 
Obesity and diabetes
Smoking and COPD
Alcohol Abuse and Liver Disease
Anxiety and Asthma
Chronic Occupational Stress and Hypertension
37
Q

Factitious disorder has what two types

A

Imposed on self and imposed on another (by proxy)

38
Q

Key criteria of factitious disorder

A

Individual presents as ill, impaired, or injured

The behavior is deceptive with absence of obvious external rewards

39
Q

What does Factitious Disorder by proxy tend to look like

A

Women age 20-40, often connected to health care acting on children

40
Q

Somatic Symptom Disorder.
Voluntary or Involuntary Symptoms?
Conscious or unconscious motivation?

A

Involuntary

Unconscious

41
Q

Factitious Disorder
Voluntary or Involuntary Symptoms?
Conscious or unconscious motivation?

A

Voluntary

Unconscious

42
Q

Malingering
Voluntary or Involuntary Symptoms?
Conscious or unconscious motivation?

A

Voluntary

Conscious

ICM - Psychiatry (8 decks)

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