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psychiatry > CK2 > Flashcards

CK2 Flashcards

1
Q

Postopartum mood disturbances - types and incidence rate

A
  1. Maternal (postpartum) “blues” –> 50-85%
  2. Postpartum depression –> 10-15%
  3. Postpartum psychosis –> 0.1-0.2%
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2
Q

Maternal (postpartum) “blues” - manifestation (and when)

A

characterised by depressed affect, tearfulness, and fatigue stating 2-3 days after delivering

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3
Q

Postpartum depression - manifestations

A

characterised by depressed affect, anxiety and poor concentrating starting within 4 weeks after delivery

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4
Q

Postpartum psychosis - risk factors

A
  1. history of bipolar or psychotic disorder
  2. first pregnancy
  3. family history
  4. recent discontinuation of psychotropic medication
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5
Q

Postpartum psychosis - treatment

A
  • hospitalization and initiation of atypical antispycotic

- if sufficient –> Electroconvulsive therapy (ECT)

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6
Q

normal grief?

A 
Normal bereavement (πένθος) characterised by 
1. shock   2. denial   3. guilt   4. somatic symptoms 5. yearning  6. hallucinations of the deceased person 
Duration varies widely (usually less than 6-12 months)
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7
Q

Pathologic grief?

A

Persistent lasts more , satisfies major depressive criteria and causes function impairment
Hallucinations (eg, hearing the voice of a deceased loved one) in the absence of other psychotic symptoms are not consider pathologic

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8
Q

Electroconvuslive therapy is used mainly for

A
  1. treatment-refractory depression
  2. depression with psychotic symptoms
  3. acutely suicidal patients
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9
Q

Panic disorder defined by

A

recurrent panic attacks not associated with known trigger

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10
Q

panic attacks?

A 
periods of intense fear and discomfort peaking in ten minutes with at least four of the following
mnemonic --> PPANICCCSSS 
Palpitations 
Paresthesias 
Abdominal distress
Nausea
Intense fear of dying or loosing control 
Chest pain
Chills
Choking
Sweating 
Shaking
Shortness of breath
AND light-headedness, depersonalizatio, derealization
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11
Q

Panic disorder - diagnosis

A

requires panic attack followed by 1 month or more of 1 (or more) of the following

  1. Persistent concern of additional attacks
  2. Worrying about consequences of attack
  3. Behavioural change related to attacks
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12
Q

specific phobia - definition

A

severe, persistent (6 or more months) fear or anxiety due to presence or anticipation of a specific object or situation
Person often recognises fear is excessive

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13
Q

Specific phobia - treatment

A

CBT with exposure (first line)

- short acting benzo (limited role, ma help acutely if terapist unavailable or insufficient time)

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14
Q

Agoraphobia?

A

exaggerated fear of open or enclosed places, using public transportation, being in line or in crowds, leaving home alone (in at least 2 situations)
it is associated with PANIC DISORDERS

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15
Q

Agoraphobia - treatment

A

CBT, SSRIs, MAO inhibitors

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16
Q

Social anxiety disorder? (and examples)

A

exaggerated fear of embarrassment in social situations (eg. public speaking, using public restrooms)

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17
Q

Social anxiety disorder - treatment

A

CBT, SSRIs, venlafaxine

- Beta blocekrs or benzo for performance-only subtype like speeches)prefer b blockers due do sedative effect

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18
Q

Generalized anxiety disorder?

A

anxiety lasting more than 6months, unrelated to specific person, situation, or event

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19
Q

Generalized anxiety disorder - treatment

A

first line: CBT, SSRIs,SNRIs

second line: Buspirone, TCAs, benzoidazepines

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20
Q

Adjustment disorder?

A

emotional symptoms (anxiety, depression) causing impairment following (within 3 months) an identifiable psychosocial stressor (eg. divorce, illness) and lasting less than six months (more than six moths in presence of chronic stressor)

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21
Q

Adjustment disorder - duration

A

less than six months (more than six moths in presence of chronic stressor)

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22
Q

Post-traumatic stress disorder - manifestations

A

may involve nightmares or flashbacks, intense fear, helplessness, horror –> leads to leads to avoidance of stimuli associated with the trauma and persistently increased arousal –> impairs social-occupational functioning
IT LASTS MORE THAN A MONTH

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23
Q

situations that are associated with Post-traumatic stress disorder

A

Dissociative identity disorder (multiple personality disorder)

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24
Q

Post-traumatic stress disorder - treatment

A

first line: cognitive behavioural therapy (CBT), SSRIs, venlafaxine

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25
Q

Acute stress disorder?

A

variation of post-traumatic stress disorder that lasts between 3 days and 1 month

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26
Q

Acute stress disorder - treatment

A

cognitive behavioural Trauma Focused brief CBT

  • consider pharmacotherapy for insomnia, intese anxiety
  • monitor for development of past traumatic stress disorder
27
Q

Obsessive compulsive disorder is considered to be

A

egodystonic: behaviour inconsistent with one’s own beliefs and attitudes (vs obsessive-compulsive personality disorder)

28
Q

Obsessive compulsive disorder is associated with

A

Tourette syndrome

29
Q

Obsessive compulsive disorder - treatment

A

first line: cognitive behavioural therapy (CBT), SSRIs, clomipramine

30
Q

Body dysmorphic disorder - everything (definition, treatment etc)

A

preoccupation with minor or imagined defect in appearance –> significant distress or impaired functioning
Treatment: CBT
OFTEN SEEK COSMETIC SURGERY

31
Q

hedonistic?

A

seeks pleasure without regard to consequences

32
Q

Cluster A personality disorder - types

A
  1. Paranoid
  2. Schizoid
  3. Shizotypal
33
Q

Cluster A personality disorder - Paranoid

A

Pervasive distrust and suspiciousness

Projection is the major defence mechanism

34
Q

Cluster A personality disorder - Schizoid

A

Voluntary social withdrawal, limited emotional expression, content with social isolation (vs avoidant)

35
Q

Cluster A personality disorder - Schizotypal

A

Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

36
Q

Cluster B personality disorder - Antisocial

A
  • Disregard for and violaton of rights of others, criminality, impulsivity,
  • males>females
  • more than 18 years old and history of conduct disorder before 15
  • if under 18 –> conduct disorder
37
Q

Cluster B personality disorder - Borderline

A

Unstable mood and interpersonal relationships, impulsivity, self-mutilation, boredom, sense of emptiness
females more common

38
Q

Cluster B personality disorder - Histrionic?

A

Excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance

39
Q

Cluster B personality disorder - Narcissistic

A

Grandiosity, sense of entitlement
lack empathy and requires excessive admiration
often demands the best and react to criticism with rage

40
Q

Cluster C personality disorder - obsessive-compuslve

A

preoccupation with order, perfectionism and control, ego-syntonic: behavior consistent with one’s own beleifs and attitudes

41
Q

Cluster C personality disorder - Dependent

A

Submissive and clingy, excessive need to be taken care of, low self-confidence

42
Q

Somatic symptoms and related disorders?

A

Category of disorders characterised by physical symptoms with no identifiable physical cause. Both illness production and motivation are inconsious drives. Symptoms not intentionally produced or feigned.
More common in women

43
Q

Somatic symptoms and related disorders - types

A
  1. Conversion disorder (functional neurologic symptom disorder)
  2. Illness anxiety disorder (hypochondriasis)
  3. Somatic symptom disorder
  4. pseudocyesis
44
Q

Conversion disorder?

A

Loss of sensoty or motor function (eg. paralysis, mutism, blindness), often following an acute stressor
Patient is aware of but sometimes indifferent toward symptoms (labelle indifférence)
ex. paralysis, mutism, blindness

45
Q

Illness anxiety disorder (hypochondriasis)?

A

preoccupation with and fear of having a serious illness despite medical evaluation and reassurance (MINIMAL SOMATIC SYMPTOMS)

46
Q

Somatic symptom disorder?

A

Variety of bodily complaints in one or more organ systems lasting for months to years.
May occur with medical illness

47
Q

Somatic symptom disorder is associated with

A

excessive, persistent thoughts and anxiety about symptom

48
Q

Anorexia nervosa

A

Excessive dieting exercise, or binge eating/purging
intense fear of gaining weight and body image distortion (distortion or overvaluation of body image)
BMI less than 18.5

49
Q

Anorexia nervosa symptoms/findings

A
  1. decreased bone density
  2. severe weight loss
    3, metatarsal stress fructures
  3. amenorrhea (loss of puslatile GnRH secretion)
  4. lanugo (the growing of fine white hairs all over the body)
  5. electrolyte disturbances
  6. anemia
  7. Reefining syndrome (increased insulin –> Hypophosphatemia –> cardiac complications) if severe malnourished patient
  8. commonly coexists with depression
50
Q

Bulimia nervosa - time

A

occurring weakly for at least 3 months

51
Q

Bulimia nervosa symptoms

A
  1. parotitis
  2. enamel erosion
  3. electrolyte disturbances
  4. alkalosis
  5. dorsal hand calluses from induced vomiting (Russell sign)
  6. overvaluation of body image
52
Q

Binge eating disorder

A

regular episodes of excessive, uncontrollable eating without inappropriate compensatoru behaviros

53
Q

Binge eating disorder - increased risk of

A

DM

54
Q

Binge eating disorder - treatment

A

psycotherapy such as CBT is first line

SSRI, lisdexamfetamine

55
Q

Gender dysphoria?

A

Strong, persistent cross-gender identification.
Characterised by persistent discomfort with one’s sex assigned at birth, causing significant distress and/or impaired functioning

56
Q

Sexual dysfunction - differential diagnosis includes

A
  1. Drugs (eg. antihypertensive, neuroleptics, SSRIs, ehtanol)
  2. Diseases (eg. depression, diabetes, STIs)
  3. Psychological (eg. performance anxiety)
57
Q

example of drugs that are related with sexual dysfunction

A

antihypertensive, neuroleptics, SSRIs, ethanol

58
Q

sleep terrors vs nightmares

A

sleep terrors –> during non-REM sleep (no memory of arousal)
nightmares –> during REM sleep (memory of scary dream)

59
Q

Causes and triggers of sleep terrors / treatment

A

causes: unknown
triggers: 1. emotional stress 2. fever 3. lack of sleep
treatment: self limited

60
Q

Narcolepsy - defnition and manifestations

A
  • disordered regulation of sleep-wake cycles

- 1ry characteristic is excessive daytime sleepiness

61
Q

Narcolepsy is caused by

A 
decreased hypocretin (orexin) production in LATERAL hypothalamus
strong genetic component
62
Q

Narcolepsy is associated with

A
  1. hallucinations (hypnagogic and hypnopompic)
  2. Nocturnal and narcoleptic sleep episodes that start with REM sleep
  3. Cataplexy (loss of all muscle tone following strong emotional stimulus, such as laughter) in some patients
63
Q

Narcolepsy - treatment

A

daytime stimulants (amphetamines, modafinil) and nighttime sodium oxybate (GHD)

64
Q

Stages of change in overcoming substance addiction (and explain)

A
  1. Precontemplation - not yet acknowledging that there is a problem
  2. Contemplation - acknowledging that there is a problem, but not yet ready or willing to make a change
  3. Preparation/determination - getting ready to change behaviours
  4. Action/willpower - changing behaviour
  5. Maintenance - maintaining the behaviour changes
  6. Relapse - returning to old behaviours and abandoning new changes

psychiatry (6 decks)

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