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Neurodisorders > csv-export (2) > Flashcards

csv-export (2) Flashcards

1
Q

psychosis

A

decreased ability to evaluate accuracy of perceptions and thoughts?? make incorrect inferences about external reality

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2
Q

positive symptoms of psychosis

A

hallucinations (false perceptions in absence of real sensory stimuli)?? can be any of the senses, but auditory is most common
delusion (fixed false belief that you maintain in the face of considerable evidence of the contrary)
disorganization? loose associations/derailment: thought production where there is no recognizable relationship between ideas

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3
Q

how are delusions organized?

A

by content

paranoid, grandiose, nihilisitc (belief you are dead), erotomanic

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4
Q

neologisms

A

making up words

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5
Q

echolalia

A

repeating sounds of phrases

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6
Q

negative symptoms of psychosis (5 As)

A

affective flattening: unchanging facial expression, decreased expressive gestures, poor eye contact, affect nonresponsivity, lack of vocal inflections
alogia: poverty of speech
avolition?apathy?? dec. grooming/hygiene, impersistance at work/school
anhedonia?associality?dec interests/activities, dec interest in sex/intimacy/closeness
attention deficits? social/testing inattentiveness

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7
Q

cognitive impairment in psychosis

A

processing speed, attention, working memory, reasoning/executive function, verbal comprehension, social cognition
precedes onset of positive symptoms
perform 1?2 standard deviations below healthy controls on neuropsych testing

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8
Q

schizoaffective disorder

A

primary psychotic disorder that also has depression/bipolar

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9
Q

brief reactive psychosis

A

less than 1 month

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10
Q

schizophreniform disorder

A

greater than 1 mo but less than 6 mo duration of symptoms

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11
Q

delusional disorder

A

only have delusions, no other symptoms of psychosis

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12
Q

schizophrenia diagnosis

A

active phase: at least 2 psychotic symptoms (delusions, hallucinations, thought disorg, catatonia, negative symptoms) for at least one month, continous signs of disturbance for at least 6 months
needs to markedly impair ability to function
no known etiology

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13
Q

risk factors for schizophrenia

A 
first generation immigrants
born late winter?early spring (inflammatory response)
OB complications
living in urban area
advanced paternal age
cannabis use early on
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14
Q

what are structural brain abnormalities with schizophrenia?

A

enlarged ventricles lead to more negative symptoms and poor prognosis
reduced volume of temporal limbic structures

REDUCED metabolic activity in frontal lobes
INCREASED activity in temporal lobe limibc structures

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15
Q

abnormalities in NT in schizophrenia

A

drugs that enhance DA activity can cause psychosis
all antipsychotics block DA receptors
altered levels of DA metabolites in CSF
glutamate: PCP/ketamine model of schizo, hypo?NMDA receptor hypotehsis
GABA
acetylcholine

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16
Q

what are bad prognostic factors for schizo?

A 
insidious onset
continuous course
earlier age of onset
prominent neg symptoms
female
enlarged lateral and 3rd ventricles
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17
Q

better prognostic factors for schizo?

A 
acute onset
episodic course
later age of onset
primarily positive symptoms
male gender
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18
Q

emotion

A

internal state of feeling that may or may not be reflexted by outward behavior (based on the moment, days activities, etc)

19
Q

mood

A

an internal state of sustained feelings that has direct or indirect effects on outward behavior

20
Q

affect

A

a collection of observed behaviors that reflect an underlying mood or emotion

21
Q

what are predisposing factors in mood disorders?

A

if parent has it, you have 10?25% risk
concordance rate is 50?70% among twins
serotonin receptor polymorphisms
life events?? childhood illness, abuse, unemployment, death of parent, social isolation

22
Q

major depressive disorder

A 
for 2 weeks, you have low mood/anhedonia +
weight loss/gain
slowed movements
fatigue/loss of energy
poor concentraiton
worthlessness/inappropriate guilt
insomnia/hypersomnia
23
Q

whats the mnemonic for MDD?

A

S? sleep disturbance
I? interest/pleasure reduction
G? guilt

E? energy loss

C?conc impairment
A? appetite changes
P? psychomotor changes
S?suicidal thoughts

24
Q

duration of MDD

A

untreated: 6?13 mo
treated: 3 mo
85% recurrence rate, mostly in first 5 yrs

25
Q

substance induced mood disorder

A

symptoms begin shortly after initiation, intoxication, or withdrawal of a substance

26
Q

persistant depressive disorder

A

mildly depressed for 2 years

insidious onset, chronic course, limited improvement without tx

27
Q

differential diagnosis for depression

A

hypothyroidism, anemia, HIV, cushings disease, bipolar disorder, substance induced mood disorder

28
Q

premenstrual dysphoric disorder

A

depression/irritability before menses due to estrogen changes occuring

diff diagnosis: PMS, substance induced mood disorder (have same peak and flow of symptoms)
dysmennorrhea

29
Q

bipolar I disorder

A

one week of elevated epxansive or irritable mood and abnormal increased activity and energy +

increased self esteem, decreased need for sleep, increased talkativeness, racing thoughts, distractible
DIG FAST (distractability, erratric behavior, grandiosity  flight of ideas, activity increased, sleep decreased, talkativeness)
30
Q

bipolar 2 disorder

A

4 days of hypomanic and a depressive episode

associated with anxiety 75% of the time

31
Q

cyclothymia

A

2 years of numerous episodes of hyomanic symptoms and depressive episodes

32
Q

anorexia nervosa

what are the 2 subtypes?

A

restriction of energy intake relative to requirements?? lead to BMI <18
intense fear of gaining weight
body image distortion or denial of seriousness of low body weight
restricting type: not regularly binge eating or purging
binge?eating/purging type

33
Q

what is poorer prognosis in anorexia?

A

older age onset, requirement of hospitalization
highest mortality rate of any psych disorder
BMI <60% IBW and low albumin are bad)

34
Q

bulimia nervosa

A

binge eating large amounts of food without control?? cant stop
recurrent inappropriate compensatory behavior (vomiting, laxatives, diuretics, enemas, fasting, excessive exercise
both occur at least once a week for 3 months
** often normal weight
swollen parotid glands, loss of normal bowel function
related to impulsivity, alcohol abuse, sexual impulsivity

35
Q

medical indications for inpatient for eating disorder

A

syncope, serum potassium below 3.2, serum chloride below 88, esophageal tears, cardiac arrhythmias including prolonged QT, intractable vomiting, hematemesis, failure to respond to outpatient tx
or if major depression, anxiety diroser, suicidal, substance use disorder

36
Q

somatic symptom disorder

A

one or more somatic symptoms, disrupt daily life. with predominant pain
illness production and motivation are unconscious

37
Q

conversion disorder

A

suddne loss of sesnory or motor functions (paralysis, blindness), following acute stressor
la belle indifference?? not distressed
show rapid response to tx
illness prod. and motivation are unconscious

38
Q

illness anxiety disorder (hypochondriasis)

A

fear of disease or conviction that one has a disease despite normal physical exam
somatic symptoms are not present, only mild in intensity

39
Q

pseudocyesis

A

false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy

40
Q

tx for somatization disorders

A 
physical therapy
relaxation, meditation
behavioral
cognitive behavioral therapy
medication that target comorbidities: antidepressants
41
Q

deception syndromes

A

factitious disorders, malingering

42
Q

malingering

A

consciously fakes/exaggerates a disorder in order to achieve a secondary gain. poor compliance to tx or follow up, complaints cease after gain

43
Q

factitious disorder

A

intentional production or feigning of physical sights/symptoms
motivation for behavior is to assume the sick role (primary gain)
no external incentives, no aliases

44
Q

manchausens

A

same criteria as factitious disorder? but with aliases, hospital shopping, grandiose storytelling
willingness to receive invasive procedures
can also be imposed on child/elderly by caregiver
manchausen syndrome by proxy

Neurodisorders (3 decks)

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