csv-export (2)

Question 1

psychosis

Answer 1

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

Question 2

positive symptoms of psychosis

Answer 2

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

Question 3

how are delusions organized?

Answer 3

by content

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

Question 4

neologisms

Answer 4

making up words

Question 5

echolalia

Answer 5

repeating sounds of phrases

Question 6

negative symptoms of psychosis (5 As)

Answer 6

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

Question 7

cognitive impairment in psychosis

Answer 7

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

Question 8

schizoaffective disorder

Answer 8

primary psychotic disorder that also has depression/bipolar

Question 9

brief reactive psychosis

Answer 9

less than 1 month

Question 10

schizophreniform disorder

Answer 10

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

Question 11

delusional disorder

Answer 11

only have delusions, no other symptoms of psychosis

Question 12

schizophrenia diagnosis

Answer 12

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

Question 13

risk factors for schizophrenia

Answer 13

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

Question 14

what are structural brain abnormalities with schizophrenia?

Answer 14

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

Question 15

abnormalities in NT in schizophrenia

Answer 15

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

Question 16

what are bad prognostic factors for schizo?

Answer 16

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

Question 17

better prognostic factors for schizo?

Answer 17

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

Question 18

emotion

Answer 18

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

Question 19

mood

Answer 19

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

Question 20

affect

Answer 20

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

Question 21

what are predisposing factors in mood disorders?

Answer 21

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

Question 22

major depressive disorder

Answer 22

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

Question 23

whats the mnemonic for MDD?

Answer 23

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

E? energy loss

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

Question 24

duration of MDD

Answer 24

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

Question 25

substance induced mood disorder

Answer 25

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

Question 26

persistant depressive disorder

Answer 26

mildly depressed for 2 years | insidious onset, chronic course, limited improvement without tx

Question 27

differential diagnosis for depression

Answer 27

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

Question 28

premenstrual dysphoric disorder

Answer 28

depression/irritability before menses due to estrogen changes occuring diff diagnosis: PMS, substance induced mood disorder (have same peak and flow of symptoms) dysmennorrhea

Question 29

bipolar I disorder

Answer 29

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) ```

Question 30

bipolar 2 disorder

Answer 30

4 days of hypomanic and a depressive episode | associated with anxiety 75% of the time

Question 31

cyclothymia

Answer 31

2 years of numerous episodes of hyomanic symptoms and depressive episodes

Question 32

anorexia nervosa | what are the 2 subtypes?

Answer 32

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

Question 33

what is poorer prognosis in anorexia?

Answer 33

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

Question 34

bulimia nervosa

Answer 34

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

Question 35

medical indications for inpatient for eating disorder

Answer 35

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

Question 36

somatic symptom disorder

Answer 36

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

Question 37

conversion disorder

Answer 37

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

Question 38

illness anxiety disorder (hypochondriasis)

Answer 38

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

Question 39

pseudocyesis

Answer 39

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

Question 40

tx for somatization disorders

Answer 40

``` physical therapy relaxation, meditation behavioral cognitive behavioral therapy medication that target comorbidities: antidepressants ```

Question 41

deception syndromes

Answer 41

factitious disorders, malingering

Question 42

malingering

Answer 42

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

Question 43

factitious disorder

Answer 43

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

Question 44

manchausens

Answer 44

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