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* DIT each session > Day 4.1 Psych > Flashcards

Day 4.1 Psych Flashcards

1
Q

Voluntarily choosing not to think of bad news

A

Suppression

Mature, bc it’s voluntary

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2
Q

Using comedy to express discomfort

A

Humor

Mature

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3
Q

Arsonist donates money to fire dept

A

altruism

mature

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4
Q

Using your aggression to succeed in business ventures

A

sublimation

mature

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5
Q

realistically planning for future discomfort

A

anticipation

mature

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6
Q

consciously postponing inner conflict until after big project is complete

A

suppression

mature

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7
Q

Redirecting impulses toward socially favorable object

A

sublimation
eg hitting pillow when angry
mature

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8
Q

Not acknowledging bad news as if it weren’t said

A

denial

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9
Q

Involuntary withholding of a feeling from conscientious awareness

A

repression

immature bc it’s involuntary

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10
Q

Veteran that can describe horrific war details without any emotion

A

isolation

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11
Q

child abuser who was abused as a child

A

identification

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12
Q

Man yells at family when had bad day at work

A

Displacement
this is immature bc it’s redirecting impulses to a socially unfavorable thing (vs sublimation to a favorable thing eg punching bag)

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13
Q

Closet homosexual hates homosexuals for the way the “make” him feel

A

projection

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14
Q

using intellectual processes to avoid affective expression

A

intellectualization

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15
Q

belief that ppl are either all good or all bad

A

splitting

borderline personality disorder pts do this

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16
Q

expressing anger thru passivity, masochism, and turning against self

A

passive-aggressive

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17
Q

believing external source is responsible for unacceptable inner impulse

A

projection

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18
Q

changing one’s character/personal identity to avoid emotional distress

A

dissociation

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19
Q

returning to earlier level of maturation to avoid conflict at current maturational level
eg stressed kids wet bed

A

regression

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20
Q

offering an explanation for an unacceptable attitude/belief/bhvr

A

rationalization

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21
Q

a thought that is avoided is replaced by an unconscious emphasis on the opposite

A

rxn formation

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22
Q

converting mental conflicts into bodily symptoms

A

somatization

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23
Q

temporarily inhibiting thinking but continuing to build more tension

A

blocking

schizophrenic pts do this

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24
Q

avoiding interpersonal intimacy to resolve conflict and obtain gratification

A

schizoid fantasy

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25
Q

extreme forms of this can result in multiple personalities

A

dissociation

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26
Q

chronically giving into impulse to avoid tension from an unexpressed unconscious wish; tantrums

A

acting out

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27
Q

Electrolyte chgs in pts who vomit a lot (eg bulemics)

A

hypokalemic, hypochloremic metabolic alkalosis

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28
Q

NT chgs in depression

A

decreased NE, serotonin, dopamine

opp is mania

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29
Q

NT chgs in anxiety

A

Increased NE

Decreased GABA and serotonin

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30
Q

NT chgs in Huntington’s

A

Decreased GABA and ACh

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31
Q

NT chgs in Alzheimers

A

Decreased ACh

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32
Q

NT chgs in schizophrenia

A

Increased dopamine

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33
Q

NT chgs in Parkinson’s

A

Decreased dopamine

Increased ACh

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34
Q

IQ

A

Stanford-Binet: IQ = mental age/chronological age x 100

WAIS III uses 14 subtests- can quantify intellectual decline

WISC is for kids 6-16yo

Mean IQ = 100, st dev = 15

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35
Q

IQ dx for MR

A

IQ <20 profound

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36
Q

Habituation, Sensitization

A 
Habituation = repeated stimulus leads to decreased response
Senitization = repeated stimulation leads to increased response
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37
Q

Classical conditioning

A 
Pavlov
Natural response (salivation) is elicited by a condition/learned stimulus (bell) that was presented together with an unconditioned stimulus (food).
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38
Q

Operant conditioning

A

Action is elicited bc it produces reward.
Positive reinforcement- desired reward produces action (press button, get food)
Negative reinforcement- do an action to remove a bad thing/avoid something bad (press button to avoid shock)
Punishment- adverse stimulus extinguished unwanted bhvr
Extinction- discontinuation of reinforcement eliminates bhvr

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39
Q

Reinforcement schedule

A

Pattern of reinforcement determines how quickly a bhvr is learned or extinguished.
Continuous- reward after every response. rapidly extinguished (vending machine)
Variable ratio- reward received after a random number of responses. slowly extinguished (slot machine)

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40
Q

Transference

Countertransference

A

Transference: pt projects feelings abt formative or other imp person onto doc (eg psychiatrist = parent)
Countertransference: doc projects onto pt

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41
Q

Goal of Freudian psychoanalysis

A

Mk pt aware of what is hidden in their unconscious

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42
Q

Id

A

Primal urges, food, sex, aggression.
Id drives Instinct
Entirely subconscious
“I want it”

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43
Q

Ego

A

Mediator bt primal urges and bhvr accepted in reality.

“Take it and you will get in trouble”

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44
Q

Superego

A

Moral values, conscience
Can lead to self-blame and attacks on ego
“You know you can’t take it, taking it is wrong”

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45
Q

Erikson’s stgs of psychosocial development

A

8 stgs of normal devt, each posing a new crisis. unsuccessful completion of a stage can manifest as psychosocial maladaption later in life.
Oral sensory stg 0 to 12-18mo (crisis = trust vs mistrust)
Adlescence stg 12-20 yrs (crisis - identity vs role confusion)

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46
Q

Ego defenses

A

unconscious mental processes of the ego used to resolve conflict and prevent anx and deprsn. can be immature or mature

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47
Q

Acting out

A

unacceptable thoughts/feelings expressed through actions.

tantrums

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48
Q

Dissociation

A

Temporary, drastic chgs in personality, memory, consciousness, motor bhvr, to avoid stress
Extreme forms = dissociative id disorder (mult personality)

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49
Q

Denial

A

Avoidance of awareness of a painful reality

Common newly-dx’d in cancer and AIDS pts

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50
Q

Displacement

A

Avoided ideas/feelings are txfrd to a neutral person or object (vs projection)
Mom blames kids bc she’s angry at husband

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51
Q

Fixation

A

Partially remaining at a more childish level of devt (vs regression)
Men fixating on sports games

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52
Q

Identification

A

Modeling behavior after another person who is more powerful (tho not nec admired)
Abused child is an abuser

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53
Q

Isolation of affect

A

Separation of feelings from ideas/events

Describing murder in graphic detail w no emotional response

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54
Q

Projection

A

Unacceptable internal impulse is attributed to an external source
Man who wants another woman think his wife is cheating

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55
Q

Rationalization

A

Proclaiming logical reasons for actions actually performed for other reasons, usu to avoid self-blame
After getting fired, saying job wasn’t imp anyway.

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56
Q

Reaction formation

A

Warded-off idea/feeling is replaced by an unconsciously derived emphasis on its opposite
pt w high libido enters monastery

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57
Q

Repression

A

Involuntary withholding of idea/feeling from conscious awareness
Not remembering conflictual/traumatic experience, pressing bad thoughts into unconscious

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58
Q

Regression

A

Turning back maturational clock and going back to earlier modes of dealing w the world
kids under stress (bedwetting)
pts on dialysis (crying)

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59
Q

Splitting

A

belief that ppl are all gd or bad at different times due to intolerance of ambiguity.
Seen in borderline personality disorder
Pt says all nurses are insensitive but all docs are friendly

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60
Q

Altruism

A

Guilty feelings alleviated by unsolicited generosity toward others
Mafia boss mks donation toward charity
Mature

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61
Q

Humor

A

Appreciating the amusing nature of an anx-provoking/ adverse situation
Nervous med student jokes abt boards
Mature

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62
Q

Sublimation

A

Replacing unacceptable wish w course of action that is similar to the wish but does not conflict w one’s value system
Actress using experience of abuse to enhance her acting.
mature

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63
Q

Suppression

A

Voluntary withholding of an idea or feeling from conscious awareness (vs repression, which is involuntary)
Choosing not to think abt USMLE until week of exam
Mature

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64
Q

Mature ego defenses (4)

A 
Mature women wear a SASH:
Sublimation
Altruism
Suppression
Humor
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65
Q

Infant deprivation effects

A 
Long-term deprivation results in:
1. decrsd musc tone
2. poor lang skills
3. poor socialization skills
4. lack of basic trust
5. anaclitic deprsn
6. weight loss
7. physical illness
Severe deprivation can result in infant death.
4 W's weak, wordless, wanting, wary
If deprivation >6 mo, irrev chgs
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66
Q

Child abuse signs

A 
healed fractures on x-ray
cigarette burns
subdural hematoma
mult bruises
retinal hemorrhage/detachment
sexual: genital/anal trauma, STDs, UTIs
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67
Q

Child abuse epi

A

abuser usu female and primary caregiver
3000 deaths/yr in USA

if sexual:
abuser usu male and known to victim
peak incidence 9-12 yo (prepuberty)

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68
Q

Child neglect

A

failure to provide adequate food, shelter, supervision, education, affection
most common form of childhood mistreatment.
evidence: poor hygiene, malnutrition, withdrawal, impaired social/emotional devt, FTT
Must be reported to authorities
More common than overt abuse

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69
Q

Anaclitic deprsn (hosptialism)

A

Deprsn in infant d/t continued separation from caregiver. Infant withdrawn, unresponsive.
Reversible, but prolonged separation can result in FTT or devt disturbances - delayed speech.

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70
Q

Regression in children

A

Regression to younger bhvr patterns under condition of stress- physical illness, punishment, new sibling, fatigue.
eg bedwetting

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71
Q

ADHD

A

limited attn span, poor impulse control.
onset <7yo
hyperactivity, motor impairment, emotional lability
normal intelligence but difficulties in school
cont to adulthood in 50%
assoc w decreased frontal lobe volume

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72
Q

Rx for ADHD

A

methylphenidate (ritalin)
amphetamines (dexedrine)
atomoxetine (non-stimulant SNRI)

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73
Q

Conduct disorder

A

repetitive, pervasive bhvr violating social norms- physical aggression, destruction of property, theft.
After 18yo is antisocial personality disorder
Disregard for rights of others
Cruelty to animals

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74
Q

Oppositional defiant disorder

A

pattern of hostile, defiant bhvr toward authority
but, not serious violation of social norms
don’t disregard rights of others

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75
Q

Tourette’s synd

A 
sudden rapid reccurent non-rhythmic sterotyped motor mvmts or vocalizations- tics.
persist for >1year
Lifetime prev .1-1% of general pop
Coprolalia (obscene speech) found in 20%
assocd w OCD
onset &lt;18yo
76
Q

Rx for Tourette’s

A 
antipsychotics
old (in FA): haloperidol
now (in DIT): anti-dopamine agents- fluphenazine, pimozide, tetrabenazine
77
Q

Separation Anx Disorder

A

overwhelming fear of separation from home or loss of attachment figure. may lead to faking illness to stay home from school
age 7-9 onset

78
Q

Autistic disorder

A

MR
severe lang impairment, poor social interactions, greater focus on obj than ppl.
repetitive bhvr
savants rarely
M>F
Rx: bhvrl therapy and supportive therapy to improve communication and social skills

79
Q

Asperger’s disorder

A

Normal intelligence
milder autism. all-absorbing interests, repetitive bhvr, problems w social relationships
no verbal or cognitive deficits, no lang impairment

80
Q

Rett’s disorder

A

X-linked dominant, so affects girls only (boys die in-utero/after birth)
Normal to age 4, the regression- loss of devt, MR, loss of verbal abilities, ataxia, stereotyped midline handwringing.

81
Q

Childhood disintegrative disorder

A

Marked regression in multiple areas of fn’g after at least 2 years of apparently normal devt. Loss of expressive or receptive lang skills, social skills, adaptive bhvr, bowel/bladder control, play, motor skills.
Common onset 3-4 yo
M>F

82
Q

Orientation

A

order of loss:
first lose time, then place, then person.
(can also lose circumstances- don’t know why they’re in the hospital. lose this last)
Common causes of loss of orientation:
alch/drugs, fluid/electrolyte imbalance, head trauma, hypoglycemia, nutritional deficit

83
Q

Retrograde amnesia

A

can’t remember what occurred before CNS insult

84
Q

Anterograde amnesia

A

no new memory- can’t remember what occur after CNS insult

85
Q

Korsakoff’s amnesia

A

anterograde amnesia (no new memory) caused by thiamine deficiency.
leads to bilateral destruction of mammillary bodies.
can also lead to retrograde amnesia
seen in alcoholics, assocd w confabulations

86
Q

Dissociative amnesia

A

inability to recall imp personal info, usu subsequent to severe trauma or stress

87
Q

Delirium

A

Waxing/waning lvl of consciousness
Acute onset (hrs/days)
Rapid decrease in attn span and lvl of arousal
Acute chg in mental status, disorg’d thinking, hallucinations (often visual), illusions, misperceptions, disturbance in sleep-wake cycle, cogntv dysfn
Often reversible
Most common psych illness in hospital
Abn EEG

88
Q

2 most common causes of delirium:

A

Drugs (esp those w anti-ACh side effects)

UTIs

89
Q

Dementia

A

Gradual decline in cognition (wks/mo/yrs)
NO chg in lvl of consciousness
Mem deficits, aphasia, apraxia, agnosia, loss of abstract thought, bhvr/personality chgs, impaired judgement
Pt is alert.
Increased incidence w age
Normal EEG
Irreversible

90
Q

Pseudodementia

A

In elderly pts, depression presenting like dementia.
If you are depressed you have memory loss and you know you have memory loss
Pts w actual dementia don’t know they have memory loss.
So if pt himself complains of mem loss, it’s not dementia, may be deprsn.

91
Q

Cause of Dementia

A 
Alz dz
Vascular thrombosis/hemorrhage (esp multi-infarct thrombosis)- can have acute or subacute onset
HIV
Pick's dz
Substance abuse (esp alch)
CJD
92
Q

Drugs used in ADHD

A

Methylphenidate (ritalin) and dextroamphetamine (adderall) are amphetamines- they increase pre-synaptic NE rls
Atomoxetine is a NE reuptake inhibitor

93
Q

Uses of stimulants (NE releasers, NE uptake inhibitors)

A

ADHD
Narcolepsy (modafinil)
Obstructive sleep apnea (excessive daytime sleepiness)
Mjr depressive disorder- bridge until other drugs start working

94
Q

Most common genetic causes of MR

A

Downs
Fragile X
Rett synd

95
Q

Non-genetic prenatal causes of MR

A

Congenital hypothyroidism
FAS (most common)
Prenatal toxin exposure (lead, merc, valproate- anticonvulsant, mood stabilizer)

96
Q

Non-genetic postnatal causes of MR

A 
trauma/abuse
CNS hemorrhage
hypoxia (near drowning)
toxins
psychosocial deprivation
malnutrition
intracranial infection
CNS malignancy
97
Q

Trichotillomania

A 
Compulsive nervous hair-pulling
young girls
wire-brush feel, pattern of broken hair
Rx: education, CBT
only if those don't work: fluoxetine or clomipramine
98
Q

Hallucination

A

see something that’s not there (absence of external stimuli)
schizophrenic- auditory
alch withdrawal- tactile
dementia- visual

99
Q

Illusion

A

See things that are there but misinterpret them

100
Q

Delusion

A

false belief not shared w others of culture.

maintained in spite of proof to contrary

101
Q

Loose associations

A

disorders in form of thought/way ideas are tied together.

102
Q

Gender identity disorder

A

cross-gender identification. persistent discomfort/anx w one’s sex
transsexual- chg body w surgery to relieve the anx
not transvestite

103
Q

Anorexia nervosa

A

excessive dieting
can be with or w/o purging
commonly coexists w depression
rx CBT

104
Q

Bulemia nervosa

A

binge eating
can be w or w/o purging
use laxitives
assoc w parotitis bc increased salivary amylase (systemically)
russell’s sign- hand callus from inducing vom
electrolyte disturbances, alkalosis
rx SSRIs

105
Q

What electrical disturbances happen when you vom a lot?

A

Vomit = get rid of HCl, so you have hypochloremia and metabolic alkalosis
Also get hypokalemia: cells have H+/K+ countertransporter. To counteract the alkalosis, cells put acid into serum, which means they pull the K+ out of serum and into cells.
Hypochloremic, hypokalemic metabolic alkalosis.

106
Q

Why do Down Syndrome pts have an increased risk of Alz?

A

familial form early-onset Alz is assoc’d with APP gene, which is on chromosome 21. Down syndrome pts have 3 copies of chr 21.
APP = amyloid precursor protein

107
Q

Genes assoc’d with Alz

A

Familial form (10% of Alz) is assoc’d with:
Early-onset: APP on Chr 21
Presenilin-1 on Chr 14
Presenilin-2 on Chr 1
Late-onset: ApoE4 on Chr 19 (Apo E4 is a chaperone protein that helps induce B-sheet formation)

Protective gene:
ApoE2 on Chr 19

108
Q

Histological findings in Alz

A

Diffuse widespread cortical atrophy
Decreased ACh
Senile plaques (extracellular B-amyloid core)- can cause amyloid angiopathy, leading to intracranial hemorrhage (AB-amyloid is synth’d by cleaving amyloid)
Neurofibrillary tangles

109
Q

What are neurofibrillary tangles?

A

Intracellular, abnormally phosphorylated tau protein, making insoluble cytoskeletal elements.
Tangles correlate with degree of dementia

110
Q

High potency neuroleptic (antipsychotic)

A

Haloperidol
Fluphenazine
Thiothixene
Trifluoperazine (can also be considered moderate potency)
High potency means more EPS side effects, less anti-ACh side eff

111
Q

Moderate potency neuroleptic (antipsychotic)

A

Molindone
Loxapine
Trifluoperazine (can also be considered high potency)

112
Q

Low potency neuorleptic (antipsychotic)

A

Chlorpromazide
Theoridazine
Low potency means less EPS side effects, but more anti-ACh side effects (hot as a hare, dry as a bone, etc)

113
Q

Atypical antipsychotics

A 
Olazapine
Risperidone
Quetiapine
Clozapine
Aripiprazole
114
Q

Halperidol

A

High potency neuroleptic

115
Q

Molindone

A

Moderate potency neuroleptic

116
Q

Loxapine

A

Moderate potency neuroleptic

117
Q

Fluphenazine

A

High potency neuroleptic

118
Q

Risperidone

A

Atypical antipsychotic

119
Q

Clozapine

A

Atypical antipsychotic

120
Q

Thiothixene

A

High potency neuroleptic

121
Q

Theoridazine

A

Low potency neuroleptic

122
Q

Olanzapine

A

Atypical antipsychotic

123
Q

Trifluoperozine

A

High/moderate potency neuroleptic

124
Q

Chlorpromazine

A

Low potency neuroleptic

125
Q

Quetiapine

A

Atypical antipsychotic

126
Q

Apiprazole

A

Atypical antipsychotic

127
Q

Alz dz epi

A

More common in elderly, down synd pts have increased risk.

10% familial

128
Q

Pick’s dz

A

Frontotemporal dementia.
Change in personality, behavior (1st), then dementia, aphasia, parkinsonian sympt
Spares parietal lob and posterior 2/3 of superior temporal gyrus, but pt has frontotemporal atrophy.
Pick bodies

129
Q

What are Pick Bodies?

A

intracellular (inside of neurons), aggregated tau protein
Stain with silver
seen in Pick’s dz (frontotemporal dementia)

130
Q

In which dz’s are Lewy bodies seen?

A

Lewy body dementia
Alzheimer’s (the diffuse lewy body type of Alz)
Parkinson’s

131
Q

Lewy Body Dementia

A

Parkinsonism plus dementia and visual hallucinations, with repeated falls and syncopal episodes.
alpha-synuclein defect
see lewy bodies

132
Q

CJD

A

Prion dz- infections proteins chg alpha helix to beta sheet, which are resistant to proteases and heat
Rapidly progressive dementia (wks-months) with myoclonus
Causes spongiform cortex

133
Q

Causes of dementia

A 
Alz, Pick's, Lewy body, CJD
Multi-infarct (2nd most common in elderly)
syphilis
HIV
B12 deficiency
Wilson's dz (copper accumulations)
134
Q

Drugs for Alz

A

Memantine
Donepezil
Galantamine
Rivastigmine

135
Q

Donepezil

A

Anti-AChE

for Alz

136
Q

Memantine

A

NMDA receptor antagonist

for Alz

137
Q

Galantamine

A

AChE inhibitor

for alz

138
Q

Rivastigmine

A 
AChE inhibitor (indirect muscarinic agonist)
for alz
139
Q

Haloperidol

A

dopamine receptor antagonist
neuroleptic
for Huntington’s

140
Q

Memantine- mech, toxicity

A

Used for Alz
NMDA (glutamate) receptor antagonist
helps prevent excitotoxicity (mediated by Ca2+)
Toxicity: dizziness, confusion, hallucinations

141
Q

Donepezil, Galatamine, Rivastigmine

A

Used for Alz
ACh-E inhibitors
Toxicity: nausea (start low, go slow!)
also dizziness, insomnia

142
Q

Sumitriptan

A

Serotonin 1b/1d agonist

use for acute migrane, cluster headaches

143
Q

Schizophrenia pos sympt

A 
Adding something:
Delusions
Hallucinations (esp auditory)
Disorganizes speech (loose assoc)
Disorganized/catatonic bhvr
144
Q

Schizophrenia neg sympt

A 
Takes something good away:
flat affect
social withdrawal
lack of motivation
lack of thought, speech (alogia)
thought blocking (abruptly halt train of thought)
poor grooming
145
Q

Dx of schizophrenia

A

req’s 2 of 5 things (the 4 pos sympt + negative symptoms counts as 1)

146
Q

Brief psychotic disorder

A

<1month

usu stress related

147
Q

Schizophreniform disorder

A

1-6months

6mo = schizophrenic

148
Q

Schizoaffective disorder

A

at least 2 wks of STABLE mood w psychotic sympt
plus a mjr depressive, manic, or mixed (depressive+manic) episode
2 subtypes:
bipolar
depressive

149
Q

Schizophrenia

A

Periods of psychosis and disturbed bhvr with a decline in functioning
>6mo
Associated with increased dopaminergic activity (too much dopamine) and decreased dendritic branching
Mj use is a risk factor in teens

150
Q

5 subtypes of schizophrenia

A 
paranoid (delusions)
disorganized (wrt bhvr, speech, affect)
catatonic (automatisms)
undifferentiated (elements of all types)
residual
151
Q

Which is more imp for schizophrenia, genes or env?

A

Genes

152
Q

Schizophrenia epi

A 
Lifetime prev 1.5% (!!)
M = F
Black = white
Presents earlier in men (late teens- early 20s)
than women (late 20s/early 30s)
Pts are at increased risk for suicide
153
Q

List the neuroleptics/antipsychotics (typical)

A 
Haloperidol
Trifluoperazine
Fluphenazine
Thioridazine
Chlorpromazine
(haloperidol + -azine)
154
Q

How do neuroleptics work?

A

They block D2 dopamine receptors, thereby increasing cAMP.
Schizophrenia is increased dopamine, so it’s good to block the receptors.
D2 = Gi, which decreases cAMP. Block the inhibitor to increase cAMP.

155
Q

Use of neuroleptics

A 
Schizophrenia (mainly pos sympt)
psychosis
acute mania
Tourette's synd
to decrease agitation in delerium, dementia
156
Q

Toxicity of neuroleptics

A
  1. slowly removed from body (bc highly lipid soluble so stored in body fat)
  2. EPS side effects
  3. endocrine side effects (D2 receptor antagonism means dopamine no longer suppresses prolactin, so hyperprolactinemia, so galactorrhea)
  4. side eff from blocking muscarinic receptors (dry mouth, constipation), alpha receptors (hypotension), and histamine receptors (sedation)
  5. NMS, Tardive dyskinesia
157
Q

What is Neuroleptic malignant syndrome (NMS)?

A 
Rigidity, myoglobinuriam autonomic instability, hyperpyrexia
Caused by neuroleptics.
Breakdown of muscle --> myoglobinura -->kidneys clog (rhabdomyolysis) --> renal failure
For NMS think FEVER:
Fever
Encephalopathy
Vitals unstable
Elevated enz
Rigidity of muscles
158
Q

Rx for NMS

A 
Dantrolene
Dopamine agonists (bromocriptine)
159
Q

What is tardive dyskinesia?

A

Stereotypical oral-facial mvmts d/t long-term anti pscyhotic use.
Often irrev

160
Q

Low potency neuroleptic side effects

A

low potency = less EPS side effects but more anti-ACh side effects
Chlorpromazine- Corneal deposits
Thioridazine- reTinal deposits

161
Q

EPS extra pyrimidal symptoms

A

4hrs- acute dystonia (muscle spasm, stiffness, oculogyric crisis-rotating eyeballs, torticollis-neck twisting

4days- akinesia (parkinsonian sympt)

4wks- akathisia (restlessness, can’t stop mvmt)

4mo-tardive dyskinesia

162
Q

List the atypical antipsychotics

A

OLanzapine, CLOzapine, QUETIapine, RISPERidone, Aripiprazole, Ziprasidone
It’s atypical for OLd CLOsets to QUIETly RISPER from A to Z

163
Q

How do the atypical antipsychotics work?

A

They block serotonin, alpha, H1, and dopamine receptors.

Have less side effects bc they block both dopamine and serotonin, but do get alpha and H1 side effects

164
Q

Schizophrenia sympt for <1mo

A

brief psychotic disorder, usu stress related

165
Q

Schizophrenia sympt for 1-6mo

A

Schizophreniform disorder

166
Q

Schizoid

A

Avoidant

167
Q

Schizotypal

A

Odd thinking

168
Q

Schizophrenic sympt >6mo + bipolar or depressive mood disorder

A

Schizoaffective

169
Q

Schizophrenic sympt >6mo

A

Schizophrenia

170
Q

visual hallucinations

A

delerium

171
Q

auditory hallucinations

A

schizophrenia

172
Q

olfactory hallucinations

A

aura of psychomotor epilepsy

esp burning rubber smell

173
Q

tactile hallucinations

A

alch withdrawal
formication-ants crawling in skin
also seen in cocaine abuse - cocaine bugs

174
Q

hypnagogic hallicinations

A

when going to sleep

175
Q

hypnopompic hallucinations

A

while waking up from sleep

176
Q

delusional disorder

A

> 1mo fixed persistent NON-bizarre belief system
functioning not impaired
often self limited
strange thoughts, but not outside scope of reality

177
Q

shared psychotic disorder

A

folie a deux
devt of delusions in a person in a close relationship w someone else w delusional disorder.
often resolves upon separation

178
Q

dissociative identity disorder

A

mult personality disorder
presence of 2 or more distinct identities or personality states
F>M, assoc w hx of sexual abuse

179
Q

depersonalization disorder

A

persistent feelings of detachment or estrangement from oneself

180
Q

dissociative fugue

A

abrupt chg in geographic location w inability to recall past, confusion abt personal identity, or assumption of new identity
assocd w traumatic circumstances (natural disaster, wartime, trauma)
leads to significant distress/impairment
not the result of substance abuse or medical condition

181
Q

Clinical use for atypical antipsychotics

A

Schizophrenia (both pos and neg sympt)
Olazapine is used for OCD, anx disorder, depression, mania, bipolar, Tourette’s, depression
Quetine can treat psychosis d/t parkinson’s

182
Q

Toxicity of atypical antipsychotics

A

Fewer EPS and anti-ACh side effects than traditional antipsychotics (haloperidol and the -azines), but olanzapine, clozapine, quetine can cause signficant weight gain (and DM bc of it).
Clozapine can cause agranulocytosis and req’s weekly monitoring of WBCs
Since they block alpha receptors, there can be some HTN, sedation, dizziness
The H1 blockage is responsible for the weight gain, and also sedation.
Rx for side effects: Amantidine (Parkinson’s med)

183
Q

Dantrolene

A

Drug used for malignant hyperthermia and NMS- neuroleptic malignant syndrome.
Prevents rls of Ca2+ from Sarcoplasmic Reticulum of skel musc, therefore stopping muscle contraction.

184
Q

Malignant hyperthermia

A

Uncontrolled increase in skeletal muscle oxidative metabolism- causing high temp, incrsd HR and respi rate, increased O2 consumption with increased CO2 production, acidosis, rigid muscles (contraction), rhabdomyolysis.
Caused by concomitant use of inhalation anesthetics (the -anes, except N2O) and succinylcholine (NMJ blocker).

185
Q

Genes involved in malignant hyperthermia

A

Autodom gene mutation in RYR1 gene, which makes the skeletal muscle’s ryanodine Ca2+ receptor

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