Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatry / Addiction Medicine > Depersonalization / Dissociative Disorders > Flashcards

Depersonalization / Dissociative Disorders Flashcards

1
Q

Delirium prevalence ?

A

1-2%, increased with age rising to 14% over 85 years old.

Incidence in ED among older individuals is 10-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Delirium Etiology and risk factors ?

A

Increases with age ( AGE!!)

Functional impairment, falls, low level of activity, drugs and medications

** alcohol wd with delirium - delirium tremmins ( they get the shakes)**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Delirium genetics and physiology ?

A

Neurocognitive disorders increase risk

Febrile illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Delirium DDx ?

A

Psychotic disorders,

Bipolar/Mood with psychotic features

Acute stress disorder
Malingering and factitious disorder

** delirium is a sign that the body is not taking care of the brain properly and it is irritated , delirium and pyschosis are hard to differentiate ( zyprexa Ziadisx )**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Delirium work up ?

A 
Look for underlying conditions 
(CBC - infection, glucose, CMP - electrolytes disturbances , 
Ammonia - liver failure, 
TSH - hyper or hypo, 
HIV - delirium or dementia longer term, 
UA - UTI, 
CXR - pneumonia , 
Utox - drugs, 
CT Brain - is there a tumor or bleed )
need to rule out other things
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Delirium prognosis ?

A

Good, with often full recovery in many individuals
reversible cause

Mortality is increased. May be as high as 40%

Increased functional decline

Requires hospitalization and increased risk of long term care placement (3X those without delirium)

  • *prognosis with dementia is less good
  • *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Delirium tx and medications ?

A

Treat underlying cause.

Fluids and nutrition

Reduce distractions and noise at night

If agitated, atypical antipsychotics (zyprexa, seroquel, risperdal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Delirium procedures / therapy / surgery ?

A

Reorientation techniques with calendar, clocks and family photos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dementia aka ?

A

Major and Minor Neurocognitive Disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dementia prevalence ?

A

Varies widely by age and etiology

At 65 years old – 1-2%

At 85 years old- up to 30%
Mild NCD is variable

65 yo 2-10%
85 yo 5-25%

** clearly age related **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dementia etiology and risk factors ?

A

Vary by subtype
-Age is risk for almost all
Ex. Alzheimer’s uncommon < 60yo, frontotemporal lobe is earlier

Genetics
-Parkinson’s, Huntington’s are strongly genetic; Alzheimer’s maybe also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dementia DDx ?

A

Normal cognition
Delirium
MDD
Learning or developmental disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dementia prognosis ?

A

Variable

Some may begin and remain static ( related to traumatic or infectious cause)

Some are progressive (Alzheimer’s, frontotemporal lobe, Parkinson’s, Huntington’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Dementia workup ?

A

Blood work (CBC, CMP, glucose, HbA1C, UA,

CT/MRI brain, PET scan, CXR

Neuropsychological assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dementia medications ?

A

Cholinesterase inhibitors

Partial N-methyl-D-aspartate antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dementia procedures ?

A

Cholinesterase inhibitors

Partial N-methyl-D-aspartate antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Alzheimer’s Dementia tx ?

A

Cholinesterase inhibitors

Partial N-methyl-D-aspartate antagonists

** think memory and learning

this is clinical dx
we dont have had and fats genetic testing and fam hx is good!**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cholinesterase inhibitors

examples?

A

-Donzepil (Aracept), Rivastigmine (Exelon), Galantamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Partial N-methyl-D-aspartate antagonists example ?

A

Memantine (Namenda)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

frontotemporal Dementia tx ?

A

Depression- SSRI’s

So far, dopaminergic (Parkinson’s) and cholinergic (Alzheimer’s) medications do not work.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is stored in the front of the head ?

A
  • decision making and personality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lewy Body Dementia tx ?

A

Rivastigmine (Exelon) and other cholinesterase inhibitors

Atypical antipsychotics - 2nd gen

Do not use haloperidol ( risk of neuroleptic malignant syndrome)

Levadopa/carbodopa- parkinsonian features
mainstay for parkinson’s
SSRI’s for depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Atypical antipsychotics examples 2nd gen?

A

quetiapine, aripiprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Vascular Dementia tx ?

A

Prevention of future CVA’s

Rehabilitation/Adaptation-PT ( more rehabilitation) and OT (more adaptation )
stroke related

cholinesterase inhibitors (Aracept) can help

Psychotic symptoms-
antipsychotics-quetiapine, aripiprazole

Depression
SSRI’s- sertraline, citalopram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Vascular Dementia ?

A

stroke and now you have dementia and this is time related to a clot etc , sometimes memory and leaning with it dx, CT or MRI of brain and you see evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Dementia due to traumatic Brain Injury tx ?

A

Prevention of future TBI’s

Rehabilitation/Adaptation-PT and OT

Alzheimer’s like symptoms
cholinesterase inhibitors (Aracept) can help

Parkinson’s like symptoms
Levadopa/carbadopa

Depression
SSRI’s- sertraline, citalopram

27
Q

Dementia due to Parkinson’s Disease tx ?

A

Levadopa/carbadopa - first line but people get tolerance so they add what is below

Monoamine oxidase B inhibitor

Dopamine agonists

Depression

28
Q

Dementia due to Parkinson’s Disease tx : Monoamine oxidase B inhibitor examples ?

A

Selegeline - specifically B

29
Q

Dementia due to Parkinson’s Disease tx: Dopamine agonists

examples ?

A

Ropinirole (Requip),

Pramipexole (Miraplex)

30
Q

Depression tx ?

A

SSRI’s- sertraline, citalopram

31
Q

Dementia due to Huntington’s Disease tx ?

A

Cholinesterase inhibitors

Partial N-methyl-D-aspartate antagonists

Atypical antipsychotics

Antidepressants

32
Q

Cholinesterase inhibitors

examples ?

A

Rivastigmine (Exelon),

33
Q

Partial N-methyl-D-aspartate antagonists

A

memantine ( Namenda)

34
Q

Depersonalization / Derealization Disorder prevalence ?

A

~2% of U.S.

35
Q

Depersonalization / Derealization Disorder Etiology and Risk factors ?

A

Trauma, significant stressor (death of a loved one, very severe financial, social or other stressors)

Severe sleep deprivation

Other disorders such as anxiety or depression

**traum trauma trauma !!!

this is not short term grieving and this is long term**

36
Q

Depersonalization / Derealization Disorder genetics ?

A

Unclear

37
Q

Depersonalization / Derealization Disorder DDx ?

A

Schizophrenia
Panic Disorder
Acute and Post Traumatic Stress Disorders
Borderline / Avoidant Personality Disorders

38
Q

Depersonalization / Derealization Disorder prognosis ?

A

variable

39
Q

Depersonalization / Derealization Disorder medications ?

A

SSRI’s (maybe) but very limited studies

Lamotrigine (mood stabilizing anticonvulsant)

40
Q

Depersonalization / Derealization Disorder procedures / therapy / surgery ?

A

CBT and psychotherapy

41
Q

Derealization symptoms ?

A

Symptoms of derealization include:

Feelings of being alienated from or unfamiliar with your surroundings, perhaps like you’re living in a movie

Feeling emotionally disconnected from people you care about, as if you were separated by a glass wall

Surroundings that appear distorted, blurry, colorless, two-dimensional or artificial, or a heightened awareness and clarity of your surroundings

Distortions in perception of time, such as recent events feeling like distant past

Distortions of distance and the size and shape of objects

Episodes of depersonalization-derealization disorder may last hours, days, weeks or even months at a time.

In some people, these episodes turn into ongoing feelings of depersonalization or derealization that may periodically get better or worse.

In this disorder, feelings of depersonalization and derealization aren’t directly caused by drugs, alcohol, a mental health disorder or a medical condition.

42
Q

Depersonalization symptoms ?

A

Symptoms of depersonalization include:

Feelings that you’re an outside observer of your thoughts, feelings, your body or parts of your body, perhaps as if you were floating in air above yourself

Feeling like a robot or that you’re not in control of your speech or movements

The sense that your body, legs or arms appear distorted, enlarged or shrunken, or that your head is wrapped in cotton

Emotional or physical numbness of your senses or responses to the world around you

A sense that your memories lack emotion, and that they may or may not be your own memories

43
Q

Dissociative Amnesia prevalence ?

A

Female > Male (~2 to 6%)

44
Q

Dissociative Amnesia Etiology and risk factors ?

A

Usually trauma after r/o of organic causes

45
Q

Dissociative Amnesia genetics ?

A

Possibly – there is a slightly higher incidence of individuals with family members having amnesia issues.

Currently unclear details of the association

46
Q

Dissociative Amnesia DDx ?

A

Dementia / Head Trauma / Substance Intoxication.
Early symptoms of neurological disorders (eg multiple sclerosis).

47
Q

Dissociative Amnesia prognosis ?

A

Generally good, improves with removal from traumatic event

48
Q

Dissociative Amnesia work up ?

A

Mini mental, look for biological causes (CT/MRI, cbc, cmp, UA, Utox, etc.)

49
Q

Dissociative Amnesia medications ?

A

Rarely successful.

depression or anxiety might benefit from treatment with a medication such as an antidepressant or anti-anxiety medicine.

hypnosis is common tx for this

**Versed causes retrograde amnesia ( can remember) **

50
Q

Dissociative Amnesia procedures / therapy / surgery ?

A

Slow gradual psychotherapy

Hypnosis

Often resolve spontaneously

51
Q

Dissociative Fugue prevalence ?

A

~0.2% more common in war time/areas

**very rare **

52
Q

Dissociative Fugue Etiology and risk factors ?

A

Related to dissociative amnesia or Extreme stress

53
Q

Dissociative Fugue genetics ?

A

Many theories - genetic influences, accounting for about 50% of the variance in twin studies. Smaller hippocampal and amygdala volumes (possible)

54
Q

Dissociative Fugue DDx ?

A

Dementia
Head Trauma
Substance Intoxication
Malingering

55
Q

Dissociative Fugue prognosis ?

A

Mostly self-limited

56
Q

Dissociative Fugue medications ?

A

There is no medication to treat the dissociative disorders themselves. However, a person with a dissociative disorder who also suffers from depression or anxiety / antidepressants or anxiolytics

57
Q

Dissociative Fugue procedures / therapy / surgery ?

A

Supportive environment and sometimes hypnosis

Psychotherapy to deal with issues associated with recovered memories

58
Q

Dissociative Identity Disorder prevalence ?

A

~.01 to 1%

59
Q

Dissociative Identity Disorder Etiology and risk factors ?

A

Family Hx

Trauma is a large risk factor

60
Q

Dissociative Identity Disorder genetics ?

A

Unclear

61
Q

Dissociative Identity Disorder DDx ?

A

Dementia
Head Trauma.
Substance Intoxication.
Malingering

62
Q

Dissociative Identity Disorder prognosis ?

A

No large scale studies but many psychiatrists report excellent results with therapy

63
Q

Dissociative Identity Disorder medications ?

A

There are no approved medications

64
Q

Dissociative Identity Disorder procedures / therapy / surgery ?

A

Supportive environment and sometimes hypnosis

Psychotherapy

Psychiatry / Addiction Medicine (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions