DIT Psych Flashcards
What is the mnemonic for reactive attachment disorder? Happens when baby hasn’t had attention.
4 W’s
Weak, Wordless, Wanting, Wary
(poor language kills, no trust, weight loss, ill), failure to thrive and immune deficiency.
What is methylphenidate?
Ritaline. Caecholamine release
What is Atomoxetine?
Norepinephrine reuptake inhibitor so more NE in synaptic cleft. ADHD treatment
What are the two things that can develop into Antisocial personality disorder? differentiate them.
Oppositional defiant disorder is hostile behavior towards auhrotiy figure, but no violation of social norms.
Conduct disorder is where they do things like steal, or burn things or torture animals but younger than 18 (Antisocial Personality Disorder is if 18+)
Tourette syndrome meds?
after behavioral therapy
Fluphenazine (antipsych)
Pimozide
Tetrabenazine (touretabenazine)
Girl with hand wringing and hand to mouth gesture and mentally retarded? Dx? Genetics?
X LINKED DOMINANT RETT SYNDROME (males die in utero)
Also, loss of verbal abilities, ataxia, loss of milestones or developmental regression
Hand biting or wringing may be on test, and it is constantly midline and hand to mouth.
Compare bulimeia vs anorexia?
Bulimia has BINGING and may be normal weight.
Anorexia is 3 criteria: Distorted body image, fear of gaining weight, can’t get BMI >17
Both may or may not puke, and they may have met alkalosis
Transsexual vs transvestite?
TransSEXual wants to live as other SEX.
TransVESTism: paraphilia dresses in other clothes (VEST). Does it to feel aroused.
Danger of alcohol withdrawal?
Tx?
Delerium tremens. 2-3 days after booze consumption.
Nightmare, hallucination, fever, seizures… can be fatal
BENZO is tx
On test may say seizures 2 days after surgery
Screening for alcoholism?
CAGE (nick cage drinks)
Cut back (need to?)
Annoyed (when people ask)
Guilty
Eye opener (early in morning
If you have a patient who smells like booze, hypoglycemia, confusion, nystagmus, ataxia… What do you do?
Well may have wernicke (thiamIne deficiency)
SO GIVE THIAMINE before sugar
glucose bad b/c gluc metal uses thiamine, and then you could put patient into coma b/c severe deficiency. so THIAMINE then glucose
Hallucination vs delusion vs illusion?
Hallucination: no stimuli to think you see something.
Illusion: misinterpret something that is there (branch mistaken for arm)
Delusion: false belief despite obvious proof of contrary
What causes positive symptoms in schizo?
And negative symptoms?
Increased dopamine in mesolimbic
Decreased dopamine in mesocortical cortex, maybe
Brief psycoitc disorder
Schizophreniform disorder?
Schizoaffective disorder?
Brief is less than a month and stress related
Schizophreniform is 1-6 months
Schizoaffective is 2 weeks or more of stable mood with psychotic symptoms THEN a time period afterwords with depressive, manic or both (those two weeks make it schizo dominant, if there were not those two weeks, it could be a mood disorder with schizo characteristics.)
Schizo straight!
Schizoid
Schizotypal
Schizophrenic
Schizoaffective
SchizOID avOID (hermit)
Schizotypal is odd thinking and avoidance behavior like schizoid. Still functional though
Schizophrenic: odd enough thinking and can’t keep it together to function.
Schizoaffective is schizophrenic psychotic symptoms + bipolar or mood disorder
What are side effects of low potency antipsychotics?
Which drugs are they?
Cheating Thieves are LOW
LOW potency:
CHlorpromazine, THioridazine
Anticholinergic effects
What neuroleptics are high potency? What are side effects?
Haloperidol and azines that aren’t starting with CH or TH (don’t fit in Cheating Thieves are LOW mnemonic)
Extra peramidal symptoms (but not anticholinergic)
What are the atypical antipsychotics? mnemonic
its ATYPICAL for OLd CLOSets to QUIETly RISPER form A to Z
OLanzapine, CLOzapine, QUETIapine, RISPERidone, Aripiprazole, Ziprasidone
What is major side effect of best antipsychotic? KNOW THAT
Clozapine can cause AGRANULOCYTOSIS. Stop making granuloytes
Mnemonic for diagnosis of bipolar?
DIG FAST. Need 3 of the 7
Distractibility Irresponsibility (hedonistic) Grandiosity (inflated self esteem) Flight of ideas Activity: goal directed, Agitation Sleepless Talkative or pressured speech
Length of time for mania? for hypomania
Mania is at least a week
Hypomania is only 4 days
Bipolar 1 vs 2?
Cyclothymic?
Bipolar 1 is history of a manic episode
Bipolar II has hypomanic episode and 1 episode of major depression
Cyclothymic is easy. Its cyclical with dysTHYMIC and hypomanic states AT LEAST 2 YEARS (its a mild bipolar). Mild so not meeting criteria, but lasts 2 years (normal periods is only lasting about 2 months between)
Lithium side effects? mnemonic alert! and one that doesn’t fit
LMNOP (alphabet!)
Lithium SE Movement (Tremor) Nephrogenic DI hypOthyroid Preggers problem (ebstein)
and HEART BLOCK
Criteria for major depression. 5 of 9 for at least 2 weeks.
Must have 1 of 2 things.
Must have 2 weeks+.
SIG E CAPS Sleep disturbance Interest loss (anhedonia) Guilt (feel worthless) Energy is low Concentration lost Appetite/weight change Psychomotor retardation/agitation Suicidal ideation
MUST HAVE DEPRESSED MOOD OR ANHEDONIA
Dysthymia or persisten depressive disorder qualification?
2 years in adults or 1 year in kids without 2 months of feeling better during that time
Risk factor for suicide?
SAD PERSONS
Sex Age (45) Depression Previous attempt Ethanol or drugs Rational thinking loss Sickness Organized plan (ask for plan) No spouse or social support Stated future intent
Atypical Depression presentation?
It is Karly, sorry.
Hypersensitive
Reversed symptom (phagia and weight gain)
Leaden paralysis
Long standing interpersonal rejection sensitivity
SSRIs?
Toxicity?
Fluoxetine paroxitine, sertraline, citalopram
Sexual dysfunction
Serotonin syndrome: hyperthermia, hyperreflexia, CV collapse, flushing, diarrhea, mental status…
Tx: COOL PATIENT and benzo
SNRIs?
Uses?
Toxicity?
Duloxetine, Venlafaxine
DEPRESSION or GAD. Duloxetine for diabetic neuropathy
Higher BP is most common, also stimulant side effects, sedation, nausea (can worsen anxiety at first)
TCA suffix (3 of them)
Mechanism?
Tox?
-ipramine, iptyline, oxepin
Mechanism: NE and 5-HT can’t be taken up (similar to SNRI but different shape)
Amitryptiline for neuropathic pain and fibromyalgia
TRI C’s
Convulsions
Coma
Cardiotoxic (antimuscarinic so ahrythmia) (hot as hare…)
ALSO sedation and alpha blocking affects (hypotension, and sedation), resp depression, hyperpyrexia, confusion and hallucination (delirium from anticholinergic)
Monoamine Oxidase Inhibitors?
MAO Takes Pride In Shainghai
Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective for parkinson)
NE, 5HT and dopamine aren’t broken down
Hypertensive crisis with tyramine (can cause migraine too)
Buproprion mechanism and use?
Smoking cessation or expression.
NDRI NE and Dopa reuptake inhib
Tox: stimulant effects (don’t take before bed) and seizure if bulimic.
NO SEX side effects
Mitrazapine mechanism and use?
alpha 2 antagonist so more NE and 5HT release.
Toxicity is sedation (may help depressed with insomnia)
Weight gain, more appetite (helps for old people)
Trazadone mechanism and use?
blocks 5HT2 and alpha adrenergic.
Used for insomnia b/c high doses needed for antidepressant
TRAZABONE! (remember priapism)
Toxicity is sedation (may be the goal) , nausea, priapism, postural hypotension
When does acute distress disorder become PTSD?
occurring more than 1 month after the event
When does adjustment disorder become GAD?
6 months
What is mechanism of buspirone?
Use?
GAD: I have ANXIETY when the BUS is ON time
BUSpirONe
Stimulates Serotonin receptors
no alcohol affect
What is conversion disorder?
V for Voltage b/c neuron doesn’t seem to be working, it is somatoform.
For some reason, something just stops and patient is INDIFFERENT.
“arm isn’t working, don’t know why.” “i can’t see out right eye, oh well”.
Suppression vs repression?
Suppres is intentionally
Repression is involuntarily withholding idea or feeling
Splitting defense mechanism?
Things are good or bad. Associated with borderline personality disorder
pg 500
Personality disorder clusters?
Weird
Wild
Worried
Projection vs displacement
Projection is where you project your flaws onto others (YOU ARE RACIST, not me)
Displacement: boss is mad at you, you transfer that anger at your kid
Avoidant is when people avoid others. Why?
B/c hypersensitive to rejection and are timid. THEY HAVE DESIRE TO MAKE RELATIONSHIPs. just worried
What is isolation ego defense?
Removing feelings from events (like physicians who see a lot of trauma don’t tie feelings to it)
APGAR is what? 4 star
Appearance Pulse Grimace Activity Respiration
0-10. Ten is good
Tumors in kids
ALL Astrocytoma Neuroblastoma Hemangioma Wilms Hepatoblastoma Retnioblastoma Rhabdomyosarcoma Ewing sarcoma Osteogenic sarcoma Lymphoma Teratoma
