EOR Flashcards
echolalia
repeats words or phrases
echopraxia
mimics behavior
5 A’s of schizophrenia (neg sx)
anhedonia affect (flat) alogia (poverty of speech) avolition (apathy) attention (poor)
Effect of APS blocking dopamine in tuberoinfundibular pthwy
hyperprolactinemia which can cause gynecomastia, galactorrhea, sexual dysfn and menstrual irregularities
Effect of APS blocking nigrostriatal pthwy
parkinsonism/EPS (tremor, rigidity, slurred speech, akathesia, dystonia and abnrml mvts)
Associated w/ better prognosis for schizophrenia
late onset good social support \+ sx mood sx acute onset female few relapses good premorbid fn
tx for EPS (esp w/ high potency 1st gen APS)
anticholinergics (benztropine, diphenhydramine), benzos/beta-blockers (specifically for akathisia)
metabolic syndrom
SE of 2nd gen APS
↑ BP, blood sugar levels, body fat around waist, abnrl cholesterol levels
What 2nd gen APS are more “weight neutral”
aripiprazole or ziprasidone
Ataxia, confusion, ocular abnormalities
wernicke’s encephalopathy (vit B1)
impaired recent memory, anterograde amnesia, compensatory confabulation
korsakoff (occurs if wernicke’s encephalopathy is untreated)
Refeeding syndrome
pts reefed too quick- lookf for fluid retention and decreased phosphorus, magnesium and calcium
complications of refeeding syndrome
arrhythmias, respiratory failure, delirium and seizures
Anorexia mortality rate
cumulative and ~5% per decade d/t starvation, suicide, cardiac failure
Tx for anorexia
outpt unless 75-80% of ideal body weight
feed first-supervised weight gain programs, CBT, fam therapy,
DSM5 for anorexia
restriction
intense fear of gaining weight
disturbed body image
Duration criteria for bulimua
at least 1x/week for 3 mo
Diff from bulimia and anorexia
usually normal or over weight, sx are more distressing (egodystonic), bulimia has better prognosis
Define binge eating
2000 calories in 2 hrs (usually they eat faster than this)
Buimia mortality rate
2% per decade
Treatment for bulimia
antidepressants + therapy
SSRI- fluoxetine is ONYL FDA approved for bulimia
Nutritional counseling, CBT, fam therapy
AVOID bupropion d/t lower seizure threshold
Binge eating duration critreia
at least once a week for 3 months
DSM5 for binge eating
recurrent ep of binge eating with at least 3 of the following: eating rapidly eating until uncomfortably full eating large amts when not hungry eating alone d/t embarrassment feeling disgusted/depressed/guilty after
duration criteria for insomnia d/o
at least 3 days a week for at least 3 months
tx for insomnia
sleep hygeiene
CBT
pharmacotherapy
pharmacotherapy for insomnia
Benzos- short term for 4-8 wks
Non-benzos- zolpidem, eszopiclone and zaleplon (good short term)
anti-depressants-trazodone, amitriptyline and doxepin
cataplexy
sudden loss of muscle tone bilaterally without LOC usually associated with intense emotion
hypnagogic hallucination
when going to sleep
hyponopomic hallucination
when transitioning from sleep
catalepsy
unprovoked muscular rigidity
tx for cataplexy
sodium oxybate (DOC)
TCAs
SSRI/SNRI
tx for hypersomnia
modafinil or stimulants (amphetamine or methylphenidate)
antidepressants (atomoxetine)
scheduled napping
central apnea and sleep-related hypoventilation tx
cpap/bipap
sup O2
meds (acetazolamide, theophylline, sedative-hypnotics)
narcolepsy tx
sleep hygiene daytime naps avoid shift work amphetamines treat cataplexy
define parasomnias
abnormal behaviors, experiences or psychological events that occur during sleep or sleep wake transitions
tx for sleep walking
most don’t need to be treated
education, reassurance, sleep hygiene
refractory cases- low dose benzo such as clonazepam
tx for sleep terrors
reassurance that it is self limited
tx for nightmare d/o
reassurance
desensitization/imagery tehearsal
medications- prazosin and antidepressants such as for PTSD cases
define REM sleep behavior d/o
repeated arousals during sleep associated w/ vocalization or motor behavior
violent behaviors in sleep resulting in injury to patient or partner
tx for REM sleep behavior d/o
d/c likely causative med
clonazepam is efficacious in most pts
melatonin
ensure enviro safety
meds that can contribute to REM sleep behavior d/o
TCAs, SSRI, SNRI, beta blockers
tx for restless leg syndrome
iron replacement if low ferritin
remove offending agents
dopamine AGONISTS and benzos are first line (bromocriptine, ropinirole)
mature defenses
altruism, humor, sublimation, suppression
neuoritc defenses
controlling displacement intellectulization isolation of affect rationalization reaction formation repression
immature defenses
acting out
denial
regression
projection
define splitting
labeling ppl as all good or all bad (common in borderline PD)
define undoing
attempting to reverse a situation by adopting a new behavior
define altruism
performing acts the benefit others in toder to vicariously experience pleasure
define sublimation
satisfying socially objectable impulses in an acceptable manner
define suppression
purposely ignoring an unacceptable impulse or emotion in order to diminish discomfort and accomplish task
define displacment
shifting emotions from undesirable situation to one that is personally tolerable
ex: angry with mother then talks back to teacher next day and refuses to obey instructions
define intellectulization
avoiding neg feelings by excessive use of intellectual functions and by focusing on irrelevant details
define isolation of affect
unconscious limiting the experience of feelings or emotions associated with stressful life event in order to avoid anxiety
define rationalization
explanations of an event in order to justify outcome or make acceptable
define reaction formation
doing opposite of an unacceptable impulse
ex: man who is in love with his married coworker insults her
define repression
preventing thought or feeling from entering consciousness
difference between repression and suppression
repression is unconscious and suppression is conscious act
define acting out
giving in to an impulse even if socially inappropriate in order to avoid anxiety of suppressing the impulse
define regression
performing behaviors from an earlier stage of development in order to avoid tension associated with current stage
define projection
attributing objectable thoughts or emotions to others
ex: husband who is attracted to other women accuses his wife of having an affair
