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Psychiatry > First Aid > Flashcards

First Aid Flashcards

1
Q

psychosis

A

distorted perception of reality

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2
Q

delusions

A

fixed, false beliefs despite evidence to the contrary

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3
Q

nonbizzare vs bizarrre

A

one is believable, other is not

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4
Q

delusions of persecution/paranoia

A

“CIA is after me” - one is being persecuted

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5
Q

delusion of ideas of reference

A

belief that external enviornmental are related to individual -TV is talking to me

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6
Q

delusion of control

A

thoughts can be heard of or by others

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7
Q

delusions of grandeur

A

super powers

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8
Q

delusions of guilt

A

guilty for something

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9
Q

somatic delusions

A

infected with a disease

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10
Q

illusion

A

misinterpretation of sensory stimulus (mistake show for a cat)

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11
Q

associations of hallucinations

A 
auditory = schizophrenia
visual = drug, alcohol withdrawal, delirium
olfactory = aura for epilepsy
tactile = withdrawal
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12
Q

delusion vs illusions vs hallucination

A 
delusion = false belief
illusion = misinterpretation of external stimulus
hallucination = perception in absence of stimulus
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13
Q

criteria for psychosis due to medical condition

A
  • prominent hallucinations/delusions
  • symptoms do not occur only during delirium
  • evidence of another cause
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14
Q

most common cause of psychosis in elderly

A

delirium

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15
Q

positive symptoms of schizophrenia

A
  • hallucinations
  • deulsions,
  • bizarre behavior
  • disorganized speech
  • responds to meds
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16
Q

negative symptoms of schizophrenia

A
  • flat or blunted affect, anhedonia, apathy, alogia and lack of interest
  • treatment resistent
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17
Q

phases of schizophrenia

A
  • prodromal - decline in funcitoning
  • psychotic
  • residual
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18
Q

criteria for schizophrenia

A
  1. delusions
  2. hallucinations
  3. disorganized speech
  4. disorganised or catatonic behavior
  5. negative symptoms
    - problem with functioning for at least 6 months
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19
Q

echolia

A

repeated words or pharases

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20
Q

echopraxia

A

mimic behavior

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21
Q

findings in schizo exam

A
  • disheveled, flat affect, disorganized thought
  • intact memory and orientation
  • auditory hallucinations
  • paranoid delusions
  • ideas of reference
  • lack on insight
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22
Q

downward drift hypothesis

A

unable to function in society, end up in lower classes

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23
Q

neurotransmitter in schizo

A

dopamine
Less so:
high serotonin, high norepi, low GABA, low glutamate

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24
Q

pathways in schizo

A
  • prefrontal
  • mesolimbic = positive symptoms
  • tuberoinfundibular - affected with antipsychotics
  • nigrostriatal = EPS symtpoms
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25
Q

neolosigm

A

made up words, seen in schizophrenia

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26
Q

treatment of schizophrenia

A

no difference between first and second generation for efficacy
- should be taken for 4 weeks

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27
Q

dystonia

A

spasms

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28
Q

parkinsonism

A

resting tremor, rigidity, bradykinesia

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29
Q

akathisia

A

feeling of restlessness

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30
Q

treatment for EPS

A

benztropine and diphenhydramine, benzos/beta blockers

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31
Q

treatment for tardive dyskinesia

A

benzos, botox and vitamin E

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32
Q

symptoms of NMS

A

fever, labile blood pressure, tachycardia, tachypnea, diaphoresis, lead pipe rigidity, elevated CPK, leukocytosis, metabolic acidosis

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33
Q

thioridazine side effects

A

irreversible retinal pigmentation at high doses

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34
Q

chlorpromazine side effects

A

deposits in lens and cornea

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35
Q

schizoaffective disorder

A
  • meet criteria for major depressive or manic episode with psychotic symptoms
  • delusions for 2 weeks with no mood symptoms
  • mood symptoms present for majority of psychosis
  • not dus to substance
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36
Q

differences in delusional disorder vs schizophrenia

A

non bizarre delusions, daily functioning not impaired, does not meet schizophrenia criteria

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37
Q

erotomanic deulsion

A

deulsion that someone else is in love with person

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38
Q

Koro

A

penis into body in southeast asia

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39
Q

amok

A

outburst of violence followed by suicide, malaysia

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40
Q

brain fag

A

disturbances in male students in Africa

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41
Q

MDD criteria

A
  1. depressed mood
  2. anhedonia
  3. change in appetite or weight
  4. worthlessness or guilt
  5. insomnia or hypersomnia
  6. diminished concentration
  7. psychomotor agitation or retardation
  8. fatigue or loss of energy
  9. recurrent thoughts of death or suicide
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42
Q

Mania criteria

A
  1. distractibility
  2. inflated self-esteem or grandiosity
  3. increase in goal directed activity
  4. decrease need for sleep
  5. flight of ideas or thoughts
  6. pressured speech
  7. excessive pleasure with risks
    - lasting 1 weeks
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43
Q

poor response to mixed mood disorder

A

lithium, valproic acid is preferred

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44
Q

hypomania vs mania

A 
mania = 7 days, social impairment, hospital, psychotic features
hypo = 4 days, no functional impairment, no hospital, no psychosis
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45
Q

stroke patients = mood disorder

A

depression

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46
Q

MDD criteria

A
  • major depressive episode

- no mania or hypomania

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47
Q

sleep with MDD

A

multiple awakenings, terminal insomnia, hypersomnia is less common, REM earlier and for longer

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48
Q

etiology of MDD

A

increased sensitivity of beta-adrenergic receptors, high cortisol, abnormal thyroid, etc

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49
Q

most common sleep disturbances in MDD

A

trouble falling sleep and early awakenings

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50
Q

time for antidepressants

A

4-6 weeks

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51
Q

fist line in patients with MDD with psychotic features

A

atypical antipsychotics

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52
Q

ECT

A
  • premeidated with atropine
  • general anesthesia with methohexital
  • muscle relaxant
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53
Q

melancholic features

A

anhedonia, early morning awakenings, depression worse in morning, psychomotor disturbance, excessive guilt and anorexia

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54
Q

atypical features of MDD

A

hypersomnia, hyperphagia, reactive mood, leaden paralysis, hypersensitivity to interpersonal rejection

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55
Q

bipolar I

A

manic episodes with or without depression, only requires one episode of mania

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56
Q

bereavement

A

not a DSMV diagnosis

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57
Q

highest genetic link of psychiatric disorders

A

bipolar I

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58
Q

rapid cycling

A

4 or more mood episodes in 1 year

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59
Q

lithium in bipolar

A

reduces suicide risk

60
Q

drugs useful for rapid cycling

A

carbamazepine and valproic acid

61
Q

avoid _____ in mania

A

antidepressants

62
Q

bipolar II

A

one or more depressive episode with at least one hypomanic episode

63
Q

treatment for mania in pregnancy

A

ECT

64
Q

dysthymia

A

persistent depressive disorder - for at least 2 years

- not without symptoms for greater than 2 months

65
Q

cyclothymia

A

alternating periods of hypomania and periods with mild to moderate depressive symptoms

66
Q

disruptive mood dysregulation disorder

A

chronic, severe, persistent irritability occurring in childhood and adolescence

67
Q

most common psychopathology

A

anxiety

68
Q

psychopathology with SOD

A

social and or occupational dysfunction

69
Q

anxiety bridge med

A

benzos

70
Q

Bs to block the Ps

A

beta blockers for panic attacks and performance anxiety

71
Q

PRN anxiety use….

A

non addictive diphenhydramine or hydroxazine

72
Q

buspirone

A

5-HT agonist, anxiolytic, not efficacious

73
Q

risk factor for panic attacks

A

smoking

74
Q

SSRI in panic disorders

A

start slowly because meds can worsen anxiety at first

75
Q

social phobia

A

fear of scrutiny by others or fear of acting in a humiliating or embarrassing way

76
Q

most common psychiatric disorder by gender

A 
women = phobias
men = substances
77
Q

obsessions and compulsions

A 
obsessions = recurrent, intrusive undesired thoughts that increase anxiety
compulsions = repetitive behaviors or mental rituals
78
Q

most serotonin selective TCA

A

clomipramine

79
Q

trichotillomania

A

hair pulling risorder

80
Q

acute stress vs PTSD

A

PTSD = greater than 1 month and trauma at any time, stress = less than 1 month

81
Q

adjustment disorder

A

within 3 months of event and resolve within 6

82
Q

cognitive processing

A

CBT where thoughts, feelings and meanings of event are revisited and questioned

83
Q

paranoid personality disorder

A
  • pervasive distrust and suspiciousness of others
  • blame own problems on others, angry and hostile
  • jealous and cheating
84
Q

schizoid personality

A

social withdrawal, eccentric and reclusive

- prefer to be alone, no desire for close relationship

85
Q

schizotypal personality

A

eccentric behavior, peculiar thought patterns, strange and odd
- seen in families with schizophrenia

86
Q

antisocial personality

A

exploitie of others, lack empathy, compassion and remorse, impulsive deceitful and break law

87
Q

antisocial differential

A

can be caused by drug abuse

88
Q

borderline personality

A

unstable moods, behaviors and interpersonal relationships, poorly formed identity, intense attachment, agression is common

89
Q

splitting seen in…

A

borderline

90
Q

drugs most useful in what personality disorder

A

borderline

91
Q

histrionic personality

A

attention seeking, emotional, dramtic, flamboyant and extroverted

92
Q

electrolyte abnormality in alcohol withdrawal

A

hypomagnesium, should be corrected early

93
Q

natrexone

A

opioid receptor blocker, decreases cravings and high

94
Q

acamprosate

A

modulate glutamate transmission

  • started post detox
  • used in liver, not renal disease
95
Q

disulfiram

A

blocks aldehyde dehydrogenase, causing averse reactions

96
Q

topiramate

A

potentiates GABA and inhibits glutamate

97
Q

lab effects of alcohol

A

macrocytosis and high LFTs

98
Q

Wernickes

A

ataxia, confusion, ocular abnormalities, nystagmus, gaze palsies

99
Q

Korsakoff

A

chronic amnesitc syndrome

100
Q

cocaine hallucinations

A

tactile

101
Q

deadly side of cocaine

A

vasoconstrictive MI, intracranial hemorrhage or stroke

102
Q

danger in MDMA

A

serotonin syndrome with SSRI

103
Q

PCP MOA

A

antagonize NMDA glutamate receptors

104
Q

rotary nystagmus =

A

PCP intoxication

105
Q

GHB

A

commonly date rape drug along with ketamine

106
Q

drug withdrawal with highest mortality rate

A

barbituates

107
Q

sedatives detox

A

sodium bicarb with barbituates

flumazenil with benzos

108
Q

opioid use disorder treatments

A
  1. methadone - long acting opioid agonist, once daily, can cause Qtc
  2. buprenorphine - partial opioid agonist, sublingual, plateau, comes as suboxone (with naloxone)
  3. naltrexone - competitive antagonist, compliance is issue
109
Q

caffeine MOA

A

adenosine antagonist causing increase in cAMP release

110
Q

delirium is a disorder of…

A

attention and awareness (like acute brain failure)

111
Q

three types of deliurm

A
  1. mixed - most common
  2. hypoactive - undetected
  3. hyperactive - in withdrawal
112
Q

medications avoided in delirium

A

benzos, unless due to alcohol or benzo withdrawal

113
Q

MMSE

A

sensitive for major neurocognitive disease if score is less than 25

114
Q

testing attention

A

serial 7s

115
Q

long half life anti depressant

A

fluoxitine

116
Q

antipsychotics and dementia

A

carry black box warning for early death

117
Q

stepwise loss of function

A

vascular dementia

118
Q

domains affected in small vessel disease

A

complex attention and executive funciton

119
Q

visual hallucinations and EPS

A

Lewy body dementia

120
Q

core features of Lewy body

A
  1. waxing and waning of cognition in areas of attention and alertness
  2. visual hallucinations
  3. EPS
121
Q

suggestive features of Lewy body

A
  1. REM sleep behavior disorder

2 pronouced antipsycotic sensitivity

122
Q

movement problems in huntingtons

A

chorea and bradkinesia

123
Q

rapidly progressive cognitive decline and myoclonus

A

creutzfeldt-Jakob disease

124
Q

pseudodementia

A

the appearence of being demented in an elederly depressed patient

125
Q

MCD vs pseudodementia when asked a question

A

MCD confabulate, depression says they dont know

126
Q

sundowning

A

confusion at night, common in dementia

127
Q

visual hallucination in early dementia suggest….

A

Lewy body

128
Q

global developmental delay is for patient under…

A

5

129
Q

comorbid ADHD disorders

A

ODD, conduct, learning disability

130
Q

coprolalia

A

obscene taboo words as an brupt sharp bark or grunt

131
Q

first choice for tourettes

A

alpha 2 agonists guanfacine and lconidine

132
Q

treatment for enuresis

A

alarm then desmopressin or imipramine

133
Q

abreaction

A

strong emotional reaction patients may experience when retrieving traumatic memories

134
Q

depersonalization vs derealization

A 
person = separation for oneself
real = separation from outside surroundings
135
Q

procedural memory

A

knowing how to do things, preserved in deissociative amnesia

136
Q

dissociative identity disorder

A

more than one distinct personality

137
Q

depersonalization vs derealization disorder

A

not feeling like yourself “out of body” or feeling like you are in a dream

138
Q

somatic symptom disorder

A

one or mor symptoms, distressing and disrupting, exessive thoughts about for at least 6 months

139
Q

conversion disorder

A

neuro symptom that cant be epxlained, clam and unconcerned

140
Q

illness anxiety

A

concern over aquiring an illness

141
Q

brain association with intermittent explosive disorder

A

low levels or serotonin in CSF

142
Q

types of anorexia

A
  1. restricting - acheived through diet, fasting and exercise

2. binging/purging - binges followed by vomiting

143
Q

anorexia vs bullemia

A

anorexia = very low weight, bullemia = normal weight

144
Q

only medication approved for bullemia

A

fluoxetine

145
Q

akathasia is treated with…

A

propranolol

Psychiatry (7 decks)

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