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Psychiatry > general > Flashcards

general Flashcards

1
Q

delirium
ophthalmoplegia
ataxia

A

Wernicke encephalopathy (EtOH, thiamine deficiency)

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2
Q

CAGE

A 
Cut down on drinking?
Annoyed by someone criticizing drinking?
Guilty about drinking?
Eye opener?
yes to 2 or more
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3
Q

stages of EtOH withdrawal symptoms

A 
jitteriness, tremulousness (6-8 hrs)
psychosis, perceptual symptoms (8-12 hrs)
sz (12-24 hrs)
delirium tremens (24-72 hrs)
- can be fatal
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4
Q

Ddx for EtOH withdrawal

A

pheo
thyroid storm
inappropriate use of beta-agonist inhalers or sympathomimetics

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5
Q

anxiety
sweating
intolerance of loud noises or light
muscle twitching

A 
bento withdrawal (later sz)
- can be life threatening
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6
Q

anxiety
irritability
hypersomnolence
fatigue

A

cocaine withdrawal

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7
Q

reduced regional brain volume
enlarged cerebral ventricles
altered dopamine function

A

schizophrenia

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8
Q

schizophrenia vs. schizoaffective vs. schizophreniform

A
  • schizophrenia > 6 mo, schizophreniform
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9
Q

schizophrenia age of onset

A

early 20s for men, late 20s for women

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10
Q

negative symptoms of schizophrenia

A 
flattened affect (little emotion), allege (lack of words), asociality 
- absence of normal social/mental functions
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11
Q

positive symptoms of schizophrenia

A

hallucinations, delusions, bizarre behavior

- addition of unusual thoughts, perceptions, behaviors

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12
Q

schizophrenia subtypes

A

paranoid, catatonic, disorganized, undifferentiated, residual

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13
Q

hyperthermia (fever)
mm. rigidity
autonomic instability

A

neuroleptic malignant syndrome

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14
Q

how long does an untreated major depressive episode last?

A

6-12 months

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15
Q

pressured speech
racing thoughts/flight of ideas
easy distractibility, etc.

A

mania

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16
Q

difference between bipolar I and II

A

I has mania, II has hypomania

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17
Q

oscillation between hypomania and dysthymia

A

cyclothymic disorder

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18
Q

specific phobia dx

A

duration of > 6 mo
insight into excessiveness of fear
impairs everyday activities/relationships

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19
Q

social phobia criteria (social anxiety disorder)

A

fear, insight, avoidance, impairment
greater than > 6 mo
not related to medical condition if applicable (i.e.: psoriasis but fear of voice cracking)

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20
Q

restlessness, pacing, jitteriness in pt with new medication

A

akathisia (side effect of antipsychotic)

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21
Q

defense mechanism for paranoid personality disorder

A

projection

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22
Q

schizoid personality disorder defense mechanism

A

fantasy

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23
Q

borderline personality disorder defense mechanism

A

splitting; acting out

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24
Q

histrionic personality disorder defense mechanism

A

dissociation

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25
Q

ocd personality disorder defense mechanism

A

isolation

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26
Q

emotionally detached, aloof
loner
difficulty expressing/experiencing emotion
* do not desire relationships

A

schizoid personality disorder

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27
Q

odd thoughts, affect, perception, beliefs
few relationships
+/- paranoia

A

schizotypal personality disorder

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28
Q

clusters A,B,C personality disorders

A

A: weird (paranoia, schizoid, schizotypal) (accusatory, aloof, awkward)
B: wild (antisocial, borderline, histrionic, narcissisitic)
C: worried (avoidant, dependent, OCD) (cowardly, compulsive, clingy)

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29
Q 
disregard for rules/laws of society
explotative
lie frequently
impulsive, aggressive
no remorse
A

antisocial personality disorder

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30
Q

reversible causes of dementia

A

NPH, B12 deficiency, hypothyroid, neurosyphilis, HIV

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31
Q

time course

A 
delusional disorder:  > 1 mo
manic episode:  > 1 wk or psychotic symptoms or hospitalization 
cyclothymic disorder: > 2 yrs
MDD: > 2 wk
dysthymia:  > 2 yrs adult, > 1 yr kids
GAD: > 6 mo
32
Q

when to use ECT

A 
MDD refractory to meds
pregnant women
acutely suicidal
depression c psychotic features
catatonia
33
Q

suffix for typical antipsychotics

A

haloperidol + “-azine”

34
Q

suffix for TCA

A

“-iptyline” or “-ipramine”

35
Q

medical conditions that can cause mania

A

Huntington’s, Wilson’s, CVA, cerebral neoplasm or trauma, encephalitis, MS, epilepsy, hyperthyroid, uremia, B12 deficiency

36
Q

in adolescence, mania is often accompanied by….

A

psychotic features

37
Q

child defiantly opposes wishes of others and breaks minor rules

A

oppositional defiant disorder

38
Q

presentation of MDD in elderly

A

usual MDD S/S +/-:

  • transient cognitive impairments reversible c tx
  • poor effort during the interview
  • good insight into intellectual difficulties (vs. dementia)
39
Q

medical conditions that present with anxiety

A

Graves, PE, hyperthyroid, Sjogren, some seizures

40
Q

comorbidites with GAD

A

other anxiety disorders (panic, phobias)
MDD or dysthymic disorder
substance use disorders

41
Q

depressed mood/hopelessness
irritability
insomnia
racing thoughts

A

think bipolar mixed state

42
Q

a few drugs that can cause manic-like behavior

A

corticosteroids
levodopa
stimulants (ie: cocaine)

43
Q

olfactory, gustatory hallucinations (new onset)

A

consider psychosis caused by a general (non psychiatric) medical condition

44
Q

timeline for acute stress disorder vs. PTSD

A

ASD: 4 weeks

45
Q

timeline for postpartum blues

A

peaks within 3-5 days after delivery

resolves 7-14 days

46
Q

biggest risk factor for postpartum depression

A

prior history of MDD (especially postpartum)

47
Q

common co-morbid condition with postpartum psychosis

A

bipolar disorder

48
Q

miosis, slurred speech, drowsiness

A

opioid intoxication

49
Q

nystagmus, HTN, mm. rigidity

A

phencyclidine intoxication

50
Q

conjunctival injection, increased appetite, dry mouth

A

cannabis intoxication

51
Q

fatigue, increased appetite, vivid and unpleasant dreams

A

cocaine intoxication

52
Q

autonomic hyperactivity, GI distress, mm. aches, yawning, goose flesh, sensitivity to touch and light

A

opioid withdrawal

53
Q

Tarasoff court case

A

clinical providers have a duty to warn and protect potential victims if pt has threatened to harm them regardless of pt confidentiality

54
Q

M’Naghten

A

a person is not responsible for a criminal act if they have a mental illness or mental retardation and do not understand the nature of the criminal act or do not realize that the criminal act is wrong

55
Q

side effect profile: anticholinergic effects

A

atypical antipsychotics or TCAs

56
Q

side effect profile: coarse tremor, confusion, ataxia, and diarrhea

A

lithium toxicity

57
Q

atypical features of MDD with atypical features

A

2 of the following: increased appetite or weight gain, hypersomnia, leaden paralysis, and a long-standing pattern of extreme sensitivity to perceived interpersonal rejection

58
Q

chronic pattern of behavior that includes excessive emotionality, superficiality despite a typical claim of having multiple intimate relationship, dramatic and provocative behavior, and inappropriate flirtation

A

histrionic personality disorder

59
Q

This disorder involves a reversible memory impairment in which memories of personal experience cannot be retrieved in a verbal form

A

dissociative amnesia

60
Q

amnesia for one’s identity coupled with sudden unexplained travel away from home

A

dissociative fugue

61
Q

pt feels sad and hopeless when alone, lacks self-confidence, and has great difficulty making decisions

A

dependent personality disorder

62
Q

physical complication of cocaine intoxication

A

chest pain from coronary vasospasm

63
Q

hallmark of delirium

A

fluctuation in the level of consciousness

64
Q

hallmark of delirium

A

fluctuation in the level of consciousness

65
Q

inflexibility, emotionally constricted, stubborn, orderly, miserly, serious, over devoted to work but trouble making deadlines

A

obsessive-compulsive personality disorder

66
Q

inflexibility, emotionally constricted, stubborn, orderly, miserly, serious, over devoted to work

A

obsessive-compulsive personality disorder

67
Q

common comorbid psych disorder with antisocial personality disorder

A

substance abuse

68
Q

dx of antisocial personality disorder

A

only made after age 18

- but a conduct disorder with onset before 15 must be present

69
Q

insomnia, paranoia, visual hallucinations in elderly pt with dementia

A

think Lewy body disease

70
Q

difference between oppositional defiant disorder and conduct disorder and antisocial personality disorder

A
  • ODD offenses do not typically cause significant harm to others like CD
  • APD diagnosed after 18yo
71
Q

schizoaffective disorder

A

combo of depressed mood and psychosis that occur with and also without each other (vs. MDD with psychotic fx that always occur together)
- types: depressed, bipolar

72
Q

dx of ADHD

A

at least 6 mo
begins before age 7
present in more than one setting (home, school, etc.)

73
Q

hallmark of hypochondriasis

A

belief that pt has a serious medical disorder (vs. focus on symptoms like somatization disorder)

74
Q

factitious disorder vs. malingering

A

both conscious (vs. somatization/pain)
factitious - motivation is to assume sick role
malingering - secondary gain motivation

75
Q

sleep terror disorder vs. nightmares

A

in sleep terror disorder pt cannot recall dream and events occur in delta (vs. REM) sleep

76
Q

dx tourette

A

presence of both motor and vocal tics
> 1 year
onset before 18 yo

77
Q

dx criteria for mental retardation

A
  • IQ

Psychiatry (4 decks)

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