HBM 06a: Psychosomatic Medicine Flashcards
List some psych factors that can affect medical treatment.
- Mental/psych disorder (like psychosis or depression)
- Poor health behavior
- Stress (physiological response)
- Personality traits
- Coping styles
Retirement is (low/moderate/high/very high) on stress level scale.
High
Changing residence is (low/moderate/high/very high) on stress level scale.
Low
Divorce is (low/moderate/high/very high) on stress level scale.
Very high
Job loss is (low/moderate/high/very high) on stress level scale.
High
Child leaving home is (low/moderate/high/very high) on stress level scale.
Moderate
Taking out mortgage is (low/moderate/high/very high) on stress level scale.
Moderate
AIDS can present with which psych symptom(s)?
Depression, Mania
Multiple Sclerosis can present with which psych symptom(s)?
Depression, Mania
Anemia can present with which psych symptom(s)?
Anxiety
Huntington’s Disease can present with which psych symptom(s)?
Depression, Personality change, Mania
Chronic pain is pain that’s lasted at least (X) (days/weeks/months/years).
X = 3 months
Ability to tolerate pain is decreased by (X) in adulthood and (Y) in childhood.
X = depression, anxiety, life stress Y = physical and sexual abuse
T/F: Ability to tolerate pain is independent of cultural or religious factors.
False
T/F: Infants and children feel pain and remember pain as much as adults do.
True
Which NT implicated in the experience of pain?
Serotonin and Glu
List the way(s) that (X) psych medication can relieve pain in patients with chronic pain.
X = antidepressants
- Directly stimulate efferent inhibitory pain pathways
- Indirectly relieve pain by relieving depression symptoms
Presentation of first episode of psych disorder in persons (younger/older) than (X) should occasion an aggressive medical workup before assuming that the disorder is primarily psychiatric.
Older;
X = 50
(X)% of adults with mental disorders have medical conditions.
X = 68
(X)% of adults with medical conditions have mental disorders.
X = 29
(X)% of adult population has mental disorders.
X = 25
(X)% of adult population has medical conditions.
X = 58
How do psych, behavioral, social processes impact health/function?
- Affect basic biological processes (leading to illness/disease)
- Maladaptive health behaviors put people at risk for certain physical disorders
A stressful situation/event is one in which person feels (X).
X = overwhelmed (can’t cope)
Peak performance is achieved at (low/moderate/high) stress levels.
Moderate
Depression is seen in (low/moderate/high) stress situations.
Low (boredom)
Sources of stress tend to be (internal/external).
Both!
Rules/regulations can be source of (internal/external) stress.
External
Rigid thinking can be source of (internal/external) stress.
Internal
Starting med school can be source of (internal/external) stress.
External
Losing a job can be source of (internal/external) stress.
External
Poor diet/sleep can be source of (internal/external) stress.
Internal
T/F: All people with high scores on stress scale become ill.
False
General adaptation syndrome, introduced by (X), describes:
X = Hans Selye
Stages that body undergoes, to maintain homeostasis, in response to stress
List stages in body’s response to stress.
- Alarm stage (fight/flight)
- Resistance stage
- Exhaustion stage
In Alarm Stage, the body releases (X) substances to provide (Y).
X = NE, cortisol, noradrenaline Y = instant E
Effect of excess adrenaline:
High BP (damage blood vessels in heart/brain); risk for MI and stroke
Effect of excess production of cortisol:
Damage to cells/muscle tissues
T/F: In Resistance Stage, hormone levels return to normal, but your body remains in state of arousal.
True
In Exhaustion Stage, (X) has continued and (Y) has gone.
X = source of stress Y = ability to resist
Decreasing stress is possible by changing:
- Lifestyle habits
- Approach to stressful situations
- Our thoughts
T/F: Avoidance is one healthy coping style to deal with stressful situations.
False
Three most common behaviors that place us at risk in long term for physical disorders.
- Smoking
- Lack of X
- Over-eating
What are the stages in the Stages of Change Model?
- Pre-contemplation
- Contemplation
- Preparation
- Action
- Maintenance
In motivational interviewing (MI), the clinician should aim to strengthen:
Patient’s own motivation for/commitment to change
T/F: Delirium is always secondary.
True
Delirium is defined as:
Sudden, severe confusion with rapid brain function changes
Delirium is common in which setting(s)?
Surgical and intensive care
Delirium in ICU patients is a risk factor for:
6 month mortality
List interventions for ICU delirium.
- Avoid over-sedation
- Wake up and breathe
- Early mobility
- Cognitive rehab
Vit B12 or D deficiencies can appear like which psych issue?
Depression
Overactive thyroid can appear like which psych issue?
Anxiety
Opium is derived from which plant?
Poppy flower
About (X)% of veteran patients have pain as their most common complaint to primary care providers.
X = 50
Henry Knowles Beecher observed that:
WWII soldiers with serious wounds complained less of pain than MGH post-op patients
The pain cycle involves:
Pain going to Distress going to Disability and back to Pain
(Children/adults) have a pain that’s more “plastic” (more influenced by psychosocial factors)
Children
T/F: Distraction techniques are beneficial for helping children deal with pain.
True
T/F: Relaxation techniques are helpful for adults, but not children, in dealing with pain.
False - children as well
T/F: Older adults tend to deal/cope better with pain than teens/young adults.
True
One of the easiest methods to learn how to relax/reduce pain is:
Relaxation training (learning how to breathe)
Cognitive restructuring is important in that it teaches patient to :
- Recognize maladaptive thoughts
- Challenge those thoughts
- Substitute them for adaptive thoughts
