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Clinical part B > Intro to Psychiatry > Flashcards

Intro to Psychiatry Flashcards

1
Q

negative psychosocial outcomes of bipolar disorder

A

suicidality
substance abuse
employment and family problems

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2
Q

what are bipolar patients often incorrectly diagnosed with

A

unipolar depression
anxiety
schizophrenia

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3
Q

common physical care problems seen in people with serious psychiatric disorders

A 
poverty 
unemplyment 
homelessness
violence
incarceration 
stigma 
lifestyle 
suicide
physical health
rising death rate
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4
Q

what happens to the life expectancy to people with schizophrenia

A

decreases

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5
Q

what contributes to the increased mortality in the mentally ill

A 
vulnerability genes 
smoking
obesity 
diet
sedentary 
diabetes
stress
polysubstance abuse
poverty 
isolation 
access to medical care
antipsychotic meds
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6
Q

people with schizophrenia are at an increased risk of what

A

CHD
smoking
diabetes
hypertension

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7
Q

how does disease alter neurotransmission

A

loss of neuronal plasticity
excitotoxicity
absence/excess/imbalance of neurotransmitters
wrong neuronal wiring

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8
Q

neurotransmitter sites of drug action

A 
NE 
serotonin 
dopamine
Ach 
GABA
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9
Q

which NT do you want to increase in depression

A

NE , 5HT, DA

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10
Q

which NT do you want to block in psychosis /schizophrenis

A

DA, 5HT

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11
Q

what do you wanna increase in bipolar affective disorder and anxiety

A

GABA

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12
Q

why is dopamine considered non selective

A

influences function of other NT pathways

inhibited by other neurotransmitters

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13
Q

what are some challenges of psychopharmacotherapy

A 
time for meds to start working 
effective regimen for patient 
management of adverse effects
drug interactions 
adherance
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14
Q

what are some factors affecting adherence to treatment

A 
insight into disease and need for medication 
personal belief about meds
therapeutic effects
management of adverse effects
complicated regimens
quality of therapeutic regimen
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15
Q

what to enhance adherence to treatment

A 
enhance education 
communication 
collaboration 
reminder systems 
med reviews
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16
Q

why might communicating with these patients be difficult

A 
emotionally not responsive 
may be slow to respond
decreased concentration 
agitated 
not interested
negativ outlook
17
Q

3 things that contribute to treatment effectiveness

A

adherence
efficacy
tolerability

18
Q

goals of treatment

A

non curative
acute: reduce and resolve symptoms
chronic: prevent recurrence
want to improve functioning

19
Q

what happens if youre deprived of REM sleep

A

less serotonin and NE synthesis
increased appetite, sexual activity, aggression, anxiety, depression
increase cortisol and stress hormones

20
Q

what is the result of poor nutrition

A

decreased NT synthesis, storage and release

21
Q

result of not exercising

A

decreased NT release

22
Q

result of high chronic stress

A

increase stres hormones and deplete NTs

23
Q

where can you go for diagnosis of mental disorders

A

DSM 4

24
Q

what is axis 1 in the multi axial assessment

A

all psychiatric diagnosis

25
Q

what is axis 2

A

personality disorders and mental retardation

26
Q

what is axis 3

A

general medication conditions

27
Q

what is axis 4

A

environmental and psychosocial stressors

positive and negative

28
Q

what is axis 5

A

global assessment of function - psychological, social, occupational scale of 1-100

29
Q

what are the 8 components of the mental status exam *

A

1 appearance

  1. speech
  2. mood, affect (emotional response)
  3. thinking
  4. perceptions (hallucinations)
  5. sensorium - MMSE
  6. insight
  7. judgement
30
Q

what are delusions

A

fixed false beliefs out of keeping with patients cultural background

31
Q

what is the mini-mental state examination (MMSE)

A

assess cognitive performance in a clinical setting
30 point scale
orientation, attention, memory, language

32
Q

what are the values for the severity of alzeihmers using the MMSE

A 
mild = 21-26
moderate = 10-2-
severe = <10
33
Q

whats in the psychiatric report

A 
history 
mental status exam 
diagnostic studies to be ordered
positive and negative findings
diagnosis 
prognosis 
recommendations
34
Q

what do rating scales show

A

objective description of the condition

snapshot - how theyre doing at that time

35
Q

whats the clinical global impression scale

A

observational

severity of illness and global improvement both on a 7 point scale

36
Q

what are the 2 schizophrenia rating scales

A

brief psychiatric rating scale (18 items)

positive and negative syndrome scale (PANSS) 30 items

37
Q

what are the depression rating scales

A

hamilton psychiatric rating scale for depression

beck depressive inventory

38
Q

describe the beck depressive inventory

A

patient rated

measure change due to treatment

39
Q

describe the hamilton psychiatric rating scale for depression

A

gold standard

clinician rated

Clinical part B (15 decks)

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