Pathology Flashcards
describe disruptive mood dysregulation disorder
onset before age 10.
severe, recurrent temper outbursts out of proportion to situation
child is irritable and angry in-between outbursts
describe intermittent explosive disorder
onset after age 6
recurrent verbal or physical outbursts representing a failure to control aggressive impulsives
outbursts < 30 mins, provide a sense of relief and feel remorseful afterwards
what part of the brain is affected in korsakoffs and what type of amnesia does it predominantly cause
antegrade amnesia (unable to form new memories)
limbic system mainly mammillary bodies and anterior thalamus
what is dissociative amnesia
unable to recall important personal information i.e. name after severe trauma or stress
what is dissociative identity disorder
presence of 2 or more distinct identities or personality states, typically with distinct memories and patterns of behaviour
diagnostic criteria for schhizophrenia
2 or more of the following symptoms of which 1 or more have to be from symptoms 1-3
delusions
hallucination
disorganized speech
disorganised or catatonic behaviour
negative symptoms
changes on imaging you may find in schizophrenia
ventriculomegaly on brain imaging
hormonal change in schizophrenia
reduced dopamine
increased serotonin
schizoaffective disorder
shares symptoms with both schizophrenia and mood disorders
must have psychotic symptoms for > 2 weeks without depressive or manic episode. if psychosis coincides with mood episode then = mood disorder with psychotic features
bipolar I vs bipolar II
bipolar I = 1 manic episode +/- hypomanic or depressive episode
bipolar II = a hypomanic and a depressive episode
diagnostic criteria for manic episode
marked functional impairment with 3 or more of the following for 1 week or more
DIG FAST
Distractibility
Impulsivity
Grandiosity
Flight of ideas
increased goal directed Activities / psychomotor Agitation
decreased need for Sleep
Talkativeness / pressured speech
illusion vs delucsion
illusion is a misperception of a real stimuli
hallucinations are perceptions in the absence of an external stimuli
side effects and contraindications to ECT
side effects; headache, retrograde or antegrade amnesia, disorientation
contraindications: none (safe in pregnancy and older adults)
what is adjustment disorder
emotional or behavioural symptoms that occur within 3 months of an identifiable psychosocial stressor lasting < 6 months after the stressor has been removed
symptoms of PTSD
hyperarousal
re-experiencing of event
avoidance of associated stimuli
change in cognition or mood
what is agoraphobia
irrational fear, anxiety and/or avoidance whilst anticipating 2 or more situations where they feels they may not be able to escape or help isnt available i.e. trains, elevators, queues, etc
what is trichotillomania
compulsively pulling out ones own hair. causes significant stress but persists despite attempts to stop.
malingering vs factitious disorder
malingering - consciously fakes symptoms etc to attain a specific secondary - external gain i.e. time off work
factitious- consciously creates a phsyical disorder in order to attain sick role and gain medical attention (primary - internal again)
what is conversion disorder
also called functional neurological symptom disorder
unexplained loss of motor or sensory function often following an acute stressor
biochemistry abnormalities seen in refeeding syndrome
low P04, Mg and K
complications associated with refeeding syndrome
electrolyte disturbance
cardiac complications
rhabodmylysis
seizures
biochemistry abnormalities seen in bulimia
low k, low Cl
metabolic alkalosis
pathophysiology of nacrolepsy
reduced orexin (hypocretin) production in lateral hypothalamus and dysregulated sleep-wake cycles
what are the stages in the transtheoretical model of change
precontemplation
contemplation
preparation/determination
action/willpower
maintenance
re-lapse
features of serotonin syndrome
3 A’s
increased Activity (i.e. seizures, clonus, tremor, hyperreflexia, hypertonia)
Autonomic intability (i.e. hyperthermia, diaphoresis, diarrhoea)
Altered mental status
1st line treatment for serotonin syndrome
benzodiazepines + supportive care
treatment for hypertensive crisis associated with MAO inhibitors
phentolamine
cause of hypertensive crisis
eating tyramine rich foods whilst taking MAO inhibitors or switching too quick to another antidepressant from MAO inhibitor without washout period
features of neuroleptic malignant syndrome
Malignant FEVER
myoglobinuria
fever
encephalopathy
vitals unstable
increased enzymes (CK)
muscle rigidity
treatment for neuroleptic malignant syndrome
dantrolene
dopaminergics i.e. bromocriptine, amantadine
cause of neuroleptic malignant syndrome
antipsychotics (typical > atypical) and genetic predisposition
treatment for acute dystonia
benztropine or diphenhydramine
