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First Aid STEP 1 - Psychiatry > Pathology 2 > Flashcards

Pathology 2 Flashcards

1
Q

What is Social Anxiety Disorder and what is the treatment?

A

Exaggerated fear of embarrassment in social situations (e.g. public speaking)

Treatment: SSRIs

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2
Q

What is agoraphobia?

A

exaggerated fear of open or enclosed places, using public transportation, being in line or in crowds, or leaving home alone

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3
Q

What is the time frame for Generalized Anxiety Disorder?

A

at least 6 months

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4
Q

What are symptoms associated with Generalized Anxiety Disorder?

A

sleep disturbance
fatigue
GI disturbance
difficulty concentrating

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5
Q

What are treatment options for Generalized Anxiety Disorder?

A

SSRI
SNRI
buspirone
CBT

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6
Q

What is Adjustment Disorder?

A

emotional symptoms causing impairment following an identifiable psychosocial stressor (e.g. divorce, illness) that lasts < 6 MONTHS

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7
Q

What is Obsessive-Compulsive Disorder and what is the treatment for it?

A

recurring intrusive thoughts, feelings, or sensations (obsessions) that cause severe distress

Tx: SSRIs, clomipramine

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8
Q

What is the difference between Post-Traumatic Stress Disorder and Acute Stress Disorder?

A

PTSD: disturbances > 1 month

Acute Stress Disorder: lasts b/t 3 days to 1 month

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9
Q

What are key components to distinguishing malingering?

A

CONSCIOUS act
chief goal is EXTERNAL (secondary gain)
Complaints CEASE after gain

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10
Q

What are key components to distinguishing factitious disorder?

A

CONSCIOUS act –> creates physical and/or psychological symptoms in order to assume “sick role”

chief goal is PSYCHOLOGICAL (primary gain)

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11
Q

What are signs of Munchausen Syndrome?

A

CHRONIC factitious disorder

Predominantly physical signs and symptoms

Multiple hospital admissions and willingness to receive invasive procedures

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12
Q

What is Manchausen Syndrome by proxy?

A

when illness in a child or elderly patient is caused by the caregiver

*form of child/elder abuse

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13
Q

Compare and contrast the Somatic Disorders

A

Somatic Disorder: category of disorders characterized by physical symptoms with no identifiable physical cause.

Somatic Symptom Disorder: variety of complaints in one or more organ systems lasting from months to years. Associated with excessive, persistent thoughts and anxiety about symptoms

Conversion Disorder: sudden loss of sensory or motor function (e.g. paralysis, blindness) often following an acute stressor. More common in females, adolescents, and young adults.

Illness Anxiety Disorder (hypochrondriasis): preoccupation with and fear of having a serious illness despite medical evaluation and reassurance

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14
Q

How does a somatic disorder differ from malingering or factitious disorder?

A

somatic disorder = UNCONSCIOUS action (Sx cannot be intentionally produced or feigned)

malingering or factitious disorder = CONSCIOUS action

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15
Q

What are the three clusters of personality disorders?

Think the “Three W’s”

A

Weird
Wild
Worried

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16
Q

What personality disorders are in Cluster A?

A

WEIRD

Definition: odd or eccentric, inability to develop meaningful social relationships

Paranoid, Schizoid, Schizotypal

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17
Q

What is the definition of Paranoid?

A

pervasive distrust and suspiciousness (e.g. believing in conspiracy theories)

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18
Q

What is the major defense mechanism in paranoia?

A

projection

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19
Q

What is the definition of Schizoid?

A

VOLUNTARY social withdrawal

limited emotional expression

SchizoiD = Distant

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20
Q

What is the definition of Schizotypal?

A

eccentric apperance

ODD BELIEFS or MAGICAL thinking

SchizoTypal = magical Thinking

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21
Q

What personality disorders are in Cluster B?

A

WILD: dramatic, emotional, or erratic; genetic association with mood disorders and substance abuse

antisocial, borderline, histrionic, narcissistic

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22
Q

What is the definition of Antisocial Disorder?

A

disregard for and violation of rights of others

M > F

Must be > 18 years old and have a history of conduct disorder before age 15

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23
Q

What is the definition of Borderline Personality Disorder?

A

unstable mood or interpersonal relationships, impulsiveness, SELF-MUTILATION, bordem

F > M

SPLITTING = major defense mechanism

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24
Q

What is the major defense mechanism in Borderline Personality Disorder?

A

splitting

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25
Q

What is the definition of Histrionic Personality Disorder?

A

excessive emotionality and excitability, attention seeking, SEXUALLY PROVOCATIVE, overly concerned with appearance

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26
Q

What is the definition of Narcissistic Personality Disorder?

A

grandiosity, SENSE OF ENTITLEMENT
lacks empathy and requires excessive admiration
reacts to criticism with rage

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27
Q

What personality disorders are in Cluster C?

A

WORRIED: anxious or fearful; genetic association with anxiety disorders

Avoidant, Obsessive-Compulsive, Dependent

28
Q

What is the definition of Avoidant Personality Disorder?

A

HYPERSENSITIVE to REJECTION
socially inhibited, timid, feelings of inadequacy
DESIRES RELATIONSHIPS WITH OTHERS (vs. schizoid)

29
Q

What is the definition of Obsessive-Compulsive Personality Disorder?

A

Preoccupation with order, perfectionism, and control

Behavior CONSISTENT with one’s own beliefs and attitudes (vs. OCD)

30
Q

What is the definition of Dependent Personality Disorder?

A

SUBMISSIVE and CLINGING

Excessive need to be taken care of, low self-confidence

31
Q

What is the time course for Schizophrenia?

A

< 1 mo - brief psychotic disorder, usually stress related
1 - 6 mo - schizophreniform disorder
> 6 mo - schizophrenia

32
Q

What are the degrees of “schizo-“?

A

schizoid < schizotypal < schizophrenic < schizoaffective

33
Q

What is the definition of Anorexia nervosa?

A

excessive dieting +/- purging

intense fear of gaining weight, body image distortion, and increased exercise

34
Q

What are symptoms of Anorexia nervosa?

A 
severe wt loss
metatarsal stress fractures
amenorrhea
lanugo (fine body hair)
anemia
electrolyte disturbances
OSTEOPOROSIS over time
35
Q

What is the definition of Bulimia nervosa?

A

binge eating +/- purging

*body wt is maintained within NORMAL RANGE

36
Q

What are symptoms associated with Bulimia nervosa?

A

parotitis, enamel erosion, electrolyte disturbances, alkalosis, dorsal hand calluses from induced vomiting (Russell sign)

37
Q

What is the Russell sign and what disorder is it seen in?

A

dorsal hand calluses from induced vomiting –> bulimia nervosa

38
Q

What is the definition of Gender Dysphoria?

A

strong, persistent cross-gender identification

39
Q

What are causes of sexual dysfunction?

A

Drugs (e.g. hypertensives, neuroleptics, SSRIs, ethanol)
Diseases (e.g. depression, diabetes, STDs)
Psychological (e.g. performance anxiety)

40
Q

What stage of sleep do sleep terrors occur?

A

non-REM sleep (no memory of arousal)

*this is different from nightmares which occur during REM sleep

41
Q

What is the cause of narcolepsy?

A

decreased orexin production in lateral hypothalamus –> excessive daytime sleepiness

42
Q

Cataplexy can be seen in some narcoleptics. What is cataplexy?

A

loss of all muscle tone following a strong emotional stimulus, such as laughter

43
Q

What is the treatment for narcolepsy?

A

stimulates and SSRIs

44
Q

What are the stages of change in overcoming substance addiction?

A
  1. Precontemplation
  2. Contemplation
  3. Preparation/determination
  4. Action/willpower
  5. Maintenance
  6. Relapse
45
Q

What are symptoms of alcohol withdrawal?

A

Mild alcohol withdrawal: anxiety, insomnia

Severe alcohol withdrawal: autonomic hyperactivity and delirium tremens (DTs), alcoholic hallucinosis

46
Q

What is the treatment for delirium tremens?

A

benzodiazepines

47
Q

What are symptoms of opioid intoxication?

A

euphoria
respiratory and CNS depression
pinpoint pupils
seizures (OD)

48
Q

What is the treatment for opioid intoxication?

A

naloxone (used for acute)

naltrexone (used for management)

49
Q

What are symptoms of opioid withdrawal?

A

sweating, dilated pupils, PILOERECTION, fever

rhinorrhea, YAWNING, nausea, stomach cramps, diarrhea (“FLU-LIKE” SYMPTOMS)

50
Q

What is the treatment for barbiturate intoxication?

A

symptom management (assist respiration, increase BP)

51
Q

What is the treatment for benzodiazepine intoxication?

A

supportive care

consider FLUMAZENIL (competitive benzodiazepine antagonist)

52
Q

Do barbiturates or benzodiazepines have a greater safety margin?

A

benzodiazepines

53
Q

What are symptoms of amphetamine intoxication?

A

euphoria, grandiosity
pupillary DILATION
prolonged wakefulness and attention
HTN, tachycardia, anorexia, paranoia, fever

Severe: cardiac arrest and seizure

54
Q

What are symptoms of cocaine intoxication?

A 
impaired judgement
pupillary DILATION
HALLUCINATIONS
paranoid ideations
angina, sudden cardiac death

Treatment: benzodiazepines

55
Q

What are treatments for nicotine withdrawal?

A

Sx: irritability, anxiety, craving

Tx: nicotine patch, gum, or lozenges; buproprion/ varenicline

56
Q

What are signs of PCP (phencyclidine) intoxication?

A 
belligerence, impulsiveness 
fever, motor psychomotor agitation
VERTICAL AND HORIZONTAL NYSTAGMUS
tachycardia
HOMICIDALITY
psychosis, delirium, seizures

*pupils are NORMAL

57
Q

What are the treatment options for PCP intoxication?

A

benzodiazepines

rapid-acting antipsychotics

58
Q

What are the signs of LSD (lysergic acid diethyl amide) intoxication?

A

HALLUCINATIONS (visual, auditory)
depersonalization, anxiety, paranoia
psychosis, possible flash backs
pupillary DILATION

*very FEW behavioral changes

59
Q

What medical uses can a patient use for marijuana?

A 
antiemetic (chemotherapy)
appetite stimulant (AIDS)
60
Q

How long can cannabinoid be detected in the urine?

A

Generally detectable in urine for 4-10 days

61
Q

Heroin users are at increased risk of what diseases and conditions?

A 
hepatitis
abscesses
OD
hemorrhoids
AIDS
right-sided endocarditis
62
Q

What are the treatment options for heroin users?

A

methadone
naloxone + buprehnorphine
naltrexone

63
Q

What is a long-acting opiate used for heroin detoxification or long-term maintenance?

A

methadone

64
Q

What is a partial agonist that has fewer withdrawal symptoms than methadone in heroin users?

A

naloxone + buprenorphine

65
Q

What is a long-acting opioid antagonist used for relapse prevention once detoxified from heroin?

A

naltrexone

66
Q

What are delirium tremens (DTs) and what is the treatment?

A

life-threatening alcohol withdrawal syndrome that peaks 2-5 days after last drink

Order of symptom appearance: autonomic system hyperactivity (tachycardia, tremors, anxiety, and seizures) –> psychotic symptoms (hallucinations, delusions) –> confusion

Tx: benzodiazepines (e.g. chlordiazepoxide)

First Aid STEP 1 - Psychiatry (4 decks)

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