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First Aid STEP 1 - Psychiatry > Pathology > Flashcards

Pathology Flashcards

1
Q

The 4 W’s: Weak, Wordless, Wanting (socially), and Wary are descriptive of what psychiatric pathology?

A

Infant Deprivation Effects

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2
Q

Spiral fractures are highly suggestive of what?

A

child abuse

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3
Q

What are signs of sexual abuse?

A

genital, anal, or oral trauma
STIs
UTIs

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4
Q

Who is usually the physical abuser or a child?

A

biological mother

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5
Q

What is usually the sexual abuser of a child?

A

known to victim, usually male

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6
Q

What is the MC form of child maltreatment?

A

child neglect

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7
Q

If suspicious, what MUST a physician report to child protective services?

A

child abuse AND child neglect

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8
Q

At what age must ADHD be diagnosed?

A

onset before age 12

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9
Q

What are findings of a patient with ADHD?

A

hyperactivity
impulsivity
inattention in multiple settings
NORMAL intelligence

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10
Q

What is the treatment for ADHD?

A

methylphenidate
amphetamines
atomoxetine
behavioral interventions (reinforcement, reward)

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11
Q

After age 18, those that have conduct disorder will meet the criteria for which diagnosis?

A

antisocial personality disorder

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12
Q

What is oppositional defiant disorder?

A

enduring pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social norms

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13
Q

What age is Tourette Syndrome diagnosed?

A

onset before age 18

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14
Q

What is the time frame that Tourette Syndrome must reach before its diagnosis?

A

> 1 year

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15
Q

What is the treatment for Tourette Syndrome?

A

antipsychotics and behavioral therapy

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16
Q

At what age is separation anxiety disorder typically seen?

A

ages 7-9 years

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17
Q

What is the treatment for separation anxiety disorder?

A

SSRIs and relation techniques/behavioral interventions

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18
Q

What are findings of a person with autism?

A

poor social interactions
communication deficits
repetitive/ritualized behaviors
restricted interests

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19
Q

When must autistic tendencies first present

A

MUST present in early childhood

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20
Q

Is autism for prevalent in boys or girls?

A

boys

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21
Q

What are findings of a person with Rett Disorder?

A 
loss of development
loss of verbal abilities
intellectual disability
ataxia
stereotyped hand-wringing
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22
Q

When do symptoms of Rett Disorder typically arise?

A

ages 1-4 years

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23
Q

Is Rett Disorder more often seen in boys or girls

A

almost exclusively in girls

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24
Q

What NT are seen in Alzheimer disease?

A

decrease in ACh

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25
What NT are seen in anxiety?
increase in NE | decrease in GABA and 5HT
26
What NT are seen in depression?
decrease in NE, 5HT, and DA
27
What NT are seen in Huntington disease?
increase in DA | decrease in GABA and ACh
28
What NT are seen in Parkinson disease?
decrease in DA | increase in 5HT and ACh
29
What NT are seen in Schizophrenia?
increase in DA
30
What is the order of loss of orientation?
1st - time 2nd - place 3rd - person
31
What is an example a disease that causes anterograde amnesia?
Korsakoff Syndrome classic anterograde amnesia caused by thiamine deficiency and the associated destruction of mammillary bodies *most often seen in EtOHics and associated with confabulations
32
What are signs of a patient with delirium?
``` "waxing and waning" level of consciousness disorganized thinking hallucinations illusions misperceptions cognitive dysfunction ```
33
What are causes of delirium?
Usually SECONDARY to other illness e.g. CNS disease, infection, withdraw, metabolic disturbance, hemorrhage
34
What is the treatment of delirium?
1. identify and address underlying cause 2. optimize brain condition 3. antipsychotics (mainly haloperidol)
35
What is a major difference between delirium and dementia?
delirium = ACUTE, loss of consciousness, EEG ABNORMAL dementia = PROGRESSIVE decline, NO loss of consciousness, EEG normal
36
What are signs of dementia?
``` memory deficits aphasia apraxia agnosia loss of abstract thought behavioral/personality changes impaired judgementq ```
37
What are REVERSIBLE causes of dementia?
``` NPH vitamin B12 deficiency hypothyroidism neurosyphilis HIV (partially) ```
38
What is the difference between hallucinations and delusions?
hallucinations - PERCEPTIONS in the absence of external stimuli (e.g. seeing a light that is not actually present) delusions - unique, false BELIEFS about oneself or others that persist despite the facts (e.g. thinking aliens are communicating with you)
39
Visual hallucinations are more commonly a feature of medical or psychiatric illnesses?
medical illnesses (e.g. drug intoxication)
40
Auditory hallucinations are more commonly a feature of medical or psychiatric illnesses?
psychiatric illness (e.g. schizophrenia)
41
Olfactor hallucinations are often associated with what conditions?
psychomotor epilepsy and brain tumors
42
Tactile hallucinations are often associated with what conditions?
alcohol withdrawal and cocaine users
43
What are the subtypes of schizophrenia?
brief psychotic disorder: < 1 month schizophreniform disorder: 1 - 6 months schizoaffective disorder: at least 2 wks
44
What are the criteria to diagnose schizophrenia?
``` delusions hallucinations - often auditory disorganized speech disorganized behavior "negative symptoms" - flat affect, social withdrawal, lack of motivation or thought ``` **Patient at increased risk for SUICIDE
45
When does schizophrenia typically present in men and women?
men: early 20s women: late 20s to early 30s
46
What is the definition of delusional disorder?
fixed, persistent, untrue belief system lasting > 1 MONTH *Functioning otherwise NOT IMPAIRED
47
What is the definition of a dissociative identity disorder?
presence of 2 or more distinct identities or personality states more common in women Associated with many disorders or past events such as sexual abuse, PTSD, depression, etc.
48
What is depersonalization/derealization disorder?
persistent feelings of detachment or estrangement from one's own body, thoughts, perceptions, and actions (depersonalization) or one's environment (derealization)
49
How long do symptoms need to occur before a patient can be diagnosed with a "manic episode"
lasting at least 1 week
50
The diagnosis of a manic episode requires at least 3 of the following..
"manics DIG FAST" ``` Distractibility Irresponsibility Grandiosity Flight of ideas Agitation Sleep (decreased need) Talkativeness or pressured speech ```
51
How long do hypomanic episodes occur?
at least 4 days with less severe mood disturbances than a manic episode
52
What is the difference between Bipolar I and Bipolar II?
Bipolar I: presence of at least 1 manic episode with or without a hypomanic or depressive episode Bipolar II: presence of a hypomanic and a depressive episode
53
What is the treatment for bipolar disorder?
``` mood stabilizers (lithium, valproic acid, carbamazepine) atypical antipsychotics ```
54
What is cyclothymic disorder?
dysthymia and hypomania (a milder form of bipolar disorder LASTING AT LEAST 2 YEARS)
55
What are the 9 symptoms that can be associated with major depressive disorder?
SIG E CAPS Sleep disturbance loss of Interest Guilt or feelings of worthlessness Energy loss and fatigue Concentration problems Appetite/weight changes Psychomotor retardation or agitation Suicidal ideations *Requires at least 5 of the 9
56
How long do major depressive disorder episodes usually last?
6-12 months
57
What is Persistent Depressive Disorder (Dysthymia)?
depression, often milder, lasting AT LEAST 2 YEARS
58
What is the best treatment for Seasonal Affective Disorder?
full-spectrum bright-light exposure
59
What is the most common subtype of depression?
Atypical Depression
60
What are signs of maternal (postpartum) "blues" and what is the time frame within which they appear and resolve?
start 2-3 days after delivery --> resolves within 10 days depressed affect, tearfulness, and fatigue
61
What are signs of postpartum depression and what is the time frame within which they appear and resolve?
start within 4 weeks after delivery --> lasts 2 weeks to 1 year or more depressed affect, anxiety, and poor concentration
62
What is the treatment for postpartum depression?
antidepressants | psychotherapy
63
What are signs of postpartum psychosis and what is the time frame within which they appear and resolve?
Lasts days to 4-5 weeks delusions, hallucinations, confusion, and possible homicidal/suicidal ideas or attempts
64
What is the treatment for postpartum psychosis?
antipsychotics antidepressants possible inpatient hospitalization assessment of child safety
65
What are signs of pathologic grief?
excessively intense grief prolonged grief lasting > 6-12 months grief that is delayed, inhibited, or denied may also experience delusions and hallucinations
66
When is electroconvulsive therapy most often used as a treatment?
major depressive disorder and for pregnant women with major depressive disorder
67
What are the risk factors for suicide completion?
SAD PERSONS Sex (male) Age (teenager or elderly) Depression ``` Previous attempt loss of Rational thinking Sickness (medical illness) Organized plan No spouse Social support lacking ``` *women try more often, men succeed more often
68
What are disorders under the umbrella of anxiety disorder?
panic disorder phobias generalized anxiety disorder
69
What is needed for a definitive diagnosis of a panic disorder?
1 month (or more) of 1 (or more) of the following: persistent concern of additional attacks worrying about consequences of the attack behavioral change related to attacks
70
What is the treatment for panic disorder?
CBT SSRIs venlafaxine benzodiazepines

First Aid STEP 1 - Psychiatry (4 decks)

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