Pathology 4 Flashcards
Excessive dieting +/- purging, intense fear of gaining weight, body image distortion and increase exercise BMI <17kg/m
Anorexia nervosa
Severe weight loss, metatarsal stress fractures, amenorrhea, lanugo (fine body hair), anemia, and electrolyte disturbances.
Anorexia nervosa
binge eating +/- purging. Body weight usualy normal range
Bulemia nervosa
Ways to purge
Vomiting, laxative, diuretics or emetics
Parotitis, enamel erosion, electrolyte disturbances, alkalosis, dorsal hand calluses
Bulimia nervosa
Russell sign
Bulimia nervosa (callus on back of hands from inducing vomiting)
Strong, persistent cross-gender identification, persistent discomfort with one’s sex assigned birth
gender dysphoria
Desire to live as opposite sex, often through Sx or hormone tx
TransSEXualism
Paraphilia, not gender dysphoria, Wears clothes of opposite gender
TransVESTism (vest like clothing)
Screaming in the middle of the night during slow-wave sleep
Sleep terror disorder
excessive daytime sleepiness caused by decreased orexin production in lateral hypothalamus
Narcolepsy
hypnagogic
Hallucination just before falling asleep, associated with narcolepsy
Hypnopompic
Hallucinations just before waking, associated with narcolepsy
Cataplexy
loss of all muscle tone following a strong emotional stimulus like laughter
tx of narcolepsy
daytime stimulants like amphetamines, modafinil;
night time sodium oxybate (GHB)
Stages of change in overcoming substance addiction
Precontemplation (not acknowledging problem)
Contemplation (acknowledge problem)
Prep/Determination (getting ready to change behavior)
Action/willpower (changing behavior)
Maintenance (maintaining behavior change)
Relapse
Withdrawal symptoms from depressants
anxiety, tremor, seizures, insomnia
List of Depressants
Alcohol, Opioids, Barbituates, Benzodiazepines
Sensitive indicator of alcohol use
serum GGT, gamma-glutamyltransferase
Causes euphoria, respiratory and CNS depression, pinpoint pupils
Opioids
Overdose of Opioids
Seizures
Tx of Opioid OD
Naloxone and Naltrexone
Withdrawal symptoms of Opioids
Sweating, dilated pupils, piloerection (cold turkey), fever, rhinorrhea, yawning, stomach cramps, nausea, dairrhea
Treatment of Opioid Withdrawal
Long-term support, methadone, buprenorphine
Withdrawal of Barbituates
Delirium, life-threatening CV collapse
Barbituates vs Benzodiazepines, which has greater safety of margin
Benzodiazepines
tx of Benzodiazepine toxicity
Flumazenil
Withdrawal of Benzodiazepines
Sleep disturbannce, depression, rebound anxiety, seizure
Withdrawal of stimulant
crash, depression, lethargy, weight gain, HA
List of Stimulants
Amphetamines, cocaine, caffeine, nicotine
Euphoria, grandiosity, pupillary DILATION, prolonged wakefullness and attention, HTN, tachycardia, anorexia, paranoia, fever
Amphetamine
Withdrawal symptoms of amphetamines
anhedonia, increased appetite, hypersomnolence, existential crisis
impaired judgement, pupillary dilation, hallucinations (tactile), paranoid ideations, angina, cardiac death
Cocaine
Withdrawal symptoms of cocaine
Hypersomnelence, malaise, psychological craving, depression/suicide
Caffeine withdrawal
Lack of concentration, HA
Tx of Cocaine withdrawal
Benzodiazepines
Withdrawal symptoms of Nicotine
irritability, anxiety, craving
Tx of Nicotine
Nicotine patch, gum, lozenge, buproprion/varenicline
Belligerence, impulsiveness, fever, psychomotor agitation, analgesia, vertical and horizontal nystagmus
PCP intoxication
Homocidiality, delirium and seizures
PCP intoxication
PCP withdrawal
depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep
Perceptual distortion, depersonalization, anxiety, paranoia, psychosis, possible flashbacks
LSD intoxication
euphoria, anxiety, paranoid delusions, perceptino of slowed time, impaired judgement, social withdrawal, increased appetite, dry mouth, conjunctival injection, hallucinations
Marijauna (cannabinoid)
Tetrahydrocannabinol isomer
Dronabinol, an antiemetic and appetite stimulant
Marijuana Withdrawal
Irritability, depression, insomnia, nausea, anorexia (peak within 48hrs and last 5-6days)
detectable in urine for 4-10days
Users at increased risk for hepatitis, abscesses, overdose, hemorrhoids, AIDS, and right-sided endocarditis. Look for track marks
Heroin
Long-lasting oral opiate used for heroin detoxification or LT maintenance
Methadone
Partial agonist; long acting with fewer withdrawal symptoms than methadone.
Naloxone + buprenorphine
Long-acting opioid antagonist used for relapse prevention oce detoxified from heroin
Naltrexone
Disulfram
used to condition a patient from drinking alcohol, increases hangover symptoms
Confusion, ophthalmoplegia, and ataxia
Wernicke encephalopathy
irreversible memory loss, confabulation, personality change
Korsakoff psychosis
Associated with paraventricular hemorrhagenecrosis of mamillary bodies
Wernicke-Korsakoff Syndrome
Longitudinal partial thickness tear at GE jx caused by excessive vomiting
Mallory-Weiss Syndrome
Life-threatening alcohol withdrawal syndrome that peaks 2-5days after last drink.
Delirium Tremens
Symptoms of Delirium Tremens
tachycardia, tremors, anxiety, seizures, hallucinations, delusions, confusion
tx of Delirium tremens
Benzodiazepines
