Personality Disorders + Schizophrenia Flashcards

1
Q

Cluster A PDs

A

Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder

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2
Q

Cluster B PDs

A

Borderline Personality Disorder
Narcissistic Personality Disorder
Histrionic Personality Disorder
Antisocial Personality Disorder

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3
Q

Cluster C PDs

A

Avoidant Personality Disorder
Dependant Personality Disorder
Obsessive-Compulsive Personality Disorder

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4
Q

Definition of PD

A

Chronic maladaptive behaviour + interpersonal problems
>2:
- cognition
- affectivity
- interpersonal function
- impulse control

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5
Q

General management

A

Clearly establish limits such as appt length
Look for medical + psych diagnosis with new symptoms
Limit use of benzos
Reflect + acknowledge own emotional responses
Address behaviours in a direct but non-threatening manner, co-create realistic goals, establish and maintain boundaries, continue relationship unless there is a risk

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6
Q

Sx management of anxiety, hostility + sensitivity

A

mesoridazine (phenothiazine)
haloperidol (APs)
thiothixene (APs)

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7
Q

Sx of Paranoid

A

SUSPECT
Spousal infidelity
Unforgiving
Suspicious of others
Perceives attacks
Enemy
Confiding in others is feared
Threats perceived

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8
Q

Sx of Schizoid

A

DISTANT
Detached
Indifferent
Sexual experiences of little interest
Tasks done alone
Absence of friends
Meither desires or enjoys relationships
Takes pleasure in few activities

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9
Q

Sx of Schizotypal

A

ME PECULIAR
Magic thinking/ odd beliefs
Experiences unusual perceptions
Paranoid ideation
Eccentric behaviour
Constricted affect
Unusual thinking/ speech
Lacks close friends
Ideas of reference
Anxiety in social situations
R/O psychotic

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10
Q

Sx of Antisocial

A

CORRUPT
Conforming to law lacking
Obligations ignored
Reckless disregard for safety
Remorseless
Underhanded
Planning insufficient
Temper

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11
Q

Sx of Histrionic

A

ACTRESS
Appearance focused
Centre of attention
Theatrical
Relationships considered more intimate than they are
Easily influenced
Seductive behaviours
Shallow emotions
Speech (vague)

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12
Q

Sx of Borderline

A

AM SUICIDE
Abandonment
Mood instability
Suicidal
Unstable/ intense relationships
Impulsivity
Control of anger
Identity disturbance
Dissociative
Emptiness

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13
Q

Sx of Narcisstic

A

SPEEECIAL
Special
Preoccupied with fantasies
Envious
Entitlement
Excess admiration required
Conceited
Interpersonal exploitation
Arrogant
Lacks empathy

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14
Q

Sz of Avoidant

A

AVOIDER
Avoids social type of work
Views self as inept
Occupied with fear or criticism
Inhibited in new relationships
Don’t get involved when uncertain of being liked
Embarrassment prevents new activities
Restraint within intimate relationships

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15
Q

Sx of Dependent

A

RELIANCE
Reassurance required
Expressing disagreement difficult
Life responsibilities assumed by others
Initiating projects difficult
Alone
Nurturance - needs support
Companionship sought
Exaggerated fears of being left alone

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16
Q

Sx Obsessive compulsive

A

OBSESSOR
Obsessed over details
Both miserly with self and others
Shows perfectionism that interferes with task completion
Excessively devoted to work
Super consciousness
Supervision required for delegated tasks
Object hoarder
Rigidity

17
Q

Ix for psychosis

A

Hemoglobin
White Blood Cell Count
Platelets
Creatinine
Fasting/Random Glucose
Blood Urea Nitrogen
Sodium
Potassium
Calcium
Albumin
Magnesium
TSH
AST
ALT
Alkaline Phosphotase
GGT
Vitamin B12
Ferritin
PTH
Urine Toxicology
Serum Toxicology
Fasting Lipids (if considering starting antipsychotic medications)

18
Q

DSM-V criteria schizophrenia

A

> 2 symptoms present for 1 month
- delusions
- hallucinations
- disorganized thinking/ speech
- negative symptoms
- disorganised or catatonic behaviour

19
Q

Complications of schizophrenia

A

Decreases lifespan by 15 years
Increased risk of CAD, DM, HTN, emphysema
Suicide risk
45% have SU disorder

20
Q

Ix of schizophrenia

A

CBC, lytes, renal, liver, TSH, FBG, lipids
Hepatitis, syphilis, HIV

21
Q

Monitoring for schizophrenia

A

Every 3 months
S+S
Functional impairment
Suicidal/ aggressive thoughts
SU
FBG, lipids, BMI + BP

22
Q

Management of schizophrenia

A

Family intervention
CBT offered to those that have not responded to AP
Social skills training
AP trial for min 2 weeks - once improvement seen, hold dose
Offer maintenance at lower dose for 2-5 years

23
Q

Ongoing management for schizophrenia

A

Positive + negative sx
Function + ADLs
Ideation of harm to self or others
Med compliance + SE
Substance use
Capacity
Psychosocial supports

24
Q

Approach to psychotic pts

A

Clearly communicate limits of confidentiality
Enquire about substance use
Ensure early treatment + FU
Determine if they meet criteria for involuntary treatment

25
Q

Sx control for lability, rejection, impulsivity, self-mutilation

A

SSRI

26
Q

Sx control for behavioural dyscontrol

A

carbamazepine

27
Q

Sx control for aggression

A

lithium

28
Q

Sx control for explosive behaviour

A

oxazepam

29
Q

1st episode of schizophrenia

A

2nd gen AP, maintain for 18mo, treat comorbid depression w/ SSRI, offer housing, family counselling, vocational rehab, financial support, admission, detox, referral to SW, check bHCG

30
Q

Negative sx of schizophrenia

A

flat affect, social withdrawal, anhedonia, avolition, poverty of speech

31
Q

Rx for NMS

A

stop offending med, IV NS, cooling blankets, ice packs, DVT prophylaxis

32
Q

Classes of meds to treat NMS

A

benzos for agitation, skeletal muscle relaxant (dantrolene), dopamine agonist (bromocriptine)