PP Clues Psychiatry Flashcards
How is major depression diagnosed?
need 5 “SIGE CAPS” >2wks
Sleep disturbances: wake in early am
Interest/Libido loss
Guilt
Energy loss
Concentration loss
Appetite loss
Psychomotor agitation
Suicide: hopelessness
depression treatment
approaches
psychotherapy
eg:
1. Lifestyle modification
2.CBT, psychodynamic …
3..Pharm
depresion pharm
SSRIs (often trialed first),
SNRIs,
atypical antidepressants bupropion and mirtazapine
depression
SSRI
fluoxetine
Sertraline
Citalopram
Excitalopram
sexual advese effect
depression pharm
SNRIs
Venlafaxine
Desvenlafaxine
Duloxetine
Duloxetine: better for neuropathic/chronic pain
atypical antidepressants
Bupropion: smoking, low sex effect, lower seizure threshold
Mirtazapine: weight gain, sedation
What is Autism?
Repetitive movements, lack of verbal skills and bonding, sx since birth
What is Asperger’s?
Good communication, impaired relationships, no mental retardation
What is Rett’s?
Only in girls, ↓head growth, loss motor skills, and hand-wringing, normal until 5 years
What is Childhood Disintegrative Disorder?
Develop normally for first 2 years, then behave autistic
What is Selective Mutism?
Kid talks sometimes
What is Separation Anxiety Disorder?
Kid screams when Mom leaves
What is Conduct Disorder?
Aggressive, disregard for rules, no sense of guilt, harm animals, illegal activity “bite”
What is Oppositional Defiant Disorder?
Defiant, noncompliant, directed at authority
“bark”
What is Attention Deficit Hyperactivity Disorder?
Overactivity, difficulty in school
What is Dysthymia?
Low level sadness >2yr
What is Cyclothymia?
Dysthymia w/ hypomania
What is Double Depression?
Depression followed by dysthymia
What is Bipolar I?
Depression and Mania (psychosis)
What is Bipolar II?
Depression and Hypomania (no psychosis)
What are Loose associations?
Ideas switch subjects, incoherent
What is Tangentiality?
Wanders off the point
What is Circumstanciality?
Digresses, but finally gets back to the point
What is Clanging?
Words that sound alike
What is Word salad?
Unrelated combinations of words
What is Perseveration?
Keeps repeating the same words
What is Neologisms?
New words
What is Delusion?
False belief
What is Illusion?
Misinterprets stimulus
What is Hallucination?
False sensory perception, EtOH withdrawal/Cocaine intox => formication
What is Nihilism?
Thinks the world has stopped
What is Loss of ego boundaries?
Not knowing where I end and you begin
What are Ideas of reference?
Believes the media is monitoring you
What is Thought blocking?
Stops mid-sentence
What is Thought broadcasting?
Believes everyone can read his thoughts
What is Thought insertion?
Believes others are putting thoughts into his head
What is Thought withdrawal?
Believes others are taking thoughts out of his head
What is Concrete thinking?
Can’t interpret abstract proverbs, just sees the facts
What is Synesthesia?
Smell colors
What is Cataplexy?
Loss of mm. tone due to strong emotions
What is a Paranoid personality disorder?
Suspicious about everything, use projection
What is Schizotypal personality disorder?
“Magical thinking”, bizarre behavior
What is Schizoid personality disorder?
“Recluse”, don’t want to fit in
What is Antisocial personality disorder?
Lie, steal, cheat, destroy property, impulsive w/o remorse, illegal activity
What is Conduct Disorder personality disorder?
<15 y/o antisocial disorder
What is Histrionic personality disorder?
Theatrical, sexually provocative, use repression
What is Borderline personality disorder?
“Perpetual teenager”, splitting (love/hate), projection, acting out, self-mutilation
What is Narcissistic personality disorder?
Pompous, no empathy
What is Dependent personality disorder?
Clingy, submissive, low self-confidence,
regression
What is Obsessive- Compulsive personality disorder?
Perfectionist, doesn’t show feelings, detail- oriented, uses isolation
What is Avoidant personality disorder?
Socially withdrawn, afraid of rejection but wants to fit in
What is Kleptomania?
Steals for the fun of it
What is Pyromania?
Starts fires
What is Intermittent
Explosive Disorder?
Loses self-control without adequate reason
What is Pathological Gambling?
Can’t stop gambling, affects others
What is Trichotillomania?
Pull out their hair
What is Lewy body dementia?
Stiff, visual hallucinations
What is Normal Pressure Hydrocephalus?
TrIAD = Incontinence, Ataxia “magnetic gait”, Dementia
“Wet, Wobbly, Wacky”
What is Korsakoff psychosis?
Alcoholic thiamine deficiency
What is Vascular “multi- infarct” dementia?
Sudden onset, uneven progression
of deficits, “stair-step” decline
What is Huntington’s?
In caudate/putamen, triplet repeat disorder, choreiform movements,
What is Creutzfeldt-Jacob?
Prion induced, die within 1 year, post- cornea transplant
What is Pick’s disease?
Frontal lobe atrophy, disinhibition
What is Alzheimer’s?
↓ACh in nucleus basalis of Meynert, bad ApoE, amyloid plaques, tangles of tau
What is Parkinson’s?
n substantia nigra, bradykinesia, pill- rolling tremor, shuffling gait, Lewy bodies
What is Somatization?
Think they have a different illness all the time (at least 4 organ systems)
What is Hypochondriasis?
Think they have the same illness all the time
What is Body Dysmorphic Disorder?
Imagined physical defect
What is Pain disorder?
Prolonged pain not explained by physical causes
What is Conversion?
Neuro manifestation of internal conflict, indifferent to disability
What is Malingering?
Fake illness for monetary gain, avoids medical treatment
What is Factitious?
Fake illness to get attention, seeks medical treatment
What is Munchausen?
Need to be the caregiver, Mom fakes child’s illness to get attention
What is Munchausen by proxy?
Mom makes child ill for gain, move a lot
What is Amnesia?
Can’t recall important facts
What is Dissociative Fugue?
No past, travel to new place, usually due to trauma
What is Multiple Personality Disorder?
Have 5-10 alters, usually associated w/ incest
What is Depersonalization Disorder?
“Out of body” experiences, Deja vu
What is Sublimation?
Substitute acceptable for
unacceptable (boxer vs. fighting)
What is Imitation?
Dress like someone else
What is Identification?
Act like someone else
What is Displacement?
Take anger out on someone else
What is Idealization?
Wait for “ideal spouse” while they are beating you up
What is Transference?
Patient views doctor as parent
What is Countertransference?
Doctor views patient as child
What is Acting out?
Expression of impulse, “tantrums”
What is Regression?
Immature behavior
What is Rationalization?
Make excuses for all situations
What is Intellectualization?
Act like a “know-it-all” to avoid feeling emotions
What is Isolation of Affect?
Isolate feelings to keep on functioning
What is Suppression?
Consciously block memory
What is Repression?
Subconsciously block memory
What is Reaction Formation?
Unconsciously act opposite to how you feel (tears of a clown)
What is Undoing?
Doing exact opposite of what you used to do to fix a wrong
What is Compensation?
Doing something different of what you used to do
What is Sadism?
Gives pain
What is Masochism?
Receives pain
What is Exhibitionism?
Exposure to others
What is Voyeurism?
Watching other people without their permission
What is Telephone Scatalogia?
Phone sex
What is Frotteurism?
Rub penis against fully clothed women
What is a Transvestite?
Dress up as opposite sex, no identity crisis
What is a Transsexual?
Gender identity crisis “man trapped in a woman’s body”
What is a Fetish?
Objects (vibrators, dildos, shoes)
What is a Pedophile?
Children (watching child pornography)
What is a Necrophile?
Corpses
What is a Beastophile?
Animals
Can you die during EtOH withdrawal?
Yes
