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PP Psychiatry Flashcards

0
Q

How is mejor depression diagnosed?

A 
Need 5 " SIG E CAPS" >2 weeks
- Sleep disturbances: wake in am
- loss of Interest (anhedonia) 
- Guilt
- Energy loss
- Concentration loss
- Appetite loss
- Psychomotor agitation
- Suicide: hopelessness
Usually lasting 6-12 month
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1
Q

What is Autism?

A

Repetitive behavior
Lac of verbal skills and social interaction
Great focus on objects than on people
Below-normal intelligence

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2
Q

What is Asperger’s?

A 
Milder form of autism
Good communication 
Impaired relationships
No mental retardation
Normal intelligence
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3
Q

What is Rett’s?

A 
Only in girls
Regression 
Decrease head growth
Lose motor skills
Normal until 5month ( symptoms apparent around 1-4 y/o)
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4
Q

What is childhood disintegrative disorder?

A

Kids stop walking/ talking after 2 years of apparently normal development
Onset 3-4 years
More common in boys

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5
Q

What is the selective mutism?

A

Kids talk some time

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6
Q

What is Separation Anxiety Disorder?

A

Kids scream when Mom leaves

Common onset at 7-9 years

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7
Q

What is Conduct Disorder?

A 
Before age 18
Aggressive 
Disregard for rule
No sense of guilt
Harm animals
Illegal activity " bite"
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8
Q

What is Oppositional Defiant Disorder?

A

Defiant toward authority figures.

Noncompliant

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9
Q

What is Attention Deficit Heyperactivity Disorder?

Tx?

A

Onset before age 12
Normal intelligence
Overactivity
Difficulty in school
A/w decrease frontal lobe vol/ metabolism.
Tx : Methylphenidate, dextroamphethamine, atomoxetine

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10
Q

What is Dysthymia?

A

Milder form of depression lasting at least 2 years

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11
Q

What is cyclothymia?

A

Dysthymia w/ hypomania

Milder form of Bipolar disorder lasting at least 2 years

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12
Q

What is Bipolar I?

A

> 1 manic episode with or without Psychotic features

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13
Q

What is Bipolar II?

A

Hypomanic episode + MDD

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14
Q

What is Neologism?

A

New word

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15
Q

What is delusion?

A

False belief

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16
Q

What is illusion?

A

Misinterprets stimulus

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17
Q

What is Cataplexy?

A

Los of all muscle tone following strong emotional stimulus

* A/w Narcolepsy

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18
Q

What is paranoid personality disorder?

A

Suspicious about everything, use projection

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19
Q

What is Schizotypal personality disorder?

A

” Magical thinking”

Bizarre behavior

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20
Q

What is schizoid personality disorder?

A

“Recluse”
Don’t want to fit in
Distant

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21
Q

What is Antisocial personality disorder?

A 
>18 year
Lie
Steal
Cheat
Destroy property 
Impulsive w/o remorse
Illegally activity
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22
Q

What is Histrionic personality disorder?

A

Theatrical

Sexually provocative, Attention seeking, concern with appearance.

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23
Q

What is Borderline personality disorder?

A

Unstable mood and interpersonal relationships.
Self-mutilation, impulsivity , sense of emptiness
Splitting (love/hate) mechanisms of defense

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24
Q

What is Narcissistic personality disorder?

A

Grandiosity

No empathy

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25
Q

What is Dependant personality disorder?

A

Clingy
Submissive
Low self confidence
Regression

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26
Q

What is Obsessive-Compulsive personality disorder?

A

Perfectionist
Doesn’t show feeling
Detail-oriented
Uses isolation

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27
Q

What is Avoidant personality disorder?

A

Socially withdraw

Afraid of rejection but wants to fit in

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28
Q

What is Kleptomania?

A

Steal for the fun of it

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29
Q

What is Pyromania?

A

Starts fires

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30
Q

What is Trichotillomania?

A

Pull out their hair

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31
Q

What is Lewy body dementia?

A

Stiff, visual hallucinations

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32
Q

What is Normal Pressure Hydrocephalus?

A

TrIAD = Incontinence, Ataxia “ magnetic gait”, Dementia

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33
Q

What is Korsakoff psychosis?

A

Alcoholic Thiamine deficiency

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34
Q

What is vascular “ multi-infarct” dementia?

A

Sudden unset
Uneven progression of deficit
“ stair-step” decline

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35
Q

What is Huntington’s?

A

In caudate/putamen
Triplet repeat disorder
Choreiform movement

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36
Q

What is Creutzfeldt-Jacob?

A

Prion included
Die within 1 year
Post cornea transplant

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37
Q

What is Pick’s disease?

A

Frontal lobe atrophy

Disinhibition

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38
Q

What is Alzheimer’s ?

A

Decrease ACh in nucleus basales of Meynert
Bad ApoE
Amyloid plaques
Tangles bodies

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39
Q

What is Parkinson’s?

A 
In substantial nigra
Bradykinesia
Pill-rolling tremor
Shuffling gait
Lewy bodies
Decrease dopamine 
Increase serotonin and ACh
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40
Q

What is Somatization?

A

Think they have a different illness all the time (at least 4 organ system)

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41
Q

What is Hypochondriasis?

A

Think they have the same illness all the time

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42
Q

What is Body Dismorphic disorder?

A

Imagined physical defect

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43
Q

What is pain disorder?

A

Prolonged pain not explained by physical causes

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44
Q

What is Malingering?

A

*Secondary gain
Fake illness for monetary gain
Avoids medical treatment

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45
Q

What is Factitious?

A

*Sick role
Fake illness to get attention
Seeks medical treatment

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46
Q

What is Munchausen syndrome by proxy?

A

Need to be the caregiver

Mom fakes child’s illness to get attention

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47
Q

What is Amnesia?

A

Can’t recall important facts

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48
Q

What is Dossociative fugue?

A

Travel to new places with inability to recall the past

Usually due to trauma

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49
Q

What is Multiple Personality disorder?

A

Is a Dissociative identity disorder
Have 5-10 alters
Usually associated w/ incest

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50
Q

What is Depersonalization disorder?

A

“Out of body” experiences

Deja vu

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51
Q

What is Sublimation?

A

Replace an unacceptable wish with an action that is similar to the wish but doesn’t conflict with once values.

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52
Q

What is Displacement?

A

Transferring avoided feeling or ideas to a person or object.

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53
Q

What is Transference?

A

Patient views doctor as parent

* patient projects feeling onto physician

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54
Q

What is Acting out?

A

Unacceptable feelings and thoughts are expressed through actions
Ex: “Tantrums”

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55
Q

What is Regression?

A
  • Immature behavior

- go back to previous stages

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56
Q

What is Rationalization?

A

“Justifying behavior to avoid difficult truth “

  • logical reasons
  • Make excuses for all situation to avoid self-blame
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57
Q

What is Intellectualization?

A

Act like a “know-it-all” to avoid feeling emotion

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58
Q

What is Isolation of Affect?

A

Is an immature defenses of the Ego

Isolate feeling to keep on functioning

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59
Q

What is Suppression?

A

Choosing to block memory

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60
Q

What is Repression?

A

Involuntarily block of memory

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61
Q

What is reaction formation?

A

Replace a bad idea or feeling by focusing on the opposite.

-Unconsciously act opposite to how you feel ( tears of a clown)

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62
Q

What is Sadism?

A

Gives pain

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63
Q

What is Masochism?

A

Receives pain

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64
Q

What is Exhibitionism?

A

Exposure to other

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65
Q

What is Voyeurism?

A

Watching other people without their permission

66
Q

What is Frotteurism?

A

Rub penis against fully clothed women

67
Q

What is Transsexual?

A

Gender identity crisis “ man trapped in a woman’s body”

68
Q

What is Fetish?

A

Objects (vibrators, dildos, shoes)

69
Q

What is Pedophile?

A

Children ( watching child pornography)

70
Q

What is Necrophile?

71
Q

What is a Beastophile?

72
Q

Can you die during EtOH withdrawal?

73
Q

Can you die during Opiod withdrawal?

A

No; just very painful

74
Q

What is Dissociation?

A
  • drastic change in personality, memory, consciousness or motor behavior to avoid emotional stress
75
Q

What is Denial?

A
  • avoidance of awareness of some painful reality
76
Q

What is Fixation?

A
  • remaining at a more childish level of development
77
Q

What is projection?

A

an unacceptable internal impulse is attributed to an external source

78
Q

What is Splitting?

A
  • belief that people are either all good or all bad

- commonly seen in Borderline personality disorder

79
Q

What is Altruism?

A
  • compensation

- alleviated the gilt with an unsolicited generosity toward others

80
Q

Which are the childhood and early-onset disorder?

A 
ADHD
Conduct disorder 
Oppositional defiant disorder 
Tourette's syndrome 
Separation anxiety disorder
81
Q

What is Tourette’s syndrome?

A 
Onset before age 18
Tics that persist for > 1 year
A/w OCD and ADHD
Treatment:
- fluphenazine
- pimozide
- tetrabenazine
- clonidine
- haloperidol
82
Q

Types of amnesias?

A
  • Retrograde: before the event
  • Anterograde: after the event ( new memory)
  • Korsakoff’s : anterograde, caused by thiamine defi., destruction of mammillary bodies, associated with confabulation
  • Dissociative: inhability to recall personal information after trauma or stress
83
Q

What is a Psychotic disorder?

A

Distorted perception of reality

Characterized bay delusion, hallucination and/or disorganized thinking

84
Q

Which are the sings of psychosis?

A

Hallucinations
Delusions
Disorganized speech

85
Q

What is Schizophrenia?

A 
Mental disorder with periods of psychosis
Impaired functioning 
Symptom last > 6 month
Increase dopamine 
Have positive and negative symptoms
86
Q

Brief psychotic disorder ?

A

< 1 month, stress related

87
Q

What is Schizophreniform disorder ?

A

Same as schizophrenia but the time is different 1-6 month

88
Q

What is Schizoaffective disorder?

A

Needs to present at least 2 weeks of psychotic symptoms with a stable mood and an episode of major depression, manic or mixed

89
Q

What is a Delusional disorder?

A

Fixed, persitent, nonbizarre belief system lasting > 1 month
Functioning is not impaired

90
Q

What is an Hypomanic episode?

A

Like a Manic episode, except mood disturbance is not severe enough to cause impairment

91
Q

What is Atypical depression?

A

Subtype of depression that is characterized by:

  • Hyperphagia
  • Hypersomnia
  • Mood reactivity
  • Rejection hypersensitivity
92
Q

What is Post-traumatic stress disorder?

A

Disturbance last > 1 month

My involve nightmares or flashback

93
Q

What is Acute-stress disorder?

A

Disturbance present between 2 days and 1 month

94
Q

What is Generalized anxiety disorder?

A

Pattern of uncontrollable anxiety for at least 6 month

95
Q

What is Conversion?

A

Sudden loss of sensory or motor Function, following an acute stressor

96
Q

Time corse of schizophrenia?

A

< 1 month : brief psychotic disorder
1-6 month: Schizophreniform
> 6 month : schizophrenia

97
Q

What is anorexia nervosa?

A 
Excessive dieting
Intense fear of gainin weight
Body image distortion
Amenorrhea 
Increase exercise
98
Q

What is Bulimia nervosa?

A

Binge eating
Self induce vomiting or use of laxatives, diuretics or emetics
Associated with: parotitis, enamel erosion, electrolyte disturbance, alkalosis
Treated with: Fluoxetine

99
Q

Which are the Depressants drugs?

A
  • Alcohol
  • Opioids ( morphine, heroine, methadone)
  • Barbiturates
  • Benzodiazepines
100
Q

Which are the Stimulants drugs?

A

Amphetamines
Cocaine
Caffeine
Nicotine

101
Q

Which are the Hallucinogens drugs?

A

PCP
LSD
Marijuana

102
Q

How are classify the Antipsychotics?

A 
Typical ( traditional neuroleptics)
- low potency 
- high potency
* block Dopamine D2 receptor { increase cAMP}
Atypicals
103
Q

Which are the low potency Antipsychotics?

A

Chlorpromazine

Thioridazine

104
Q

Which are the High potency Antipsychotics?

A 
Haloperidol
Fluphenazine 
Loxapine
Thiothixene
Trifluoperazine
105
Q

Which are the Atypicals Antipsychotics?

A 
Olanzapine
Quetiapine
Risperidona 
Aripiprazole
Clozapine ( causes agranulositosis)
106
Q

Buspirone?

A

Stimulates 5-HT1A receptors

Use for Generalized anxiety disorder

107
Q

Which are the types of Antidepresants?

A

SSRIs: inhibits re-uptake of Serotonin
SNRIs: inhibits re-uptake of Norepinephrine and Serotonin
TCA: inhibits re-uptake of Norepinephrine and Serotonin
MAOI: inhibits enzyme that metabolize and inactivates Norepinephrine

108
Q

Which are the SSRIs?

A

Fluoxetine
Paroxetine
Sertraline
Citalopram

109
Q

Which are the SNRIs?

A

Venlafaxine

Duloxetine

110
Q

Which are the TCA?

A 
Amitriptyline
Nortriptyline
Imipramine 
Desipramine
Clomipramine
Doxepin
Amoxapine
111
Q

Which are the MAO?

A

Tranycypromine
Phenelzine
Isocarboxazid
Selegiline

112
Q

Which are the Atypical Antidepressants?

A

Buspiron
Mirtazapine:
Maprotiline:
Trazodone:

113
Q

Lithium is use for?

A

Mood stabilizer for Bipolar disorder

Blocks relapse and acute manic event

114
Q

What is akathisia?

A

restlessness

inability to sit still

115
Q

Which are the diagnostic criteria for a Manic episode?

A 
"DIG FAST"
Disutractibility
Irresponsibility 
Grandiosity
Flight of ideas
Increase Activity/ Agitation
Sleep
Talkativeness
116
Q

What is a Manic episode?

A

Period of abnormally and persistently elevated, expansive or irritable mood
Lasting at least 1 week

117
Q

Generalized anxiety disorder?

A

Chronic multiple worries, anxiety, tension.

118
Q

Mention the Key clinical features for acute drug intoxication?

  1. PCP
  2. LSD
  3. Cocaine
  4. Methanphetamine
  5. Marijuana (Canabis)
  6. Heroine
A
  1. Nystagmus, violent behavior
  2. Visual hallucinations
  3. CP, seizures, Mydriadis ( dilated pupil )
  4. Choreiform movement, tooth decay
  5. Conjunctival injection ( red eyes), increase appetite
  6. Depressed mental status, Miosis ( constricted pupil), respiratory depression
119
Q

What is adjustment disorder?

A

Involves emotional or behavioral symptoms developing within 3 months of an indentifiable stressor.

120
Q

Which are the 2 types of Breath-holding spell?

A
  • They are benign
  • Characterized by brief period of apnea and skin color change
  • Common in children age 6mo - 2y
    1. Cyanotic type:
    -crying & BH follow by apnea and loss of consciousness.
    -brief with rapid return to baseline.
    2. Pallid type:
    -trigger by minor trauma
    -fleeting loss of consciousness follow by BH, pallor & diaforesis
    -less than 1 min with subsequent confusion and sleepiness for a
    few min
121
Q

Nightmare disorder vs. Sleep terror disorder?

A
  • Nightmare: recurrent awakening from REM sleep, full alertness, dream recall, can be consoled.
  • Terror: non-REM arousal, incomplete awakening, cannot recall dream, unresponsiveness to confort
122
Q

Delayed vs. Advanced sleep phase syndrome?

A

*circadian rhythm disorder characterized by the inability of:

  • Delayed: fall asleep at normal bedtime ( results in sleep-onset insomnia & daytime sleepiness)
  • Advanced:stay awake in the evening, past 7 ( result in social functioning & early morning insomnia)
123
Q

Catatonia

A

A syndrome seen in severe psychiatric &a medical illness.

  • Characterized by: immobility, mutism and posturing.
  • A Lorazepam challenge test can confirm the Dx
  • Tx: Benzodiazepine, ECT for pt that don’t improve.
124
Q

Dissociative identity disorder

A

Discontinuity in identity and loss of personal agency with fragmentation into >2 distinct personality state

125
Q

New onset of severe GI symptoms, confusion, ataxia and tremors.

A

Lithium toxicity

  • use of Lithium in combination of : Thiazides, ACE-inhibitors, Tetracyclines, Metronidazole
126
Q

Prevalent comorbid conditions that complicate the management and quality of life in pt with Tourette sy.

127
Q

Neuroleptic Malignant syndrome signs/symptoms?

A 
Muscle rigidity 
Fever > 40C (104F)
Confusion 
Autonomic instability 
Increased CK
Leukocytosis

*Serotonin syn: tremor, hyperreflexia, myoclonus, Fever but not as high, nausea and vomiting.

128
Q

Dissociative Amnesia

A

Inability to recal important personal info; usually of a traumatic or stressful nature

  • Not exploded by another disorder
129
Q

Precontemplation?

A

Not yet acknowledged that there is a problem

130
Q

Atypical depression is characterized by?

A 
Mood reactivity ( feeling better in response to positive events)
Laden paralysis (extremities feel heavy)
Rejection sensitivity ( overly sensitive to criticism)
Increase sleep and appetite
131
Q

Acute stress disorder Vs. Post-traumatic stress disorder

A

ASD: more than 3days but less than a month

PTSD: persistence of symptoms for more than a month

132
Q

4hour Acute dystonia Tx?

A

Anticholinergics:

  • Benztropine
  • Diphenhydramine
  • symptoms: muscles spasm, stiffness, oculogyric crisis
133
Q

4 month Tardive dyskinesia?

A 
Involuntary movement ( tongue,lips, face, extremities)
* Clozapine may help
134
Q

Serotonin syndrome is characterized by a triad of?

A
  1. Autonomic instability: hyperthermia, HTN, tachycardia
  2. AMS
  3. Neuromuscular hyperactivity ( hyperreflexia, miotonic)
135
Q

Action/ willpower

A

Changing behavior

136
Q

Pt experiencing MDD episode should be screen for?

A

Past MANIC episode to rule out Bipolar disorder

137
Q

Contemplation

A

Acknowledging that there is a problem, but not yet ready or willing to make a change

138
Q

Depressant drugs?

A

Alcohol
Opioids (morphine, heroin, methadone)
Barbiturates
Benzodiazepines

139
Q

Delusions or hallucinations fro more than 2 weeks in the absence of MD episode or manic episode is?

A

Schizoaffective disorder

140
Q

Symptoms of opioids intoxication?

A
  • morphine, heroin, methadone
    Euphoria
    Respi & CNS depression
    Pupillary constriction ( point pupil)

-Tx for overdose: Naloxone

141
Q

Caine withdrawal is characterized by?

A

Acute depression accompanied by:

  • Vivid dreams
  • Hyperinsomnia
  • Hyperphagia
  • Fatigue
142
Q

Dilate pupils, yawning, lacrimation

A

Heroin withdrawal

  • in baby - look for sneezing, vomiting, diarrhea
143
Q

Pupillary findings on intoxication with

  1. Stimulants
  2. Depressants
A
  1. Stimulants- dilate

2. Depressant- constrict

144
Q

Delirium is characterized by?

A

Acute
Fluctuating cognitive impairments
Ex. Poor attention, disorientation

145
Q

Alcohol withdrawal syndrome 6-24hrs?

A

Mild

-symp: anxiety, insomnia, Tremors, diaphoresis, palpitations, GI upset, oriented.

146
Q

Alcohol withdrawal syndrome 12-48hrs?

A
  • seizures
  • hallucinations
  • oriented
  • normal VS
147
Q

Alcohol withdrawal syndrome 48-96hrs?

A

Delirium tremors

- confusion, agitation, fever, tachycardia, HTN, diaphoresis, hallucinations

148
Q

Tx for Neuroleptic malignant syndrome?

A
  • Dopaminergic agents: Bromocriptine, Amantadine

- Muscle relaxant: Dantrolene

149
Q

Most consistently replicated neuroimaging finding in schizophrenia?

A

Enlargement of the. Lateral cerebral ventricles

150
Q

Specific phobia?

A

Excessive anxiety about specific object or situation.

151
Q

Panic disorder?

A

Recurrent, unexpected panic attack’s

152
Q

Neurotransmitter changes in Alzheimer disease?

A

Decrease ACh

Increase glutamate

152
Q

Neurotransmitter changes in Anxiety?

A

Increase NE

Decrease GABA and 5-HT

152
Q

Neurotransmitter changes in Depression?

A

Decrease: NE, dopamine and 5-HT

152
Q

Neurotransmitter changes in Huntington disease?

A

Increase:dopamine
Decrease: GABA and ACh

152
Q

Neurotransmitter changes in Parkinson disease?

A

Decrease dopamine

Increase ACh

152
Q

Sensation of bugs crawling

A

MC in alcohol withdrawals

Also seen in cocaine abusers

152
Q

Negative symptoms of schizophrenia?

A

Flat affects
Social withdrawals
Lack of motivation
Lack of speech or thought .

-Symptoms improve with antipsychotic

152
Q

Maternal blues

A

Starts 2-3 days after delivery
Symptoms: depress affect, tearfulness and fatigue.
Tx supportive, FU for evaluation of PD

152
Q

Postpartum depression (PD)

A

Starts after 4 weeks of delivery
Symptoms: depression, anxiety, poor concentration
Tx CTB AND SSRI 1 line

152
Q

Common side effect of ECT?

A

Amnesias: retrograde and anterograde

152
Q

Social anxiety disorder?

A

Social phobia

  • anxiety restricted to social & performance situations.
  • fear of scrutiny & embarrassment.

Step 1 (17 decks)

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