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Geri Royal B > Primary Psychiatric > Flashcards

Primary Psychiatric Flashcards

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1
Q

Protective factors for anxiety disorder

A

Social support
Religiosity
Physical activity
Cognitive stimulation
Effective coping skills

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2
Q

Drugs that mimic anxiety

A

Sympathomimetics
Salbutamol
Theophylline
Thyroxine
Caffeine
Amphetamine
WITHDRAWAL from sedatives

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3
Q

Illnesses that mimic anxiety as per dsm

A

Endocrine (HyperThyroid, pheo, hypoglycaemia,hyperadrenocortisolism)
CVDisroder (CHF, PE)
Reso
B12, porphyria
Hypoxia
Ischenia
Metabolic changes (hypercalcemia, hypoglycaemia)

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4
Q

Comorbid anxiety and depression leads to what deleterious effect

A

-increase in severity of illness
-increased suicidaity
-increase cognitive decline
-chronic course

Anxiety in general

-other places list worse QOL and worse mortality

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5
Q

Illnesses that mimic panic attacks as per DSM

A

-vestibular dysfunction
-seizures
-cardiac (SVTas, afib,
-COPD
-hyperT4
-hyperparathyroidism
-pheo

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6
Q

Differences in anxiety presentation young vs old

A
  • more worry
    -more sleep disturbance
    -late onset usually signals depression
    -may be related to medical cause
    -late onset agoraphobia becomes more common (and not related to panic disorder)
    -GAD: more health, more about fam
    -OCD: more hand washing, more sinning
    -greater cognitive function impairment
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7
Q

Mechanism for how anxiety affects cognitive impairment

A

-may be bidirectional
-can’t stop HPA axis, increased CRF, inc cortisol, alters NMDA activity and get synaptic and morphological change of hippocampus and prefrontal
- or increase in B amyloid 42 and tau hyperphosphorylation due to high HPA
-possible telomere shrinkage

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8
Q

Differences in early vs late schizophrenia

A

More women
More positive symptoms
More variability in profile of cognitive deficits
Respond to Lower doses of meds
Larger thalamic volumes
More paranoid subtype, more persecutors and partition delusions
More organized delusions
Higher premorbid functioning

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9
Q

AD vs schizophrenia

A
  • schizophrenia has more thought control delusions, auditory hallucinations, family history of major mental Illness, more single and socially isolated

Vs AD
More visual hall and someone stealing delusions

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10
Q

Service needs for patients with schizophrenia

A

Bio
Med management

Psycho
Mood and cognition monitoring

Social
Accessible services
Social integration
Social rehab
Coordination of care with primary care providers

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11
Q

Psychosocial interventions for patients with schizophrenia that have been shown to improve functioning

A

Cognitive behavioural social skills training
Functional adaption skills training
CBT for psychotic symptoms
Cognitive training
Supported employment
Preventative health care programs like case managers

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12
Q

Def of catalepsy vs posturing

A

-passive induction of a posture held against gravity (patient can be repositioned that the patient maintains)

Vs
Spontaneity’s and active maintenance of a posture against gravity (patient does thus spontaneously)

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13
Q

Ways to improve nausea associated with Li

A

-dose at night
-slower titration
-take with food
-slow release preparations

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14
Q

Meds that could cause late onset mania

A

Steroids
Thyroxine
Dopimanergic agents
Antidepressants
B2 agonists

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15
Q

Benefits to lithium tx

A

-most effective mood stabilizers and treats all phases
-inexpensive
-reduces risk of suicide
-potential for Neuro protection
-decreased short term mortality

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16
Q

As per paper, some psychosocial interventions used in bipolar

A

Mostly extrapolated from young data
HOPES- combines skills training and health management intervention
-medication adherence (MAST BD study)

17
Q

Factors that determine cognitive and functional abilities in persons with late life schizophrenia

A

-progression of the disease itself
-aging
-medical comorbidities
-medications
-allostatic load

18
Q

Differential for late onset anxiety

A

-depression
-dementia
-delirium
-withdrawal from substance
-medication tox (salbutamol thyroid one)
-physical illness (svts, hypoglycaemia)

19
Q

Comorbiditu of anxiety with depression leads to what deleterious effects

A

-treatment refractory
-severity of illness
-suicidal ideation and completed suicide
-increased cognitive decline
-chronic course

20
Q

Harm reduction approaches to prescribing z drugs

A

-assessing risk for drug drug interactions
-using lowest effective dose for the shortest period of time
-intermittent dosing
-regularly assessing and noting response to the intervention

Geri Royal B (14 decks)

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