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Psych Flashcards

1
Q

Fever, tachycardia, HTN, diaphoresis, tactile or liliputian hallucinations

A

DTs - 48-96 hrs

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2
Q

Skin popping, pinpoint pupils, drowsiness, constipation intoxication

A

Heroin

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3
Q

SLUDGE - sweating, lacrimation, pupillary dilation, diarrhea, rhinorrhea withdrawal

A

Heroin

- tx w/ clonidine, methadone

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4
Q

Agression, paranoia, VERTICAL NYSTAGMUS, HTN, tachycardia, hyperacusis intoxication

A

PCP

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5
Q

Visual hallucinations, SENSORY INTENSIFICATION, illusions, sweating, tachycardia intoxication

A

LSD

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6
Q

Pupillary dilation, insomnia, delusions, paranoia intoxication

A

Amphetamines

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7
Q

Tx for agitation w/ & w/o psychosis

A 
With = haldol
Without = diazepam
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8
Q

Erythema of turbinates, EPISTAXIS, pupillary dilation, bugs crawling on skin, aggression, insomnia intoxication

A

Cocaine

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9
Q

INC appetite, hypersomnia, vivid dreams withdrawal

A

Cocaine

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10
Q

Unexpected travel, can’t remember past, hx of head trauma

A

Dissociative fuge

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11
Q

2+ distinct identities

A

Dissociative identity

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12
Q

1+ episode of amnesia related to stressful event

A

Dissociative amnesia

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13
Q

Observing own body from afar

A

Depersonalization

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14
Q

Experiencing familiar persons and surroundings as if strange or unusual

A

Derealization

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15
Q

<85% IBW, fear of becoming fat, absence of 3 periods, show great concern with appearance

A

Anorexia

  • arrhythmia –> death
  • hospitalization, psychotherapy, SSRIs
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16
Q

GLOBAL body desire, low K, acidosis, inc LFTs, dec grey matter in anterior cingulate gyrus

A

Lanugo

- assess severity w/ low albumin

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17
Q

Normal weight, large eating volumes, use of exercise, fasting, vomiting, laxative, diuretics, enemas, HX of obesity

A

Bulimia

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18
Q

Parotid enlargement, inc amylase, gastric dilation or tear, HX OF PICA, excessive exercising

A

Bulimia

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19
Q

Tx for anorexia

A
  1. Olanzapine

2. CBT & FAMILY therapy

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20
Q

Tx for bulimia

A
  1. CBT

2. FLUOXITINE (prozac = no weight gain)

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21
Q

Dependence vs. Abuse

A

Dependence
- withdrawal sx, can’t cut down but trying, time spent recovering, interferes w/ normal life

Abuse
- don’t fulfill obligations, use in dangerous situations, legal and social problems, CONTINUED use despite adverse consequences, ELEVATED GGT

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22
Q

Neurotransmitter that initiates sleep

A

Serotonin

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23
Q

Neurotransmitter that produces arousal/wakefulness

A

DA

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24
Q

Levels of Ach and NE during REM

A 
Ach = high
NE = low
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25
Q

Stage 1 sleep waves

A

Theta (3-7hz)

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26
Q

Stage of sleep with sleep spindle and K complexes

A

Stage 2

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27
Q

Abrupt awakening in early sleep, intense, can’t be calmed, NO memory, assoc w/ RLS, precursor to temporal epilepsy

A

Night terrors

- tx w/ benzos

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28
Q

Tx for enuresis

A
  1. Alarms

2. Imipramine, & DDAVP

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29
Q

Previously toilet trained now wetting bed after north of new sibling

A

Regression

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30
Q

IVDU gets HCV and blames poor control of HCV in community

A

Distorsion - altered perception of disturbing aspects of reality

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31
Q

Angry w/ person - believes person is angry at them

A

Projection

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32
Q

Classifies things as all good or bad

A

Splitting = borderline personality

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33
Q

Abused child identifies themselves as an abuser

A

Identification

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34
Q

Angry at person, instead goes and wrecks car

A

Displacement

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35
Q

Pt rescued from burning building now denies memory of event

A

Dissociation - block memory or drastic change in behavior to avoid emotional distress

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36
Q

Involuntary withholding idea or feeling from consciousness

A

Repression

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37
Q

Got fired - now claims job was not that important anyway

A

Rationalization - avoid self blame

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38
Q

Replacing behavior/thoughts/feelings opposed to their own with OPPOSITE behavior

A

Reaction formation

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39
Q

Explosive anger channeled into athletic pursuits

A

Sublimation

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40
Q

Kid focuses on homework rather than dad’s cancer dx

A

Suppression - VOLUNTARY postponement of anxiety producing thought

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41
Q

3 months of stressful situation, last NO LONGER than 6mo, somatic sx in kids, irritable, short temper, anxiety, depression

A

Adjustment disorder

- psychotherapy

42
Q

Abrupt feeling of intense anxiety, palpitations, sweating, SOB, dizziness, hot flashes, following a particular stimuli

A

Panic attack –> alprazolam

43
Q

UNEXPECTED, out of the blue intense anxiety, worrying about future attacks, behavior change after attack
Lasts >15min but

A

Panic disorder –> SSRIs

- w/ agoraphobia

44
Q

Work-up/DDx for panic disorder

A
  1. Thyroid - ? high thyroxine or hypothyroid
  2. # 1 = depression
  3. Agoraphobia
45
Q

> 6mo
Worry about multiple things that may not have happened yet, no trigger
Restless, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

A

Generalized anxiety disorder

  • Major depression in 50-90%, Sjogren’s, Grave’s, hyperthyroid
  • SSRIs, also venlafaxine, buspirone
46
Q

Stressful event + in a daze/numbing + derealization/depersonalization + dissociative amnesia and re-experiencing event, avoidance of certain stimuli, MAXIMUM 4 WEEKS

A

Acute stress disorder

  • support
  • propanolol to prevent PTSD
47
Q

Re-experience traumatic event, LONGER than 4 WEEKS, hallucinations, intense fear, horror,

A

PTSD

  • paroxetine or sertraline
  • prazosin for nightmares
  • relaxation, hypnosis, psychotherapy
48
Q

Co-morbidities w/ PTSD

A

MDD, anxiety, substance abuse

49
Q

Fear of being in places from which escape may be difficult or embarrassing - crowds, public places, traveling

A

Agoraphobia

- 91% have MDD, complication of PANIC DISORDER

50
Q

Fear of being humiliated or embarrassed + blushing, shaking, vomiting, urgency or fear of micturition or defecation + >6mo under 18 y/o
Public restrooms, public speaking or eating in public

A

Social phobia

- BBs, assertiveness + SSRI

51
Q

Fear of reptiles, blood, heights, tunnels, closed spaces, fear of CONTRACTING disease, even anticipation provokes anxiety + recognized as irrational

A

Specific phobia disorder

  • desensitization, relaxation
  • BBs and SSRIs
52
Q

Intrusive thoughts and repetitive behaviors - cleaning, hand washing, ordering, counting, meditating, toe tapping + aware of unreasonableness

A

OCD –> SSRI

  • 2/3 have MDD
  • Tourette disorder
  • other tx = clomipramine, behavior therapy
53
Q

2 weeks
Sleep disturbance, dec interests, guilt, dec energy, dec concentration, appetite disturbance, psychomotor changes, suicidal thoughts

A

Major depressive episode - disorder w/ >1 episodes

  • SSRIs
  • Duloxetine w/ neuropathic pain
  • Bupropion if scared of sexual SE or weight gain
  • r/o Parkinson, dementia, hypothyroidism
54
Q

1+ week

Distracted, indiscretion, grandiosity, flight of ideas, activity inc, sleep deficit, talkative/pressured speech

A

Manic episode

  • r/o medical condition/drugs
  • OLANZAPINE, haldol, lithium for acute
  • LITHIUM, lamotrigine, valproic acid, quetiapine maintenance
  • NEVER “refer to psychiatrist”
55
Q

1+ manic episodes, CAN have delusions or hallucinations, low risk of suicide

A

Bipolar 1

  • Lithium, valproic (<12) for non-psychotic
  • kids never calm down after they get their way (vs. ODD)
56
Q

1+ MDD + hypomanic episode, higher risk of suicide, no delusions or hallucinations

A

Bipolar 2

-

57
Q

<30 y/o, pain + GI + sexual or reproductive + weakness or sensory loss

A

Somatization disorder

- weekly psychotherapy

58
Q

Loss of specific bodily function or part of body, hemianesthesia, seizures w/ no LOC or incontinence, UNCONCERNED about seriousness

A

Conversion disorder

- reassurance of sensory deficits

59
Q

Preoccupation of HAVING an illness, CAN be reassured (vs. somatic), >6mo

A

Hypochondriasis

- regularly scheduled appts

60
Q

Pain without cause, anatomic or imaging findings

A

Pain disorder

- validation, TCAs, SSRIs

61
Q

Health care worker, poor parental relationships, borderline personality, intentional feigning of illness to assume sick role - injecting insulin

A

Factitious disorder

62
Q

Consciously making up an illness for secondary gain - avoiding difficult things, responsibilities, punishment, compensation, drugs, lack of cooperation/compliance, anti-social disorder, common in prisoners and military personnel

A

Malingering

63
Q

Lack peer relationships, eye contact, social smile & lack separation anxiety.
Routines, rituals, repetitive manners - spinning, banging head, self-injurious.
Impaired non verbal behaviors, NO speech b4 3 y/o, tantrums

A

Autism

  • greater in BOYS
  • r/o deafness if child doesn’t respond to name
64
Q

Girls w/ progressive encephalopathy, microcephaly - deceleration of head growth after 5th mo
Hang wringer, toe walkers, loss of social engagement/peek a boo, poorly coordinated gait or trunk movements

A

Rhett disorder

65
Q

NO delay in language, impaired peer relationships, doesn’t share, no emotional reciprocity, struggle with peer pressure, drugs – depression, bullying

A

Asperger’s

- SSRIs

66
Q

Normal development to age 2 –> Loss of expressive language, bowel/bladder control, motor skills, social skills
May have repetitive, stereotyped behaviors

A

Childhood disintegrative disorder

67
Q

Pathogenic caregivers, no respect for personal boundaries, indiscriminate

A

Reactive attachment disorder

68
Q

Cruelty toward animals, destruction of property, theft, setting fires, vandalism, truancy, running away

A

Conduct disorder

  • atomoxetine or guanfacine
  • parents have anti-social or etOH dependence
69
Q

Age 8

Loses temper, argues w/ authority, refuses requests, blames others, easily annoyed, spiteful, resentful

A

Oppositional defiant disorder

- teach parents child management skills

70
Q

ADHD can lead to?

A

Bi-polar

Oppositional defiant disorder

71
Q

Tx for ADHD

A
  1. Methylphenidate, dextroamphetamine –> insomnia, HA, dec appetite
  2. Atomoxetine
  3. Clonidine, guanfacine (w/ sleep problems)
72
Q

Delusions, hallucinations, disorganized speech, catatonic behavior, brief mood disorder, >6mo

A

Schizophrenia

- if no time-frame is mentions = pick this

73
Q

Brain findings in schizophrenia

A

Inc ventricle size
Prominent sulci
Hippocampal disarray
5HT –> suicidal & impulsive

74
Q

2+ weeks of delusions, hallucinations with or without mode disorders. Depression only present with psychotic features.

A

Schizoaffective disorder

- haldol, risperidone

75
Q

Psychotic features only present during mood disorders

A

Mood w/ psychotic features

76
Q

Magical thinking, transient psychosis, dresses oddly

A

Schizotypal

- fam hx of schizophrenia

77
Q

NO affect, LONERS, NO bizarre cognition or psychosis, NO family hx, NO friends, NO desire for friends, successful at work if isolated

A

Schizoid personality disorder

78
Q

False beliefs that others want to harm them, ppl will take advantage of them, suspicious

A

Paranoid personality disorder

79
Q

Schizophrenia that lasts >1mo but <6mo

A

Schizophreniform

80
Q

Schizophrenia that lasts 1 day to 1 month

A

Brief psychotic disorder

81
Q

NON-bizzare delusions (vs. schizo) - being followed, poisoned, loved, deceived, or have a disease and see that as normal. NO impairment

A

Delusional disorder –> atypical anti-psychotic

- erotomatic, grandiose, jealous, persecutory, somatic types

82
Q

Sense of entitlement, aggressive toward others, violate social norms, >18 and had conduct disorder

A

Anti-social

- common to develop somatization disorder when older

83
Q

Can’t be alone but has short-lived relationships, EMPTINESS, things are all good or all bad, cut/burn themselves, hx of childabuse/neglect

A

Borderline personality disorder

- may have short psychotic episodes

84
Q

Overly emotional, dramatic, hungry for ATTENTION, afraid of intimacy but appear seductive, theatrical

A

Histrionic personality disorder

85
Q

Self-important, crave ADMIRATION, exploitive, unrealistic inflated views of their accomplishments, grandiose

A

Narcissistic personality disorder

86
Q

Hypersensitive to criticism, fear of rejection, shy away from situations that expose INADEQUACY, WANT friends but unwilling to get involved –> become isolated

A

Avoidant personality disorder

- co-morbid dependent personality disorder

87
Q

Afraid of being on their own, submissive in order to avoid displeasing people, can’t make decisions, don’t question authority, cling to ONE person

A

Dependent personality disorder

  • regular but brief appts
  • group psychotherapy
88
Q

Must attain perfection, adhere to plans, schedules, workaholics, stiff, stubborn, do NOT realize this causes them more distress

A

Obsessive-compulsive personality disorder

- perfection & inflexibility

89
Q

Dec DA in tuberoinfundibular

A

Hyperprolactinemia

90
Q

Dec DA in nigrostriatal

A

Chorea/tics

91
Q

Inc DA in nigrostriatal

A

EPS & parkinson

92
Q

Inc DA in mesolimbic

A

Drug use & hallucinations

93
Q

Dec DA in mesolimbic

A

Anti-psychotics

94
Q

Anti-psychotic binds DA in nigrostriatal –> brief painful muscle contractions, TORTICOLLIS, eyes, larynx in a matter of HOURS to DAYS

A

Acute dystonic rxn –> benztropine or benadryl IM

95
Q

Restlessness, anxiety, pacing, rocking, leg crossing, can’t get out of chair days to WEEKS after anti-psychotic start

A

Akathisia –> BBs

96
Q

Increased sleep, weight, appetite, mood worse in evening and feels “heavy.”

A

Atypical depression –> MAOIs

97
Q

Immediate sadness, lability, tearfulness lasting 2 WEEKs after birth

A

Post-partum blues

98
Q

Depressed mood, weight changes sleep disturbances, excess anxiety, may have negative feelings toward baby for 1-3 months after birth

A

Post-partum depression –> SSRI

99
Q

Depression, delusions and thoughts of harming baby 2-3 WEEKs after birth

A

Post-partum psychosis –> anti-psychotic, lithium, SSRI

100
Q

Bereavement vs. Depression

A

Depression has thoughts of death, WORTHLESSNESS, >2months affecting function, psychomotor retardation, psychosis

101
Q

agitation, confusion, hallucinations, sweating, hyperthermia, nausea, diarrhea, tremor, myoclonus

A

Serotonin syndrome –> stop SSRI + cyproheptadine

102
Q
  1. Schizophrenia w/ persecution, delusions
  2. Schizophrenia w/ mutism, stupor, rigidity
  3. Schizophrenia w/ disheveled, EARLY age, bizarre emotional responses
  4. Schizophrenia w/ no + sx, only flat affect
A
  1. Paranoid = most common
  2. Catatonic
  3. Disorganized
  4. Residual
    * choose atypical anti psych for acute psychosis, not haldol*

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