psych Flashcards
Autisim is associated with what diseases
mental retardation (intellectual disability), tuberous sclerosis, fragile x
Alzheimer disease NT changes
decrease ACh increase glutamate
Anxiety NT changes
increase NE, decrease GABA, decrease 5-HT
depression NT changes
decrease NE, decrease 5-HT, decrease dopamine
huntington disease NT changes
decrease GABA, decrease Ach, increase dopamine
parkinson disease NT changes
decrease dopamine increase Ach
schizophrenia NT changes
increase dopamine
Order of loss in terms of orientation
1st: time 2nd: place 3rd: person
What is dissociative fugue?
aburupt ravel or wandering during a period of dissociative amnesia, associated with traumatic circumstances
In elderly ppl what can present like dementia and what should you screen for?
Depression and hypothyroidism (pseudodementia)–>measure TSH, b12 levels
Time period schizophrenia
> 6 months
time period brief psychotic disorder
time period schizophreniform disorder
lasting 1-6 months
time period schizoaffective disorder
lasting >2 weeks (schizophrenia with episodic superimposed major depression or mania (or both))
time period delusional disorder
> 1 month
time period of manic episode
lasts at least 1 week
time period for hypomanic episode
lasts at least 4 consecutive days
Difference btwn hypomanic and manic
manic has severe mood disturbance with persistently elevated, expansive, or irritable mood while mood disturbance not severe enough in hypomanic
Treatment of bipolar and what can make it worse?
Treatment is mood stabilizer (lithium, carbamazepine, valproic acid), atypical antipsychotics. Antidepressants can percipitate mania
how long does cyclothymic disorder last for diagnosis?
at least 2 years
What does electroconvulsive therapy do?
produces grand mal seizure in an anesthetized patient
Access of patients to what item increases risk of suicide?
firearms
Infant deprivation effects (4 W’s)
Wanting (infant withdrawn/unresponsive)
Wary (lack of basic trust)
Weak (failure to thrive)
Wordless (lack of socialization skills)
3 parts to psychosis
Delusions, Hallucinations (usually auditory), Disorganized speech
Often occur as an aura of psychomotor epilepsy and in brain tumors
Olfactory
Common in alcohol withdrawal and also seein in cocain abusers as bugs crawling on one’s skin
Tactile
Occurs while goign to sleep sometimes seen in narcolepsy hallucination
Hypnogogic
Occurs while waking from sleep sometimes seen in narcolepsy
Hypnopompic
Hyperactive pathway in schizophrenia
mesolibic-mesocortical pathway
Persistent feelings of detachment or estrangement from one’s own body, thosughts, perceptions, and actions (__) or ones environment (_____)
Depersonalization
Derealization
Characteristics of MANIC episode
Distractibility, Irresponsibility (seeks pleasure w/o regard to consequences), Grandiosity (inflated self esteem), Flight of Ideas, Increase in goal directed Activity/psychomotor Agitation, decrease need for Sleep, Talkativeness or pressured speech
How long does major depressive episodes last?
6-12 months
Criteria for depression
SIG E CAPS
1) Sleep disturbance
2) Loss of interest
3) Guilt or feelings of worthlessness
4) Energy loss and fatigue
5) Concentration problems
6) Appetite/weight changes (usually decreased)
7) Psychomotor retardation or agitation
8) Suicidal ideations
Main difference btwn atypical depression and major depression
Improved mood with positive events
Depression vs anxiety sleep stages?
Think of norepinephrine (decreased in depression so incrreased REM sleep; increased in anxiety so decreased rem sleep)
Length of pathologic grief
> 6 months
Risk factors for suicide
Sex (male) Age (teenager or elderly) Depression Previous attempt Ethanol or drug use loss or Rational thinking Sickness (medical illness, 3 or more prescription) Organized plan No spouse Social support lacking
What is not considered pathologic grief
Hallucinations (eg hearing voice of deceased love one) in the absence of other psychotic symptoms are not pathologic
Panic disorder criteria
PANICS Palpitations Paresthesias Abdominal distress Nausea Intense fear of dying or losing lIght headedness Chest pain/Chills/Choking/disConnectedness Sweating Shaking Shortness of breath
Diagnosis of panic disorder
Attack + 1 month (or more ) of following
- Persistent concern of additional attacks
- Worrying about consequences of attack
- Behavioral change related to attacks
Length of generalized anxiety disorder vs adjustment disorder
> 6 months,
PTSD vs Acute stress disorder time period
> 1month, 3 days to one month
enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and onself
Personality trait
Inflexible, maladaptive and rigidly pervasive behavior causing distress + impaired functioning
Personality disorder
Pervasive distrust and suspiciousness; projection is major defense mechanism
Paranoid
Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness
Schizotypal
Unstable mood and interpersonal relationships, impulsivity, self-mutiliation, boredom, snese of emptiness; splitting major defencse
Borderline
Excessive emotionality and excitability, attention seeking, sexually provocative, overlly concerned with appearance
Historinic
Submissive and clingy, excessive need to be taken care of, low self-confidence
dependent
Preoccupation with order, perfectionism, and control and behavior is consistent with ones own beliefs or values
OCPD
Transsexualism vs Transvestism?
Transsexualism-desire to live as opposite sex through surgery and hormone therapy
Tresvestism-paraphilia, not gender dysphoria. Wearig clothes of opposite sex
Stages of change in overcoming substance addiction
1) Precontemplation
2) contemplation
3) preparation/determination
4) action/willpower
5) maintenance
6) relapse
1st symptom of alcohol withdrawal
tremouslousness (5-10 hr after) w/ gi distress, anxiety, agitation, autonomic disturbance (increase HR, respiration, body temp)
2nd major symptom of alcohol withdrawal
DT (48-72 hours after)
Treatment of opioid intoxication
naloxone, naltrexone
Treatment of opioid withdrawal
methadone, buprenorphine
How does opioid withdrawal present?
“Flu-like symptoms”–> sweating, dilated pupils, piloerection (“cold turkey”), fever, rhinorrhea, yawning, nausea, stoach cramps, diarrhea
ADHD treatment
Stimulants (e.g. methylphenidate)
Alcohol withdrawal treatment
Long acting benzodiazepines (eg chlordiazepoxide loarazepam, diazepam)
Bipolar disorder treatment
Lithium, valproate (mood stabilitzing), atypical antipsychotics
Bulimia treatment
SSRI
Depression treatment
SSRI
GAD treatment
SNRI SSRI
OCD treatment
SSRI, clomipramine
PAnic disorder treatment
SSRI, venlafaxine, benzodiazepine
PTSD treatment
SSRI, venlafaxine
Schizophrnia tratment
Atypical antipsychotics
Social phobia treatment
SSRI, B blocker
Tourette syndrome treatmen
Antipsychotics (e.g. fluphenazine, pimozide, tetrabenazine, clonidine)
PCP acts at what receptor and what does it do?
Acts as a NMDA receptor antagonist leading to excess release of excitatory neurotransmitters
LSD acts at what receptor and what does it do?
Acts on the 5-HT serotonin receptor
Heroin addiction treatment?
Methadone-long term oral opiate with good oral bioavailability for heroin detoxification or long-term maintenance
Naloxone+buprenorphine-antagonist +partal agonist. Naloxone not orally bioavailable, withdrawal if injected
Naltrexone-long-acting opioid antagonist used for relapse prevention once detoxified
Untreated Wernicke encephalopathy can lead to what?
Irreversible memory loss in korsakoff syndrome
Triad of wernicke encephalopathy
Ataxia, confusion NOT confabulations , ophthalmoplegia
