Psych Flashcards
Delusions; subtypes?
Fixed, false beliefs that remain despite evidence to the contrary and cannot be accounted for by the cultural background
Bizarre or non-bizzare
What does DIG FAST stand for and what is it used for
Sx of mania
Distractibility, Irritable mood/insomnia, Grandiosity, Flight of ideas, Agitation/increase in goal-directed activity, Speedy thoughts/speech, Thoughtlessness: seek pleasure without regard to consequences
What does SIG E. CAPS stand for and what is it used for?
Depression
Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation
Mood stabilizers
Lithium
Valproate, lamotragine, carbamazepine
Aripiprazole and atypical antipsychotics
DSM-5 for schizophrenia
-2+: Delusions, Hallucinations, Disorganized speech (must have at least one of these)
Grossly disorganized/catatonic behavior or Negative symptoms
-Significant impair of life
-at least 6m
Which neurotransmitter is likely involved in schizophrenia
Dopamine
Which neural pathways are likely involved for positive and negative symptoms in schizophrenia?
Prefrontal cortical: Inadequate dopaminergic activity responsible for negative symptoms
Mesolimbic: Excessive dopaminergic activity responsible for positive symptoms
Implications of tubuloinfundibular pathway in schizophrenia?
Blocked by antipsychotics, causing hyperprolactinemia, which may → gynecomastia, galactorrhea, sexual dysfunction, and menstrual irregularities
Implications of nigrostriatal pathway in schizophrenia?
Blocked by antipsychotics, causing Parkinsonism/ extrapyramidal side effects such as tremor, rigidity, slurred speech, akathisia, dystonia, and other abnormal movements
Sx of NMS?
Change in mental status, autonomic instability (high fever, labile blood pressure, tachycardia, tachypnea, diaphoresis), “lead pipe” rigidity, elevated creatine phosphokinase (CPK) levels, leukocytosis, and metabolic acidosis.
DSM-5 of schizophreniphorm
Same as schizophrenia except time frame; 1m-6m
DSM-5 for schizoaffective
- Meet criteria for a major depressive or manic episode AND psychotic symptoms consistent with schizophrenia
- Delusions or hallucinations for 2 weeks in the absence of mood disorder symptoms
- Mood symptoms present for a majority of the psychotic illness
Brief psychotic disorder
Like schizophrenia but 1w-1m
DSM-5 delusion disorder
- One or more delusions for at least 1 month.
- Does not meet criteria for schizophrenia.
- Functioning in life not significantly impaired, and behavior not obviously bizarre
Schizotypal personality disorder
Paranoid, odd or magical beliefs, eccentric, lack of friends, social anxiety. Criteria for overt psychosis are not met
Schizoid personality disorder
Solitary activities, lack of enjoyment from social interactions, no psychosis.
SAD PERSONS
Suicide risk
Sex (male), Age (<19/>45), Depression, Previous attempt/Psych hx, EtOH or drugs, Rational thinking loss, Separated/divorced, Organized (plan), No social support, Sick
Time frame for a major depressive episode?
2 weeks
Brand names of SNRIs
venlafaxine (Effexor) and duloxetine (Cymbalta)
Persistant depressive disorder
aka dysthymia
Depressed mood most of the time most days for at least 2 years (no more than 2 months asymptomatic)
Cyclothymic disorder
Alternating periods of hypomanic sx (but not full episode) and periods with mild-to-moderate depressive symptoms (but not full MDE)
-2 years with no asymptomatic period >2m
Difference in using SSRI to treat anxiety vs depression
Takes longer and higher dose required for anxiety
Panic disorder
Spontaneous, recurrent panic attacks that occur suddenly, “out of the blue”
Order of glucose and thiamine in EtOH abuse?
Thiamine first; prevent precipitation of Wernike-Korsakoff
What do you give for severe agitation in cocaine abuse?
Antipsychotics (Haldol)
Why does paroxetine suck?
(Paxel) anticholinergic SE, most sexual dysfunction, not as good as the others
First line antidepressant in cancer patients?
Mirtazipine
Anti-anxiety and increases appetitie
What do you use to treat a depressive episode in someone with BP?
2nd gen antipsychotics (quetiapine and lurasidone) or lamotragine
First step in acute psychosis in children
Rule out medical cause (SLE, UTI, DM etc)
Most common used psychoactive substance in US?
Caffeine
Best antipsychotic for diabetics
Ziprasidone (geodon)
Treat aggression in PCP intoxication
Benzo
First line pharmacotherapy for ETOH abuse?
Naltrexone or acamprosate
