Psych Flashcards
Case: Recurrent and persistent thought of killing her children & Significant anxiety and distress, relieved by short prayers.
1) Dx?
2) Most appropriate management?
3) Duty to report
1) OCD
2) SSRI (i.e., sertraline)
3) None. OCD is ego-dystonic, thus her children are not in imminent danger.
Eating disorder: Most likely comorbid disorder?
Substance use disorder (30%)
Cf. Body dysmorphic disorder can be comorbid, but not as common. Body image distortion is usually a Sx of eating disorder.
Clinical Triad in Peds with Tourette syndomre
1) SSx
2) Other disorders of the triad
1) Repetitive, stereotyped, involuntary movements and vocalizations (tics): e.g., shrugging, grunting, spitting,
2) ADHD and OCD
Delusional disorder
1) Def of delusion
2) SSx
1) Fixed false belief
2) Day-to-day function is NOT impaired (cf. Somatic symptom disorder)
Eating Disorder: Best Tx?
CBT and interpersonal thearpy.
Cf. Nutrition counseling is an adjunct.
Note: Bupropion contraindicated because it lowers Sz threshold (to which eating disorder is susceptible).
Hyperprolactinemia
1) Cause
2) SSx
1) Antipsychotic meds (hypothalamic dopamine blockade)
2) gynecomastia, infertility, sexual dysfunction, irregular menses
Opioid use d/o comes after friend died of OD: Best next steps?
- Naloxone kit (most important)
- Grief counseling
- Encourage rehab / opioid replacement therapy.
Cocaine Intoxication
1) SSx
2) VS
1) Increased arousal, self-confidence, euphoria, confusion, restless, sweating
2) HTN, Tachycardia
- Sympathetic over-activity
Agitation in sympathomimetic intoxication: Tx
Benzodiazepines until agitation controlled.
- Monitor respiratory depression & hypotension.
- Usually the 1st line (or its component) for agitation of any cause. (Schizo: benzo + haldol)
- Cf. Antipsychotic alone is NOT adequate, given its SE, onset and duration.
