Psych Flashcards
- Fixed, false belief Persecutory most common Schizophrenia
- bipolar beliefs lasting >1 month
Delusions
Delusions treatment:
Atypical Antipsychotic Agents
- Cluster B personality disorder
- F > M
- Splitting Unstable mood and relationships Self-mutilation
- Increased suicide risk
Treatment
- Psychotherapy
Borderline Personality Disorder (BPD)
- Sx duration > 1 month
- Persistent re-experiencing of event
- Persistently ↑ arousal
- Avoidance of stimuli
- ↑ Risk for suicide, substance abuse
Post-Traumatic Stress Disorder (PTSD)
- history of taking typical (1st generation) antipsychotic medication
PE will show:
- repetitive facial movements (chewing, lip smacking)
Treatment:
- stopping the offending drug
Tardive Dyskinesia
What are first-line treatment options for a patient with acute mania?
- Mood stabilizer (e.g., lithium, valproic acid)
or
- atypical antipsychotic medication (e.g., olanzapine, quetiapine).
treatment for patients with debilitating anxiety related to performance situations?
Propranolol.
Pediatric version of antisocial personality disorder Violating human rights of others
Conduct Disorder
Depression Symptoms SIG E CAPS
- Sleep (insomnia/hypersomnia)
- Interest (anhedonia)
- Guilt (worthlessness)
- Energy (fatigue)
- lack Cognition/Concentration
- Appetite (wt. loss); usually declined, occasionally increased
- Psychomotor retardation or agitation (restlessness or slowness)
- Suicidality (thoughts of death)
Excessive/unreasonable fear interfering with normal function for > 6 months Focused, detailed history Provocation: specific feared object/situation exposure Leads to avoidance behavior Not better explained by another disorder Management includes medications, behavioral modification, and desensitization therapy
Phobia
PE will show respiratory depression, sedation, miosis, hyporeflexia, bradycardia, hypotension, hypothermia Diagnostics may show prolonged QTc interval
Opioid Toxicity
Opioid Toxicity management:
stabilization naloxone
treatment for delusional dissorder:
aripripazole
When taking olazanpine you must monitor:
Lipid Profile
___________is contraindicated to use in patients with a history of bullimia nervosa becyase it can cause seizures
Bupropion
Patient with a history of binge eating followed by purging via forced vomiting, purging via laxative abuse, driven exercise or fasting
Bulimia Nervosa
PE will show dental erosions and calloused knuckles
Bulimia Nervosa
Diagnosis is made by one episode of binge eating with inappropriate compensatory behavior per week for a minimum of three months in a patient whose self-evaluation is unduly influenced by body shape or weight
Bulimia Nervosa
Bulimia Nervosa treatment
psychotherapy, cognitive behavioral therapy, and antidepressants
Lifelong, recurrent mood episodes of either mood pole Mania, hypomania Inflated self esteem Decreased need for sleep Pressured speech Flight of ideas Excessive pleasurable activity
Bipolar disorder
Excessive worry Persistent symptoms Difficult to control feelings Symptoms last over six months Treat with CBT, SSRI
Generalized Anxiety Disorder (GAD)
≥ 2 symptoms: Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms
Schizophrenia
Duration: Brief psychotic disorder:
< 1 month
Duration Schizophrenia:
> 6 months
Duration Schizophreniform disorder:
1–6 months
psychosis + mania or depression=
Schizoaffective disorder
History of excessive dieting, purging, body image disturbance, and fear of weight gain Complaining of amenorrhea PE will show > 15% below ideal body weight, lanugo, osteoporosis Treatment is behavioral therapy Comments: Patient will be in denial of illness
Anorexia Nervosa
Abnormal ejaculation Erectile dysfunction Low libido Take a thorough history Review medication list Manage medical co-morbidities Weight loss, quitting smoking, exercise
Male Sexual Dysfunction
Alpha adrenergic receptors such as __________help reduce nightmares and imporve sleep in patients with PTDS
Prazosin
Besides schizoid personality disorder, what are the other cluster A personality disorders?
Paranoid and schizotypal.
Few friends Odd attire, behavior and beliefs Social anxiety Treatment: psychotherapy, anti-psychotics
Schizotypal Personality
Schizotypal Personality treatment:
Treatment: psychotherapy, anti-psychotics
Recurrent thoughts (obsessions), behaviors (compulsions) Difficult to control Disruption of daily living Need to perform rituals Yale-Brown Obsessive Compulsive Scale Treat with medications and therapy
Obsessive-Compulsive Disorder
Arrogant Entitlement Lack empathy Self-importance Superiority
Narcissistic Personality Disorder
Narcissistic Personality Disorder treatment:
Psychotherapy Addition of mood stabilizers or antipsychotics if pt poses threat to self/others
Inattention + impulsivity + hyperactivity
Attention-Deficit/Hyperactivity Disorder (ADHD)
Most common childhood behavioral disorder Inattention + impulsivity + hyperactivity Dx criteria: Sx present in 2 areas of interaction Sx must present before 12 years Sx > 6 months Sx maladaptive/inappropriate for child’s developmental stage
Attention-Deficit/Hyperactivity Disorder (ADHD)
Deficits in interpersonal relationships Speech and language delay, poor eye contact, stereotypic behaviors Not linked to vaccinations
Autism
What is the correct term to describe a person sexually excited by inflicting psychological or physical harm on a sexual partner?
Sexual sadism.
Fantasies/urges about children Person is greater than age 16 and age gap is greater than 5 years Use of pornography
Pedophilic Disorder
Pedophilic Disorder management:
Psychotherapy Medical management: medroxyprogesterone IM
Formerly Munchausen Syndrome Desires “sick role” Hx of multiple hospital admissions Willingness to undergo procedures
Factitious Disorder
first line threatment for patients with factitous disorder?
psychotherapy
most effective medication for patients with conduct disorder?
stimulatns: methylphenidate dextroamphetamine
Pediatric version of antisocial personality disorder Violating human rights of others
Conduct Disorder
Early symptoms: anxiety, nausea, restlessness Risk of seizure Delirium tremens may start after 48 hours Correct nutritional deficiencies Offer alcohol cessation support /resources
Alcohol Withdrawal Syndrome
Alcohol Withdrawal Syndrome treatment:
Treat with benzodiazepines
Patient will be a man With a history of using smokeless tobacco products PE will show a thickened, white plaque with an irregular outline Diagnosis is made by biopsy Most commonly caused by precancerous hyperplasia of the squamous epithelium Treatment is close observation or surgical excision Comments: CAUTION! NOT the same as Oral Hairy Leukoplakia
Oral Leukoplakia
At least six months of symptoms in a child Angry, argumentative, defiant behavior Vindictiveness Evaluate for other co-morbidities
Oppositional Defiant Disorder (ODD)
Oppositional Defiant Disorder (ODD) treatment
Treat with psychotherapy
Flu-like illness Abdominal cramps Diarrhea Mydriasis Piloerection Yawning
Opioid Withdrawal
Opioid Withdrawal treatment:
Rx: methadone, buprenorphine, clonidine for iatrogenic, other nonopioid adjuncts
Concerned with appearance and flaws May seek out cosmetic procedures Evaluate for other mental health conditions
Body Dysmorphic Disorder (BDD)
Body Dysmorphic Disorder (BDD) treatment:
Treat with SSRI, CBT
Schizophrenia is characterized by which two symptoms?
Hallucinations and delusions.
Cluster B personality disorder F > M Splitting Unstable mood and relationships Self-mutilation, increased suicide risk
Borderline Personality Disorder (BPD)
Borderline Personality Disorder (BPD) treatment:
Psychotherapy
Attention seeking, want to be center of attention Dramatic Flamboyant Seductive behavior Sexually inappropriate
Histrionic Personality Disorder
Histrionic Personality Disorder treatment:
Psychotherapy
Genuine sx with no identifiable cause Precipitating emotional event often precedes somatic symptoms F > M Management involves a combination of behavior modification, and psychological and social therapy
Somatic Symptom Disorder (formerly Somatoform Disorder)
Hypochondriasis Preoccupied with serious illness, despite negative exam/testing Evaluate for other medical diagnosis Management is CBT, psychotherapy, anti-depressants
Illness Anxiety Disorder
What does anosognosia mean?
Poor insight.
HTN, tachycardia, hyperthermia Vertical, horizontal, or rotatory nystagmus Variable pupil size Combative behavior Complications: rhabdomyolysis, seizures
Phencyclidine (PCP) Intoxication
Phencyclidine (PCP) Intoxication treatment:
BZDs, cooling, IVF, charcoal
What class of medication is most effective in treating a patient with somatic symptom disorder that has not improved with therapy?
Antidepressants.
Which is the most common mood episode specifier associated with cyclothymic disorder?
Anxious distress.
Milder form of bipolar Symptoms for at least 2 years (for children, a full year) Both hypomania and depressive periods Never fulling the criteria for an episode of mania, hypomania, or major depression
Cyclothymic Disorder
DSM 5 criteria ≥ 1 symptom(s) of altered sensory function or altered voluntary motor function Not consistent with recognized neurological or medical conditions Patient’s symptoms are not better explained by another medical condition or medical disorder Symptoms causes significant distress impairment in functioning a need for medical evaluation
Conversion Disorder (Functional Neurologic Symptom Disorder)
