Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

6 MD > Psych > Flashcards

Psych Flashcards

1
Q

what disease has frequently smell hallucinations

A

Typical neurodegeneretive disorders like Parkinson, Alzheimers, epilepsy?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bulimia vs Anorexia, similarities? (7)

A
  1. Both are eating disorders
  2. Both can include the binge-purge
  3. Both suffer from low self-esteem
  4. Bad self-image
  5. Both affected by genetic and enviornmental factors
  6. Hypotension (bulimia = tach, anorexia = brady)
  7. Malnutrition and low electrolytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bulimia vs Anorexia, main difference?

A

Bulimia = norm/overweight, Anorexia = underweight (BMI <18.5)

(Bulimia patients are more characterized by Binge-purge than anorexia patients=

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DSM-V criteria for bulimia nervosa?

A

Binge-purge at least once/week over 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Other signs that someone has bulimia? (6)

A
  1. Russel’s sign
  2. Mallory-Weiss syndrome
  3. Halatosis
  4. Eroded teeth
  5. Parotid gland swelling
  6. Loss of electrolytes and metabolic alkalosis (due to puking)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for bulimia? (2)

A
  1. Psychotherapy and CBT (try to eat small amounts of desired food, see that it has not consequenses)
  2. Medical: Fluoxetine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Typical signs of anorexia?

A
  1. BMI < 18,5
  2. Fear of Gaining Weight
  3. Bad self-image
  4. Binge-purge, overexercise
  5. Food rituals
  6. Refuse to eat in front of others
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Physical changes with anorexia? (12)

A
  1. Muscle loss
  2. Hypotension with bradycardia (cardiac muscle loss)
  3. Orthostatic hypotnsion
  4. Edema (CHF and low protein)
  5. Electrolyte loss (decreased intake)
  6. B1 def
  7. Amenorrhea
  8. Bloating and constipation
  9. Pancytopenia
  10. Lanugo
  11. Osteoprorosis
  12. Refeeding syndrome!!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment for anorexia? (2)

A
  1. CBT (individual and with family, improve self esteem etc…)
  2. Medical: Fluoxetine (if they take antipsychotics for something else, consider quetiapin or mirtazipin as they increase apetite)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Difference in ICD vs DSM? (9)

A
  1. ICD does not list characteristics/requirements to confirm diagnosis like DSM does
  2. ICD is more about clinical discression (guidelines rather than criteria)
  3. Especially different in the ways of classifying personality disorders (DSM classifies types, ICD clissify by severity and trait)
  4. DSM is better to diagnose people, as it doesn’t only list a bunch of symptoms where all need to be met, instead it tells you how many of the listed symptoms need to be met to determine a diagnosis
  5. DSM also allows clinical discression (remember, the DSM is just a manual, doesn’t need to diagnose even if criteria are met)
  6. ICD has less specified grouping on some disorders (example instead of choosing between bipolar or depressive disorder, you have a common goup in ICD called mood disorders)
  7. Different typing of schizophrenia
  8. Some disorders in ICD have their own chapter instead of being a part of “mental disorder” chapter (e.g sleep-wake disorders, as they often are due to neurological problems as well, not only psychiatric)
  9. DSM has exclusion criteria, while ICD puts these other possible disorders as their own part called “boundries with other disorders”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diagnostic criteria for Schizophrenia? (5)

A

2 of the following symptoms with at least one being a major symptom lasting for at least 6 months were at least 1 month of that time is spent in active phase, and other causes must be ruled out:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech (word-salad)
  4. Disorganized behaviour /catatonic behaviour (weard movements)
  5. Negative symptom
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 phases that Shizophrenia patients cycle through?

A
  1. Prodromal phase - withdrawn, anxiety
  2. Active phase - severe symptoms/positive symptoms
  3. Residual phase - cognitive symptoms (concentration problems)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Shizophrenia: Positive symptoms? (5)

A
  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Disorganized behaviour
  5. Catatonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Shizophrenia, Negative symptoms? (3)

A
  1. Flat affect
  2. Alogia (poverty of speech)
  3. Avolition (decreased motivation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Main treatment for Schizophrenia?

A

Atypical Antipsychotics!!! (Olanzapine, Quetiapine etc…)

*Supportive psychotherapy and training in social skills may also help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

According to the old classification, what are the 5 subtypes of schitzophrenia?

A
  1. Paranoid: Where someone feels he is being persecuted or spied on.
  2. Disorganized: Where people appear confused and incoherent.
  3. Catatonic: Where people can be physically immobile or unable to speak.
  4. Undifferentiated schizophrenia: A subtype in which no paranoid, disorganized or catatonic features are prominent .
  5. Residual Schizophrenia: In which psychotic symptoms are markedly diminished or no longer present .
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which type of Schitzophrenia is treated with ECT?

A

Catatonic (though this is an old classification, these days ECT is reserved for treatment-resistant schizophrenia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Another name for Disorganized Schizophrenia?

A

Hebephrenic Schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment depending on the subtype of Schizophrenia:

A
  1. Paranoid: AA
  2. Catatonic: ECT, AA + benzodiazepines (relax muscles –> easier movements, lorazepam can be used for both diagnosis and treatment)
  3. Undifferentiated: AA (respond slower, they are alert, but thinking takes time to recover if it does at all)
  4. Schizoaffective: AA + antidepressants/mood stabilisers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Etiology of Schizophrenia? (5)

A

Combination of physical, genetic, psychological and environmental factors:

  1. Identical twin of someone with the disease have a 50% chance of getting it themselves
  2. Shcizophrenia patients have small difference in brain structure
  3. Dopamine and Seretonin imbalance may be a cause
  4. Problems in birth may increase chance of developng it
  5. Stress and drug abuse may be a trigger of developing it in high-risk patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Examples of type of delusions and hallucinations Schizophrenia patients might have?

A
  • Delusions: of control (someone/something controls their actions) and reference (think insignificant remarks are directed at them “tv speaks to me”)
  • Hallucinations: mainly auditory (hearing voices), but also some have visual hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do we mean by “pillow sign” when discussing Schizophrenia?

A

Remember, these patients have abnormal movements! What we often see is that when these patients are lying down, their head might still stay elevated even though there’s no pillow under it (pillow sign).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Long term management of Schizophrenia?

A

Important that they get early medical treatment. Further on, psychotherapy for teaching them social skills and health managment so they can take care of themselves (remember to shower, get out of bed, be with others etc…)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Epidemiology of Schizophrenia?

A
  • Prevelance: 1%
  • Men = Women
  • Earlier in Men (early 20’s, than in women (late 20’s)
  • More in people with first-degree relatives
  • Half of them attempt suicide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What do we mean by calling it “Autism Spectrum”

A

That it’s a spectrum of disorders differing in severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

2 major areas of consideration when evaluating Autism spectrum?

A
  1. Social communication and interaction
  2. Restricted or repetitive behaviour

These areas are again divided into sub-categories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

4 subdivisons of Social communication and interactions in Autism?

A
  1. Social reciprocity - how child responds in social inteactions, autistic children often want to be alone
  2. Joint attention - ability to share interest with someone else
  3. Nonverbal communication - using or interpreting nonverbal communication (e.g child doesn’t put its arms up when it wants to be picked up, or can’t tell when parents are upset from their body language)
  4. Social relationships - making and maintaining friends (behaviour problems)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Restricted or repetitive behaviour in autism? (6)

A
  1. Lining up toys
  2. flapping hands
  3. imitating words or phrases
  4. fixated routines
  5. restrictive thinking (fixated on knowing about one major subject like vacuum cleaners)
  6. Hypo- or hyperactivity to sensory input
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Other important signs commonly seen in autism? (2)

A
  1. reacts badly to sounds
  2. problems maintaining eye contact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Important cooperative partner in diagnosing autism?

A

Parents or teachers, as many of the symptoms can be observed at home or in school, parents can be given a list of things to look for or a severity chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does a severity chart in autism organised?

A

As a spectrum from level 1 (high-functioning) to level 3 (severe autism)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Give an example of how autism lvl 1 can manifest?

A
  • Patient can maybe speak full sentences, but have problem with having a conversation with others (back and forth exchange of info)
  • May show some difficulty with exchanging between activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Give an example of a lvl 3 autism

A
  • only speak a few words or rarely interacts
  • extremely resistant to change
  • problems are considered to severely interfere with daily life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In addition to the signs, what other criteria has to be met before an autism diagnosis can be set? (3)

A
  1. Has to interfere with daily life (social, academic etc…)
  2. Has to manifest itself from an early age (< 3 years old)
  3. Exclude disorders with similar symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Asperger syndrome, where does it fall on the autism spectrum?

A

level 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Exclusion disorders similar to autism? (4)

A
  1. Rett syndrome (genetic disorder, slow development in early age)
  2. Hearing impairment (rule out with audiometry)
  3. Selective mutism (refusal to speak)
  4. Intellectual disability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Diagnostic criteria for autism?

A
  • Patient must experience all communicating problems, and at least 2 restricted/repetitive behaviour symptoms
  • Must be < 3 years old
  • Must be considered an issue to daily life
  • Other causes are excluded
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Etiology of autism?

A

Mainly thought to be due to genetic causing changes in brain development (though no genes have been specified yet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Treatment for autism?

A
  1. Special education
  2. Lifelong behavioural management
  3. Symptom-targeted medication
    • Neuroleptics for aggression
    • SSRI for repetitive behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Symptoms of mania? (DIG FAST)

A
  • Distractability
  • Insomnia
  • Grandiosity (high self-esteem)
  • Flight of ideas
  • Activities (psychomotor Activation)
  • Sexual indiscretions (or other pleasurable activities)
  • Talkativeness/pressured speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Difference between mania and hypomania? (4)

A
  1. Mania is more severe
  2. Mania > week || Hypomania >4 days
  3. Mania causes significant problems in social/occupational function, while Hypomania doesn’t
  4. Mania may be have psychotic features, Hypomania doesn’t
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Shortly explained, what is Bipolar disorder?

A

A disorder where a patient shifts between periods of extreme lows (depression similar to Major depressive disorder) and extreme highs (mania)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

3 types of Bipolar Disorder?

A
  1. Bipolar 1
  2. Bipolar 2
  3. Cyclothemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Manic-depressive interval of bipolar disorder 1?

A
  • Depressive episodes lasting > 2 weeks
  • Manic episodes lasting > 1 week (though can last for months)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Manic-depressive interval of bipolar disorder 2?

A
  • Depressive episodes lasting > 2 weeks (like in bipolar 1)
  • HYPOmanic episodes lasting > 4 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Manic-depressive interval of Cyclothymia?

A
  • Less severe depressive episodes
  • Less severe manic episodes

Depressive and manic episodes are similar in duration here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

2 variations that may occur within the cycle of bipolar disorder?

A
  1. Mixed episodes - where depression and mania may occur at the same time
  2. Rapid cycling - 4 or more episodes of depression or mania within 1 year
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Etiology of Bipolar disorder?

A

Genetic and enviromental

  • 10x risk if family member has it
  • High risk if you have other psych-disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

General treatment for Bipolar disorder?

A
  • Lifelong moodstabilizers (first line, and can be used alone i monotherapy)
  • Consider including or replacing with antipsychotics if mood stabilizers can’t control mania
  • Consider including SSRI if mood stabilizers can’t control depression
  • ECT if mania is refractory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Which mood stabilizers may be used in bipolar disorder?

A
  1. Lithium (first line)
  2. Lamotrigine (second line)
  3. Carbamezipine
  4. Valproic Acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Which mood stabilizer is NOT teratogenic?

A

Lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Lithium side effects? (9)

A
  1. GI symptoms (nausea/diourrhea…)
  2. Milde tremors
  3. Polyuria/Nefrogenic Diabetes Insipidus (blocks ADH-rec)
  4. Acute kidney failure
  5. Hypothyroidism (blocks TSH-receptors) and Goiter
  6. Leukocytosis
  7. Teratogenic (Epstein’s anomaly in fetus)
  8. Neurologic symptoms (ataksia, dysarrthria, confusion, coma)
  9. Skin (psoriasis, dermatitis, acne)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Therapeutic index of lithium?

A

0.6 - 1.5 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Why do most bipolar patients need Lithium + SSRI treatment?

A

Cause mood stabilizers like lithium are best at controlling manic episodes than they are at controlling depressive episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Treatment for acute mania (severe) in bipolar patients? example?

A
  • Mood stabilizer + Antipsychotic
  • Lithium + Haloperidol is a common combo, but atypical antipsychotics like Olanzapine and Quetiapine may also be used
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Typical or atypical antipsychotics for mild/moderate mania?

A

Atypical er usually used (although typical are also effective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Treatment for bipolar pregnant patient

A

CAVE: Mood stabilizers (Lithium and Valproic acid are bad for fetus)

  • Give typical antipsychotics like Haloperidol for mania
  • Give SSRI like escitalopram for depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Treatment option if you want to switch mood-stabilizer monotherapy with something else when treating bipolar patients?

A
  • Atypical antipsychotic (Aripiprazole, Olanzapine, Quetiapine…) for mania
  • SSRI for depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Why do you have to be careful when treating bipolar patient with SSRI?

A

Cause it might increase the mania!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Other possible medications that may be used in bipolar disorder? (2)

A
  1. Anticonvulsants (Lamotrigine, Valpric Acid, Carbamezipine)
  2. Benzodiazepines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What’s a delusion and how can it manifest itself as? (8)

A

Delusion is a break from reality, with fixed false beliefs that can’t be changed with reasonable arguments

  1. Paranoia
  2. Ideas of reference
  3. Thought broadcasting
  4. Delusions of grandur
  5. Delusions of guilt
  6. Persecutory delusions
  7. Erotomanic delusions
  8. Somatic delusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What’s paranoia?

A

feeling being followed, tracked or targeted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What do we mean by “Ideas of reference”?

A

Believe some event is especially related to them (“the guy on tv is talking to me”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What’s Thought broadcasting?

A

To believe others can hear their thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are Delusions of Grandur?

A

Believe they have special powers or are sent on a special misson that only they can do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What are Delusions of guilt?

A

To believe unrelated events are somehow their fault (“WW2 is my fault”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are Persucatory delusions?

A

Believing they are being harassed by others, even though they’re not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are Erotomanic delusions?

A

Feeling someone that doesn’t know them are in love with them (being in love with an movie star)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What are Somatic delusions?

A

Thinking you have a somatic ilness even though you don’t

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What types of hallucinations are there? (5)

A
  1. Visual hallucination (seeing)
  2. Olfactory (phantosmia).
  3. Gustatory hallucinations (tatse)
  4. Auditory hallucinations (hearing)
  5. Tactile hallucinations /feeling)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Most common cause of visual hallucinations?

A

Lewy body dementia or drug intoxication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Most common cause of olfactory hallucinations?

A

Neurodegenerative disorders like parkinson and alzeihmers, but also Epilepsy with aura (affecting temporal region)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Most common cause of tactile hallucinations?

A

Drug or alcohol abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What’s the difference between obsessions and compulsions?

A
  • Obsessions: recurrent, intrusive thoughts that may cause anxiety
  • Compulsions: actions that OCD patients do to reduce the anxiety that comes from the obsessions (impact daily life)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Give examples of obsessions and their compulsions

A
  1. Germs –> Cleaning
  2. Unsafe –> Checking
  3. “Something bad wil happen” –> Repeating
  4. Anxiety –> Arranging
  5. Bad thoughts –> come up with words or phrases to replace the bad thoughts and turn them into good thoughts (mental rituals)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

DSM criteria for OCD? (4)

A

Following criteria has to be met:

  1. Having obsessions, compulsions or both
  2. Time consuming (distress in daily life)
  3. Not due to substance abuse or somatic illness
  4. Rule out other mental disorder (OCPD etc…)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Causes for OCD?

A
  1. Genetics (higher risk if you have an identical twin with OCD)
  2. Environment and upbringing
  3. Seretonin abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Treatment for OCD? (5)

A
  1. CBT (Exposure and response therapy), where patient is exposed for trigger of obsession, but learns to handle anxiety without doing compulsion
  2. Medication: SSRI (sertraline or escitalopram), Antipsychotics (Risperidone), TCA (clomipramine)
  3. Deep brain stimulation (brain pacemaker) for refractory OCD
  4. Neuromodulory surgeries as last resort for severe refractory OCD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

First line and second line treatment regimen for OCD?

A
  • First-line: CBT + SSRI (sertarlin)
  • SNRI (venlafaxine) + TCA (Clomipramine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

1st-line treatment for trichotillomania?

A

TCA (Clomipramine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

SSRI dosage when treating OCD?

A
  • Sertraline, start 25mg, increase to 50mg afte 1 week (if you need to increase further, you can increase by 50mg at a time each week, up to a max dosage 200mg/day
  • Escitalopram, start 10mg, can increase dosage up to 20mg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

How does SSRI treatment of OCD differ from SSRI treatment in depression?

A

OCD may require higher SSRI dosage and longer time for treatment to have effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Explain the Psychodynamic theory on OCD?

A

Psychodynamic theories of OCD state that obsessions and compulsions are signs of unconscious conflict that you might be trying to suppress, resolve, or cope with.11 These conflicts arise when an unconscious wish (usually related to a sexual or aggressive urge) is at odds with socially acceptable behavior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is Agoraphobia?

A

A fear of leaving the house

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

How to treat Agoraphobia?

A
  • 1st line: CBT + SSRI (sertralin)
  • Benzodiazepines or pregabalin may also be of help as they have a relaxing effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Common rule to remember when giving a personality disorder diagnosis?

A

Make sure the patient is over 18 years old!! (because it’s normal for teenager to behave oddly cause they’re premature and hormonal, and it usually goes over for them)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Subdivisions of Cluster A personality disorders? (3)

A

“Weird”

  1. Paranoid personality disorder (accusatory)
  2. Schizoid personality disorder (alone)
  3. Schizotypal personality disorder (awkward)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

How does Paranoid personality disorder manifest itself? (7)

A
  1. Accusatory
  2. Distrustful and suspicious of others
  3. Assume that others will dissapoint, manipulate or talk shit about them (have superficial relationships, often live in isolation)
  4. They try to ensure loyalty of friends and family
  5. Act severely if they feel like they’ve been lied to or backstabbed
  6. Hold grudges for long of time
  7. In return their behaviour often leads to people starting to dislike them or talk badly about them
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

How does Schizoid personality disorder manifest itself? (4)

A

“Alone”

  1. Avoid social interaction
  2. Not interested in being with others (not due to anxiety or paranoia, just due to them being not interested)
  3. Finds all types of physical contact to be unpleasurable
  4. Flat affect
90
Q

How does Schizotypal personality disorder manifest itself? (4)

A

“Awkward”

  1. Magical thinking (“got up on left side, so today it’s gonna rain”)
  2. Ideas of reference (think everything that happens in the world relate to their destiny)
  3. They think they’re in tune with everything around them –> overconfidence and self-centered way of speech (socially innapropriate)
  4. Alone, but they don’t like being alone, they’re just alone because people generally find them weird
91
Q

Which disorder are people with Cluster A at higher risk of developing?

A

Schizophrenia

92
Q

Main difference between Paranoid Personality Disorder and Paranoid Schizophrenia?

A
  1. Paranoid schizophrenia has more intense paranoia
  2. Paranoid schizophrenia often accompanies delusions (PPD don’t)
  3. No positive symptoms in PPD
93
Q

What do Schizoid personality disorder and Schizophrenia have in common?

A

Flat affect

94
Q

Treatment for Cluster A personality disorder?

A

Psychotherapy, although general therapy tend to be ineffective since asking these patient confront their own actions and beliefs might cause them more strain, and people with PPD might even become more distrustful. It’s better to just try to support the individual instead of challenging them, for example by helping them improve their understanding of social activities.

95
Q

Subdivisions of Cluster B Personality Disorder? (4)

A

“Wild”

  1. Antisocial
  2. Borderline
  3. Histrionic
  4. Narcissistic
96
Q

Which disorders do Cluster B personality disorders often relate with? (2)

A
  1. Mood disorders: Depression and Bipolar
  2. Substance abuse disorders
97
Q

How does Antisocial Personality Disorder manifest itself? (6)

A
  1. Manipulate for personal gain (often by charming others)
  2. Disregard for moral values and social norms
  3. Little empathy
  4. Willing to hurt others to help themselves
  5. Prone to aggressive and unlawful behaviour (sociopath/psychopath)
  6. Feel no remorse or guilt for their actions
98
Q

Other than the signs, what else is important to remember when considering to diagnose someone with Antisocial Personality Disorder? (2)

A
  1. Must be over 18 years old
  2. Have a history of conduct disorder
99
Q

How does Borderline Personality Disorder manifest itself? (4)

A
  1. Unstable moods (go from intense joy to rage)
  2. Good relationships often get dramatic and sour
  3. Use splitting as defence mechanism (shift between seeing things as completely good or completely bad)
  4. Terrified of abandonement (do extreme things to keep people from leaving)
100
Q

How does Histrionic Personality Disorder manifest itself? (4)

A
  1. Attention seeking
  2. Very emotional
  3. Manipulate situations to get more attention (leads to superficial relationships)
  4. Viewed as shallow, flighty and egocentric
101
Q

How does Narcissistic Personality Disorder manifest itself? (5)

A
  1. Grandiose self-image (think they’re better than they are and deserve the best)
  2. Think their ideas are the best and others must agree
  3. Secretly have bad self-esteem
  4. Lash out if they get criticized
  5. Exploit others for own personal agenda
102
Q

Treatment for Borderline personality disorder?

A
  • Mainly: Dialectical Behaviour Therapy
  • in norway we mostly use Mentalization-Based Therapy
  • You can additionally also give antidepressants or anti-anxiety meds for symptomatic relief
103
Q

What’s Dialectical Behaviour Therapy?

A
  • Dialectical behavior therapy (DBT) is a type of cognitive-behavioral therapy.
  • Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.
  • Has some similarities with mindfullness.
104
Q

What’s Mentalization-Based Therapy?

A
  • Mentalization based therapy (MBT) is a specific type of psychodynamically-oriented psychotherapy designed to help people with borderline personality disorder (BPD).
  • Its focus is helping people to differentiate and separate out their own thoughts and feelings from those around them.
105
Q

Subdivisions of Cluster C personality disorders? (3)

A

Worried

  1. Avoidant
  2. Obsessive-Compulsive
  3. Dependent
106
Q

Which disorder do Cluster C personality disorders have strongest relationship with?

A

Anxiety disorders

107
Q

How does Avoidant Personality Disorder manifest itself? (5)

A
  1. Shy
  2. Socially inhibited
  3. Want social relationship with others, but rarely take social risks and usually avoid social situations
  4. Low self-esteem
  5. Respond badly to rejection and negative feedback (become more withdrawn whan that happens)
108
Q

Main difference between Avoidant personality disorder and social phobia?

A

In Social phobias, the anxiety is due to a specific situation (like public speaking)

109
Q

How does Obsessive-Compulsive Personality Disorder manifest itself? (5)

A
  1. Obsessed with orderliness, control, rules, details, perfectionism
  2. Is often inflexible
  3. Easily stressed
  4. Ineficient (spend more time worrying about tasks, than doing them)
  5. Rigid to beliefs and moral issues (stubborn)
110
Q

There are a few differences between OCD and OCPD, but what’s the main one?

A
  • OCD is ego-dystonic (they realise that their behaviour is a problem and want to stup but can’t)
  • OCPD is ego-syntonic (they don’t see their behaviour as a problem)
111
Q

How does Dependent Personality Disorder manifest itself? (3)

A
  1. Intense fear of seperation and rejection (overly cling to their relationships)
  2. Lack self-confidence (inability to make decisions)
  3. Hold on to someone that can take care of them (often get trapped in abusive relationships)
112
Q

Type of treatment for Cluster C Personality Disorders? (2)

A
  1. Social skills training (group therapy is good)
  2. Anxiety management (either by psychotherapy or medication)
113
Q

10 types of immature defense mechanisms?

A
  1. Acting out
  2. Denial
  3. Displacement - redirecting feelings to a less threatening object
  4. Intellectualization - facts and logic to avoid stressful thoughts/emotions
  5. Passive aggression -
  6. Projection - attributing their impulses onto others (often in PPD)
  7. Rationalization
  8. Reaction formation - behaving opposite to what they feel
  9. Regression - revert to earlier developmental stage (often in DPD)
  10. Splitting - believing people are either just good or just bad (BPD)
114
Q

4 mature defense mechanisms?

A
  1. Sublimation - transform unacceptable thoughts into acceptable actions
  2. Altruism - coping with stressor by helping others
  3. Suppression - avoiding bad thoughts/feelings
  4. Humor - joking about their bad situation
115
Q

Clinical Indications for ECT? (4)

A
  • MDD:
    • If it’s severe and suicidal risk is very high
    • If there are Psychotic features and antipsychotics don’t help
    • Drug-resistant MDD or in patient’s that don’t handle the drugs well
  • Bipolar disorder:
    • If mood stabilizers and other drugs doesn’t help (ECT treats both mania and depression)
    • If it has severe or drug-resistant depression episodes
    • Refractory or severe mania
  • Schizophrenia
    • If it’s drug resistant or if drugs have caused severe side-effects (e.g NMS)
    • In catatonic Schizophrenia
  • Dementia (if there’s severe aggression)
116
Q

In which circumstances do we consider ECT to be of less risk than typical medication? (2)

A

If we are treatinng:

  1. Elderly patients
  2. Pregnant patients
117
Q

What’s Othello syndrome?

A

Pathological jealousy, a psychological disorder in which a person is preoccupied with the thought that their spouse or sexual partner is being unfaithful without having any real proof.

118
Q

What’s a mood-congruent delusion?

A

Any delusion that may occurr during depression and mania

119
Q

What’s important to remember when you give elderly patients psych-medicines?

A

Be careful with giving elderly patients drugs that decrease neurocognitive function (e.g benzo’s, pregabalin etc…) as many of them often already have decreased cognitive function

120
Q

When giving elderly patients medicine, what’s important to remember about dosage?

A

Give minimal effective dose (remember they have decreased metabolism, so low doses in elderly people have good effect)

121
Q

Most common psychiatric illnesses in geriatric patients?

A

Depression

122
Q

After depression, what are other common psychiatric illnesses in geriatric patients? (3)

A
  1. Dementia
  2. Delirium and delusions
  3. cognitive Decline
123
Q

Cuses for depression in elderly patients?

A
  1. Psychosocial (retired, death of loved ones etc…)
  2. Biological like medical and psychiatric illness (3D’s)
124
Q

How does psychiatric illnesses progress with age (esp. schizo and mood disorders)?

A
  • Generally worsens
  • Cognitive impairment
  • Decreased functionality (because of recurrence and relapses over time
125
Q

How does Bipolar disorders progress with age?

A

Increased depression with age

126
Q

Definition of a delusion? Example?

A

A delusion is a fixed belief that is not amenable to change in light of conflicting evidence. (example: believing someone is spying on them even though they’re proved otherwise)

127
Q

Main difference between obsession and delusion?

A
  • Obsession speaks to quality of thought
  • Delusion speaks to quality of belief
128
Q

Treatment of delirium vs treatment of psychosis?

A

Both can be treated with antipsychotics, but in delirium you have to additionally treat the underlying issue and there are many (e.g infection = antibiotics, electrolyte imbalance = give fluids and electrolytes, alcohol withdrawl =give benzo etc…)

129
Q

What’s a Pseudohallucination?

A

AN involuntary sensory experience vivid enough to be regarded as a hallucination, but considered by the person as subjective and unreal

130
Q

Most common cause of dementia?

A

Alzheimer disease (65%), after that you have vascular dementia (20%)

131
Q

Other causes for dementia?

A

Causes for dementia:

  • Degenerative disease (alzheimer, parkinson etc…)
  • Endocrine (parathyroid, thyoid, pituitary, adrenal ec…)
  • Metabolic (alcohol, electrolytes, B12 def, hepatic, renal glucose)
  • Exogenous (heavy metals, CO, drugs)
  • Neoplasia
  • Trauma
  • Infection
  • Affective disorder (pseudodementia)
  • Stroke/Structure (vascular dementia, hydrocephalus etc…)
132
Q

Another name for dementia is?

A

Major Neurocognitive Disorder

133
Q

What are the 4 parts the within our conciousness that are usually affected by a neurocognitive disorder?

A
  1. Memory
  2. Judgement
  3. Attention
  4. Orientation
134
Q

Define dementia and how does it manifest itself?

A

A decline in cognitive function with global deficits and stable loss of consciousness.

  1. Progressive memory loss worsening over time
  2. Personality changes
  3. Mood and behaviour changes (e.g wandering around, aggression etc…)

It’s progression can be classified into one of 4 levels, depending on severity

135
Q

4 stages of severity of Dementia?

A
  1. Preclinical - slight forgetfulness, fully oriented and capable of self-care
  2. Mild - moderate memory loss, impaired executive function, impaired function at home, but can still do most chores
  3. Moderate - severe memory loss, agnosia, impaired social judgement, needs help with several chores like dressing and hygiene
  4. Severe - severe memory loss, oriented only to one person, needs help with all chores in daily life, might develop aphasia
136
Q

How is Dementia diagnosed?

A
  • Mainly clinical
  • Mini-Mental State Exam (MMSE) or Montreal Cognitive Assessment (MoCA)
  • Normal diagnostic tests like blood tests, culture, virology etc… to find out if there’s a somatic cause for it
  • Brain MRI might show atrophy and other changes
  • Definitive answer requires brain autopsy (histopathology)
137
Q

Treament for dementia?

A
  • Mainly Cholinesterase inhibitors (donepezil, rivastigmine, galantamine)
  • If it’s Alzheimer dementia, add Memantine (NMDA antagonist)
  • If they have strong psychosis, add low-dose antipsychotic (avoid benzo)
  • Provide environmental cues, structure in daily life, and education for them, their family and their caregivers
138
Q

Dementia types? (6)

A
  1. Alzheimer’s disease.
  2. Vascular dementia.
  3. Lewy Body Disease.
  4. Frontotemporal dementia.
  5. Alcohol related dementia.
  6. Down syndrome and Alzheimer’s disease.
139
Q

2 Main signs of frontotemporal dementia?

A
  • Personality and behavior changes (frontal part)
  • Progressive aphasia and other speaking disorders (temporal)
140
Q

2 main causes of Frontotemporal dementia?

A
  1. Alzheimer disease (neurofibrillary tangles)
  2. Pick disease (tau bodies)
141
Q

What’s delirum?

A

An acute disturbance with altered cognition that develops over a short period of time (hours to days).

142
Q

Causes for delirium?

A

I WATCH DEATH

  • Infection
    • Withdrawl
  • Acute metabolic/substance Abuse
  • Trauma
  • CNS pathology
  • Hypoxia
    • Deficiencies
  • Endocrine
  • Acute vascular (MI)
  • Toxins
  • Heavy metals
143
Q

How does delirum manifest itself? (6)

A
  1. Acute onset within hours-days (often after a somatic illness)
  2. Shift between intervals of Hyperactive and and Hypoactive symptoms
  3. Hallucinations, illusions or delusions
  4. Combative, anxious, paranoid or stuporous behaviour
  5. Decreased memory and attention
  6. Sundowning (more symptoms at night)
144
Q

Hyperactive symptoms of delirum?

A
  1. Agitation
  2. Incoherent speech
  3. Disorganized thoughts
  4. Delusions
  5. Hallucinations and illusions
  6. Disorientation
145
Q

Hypoactive symptoms of delirum?

A
  1. Lethargy
  2. Drowsiness
  3. Less reactive
  4. Withdrawn
146
Q

Diagnosis of delirium?

A

Check for an underlying cause and do according tests for that

  1. Neurological exam
  2. Vital signs and blood tests
  3. Consider if the medications they take may be a cause
  4. Consider if substance abuse is a reason and test for it
  5. Renal and hepatic status
147
Q

Treatment of delirium? (4)

A

Remember, deirium is often reversible!

  1. Treat underlying cause (e.g infection = antibiotics etc…)
  2. Normalize fluids and electolytes if they’re abnormal
  3. Optimize sensory environment (e.g hearing aid for hearing problems)
  4. Low-dose antipsychotics (haloperidol) for agitation and psychosis
148
Q

Delirium vs Dementia? (5)

A
  1. Delirium is acute onset, while dementia is slowly-progressive
  2. Early phase of delirium presents with severe cognitive symptoms, while early dementia presents with little to no symptoms (cause it hasn’t progressed enough)
  3. Hallucination is mainly seen in delirium, only possible in dementia if it’s dementia with delirium
  4. Delirium is usually reversible, dementia is not
  5. Delirium might quickly fluctuate in symptoms and severity within a short time-period, dementia doesn’t
149
Q

Delirium tremens vs normal delirium? (4)

A
  1. Delirium Tremens is mainly a withdrawl symptoms in alcohol-withdrawl
  2. DT symptoms can occur anytime of day in any severity (no sundowning)
  3. Normal delirum is mainly due to an underlying disease not necessarly associated with alcohol withdrawl
  4. DT is treated with benzos, normal delirium is not
150
Q

Definition of Generalized Anxiety Disorder?

A

It’s an anxiety disorder characterized by excessive, persistent and often irrational worry about events or activities in daily life. This excessive worry often interferes with daily functioning, and sufferers are overly concerned about everyday matters.

151
Q

Symptoms of GAD? (5)

A
  1. Worries and Anxiety
  2. Restlessness
  3. Concentration problems
  4. Muscle tension
  5. Insomnia –> fatigue
152
Q

DSM diagnostic criteria for GAD? (5)

A

Following criteria has to be met:

  1. Excessive anxiety more days than not for >6 months (e.g >90 days out of 180 days)
  2. Patient finds it hard to control (can’t calm down)
  3. Adult: 3 or more GAD symptoms, Child: 1 or more GAD symptoms
  4. Impairs daily life
  5. Not due to medication, drug abuse or other illness
153
Q

Treatment for GAD? (3)

A
  1. CBT is first line
  2. SSRI’s are helpful
  3. if nothing else helps, try benzo’s
154
Q

Define Social Anxiety Disorder? (4)

A
  1. Fear and anxiety in social situations due to a fear of being judged by others
  2. Egodystonic
  3. Interfere with daily life and relationships
  4. Lasts for > 6 months
155
Q

Physical symptoms seen in people with Social Anxiety? (5)

A
  1. Trembling
  2. Derealization (in severe anxiety)
  3. Blushing
  4. Spacing out
  5. Use of drugs/alcohol to deal with anxiety
156
Q

Treatment of Social Anxiety Disorder? (4)

A
  1. CBT is 1st line
  2. SSRI may often help
  3. Benzo may also help
  4. B-blocker may help some of the physical symptoms
157
Q

What’s a panic attack?

A
  • An intense fear that something bad is going to happen
  • Symptoms may last minutes to hours
  • Can happen evereywhere, even in familiar places where one is usually calm
  • women > men
158
Q

DSM criteria for diagnosing panic attacks?

A

At least 4 of the following symptoms /can last minutes to hours):

  1. Dizziness
  2. Nausea
  3. Sweating
  4. Shortness of breath
  5. Trembling
  6. Numbness
  7. Palpitations
  8. Angina
  9. Chills
  10. Feeling chocked
  11. Feeling detached
  12. Fear of losing control
  13. Fear of death
159
Q

Which mental disorders are often prone to panick attacks?

A
  1. Panic Disorder
  2. Anxiety disorders
  3. PTSD
  4. Depressive disorder
  5. Substance abuse disorder
160
Q

Criteria for diagnosing someone with Panic Disorder? (4)

A
  1. Recurrent and unexpected panic attacks
  2. Persitant worry or behavioral change due to panic attack
  3. Not due to medication or substance abuse
  4. Not due to other illness
161
Q

Behavioural changes that people with panic disorder might develop after a while? (3)

A
  1. Avoidance - avoiding places where they previously hade panic attacks
  2. Anticipatory anxiety - being anxious of developing a panic attack
  3. Agoraphobia - choose to stay isolated so no-one can se them panicking
162
Q

Treatment of panic disorder? (4)

A
  1. CBT (learn, monitor, breathing and relaxation techniques, change beliefs, exposure)
  2. SSRI
  3. Benzodiazepines
  4. Antiseizure medications like pregabalin may also be used sometimes
163
Q

Types of psychotherapy? (6)

A
  1. Psychodynamic therapy – a psychoanalytic therapist will encourage you to say whatever is going through your mind. This will help you become aware of hidden meanings or patterns in what you do or say that may be contributing to your problems.
  2. Cognitive Behavioural Therapy (CBT) – a form of psychotherapy that examines how beliefs and thoughts are linked to behaviour and feelings. It teaches skills that retrain your behaviour and style of thinking to help you deal with stressful situations.
  3. Cognitive Analytical Therapy (CAT) – uses methods from both psychodynamic psychotherapy and CBT to work out how your behaviour causes problems, and how to improve it through self-help and experimentation.
  4. Interpersonal Psychotherapy (IPT) – looks at the way an illness can be triggered by events involving relationships with others, such as bereavements, disputes or relocation. It helps you cope with the feelings involved, as well as work out coping strategies.
  5. Humanistic Therapy – encourage you to think about yourself more positively and aim to improve your self-awareness.
  6. Family and Couple (systemic) therapy – therapy with other members of your family that aims to help you work out problems together.
164
Q

Name all 6 SSRI’s

A
  1. Sertralin
  2. Citalopram
  3. Escitalopram
  4. Fluoxetin
  5. Fluvoxamin
  6. Paroxetin
165
Q

Indication for SSRI’s? (7)

A
  1. Depression
  2. OCD
  3. Panic Disorder
  4. PTSD
  5. GAD
  6. Social disorder and social fobia
  7. Fluoxetin: Bulimia
166
Q

Side effects of SSRI’s? (6)

A
  1. Nausea/Vomiting
  2. Diarrhea
  3. Insomnia
  4. Decreased libido, orgasm and ejaculation
  5. SIADH
  6. Seretonergic Syndrom
167
Q

Medication-spesific side-effects of SSRI’s? (3)

A
  1. Paroxetin = Category D pregnancy (heart problems in fetus)
  2. Citalopram/Escitalopram = Long QT-interval
  3. Fluoxetin, Fluoxamin, Paroxetin = Inhibit Cyt p450
168
Q

Name all 5 SNRI’s

A
  1. Duloxetin
  2. Venlafaxin
  3. Desvenlafaxin
  4. Milnacipran
  5. Levomilnacipran
169
Q

3 conditions that any of the SNRI’s can treat?

A
  1. Depression
  2. Anxiety
  3. Neuropathic pain
170
Q

2 additional indications for Duloxetine?

A
  1. Urinary incontinence
  2. Fibromyalgia
171
Q

5 additional indications for Venlafaxine?

A
  1. Social anxiety
  2. Panic disorder
  3. OCD
  4. PTSD
  5. Postmenopausal hot-flashes
172
Q

Side-effects of SNRI’s?

A
  1. Insomnia
  2. Nausea/vomiting
  3. Increased BT (and other adrenergic symptoms)
  4. Decreased libido, orgasm and ejaculation
  5. Seretonin syndrome
  6. Duloxetin: hepatotoxic
  7. Venlafaxine: inhibit cyt p450
173
Q

What is seretonin syndrome?

A

A complex of severe seretonin activity, usually an antidepressant side-effect

174
Q

Symptoms of Seretonin Syndrome? (7)

A
  1. Hyperthermia
  2. Rubor
  3. Rigidity
  4. Aggitation
  5. Psychogenic Non-Epileptic Seizure (PNES)
  6. Coma
  7. Suicidal thoughts
175
Q

Antitoxin to seretonin syndrome?

A

Cyproheptadine

176
Q

Pharmacokinetiks of Tricyclic Antidepressants?

A

Inhibit reuptake of Seretonin and Norepinephrine, incrising their level

177
Q
A
178
Q

What are the 2 types of TCA’s?

A
  1. Tertiary (non-selective)
  2. Secondary (only increase Norepinephrine)
179
Q

Name the 3 Tetriary TCA’s and 2 Secondary TCA’s

A

Tertiary (non-selective):

  1. Amitriptylin
  2. Klomipramin
  3. Imipramine

Secondary (selective, norepinephrine):

  1. Desipramine
  2. Nortriptyline
180
Q

Indications for TCA’s? (4 + 2)

A
  1. Severe depression
  2. Neuropathic pain
  3. Migraine
  4. Phobias
  5. Clomipramine: OCD, anxiety, narcolepsy
  6. Amitriptyline: chronic pain, nocturnal eneuresis
181
Q

Side-effects of TCA’s? (7)

A
  1. Sedation (H1 inhibitor)
  2. Anticholinergic effect (inhibit M-receptors)
  3. Ortthostatic hypotension (a1-inhibitor)
  4. Serotonin syndrome
  5. 3C’s = Convulsjoner, Coma, Cardiotoksisk (arytmi og QT-forlengelse)
  6. Cyt p450 inhibitors
  7. Weight increase
182
Q

Pharmacokinetics of Typical Antipsychotics, and the pathways the affect? (6)

A

Inhibit D2 receptors, affecting the following pathways

  1. Mesolimbic system - motivation, wishes, beliefs,
  2. Mesocortical system - feelings
  3. Nigrostriatal pathway - unconcious movements
  4. Tuberofundibular pathway - prolactin release
  5. Chemoreceptor trigger zone (Area Postrema) - nausea
  6. Medullar periventricular zone - apetite
183
Q

Name the typical antipsychotics (3 +4)

A

High-dose (weak):

  1. Chlorpromazin
  2. Chlorprothixene
  3. Levomepromazin

Low-dose (strong):

  1. Haloperidol
  2. Fluphenazine
  3. Flupentixol
  4. Pimozid
184
Q

Indication for Typical Antipsychotics (5)

A
  1. Psychotic episodes
  2. Strong manic episodes
  3. Strong delusions
  4. Huntington’s syndrome
  5. Tourette’s syndrome
185
Q

Side-effects of Typical Antipsychotics? (10)

A
  1. Orthostatic hypotensionn og long QT-interval (inhibit a1)
  2. Sedative (H1 inhibitor)
  3. Anticholinergic (M-receptor inhibitor)
  4. Metabolic syndrome: dyslipidemia and hyperglycemia
  5. Dystonia
  6. Oculogyric crisis
  7. Akathisia
  8. Pseudoparkinosnism
  9. Tardive dyskinesia
  10. NMS - neuroleptic malignant syndrome
186
Q

What’s Dystonia?

A

Muscular spasms of facial muscles, tongue and back-muscles ocurring within hours - days

187
Q

What’s an Oculogyric crysis?

A

Spasms of the ocular muscles causing them to look up and to the side

188
Q

What’s Akathisia?

A

Restlessness and uncontrollable movements lasting days - months

189
Q

What’s pseudoparkinsonism?

A

Syndrome of parkinson-like symptoms: rigidity, bradykinesia and tremors

190
Q

What’s tardive dyskinesia?

A

Continous, rythmical movements of oral muscles.

191
Q

What’s Neuroleptic Malignant Syndrome?

A
  • Side-effect of antipsychotics.
  • Same symptoms as seretonin syndrome, but only difference is that in NMS has HYPOreflexia and normal pupils, while in seretonin syndrome it’s the opposite.
192
Q

Treatment of NMS? (2)

A
  1. Dantrolene (muscle relaxor)
  2. Bromocriptine (D2 agonist)
193
Q

Causes for MDD? (4)

A
  1. Genetics (increased when family members have it)
  2. Environment
  3. Monoamine deficiency theory - decreased/changed seretonin, norepinephrine or dopamine
  4. Tryptophan deficiency - less tryptophan means less seretonin made in the body
194
Q

Symptoms of MDD?

A
  • Sleep changes (more or less)
  • Interest loss (less interest of previous pleasurable activities)
  • Guilt (worthlessness)
    • Energy decrease (lack of energy)
    • Concentration decrease (decreased concentration/cognition)
  • Appetite loss/gain
  • Psychomotir increase or decrease (anxiety or lethargy)
  • Suicidality (thoughts or attempts)
195
Q

DSM criteria for diagnosis of MDD? (4)

A
  1. 5 of 9 SIG E CAPS symptoms
  2. NO MANIA!!
  3. Affects daily life
  4. Not due to drugs, substances or other illness
196
Q

Non-pharmacologic treatment of MDD? (2)

Pharmacologic treatment of MDD? (4)

A
  • Non-Pharm:
  1. Physical activity and healthy diet
  2. Psychotherapy (CBT and interpersonal therapy)
  • Pharmacologic:
  1. SSRI
  2. SNRI
  3. TCA
  4. Antipsychotics (if there’s psychotic depression)
197
Q

What’s atypical depression?

A

depression, but certain things can still make you happy (less loss of interest)

198
Q

What’s dysthymia?

A

Milder depression symptoms for longer time (>2 years)

199
Q

What’s Post-partum depression?

A
  • Depression starting during or within first month after childbirth
  • Can occurr in men as well
  • Hormonal changes and sudden lifestyle change may be a cuse
200
Q

Most common phobias? (4)

A
  1. acrophobia, fear of heights.
  2. arachnophobia, fear of spiders
  3. autophobia, fear of being alone
  4. claustrophobia, fear of tight spaces
201
Q

Risk Factors for Suicide?

A

SAD PERSONS

  • Sex (male)
  • Age (<19 or >45)
  • Depression
    • Previous attempt
  • Excess alcohol or subtance abuse
  • Rational thinking loss
  • Single
  • Organizing an attempt
  • No social support
  • Sickness (somatic)
202
Q

Name the Atypical Antipsychotics (7)

A
  1. Aripiprazol
  2. Clozapin
  3. Quetiapine
  4. Olanzapine
  5. Paliperidone
  6. Risperidone
  7. Ziprasidone
203
Q

Indications for Atypical Antipsychotics? (6)

A
  1. Acute manic episodes
  2. OCD
  3. Bipolar disorder
  4. Anxiety
  5. Depression
  6. Tourette’s syndrome
204
Q

Side-effects of Atypical Antipsychotics? (7)

A

Like the typical antipsychotics, but less severe

  1. Orthostatic hypotension (a1-inhibitor)
  2. Sedation (H1-inhibitor)
  3. Anticholinergic effects (M-inhibitor)
  4. Hyperprolactinemia (Risperidon)
  5. Prolonged QT-interval (Ziprasidone)
  6. Metabolic Syndrome (Clozapin og Olanzapine)
  7. Seizure og Agranulocytosis (Clozapin)
205
Q

Injectable (IM) antipsychotics? (2 +4)

A

Typical:

  1. Fluphenazin
  2. Haloperidol

Atypical:

  1. Aripiprazole
  2. Risperidone
  3. Paliperidone
  4. Olanzapine
206
Q

What’s Psychoanalysis treatment and which disorders is it used for?

A
  • Psychoanalysis is a method of treating emotional difficulties that involves communication between a psychoanalyst and an individual, with the goal of gaining insight into the individual’s inner world and how it affects his or her emotions, behavior, and relationships.
  • Used for anxiety and depression
207
Q

Causes for aggression? (3)

A
  1. Psychiatric (psychosis, delirium and others)
  2. Substance abuse
  3. Somatic (dementia, tumor , pain)
208
Q

In which neurodegenerative disease is depression most common?

A

Parkinson’s disease

209
Q

What’s Acute Stress Disorder?

A

An intense, unpleasant, and dysfunctional reaction beginning shortly after an overwhelming traumatic event and lasting less than a month. (if it lasts more, it’s PTSD)

210
Q

What’s PTSD?

A

An intense, unpleasant, and dysfunctional reaction beginning shortly after an overwhelming traumatic event and lasting over a month.

211
Q

Symptoms of PTSD? (4) What about children?

A
  1. Re-experiencing the trauma (nightmares, flashbacks)
  2. Avoids certain situations and environments that may cause stress
  3. Hypervigilant (always on-guard)
  4. Hyperarousal (startled by even small triggers)

*Children don’t show these symptoms, but may show symptoms later in life

212
Q

Treatment of PTSD? (3)

A
  1. Exposure therapy (expose to triggers and show them that they are safe)
  2. Group therapy (can re-live trauma in a supportive environment)
  3. Medication: Antidepressants (esp. SSRI’s), antianxiety medications and sleep medication
213
Q

Criteria/signs for substance-use disorder? (11)

A
  1. Taking the substance in larger amounts or for longer than you’re meant to.
  2. Wanting to cut down or stop using the substance but not managing to.
  3. Spending a lot of time getting, using, or recovering from use of the substance.
  4. Cravings and urges to use the substance.
  5. Not managing to do what you should at work, home, or school because of substance use.
  6. Continuing to use, even when it causes problems in relationships.
  7. Giving up important social, occupational, or recreational activities because of substance use.
  8. Using substances again and again, even when it puts you in danger.
  9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance.
  10. Needing more of the substance to get the effect you want (tolerance).
  11. Development of withdrawal symptoms, which can be relieved by taking more of the substance
214
Q

Background of CBT?

A
  • CBT is based on the combination of the basic principles from behavioral and cognitive psychology.
  • It is different from historical approaches to psychotherapy, such as the psychoanalytic approach where the therapist looks for the unconscious meaning behind the behaviors and then formulates a diagnosis. Instead, CBT is a “problem-focused” and “action-oriented” form of therapy, meaning it is used to treat specific problems related to a diagnosed mental disorder. The therapist’s role is to assist the client in finding and practicing effective strategies to address the identified goals and decrease symptoms of the disorder.
  • CBT is based on the belief that thought distortions and maladaptive behaviors play a role in the development and maintenance of psychological disorders,and that symptoms and associated distress can be reduced by teaching new information-processing skills and coping mechanisms.
  • The modern roots of CBT can be traced to the development of behavior therapy in the early 20th century, the development of cognitive therapy in the 1960s, and the subsequent merging of the two.
215
Q

Criteria/signs for diagnosing someone with catatonia? (8)

A

Having 3 or more of the following:

  1. Not responding to other people or their environment
  2. Not speaking
  3. Holding their body in an unusual position
  4. Resisting people who try to adjust their body
  5. Agitation
  6. Repetitive, seemingly meaningless movement
  7. Mimicking someone else’s speech
  8. Mimicking someone else’s movements
216
Q

The 3 types of catatonia?

A
  1. Akinetic catatonia
  2. Excited catatonia
  3. Malignant catatonia
217
Q

Signs of Akinetic catatonia? (4)

A
  1. Most common
  2. Stares blankly and won’t respond when spoken to
  3. May repeat words/phrases they hear
  4. Sometimes sit or lie in an unusual position and won’t move
218
Q

Signs of Excited catatonia? (3)

A
  1. Patient may move, but movement seem pointless or impulsive
  2. They may seem agitated, combative or delirious
  3. May mimic movement of others around them
219
Q

What’s Malignant catatonia?

A
  • When the catatonia affects somatic health like dangerous changes in BP, temperature, breathing or heart rate
  • These patient may be dehydrated, have blood clots, or kidney failure due to their catatonia
220
Q

Psych symptoms of Hypo- and Hyperthyroidism? (2+4)

A

Hypothyroidism:

  1. Mild to severe fatigue
  2. Depression

Hyperthyroidism:

  1. Anxiety
  2. Nervousness
  3. Restlessness
  4. Irritability
221
Q

First time depressed patient that started on ssri, feeling better after two months, what to do?

A

6 months medication, 6 weeks tamper down

222
Q

Main symptoms of Delirium Tremens? (3)

A
  1. Fever
  2. Agitation
  3. Hallucinations

6 MD (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions