Psych/Behavioral Med (Alice) (6%) Flashcards
3 anxiety d.o’s to know
gad
panic d.o
phobias
GAD involves persistent/excessive worry pertaining to multiple events/domains that continues for _ or more
6 months
panic d.o is characterized by recurrent unexpected panic attacks with at least _ or more of of worry or avoidant behavior
1 month
symptoms of panic attack develop abrupty and reach a peak w.in _
10 mins
symptoms of phobias begin _ prior to stressful event
10-15 min
first line tx for phobias
exposure therapy
tx for agoraphobia
ssri
cbt
ADHD involves hyperactvity, impulsivity, or inattentiveness prior to age
12
dsm 5 for ADHD
> 6 symptoms of inattention/hyperactivity/
impulsivity x 6 months
symptoms must occur in more than 1 setting
non stimulant used to tx ADHD
atomoxetine
moa for stimulants vs non stimulants
stimulants: block reuptake up NE, DA, and 5HA
non stimulants: selective NE reuptake inhibitor
second line pharm for ADHD
antidepressants:
guanfacine
clonidine
imipramine
buproprion
venlafaxine
developmental delay in socialization, language, and cognition
autisim spectrum d.o (asd)
ASD encompasses (4)
autistic d.o
childhood disintegrative d.o
pervasive developmental d.o nos
asperger
normal cognitive development, poor relationships, does not spontanesously seek activities w. others
asperger d.o
dsm 5 for ASD
-social communication/interaction deficit in many contexts (emotion,verbal, relationships etc)
-restricted/repetitive patterns of behavior, interests, or activities (motor/inability to change/restricted or fixed interests/hyper or hypoactivity)
-symptoms present in early developmental period
-symptoms not better explained by other condition
tx for ASD (6)
refer
audiology eval
SLP
CBT
SGA’s
SSRIs
SSRI’s are used to treat what type of ASD behavior
stereotyped/repetitive behavior
definition of child abuse/neglect
deliberate action that is harmful to a child’s physical, emotional, or sexual well-being
what type of fx makes you concerned for child abuse
spiral
what type of burns make you concerned for child abuse (2)
doughnut shaped
stocking-glove
possible manifestations of child abuse (lots!)
anxiety
aggression
PTSD
dpn/suicide
SUD
poor self esteem
dissociative d.o
paranoid ideation
ftt
neglect can include (2)
-minor allowed to engage in harmful behavior
-minor left unattended
t/f: healthcare providers must report any suspicion of child abuse to protective services
t!
3 depressive disorders to know
mdd
persistent depressive d.o (dysthymia)
pmdd
dsm 5 for mdd
-5 or more sigecaps >/= 2 weeks nearly every day
-at least one symptom is dpn or anhedonia
what does sigecaps stand for
sadness
interest loss (anhedonia)
guilt
energy loss
concentration issues
appetite (increased vs decreased)
psychomotor acvitity
suicidal
titration for ssri’s
uptitrate 3-4 weeks until desired effect
ssri’s become fully effective in _ weeks
4-6
dsm 5 for persistent depressive d.o (dysthymia) (3)
depressive sx > 2 years
never been w.o sx > 2 months at a time
no mania or hypomania
dsm 5 for pmdd (3)
-at least 5 sx in the week before onst of menses
-begin to improve w.in a few days after onset
-minimal to absent 1 week post menses
second line tx for pmdd (3)
birth control
diuretics
GnRH
2 disruptive, impulse-control, and conduct d.o to know
conduct d.o
oppositional defiant d.o
less intense form of conduct d.o
odd
dsm 5 for odd
-4 sx for at least 6 months
-exhibited during interaction with at least one non sibling
frequent temper tantrums
arguments w. authority
non-conforming to rules/regulations
intentional exasperation of others
easily annoyed by others
revenge-seeking/vindictive
angry attitude
harsh/unkind
major differentiator btw odd and conduct d.o
w. odd:
-no aggression towards people or animals
-no destruction of property
-no pattern of theft/deceit
pharm for odd/conduct d.o (2)
antipsychotics
stimulants
anorexia is < _% IBW
85
how does anorexia differ from bulimia (2)
BMI < 17
< 85% IBW
_ has the highest rate of eating disorders
anorexia
2 types of anorexia
binging/purging
restricting
t/f: binging/purging includes laxatives/diuretic use and excessive exercise
t!
restricting includes (2)
eating very little
excess exercise
indication for hospitalization w. anorexia
< 75% IBW
t/f: SSRIs have little proven efficacy for anorexia
t!
but may help w. weight gain
t/f: bulimia is binge eating +/- purging
t!
lab abnl’s seen w. bulimia (3)
metabolic alkalosis
urinary chloride < 20 mEq
hypokalemia
t/f: bulimia includes laxative/diuretic use and excessive exercise
t!
t/f: bulimia pt’s are disturbed by their behavior
t!
dsm 5 for bulimia
binging and compensatory behaviors occur at lest once a week for 3 months
PE findings of bulimia (4)
scars on knuckles
swollen parotids
dental erosions
normal weight/overweight
pharm for bulimia
fluoxetine 60 mg (greater dose than for dpn)
alt: TCAs, MAOIs
t/f: male deaths by suicide outnumber female 4 to 1
t!
t/f: females attempt suicide more ofthen than males
t!
5 rf for suicide
mental d.o
previous suicide attempt
LGBTQ
hx physical or sexual abuse
fam hx suicide
general principles for managing suicidal kids/adolescents (6)
-address fam interactions/increase fam support
-sufficient treatment sessions
-target AUD/SUD
-discuss motivation for tx
-initiate tx quickly and w. higher intensity
-coordinate tx from multiple providers
