Psych/Behavioral Med (Alice) (6%) Flashcards by Seth Northway

3 anxiety d.o’s to know

gad
panic d.o
phobias

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GAD involves persistent/excessive worry pertaining to multiple events/domains that continues for _ or more

6 months

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panic d.o is characterized by recurrent unexpected panic attacks with at least _ or more of of worry or avoidant behavior

1 month

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symptoms of panic attack develop abrupty and reach a peak w.in _

10 mins

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symptoms of phobias begin _ prior to stressful event

10-15 min

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first line tx for phobias

exposure therapy

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tx for agoraphobia

ssri
cbt

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ADHD involves hyperactvity, impulsivity, or inattentiveness prior to age

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dsm 5 for ADHD

> 6 symptoms of inattention/hyperactivity/
impulsivity x 6 months

symptoms must occur in more than 1 setting

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non stimulant used to tx ADHD

atomoxetine

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moa for stimulants vs non stimulants

stimulants: block reuptake up NE, DA, and 5HA

non stimulants: selective NE reuptake inhibitor

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second line pharm for ADHD

antidepressants:
guanfacine
clonidine
imipramine
buproprion
venlafaxine

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developmental delay in socialization, language, and cognition

autisim spectrum d.o (asd)

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ASD encompasses (4)

autistic d.o
childhood disintegrative d.o
pervasive developmental d.o nos
asperger

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normal cognitive development, poor relationships, does not spontanesously seek activities w. others

asperger d.o

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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

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tx for ASD (6)

refer
audiology eval
SLP
CBT
SGA’s
SSRIs

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SSRI’s are used to treat what type of ASD behavior

stereotyped/repetitive behavior

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definition of child abuse/neglect

deliberate action that is harmful to a child’s physical, emotional, or sexual well-being

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what type of fx makes you concerned for child abuse

spiral

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what type of burns make you concerned for child abuse (2)

doughnut shaped
stocking-glove

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possible manifestations of child abuse (lots!)

anxiety
aggression
PTSD
dpn/suicide
SUD
poor self esteem
dissociative d.o
paranoid ideation
ftt

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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

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

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

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

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/f: bulimia pt's are disturbed by their behavior

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/f: females attempt suicide more ofthen than males

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