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IPAP > Psych Block 2 > Flashcards

Psych Block 2 Flashcards

1
Q

Define Dissociation

A

Mental process of disconnecting from thoughts, feeling memories of sense of identity

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2
Q

Define Dissociative Symptom

A

Depersonalization- feeling detached from and as an outside observer of one’s mental processes or body

Derealization- experiences of unreality of surroundings

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3
Q

What can cause Acute Stress Disorder

A

Exposure to actual or threatened death/injury/sexual violence

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4
Q

How many Sxs are needed to Dx Acute Stress Disorder

A

9 Sxs that last between 3 days and 1month

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5
Q

What are the five categories and 14 Sxs that can be used to Dx Acute Stress Disorder?

A

Intrusive- memory, dream, flashback

Negative Mood- negative mood or emotions

Dissociative- altered sense of reality

Avoidance- avoiding memories or reminders

Arousal- disturbed sleep, irritable, hypervigilant, decreased concentration, exaggerated startle response

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6
Q

The clinical presentation of Acute Stress Disorder is variable but typically includes ?

A

Anxiety response

Form of re-experiencing/reactivity to traumatic event

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7
Q

What are the non-pharm and pharmaceutical methods for treating Acute Stress Disorder?

A

Non: CBT, exposure and debriefing

Rx- SSRI, Benzo, Propanolol, Morphine

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8
Q

How do people get PTSD?

A

Exposure or threat of death, injury, or sexual violence

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9
Q

What are the criteria for Dx PTSD?

A

Sxs lasting more than 1mon
One or more intrusive Sx
Avoidance of BOTH memories and external reminders
Two or more alterations in cognition/mood
Two or more alterations in arousal/reactivity

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10
Q

How is PTSD characterized?

A

Heightened sensitivity to potential threats

Very reactive to unexpected stimuli

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11
Q

What are the DDxs for PTSD?

What are the DDxs for Acute Stress Disorder?

A

M GOAT- MDD, GAD, OCD, Acute Stress DO, TBI

PAP TOP- PTSD, Adjustment D/o, Panic D/o, TBI, OCD, Psych D/o

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12
Q

What are the non-pharmaceutical treatments for PTSD?

A

Psychtherapy ASAP after event and brief 8-12 sessions
Cognitive processing
Prolonged exposure therapy
Eye movement desensitization

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13
Q

What are the pharmaceutical treatments for PTSD?

A 
SSRIs- Sertraline or Paroxetine
Propanolol- peripheral anxiety Sxs
Clonidine- hyperarousal
Prazosin- nightmares
Carbamazepine- impulse or anger
Benzos- anxiety and panic 
Trazadone- insomnia
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14
Q

How does Adjustment Disorder develop?

A

Emotional/behavior problems that develop withing 3mon of an identifiable stressor

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15
Q

What are the Sxs for Dx Adjustment Disorder?

How long does it take for the Sxs to resolve?

A

Distress OOPT stressors intensity
Impaired social/occupation function

Within 6mon of removal of stressors/consequences

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16
Q

For a Dx of Adjustment Disorder the Sxs must not be normal for what other Dx?

A

Bereavement

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17
Q

What are the 3 DDXs for Adjustment Disorder?

A

MDD
PTSD
Personality D/o

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18
Q

What are the non/pharmaceutical methods for treating Adjustment d/o?

A

Immediate Sx redution- bag breathing
Recognition and removal of stress source
Logging
Exercise and relaxation

Short term use of Benzo, Anti-histamine or SSRIs

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19
Q

In summary, what are the timelines for ASR, PTSD and AD Sxs?

A

ASR- traumatic event causing Sxs for 3days-1mon
PTSD- traumatic event causing Sxs for 1mon or more
AD/o- stressful event presenting 3mon from start and resolves in 6mon

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20
Q

Define Bereavement

Define Grief

A

Situation where someone who’s close dies

Natural response to bereavement

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21
Q

What are the two phases of Grief?

Complicated grief is AKA ?

A

Acute and Integration

Persistent Complex Bereavement D/o

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22
Q

What events occur during acute first phase of grief?

A

Immediate feeling of numb, shock and denial
Comprehension occurs months later
Intense sadness, longing and emptiness may peak after recognition sets in

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23
Q

Sometimes grief can present with what Sx that actually provides some benefits?

A

Denial

Pain relief and allows time for funeral/post-death affairs

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24
Q

What can cause the Acute Phase of grief to be substantially extended?

A

Suicides

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25
Q

What are the hallmarks of healing from death?

A

Recognition they have grieved
Returning to work/daily plans
Re-experiencing pleasures/companionship

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26
Q

How is grief treated?

A

Resources as requested
No formal interventions are indicated
Reserved therapy/pharmacotherapy

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27
Q

What complicating factors can decrease the prognosis for grief?

A

Nature of the loss
Poor support network
Comorbid psychiatric conditions

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28
Q

What causes Persistent Complex Bereavement Disorder and what Sxs are needed for Dx?

A

Death of someone close

One of: SY DC
Yearning, Intense sorrow, Preoccupation w/ deceased, Preoccupied w/ circumstances of death
Six of: DAAM ARMPIT AD
Accepting, Disbelief, Positivity, Anger, Maladaptive, Die, Trusting, Alone, Meaningless, Role, Interests

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29
Q

What is the time frame for diagnosing Persistent Complex Bereavement Disorder

Typically what is seen here from the PT?

Why is this time frame needed?

A

Sxs x 12mon (6mon if child) since death of person of close relationship

Persistent yearning/longing for deceased

Differentiates normal from persistent grief

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30
Q

What are the risk factors that can lead to Persistent Complex Bereavement Disorder?

A

Hx of Anx/Depression
Emotionally misunderstood/insecure
Several previous deaths near them
Death of child or young adult
Violent death- homicide, suicide, accident
Traumatic notification
Hostile/insensitive behavior of others before/after death

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31
Q

What comorbidites are associated with Persistent Complex Bereavement Disorder?

What needs to be screened/monitored for in these PTs?

A

Depression, PTSD, Substance abuse

SIs

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32
Q

What are the DDxs for Persistent Complex Bereavement Disorder?

A

Normal Grief
PTSD
GAD
MDD

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33
Q

What are the treatment methods for Persistent Complex Bereavement Disorder?

A

Resolve grief Sxs and foster adaptation for loss
Education
Monitor every 1-4wks
1st line= behavior therapy to focus on loss acceptance and resuming daily life
2nd line= Rx for comorbid psych conditions (depression, PTSD)
Serotonin active anti-depressants may augment therapy

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34
Q

What are the long term risks of untreated Persistent Complex Bereavement Disorder?

A

13mon= smoking, depression, eating and HTN
25mon= CVD or neoplastic Dz
SI/SAs
Chronic and unremitting

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35
Q

Suicide won’t always be caught on screenings but what can be screened for?

A

High risk situations

Suicidiality in depressed PTs

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36
Q

What is the strongest risk factor for suicide?

A

Hx of previous attempts/threats

Previous attempt= 5-6x higher risk of repeat attempt

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37
Q

> 90% of PTs who attempt suicide have ?

95% of are successful have ?

A

Psych d/o

Psych dz

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38
Q

What are two strong predictors for suicide?

A

Sx of hopelessness

Impulsivity

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39
Q

What psych conditions have a higher risk factor for suicide?

A

BED PODS P
Bipolar, Eating, Depressive, Panic, OCD/PTSD, Dissociative, Substance abuse
Personality

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40
Q

What type of living statuses have a higher risk for suicide?

Regardless of martial status, what is the universal risk?

A

Never married- highest
Widowed, Separated, Divorced, Married w/o kids

Living alone

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41
Q

What age groups are at increased risk for suicide?

What other factors can increase the risks of a suicide?

A

Completed suicides increase w/ age, >85 males are at elevated risks

Military service
Poor health
FamHx of Suicide

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42
Q

What are the protective factors against a suicide?

A

Support
Pregnancy
Parenthood
Religion/participation in activities

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43
Q

What questions are asked to fill in the Objective part of the note for a suicidal PT?

A 
AMSIT
Appearance
Mood/Affect
Sensorium/Intellect
Thoughts
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44
Q

What is the difference between Mood and Affect of a SI history note?

A

Mood- subjective

Affect- objective

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45
Q

What are the four parts of managing an SI PT?

A

Keep self and staff safe
Reduce immediate risk
Manage underlying conditions
Monitor and f/u

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46
Q

What meds can be prescribed to PTs presenting w/ SIs?

When are SI PTs at the highest risk for suicide?

A

SSRIs- best initial choice due to low chance of OD

First week after d/c
30% withing first year after release due to perceived loss of therapeutic support

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47
Q

What is the criteria for child abuse?

A

Any injury under 6mon
If older than 6mon:
Bruises, lacerations, scald burns, fractured bone presentation, drugged/intoxication, self report or shows fear of care taker

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48
Q

What types of PT presentation can suggest concerns of child neglect?

A

Unsupervised in dangerous environments
Malnourished/starved
Disregard of basic child needs- including drugs/ETOH use by caretaker

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49
Q

What type of info can an abusive parent provide regarding the presentation of their child?

A

Denial/lack of knowledge
Vague
Conflicting
Partial/complete admission

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50
Q

What type of info can a non-abusive parent provide about the presentation of their child?

A

Denial
Defends the abuser
Evasive answers
Witnesses

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51
Q

What type of info can a child who is a victim of abuse provide to a provider?

What can their sibling offer?

A

Denial
Protection of abuser
Truth

Denial/lack of knowledge
Truth

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52
Q

What act mandates professional reporting of cases of suspected/identified child abuse or neglect?

A

Child abuse Protection and Treatment Act of 1974 Public Law 93-247

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53
Q

What are the two most common types of elder abuse?

A

Physical

Emotional

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54
Q

Define Physical elder abuse?

Define Emotional elder abuse?

A

Non-accidental use of force including drugs, restraints or confinement

Speaking/treating elders in ways that cause pain

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55
Q

Define Verbal elder abuse?

Define Non-Verbal abuse?

A

Intimidation w/ yelling or threats

Ignoring, terrorizing or menacing including isolation from friends/activities

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56
Q

Who is generally the first responder to report elder abuse, neglect or exploitation?

A

Adult Protective Services

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57
Q

When does domestic violence usually begin or escalate?

A

Pregnancy

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58
Q

Domestic violence PTs are at increased risks for ? and can have what non-specific somatic complaints?

A

Depression, suicide, substance abuse

Insomnia, HA, GI, pelvic, chest or back pain

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59
Q

Domestic violence can cause what health risks for families?

A

Older kids witnessing violence- issues at school, domestic complaints, participants of violence

Teens- more likely to be homeless, substance abusers, sex Dzx, early pregnancy, inc risk of suicide or self mutilation

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60
Q

How does possible domestic abuse victim present/info is offered?

A 
Unexplained/multiple injuries
"Accident" prone
Partner is present or speaks for PT
Low self esteem
Somatic complaints
Hx of anxiety, depression, SIs of substance abuse
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61
Q

How are questions presented to PTs to screen for domestic violence and why are they asked in this way?

A

Present in matter of fact way

Implies willingness to help

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62
Q

Define the criteria for Anorexia Nervosa

A

Energy intake restrictions resulting in body weight lower than normal due to intense fear of gaining weight or becoming fat or a behavior that prevent weight gain despite being low weight

Disturbance of self image in relation to body weight or lack of recognition of seriously low weight

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63
Q

What are the 3 essential features of anorexia nervosa

A

Persistent energy intake restriction
Intense fear of gaining weight/becoming fat
Disturbance in self perceived weight/shape

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64
Q

When does anorexia nervosa begin and what type of social life can the PT have?

A

Rarely begins before puberty

Some can remain socially active, others isolate and become reclusive

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65
Q

What are the 3 primary goals to anorexia nervosa treatment?

All PTs Dx need to be co-managed w/ ?

A

Restore normal body weight
Establish normal eating behavior
Resolve psychological difficulties

Psychiatrist

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66
Q

When do PTs w/ anorexia nervosa need to be admitted?

A

Hypovolemia
E+ d/o
Severe protein/energy nutrition
Failure to improve w/ out patient methods

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67
Q

What are the criteria for bulimia nervosa?

A

Binge eating episodes of too much in one sitting w/ a sense of loss of control that occurs once per week x 3mon and outside of anorexia nervosa periods

68
Q

What are the 3 essential features of bulimia nervosa?

A

Recurrent binge eating episodes
Inappropriate compensatory behaviors to prevent gain
Self evaluation that is influenced by body weight/shape

69
Q

How do PTs w/ bulimia nervosa compensate for their actions?

What is an increased risk in these PTs?

A

Ashamed and conceal Sxs despite being within normal or overweight range

Suicide

70
Q

What are the 4 DDx for bulimia nervosa?

A

Anorexia
Binge eating
Borderline personality d/o

71
Q

What are the treatment methods for bulimia nervosa?

A

Support
Psychotherapy
SSRIs- fluoxetine hydrochloride

72
Q

What are the criteria for binge eating disorders?

A

Recurrent episodes of binge eating (too much, loss of control)
3 or more: too fast, uncomfortably full, eating alone due to embarrassment, disgusted/depressed
Once a week x 3 mon with no compensatory/anorexia

73
Q

What are the DDxs for binge eating d/o?

How is it treated?

A

Bulimia
Border line

Psychotherapy and CBT are best

74
Q

Define ADHD

A

Persistent pattern of impaired functionality or development with inattention and/or hyperactivity or impulsivity

75
Q

What are the inattention Sxs of ADHD?

A 
6 of:
No attention to detail
Sustained attention
Not listening
Follow through w/ instructions
No organization
Avoids sustained mental effort
76
Q

What are the hyperactive Sxs of ADHD?

A 
Fidgets
Leaves seta 
Runs/climbs
No leisure
"on the go"
Talks excessively
Blurts out/can't wait for turn
Interrupts/intrudes
77
Q

What are the most notable/important S/Sxs of ADHD?

A

Peer rejection or accidental injury with hyperactivity or impulsivity

78
Q

What are the most effective pharmaceuticals for ADHD?

A

Methylphenidate
Amphetamine
Desipramine- TCA for PTs w/ concomitant depression/neurological pain

Bupropion- contraindicated stimulant or PTs w/ major depression

Atomoxetine- NON-stimulant and second line drug approved by FDA for ADHD

Fuanfacine and clonidine- non-stimulants w/ efficacy for ADHD

79
Q

Why do ADHD PTs need to have behavior and pharmaceutical therapies at the same time?

A

High concern for addiction w/ med monotherapy

80
Q

What are the criteria for Autism?

A

Deficit in social/emotional reciprocity, non-verbal communication and relationships
Two of:
Motor movement, object or speech
Inflexible adherence to routines
Restricted/fixated interest that are abnormal in intensity
Unusual interest in sensory aspects of environment

81
Q

Describe Levels 1 of Autism

A

1- Inflexibility of behavior causes significant interference w/ functioning.
Difficulty switching activities
Issues w/ organization and planning hamper independence

Person can speak full sentence and engage in communication but to/from conversations w/ others fail and attempts to make friends fail

82
Q

Describe Levels 2 of Autism

A

Inflexible behavior
Difficult coping with change
Restricted/repetitive behavior noticeable to passerby

Person speaks w/ simple sentences, interaction is limited to narrow special interests and markedly odd nonverbal communication

83
Q

Describe Levels 3 of Autism

A

Inflexibility of behavior
Extreme difficulty coping with change
Great distress/difficulty changing focus or action

Person w/ few words of speech and rarely initiates interaction or makes unusual approaches to meet needs and only responds to very direct social approaches

84
Q

What are the first Sxs seen of Autism?

A 
Delayed language development
Lack of social interest
Unusual social interactions
Odd play
Unusual communication patterns
85
Q

What are the primary treatments for Autism?

A

Developmental and behavioral therapies

Risperidone/Aripiprazole- only ones w/ FDA approval

86
Q

Define Oppositional Defiant Disorder

A 
Angry/irritable mood w/ argumentative/defiant behavior for 6mon with 4 of:
Loses temper
Easily annoyed
Angry
Argues w/ authority
Refusal to comply w/ authority/rules
Intentional annoys rules
Blames others for mistakes
Spiteful/vindictive- 2x in 6mon
87
Q

When/where is Oppositional Defiant Disorder seen?

A

Families w/ child care is disrupted by succession of different caregivers or,
Families w/ harsh, inconsistent or neglectful practices

88
Q

What are the two most common co-occurring conditions appear with oppositional defiant disorder?

A

ADHD

Conduct d/o

89
Q

How is Oppositional Defiant Disorder treated?

A

Psychotherapy

Pharmacotherapy- to treat comorbidity

90
Q

Criteria for conduct disorder?

A

Behavior that violates the basic right of others or social norms manifested as 3 of:
ALOT

91
Q

What is the essential feature of conduct disorder?

A

Repetitive and persistent pattern of behavior where basic rights of others are violated

92
Q

What other disorder is less severe than conduct disorder?

A

Oppositional defiant disorder

93
Q

What are the treatment methods of Conduct Disorder?

A 
Psychotherapy
Pharm:
Antipsychotics- Haloperidol, Risperidone, Olanzapine
Lithium
Stimulant if ADHD is present
94
Q

What are the “CAPRI” of personality?

A 
Cognition
Affect
Personal
Relations
Impulse control
95
Q

What are the 3 clusters of personality disorders?

A

A- “weird”: peculiar or withdrawn w/ FamHx of Psych Illness

B- “dramatic”: emotional or dramatic w/ FamHx of mood disorders

C- “worried”: anxious/fearful w/ FamHx of anxiety disorder

96
Q

Cluster A Personality disorders includes what 3?

A

Paranoid Personality d/o
Schizoid Personality d/o
Schizotypal Personality d/o

97
Q

Criteria for Dx of Paranoid Personality D/o

A

Pervasive distrust and suspiciousness of others w/ 4 Sxs:

98
Q

Criteria for Cluster A Schizoid Personality Disorder

A

Detachment from social relationships and restricted range of emotion expression w/ 4 Sxs:

99
Q

Criteria for Cluster A Schizotypal Personality Disorder

A

Acute discomfort w/ close relationships and cognitive/perceptual distortions w/ 5 Sxs:

Excessive social anxiety

100
Q

What are the 4 Cluster B Disorders?

A

Antisocial
Borderline
Histrionic
Narcissistic

101
Q

What are the criteria for Cluster B antisocial personality disorder?

A

Disregard and violation of rights of others starting at 15 and w/ 3 Sxs:

102
Q

Antisocial personality disorder has also been AKA what 3 names?

A

Psychopathy
Sociopathy
Dyssocial personality disorder

103
Q

What characteristics do antisocial personality disorder PTs have that allows them to blend in?

A

Exploits others for own need w/out empathy, compassion or remorse
Skilled at reading social clues and people so they appear charming
Hx of childhood sex/physical abuse
Hx of hurting animals or starting fires

104
Q

What are the criteria for borderline personality disorder?

A

Instability of relationships, self image and impulsivity w/ 5 Sxs:

105
Q

What are the criteria for Histrionic Personality D/o

A

Excessive emotion/attention seeking w/ 5 of:

106
Q

What is the defense mechanism commonly used by PTs with Borderline Personality D/o

A

Splitting- view others or self as either all good or all bad

107
Q

What type of meds can help PTs w/ Borderline Personality d/o?

A

Antidepressants have helped with anxiety, depression, and sensitivity to rejection

108
Q

Who is more functional, borderline personality PTs or Histrionic PTs?

A

Histrionic

109
Q

What are the criteria for Narcissistic Personality D/o?

A

Grandiosity, need for admiration and lack of empathy with 5 Sxs:
ehavior

110
Q

What are the Cluster C Personality Disorders?

A

Avoidant personality
Dependent Personality
Obsessive Compulsive

111
Q

What are the criteria for Avoidant Personality D/o?

A

Social inhibition, feeling inadequate and hypersensative to negative evaluation w/ 4 Sxs:

112
Q

What meds can benefit Avoidant Personality D/o?

A

SSRIs

Benzos

113
Q

Criteria for Dependent Personality D/o

A

Pervasive and excessive need to be taken care of leading to submissive/clinging behavior or fear of separation w/ 5 Sxs:

114
Q

What are the criteria for Obsessive Compulsive D/o?

A

Preoccupation w/ orderliness, perfectionism and interpersonal control w/ 4 Sxs

115
Q

How is Social Personality D/o treated?

A

Social/therapeutic environments to peer pressure modification of self destructive behavior

If young, school and home can be foci of intensified social pressure

116
Q

How is Behaviors personality d/o treated?

A

Operant conditioning

Aversive conditioning

117
Q

How is Pyschological personality d/o treated?

A

Group therapy w/ peer pressure

Individual therapy

118
Q

What pharmacologic treatments can help w/ personality d/o?

A

Antidepressants- Anx/Dep and sensitivity
SSRI- reduce aggression in impulse aggressive PTs
Antipsychotics- help w/ targeting hostility, agitation, and adjunct to anti-depressants
Anticonvulsant- decrease behavioral dyscontrol

119
Q

Schizotypal personality PTs improve on what meds?

A

Anti psychotic

120
Q

Avoidant personality PTs improve from ? strategies?

A

Anxiety reduction
SSRI
Benzos

121
Q

Define Tolerance

A

Reduced effect when using the same amount of a substance and need for increased amounts to gain the same effect

122
Q

Define Withdrawal

A

Reduction/lack of substance use causing PT to feel the “need” to use substance for Sx relief

123
Q

What are the 11 criteria for alcohol abuse?

A 
Increased use
Desire/attempts to reduce
Time using/obtaining
Craving
Decreased work/home/life
Continued use despite issues in life
Dangerous situation usage
Continued use despite psych/physical problems
Tolerance
Withdrawal
124
Q

Define Alcohol use disorder

A

Behavior and psych problems w/ first episode during mid-teens and characterized by periods of remission/relapse

125
Q

Define Alcohol withdrawal

A 
Diaphoresis/+100bpm
Tremor
Insomnia
N/V
Hallucination/illusion
Psychomotor agitation
Anxiety
Seizure
126
Q

How long do alcohol withdrawals last?

What other issues can it mimic?

A

4-5 days

Hypoglycemia
DKA

127
Q

What meds are used for alcohol abuse and withdrawal?

A

Disulfiram- aversive med to discourage use

Naltrexone- opiate antagonist to lessen pleasure effects

Haloperidol- hallucinations

Benzo- depress CNS

All hospitalized PTs- hydration, E+, Mg, Ca, K, thiamine, folic acid and multi-vitamin

128
Q

What meds are used for alcohol withdrawal if benzos efficacy is lacking?

A

Propofol

Phenobarbital

129
Q

Define Caffeine Intoxication

How long is caffeine’s half life?

A

Consumption +250mg and 5 Sxs

4-6hrs

130
Q

What are the criteria for caffeine withdrawal?

A 
Prolonged use
Cessation 
3 of:
HA, fatigue, moody, difficult concentration, flu like Sxs
HA= hallmark
131
Q

How long do caffeine withdrawal Sxs last?

How quickly do they subside w/ ingestion of caffeine?

A

2-9 days, up to 21

30-60min

132
Q

How many Sxs are needed to meet criteria of substance abuse?

A

2 of the same 11 from alcohol

133
Q

What type of brain function is altered in cannabis users?

A

Higher executive function

134
Q

What are the criteria for cannabis intoxication?

A 
2 Sxs within 2hrs of use
Conjunctival injection
Inc appetite
Dry mouth
Tachy
135
Q

What are the Sxs of cannabis high?

A 
Inappropriate laughter
Grandiosity
Sedation
Lethargy
Impaired short term memory
136
Q

What are the criteria for cannabis withdrawal?

A 
3 of:
Irritable
Anxiety
Sleep issues
Dec appetite
Restlessness
Depressed

One of :
ab pain, tremor, sweating, fever, chills, HA

137
Q

Cannabis withdrawals can mimic what other two issues/

A

Depressive d/o

Bipolar d/o

138
Q

What are the effects of using PCP?

A

Separation from body/mind
Residual Sxs resemble schizophrenia
Nystagmus, analgesia and HTN distinguish PCP use from other hallucinogens

139
Q

What are the S/Sxs of PCP use?

A 
Within 1hr and 2 of:
Vert/Horizontal nystagmus
HTN/Tachy
Diminished pain response
Ataxia
Dysarthria
Muscle rigidity
Seizure/Coma
Hyperacusis
140
Q

What are the most COMMON Sxs of PCP use?

A

Coinfusion w/out hallucination
Hallucination/delusion
Catonic syndrome
Coma

141
Q

What are the criteria for hallucinogen intoxication but NOT from PCP?

A 
2 of:
Dilated pupils
Tachy/diaphoresis
Sweating
Palpitations
Blurred vision
Tremor
142
Q

What is the hallmark Sx of hallucinogen persisting perception disorder?

This is primarily seen after what drug use?

A

Re-experiencing perceptual disturbances but while PT is sober

LSD

143
Q

What is the only dissociative hallucinogen?

A

PCP

All other- psychedelic

144
Q

How are hallucinogen drugs treated?

A

Primary= protection of PT
Severe- antipsychotics (haldol)
Bad trips- Olanzapine, Risperidone
Acute agitation- Lorazepam or Clonazepam

145
Q

What evidence is used to support the diagnosis of inhalant use disorder?

A

Recurrent episodes of intoxication w/ negative results in standard drug screens

146
Q

What class of vapors are inhaled to get high?

A

Volatile hydrocarbon

147
Q

Why do PTs die from Sudden Sniffing Death?

A

Cardiac arrhythmias

148
Q

How are PTs the present with inhalation intoxication treated?

A 
Supportive care for Sxs:
Respiratory suppression
Ventricular arrhythmias
Hypokalemia
Coma
149
Q

Of the drug abuse disorders, which one has a higher risk of suicide?

150
Q

What are the Sxs of opioid use and withdrawal?

A

Use- dry mucous secretions, constipation, pupils constricted

Withdrawal- anxiety, restless, rhinorrhea, lacrimation, dilated pupils

151
Q

What are the most common medical condition associated with opioid use disorder?

A

Viral- HIV, Hep C

Bacterial infection- especially if injecting

152
Q

What criteria is used for opioid intoxication?

A

Pupil constriction plus one:
Drowsy/coma
Slurred speech
Impaired attention/memory

153
Q

What are the criteria for opioid withdrawal?

A 
3 Sxs after cessation or administration of opioid antagonist:
Dyphoric mood
N/V
Muscle aches
Lacrimation
Diarrhea
Yawning
Fever
Insomnia
154
Q

What drug is used for immediate opioid reversal?

Which one is used for PTs opioid free for 7-10 days?

A

Naloxone

Naltrexone

155
Q

What is the benzo reversal agent?

Why mus there be caution when using this drug?

A

Flumazenil- don’t use in PTs w/ seizure disorder and benzos will be ineffective

156
Q

What type of Sxs may be prominent in stimulant abusers?

A

Auditory hallucinations

Paranoid ideations

157
Q

What are the criteria for stimulant withdrawal?

A 
Dysphoric mood and 2:
Fatigue
Vivid bad dreams
In/hypesomnia
Inc appetite
Psychomotor retardation
158
Q

When are acute stimulant withdrawal Sxs usually seen?

A

Periods of repeated high douse use called runs or binges

159
Q

What drug can be used for stimulant treatment?

A

Bromocriptine for cocaine withdrawal

160
Q

How is tobacco tolerance identified?

A

Disappearance of nausea and dizziness

161
Q

What are the most common presentations of tobacco use disorder?

A

Within 30min of waking
Daily
More and more
Waking at night to smoke

162
Q

What is the criteria for tobacco withdrawal?

A 
Cessation for 24hrs and 4 of:
Anger
Anxiety
Difficulty concentrating
Restless
Depressed
Insomnia
163
Q

What odd Sx can present w/ tobacco withdrawal?

A

Sugar cravings

Impaired performance on vigilant tasks

164
Q

What type of smoking PTs have more severe tobacco withdrawal Sxs?

A

Depression/Anxiety
Bipolar
ADHD
Substance abuse

165
Q

What meds are given for tobacco cessation?

A

Varenicline

Buproprion

166
Q

What are the defense mechanisms of Borderline and Histrionic disorders?

A

Border- Splitting

Histrionic- Regression

IPAP (212 decks)

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