Psych Brief Flashcards
Describe the first-line investigation for a young female with a BMI of 16 presenting with primary amenorrhea.
Ultrasound
Female BMI 16 with bony pain first inv……
DEXA scan ..osteoporosis
What is the priority in managing a patient with anorexia nervosa?
Monitoring electrolyte levels, especially potassium (hypo K)
Define the main difference between bulimia and anorexia nervosa.
Bulimia patients typically maintain a normal weight.
How does anorexia nervosa affect pregnancy outcomes?
It often leads to low birth weight infants.
Do individuals with body dysmorphic disorder always have a high BMI?
No, even with a normal BMI, they may perceive themselves as overweight.
Effect of anorexia nervosa on pregnancy……
Effect of malaria on pregnancy…….
Effect of cocaine on pregnancy……
Effect of smoking on pregnancy……..
Effect of anorexia nervosa on pregnancy……Low birth weight
Effect of malaria on pregnancy…….low birth weight
Effect of cocaine on pregnancy……low birth weight
Effect of smoking on pregnancy……..low birth weight
Inv NOT routine in anorexia nervosa……
gonadotropins
Long term prognosis of bulimia nervosa……
Long term prognosis of OCD….
Long term prognosis of borderline personaity disorder…
Long term prognosis of generalized anxiety…..
Long term prognosis of panic attack……
Long term prognosis of bulimia nervosa……depression
Long term prognosis of OCD…..PSYCHOSIS
Long term prognosis of borderline personaity disorder….psychosis
Long term prognosis of generalized anxiety…..depression
Long term prognosis of panic attack…….depression
Female always feel that she is overweight although normal BMI…
.body dysmorphic disorder
Causes of body dysmorphic disorder?
1-bulimia nervosa
2-anorexia nervosa
3-amputated limb
4-acromegaly
5- neglect syndrome
Most common course of obsessive compulsive disorder….
wax and wane
Most common course of depression…….
.regressive
Distrustiful suspicious person……Female with history of crimes, drug abuse, sexual troubles, left her family and lives alone……
Male with history of crimes, drug abuse, sexual troubles, left his family and lives alone more than 18 ys……
Most risk with borderline……suicide
Psychotherapy for borderline……
Psychotherapy for trichillomania…..
Male lives alone doesnot care about people……
Male lives alone feels being rejected……..
Male lives alone with with ideas of reference……
Male with high self esteem doesnot show empathy….
.paranoid
Female with history of crimes, drug abuse, sexual troubles, left her family and lives alone……borderline
Male with history of crimes, drug abuse, sexual troubles, left his family and lives alone more than 18 ys……antisocial
Most risk with borderline……suicide
Psychotherapy for borderline……dialectal
Psychotherapy for trichillomania…..aversion
Male lives alone doesnot care about people……schizoid
Male lives alone feels being rejected……..avoidant
Male lives alone with with ideas of reference……schizotypal
Male with high self esteem doesnot show empathy….narcissitic
Female being abused by her boy friend but still feels as if she can never live without him……
Female gives great care to the order of furniture in her home and has a strict schedule of her life routine…
Female during interview wears sexy clothes and tries to seduce the employer to get the job……
Child 5 ys his mother complains of his overactivity and that he doesnot listen to what she says…..
First step to confirm ADHD……
Drug of choice for ADHD…….
Most imp test for ADHD………..
Female being abused by her boy friend but still feels as if she can never live without him…… dependent
Female gives great care to the order of furniture in her home and has a strict schedule of her life routine… Obsessive compulsive
Female during interview wears sexy clothes and tries to seduce the employer to get the job……historionic
Child 5 ys his mother complains of his overactivity and that he doesnot listen to what she says…..ADHD
First step to confirm ADHD……call the teacher and ask for his grades
Drug of choice for ADHD…….methyphenidate
Most imp test for ADHD………..hearing test
Boy 4 ys old with low IQ limited social activity, limited language development , fascinating with certaing toys…..
Boy 4 ys old with normal IQ , limited social activity, normal language development , fascinating with certaing toys…..
Kid diagnosed as asperger syndrome on SSRI now agitated:
Most common cause……….SSRI ( side effect)
2nd most common cause…….part of the disease
Boy 4 ys old with low IQ limited social activity, limited language development , fascinating with certaing toys…..AUTISM
Boy 4 ys old with normal IQ , limited social activity, normal language development , fascinating with certaing toys…..asperger
Kid diagnosed as asperger syndrome on SSRI now agitated:
Most common cause……….SSRI ( side effect)
2nd most common cause…….part of the disease
Describe the long-term prognosis of bulimia nervosa.
It is often associated with depression.
What is the most common psychiatric disorder causing the highest rate of death?
Anorexia nervosa
What is the primary psychotherapy approach used for borderline personality disorder?
Dialectical behavior therapy
Define the behavior of a person with schizoid personality disorder.
They prefer to live alone and are indifferent to social relationships.
How does cocaine use during pregnancy affect the baby?
It can lead to low birth weight in newborns.
What is the drug of choice for treating ADHD?
Methylphenidate
Describe the characteristics of a child with autism.
They may have limited social activity, language development, and show fascination with specific objects or toys.
8 ys child doing recurrent grimacing and recurrent strange sounds….
Most common association with Tourret’s……
Drug of choice for tourret’s……antipsychotic
Child 14 ys with history of drinking alcohol and recurrent fighting with his peers in school…….
6 ys old kid doesno have many friends accused before of making making fights……….
8 ys child doing recurrent grimacing and recurrent strange sounds….Tourret’s
Most common association with Tourret’s……OCD
Drug of choice for tourret’s……antipsychotic
Child 14 ys with history of drinking alcohol and recurrent fighting with his peers in school…….conduct
6 ys old kid doesno have many friends accused before of making making fights……….oppositionsl deficient disorder
What is the most common association with Tourette’s syndrome?
Obsessive-compulsive disorder (OCD)
Is masturbation considered a normal act?
Yes
Is being gay or lesbian considered a normal act?
Yes
TTT of choice for :
Anorgasm………..
Premature ejaculation……….
Vaginismus…………
TTT of choice for :
Anorgasm………..self stimulation
Premature ejaculation……….squeeze technique
Vaginismus…………vaginal dilators
Male feels orgasm by rubbing his body against clothed females in crowded places……
Male feels orgasm by having sex with kids….
Male feels that he is a woman in male’s body and asking for plastic surgeries to change his sex…..
Male feels orgasm by rubbing his body against clothed females in crowded places……frotteruism
Male feels orgasm by having sex with kids….pedophilia
Male feels that he is a woman in male’s body and asking for plastic surgeries to change his sex…..transsexualism
Young females with recurrent attacks of hyperventilation, palpitationg and feeling as if she will die….
panic
What is the squeeze technique used for?
Premature ejaculation
Describe the treatment for an acute attack of panic.
Benzodiazepine
Lab of panic…..
alkalosis, hypocapnea and increased O2
Woman with marked fear each time she has to give public speaking…..
Best ttt for specific phobia…..
Imp test for dementia……..
There is no definitive investigation for Alzheimer
Alzheimer is not preventable nor curable
First to be affected in Alzheimer……
Least likely to be affected with Alzheimer is
Psychiatric illness increases in incidence………..
2nd most common cause of death in australia….
Woman with marked fear each time she has to give public speaking…..social phobia
Best ttt for specific phobia…..gradual exposure
Imp test for dementia……..MMSE test|( less than 24)
There is no definitive investigation for Alzheimer
Alzheimer is not preventable nor curable
First to be affected in Alzheimer…….memory
Least likely to be affected with Alzheimer is face recognition
Psychiatric illness increases in incidence………..dementia
2nd most common cause of death in australia….dementia
Memory affection with normal aging sometimes very similar to Alzheimer except that there is no impairment of normal function……..
Drug of choice for alzeheimer….
Best drug for alzeheimer with heart disease……..
Dementia + visual hallucinations + parkinsonism…
Dementia+personality changes+abnormal movements…
Dementia + marked personality and attitude changes…..
Dementia+urine incontinence+abnormal gait…..
Dementia+young aged male with uncontrolled HTN….
Short history of dementia+sleeping troubles….
Old age in the hospital sleeping during the day, agitated…
Most imp inv for delirium…….
Most imp drug to control agitation in delerium…..
Agitation in admitted person…..
TTT of alcohol withdrawal…..
Female being raped now complains
of flashbacks and troubles in sleeping……
Memory affection with normal aging sometimes very similar to Alzheimer except that there is no impairment of normal function…….. he lives independently
Drug of choice for alzeheimer….donepezil, tacrine
Best drug for alzeheimer with heart disease……..memantine
Dementia + visual hallucinations + parkinsonism….lewy body
Dementia+personality changes+abnormal movements…Huntington
Dementia + marked personality and attitude changes…..frontal lobe dementia
Dementia+urine incontinence+abnormal gait…..normal pressure hydrocephalus
Dementia+young aged male with uncontrolled HTN….vascular
Short history of dementia+sleeping troubles….depression
Old age in the hospital sleeping during the day, agitated…delerium
Most imp inv for delirium…….urine analysis
Most imp drug to control agitation in delerium…..antipsychotic
Agitation in admitted person…..think of alcohol withdrawal
TTT of alcohol withdrawal…..diazepam
Female being raped now complains of flashbacks and troubles in sleeping……PTSD
Most effective ttt in PTSD…..
Drug of choice for PTSD…..
Drug of choice for OCD……
Drug of choice for depression…..
Drung of choice for GAD……
Long term ttt for panic….
Most effective ttt in PTSD…..group councelling
Drug of choice for PTSD…..SSRI
Drug of choice for OCD……SSRI
Drug of choice for depression…..SSRI
Drung of choice for GAD……SSRI
Long term ttt for panic….SSRI
Define transvestism.
Male feeling orgasm by wearing his girlfriend’s underwear
What is the most common association with panic disorder?
Agoraphobia
How is vaginismus treated?
Vaginal dilators are used
Do individuals with transsexualism seek plastic surgeries to change their sex?
Yes
What is the main cause of Wernicke’s encephalopathy?
Thiamine deficiency
Describe the main symptom of a patient with frontal lobe dementia.
Marked personality and attitude changes
What is the drug of choice for Alzheimer’s disease?
Donepezil or tacrine
Female patients with long history of hospital admissions with many procedures and surgeries done…..
Kid admitted hospital becomes sick only when his mom visits him…..
Male patient presents with symptoms of insomnia and dereased appetite but has problems with immigration……
Male patient comes to the clinic with severe renal colic asking for strong analgesics, his investigations normal…..
First step in this patient…urine sampling in front of you
Male patient alcoholic now complains of nystagmus, gait instability and drowsy….
Main cause of wernike’s encephalopathy….
TTT of wernike’s encephalopathy….
18 ys female patient failed an exam 6 months age, since that time she doesnot feel she is the same person before the exam…..
Female patients with long history of hospital admissions with many procedures and surgeries done…..factitious
Kid admitted hospital becomes sick only when his mom visits him….. mauchusen syndrome by proxy
Male patient presents with symptoms of insomnia and dereased appetite but has problems with immigration……think of malingering
Male patient comes to the clinic with severe renal colic asking for strong analgesics, his investigations normal…..malingering
First step in this patient…urine sampling in front of you
Male patient alcoholic now complains of nystagmus, gait instability and drowsy….wernike’s encephalopathy
Main cause of wernike’s encephalopathy….thiamine deficiency
TTT of wernike’s encephalopathy….THIAMINE then GLUCOSE
18 ys female patient failed an exam 6 months age, since that time she doesnot feel she is the same person before the exam…..adjustment disorder
How is PTSD commonly treated?
Group counseling is the most effective treatment
Police brings to you male confused doesn’t know his name, addressor any thing about his work….
Causes of IMPULSE CONTROL DISORDER:
1-KLEPTOMANIA
2-PYROMANIA
3-TRICHILLOMANIA
4-PATHOLOGICAL GAMBLING
Female patient with recurrent acts of stealing of stuff she doesnot really needs….
Main ttt of kleptomania…..
Male patient with recurrent episodes of doing firing in home and school……
Why pyromanics do firing……
Female patient with no hair on half of her scalp…
Most common cause of fires in australia……….
Police brings to you male confused doesn’t know his name, addressor any thing about his work…. dissociative fugue
Causes of IMPULSE CONTROL DISORDER:
1-KLEPTOMANIA
2-PYROMANIA
3-TRICHILLOMANIA
4-PATHOLOGICAL GAMBLING
Female patient with recurrent acts of stealing of stuff she doesnot really needs…. KLEPTOMANIA
Main ttt of kleptomania…..aversion
Male patient with recurrent episodes of doing firing in home and school……pyromania
Why pyromanics do firing……satisfaction
Female patient with no hair on half of her scalp… TRICHILLOMANIA
Most common cause of fires in australia……….pyromania
Define frotteurism.
Male feeling orgasm by rubbing his body against clothed females in crowded places
What is the best treatment for specific phobia?
Gradual exposure therapy
How is delirium managed in hospitalized patients?
Antipsychotic drugs are used to control agitation
Describe the presentation of a patient with Lewy body dementia.
Dementia with visual hallucinations and parkinsonism
What is the long-term treatment for panic disorder?
- CBT
- Behavioural therapy (Graded exposure)
- SSRI for 6-12m (Fluoxetine)¥
NOTE: if there is no trigger, exposure therapy is not indicated
Do individuals with pedophilia feel orgasm by having sex with kids?
Yes
Define malingering.
Feigning illness for secondary gain, such as obtaining strong analgesics
How is vascular dementia characterized?
Young aged male with uncontrolled hypertension
Describe the main symptom of a patient with normal pressure hydrocephalus.
Dementia with urine incontinence and abnormal gait
What is the most important investigation for delirium?
Urine analysis
Do individuals with factitious disorder have a long history of hospital admissions with many procedures done?
Yes
Define PTSD.
Post-Traumatic Stress Disorder
How is PTSD commonly treated pharmacologically?
SSRI medication is the drug of choice
What is the drug of choice for OCD?
SSRI medication
Describe the presentation of a patient with Huntington’s disease.
Dementia with personality changes and abnormal movements
What is the first step in managing a patient with suspected malingering?
Urine sampling in front of the healthcare provider
How is adjustment disorder characterized?
Feeling like a different person after a specific stressful event
Describe the presentation of a patient with Mauchausen syndrome by proxy.
Child becomes sick only when the caregiver is present
What is the drug of choice for depression?
SSRI medication
Describe dissociative fugue
A dissociative disorder characterized by sudden, unexpected travel away from home or customary place, often memory loss of one’s past.
Define impulse control disorder
A psychiatric condition where individuals struggle to resist impulses or urges that may harm themselves or others.
How is kleptomania treated?
Main treatment is aversion therapy.
Do pyromaniacs set fires for satisfaction?
Yes, pyromaniacs set fires for satisfaction.
Describe trichotillomania
A disorder where individuals have an irresistible urge to pull out their hair, leading to noticeable hair loss.
What is the main treatment for grief?
Support is the main treatment for grief.
Main ttt of grief……
TTT of grief and depression……
TTT of marked insomnia with grief…..
Most imp to depression with grief………
Grief + visual hallucination…..
Main ttt of grief……support
TTT of grief and depression……SSRI
TTT of marked insomnia with grief…..benzodiazepines
Most imp to depression with grief………suicidal ideation
Grief + visual hallucination…..normal grief
Imp question to patient with postpartum ……
Main risk factor for postpartum psychosis……….
Most imp to check in mom after labor…..
Main ttt of mild post partum depression……
Important steps for mild postpartum blue……
Treatment of cases of postpartum psychosis…
Imp question to patient with postpartum …… if she have any feeling of hurting herself or her baby
Main risk factor for postpartum psychosis……….primipara
Most imp to check in mom after labor…..mood
Main ttt of mild post partum depression……family support
Important steps for mild postpartum blue……family involvement and continue breast feeding
Treatment of cases of postpartum psychosis…involuntary admission and .ECT
Define circumstantiality
Inability to answer a question without giving excessive, unnecessary detail, but eventually answering the question.
Inability to answer a question without giving excessive, unnecessary detail.. but eventually will answer the question…….
if doesnot answer the question…..
feeling that you saw this situation before….
Female patient told you that a very famous celebrity loves her…
Male patient came to told shouting that he is the God and should be followed…..
Old age patient anxious telling you his neighbors trying to kill him by putting poisons in his food ….
Patient feels that the people are talking about him….
Main ttt of delusions………
Inability to answer a question without giving excessive, unnecessary detail.. but eventually will answer the question…….Circumstantiality
if doesnot answer the question…..tangentiality
feeling that you saw this situation before….deja vu
Female patient told you that a very famous celebrity loves her…delusion of erotomania
Male patient came to told shouting that he is the God and should be followed…..delusion of grandiosity
Old age patient anxious telling you his neighbors trying to kill him by putting poisons in his food ….delusion of persecution
Patient feels that the people are talking about him….delusions of reference
Main ttt of delusions………antipsychotics
How is delusion of grandiosity characterized?
Belief that one has exceptional abilities, wealth, or fame, often leading to a sense of superiority.
2 sisters sharing the same psychotic’s symptoms…
Female patient with recurrent thoughts of cleaning her hands..
When you commit the recurrent tought ………
Long term prognosis of OCD……
Most common course of OCD………
TTT of choice of OCD…….
TTT of choice of OCD in kids………
BEST PSYCHOTHERAPY……
2 sisters sharing the same psychotic’s symptoms…folie a deux
Female patient with recurrent thoughts of cleaning her hands..OCD
When you commit the recurrent tought ………compulsions
Long term prognosis of OCD……psychosis
Most common course of OCD………wax and wane
TTT of choice of OCD…….SSRI
TTT of choice of OCD in kids……….fluvoxamine
BEST PSYCHOTHERAPY……exposure and prevention
Do individuals with OCD experience compulsions?
Yes, individuals with OCD experience compulsions in response to recurrent thoughts.
Female patient worries about her financial condition and also about her husband’s work ……
Main ttt of GAD…..
Long term prognosis of GAD……
Female patient with recurrent thoughts of washing her hands…
Young boy taking more than 10 showers per day…
Drug of choice for OCD in kids……
Young male with recurrent attacks of sleeping per day that are accompanied with hallucinations……
Main ttt of narcolepsy……
Female patient worries about her financial condition and also about her husband’s work ……GAD
Main ttt of GAD…..SSRI
Long term prognosis of GAD……depression
Female patient with recurrent thoughts of washing her hands…OCD
Young boy taking more than 10 showers per day…OCD
Drug of choice for OCD in kids……fluvoxamine
Young male with recurrent attacks of sleeping per day that are accompanied with hallucinations……narcolepsy
Main ttt of narcolepsy……psychostimulant
Describe narcolepsy
A neurological disorder characterized by excessive daytime sleepiness, sudden attacks of sleep, and sometimes hallucinations.
What are the types of hallucinations associated with narcolepsy?
Hypnagogic hallucinations occur before sleep, while hypnopompic hallucinations occur upon waking up.
Define obstructive sleep apnea
A sleep disorder where breathing is briefly and repeatedly interrupted during sleep, often due to obstruction of the airway.
Hypnogogic ………..
Hypnopompic ……
Middle age male obese with recurrent attacks of sleeping and his wife complains of his snoring……
Inv of choice…….
First advice for this patient…..
TTT of choice……
What does insomnia means……
Main ttt of insomnia……
Drug of choice for insomnia….
Hypnogogic ………..before sleep
Hypnopompic ……after walking up
Middle age male obese with recurrent attacks of sleeping and his wife complains of his snoring……Obstructive sleep apnea
Inv of choice…….polysomonography
First advice for this patient…..loss weight
TTT of choice……CPAP
What does insomnia means……bad quality of sleep
Main ttt of insomnia……non pharmacological
Drug of choice for insomnia….short acting benzodiazepine
First advice for this patient…..loss weight
Obstructive sleep apnea
First advice for this patient…..loss weight
TTT of choice……CPAP