Psych Cards from Questions Flashcards
Classically, left frontal hemisphere infarct produces
depression
Classically, right frontal hemisphere infarct produces
euphoria, indifference
Diffuse bilateral frontal injury produces
obsessive-compulsive behaviors
% of impotence due to psychological cause
- 90% between ages 30-50
- more medically related after 50
Neurotransmitter decreased in suicidal, impulsive, depressed patients
- serotonin (metabolite 5-HIAA)
Abnormalities in smooth pursuit eye movements are associated with
schizophrenia
Antidepressant class more likely to tip a vulnerable patient into manic episode
TCA vs SSRI
Feeling that ones surroundings are strange or unreal
derealism
feeling that ones identity is lost or the feeling of being unreal or strange
depersonalization
mental activity not in accordance with reality
dereism
abnormal recall of details/ability to recall detailed material that is not usually available to recall
hypermnesia
abnormal sensation of tingling or pricking
paresthesia
not being able to recognize an object by touch, despite intact tactile sensation
astereognosis
inability to remember faces despite being able to recognize that it is a face
psosopagnosia
inability to communicate by speech or language
aphasia
irregular pauses between syllables, which breaks up fluidity but does not cause repeating of sounds or syllables
scanning speech
abrupt interruption of idea and after a time beginning a new topic
derailment
macropsia vs micropsia
things appearing larger vs smaller than they actually are
persistence of visual image after stimulus is removed
palinopsia
areas of brain with increased activity in OCD
caudate nucleus, frontal lobes, cingulum
inability to perform previously learned motor skills
apraxia
sexual sadism vs masochism
deriving sexual pleasure from causing vs receiving mental/physical abuse
worry that penis is shrinking into abdomen
Koro, found in south and east asia
belief that one’s body is offensive to others
tajin-kyofusho
delusional belief of possession by a spirit
zar
delusion that imposters have replaced once familiar persons
capgras syndrome
slowly progressive neurological disease leading to death, similar to cruzfeldt jakob
Kuru
area of brain that is hyperactive in anxiety states
locus ceruleus
location of most NE neurons n brain
locus ceruleus
area of brain involved in fear/anger responses
amygdala
area of brain involved in memory formation
hippocampus
area of brain involved in coordination of motor activity
basal ganglia
area of brain involved in information relay
thalamus
enactment of a behavior originating from a conflict
acting out
tendency to project one’s own internal characteristics onto others
externalization
channeling of drives or conflicts into goals that are gratifying but socially acceptable
sublimation
worsening motor performance, incoordination and judgement errors, mood lability, nystagmus, slurred speech, blackouts, altered vital signs, possible death
alcohol intoxication
autonomic instability, tremors, insomnia, nausea/emesis, transient hallucinations or illusions, psychomotor agitation, anxiety, and seizures
alcohol withdrawal
behavioral and physiological changes, euphoria, interpersonal sensitivity, tension, anxiety, anger, impaired judgement, impaired social and occupational functioning, tachycardia, bradycardia, pupillary dilation, insomnia, blood pressure changes, sewating/chills, nausea/vomiting, dry skin, acne-like lesions, chronic nose-bleeds
amphetamine intoxicaton
fatigue, vivid dreams, sleep disturbances, increased appetite, psychomotor retardation or agitation
amphetamine withdrawal
jitteriness, diuriesis, irritability, insomnia, pschomotor agitation, nausea
caffeine intoxication
headache, sleepiness, irritability, concentration problems, vomitine, muscle aches/stiffness
caffeine withdrawal
increased heart rate, posture dependent BP, injected conjunctivae, high with mild euphoria, relaxation, perceptual changes, increased sociability
cannabis intoxication
decrease in mood and appetite, increase in irritability, anxiety, and tension
cannabis withdrawal
behavioral and physiological changes, euphoria, interpersonal sensitivity, tension, anxiety, anger, impaired judgement, impaired social and occupational functioning, tachycardia, bradycardia, pupillary dilation, insomnia, blood pressure changes, sewating/chills, nausea/vomiting, dry skin, acne-like lesions, chronic nose-bleeds, at hight doses: seizures, chest pain, hyperpyrexia, death, paranoia,
cocaine intoxication
dysphoric mood, hypersomnia, increased appetite and fatigue
cocaine witdrawal
mood changes, paranoia, ideas of reference, depersonalizatin, hallucinations, synesthesia, blurry vision, tachycardia, sweating, tremors, pupil dilation
hallucinogens
pupillary constriction, drowsiness, slurred speech, pulmonary edema, at high doses: coma or death with resp. depression
opiate intoxication
muscle aches, dysphoria, nausea/vomiting, lacrimation, rinorrhea, piloerection, sweating, diarrhea, yawning, fever, insomnia
opioid withdrawal
vertical or horizontal nystagmus, hypertension, tachycardia, ataxia, numbness, high pain tolerance, ataxia, hyperacusis, hyperthermia, muscle rigidiy, seizures, death, severe agitation, rage, panic, disinhibition
Pcp intoxicaton
improvement of cognitive and affective symptoms of schizophrenia by blocking
5-HT2A receptor
dizziness, sedation, orthostatic hypotension ssociated with atypical antipsychotics by blocking
alpha 1 receptors
reduction of positive symptoms of schizophrenia by blocking __ in the __ areas of the brain
D2 in mesolimbic and mesocortical areas
extrapyramidal symptoms by blocking __ in __
D2 in nigrostriatal pathway
hyperprolactinemia symptoms by blocking __ in __
D2 in tuberinfundibular patheway
weight gain and sedation by blocking __
Histamine receptors
sedation, dry mouth, constipation by blocking
muscarinic (M1) receptors
channeling of ones unacceptable wishes or feelings into less anxety-producing ones
displacement
ones unacceptable ideas or thoughts are seen as coming from another
projection
patient’s unacceptable feelings are projected to another but the other acts in such a way that they become true
projective identification
turning unacceptable drives and desires into their opposite
reaction formation
acceptable actions that serve others and bring pleasure to the individual
altruism
lamotrigine interacts with
OCP's (incr. clearance of lamotrigine, incr. metabolism of OCP) valproic acid (decr. clearance of lamotrigine)
ECG changes with lithium
t wave depression or inversion
then SA block, AV dissociation, bradyarrhythmia, vtach, vfib
lithium interacts with
thiazide diuretics (decr. clearance)
NSAIDS
metronidazole, tetracycline
spironolactone, triamterene
how to augment treatment in OCD after SSRI ltd response
augment with atypical antipsychotic
clozapine acts at
d1, d2, d4, H1, M, a1, 5HT2, 5-ht2c, 5ht3
mood stabilizer not helpful for mania
lamotrigine (better for bipolar depression)
ECG changes with TCA
- slow cardiac conduction
- In overdose, can cause prolonged QT, widen QRS, AV conduction abnormalities, tachyarrhythmias
ECG changes with low-potency antipsychotics
QTprolongation
naltrexone vs naloxone
longer vs shorter-acting
antipsychotic not to use in elderly
quetiapine
side effect of flumazenil
may lower seizure threshold
risperidone side effect to consider
orthostatic hypotension, dueto blocking at5-HT2a and D2 and alpha1, most EPS associated with any atypical antipsychotic
drugs for binge-eating and bulimia
SSRI
topiramate
cardiovascular changes expected with TCA
increased heart rate
decreased blood pressure
pimozide interacts with
citalopram- prolonged atc
antipsychotic most likely to cause hyperglycemia
clozapine, leading to development of diabetes
bipolar disorder treatment that can lead to pancreatitis
divalproex sodium
psychiatric drugs that can cause agranulocytosis
clozapine
carbamazapine
rare mirtazapine
antipsychotic most likely to increase cholesterol
clozapine
recommended length of antidepressant tx
6 mo minimum, usually 8-12
sialorrhea
excessive production of saliva, produced in up to 30% of clozapine-treated individuals
tx for sialorrhea
clonidine
first line bipolar treatments
lithium
divalproex
least likely atypicals to cause metabolic syndrome
aripiprazole/ziprasidone
useful for middle insomnia (staying asleep)
zeleplon because has 4hr half-life
ECT contraindications
- recent MI
- space-occupying lesion
spasm of neck and back causing patient to arch forward
opisthotonos
spasm of muscles controlling tongue and throat
laryngospasm
spasm of extraocular muscles
oculogyric crisis
leaning posture induced by spasm of torso muscles
pleurothotonos
spasm of neck muscles that brings neck to one side
torticollis
psychotropic medications that can interact with warfarin - 4
bupropion
buspirone
citalopram
venlafaxine
pancreatitis can be a side effect of
valproic acid
obstructive jaundice can be seen with
chlorpromazine
attribution of excessive negative or poitive qualities to another
devluation/idealization
