Psych Conditions Flashcards

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1
Q

Schizophrenia

A

Delusions/Hallucinations/Disorg. Speech
+
Disorganized Behavior/Catatonia
&/or Negative Symptoms

**for 6 months or more

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2
Q

Schizofreniform

A

Signs of Schizophrenia for 1-6months

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3
Q

Bipolar 1 Disorder

A

At least 1 Manic episode

> /= 1 week of
Elevated Mood +3 DIGFAST
or Agitation +4 DIGFAST

Distractibility
Indiscretion
Grandiosity
Flight of Ideas
Activity Increase/Psychomotor Agitation
Sleep Need Decreased
Talkative w/ Pressured Speech

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4
Q

Generalized Anxiety Disorder (GAD)

A

> /= 6 months
/= 3 symptoms

restlessness
difficulty concentrating
irritability
muscle tension
sleep disturbance
fatigue

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5
Q

Panic Disorder

A

4 or more panic attacks in a 4-week period
or
≥ 1 panic attacks followed by at least 1 month of fear of another panic attack

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6
Q

Symptoms of a Panic Attack

A

sweating
palpitations
abdominal distress/nausea
hyperventilation
paresthesia
light-headedness
chest pain
chills
choking
disconnectedness/loss of reality
shaking

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7
Q

Intermittent Explosive Disorder

A

Stressor=Anything
Action=Violence (disproportionate to stressor)

mild: 2x/wk for 3 months
severe (causes harm): 3x in 12months

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8
Q

At age 18, Conduct Disorder become what diagnosis

A

Antisocial Disorder

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9
Q

What are the (CLUSTER A) personality disorders

A

Paranoid
Schizoid
Schizotypal

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10
Q

What are the (CLUSTER B) personality disorders

A

Antisocial
Narcissistic
Borderline
Histrionic

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11
Q

What are the (CLUSTER C) personality disorders

A

OCD-PD
Dependent
Avoidant

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12
Q

Bipolar 2

A

Depressive & Hypomanic symptoms, not
associated with derangements in social or occupational functioning.

Hypomania >/= 4days

Elevated Mood
Increased Energy
Increased Goal Directed Activity
Increased Self Confidence
Decreased Need for Sleep

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13
Q

Tourette Syndrome

A

1 vocal tic + 2 motor tics for 1 year

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14
Q

What are the most common co-morbidities for Tourette Syndrome

A

ADHD & OCD

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15
Q

Criteria for Acute Stress Disorder

A

3 days to 1 month of symptoms caused by exposure to threatened death, injury, assault or actual trauma.

symptoms cause significant distress or dysfunction

persistent re-experience of event
avoidance of potential triggers
negative alterations in cognition and mood
hyperarousal

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16
Q

Criteria for PTSD

A

1 month of symptoms caused by exposure to threatened death, injury, assault or actual trauma.

symptoms cause significant distress or dysfunction

persistent re-experience of event
avoidance of potential triggers
negative alterations in cognition and mood
hyperarousal

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17
Q

What are Psychogenic Nonepileptic Seizures (PNES)

A

Asynchronous Limb Movement
& NO post-ictal period

Dx: Video EEG Tx: CBT

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18
Q

Illness Anxiety Disorder (Hypochondria)

A

Minimal/No symptoms
+
Preoccupation with having a serious illness

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19
Q

Somatic Symptom Disorder

A

1 or more unexplained symptom(s)
+
excessive thought/anxiety/behavior in response to the symptom(s)

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20
Q

Conversion Disorder

A

Neurological Symptoms that are not compatible with anatomy or physiology

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21
Q

Dysthymia (PDD)

A

Chronic depressed mood for >2 years in Adults (1 yr in adolescents)

NO symptom free periods >2 months

2 or more of the following symptoms:

change in appetite
change in sleep
fatigue
poor concentration
hopelessness
low self-esteem

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22
Q

Cyclothymia

A

cyclical mood disorder for 2 or more years that is not full blown depression or hypomania

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23
Q

Creutzfeldt-jakob symptoms

A

startle myoclonus
hyperreflexia
EPS
rapid progression (death in 1 yr of dx)

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24
Q

Delusional Disorder

A

At least 1 delusion
for at least 1 month
without other psychotic symptoms

subtypes:
Grandiose (great talent)
Jealous (Spouse cheating)
Persecutory (FBI watching)
Somatic (I have cancer)
Erotomanic (famous lover)

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25
Q

Treatment of antidepressant induced mania

A

*all antidepressants have risk of inducing mania in susceptible pts *
Clue: “cure” of depression in a few days, not weeks.

Tx: Immediately Discontinue Antidepressant

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26
Q

What is Delirium

A

Acute Onset & Fluctuating Course

Inattention (distracted/cant track conversation)

Disorganized Thinking (rambling/illogical/subject switching)

Altered Consciousness (anything other than alert)

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27
Q

seizures and autonomic instability associated with Delirium Tremens from
the visual hallucinations and relative autonomic stability associated with alcoholic
hallucinosis.

A
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28
Q

Presentation of Huntington’s Disease

A

Chorea, tics/grimacing
Psychosis, OCD, Executive Dysfunction

A cytosine-adenine-guanine (CAG) trinucleotide repeat expansion in the huntingtin (HTT) gene on chromosome 4p.
MRI scan of the brain shows atrophy of the cerebral cortex and caudate nucleus/putamen.

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29
Q

What neurons are damaged in Huntington’s Disease

A

GABAergic (caudate & putamen atrophy)

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30
Q

CJD presentation

A

Early behavioral changes
Myoclonus/Seizures
MRI: Hockey-stick Sign
(pulvinar and dorsomedial thalamic nuclei)
14-3-3 protein in CSF
EEG: Sharp TRIPHASIC
+ R-T quaking in CSF

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31
Q

Dementia with early onset behavior changes with myoclonus/hyperreflexia/seizures

A

CJD

(none of these signs seen in FTD)

32
Q

Presentation of LB Dementia

A

(alphasynuclein deposits in the cerebral cortex)
Visual Hallucinations
Spontaneous parkinsonism*
Fluctuating cognition

*REM Behavior Disorder highly active in their sleep

33
Q

Presentation of Vascular Dementia

A

Step-wise decline

Early executive disfunction

Cerebral Infarct/White matter changes

34
Q

Alzheimer’s Disease

A

Early/Insidious SHORT TERM memory loss

Language deficits

Spatial Disorientation

Later personality changes

35
Q

Which dementia gets lost while driving

A

Alzheimer’s

36
Q

What are the Mature Defense mechanisms

A

altruism
anticipation
humor
sublimation
suppression

37
Q

What is Sublimation

A

Channeling unwanted or unacceptable urges into an admissible or productive outlets (aggression into sports)

38
Q

What is the difference between Projection and Displacement

A

Projection: Projecting my behaviors/thoughts onto another person.

Displacement: taking my anger out on the wrong person

39
Q

What is Reaction Formation

A

Pretending you are different

  • you don’t like someone, but you pretend that you do and are overly nice to them.
40
Q

Who commits Countertransference

A

Doctor to Patient

41
Q

Who commits Transference

A

Patient to Doctor

42
Q

Guideline for Narcolepsy

A

3 times/wk for 3 months, recurrent lapses into naps.
+ (1)
Cataplexy
or
LOW orexin/hypocretin
or
Shortened REM sleep latency (hits REM faster)

43
Q

What is the condition

Acute psychiatric symptoms
Neuropathy
Abdominal Pain
Dark Urine

A

Acute Intermittent Porphyria

Porphobilinogen Deaminase Deficiency

HIGH levels of PGB (porphobilinogen)

44
Q

Increased sensitivity to Lactate Infusion (ringers) is seen in what disorder

A

Panic Disorder
***Provokes Panic Attack

45
Q

what is the lack of concern called in Conversion Disorder

A

LaBelle Indifference

46
Q

Psych patient with increased Amylase

A

Bulimia Nervosa
Vomiting>Parotitis>Increased Amylase

47
Q

Symptoms of ATYPICAL depression

A

Hyperphagia

Hypersomnia

Increased sensitivity to Rejection

Laden paralysis (heavy limbs)

48
Q

Difference between:
DMDD (Disruptive Mood Dysregulation Disorder)
and
Intermittent Explosive Disorder

A

DMDD has PERSISTANT irritable mood between episodes for 1year.

49
Q

FT Dementia

A

Frontal: decision making issues

Temporal: Language Issues

Strange Behavior
(apathy/disinhibition/compulsive)

50
Q

Are people with Alzheimer’s concerned about loss of ability to complete ADLs

A

No.
Alzheimer’s has a lack of patient concern.

51
Q

Anatomy focus in Alzheimer’s

A

Nucleus Basalis of Meynert in the Hippocampus.

52
Q

How to calculate BMI for use in eating disorder questions

A

weight in pounds/ (inches x inches) *703

<18.5 = anorexia

53
Q

What imaging is seen in schizophrenia

A

Lateral Ventricle Enlargement

54
Q

Changes in Slow Wave Sleep and REM Latency in MDD & Narcolepsy

A

Decreased REM Latency (quickly to REM)

Decreased Slow Wave Sleep

55
Q

What feature of sleep leads to Poor Quality in MDD

A

Longer/more frequent Periods of REM Sleep

Disruptions in sleep continuity

56
Q

What stage of sleep to NIGHT TERRORS occur

A

NON-REM (N3)

57
Q

What stage of sleep do Nightmares you remember occur

A

REM Sleep

58
Q

What are the stages of sleep

A

Wake/open
Wake/closed
n1
n2
n3
REM

59
Q

In what stage of sleep do you spend the most time

A

N2 sleep is aprox 50% of your sleep

60
Q

What four things occur in REM sleep

A

Dreams you remember
Memory Consolidation
Erections/Tumescence
REM Behavior Disorder

61
Q

What three things occur in N3 (deepest) sleep

A

Terrors (no memory)
Enuresis
Sleep walking

62
Q

What are the sleep consequences of MDD

A

Increased REM Latency

Increased REM Frequency & Duration

Decreased Slow Wave Sleep

63
Q

How does sleep change with age

A

Decreased REM Sleep
Decreased n3 (deep) Sleep

64
Q

Which sleep stage has bruxism

A

n2

65
Q

What is the mnemonic for wave patterns in sleep

A

BATS Drink Blood

66
Q

Histology seen in LB Dementia

A

Intracytoplasmic, eosinophilic inclusions in the
cerebral cortex and substantia nigra
#alpha-synuclean protein

67
Q

How is EtOH metabolized

A

by zero order kinetics (same
amt/unit time = 25mg/hr)

68
Q

Most specific test for EtOH
consumption in the past 10
days

A

Carbohydrate-deficient transferrin

Less specific:
elevated GGT
and
AST more than twice ALT

69
Q

1st step for patient with Confusion, Ataxia, and ophthalmoplegia

A

Give thiamine 1st, then glucose
containing fluids for Wernicke Encephalopathy

70
Q

What are the findings in Korsakoff’s syndrome

A

Irreversible damage to
mamillary bodies.

Apathy
anter/retrograde amnesia
confabulation

MB atrophy on MRI

71
Q

Patient with incontinence, gait disturbance,frequent
falls, and rapidly developing
dementia.

A

Normal Pressure Hydrocephalus

72
Q

Diagnosis and Treatment for Normal Pressure Hydrocephalus

A

CT/MRI shows hydrocephalus, spinal tap shows normal opening pressure

Ventriculoperitoneal shunt improves cognitive fxn in 50-67% of pts

73
Q

Patient with myoclonus, startle response,
seizures. Recently had a corneal
transplant.

A

Creutzfeldt Jakob

Path: Spongiform encephalopathy

EEG: Triphasic bursts

74
Q

Patient with loss of vibration sense, labile
affect. Pupil that accommodates
but doesn’t react.

A

Tertiary Syphilis
+RPR, VDRL
Do spinal tap to look for spirochetes

Tx: IV penicillin

If Pen-allergic, must desensitize

75
Q

In what condition do you find: Intra cytoplasmic Alpha-synuclein inclusions in neocortex

A

Lewy Body Dementia