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Psych disorders Flashcards

1
Q

DEFINE THINCMED in relation to Psychiatric

A

Tumors
Hormones (thyroid, adrenals, gonadal, insulin)
Infections and immune disease: aids, lyme disease, mono, lupus, syphilis
Nutrition b12, B6, manganese, iron overload
Central Nervous system-head trauma, MS, seizures, parkinsons disease, huntingtons disease
Miscellaneous-sleep apnea, anemia CHF, Wilsons disease
Electrolyte abnormalities and toxins-K na Organophosphates and chemical exposures
Drugs: OTC, homeopathic, prescribed or illicit drugs, also include nicotine and caffeine

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2
Q

define anxiety

A

a psychological and physical experience of dread foreboding, apprehension or panic in response to emotional or physiologic stimuli maybe acute or chronic

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3
Q

What are common types of anxiety?

A 
acute situational anxiety
generalized anxiety disorder
panic disorder
post traumatic stress disorder
obsessive compulsive disorder
phobias
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4
Q

what is behavioral therapy

A

anxiety is the conditioned response to specific environmental stimuli

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5
Q

what are the biologic theories for anxiety?

A

norepinephrine , serotonin and y aminobutyric acid (GABA) are poorly regulated
automonic nervous system responds inappropriately to stimuli
functional cerebral pathology causes anxiety disorder symptoms

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6
Q

what are organic syndromes that cause anxiety

A

endocrinopathies, cardio-respiratory disorders, anemia

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7
Q

what other causes trigger anxiety

A

withdrawal from alcohol, antihypertensive meds
caffeine, cocaine, marijuana corticosteroids, lidocaine oral contraceptives, nsaids, withdrawal from selective serotonin reuptake inhibitors

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8
Q

what is hamilton anxiety scale

A

The HAM-A was one of the first rating scales developed to measure the severity of anxiety symptoms, and is still widely used today in both clinical and research settings. The scale consists of 14 items, each defined by a series of symptoms,

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9
Q

what is the treatment for acute treatment of GAD

A

SSRI SNRI

Lexapro, paxil zoloft effexor buspirone

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10
Q 
name the brand:
buspirone
venlafaxine
sertraline
paroxetine
escitalopram
A 
buspar
effexor
zoloft
paxil
lexapro
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11
Q

what are TCAs

A

tricyclic antidepressants such as imipramime

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12
Q

sedating medications for anxiety include:

A

antipsychotic-trifluoperazine (stelazine)
antihistamine-vistaril (hydroxazine)
antiseizure-lyrica (pregabalin)

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13
Q

What drugs are used for panic disorder

A

SSRI
TCA
Benzodiazepams

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14
Q

drugs for OCD

A

SSRI

TCA

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15
Q

DRUGS FOR GAD

A

SSRI

BUSPAR

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16
Q

BENZOS-can use during pregnancy?

A

no!

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17
Q

TCA contraindicated in pregnancy

A

yes!

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18
Q

SSRI contraindicated in pregnancy?

A

1st trimester only but often continued by ob gyn

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19
Q

diagnostic criteria for agorphobia

A

avoidance behavior must be associated wtih at least two settings or situations (public places, crowds, mass transportation)
onset of sx with specific circumstances-fears out of proportion to actual danger
may avoid trigger situations

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20
Q

panic disorder: what are the risk factors?

A

family history, young adulthood, genetic component
may have at least one major depressive episode in lifetime; symptoms are intense, short episodes of panic evel psychological and physical symptoms of anxiety

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21
Q

describe first episode of panic disorder

A

spontaneous, unexpected and cannot occur when the person is the focus of others attention

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22
Q

what is the second symptom of a panic disorder?

A

FEAR-SEEK emergency care, life threatening and impending nervous breakdown

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23
Q

what are the symptoms of a panic attack

A 
palpations, pounding heart, accelerated heart rate
sweating
trembling or shaking
sensations of shortness of breath or smothering
feeling of choking
chest pain of discomfort
nausea or abdominal distress
feeling dizzy, unsteady, lightheaded or faint
derealization or depersonalization
fear of losing control of going crazy
fear of dying
paresthesias
chills or hot flushes
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24
Q

what are the 4 criteria of panic disorder

A

at least one of the attacks has been followed by 1 month or more of one or more of the following
persistent concern about having additional attacks
worry about the implications of an attack or its consequences significant change in behavior related to the attack
not due to ay direct physiologic effect of a substance or a general medical condition
not better accounted for by another mental disorder ocd, ptsd, separation anxiety disorder

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25
what is first line drug regimin for panic disorder
SSRI,SSNI MAY NEED TO DO A COMBO OF THE TWO tricyclic, benzo, valproic acid, gabapentin
26
what anxiety scale is used for ptsd?
Hamilton anxiety scale
27
meds for PTSD
SSRI-paxil, zoloft improves core ptsd clusters acute treatment Minipress-prazosin-improved global functioning and decrease ptsd symptoms anxiolytic-buspar for acute or short term symptom management reduce intrusive symptoms
28
etiology of depression
impaired synthesis a/o metabolism of the neurotransmitters norepinephrine, serotonin a/o dopamine or genetic basis
29
what is the most common method of suicide
drug overdoses
30
what does serotonin do for depression?
calmness/relaxed states of being
31
what does norepiephrine and dopamine do for depression
enhances productivity, ambition and ability to concentrate
32
what are some drugs that cause depression
antihypertensive:reserpine, propranolol, methyldopa, clonidine, hydrochloridine, monosulfate, guanethidine corticosteroides or hormones antiparikinsonian drugs: levadopa carbidopa amentadine, hydrochloride antianxiety-diazepam, chlordiazepoxide accutaine birth control pills
33
Which diagnostic study distiguishes dementia from depression?
halstead-reita battery
34
what is the geriatric depressoin scale?
ye-savage
35
what arethe depression diagnostic studies
``` CBC w diffrential comprehensive metaboli profile lipid profile tsh serum vit b12 and d levels urine screen for substance ue disorders eck baseline ro tule out arrythmias, heart block before institution tca ```
36
what arethe depression diagnostic studies
CBC w diffrential comprehensive metaboli profile lipid profile tsh serum vit b12 and d levels urine screen for substance abuse disorders check baseline to rule out arrhythmia, heart block before institution tca
37
What is first line tx for panic attacks?
cognitive behavior therapy
38
After panic attack cease, how long should the patient remain on medication?
6 months
39
what are the mental tests for panic disorder?
Mini international neurophsychatric Interview and Prime MD Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ). Purpose. The Patient Health Questionnaire (PHQ) is designed to facilitate the recognition and diagnosis of the most common mental disorders in primary care patients. For patients with a depressive disorder, a PHQ Depression Severity Index score can be ...)
40
What is another name for valproic acid?
depakote
41
What is the first line pharmaceutical for panic attacks?
ssri and snri
42
What are the 3 categories that a patient will exhibit to be diagnosed with PTSD
Intrusive symptoms-Recurrent, unwanted distressing memories of the traumatic event. Reliving the traumatic event as if it were happening again (flashbacks) Upsetting dreams or nightmares about the traumatic event. avoidance symptoms-the avoidance cluster of PTSD symptoms include attempting to avoid thoughts, feelings or conversations about the traumatic event, and places or people bring the event to mind hyperarousal symptoms-sleeping problems. difficulties concentrating. irritability. anger and angry outbursts. panic. constant anxiety. easily scared or startled. self-destructive behavior (such as fast driving or drinking too much)
43
what are the objective symptoms of PTSD
``` palpations tachycardia tachypnea hyperventilation diaphorsis ```
44
What diagnostic tests should be performed with a clieNt with PTSD
GENERAL EXAM R/T SERIOUS cnsCARDIO OR ENDo v/s, cardiac and pulmonary exam ecg, tsh cbc chem panel and to r/o medical condition
45
what is the mental exam given to suspected PTSD patients
Hamilton anxiety scale
46
What is the pharmaceutical combo for acute panic disorder?
paxil/zoloft
47
What does serotonin do?
calmness.relaxes state of being
48
What do norepinephrine and dopamine do?
enhance productivity, ambition and ability to concentrate
49
What population has the highest rate of suicide?
adolescents 15-24 and geriatrics 65 and older
50
what is the most common method o suicide
drug overdose
51
What are the symptoms of Depression? SIGECAPS
``` sleep interest guilt energy concentration appetite psychomotor suicide ```
52
Drugs that can cause depression
accutaine/antianxiety/antiparkinsonian drugs/antihypertensive: reserpine, propanolol, methyldopa, guanethidine, monosulfate, clonidine, hydrochloride birth control pills corticosteroids hormone pills
53
What are the depression scales names?
``` childrens depression inventory childrens depression scales depression self rating scale becks depression inventory zung self rating depression scale halstead reitan battery-helps distinguish dementia from depression ye saveage- geriatric depression scale ```
54
what are the depression diagnostic studies?
``` cbc with diffrential comprehensive metabolic profile lipid profile TSH> 50 to r/o out hypothyroidism serum b12 and vit d levels urine screen for substance use disorders ecg baseline to rule out arrhythmias/heartblock/before instituting TCA ```
55
What is recurrent bipolar disorder
mood disorder featuring one or more episodes of mania, hypomania, or mixed episode of mania or depression
56
What is DIGFAST symptoms in bipolar disorder?
``` D = Distractibility and easy frustration I = Irresponsibility and erratic uninhibited behavior G = Grandiosity ``` ``` F = Flight of ideas A = Activity increased with weight loss and increased doesn't require rest S = Speech, pressure, increased talkativeness, rapid and can be garbled T = Thoughtlessness-pleasure seeking activities that show poor judgement such as spending sprees, sexual indiscretions, reckless driving, arguments if irritable ```
57
What is Bipolar 1
lifetime history of at least one manic or mixed episode
58
What is Bipolar 2
lifetime history of at least one hypomanic episode with no lifetime history of a manic episode or a mixed episode and the presence or history of one or more depressive episodes
59
numerous episodes of depressed mood that do not meet full criteria for major depression and episodes of hypomania that occur over a period of at least two years in adults or 1 year in children and adolescence is called
cyclothymic
60
what are the names of the bi polar screenings in primary care settings
bipolar spectrum diagnostic scale to rule out the diagnosis of bipolar disease than for giving a positive diagnosis mood disorder questionnaire-validated screening tool for bipolar disorder mental assessment-minimental status exam
61
what is the blood work for bipolar disease?
CBC, CMP, TSH, T4, RPR HIV antibody, U/A urine toxicology, pregnancy mri and cat scan
62
What pharmaceutical is used for rapid treatment of manic symptoms
clomazepam and lorazepan to calm and sedate patient
63
What is the gold standard of bipolar disease treatment
lithium
64
what are the serum levels for lithium an how often is it taken?
<20m/eq twice a week until stable and then every 1-3 months
65
What should the concentrations of Tegretol (carbamazapime) be?
4-12 mcg/ml
66
What are the side effects of Tegretol
agranulocytosis, aplastic anemia hepatic failure stephen-johnson syndrome pancreatitis
67
What other medication does Tegretol reduce levels?
oral contraception dihydropyridine calcium channel blockers

Psychiatric disorders (1 decks)

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