PSYCH EOR Flashcards by Caroline Bouillon | Brainscape

Q

what is somatic symptom
disorder

tx

A

> 1 unexplained somatic sx that is distressing to the pt or leads to significant amt of disruption in life and ongoing for >6MO

In response to the sx the pt starts to have excessive thoughts, feelings and behaviors in relation to their somatic sx

tx
-after tx initiated etc
-group therapy and hypnosis
-biofeedback therapy
-social support

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Q

define conversion disorder

A

neuro symptoms incompatible with anatomy or pathophysiology

**Pt is not attempting to decieve—- they are concerned with real sx

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Q

what is factitious disoder

tx

A

IMPOSED ON SELF= MUNCHAUSEN SYNDROME

falsification of sx/inducing injury in the abscence of obvoious external rewards (this differnetiates it from malingering)

they will deceptively produce sx of a medical or psych illness or induce injury to obtain attention and get care

EX
*manipulating lab samples
*ingesting substance–insulin
*altering medical records
*inudincg illness (fecal matter into a cut to produce abscess

doing this to someone else is called FACTICIOUS DISORDER IMPOSED ON ANOTHER or MAUNCHAUSEN SYNDROME BY PROXY

tx
-conjoint confrontation by PCP and psychiatrist
-overt disclosure using tehrapy like biofeedback, self hypnosis, double blind therapy

-mauchinhousin by proxy—– child must be removed and sent to CPS

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Q

clozapine

A

atypical antidepressant for BP 1

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Q

olanzapine

A

atypical antidepressant for BP 1

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Q

risperidone

A

atypical antidepressant for BP 1

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Q

quetiapine

A

atypical antidepressant for BP 1

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Q

ziprasidone

A

atypical antidepressant for BP 1

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Q

gabapentin

A

mood stabilizers for mania

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Q

carbamazepine

A

mood stabilizer for mania

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Q

topiramate

A

mood stabilizer for mania

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Q

lithium

A

mood stabilizer for mania

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Q

tx for acute mania

A

**lithium
valproate
SGA—- olanzapine, aripirazole, carbamazepine

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Q

tx for mania maintenance

A

SGA
gabapentin
lamotrigine

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Q

if BP pt is acutely aggitated what is tx

A

haldol, risperidone or benzos

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Q

diff b/w manic and hypomanic episdoes

A

HYPO= does not cause impairment, no psychotic sx, and impulsivity is present

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Q

what to check before ptting pt on lithium

A

creatinine

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Q

lithium in pregnancy can cause?

A

hypothyroidism and Epstein’s anomaly (tricuspid valve issue)

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Q

BP patient who has renal dysfcuntio— what is a good drug for them?

A

valproate or carbamazepine

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Q

first line of tx for pregnant pt with BP

A

haloperiodl

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Q

mood disorder thats episodes of depression and hypomania for at least 2 years

A

cyclothymic disorder

less intense and often longer lasting version of BP

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Q

time line to dx cyclothymic disorder

A

ADULTS— 2 yers
KIDS–1 yr

*numerous periods of hypomanic sx that dont meet crteria for hypomanic episode

*numerous episodes of depressive sx that dont meet criteria for MDD

*have not been without sx for more than 2 mo at a time

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Q

tx for cyclothymic disorder

A

*lithium

*valproate and carbamazepine alternatives to lithium

psychotherapy

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Q

what do you need to r/o in someone showing sx of MDD

A

hypothryoid, addisons, cushings

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Q

fluoxetine

A

ssri

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Q

paroxetine

A

ssri

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Q

sertraline

A

ssri

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Q

fluvoxamine

A

ssri

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Q

citalopram

A

ssri

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Q

escitalopram

A

ssri

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Q

venlafaxine

A

ssnri

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Q

duloextine

A

ssnri

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Q

bupoprion

A

atypical antidep

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Q

nefazodone

A

atypcal antidep

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Q

mirtazapine

A

atypical antidep

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Q

trazadone

A

atypical antidep

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Q

amitrptiline

A

TCA

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Q

nortriptyline

A

TAC

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Q

desipramine

A

TCA

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Q

clomipramine

A

TCA

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Q

doxepin

A

TCA

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Q

protriptyline

A

tca

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Q

clmipramine

A

tca

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Q

imipramien

A

tca

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Q

pheneziine

A

MAOI

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Q

tranylcyproamien

A

MAOI

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Q

Persistent depressive disorder
-dx
-tx

A

*at least 2 yrs
*less acute and severe than MDD
**more chronic than MDD

TX
ssri
*fluoxetine
*paroxetine
*sertraline
*fluvoxamine

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Q

what to r/o to dx GAD

A

substance abuse
thyroid dysfunction
ETOH withdrawl

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Q

GAD tx

A

SSRI— paroxetine and escitalopram but take weeks to work

Buspirone—- low dose—- can also take 2 weeks to work and can be adjunct to SSRI

SNRIs—venlafaxine

Benzos— not long term tx but used interium until SSRI kick in

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Q

how to dx panic attacks

tx

A

three panic attack episodes in 3 weeks

tx
1st for long term tx–> SSRI–>paroxetine, Sertraline, Fluoxetine

BEzos for acute attacks

CBT

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Q

tx for specific phobias

tx for agoraphobia

A

1st line=exposure therapy

then can do SSRI + CBT
short acting benzos like alprazolam before flying for ex

tx agoraphobia jsut like GAD with SSRI + CBT

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Q

tiimeline for PTSD

tx

A

> 1 month

<1 month is acute stress reaction

TX
*SSRI first line with CBT
-sertralie
-paroxetine
-fluxoetine
-venlafaxine

*nightmares—prazosin
*benzos—- not for long term use bc LT use can lead to exacerbtion of sx
*dont use benzos >2 weeks after traumatic event —-use alprazolam bc its shorter actig

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Q

illness anxiety disorder
-define
-tx

A

-worried about having or developing a serious illness
>6 MO

somatic sx NOT present and if present its very mild

TX
-improve coping skills
-dont dismiss fears
-group/insight oriented therapy
-regular appts with provider for reassurance
-SSRI if current/underlying anxiety or MDD

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Q

Korsakoff syndorme

A

extreme thiamine B1 deficiency from ETOH (MC), eating disorders, chronic malnutriiton

retrograde and anterograde amnesia
preserved LT Memory
confabulation (memory fabrication w/o intent to lie)
lack of insight

MC develops in PT with hx of Wernicke encephalopathy

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Q

non benzo anxiolytic for GAD

A

Buspirone
*does not cause sedation

MOA: partial serotonin recep agonist and dopamine rec antagonist

often used in combo with SSRI

SE
HA, n, dizziness, restless leg syndrome, EPS

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Q

mc type of social phobia

A

public speaking

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Q

tx for social anxiety disorder

A

1st psychotherapy—-esp exposure therapy
then can add SSRI (fluoxetine, sertraline), or SNRI (venlafaxine),
+/- adjunct use benzo

situational–>can give BB for performance anxiety and public speaking like propranolol or atenolol 30-60 mins b4 speech

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Q

list some drugs that have SE fo depression

A

OCP
corticosteroids
ETOH
BB
interferon
amphetamines

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Q

Tx for PHQ9 scores
5-9
10-14
15-19
20-27

A

5-9=mild–watchful waiting, psychotherapy +/-

10-14=moderate–psychoterhapy 1st line

15-19= moderately severe–psychoterapy +/- SSRI

20-27=severe–psychotherapy + SSRI +/- ECT

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Q

tx refractory, actively suicidal, pregnant or elderly depressed pt

A

can try ECT

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Q

what sx must be included to be considered MDD

A

depressive mood or anhedonia and 4 others

-fatigue most of the day
-insomnia or hypersomnia
-feelings of guilt or worthlessness
-recurring thoughts of death/suicide
-psychomotor agiation or retardation (restlessness or slownes)
-sig wt change
-decr or incr appetite
-decr concentration

NO MANI OR HYPOMANIA

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Q

MC time for serotonin syndrome to occur

A

within 24 hours (esp 6) of initiation or change in SSRI, SNRI, MAOI, Buspirone, Triptans or combo of these drugs + St johns wort, MDMA, cocaine, amphetamine

Q

PE for serotonin syndrome

A

Cognitive: ams, confusion, agitation, hallucinations, hypomania

autonomic instability: hyperthermia, tachycardia, diaphoresis, BP changes

GI: N/V, incr bowel sounds, diarrhea

Neurmuscular Hyperactivity: spontaneous or inducible clonus, hypertonia (INCR DTR), tremor, akathasia (restlessness)

Mydriasis (dilated)
dry mucous mem
flushed skin

Q

tx of serotonin syndrome

A

stop the drug

suppportive: oxygen, IVF, benzos (for agiation, to reduce hyperthermia and correct tachycardia and HTN)

MODERATE-SEVRE:
*above + Cyproheptadine (serotonin antagonist)

DO NOT USE ANTIPYRETIS they dont help with hyperthermia ****

Q

what is dysthymia

sx

tx

A

long standing depression w/o other mental health disorders and substance use

sx last at least 2 years–bassically mDDbut >2 yrs
sx begin during adolescence

tx
1st: psycotehrapy
1st line pharmaco: SSRI

2nd line: SNRI, NRI, NDRI, atypic, etc

Q

biggest RF for suicidal/homicidal

A

previous attempt

Q

mc method for suicide? homicide?

A

suicide=drug ingestion

homicide=guns

Q

RF age group for homicide/suicide

A

45-64

Q

pharmaacotx options for suicide/homciide ideastion inpatient

A

antipsychotics MC

ECT for acute suicidail patients

Q

premestrual dysphoric disoder

timeline

tx

A

must occur 1 yr

tx
1: life style mods– dietary changes (decr sugar, incr protein, avoid caffeien), avoid stressful acitities, exercise, CBT

2: moodd sx: SSRI 1st choice–>Fluoxetine, Sertraline, Paroxetine, Citalopram

3: PMS longterm relief: OCPs or Leuopride (GNRH agonist)

4: PMDD–> Drospirenone (progestin medication)

Q

timeline for BP 1 and 2

strongest RF

requiremnet for dx?

what to r/o beofr dx with BP

A

1
>1 week with >3 manic s/s
***major depression not requried for dx

2
>4 days depression with >1 hypomanic episode

SX
MOOD: euphoria, irritable, labile or dysphoric
THINKING: racing, flight of ideas, diroganized, easuy distracted, expanisve or grandios, impaired judgement
BEHAVIOR: hyperactivity, pressured speech, decreased need for sleep, incr impulsivity, excessive involvement in pleasure activities

+/- psychotic sx: paranoia, delusions, hallucinations,

**only needs one manic or hypomanic episode
*major dpressive episodes NT requried for dx

strongest RF=fam hx

want to R/O
1. subtance abuse
2. thyroid disorder like hyper
3. environmental toxins

Q

wht is cyclothymia

A

2 years of alternating hypomanic and depressive episodes

Q

tx for BP 1 and 2

A

LITHIUM**** mood stabilizer 1st line
**lithium also decrs risk if==of suicide

antivonculsants (lamotrigine, valproate, carbamazepine)

2nd gen antipsychotics
*risperidone
(quetiapine
*olanzapine

always adjunct with pschotherapy

**antidepressant monotherpay can drive them into mania

ACUTE MANIA TX
*antipsychotics–risperidone or olanzapine > Haldol
OR
*mood stabilizer like lithium or valproic acid

can use ECT for refractory

Q

lithium
-indications
-SE
-before starting get what
-how often to check levels
-pregnancy
-caution with concomitant use of what drugs

A

INDS
*BP
*Acute mania (mood stab)
*schizoaffective disorder

SE
*endocrine: hypothy, nephrogenic DI, hyperparathyroidism, hypercalcemia, hypermag, NA depletion, increase thirst,

*Neuro: seizures, tremors, HA, sedation

*GI: n/v/d, wt gain

*Cardio: arrythmisa

*Heme: leukocytosis

****NARROW INDEX
-before starting tx get: EKG, chems, thryoid, beta HCG, CBC,
**lithium levels initially checked in 5 days, then every 2-3 days until therapeutic, once therapeutic—check every 4-8 weeks.

TOXIC= >1.5

preg + lithium=ebstein’s anomaly during first tri, renal and cardaic disease

CAUTION w/ use of NSAIDS, thiazide diuretics, ACEI

Q

define hypomania

A

UNDER 1 week of:
*abnormal and persistenyl eelevated, expanisve or irritable mood

does not require hosp, not assoc with marked impairment, not assoc with psychotic feartures,

**need at least 3 sx affecting mood, thinking and behavior (sx otherwise sim to mania)

Q

PMDD sx occur in wht phase of cycle

A

luteal

Q

autism PE findings

A

*deficit sharing of emotions or interests

restricted repetitie behaviors

**thrive on routine
***fixed interest in sacking blocks

Q

inds for clonidine

A

adhd
opioid withdrawl
resistnet HTN

Q

physostigmine

A

antidote for antichloinergic poisoning

Q

indications for buprenorphine

A

*its partial opioid agonist
*symp tx of opioid withdrawl
*ongoing maintenance threapy for opioid disorder
NOT USED FOR ACUTE INTOXICATION

Q

Flumazenil
-inds
-se

A

INDS
*benzo OD
*does not reverse resp effects of benzos
*SE is seizures

Q

key neurotrans involvd with ADHD

A

norepi and dopmaine

Q

1st gen antipsychotics
-inds
-moa
-se

A

all types of shizo
-psychotic ideations
-drug inuded psychosis
-depression
-acute mania

1st— pos sx– hallucinations and delusions
*Clorpromazine –sedation +orthostatic hypotension
*haldol–>EPS sybdrome very common
*thioridazine–>higher incidende of QTc»>, retinitis
*fluphenazine–>comes in LA IM formula
*trifluoperazine–
*thiothixene
*loxapine
*pimozide

SE
*EPS—tarditive dyskinesia, neuropleptic malignant syndrome
*sedation
*anticholinergic sx— mydriasis, dry mucous mems, constipation
*endocrine effects— incr prolactin causing galactorhea, sexual dysfuncion, weight gain
*cardiovasc– hpotension, QTc&raquo_space;

Q

second gen antipsychotics
-inds
-moa
-list some
-SE generally

A

+ and - sx of schizophrenia
more comonly used
1st line drugs due to metabolic adverse effects vs EPS sx seen with 1st gen

MOA
blocks central dopamine and serotonin recs

THE PINES
Asenapine
clozapine–mc causes metabolic syndorme and agranulocytosis ****
*Olanzapine—-mc cause metabolic syndrome
*Quetiapine

THE DONES
*risperidone
*ziprasidone
*Lurasidone
*Paliperidone
*Iloperidone

THE PIPS AND RIP
*Aripiprazole
*Brexpiprazole
*cariprazine

SE
*less EPS, TD, NMS but causes MORE Metabolic syndrome including higher risk for DM, weight gain and sexual dysfunction

*monitor pt with cbc, lipid panel and HbA1c

Q

what can you give pt experieincing dystonia from antipsychotics

A

benadryl or cogentin
*prevents
*avoid
*reduce

Q

what can you give pt experieicng parkinsoniansm from antisychtics drugs

A

amantadine or anticholinergics

Q

what is MC EPS sx

A

akathisia—- subjective feeling of restlessness anxiety pacing or freuqent sitting/standing

Q

what does akathisa respond to

A

BB and Benzos
BB 1st then try benzo

Q

timing for when tardive dyskinesia can develop after starting antipsychotic

A

YEARS

Q

what is neuroleptic malignant syndrome

patho

tx

A

medical emergnecy
muscle rigidity, tremors, feever, automonitc instability, diaphoresis, delirium,

**1st gen mc

patho: increased WBC, increase CPK and increase liver enzymes lead to muscle breakdown causing autonimic instability

tx
*responds to bromocriptine (dopamine agonist)
*Dantrolene sodium– muscle relaxant that inibits CA into sarcoplastic riticuluum

Q

MOOD STABILIZERS
-list the MC one
-MOA
-SE
-how to monitor levels

A

LITHIUM=MC for BP1

MOA: stimulates NMDA receptor and increases glutamate at postsynaptic neuron

SE
*nausea
*tremor
*polyuria/DI
*hypothryoid
*cardiac aryhm
*weigth gaint
*thirst
*acne
*edema
*leukocytosis

*renally cleared— watch BUN/CR
*CBC
CMP
TSH
HCG– its teratogenic
*ECG

lithium levels— narrow index

Q

Valproic acid
-idns

A

anticonvulsant

radpily cycling disorders b.w mania and depression

MOA
opens cl chanels— blocks sodium and increases GABA

SE
thrombocytopenia
pancreatitis
hari loss
weight gain
GI dysfunction
neural tube defects
***teratogenic

Q

Carbamazepine

A

Anticonvulsant

MOA: inhibs firing via inactivating NA chanels–potent CYP450 inducer

SE
*n/v
*agranulocytosis
*incr LFT
*slurred speech
*drowsiness

Q

Lamotrigene

A

MOA: selectively binds to NA and inhibs release of glutamte

SE:
RASH–SJS
hepatitis
N/V/D
sleep dissutrbances

Q

Gabapentin

A

anticonvulsant

SE: fatigue wieght gain

Q

which SSRI has lowest risk for SSRI discontinuation syndome

A

Fluoxetine bc has longest 1/2 life

Q

which SSRI least likely to cause weight gain

A

Sertraline

Q

which SSRI most asso with weight gain and cardiac abnormalities

A

Paroxetine

Q

which SSRI to avoid in pt with long QT

A

Citalopram

Q

SSRI + what meds put pt at risk for serotonin syndrome

A

SSRI +cough suppressants like Dextromethorphan

or SSRI + abotive mirgraine meds like Sumatriptan

Q

sx for serotonin sx

tx

A

TRAID
1. AMS
2. Automotic instability
*diaphoresis
*shivering
*tachy
*hyperthermia
3. Neuromuscular abnormalitiy
*weakness
*hyper reflexia
*myoclonus
*incoodrination
*tremos

tx
*cyproheptadine— 5HT-2 antagonist

Q

which SSRI most likely to cause SSRI discont syndrome

sx?

A

paroxetine and Sertraline
bc shortler half lives

SX

F–flu like symps
I—insonia
N—-nausea
I—imbalance
S–sensory disturbances
H—-hyperarousal

Q

neurotrans that SNRI Affect

A

serotoni
norepi
dopamine

Q

all indications for SNRI

A

depression –2nd line

chronic pain

Q

which SNRI used for osteoarthritis, dm pain, fibromyalgia

A

Duloxetine

Q

Venlafaxine

A

SNRI

Anxiety and Panic disorder

Q

SE SNRI

A

similar to SSRI PLUS:
-htn
-dizziness

Q

Atomoxetine

A

Straterra

-norepei reuptake inhibitor

ADHD

Q

what med can you adjucnt with olanzapine to avoid weight gain

A

Reboxetine

Q

Buproprion
-MOA

A

MOA=block NE and dopamine from being tranps back into the cells–causing greater number of NE and dopamine to be availeble overtime

ONLY NDRI FDA approved to tx depression,
-lowers seizurre threshold*

So why we dont give to bulemia pt and epilpetict pt

Q

Amytripltine
-cass
-inds

A

TCA
***also used for migraine prophylaxis

Q

DOxepine

A

TCA

Q

mipramine

A

TCA

Q

imipramine

A

TCA

Q

Noretryptline

A

TCA

Q

sipramine

A

TCA

Q

moxapine

A

TCA

Q

SE of TCA

A

toxic triad
1. carido –QRS»>torsades
2. convulsions
3. coma

Q

TX of TCA OD

A

**will cause QRS&raquo_space;» torsades

sodium bicarb

Q

Phenelzine

A

MAOI

Q

Selegiline

A

MAO-B

*less chance of HTN crisis

Q

Tranylcypromine

A

MAOI

Q

SE MAOI

Contras to giving MAOI

A

HTN Crisis with sympathomimetics or foods high in tyramine— aged cheese, wine, beer, smoked meat, coffee, tea, chocolate

*insomina
*anxiertty
(weight gain
*orthostasis

CONTRA
*MAOI + SSRI —-serotonin syndrome
*MAOI + TCA —-delirium and HTN

Q

Trazadone
inds
SE
avoid in who
CIs

A

MC used for refractory depression

SE– priapism, vasodilation, sedation,

Avoid in sickle cell pt and multiple myeloma

CI with benzo use or barbituates

Q

pt has hx of sexual dysfnction– which antidep to give

A

buprobion or mirtazapine

Q

pt has dep + difficulty sleeping or poor appetite which antidep to give

A

mirtazipine or paroxetine

Q

define at risk drinking M and W

A

M: 4 drinks/day or 14 drinks/week

W: 3/day or 7/wk

Q

deinfe a drink

A

12 oz beer
8 oz malt liquir
1.3 oz spirits
5 oz wine

Q

sx and tx for minor etoh withdrawl

A

trembling, anxiety, irritability, HA, tachycardia, insomnia

tx
*thiamine
*folate
*miltivit
*dextrose
*IVF

Q

sx and tx for etoh hallucinosis

A

sx
-VA and sometimes tacticle hallucinations

tx
*benzo to avoid seizure

Q

withdrawl seizure tx

A

Head ct

benzo tx

Q

DTs
-timing
-sx
-tx

A

48-96 hrs after last drink

autonomic instability
disorientation
hallucinations
agiation

denzo

Q

disulfiram

A

do not give to pt acitvely drinking

Q

naltrexone PO

A

decreaes desire to drink

cant give to pt taking opioids

Q

list two anticonvulsants that help with ETOH stop

A

topiramate

gabapentin

Q

tx for Opioid withdrawl

A

withdrawl is NOT LIFE THREATENING

*clonidine— methadone—-buprenirphine + nalaxone (suboxone)—zofran for n/v

Q

what to use for diarrhea assoc opioid withdrawl sx

A

Dicyclomine

Q

tx for delusional disoder

A

atyical antipsychotics like olanzapine and risperidone

Q

schizoaffective disorder

A

depressive, manic or hypomanic episode–precedes or occurs same time with dellusions and halucinations—-these must occur for at least 2 weeks in absence of mania/hypomania/depression

Q

schizophrneia
-sx

dif b/w schizoprhenia, schizoaffective and schizophreniform

A

POS SX
*hallucinations
*delusions
*disorganized speech

NEG SX
*poor affect
*anhedonia
*asociality

need at least 2 sx need to last > 6MO and at least one of the sx must be *
*delusions
*hallucinations
*disorganized speech

-grosly disorganize or catatonic behavior
-negative sx—– diminshed emotional expression or avolition

**1-6 months is schizophreniform
*no social or occupational impariment

***<1 month is schizoaffective and MC in females

Q

schizoid personality disorder

tx

A

isolation, restricted emotions secondary to neglect or trauma

detached, distant, carefree, dull, bland with lack of desire to form relationships,

tx
*1st social skills training
not very responsive to drugs

Q

schiotypal personality disorder

A

disturbances in thoughts , mood or perception
no close friends
eccentric behavior, magical thoughts, odd beliefs, perception distortion

can function in soceity but struggle to maintain social relationships

can develop in schizophrenia

tx
CBT 1st
shot term and low dose atyical antischioptics

Q

lack of remorse and emptahy
pervasive pattern of disregard for onseuenes and for the rights of tehrs

A

anti personality disorder
aka
sociopath

sx will typically begin in early childhood with conduct disorder (<15 YO )

Q

borderline personality disorder

A

“borderline” on border b/w neurosis and pschosis

unstable personal relationships, poor impulse control (spending, sexual conduct, driving, eating, SU)

sometimes sucidial threats

cant be alone– will do anything to avoid abdanoment

very common to be occuring with other disorder: SUD, eating disorder, MDD, BP

tx
1st=psychoteraphy
2nd=ssri, risperidone or naltrxone if SUD

Q

Narcissistic personality disorder

A

grandiose and require admiration from others

exagertion of their own talents or accomplishments
s
ense of entitlement
expotation ofo thers
lack of empathy
arrogant

LYING*****
tx
1st therapy
2nd ssri

Q

OCD vs OCPD

A

OCD
*obsessions—>recurring intrusive thoughts that cause severe distress and impairment

*compulsions–performance or repeptitive actions or rituals in an atempt to neurtralize the obsessios

assoc with tourette’s disorder
EGO DYSTONIC— behaviors are inconsistent with own beliefs and attidues (makes this diff from OCPD)

TX
*CBT
*SSRI
*1st line TCA= clomipramine

OCPD:
*preocupied with perfectonism and control—- orderliness
*lack flexiblity and openess
*perfectionist
*egocentric
*indecisive

EGO-SYNTONIC–pt is not aware of their behavior causing issues

Q

pharmaco tx for tourettes

A

1st line for modrate tics
– clonidine and guanfacine

rispiridone and haloperiold for neuroplectics

aripiprazole–peds

SSRI can be used in OCD sx

DBS severe or disabiling cases

Q

pharmacotherapy for pediphilia

A

IM Medroxyprogesterone acetate

Leuoprolide is 2nd line

maintain testosterone levels in males in normal female range—– <62

Q

sadism

A

has to be with a NON CONSENTING adult

sexual arousal from inflicting pain or suffering on another

Q

sexual masochism

A

pt finds pleasure in being humiliated–bound beaten abused etc

Masochists hurt Me
Sadists hurt Someone else

Q

voyeuristic disorder

A

sexual arousal by observing a non-consenting person naked or engaging in sexual acts

must be >18 for dx

mc disorder to result in arrests

Q

Frotteuristic disorder

A

paraphilia where pt aroused by rubbing up on an unwilling individual

dx needs to tuch someone at leasrt 3 times

Q

anorexia

A

INTENSE FEAR OF OBESITY DESPIRTE SLENDERNESS

two types
-restrictive
-binge/purging

hx of extreme wt loss methods
-diruetics
-laxative s
-amphetamiens
-emesis

cardiac arrhytmias
»> QT
elevated BUN, edema, acidosis, hypokalemia, hypochloremic alkalosis with vomiting, hyperaldosternonsim