Psych II Flashcards
Orientation
order of loss
time
place
person
korsakoff syndrome
anterograde amnesia
B1 deficient
destruction mammillary bodies - alcoholics
dissociative amnesia
cannot recall personal info
severe trauma/stress
fugue - travel or wandering
delirium
wax and wane consciousness
disorganized thinking
hallucination
illusion
misperception
disturbed sleep cycle
secondary other issue
abnormal EEG
benzo - alcohol withdrawal
dementia
decreased intellectual function
no affect LOC
memory loss, apraxia, aphasia, impaired judgement
AD
increased risk of delirium
reversible dementia
hypothyroid
depression
vit B12 deicient
normal pressure hydrocephalus
irreversible dementia
AD lewy body HD pick disease cerebral infarct prion disease chronic substance abuse
psychosis
distorted perception of reality
delusion, hallucination, disorganized thinking
hallucination
pereption absence of external stimuli
visual auditory olfactory gustatory tactile hypnagogic - while going to sleep hypnopompic - occur waking from sleep
delusion
unique false belief about oneself or others that persist despite the facts
schizophrenia
last longer than 6 months
mental disorder, period psychosis
high DA activity
diagnosis - 2 or more symptoms -positive - delusion hallucination disorganized speech catatonic -negative sx - flat affect, social withdrawal, lack motivation, lack of speech or thought
increased risk of suicide
brief psychotic disorder
less than 1 month
often stress related
schizophreniform
1-6 months
schizoaffective
longer than 2 weeks
psychotic sx with episodic superimposed major depression or mania
psychosis is present with and without mood disorder
mood disorder - only present with psychosis
tx schizophrenia
risperidone
atypicals are first line
frequent marijuana in teen
psychosis/schizophrenia
delusional disorder
fixed persistent false belieft
longer than 1 month
women believes married to celebrity when she isn’t
dissociative identity disorder
2 or more identities
MC in women
hx sex abuse, PTSD, depression, substance abuse
depersonalization disorder
detach from ones own body or environment
mood disorder
abnormal range of mood
loss control over mood
manic episode
period of abnormal persistent elevated, expansive, irritable mood
abnormal and persistent high activity or energy
diagnosis - require hospitalization
distractable, grandiose, flight of idea, less need for sleep
hypomanic episode
like manic - but no hospitalization
bipolar disorder
bipolar I - 1 manic episode with or without low episode
bipolar II - presence of hypomanic and depressive episode
antidepressant tx - can precipitate mania
high risk suicide
tx bipolar
lithium, valproic acid, carbamazepine
cyclothymic disorder
dysthymia and hypomania
milder form of bipolar disorder lasting at least 2 years
major depressive disorder
6-12 months
5 of 9 sx for 2 or more weeks
SIGECAPS sleep problem interest loss guilt energy loss concentration problem appetite change psychomotor retardation suicide
sleep changes with depression
less slow wave
less REM latency
more REM early in sleep cycle
more total REM
nighttime awakening
early morning awakening
persistent depressive disorder
dysthymia
depression, mild - at least 2 years
tx depression
CBT SSRIs - first line
SNRIs, mirtazapine, bupropion
ECT
atypical depression
mood reactivity
reversed vegetative sx
leaden paralysis - heavy arms/legs
MC subtype
tx - CBT and SSRI
also MAOI
maternal blues
within 4 weeks of delivery
depression, tearfulnes, fatigue, resolve 10 days
tx supportve
postpartum depression
depression, anxiety, poor concentration
tx - SSRI, CBT
postpartum psychosis
delusion, hallucination
thought of harming baby or self
risk fx - hx bipolar or psychosis
-first pregnancy, fam bx
tx - hospitalization
pathologic grief
shock, denial, guilt, somatoc sx
longer than 6 months
satisfies major depression
hallucinations - voice of deceased loved one - not psychotic
ECT
tx refractory depression with psychosis and acutely suicidal patient
risk fx suicide completion
male teen or elderly depression previous attempt ethanol drug abuse loss rational thinking sickness organized plan no spouse social supprt lacking
women try more, men succeed more
anxiety disorder
inappropriate fear/worry
interfere with daily functioning
tx - CBT, SSRI, SNRI
panic disorder
recurrent panic attacks
-peak in 10 minutes
palpitation, paresthesia, GI distress, nausea, fear of dying, light headed, chest pain, chill
diagnosis - attack followed by 1 month of:
- persistent concern more attacks
- worry about consequence of attack
- behavioral change due to attacks
