Psych - Pathology (Eating/Sex/Sleep disorders & Substance abuse)

Question 1

What are 2 types of eating disorders?

Answer 1

(1) Anorexia nervosa (2) Bulimia nervosa

Question 2

What defines Anorexia nervosa? Include behavior and body weight.

Answer 2

Excessive dieting +/- purging; intense fear of gaining weight, body image distortion, and increased exercise, leading to a body weight well below ideal (~ BMI < 18.5 kg/m^2)

Question 3

What BMI characterizes Anorexia nervosa?

Answer 3

Body weight well below ideal (~ BMI < 18.5 kg/m^2)

Question 4

What are 6 clinical findings associated with anorexia nervosa?

Answer 4

Associated with (1) decrease bone density. (2) Severe weight loss, (3) metatarsal stress fractures, (4) amenorrhea, (5) Lanugo (fine body hair), (6) anemia, and (7) electrolyte disturbances.

Question 5

What bone condition occurs in Anorexia nervosa, and why?

Answer 5

Osteoporosis caused in part by decreased estrogen over time

Question 6

In what patient population is anorexia nervosa primarily seen?

Answer 6

Seen primarily in adolescent girls

Question 7

With what other psychiatric condition does anorexia nervosa commonly coexist?

Answer 7

Commonly coexists with depression

Question 8

What defines bulimia nervosa? Include behavior and body weight.

Answer 8

Binge eating with recurrent inappropriate compensatory behaviors (e.g., self induced vomiting, using laxatives or diuretics, fasting, or excessive exercise). Body weight often maintained within normal range.

Question 9

What are 5 clinical findings associated with Bulimia nervosa?

Answer 9

Associated with (1) parotitis, (2) enamel erosion, (3) electrolyte disturbances, (4) alkalosis, (5) dorsal hand calluses from induced vomiting (Russell sign).

Question 10

What is Russell sign, and what causes it? With what condition is it associated?

Answer 10

Dorsal hand calluses from induced vomiting (Russell sign); Bulimia nervosa

Question 11

In what patient population is bulimia nervosa predominantly seen?

Answer 11

Seen predominantly in adolescent girls

Question 12

What is Gender dysphoria? What characterizes it?

Answer 12

Strong, persistent cross-gender identification. Characterized by persistent discomfort with one’s sex assigned at birth, causing significant distress and/or impaired functioning.

Question 13

How are individuals affected by gender dysphoria often referred to?

Answer 13

Affected individuals are often referred to as transgender.

Question 14

What are 2 types of gender dysphoria?

Answer 14

(1) Transsexualism (2) Transvestism

Question 15

Define Transsexualism.

Answer 15

TransSEXualism - desire to live as the opposite SEX, often through surgery or hormone treatment

Question 16

Define Transvestism.

Answer 16

TransVESTism - paraphilia, not gender dysphoria. Wearing clothes (e.g., VEST) of the opposite sex (cross-dressing).

Question 17

What 4 types of disorders are included in Sexual dysfunction?

Answer 17

Includes (1) sexual desire disorders (hypoactive sexual desire or sexual aversion), (2) sexual arousal disorders (erectile dysfunction), (3) orgasmic disorders (anorgasmia and premature ejaculation), and (4) sexual pain disorders (dyspareunia and vaginismus).

Question 18

What are 2 examples of sexual desire disorders?

Answer 18

Sexual desire disorders (hypoactive sexual desire or sexual aversion)

Question 19

What is an example of sexual arousal disorder?

Answer 19

Sexual arousal disorders (erectile dysfunction)

Question 20

What are 2 examples of orgasmic disorders?

Answer 20

Orgasmic disorders (anorgasmia and premature ejaculation)

Question 21

What are 2 examples of sexual pain disorders?

Answer 21

Sexual pain disorders (dyspareunia and vaginismus)

Question 22

What are 3 differential diagnoses for sexual dysfunction?

Answer 22

Differential diagnosis includes: (1) Drugs (e.g., hypertensives, neuroleptics, SSRIs, ethanol) (2) Diseases (e.g., depression, diabetes, STDs) (3) Psychological (e.g., performance anxiety)

Question 23

What are 4 examples of drugs that may cause sexual dysfunction?

Answer 23

Drugs (e.g., hypertensives, neuroleptics, SSRIs, ethanol)

Question 24

What are 3 examples of conditions that may cause sexual dysfunction?

Answer 24

Diseases (e.g., depression, diabetes, STDs)

Question 25

What is an example of a psychological condition that may cause sexual dysfunction?

Answer 25

Psychological (e.g., performance anxiety)

Question 26

What defines sleep terror disorder? During which kind of sleep does it occur?

Answer 26

Periods of terror with screaming in the middle of the night; occurs during slow-wave sleep.

Question 27

In what patient population is sleep terror disorder most common?

Answer 27

Most common in children

Question 28

During what phases of sleep do sleep terrors versus nightmares occur? What distinguishes each?

Answer 28

Occurs during non-REM sleep (no memory of arousal) as opposed to nightmares that occur during REM sleep (memory of a scary dream).

Question 29

What causes sleep terror disorder?

Answer 29

Cause unknown, but triggers may include emotional stress, fever, or lack of sleep

Question 30

How is sleep terror disorder usually resolved?

Answer 30

Usually self limited

Question 31

What defines Narcolepsy? What is its primary characteristic?

Answer 31

Disordered regulation of sleep-wake cycles; primary characteristic is excessive daytime sleepiness

Question 32

What causes Narcolepsy?

Answer 32

Caused by decreased orexin production in lateral hypothalamus

Question 33

Besides daytime sleepiness, what are 3 conditions/symptoms associated with Narcolepsy?

Answer 33

Also associated with: (1) Hypnagogic (just before sleep) or Hypnopompic (just before awakening) hallucinations (2) Nocturnal and narcoleptic sleep episodes that start off with REM sleep (3) Cataplexy (loss of all muscle tone following a strong emotional stimulus, such as laughter) in some patients; Think: “hypnaGOgic - GOing to sleep & hypnoPOmpic - POst-sleep”

Question 34

Is their a genetic component to Narcolepsy?

Answer 34

Strong genetic component

Question 35

What are 2 kinds of treatment for Narcolepsy? Give at least one example of each.

Answer 35

Treatment: Daytime stimulants (e.g., amphetamines, modafinil) and nighttime sodium oxybate (GHB)

Question 36

In general, what is used to define substance use disorder? What are the 11 specific criteria?

Answer 36

Maladaptive pattern of substance use defined as 2 or more of the following signs in 1 year: (1) Tolerance - need more to achieve same effect (2) Withdrawal (3) Substance taken in larger amounts, or over longer time, than desired (4) Persistent desire or unsuccessful attempts to cut down (5) Significant energy spent to obtaining, using, or recovering from substance (6) Important social, occupational, or recreational activities reduced because of substance use (7) Continued use in spite of knowing the problems that it causes (8) Craving (9) Recurrent use in physically dangerous situations (10) Failure to fulfill major obligations at work, school, or home due to use (11) Social or interpersonal conflicts related to substance use

Question 37

What are the 6 stages of change in overcoming substance addiction? Define each.

Answer 37

(1) Precontemplation - not yet acknowledging that there is a problem (2) Contemplation - acknowledging that there is a problem, but not yet ready or willing to make a change (3) Preparation/Determination - getting ready to change behaviors (4) Action/Willpower - changing behaviors (5) Maintenance - maintaining the behavior change (6) Relapse - returning to old behaviors and abandoning new changes