Psych personality disorders and more Flashcards
Todds paralysis?
Postictal hemiparesis lasting 15 hours but no longer than 24
Personality trait vs disorder?
Trait, means you still work well in society and able to function
Cluster A?
NO PSYCHOSES!
Paranoid, Schizoid, Schizotypal
Schizotypal?
Schizotypal goes to work dressed like a pickle
Eccentric odd beliefs/magical thinking
Avoidant vs schizoid?
Avoidant want to relate to others but don’t know how.
Schizoid don’t care
Cluster A tx?
Low dose antipsychotics if psychotherapy
Treatment of personality disorder?
Psychotherapy
DT symptoms?
Nihgtmares, agitation, disorientation, hallucinations, fever, htn…. EVENTUALLY SEIZURES or AUTONOMIC HYPERACTIVITY
Wernicke korsakoff from what?
B1 thiamine deficiency. alcoholics. Mammallary bodies
Wernicke: confusion, ataxia and coma and DEATH
Korsakoff: Amnesia. Confabulation. Hallucinations
How many do you need in CAGE questionnaire?
more than 1
Cut down. Annoyance. Guilt. Eye opener
Intoxication of amp or cocaine intoxication?
WHAT DONT YOU GIVE?
Benzo and haloperidol if psychosis
Phentolamine is alpha 1 blocker can be used for htn.
DO NOT GIVE BETA BLOCKERS b/c beta 2 actually vasodilator a bit and beta blockers cause unopposed Alpha constriction
Patient with nystagmus who is super violent is on what?
PCP
CALM THEN DOWN!!! bento and haloperidol
Phentolamine is what?
Alpha blocker for cocaine
Anorexia tx?
What is contraindicated?
Psychotherapy is tx
If depressed give SSRI, NO BUPRORPRIONe
OCD tx?
CBT and ssri
PTSD dirsturbance must last how long?
1 month!
Tx of ptsd?
Nightmares?
PSYCHOTHERAPY and SSRI is only to work for it!!!
prazosin may improve sleep (alpha antagonist)
Bezos are abused! so don’t give them
Acute stress disorder is different than PTSD how?
less than one month!
What is adjustment disorder? Timeline?
emotional response to stressor.
MUST BEGIN WITHIN 3 months then must resolve within 6 months
Must be start within 3 months of stressor and gone after 6 months of the disappearance of the stressor
Conversion disorder?
V for Voltage
Motor symptoms or sensory symptoms without neuro or medical cause
What is somatic symptom disorder?
Some symptoms possible but SUPER WORRIED ABOUT IT AND WAYYYY PREOCCUPIED about it
patients bring detailed notes
factitious vs malingering
factitcious may be hurting themselves!
malingering is for a reward!
ADHD dx
6 inattention or 6 hyperactivity before age 12 with questionnaires from parents and 2 other people
Tx if stimulants failed in ADHD?
TCA Bupropion or CLONIDINE alpha 2 antagonist
Stimulants for ADHD effect on height?
Growth delayed, but adult height not affected
Risk with atomoxetine?
Risk of suicidality
Tx for tourette?
Counseling to adjust
fluphenazine, pimozide, tetrabenazine (dopa antagonists, haloperidol not tolerated well)
SSRI or clonidine helps impulses
learning disability is different than intellectual disability
Intellectual is with all, learning is specific things
Autism signs early on?
“Living in their own world. Lack of responsiveness to others with poor eye contact and absence of social smile…)
repititions
DT is what vitally?
vital signs unstable!!!
Alcoholic hallucination is vitally stable
How do you remember DPP4 inhibitors?
Only ones with p’s in them consistently
GLIPTINS!
Other Metformin mechanism?
Increased sensitivity to insulin kinda!
KUSSMAUL breathing associated with DKA
Deep labored breathing to blow off CO2
Potassium status in DKA?
Serum level measured high, but total level is actually low (dehydrated and extracellular shift)
K and H+ shift b/c acidosis
DKA tx?
What do you do about KCl?
ICU IV fluids! Lots of it, 2 X IV amount IV insulin KCl IV glucose if needed
DO NOT STOP just b/c glucose is normal
When do you stop insulin drip in DKA?
When anion gap back to 10-12
HHNS is what?
Hyperosmolar hyperglycemic nonketotic state. from not enough insulin, but enough to prevent ketoacidosis
Hyperosmolar and dehydrated
Workup for cause of DKA includes what?
Infectin: Culture, UA, CXR
To screen
Pancreatitis: amylase or lipase
Evaluate for MI
TCA overdose symptoms?
Cardiotox: wide QRS or tacky
CNS toxicity
Anticholinergic
Anterior 2/3 of tongue taste?
Monitors chemo and baroreceptors?
VII
CN IX
2 types of diabetic retinopathy.
Findings? Which is worse.
Nonprolif has cotton wool spots/exudates. (MORE COMMON, LESS SEVERE)
Proliferative has proliferation of vascularization. Can see hemmorhages which causes blindness
Tx for proliferative retinopathy?
Laser photocoag to stop hemorrhage of neovascularture
Diabetic nephropathy is what? WHAT IS ON biopsy?
How do you screen?
glomerular sclerosis b/c expansion of mesangial matrix
See kimmelstiel wilson nodules
Screen for microablumin in urine
Most common neuropathies with DM?
Sensory, then motor and then autonomic
Charcot joint?
Arthropathy from chronic repetitive trauma. Think DM or tabes dorsalis
