Psych Review Flashcards by Mikayla Knaebel

How long must symptoms last in order to meet the diagnostic criteria for schizophrenia?

> 6 months

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How long must symptoms last in order to meet the diagnostic criteria for delusional disorder?

> 1 month

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How long must symptoms last in order to meet the diagnostic criteria for brief psychotic disorder?

< 1 month

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Howl long must symptoms last in order to meet the diagnostic criteria for schizophreniform disorder?

1-6 months

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Schizoaffective disorder

meets criteria for schizophrenia in addition to major mood disorder; patient must have >2 weeks of hallucinations or delusions without major mood episode

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Where in the brain is dopamine affected in schizophrenia?

increased in mesolimbic pathway

decreased in mesocortical pathway

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What are the criteria for the diagnosis of mania?

Symptoms lasting > 1 week
Hospitalization or at least 3: (DIG FAST)
- distractibility
- irresponsibility
- grandiosity
- flight of ideas
- increase in Activity
- decreased Sleep
- talkative

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What are the criteria for the diagnosis of major depressive episode?

Depressed mood + 5/9 of the following for >/= 2 weeks:
SIG E CAPS
S- Sleep disturbance
I- decreased Interest
G- Guilt/feelings of worthlessness
E- decreased Energy
C- Concentration problems
A- Appetite/weight changes
P- Psychomotor retardation/agitation
S- Suicidal ideation

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What is the presentation of major depressive disorder with atypical features?

can be cheered up (mood reactivity)
increased appetite/weight gain
hypersomnia
leaden paralysis
hypersensitivity to rejection

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A 28 year old woman has symptoms of mild depression for six years. What’s the diagnosis?

persistent depressive disorder

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What is serotonin syndrome? What drugs can cause it?

triad: mental status changes, hyperreflexia, autonomic instability (hyperthermia, diaphoresis, diarrhea)
drugs: SSRIs, SNRIs, TCAs, tramadol, ondansetron, triptans, linezolid, MDMA, dextromethorphan, St. John’s wort, kava-kava

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What is the treatment for serotonin syndrome?

stop meds
cool patient down
can give benzodiazepines
can give serotonin antagonist (cyproheptadine)

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unexplained pain

somatic symptom disorder

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patient with normal anatomy is convinced part of his/her appearance is abnormal

body dysmorphic disorder

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unexplained loss of sensory or motor function (tests and PE are negative)

conversion disorder

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unwavering belief by the patient that she has a specific disease (despite medical reassurance)

illness anxiety disorder

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unexplained complaint despite normal workup

somatic symptom disorder

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what is the difference between malingering and factitious disorders?

both the patient is consciously making the illness up; malingering is for secondary gain (avoiding work, obtaining compensation); factitious disorder is for the sympathy/attention of being sick

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How long does PTSD have to last in order to be diagnosed?

> 1 month

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How long does acute stress disorder last?

3 days - 1 month

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What is first line treatment for PTSD?

CBT, SSRIs, and venlafaxine

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What is first line treatment for GAD?

CBT, SSRIs, SNRIs

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What is first line treatment for OCD?

CBT, SSRis, and clomipramine (TCA)

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What is the treatment for specific phobias?

systematic desensitization

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What is the treatment for social anxiety disorder?

CBT, SSRI, venlafaxine

How long must symptoms last for the diagnosis of a phobia?

> 6 months

What is the treatment for panic disorder?

prevention: CBT, SSRI, venlafaxine; benzodiazepines for during panic attack

What are the diagnostic characteristics of anorexia nervosa?

BMI < 18.5 Restricting food intake distorted body image intense fear of gaining weight

What are the diagnostic characteristics of binge eating disorder?

overeating without compensation (tend to be obese)

What are the diagnostic characteristics of bulimia nervosa?

normal body weight excessive purging, laxative use, or calorie restriction binge eating

What electrolyte changes are seen in patients with excessive vomiting over time?

hypokalemic hypochloremic metabolic alkalosis

What is the most common class of medication used for bulimia nervosa?

SSRIs (fluoxetine)

What are the results of child neglect?

poor socialization skills, poor language skills, inability to trust others, poor feeding, weight loss, failure to thrive, poor muscle tone

What is reactive attachment disorder?

diagnosed after 9 months of age emotionally withdrawn sadness, fearfulness, irritability due to abuse

What is the difference between conduct disorder and antisocial personality disorder?

conduct disorder < 18 yo | antisocial personality disorder > 18 yo

What is the difference between conduct disorder and oppositional defiant disorder?

oppositional defiant disorder keeps respect for societal norms and laws

How long must tics last in Tourette's syndrome for diagnosis?

> 1 year

After what age can you diagnose separation anxiety disorder?

Normal up to age 3-4

What name is given to chronic, compulsive hair pulling common in young girls?

hair pulling disorder

What stimulant medications are commonly used int he treatment of ADHD?

stimulants - methylphenidate - dexmethylphenidate - mixed amphetamines - dextroamphetamine

What is the most common medication used for treating ADHD?

methylphenidate

post-op constipation and/or respiratory depression

opioids

severe depression, HA, fatigue, insomnia/hypersomnia, hunger

cocaine or amphetamine withdrawal

pinpoint pupil, N/V, seizures

opioid overdose

belligerence, impulsiveness, nystagmus, homicidal ideation, psychosis

PCP intoxication

HA, anxiety, depression

withdrawal from nicotine/caffeine

anxiety/depression, delusions, hallucinations, flashbacks

LSD

euphoria, social withdrawal, impaired judgement, hallucinations

marijuana intoxication

rebound anxiety, tremors, seizures, life threatening

benzodiazepines, barbs, alcohol withdrawal

anxiety, piloerection, yawning, fever, rhinorrhea, nausea, diarrhea

opioid withdrawal

what is the treatment for a patient that is overly intoxicated with alcohol?

fluids, resp monitoring, blood alcohol monitoring, time

What is the treatment for a patient that is overly intoxicated with benzodiazepines?

supportive care, flumazenil

What is the treatment for a patient that is overly intoxicated with PCP?

benzodiazepines, haloperidol

What is the treatment for a patient that is overly intoxicated with opioids?

naloxone, naltrexone

What are the stages of behavioral change?

1. precontemplation 2. contemplation 3. preparation 4. action 5. maintenance 6. relapse

What is the mechanism of action of disulfiram?

inhibits acetaldehyde dehydrogenase, which leads to a buildup of acetaldehyde, which makes you feel like shit

When does delirium tremens occur?

2-4 days after last drink

What medications are effective in helping to prevent relapse in recovering alcoholics?

1. alcoholics anonymous 2. naltrexone 3. disulfiram 4. topiramate 5. acamprosate

What ist he medical treatment for alcohol withdrawal?

benzodiazepine

What defense mechanism is voluntarily choosing not to think about a piece of bad news?

suppression

What defense mechanism is not acknowledging a piece of bad news as though it were never said?

denial

What defense mechanism is involuntary withholding of a feeling from conscious awareness?

repression

What defense mechanism is a veteran who can describe horrific war details without any emotion?

isolation

What defense mechanism is a belief that a person or thing is either all good or all bad?

splitting

What defense mechanism is a man that yells at his family when he has a bad day at work?

displacement

What defense mechanism is an 8-year-old girl who is being bullied in school who starts carrying around her security blanket again?

regression

What are the Cluster A personality disorders?

weird paranoid schizoid schizotypal

What are the Cluster B personality disorders?

``` wild Antisocial Borderline Histrionic Narcissistic ```

What are the Cluster C personality disorders?

weird Avoidant Obsessive-Compulsive Dependent

Schizoid

schizoids avoid | voluntary social withdrawal

Schizotypal

eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

Histrionic

excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance

Avoidant

hypersensitive to rejection, socially inhibited, timid, feelings of inadequacy, desires relationships with others

Dependent

submissive and clingy; excessive need to be taken care of, low self-confidence