Psych Review Flashcards
How long must symptoms last in order to meet the diagnostic criteria for schizophrenia?
> 6 months
How long must symptoms last in order to meet the diagnostic criteria for delusional disorder?
> 1 month
How long must symptoms last in order to meet the diagnostic criteria for brief psychotic disorder?
< 1 month
Howl long must symptoms last in order to meet the diagnostic criteria for schizophreniform disorder?
1-6 months
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
Where in the brain is dopamine affected in schizophrenia?
increased in mesolimbic pathway
decreased in mesocortical pathway
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
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
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
A 28 year old woman has symptoms of mild depression for six years. What’s the diagnosis?
persistent depressive disorder
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
What is the treatment for serotonin syndrome?
- stop meds
- cool patient down
- can give benzodiazepines
- can give serotonin antagonist (cyproheptadine)
unexplained pain
somatic symptom disorder
patient with normal anatomy is convinced part of his/her appearance is abnormal
body dysmorphic disorder
unexplained loss of sensory or motor function (tests and PE are negative)
conversion disorder
unwavering belief by the patient that she has a specific disease (despite medical reassurance)
illness anxiety disorder
unexplained complaint despite normal workup
somatic symptom disorder
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
How long does PTSD have to last in order to be diagnosed?
> 1 month
How long does acute stress disorder last?
3 days - 1 month
What is first line treatment for PTSD?
CBT, SSRIs, and venlafaxine
What is first line treatment for GAD?
CBT, SSRIs, SNRIs
What is first line treatment for OCD?
CBT, SSRis, and clomipramine (TCA)
What is the treatment for specific phobias?
systematic desensitization
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?
- precontemplation
- contemplation
- preparation
- action
- maintenance
- 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?
- alcoholics anonymous
- naltrexone
- disulfiram
- topiramate
- 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
