Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med School Rotations > Psych Tips, Techniques and Treatment Options > Flashcards

Psych Tips, Techniques and Treatment Options Flashcards

1
Q

What is a good way to close a patient encounter

A

Ask the patient what their goal was for the visit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Generally how should you diagnose personality disorders

A

Unless a patient meets every single wicket for a disorder, use the diagnosis of Personality Disorder NOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What treatment options should be considered when treating depression and an unresolved neurovegitative state

A

Consider using Buproprion first, and then adding adderall on later.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some common drugs that need to be titrated up and down

A 
SSRI
SNRI
Benzodiazepines
Lamictal
Topamax
Beta blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When should you consider do genetic testing for medical treatment in psych?

A

consider in patients who are low responders and have sensitivity problems with a few different classes.

Generally not beneficial in patients that have tried many different classes already

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the benefit of using an anxiolytic over a benzodiazepine when treating anxiety

A

Benzo’s will only mask the problem, while anxiolytics have the ability to correct the problem.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should you do if a patient is sensitive to a medication after beginning treatment

A

Switch to a different medication and start on a low dose. Titrate up slowly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What determines the interval between visits

A

Disease progression, patient stability and support group determines intervals.

4-6 weeks after initiating a medical change or unstable patient.
2-3 months if the patient is showing improvements but not at target
4-6 months if the patient is stable and has met or is near target

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a good medication to start for a patient with anxiety?

A

Anxiety is closely related to Serotonin levels so initiate therapy with an SSRI.

If the patient is also experiencing depression, start with the lowest possible dose and titrate up slowly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What psychiatric effect does antihypertensive medications have?

A

May cause depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What cardiac effect does anti-depressants cause

A

Arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a patient is depressed and anxious but is experiencing negative sexual side effects from an SSRI, what is a good alternative

A

Mirtazipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a serious complication of trazadone

A

Priapism in 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is trazadone used medically

A

Commonly used as an adjunct of treatment with bupropion. It is also used to assist patients in sleeping

It is mainly used to treat anxiety and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you treat fibromyalgia and depression

A

Initiate treatment with an SNRI. Consider adding an SSRI after the SNRI has been maxed.

Be sure to monitor for symptoms of seratonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a limiting side effect of duloxetine

A

comorbid liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When adjusting dose of lamictal, what should the patient look for

A

a Rash. There is the potential to develop Steven-Johnson Syndrome (SJS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nefazadone. No longer used in the US do to what side effect

A

Liver dysFunction

Contraindicated in patients with a comorbid liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the mnemonic for dementia

A 
(DEMENTIAS)
Degenerative disease
Endocrine
Metabolic
Exogenous
Neoplasm
Trauma
Infection
Affective Disorder
Stroke/Structure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the mnemonic for delerium

A 
(I WATCH DEATH)
Infection
Withdrawal
Acute metabolic/Abuse of substance
Trauma
CNS pathology
Hypoxia
Deficiencies
Endocrine
Acute vascular / MI
Toxins or drugs
Heavy metals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the mnemonic for a depressive episode

A 
(SIG E CAPS)
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor agitation or Retardation
Suicidal ideation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the mnemonic for TCA toxicity

A

“Tri C’s”
convulsions
coma
cardiac arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the mnemonic for mania

A 
(DIG FAST)
Distractability
insomnia
Grandiosity
Flight of ideas
Activities / Psychomotor agitation
Sexual indiscretions
talkativeness or pressured speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the mnemonic for a personality disorder

A 
(MEDIC)
Maladaptive
Enduring
Deviate from cultural norms
Inflexible
Causes impairment in social or occupational functioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the mnemonic for the evaluation of EPS

A 
"4 and A"
4 hours: acute dystonia
4 days: Akinesia
4 weeks: Akathisia
4 months: Tardive dyskinesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the mnemonic for the features of substance abuse

A

(WITHDraw IT) 3 or more in a 12 month period

Withdrawal
Interest or important activities decreases
Tolerance
Harm
Desire to cut down
Intended time or amount exceeded
Time spent with or for substance increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the screening tool for alcoholism?

A

“CAGE Questionnaire”

  1. have you ever felt the need to cut down on drinking ?
  2. have you ever felt annoyed by criticism of your drinking?
  3. have you ever felt guilty of your drinking?
  4. have you ever had to have a morning “eye opener”?

answer of yes to more than one makes alcoholism likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the mnemonic for the risk factors associated with suicide

A 
(SAD PERSONS)
Sex (male)
Age (older)
Depression
Previous attempt
Ethanol or substance abuse
Rational thought
Sickness
Organized plans and access to weapons
No spouse
Social support lacking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Can antihypertensive medications cause depression

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What cardiac side effect is associated with several antidepressants

A

May cause arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

If a patient is sensitive to the sexual side effects associated with SSRI’s, what medication should be considered

A

mirtazipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the major side effect of trazodone

A

Priapism

1% of population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When is trazodone indicated

A

Anxiety and depression

Can be used as an adjunct therapy with buproprion to assist with insomnia (increases sleep duration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is key consider when prescribing duloxetine

A

Comorbid liver disease use with caution.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most serious side effect of lamictal

A

Rash. Can develop Steven Johnson Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

When should you use nefazodone

A

not in the US. It is contraindicated with liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the common side effects of topamax

A

Skinny and stupid (trouble finding words/speaking)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What tends to happen with depressed and anxious periods of increased stress

A

Generally their symptoms will decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What psychological conditions are generally associated with outburst

A
  1. Bipolar
  2. Anxiety
  3. ADHD
  4. Drug Side Effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What drug is known to decrease seizure threshold

A

Buproprione

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What can be used to help reduce racing thoughts at bed time

A

Neurontin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Is GAD always associated with Panic Disorders

A

NOPE, anxiety attacks are the key feature not necessarily generalized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

If Lamictal is insufficient in treatment what is a good complimentary medication to add

A

Abilify

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the drug of choice (gold standard) for anxiety and depression

A

Prozac (fluoxetine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What affect does lap bands and gastric by-pass surgeries have on anti-depressants

A

Lap bands have a limited effect

Gastric Bypass will tend to have a greater effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

If a patient has bouts irritability, what other conditions should be considered

A

Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

acute dystonia

A

neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.[

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

akinesia

A

the inability to initiate movement due to difficulty selecting and/or activating motor programs in the central nervous system

a result of severely diminished dopaminergic cell activity in the direct pathway of movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

akathesia

A

characterized by unpleasant sensations of inner restlessness that manifests itself with an inability to sit still or remain motionless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Tardive dyskinesia

A

characterized by repetitive, involuntary, purposeless movements. Some examples of these types of involuntary movements include grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is atypical depression

A

similar to MDD but is characterized by reversed vegetative symptoms, namely over-eating and over-sleeping, and separately by interpersonal rejection sensitivity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are the primary drugs used for depression

A

SSRI
SNRI
TCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are the primary drugs for atypical depression

A

MAOI

SSRI’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What can be used for depression with insomnia

A

Mirtazipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Name the MAOI’s generally used for depression

A

phenelzine
tranylcypromine
isocarboxazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what is the mechanism for Buproprion

A

Norepinephrine - dopamine reuptake inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what kind of plasma levels should be drawn with carbamazepine

A

during the first three months weekly CBC’s should be drawn.

Liver function tests every 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what kind of plasma levels should be drawn with valproate

A

serum valproate levels (therapeutic 45-50mg/mL)

LFT’s every 6-12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the 3 classifications of the causes of mental illness

A

Biologic
psychological
Environmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is included in Axis I

A

clinical syndromes (organic mental disorders)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is included on Axis II

A

Personality disorders and Mental Retardation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What additional lab work is needed with Clozapine

A

weekly CBC for 6 months followed by every other week CBC’s for 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is included on Axis III

A

General medical conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is included on axis IV

A

Psychosocial and environmental problems (stressors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is included on Axis V

A

Global assessment of function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How is GAF determined

A

a numeric scale (0 through 100) used by mental health clinicians and physicians to rate subjectively the social, occupational, and psychological functioning of adults, e.g., how well or adaptively one is meeting various problems-in-living. The scale is presented and described in the DSM-IV-TR on page 34.

100 - no problems
40 - suicide idealation
10 - danger to hurting others or self

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the positive symptoms associated with Schizophrenia

A

delusions
hallucinations
catatonia
agitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are the negative symptoms associated with Schizophrenia

A 
affective flattening
apathy
social withdrawal
anhedonia 
poverty of thought
content of speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is required for diagnosis of Schizophrenia

A

Two of the following for most of 1 month (group A)

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Grossly disorganized or catatonic behavior
  5. Negative symptoms

Marked social or occupational disturbance

Duration of at least 6 months of persistent symptoms such as attenuated forms of group A symptoms or negative symptoms

substance use, medical conditions and associated mood disorders ruled out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are the subtypes of schizophrenia

A 
Paranoid
disorganized
Catatonic
Undifferentiated
Residual
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is catatonic schizophrenia

A

clinical picture dominated by 2 of the following

a. motoric immobility as evidenced by catalepsy or stupor
b. excessive motor activity
c. extreme negativism or mutism
d. peculiarities of voluntary movement such as posturing, stereotyped movements, prominent mannerisms, or prominent grimacing
e. echolalia or echopraxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the effect of GABA for psychiatric disorders

A

plays an inhibitory role with dopaminergic neurons.
GABA may be responsible for terminating or controlling the activity with in the dopamine system
1. Low levels of GABA are found early in the course of schizophrenia
2. Benzodiazepines, which work in part as GABA agonists can relieve some symptoms of schizophrenia in some patients
3. Baclofen, a GABA receptor Antagonist can exacerbate symptoms of schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the theory behind using D2 blockers with schizophrenia

A

Dopamine receptros, particularly D2 receptors, are found in abnormal numbers in the brains of persons with schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

How is glutamate affected in patients with schizophrenia

A

Glutamate levels are reduced in the CSF of persons with schizophrenia. In addition, glutamate receptor antagonist such as phencyclidine can cause schizophrenia-like symptoms

Glutaminergic neurons interact with both serotonergic and dopaminergic systems

75
Q

What are two types of catatonic posturing

A

catatonic rigidity

wavy flexibility

76
Q

What is a brief psychotic episode

A

Duration of schizophrenia like symptoms for one day but less than one month

77
Q

What is schizopheniform disorder

A

schizophrenia like symptoms for more than one month but less than 6 months

78
Q

What is schizoaffective disorder

A

schizophrenia with mania or major depression

  1. Subtype Bipolar
  2. Subtype Depressive
79
Q

Which group of antipsychotic medication is associated more with anticholinergic side effects

A

low potency

80
Q

Due 1st generation antipsychotics effect more of the positive or negative symptoms

A

Primarily positive but less effect on chronic well organized delusions

81
Q

How do you treat the side effect of an acute dystonia

A

benztropine (1-2mg IM)

Diphenhydramine (25-50mg IV or IM)

82
Q

What is the mechanism of benztropine

A

anticholinergic

83
Q

How do you treat the side effect of akathisia

A

May respond to antiparkinsonian agents.

If the patient responds poorly to these agents, consider:
propranolol, benzodiazepines, vitamin E

84
Q

What are the antiparkinsonian agents

A 
Amantadine (Symmetrel)
Benztropine (Cogentin)
Biperiden (Akineton)
Diphenhydramine (Benadryl)
Trihexyphenidyl (Artane)
85
Q

Buspirone is used to treat what

A

Antianxiety

86
Q

Buproprion is used to treat what

A

depresssion

87
Q

What is the mechanism for buspirone

A

binds to serotonin and dopamine receptors

88
Q

Hydroxyzine can be used to treat what psychiatric disorder

A

Anxiety

89
Q

Name the Atypical Antipsychotics

A 
aripiprazole
asenapine
clozapine
iloperidone
olanzapine
paliperidone
Quetiapine
Risperidone
Ziprasidone
90
Q

Name the conventional Antipsychotics

A 
Chlorpromazine
Thioridazine
Fluphenazine
Perphenazine
Trifluoperazine
Thiothixine
Haloperidol
Loxapine
Molindone
91
Q

What are the neurochemical factors associated with mood disorders

A

NE
Dopamine
5-HT
GABA

92
Q

What is the proposed neurochemical cause of mania

A

increase NE activity

93
Q

Name 2 dopaminergic agents that can be used to treat depression

A

Methylphenyldate

Modafinil

94
Q

What is the duration of symptoms for a MDE

A

2 weeks

95
Q

What is the duration of symptoms for a Manic episode

A

1 week

96
Q

What defines a mixed episode

A

patient satisfies criteria for both manic episode and MDE over a 1 week period

97
Q

What defines a hypomanic episode

A

Duration only needs to last 4 days and the symptoms of mania are milder

98
Q

What is the duration of symptoms needed to diagnose dysthymia

A

2 years for adults

1 year for children and adolescents

99
Q

What is a cyclothymic disorder

A

dysthymic disorder with intermittent hypomanic periods.

Chronic illness of at least 2 years in duration

100
Q

Name the mood disorder modifiers

A 
Severity (presence or absence of psychosis)
Remission
Catatonic features
Melancholia
Atypical features of depress
Postpartum onset
101
Q

What are mood stabilizers used in the treatment of Bipolar

A 
Lithium
Valproate
Carbamazepine
Second generation antipsychotics
Lamotrigine
Benzodiazepines for mania and sedation
Anticonvulsants (oxcatbazepine, topiramate, gabapentin, tigabine)
102
Q

What are the side effects of lithium

A 
tremor
sedation
nausea
polyruria
polydipsia
memory problems
weight gain
hypothyroidism
103
Q

How is Lithium excreted

A

renally;

monitor clearance and therapeutic levels in pts with reduced kidney function

104
Q

What are some side effects of Carbamazepine

A 
blurred vision
ataxia
nausea
fatigue
hyponatremia
asymptomatic leukopenia

RARE BUT SERIOUS
AGRANULOCYTOSIS
SJS
PANCREATITIS

105
Q

What is the pharmacological treatment of OCD

A

SSRI’s

106
Q

What is the duration required to diagnose GAD

A

6 months

107
Q

What is the duration of symptoms required to diagnose panic disorder

A

1 month

108
Q

What 2 SSRI’s have an FDA approval for PTSD

A

Sertraline
Paroxetine

SSRI’s are less effective against combat related PTSD

109
Q

What is aphasia

A

impairment or loss of language function

110
Q

What is apraxia

A

inability to execute previously learned complex motor behaviors such as bathing, dressing, driving, or drawing

111
Q

What is agnosia

A

failure to recognize or identify previously known objects

112
Q

What defines cortical dementia

A

characterized by the early appearance fo aphasia, difficulties with calculation and memory loss.

Disturbances of speech and psychomotor behavior are less predominant

113
Q

What defines subcortical dementia

A

is characterized by the early appearance of problems with executive functioning and recall, dysarthria, motor skill impairment, and personality changes.

These symptoms can occur in the absence of significant aphasia

114
Q

What is the pathology behind huntington’s disease

A

progressive neurodegenerative disease that involves loos of GABAnergic neurons of the basal ganglia.

Manifest y choreoasthetosis and dementia

115
Q

what is cataplexy

A

complete loss of muscle tone associated with narcolepsy and atonic seizures

116
Q

what defines myoclonic seizures

A

muscle contraction with out loss of consciousness

117
Q

What are the 4 types of generalized seizures

A

tonic clonic
atonic
Absence
myoclonic

118
Q

What are the 2 types of partial seizures

A

Simple partial

Complex partial

119
Q

What defines simple partial seizures

A

manifested by motor, sensory or autonomic disturbances depending on the location of the seizure focus

120
Q

What defines complex partial seizures

A

disturbances of consciousness, including decreased awareness and alteration of cognition, emotion and sensory experience

may resemble symptoms of dissociative fugue

121
Q

Define beriberi

A

thiamine deficiency

Wet beriberi: pt present with high-output cardiac failure,

Dry beriberi: peripheral neuropathy with bilateral distal impairment of motor and sensory skills and reflexes

Cerebral Beriberi: CNS damage with motor and cognitive impairments

122
Q

Define pelagra

A

nicotinic acid deficiency

Caused by alcohol dependence, vegetarian diets, starvation

Symptoms include dermatitis, diarrhea, peripheral neuropathies, cognitive deficits, and personality changes that progress to delirium

123
Q

Psychiatric symptoms of hyperparathyroid disorders

A

muscular weakness, anxiety and personality changes. Delirium, seizures and death can occur with a parathyroid storm

124
Q

Psychiatric symptoms associated with hypoparathyroid disorder

A

increased excitability, transient parathesias, crampon, twitching, tetany and seizures

125
Q

Hypothyroid disorder is also known as

A

myxedema

126
Q

Psychiatric presentation of AIP

A

acute intermittent porphyria

abdominal pain, motor neuropahties and mental disturbances that range from personality changes to psychotic symptoms and delirium.

127
Q

What are egosyntonic symptoms

A

patients do not recognize that anything is wrong with them that needs to be changed. They view existing disturbances as being the result of the worlds being out of step with with them.

128
Q

Name the Cluster A personality disorders

A

Schizoid
paranoid
schizotypal

129
Q

Name the cluster B personality disorders

A

histrionic
narcissistic
antisocial
borderline

130
Q

Name the cluster C personality disorders

A

Avoidant
dependent
Obsessive-Compulsive Personality D/O

131
Q

What is the progression to antisocial

A

conduct disorder
oppositional defiant
Antisocial

132
Q

How do you distinguish avoidant from schizoid

A

avoidant personality has the fear of rejection yet still wants friends

Schizoid does not want friends

133
Q

What defines conversion disorder

A

subjective symptoms unexplained by physical findings

Often the patient will show little concern to the symptoms

Modeling is common

134
Q

what defines body dysmorphic disorder

A

unusual attention to and /or preoccupation with symptoms, organs, and body parts

135
Q

what defines somatization disorder

A

four pain symptoms
two GI symptoms
one sexual symptom
One pseudoneurologic symptom

136
Q

What defines hypochondriasis

A

preoccupation with fears of having a serious disease due to a misinterpretation of a bodily symptom

137
Q

What is a dissociative fugue

A

sudden, unepected travel away from home or place of work with an inability to recall one’s past and confusion about personal identity or assumption of a new identity

138
Q

What is dissociative amnesia

A

inability to recall important personal information, usually of traumatic or stressful nature, too extensive to be accounted for by ordinary forgetfulness

139
Q

What is a dissociative identity disorder

A

involves the presence of two or more distinct personalities or personality states which recurrently take control of the person’s behavior

140
Q

What is a depersonalization disorder

A

persistent or recurrent experiences of detachment from one’s body or mental processes

141
Q

What differentiates malingering from factitious disorder

A

malingering has a motive. Both have deliberate cause of symptoms

142
Q

What are the stages of sexual response

A

I: desire
II: Excitement
III: Orgasm
IV: Resolution

143
Q

What is sexual identity

A

individuals’ biologic make up including chromosome configuration, genitalia, hormone levels, and after puberty the secondary sex characteristics

144
Q

What is gender identity

A

a person’s self-identification as male or female which usually occurs by age of 2-3 years

145
Q

What is sexual orientation

A

the object of an individuals sexual desire

146
Q

What is frotteurism

A

characterized by touching or rubbing against a nonconsenting person

147
Q

What is klismphilia

A

arousal from enemas

148
Q

What is telephone scatologia

A

arousal from making obscene phone calls

149
Q

What sexual effect can dopaminergic medications have

A

increases libido

150
Q

What body weight is required for diagnosis of anorexia

A

85% of ideal weight

151
Q

What are the two subtypes of anorexia

A

Restricting

Binge/purge

152
Q

What are the abnormal associated findings of anorexia

A 
Peripheral edema
Lanugo hair development
Skin changes
Lowered metabolic rate
Decrease total brain volume
153
Q

What medications are indicated for anorexia

A

Cyproheptadine (apetite stimulation)

Fluoxetine (after weight has returned)

154
Q

What are associated findings in bulimia nervosa

A 
ingestion of high calorie food
bingeing episodes occur in secret
wide fluctuations in weight
persistent overconcern with weight and body shape
attempts to lose weight
Lengthy phases of normal eating
155
Q

What are some medical complications of bulimia nervosa

A 
metabolic abnormalities 
parotid gland swelling
dental erosions
menstrula irregularities
gastic dilation and rupture
chronic sore throats and esophagitis
anemia
Neropsychiatric symptoms (seizures, neuropathies)
156
Q

How will a patient present with Neuroleptic malignant syndrome

A 
altered mental status
muscle rigidity
hyperthermia
diaphoresis
tachycardia
elevated blood pressure

LABS:
Elevated CPK
Leukocytosis

157
Q

What is used for the treatment of NMS

A 
stop the offending agent
Fluids
Cooling blankets
dantrolene
ECT if pharmocotherapy fails
158
Q

How will a patient present with Serotonin Syndrome

A 
myoclonus
mental status changes
akathisia
diaphoresis
tremor
hyperreflexia
mydriasis
diarrhea
headache
autonomic instabilities
159
Q

What is the treatment for serotonin syndrome

A

Stop the offending agent
supportive care
control agitation with benzodiazepine
Cyproheptadine can be given in moderate cases to control symptoms

160
Q

What is pica

A

persistent (for a period of atleast 1 month) eating of nonfood products

161
Q

What symptoms should cause you to suspect lead poison in a child

A

suspected in any child who has an encephalopathy or who exhits unusual behavior (irritability, anorexia, decreased activity)

162
Q

What is rumination disorder

A

a potentially fatal disorder that is characterized by the regurgitation of previously ingested food followed by rechewing of the foot.

Onset is typically in the first year of life, but in mentally retarded individuals may be delayed until adult hood

163
Q

What is anaclitic depression

A

infants that have failure to thrive after being removed from their between 9 and 12 months of age

164
Q

What is reactive detachment disorder

A

The child has impaired social interactions that are due to pathologic parenting and not due to an autism spectrum disorder.

Two types:
inhibited type: the child does not initiate or respond appropriately socially and may avoid contact or approach and then avoid contact

Disinhibited type: children are overly familiar with strangers

165
Q

What is autistic disorder

A

the child is relatively unresponsive to other hum beings, demonstrates bizarre responses to the environment, and has unusual language development.

Most commonly before the age of 3.

166
Q

What 3 things are required to diagnose autism

A

Social interactional deficits
Communicative deficits
Behavioral deficits

167
Q

What are the 3 subtypes of ADHD

A

inattentive type
hyperactive-impulsive type
combined type

168
Q

What is the pharmacological treatment for oppositional defiant disorder in patients with ADHD

A

Stimulants
atomoxetine
clonidine

169
Q

What is the medical treatment for tourettes

A

dopamine blocking agents
Clonidine
Guafacine

170
Q

What is PANDAS

A

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal group A

abrupt onset in early childhood of OCD symptoms

171
Q

What is somnambulism

A

sleep walking

onset between 4 and 8. peaks at 12

172
Q

what is somniloquy

A

sleep talking

173
Q

how are night terrors characterized

A
  1. inconsolability of the child during the event
  2. absence of recall of the content of the dream
  3. absence of recall of the event the following morning
174
Q

What is the treatment for narcolepsy

A

modafinil

175
Q

What is primary nocturnal enuresis

A

Bed wetting

parasomnia that occurs during stages 3 and 4 sleep

176
Q

What is primary diurnal enuresis

A

Bed wetting

parasomnia that occurs during the waking hours

177
Q

What is secondary enuresis

A

unrinating at inappropriate time and places that develops after one year of good bladder control

178
Q

What is encopresis

A

fecal incontinence beyond the period when bowel control should normally have developed

179
Q

define dementia with lewy bodies

A

cytoplasmic inclusions found in cells of the sbstantia nigra in patients with idiopathic parkinson disease

180
Q

what are lewy bodies

A

round inclusions composed of a-synuclein, found intracellulary in substantial nigra cells and in the locus ceruleus, nucleus basalis of Meynert, dorsal raphe nuclei, and dorsal motor nucleus of CN X

181
Q

what is the pharmacological treatment for dementia

A

acetylcholinesterase inhibitors

NMDA receptor antagonist

182
Q

What is parkinsons dementia

A

degenerative disease caused by the loss of dopaminergic neurons in the substantia nigra

183
Q

What effect does anticholinergic medications have on dementia and cognition

A

exacerbates symptoms of dementia

Avoid anti-cholinergic medications in the elderly

184
Q

What is the mechanism of cyproheptadine

A

Anti histamine

Med School Rotations (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions