Psych treatments: Anxiety, Eating, and Sleep disorders Flashcards
Which medical conditions should be ruled out when considering an anxiety disorder, characterized by symptoms less than 30 minutes that may have agorophobia
Hypothyroidism, cardiac abnormalities, hypoglycemia
What is the medical treatment for all anxiety disorders
SSRI’s + benzodiazapene
Do this because benzo starts acting immediately while SSRI takes some time, but once SSRI kicks in start tapering the benzo to avoid dependance.
What is the treatment for a panic disorder vs. a panic attack
Panic disorder: SSRI
Panic attack: Benzodiazepene
What is the treatment for specific phobias and social phobias (fear of any situation)
Behavioural modification: Systemic desensitization
Relaxation techniques
What is the treatment for obessive compulsive disorder
All SSRI’s
Behaviour therapy: Exposure and response prevention
What is the treatment of post traumatic stress disorder (more than 1 month) and acute stress disorder (2 days to 1 month)
SSRI: Specifically paroxetine and sertraline
Relaxation
Psychotherapy
What is the treatment of generalized anxiety disorder
All SSRI’s
Venlafaxine and Buspirone
What are some anti-anxiety medications and their special indications (the benzos)
Lorazepam - Given emergently through IM
Clonazepam - longer half life, give if abuse potential
Alprazolam: Given for panic disorders
What is the risk of flumenazil
Can cause seizures in benzo dependant people, looks like delerium tremens
Match the description with the intoxication: Talkative, disinhibited
Alcohol - treat with mechanical ventilation if severe
Match the description with the intoxication: Euphoric, hypervigiliant, pupillary dilatation, autonomic hyperactivity, perceptual disturbances, weight loss
Cocaine and amphetamines. Treat intoxication with antipsychotics/benzos/antihypertensives
Match the description with the intoxication: Impaired motor coordination, slowed sense of time, social withdrawal, increased appetite, conjunctival injection
Maraijuana
Match the description with the intoxication: Ideas of reference, perceptual disturbances, impaired judgement, tremors, incoordination, dissociation
Hallucinogens: Treat intoxication with antipsychotics/benzos/talking down
Match the description with the intoxication: Apathy, dysphoria, pupillary constriction, drowsy, slurred speech, coma, death
Opiates - treat with nalaxone
Match the description with the intoxication: Belligerence, psychomotor agitation, violence, nystagmus
PCP: Antipsychotics/benzos/talking down
Match the description with the WITHDRAWAL: Tremors, hallucinations, seizures, delerium tremens
Alcohol - treat withdrawal with benzos, thiamine, folic acid
Match the description with the WITHDRAWAL: Anxiety, tremors, headache, increased appetitite, depression, risk of suicide
Cocaine - treat withdrawal with bupropion or bromocriptine (both mildly increase dopamine reward)
Match the description with the WITHDRAWAL: Everything runny, including nose, eyes, diarrhea, with muscle cramps
Opiates - treat with clonidine, methadone, or buprenorphine
What is the method of treatment of all somatoform disorders, which are disorders without medical explanation and include somatization, hypochondriasis, conversion, body dysmorphic disorder, and pain disorder
Psychotherapy - because basis is psychological in nature
What is the difference between somatization disorder, hypochondriasis, and conversion disorder
Somatization: 4 pain, 2 GI, 1 sexual, 1 neuro
Hypochondriasis: Believe they have specific disease despite reassurance
Conversion: Voluntary motor and sensory functions affected in response to stressor
What is the treatment for adjustment disorde,r, which is maladaptive reaction to IDENTIFIABLE stressor within 3 months causing impairment of function
Psychotherapy
What is the treatment for all personality disorders
Psychotherapy
Which personality disorders have associated short lived psychotic episodes
Borderline and schizotypal
What is the most common cause of death for anorexia nervosa patient
Arrhythmia due to potassium deficiency (remember this because they keep throwing up)
What is the treatment for anorexia nervosa
Hospitalization - dehydration, starvation, electrolyte imbalance, with psychotherapy and SSRI’s
What is the treatment for bulimia nervosa
No hospitalization unlike anorexia nervosa unless severe electrolyte problem, otherwise just treat with psychotherapy and SSRI’s (same as anorexia nervosa)
In what three situations do you diagnose eating disorder not otherwise specified
- ) Anorexia with normal menstruation
- ) Anorexia with normal weight
- ) Use of compensatory behavior after eating normal amount of food (bulimia over-eat, anorexia under-eat)
What is the diagnostic procedure and treatment for narcolepsy, charactierized by excessive daytime sleepiness
Forced naps during day and modafinil for alertness
The four features of narcolepsy are sleep attacks, cataplexy, hypnogogic/hypnopompic hallucations, and sleep paralysis. What is each of them
Sleep attack: Irresistable sleepiness during day and feeling refreshed when waking up
Cataplexy: Sudden loss of muscle tone in response to loud noise or emotions, pathognomonic
Hallucinations going to sleep and waking up
Sleep paralysis: Patient awake but unable to move after waking up in morning
What is the treatments for insomnia
Sleep hygiene: Going to sleep and waking up at same time, avoid caffeine, avoid daytime naps
Medical therapy: Zolpidem, eszopiclone, zaleplon
The four sexual dysfunctions are impotence, premature ejacualation, dyspareunia, and vaginismus. What is the treatment for each?
Impotence: Psychotherapy, couples sexual therapy
Premature ejaculation: Psychotherapy, stop go squeeze technique, and SSRI
Dyspareunia: Psychotherapy
Vaginismus: Psychotherapy and dilator therapy
What is the treatment for paraphilias
Psychotherapy, aversive conditioning
Medications: antiandrogens and SSRI’s to reduce sexual drive
What is the treatment for gender identity disorder
Sexual reassignment surgery and psychotherapy
