Psychiatric Disorders Flashcards
What are some risk factors for psychiatric disorders?
Family hx. and personal trauma.
Though exact cause is not well understood, there is often an imbalance of neurotransmitters regulating mood, reward-motivated behaviour, appetite and sleep.
What are the three main neurotransmitters related to psychological well-being, and the moods they affect?
Serotonin –> obsessions, compulsions, confidence & happiness
Dopamine –> attention, motivation, pleasure
Norepinepherine –> anxiety, attention, “physical high”
What is the working theory of the patho of depression?
Depression is associated with hyperactivity of the HPA (hypothalamic, pituitary, adrenal) axis, which increases cortisol, decreases hippocampal and frontal lobe volumes and decreases slow wave sleep patterns.
What are some symptoms of depression?
Hopelessness, lack of purpose Anhedonia (no longer taking pleasure in things that they used to enjoy) Weight gain or loss Sleeping too much or too little Hypo/hyperactivity Feelings of worthlessness Excessive guilt Inability to concentrate Suicidal ideation
Describe anxiety disorder
randomfact: 30% of adults have anxiety disorders
Anxiety disorders are thought to be related to low GABA. Key symptoms are fear and uncontrollable anxiety (dread).
For dx., patient’s worry without a specific cause to the point their daily lives are interrupted.
What are the symptoms of schizophrenia?
Schizophrenic disorders are marked by difficulty thinking clearly, making good decisions, distinguising reality from imagination and behaving appropriately. Excess dopamine may be a contributing factor.
POSITIVE s/s: delusions, hallucinations, disorganized speech, abnormal motor behaviour
NEGATIVE s/s: affective flattening, reduced eye contact and speech intonation, reduced gesturing
COGNITIVE s/s: difficulty understanding, difficulty expressing thoughts, poor memory
Definition of dementia
Dementia is a decrease in cognitive skill that impairs daily function and independence.
What are some reversible and irreversible causes of dementia?
REVERSIBLE: syphilis, alcoholism, hydrocephalus
IRREVERSIBLE: alzheimer’s, vascular dementia, parkinson’s, huntington’s, lewy body dementia
Describe excited delirium
Excited delirium is a hypermetabolic state and medical emergency. Patients are sympathetically driven due to a massive catecholamine dump.
Patient signs/symptoms in excited delirium
Violent/combative Hallucinations Excessive strength Hyperthermic Tachycardic Reduced pain reception
Causes of death in excited delirium
Positional asphyxia Dopanine dysregulation Acidosis Hyperkalemia Rhabdomyalisis MI
ACP tx. for excited delirium
Scene safety #1
IM ketamine is the preferred drug in the management of severely agitated patients (RASS +3-4) and in excited delirium syndrome (ExDS) because of its faster onset, shorter duration, superior efficacy, and fewer side effects compared to midazolam.
Do not titrate ketamine for ExDS.
Administer 5 mg/kg IM Administration may require two or more IM injections Maximum volume for Adult IM injections: Deltoid 2.0 mL Lateral thigh 4.0-5.0 mL Larger Muscles (Gluteal) 5.0 mL
Cool the hyperthermic patient!
