Psychiatric Emergencies -Heh Flashcards

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1
Q

Who has the highest rate of death by homicide in the US (age range and sex)?

A

Young males (10-24)

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2
Q

What race has the highest homicide rate in the US?

A

non-hispanic black

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3
Q

What is the most common weapon used in homicide in the US?

A

guns

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4
Q

What is the most important predictor of future violence?

A

past violence

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5
Q

What does a low CSF 5HIAA indicate?

A

it is a metabolite of serotonin

indicates low serotonin levels (may be seen in many violent patients)

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6
Q

What are the 4 kinds of aggression?

A

verbal aggression

physical aggression against objects

physical aggression against self

physical aggression against other people

–> can see people progress through all 4.

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7
Q

What age group has the highest rate of suicide?

A

elderly (65+)

males > females

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8
Q

Which age group is suicide most commonly seen in women?

A

middle aged females (25-64 yo)

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9
Q

Which profession has a higher suicide rate than other professions?

A

physicians (twice as likely as the general population to kill themselves–> even more in women)

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10
Q

What is the primary method of suicide in 10-24 year old age group?

A

suffocation (can include hanging and CO poisoning)

important to ask about suffocation in the interview

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11
Q

What seasons is suicide more prevalent?

A

late spring and fall

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12
Q

What is the strongest correlate for suicide?

A

hopelessness

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13
Q

What is the mnemonic for suicide risk assessment?

A

SADPERSONS

Sex (male) 
Age (45) 
Depression
Previous suicide attempt of psych care 
Excessive EtOH or drugs 
Rational thinking loss (psychosis, organic brain syndrome) 
Separated, divorced or widowed
Organized plan or serious attempt 
No social support 
Sickness, chronic disease 

0-2=low risk
3-4=mild risk
5-6=moderate risk
7-10=high risk of suicide (hospitalize or commit)

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14
Q

What will you see with anti-cholinergic toxicity?

A
Hot as a hare (Hyperthermia)
Dry as a bone (Dry Skin)
Red as a beet (Flushed)
Blind as bat (Mydriasis)
Mad as a hatter (Delirium)

can’t see, can’t spit, can’t pee, can’t poop

also, tachycardia, HTN, and seizures

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15
Q

What will you see with cholinergic toxicity?

A

DUMBBELSS

diarrhea, urination, miosis, mm weakness, bronchorrhea, bradycardia, emesis, lacrimation, salivation/sweating, hypothermia

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16
Q

What types of symptoms will a pt with sympathomimetic toxicity present with?

A
AMS
Delusions
Diaphoresis
Hyperreflexia
Hypertension
Hyperthermia
Nystagmus
Arrythmias
Rapid irregular breathing
Pneumothorax
Anorexia
Nausea/vomiting
Diarrhea/GI upset
Hallucinations
Anxiety/restlessness
Suicidal ideation
Mydriasis
Paranoia
Seizures
Tachycardia
17
Q

Which medications can cause Neuroleptic Malignant Syndrome? What will these pts often present with?

A

1st and 2nd generation antipsychotic agents

get mm rigidity and mm breakdown (rhabdomyolysis)

often present: change in mental status; leukocytosis; elevated serum creatinine kinase (CK), hyperthermia, seizures, gradual onset, M>F

18
Q

Which medications can cause Serotonin Syndrome?

A

SSRIs (too much 5HT)

often presents with agitation, diarrhea, diaphoresis, mydriasis, HTN, tachycardia, hyperreflexia, clonus, tremor

19
Q

In what disease can you see lethal catatonia? What will alleviate catatonia?

A

severe schizophrenia

will have a gradual onset and no recent changes in meds can cause this

still show: change in mental status, mm rigidity, hyperthermia and elevated CPK, F>M

-alleviated by benzodiazepines and antipsychotics

20
Q

What will be seen with SSRI withdrawal?

A

mental status change after a discontinuation of SSRI (esp short half lives)