Psychiatrics Flashcards
What are these abbreviations stand for?
MSE
ABS
MAP
Cl
- MSE: Mental Status
Examination - ABS: Appearance, Behavior, Speech
- MAP: Mood, Affect, Perception
- Cl: Cognition, Insight
only … and … may have insight.
OCD
Avoidant personality disorders
Insight means …..
to agree having problem
What is functionality?
𝐈𝐧𝐭𝐚𝐜𝐭𝐧𝐞𝐬𝐬 𝐨𝐟 𝐚𝐧𝐲 𝐚𝐬𝐩𝐞𝐜𝐭 𝐢𝐧 𝐭𝐡𝐞 𝐬𝐨𝐜𝐢𝐚𝐥 𝐫𝐞𝐥𝐚𝐭𝐢𝐨𝐧𝐬𝐡𝐢𝐩 𝐥𝐢𝐤𝐞 𝐬𝐜𝐡𝐨𝐨𝐥, 𝐮𝐧𝐢𝐯𝐞𝐫𝐬𝐢𝐭𝐲 𝐨𝐫 𝐣𝐨𝐛.
𝐖𝐡𝐚𝐭 𝐢𝐬 𝐬𝐜𝐡𝐢𝐳𝐨𝐚𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞 𝐝𝐢𝐬𝐨𝐫𝐝𝐞𝐫?
𝐬𝐲𝐜𝐡𝐨𝐬𝐢𝐬+ 𝐬𝐚𝐝 𝐦𝐨𝐨𝐝
𝐖𝐡𝐚𝐭 𝐢𝐬 𝐬𝐜𝐡𝐢𝐳𝐨𝐚𝐟𝐟𝐞𝐜𝐭𝐢𝐯𝐞 𝐝𝐢𝐬𝐨𝐫𝐝𝐞𝐫?
𝐬𝐲𝐜𝐡𝐨𝐬𝐢𝐬+ 𝐬𝐚𝐝 𝐦𝐨𝐨𝐝
What is 𝐏𝐃𝐃?
𝑷𝒆𝒓𝒔𝒊𝒔𝒕𝒂𝒏𝒕 𝑫𝒆𝒑𝒓𝒆𝒔𝒔𝒊𝒗𝒆 𝑫𝒊𝒔𝒐𝒕𝒅𝒆𝒓
(𝒔𝒚𝒎𝒑𝒕𝒐𝒎𝒔 𝒇𝒐𝒓 > 2𝒚𝒓
vs 𝑴𝑫𝑫 >2𝒘)
What is 𝐏𝐃𝐃?
𝑷𝒆𝒓𝒔𝒊𝒔𝒕𝒂𝒏𝒕 𝑫𝒆𝒑𝒓𝒆𝒔𝒔𝒊𝒗𝒆 𝑫𝒊𝒔𝒐𝒕𝒅𝒆𝒓
(𝒔𝒚𝒎𝒑𝒕𝒐𝒎𝒔 𝒇𝒐𝒓 > 2𝒚𝒓 𝒊𝒏 𝑴𝑫𝑫 >2𝒘)
What are 𝐌𝐃𝐃 𝐤𝐞𝐲 𝐬𝐲𝐦𝐩𝐭𝐨𝐦𝐬?
1- 𝒍𝒐𝒘 𝒎𝒐𝒐𝒅
2- 𝒍𝒐𝒔𝒔 𝒐𝒇 𝒊𝒏𝒕𝒆𝒓𝒆𝒔𝒕
3- 𝒂𝒑𝒑𝒆𝒕𝒊𝒕𝒆 𝒄𝒉𝒂𝒏𝒈𝒆𝒔
4- 𝒔𝒍𝒆𝒆𝒑 𝒅𝒊𝒔𝒕𝒖𝒓𝒃𝒂𝒏𝒄𝒆𝒔
5- 𝒔𝒖𝒊𝒄𝒊𝒅𝒂𝒍 𝒕𝒉𝒐𝒖𝒈𝒉𝒕𝒔
6- 𝒆𝒏𝒆𝒓𝒈𝒚 𝒄𝒉𝒂𝒏𝒈𝒆𝒔
In 𝑴𝑫𝑫 & 𝑷𝑫𝑫 treatment typically starts with … for … weeks, with potential … or… if insufficient,
𝑺𝑺𝑹𝑰𝒔
8
augmentation- switching
Risk factors for 𝑴𝑫𝑫 include … , …. and ….
female sex
family history
recent stressors
𝐖𝐡𝐞𝐧 𝐝𝐨 𝐲𝐨𝐮 𝐫𝐞𝐟𝐞𝐫 𝐚 𝐌𝐃𝐃 𝐩𝐚𝐭𝐢𝐞𝐧𝐭 𝐭𝐨 𝐩𝐬𝐲𝐜𝐡𝐢𝐚𝐭𝐫𝐢𝐬𝐭?
If no improvement after two medication trials of 8
weeks each.
The diagnosis of major depressive disorder (MDD)
requires at least … major depressive episode (MDE)
lasting … weeks.
𝒐𝒏𝒆
𝒕𝒘𝒐
The diagnosis of MDD requires a minimum of … symptoms out of six key symptoms including …, …., …, …., …, …..
5
low mood, loss of interest, appetite changes, sleep disturbances, suicidal thoughts, and energy changes.
Atypical depression is characterized by … and symptoms like …, … and ….
social detachment
increased appetite
weight gain
excessive sleep
Atypical depression is more common in … who are… and .. more.
𝒕𝒆𝒆𝒏𝒂𝒈𝒆𝒓𝒔
𝒊𝒓𝒓𝒊𝒕𝒂𝒃𝒍𝒆
𝒔𝒍𝒆𝒆𝒑
Treatment for atypical depression often involves a combination of symptoms, including ….
𝒂𝒏𝒙𝒊𝒆𝒕𝒚
What is recurrent MDD?
Recurrent MDD is defined by 𝑻𝑾𝑶 or more MDEs with a gap of more than 𝑻𝑾𝑶 months between them.
Secondary causes of mood disorders include …, …, …., and …
heart conditions
endocrine disorders
infections
cancers
…. is typically the first choice for treatment of MDD but … may be used if other symptoms are more pronounced.
Fluoxetine
monoamine oxidase inhibitors
…. is typically the first choice for treatment of MDD but … may be used if other symptoms are more pronounced.
Fluoxetine
monoamine oxidase inhibitors
… are described as seeing or hearing things that others do not, while … involve false beliefs about others’ intentions.
𝒉𝒂𝒍𝒍𝒖𝒄𝒊𝒏𝒂𝒕𝒊𝒐𝒔
𝒅𝒆𝒍𝒖𝒔𝒊𝒐𝒏𝒔
𝐓𝐡𝐞 𝐟𝐢𝐫𝐬𝐭 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭𝐢𝐚𝐥 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬 𝐨𝐟 𝐯𝐢𝐬𝐮𝐚𝐥 𝐡𝐚𝐥𝐥𝐮𝐜𝐢𝐧𝐚𝐭𝐢𝐨𝐧 𝐢𝐬 … 𝐚𝐧𝐝 𝐭𝐡𝐞 𝐬𝐞𝐜𝐨𝐧𝐝 𝐢𝐬 …
𝒃𝒓𝒂𝒊𝒏 𝒕𝒖𝒎𝒐𝒓
𝒔𝒖𝒃𝒔𝒕𝒂𝒏𝒄𝒆 𝒂𝒃𝒖𝒔𝒆
𝐖𝐡𝐚𝐭 𝐢𝐬 𝐭𝐡𝐞 𝐟𝐢𝐫𝐬𝐭 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭𝐢𝐚𝐥 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬 𝐨𝐟 𝐚𝐮𝐝𝐢𝐭𝐨𝐫𝐲 𝐡𝐚𝐥𝐥𝐮𝐜𝐢𝐧𝐚𝐭𝐢𝐨𝐧𝐬?
𝒔𝒄𝒉𝒊𝒛𝒐𝒑𝒉𝒓𝒆𝒏𝒊𝒂
In tactile hallucinations
(توهمات لمسی),
the first differential diagnosis is …
substance use
In tactile hallucinations
(توهمات لمسی),
the first differential diagnosis is …
substance use
𝐓𝐡𝐞 𝐟𝐢𝐫𝐬𝐭 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭𝐢𝐚𝐥 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬 𝐢𝐧 𝐬𝐦𝐞𝐥𝐥 𝐡𝐚𝐥𝐥𝐮𝐜𝐢𝐧𝐚𝐭𝐢𝐨𝐧𝐬 𝐢𝐬 …
𝒆𝒑𝒊𝒍𝒆𝒑𝒔𝒚
After … days, no one will have withdrawal symptoms.
30
𝐈𝐟 𝐡𝐚𝐥𝐥𝐮𝐜𝐢𝐧𝐚𝐭𝐢𝐨𝐧𝐬 𝐥𝐚𝐬𝐭 𝐦𝐨𝐫𝐞 𝐭𝐡𝐚𝐧 𝟔 𝐦𝐨𝐧𝐭𝐡 𝐭𝐡𝐞 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬 𝐢𝐬 … 𝐚𝐧𝐝 𝐢𝐟 𝐥𝐞𝐬𝐬 𝐭𝐡𝐚𝐧 𝟔 𝐦𝐨𝐧𝐭𝐡, 𝐢𝐭 𝐰𝐢𝐥𝐥 𝐛𝐞 ….
𝐬𝐜𝐡𝐢𝐳𝐨𝐩𝐡𝐫𝐞𝐧𝐢𝐚
𝐬𝐜𝐡𝐢𝐳𝐨𝐩𝐡𝐫𝐞𝐧𝐢𝐚𝐥 𝐝𝐢𝐬𝐨𝐫𝐝𝐞𝐫
If behavior and mood match, it is called … and if not it is called… which happens in schizophrenia
𝒄𝒐𝒏𝒈𝒓𝒖𝒆𝒏𝒕
𝒊𝒏𝒄𝒐𝒏𝒈𝒓𝒖𝒆𝒏𝒕
𝐖𝐡𝐚𝐭 𝐚𝐫𝐞 𝟓 𝐚𝐱𝐢𝐬𝐞𝐬 𝐨𝐟 𝐃𝐒𝐌-𝐈𝐕?
Axis I: Mental health and substance use disorders
Axis II: Personality disorders and mental retardation
Axis III: General medical conditions
Axis IV: Psychosocial and environmental problems (stress)
Axis V: Assessment of overall functioning
… represent a combination of symptoms composing predominant mood state that is abnormal in … and …
Mood episodes
quality
duration
What are types of mood episodes?
- depressive
- major depressive
- manic
- mixed
- hypomanic
The most important drug grouop that cause deprebssion is …
beta blockers
In MDD, the only disease that should be excluded by test is …
𝒉𝒚𝒑𝒐
𝒕𝒉𝒚𝒓𝒐𝒊𝒅𝒊𝒔𝒎
Medical workup for mood disorder, include …, …, …, …, and …
CBC
urine analysis
electrolytes
thyroid function tests
drug screening
بیماران هایپوتیروئیدیِ افسرده، برخلاف سایر این دسته از بیماران، … هستند که علت آن بیاشتهایی است.
لاغر
چند دسته دارو نام ببرید که سبب افسردگی میشوند.
- بتابلوکرها
- کورتیکواستروئیدها
- آنتی سایکوتیکها
- آمفتامین
- الکل
In which condition the patient need to be admitted without their consent?
Suicidal plan
Personality disorders like …, …, … and … may develop MDD
insecure
dependent
obsessional
borderline
Borderline can develop any time … disorder or …
major depressive
bipolar
Which images we may ask for a depressive patient to exclude medical conditions?
X-ray
CT
MRI
All depressive patients should be started on…., except contraindication.
SSRIs
If a SSRI does not work we should switch to …
another SSRI
What are depression risk factors?
1- female
2- age : 25 to 50 years
3- family history of depression
4- alcohol abuse
5- sociopathy (problems with the social relationship)
6- living in crime area
7-childhood experiences: loss of parent before age 11-. 8- personality: insecure, dependent, obsessional
9-recent stressors
10- illness
11- financial, legal issues
12-postpartum: less than six months, and usually develop within four weeks of delivery
13- lack of intimate confiding, social isolation.
