Psychiatry Flashcards
What is Autism?
Poor eye contact, repetitive movements, lack of verbal skills and bonding
symptoms since birth
Tx: Behavioral modification, use antipsychotic for aggressive behavior
What is Asperger’s?
Good communication skills, impaired relationships, no mental retardation
What is Rett’s
Only in girls
decreased head growth, lost motor skills, hand-wringing
normal until 5 months of age
Tx: Behavioral therapy and physiotherapy
What is Childhood Disintegrative Disorder?
Kid stops talking and walking. (They lose all their milestones)
What is Selective Mutism?
Kid talks sometimes
What is Separation Anxiety Disorder?
Kid screams when mom leaves
What is Conduct Disorder?
Younger than 18 y/o with traits of antisocial disorder: aggressive, disregard for authority/rules, no sense of guilt/remorse, harms animals, illegal activity “bite is worse than bark”. Behavioral therapy and antipsychotic
What is Oppositional Defiant Disorder?
Breaking the rules, defiant, noncompliant, resists authority, “bark is worse than bite”. Teach appropriate child management skills
What is ADHD?
Over activity, short attention span, difficulty in school, must be identified in two different locations (home and school).
Tx: First line- methylphenidate and dectroamphetamine; Second line- Atomoxetine (SNRI)
How is Major Depression diagnosed?
Need 5 of 8 "SIGECAPS" for over 2 weeks Sleep disturbance: wake in early or wake up late Interest/ libido loss Guilt Energy Loss Concentration Loss Appetite Loss Psychomotor Agitation Suicidal Ideation (hopelessness)
What is Dysthymia?
Low level sadness >2 years, looks like depression
Tx: Psychotherapy and SSRI (example: fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram)
What is cyclothymia?
Dysthymia with hypomania for more than 2 years
Tx: Lithium, Valproic Acid or Carbamazepine and psychotherapy
What is Double Depression?
Depression followed by dysthymia
What is Bipolar I?
Mania with or without depression for at least 1 week, as well as period of normal mood
Tx: First line - Lithium, Lamotrigine or Risperidone
Second line - Aripripezole, Divalproex, Quetiapine, Olanzapine, Psychotherapy and cognitive behavioral
Acute Mania: Hospitalize, mood stabilizer (Lithium), acute antipsychotic (Risperidone) and IM phenothiazine - if non-compliant
What is Bipolar II?
Depression and Hypomania (no psychosis)
What are Loose Associations?
Ideas switch subjects, incoherent
What is Tangentiality?
Wanders off the point
What is Circumstantiality?
Digresses but finally gets back to the point
What is Clanging?
Words that sound alike
What is Word Salad?
Unrelated combinations of words
What is Perseveration?
when someone gets stuck on the same idea
keeps repeating the same words
What is Neologisms?
New words
What is Delusion?
Fixed false belief for more than one month and no effect to normal living
Tx: Atypical antipsychotic and psychotherapy
What is Illusion?
Misinterprets stimulus
What are Hallucinations?
False sensory perception with absence of external stimuli, seen commonly in ETOH(alcohol) withdrawal and cocaine intoxication
What is Nihilism?
Feeling of “life is meaningless”
What is Loss of Ego Boundaries?
Where we lose sight and sense of our mind and body and its influences
What are Ideas of Reference?
Believes the media is monitoring you
What is Thought Blocking?
Stops mid-sentence
What is Thought Broadcasting?
Believes that everyone can read his thoughts
What is Thought Insertion?
Believes that others are putting thoughts into his head
What is Thought Withdrawal?
Believes that others are taking thoughts out of his head
What is Concrete Thinking?
Can’t interpret abstract proverbs, only sees the facts
What is Synesthesia?
Smells colors
What is Cataplexy?
Loss of muscle tone due to strong emotions
What is a Paranoid Personality Disorder?
Suspicious about everything, they use projection as defense mechanism
What is Schizotypal Personality Disorder?
“Magical Thinking”, odd/bizarre behavior, people leave them alone because they are weird but they will interact if approached. Brief psychotic episode
What is Antisocial Personality Disorder?
Lie, cheat, steal, destroy property, impulsive without remorse, illegal activity, aggressive towards others. Must be over 18 y/o
What is Schizoid Personality Disorder?
Recluse, they don’t want to interact with others, emotional coldness
What is Conduct Disorder Personality Disorder?
Younger than 15 years old who have Antisocial personality disorder
What is Histrionic Personality Disorder?
Theatrical, sexually provocative, use repression
What is Borderline Personality Disorder?
“Perpetual Teenager”, splitting (love/hate), projection, acting out, self-mutiliation, unstable relationships, impulsive
What is Narcissistic Personality Disorder?
Pompous, no empathy, thinks they deserve everything
What is Dependent Personality Disorder?
Clingy, submissive, low self-confidence, uses regression
What is Obsessive-Compulsive Personality Disorder?
Perfectionist, doesn’t show feelings, detail oriented, uses isolation
What is Avoidant Personality Disorder?
Socially withdrawn, afraid of rejection but wants to fit in
What is Kleptomania?
Steals for the fun of it
Tx: Psychotherapy
What is Pyromania?
Sets fires for the fun of it
What is Intermittent Explosive Disorder?
Loses self-control, disproportional to circumstances?
What is Pathological Gambling?
Can’t stop gambling, affects others
What is Trichotillomania?
They pull out their own hair and eat it
What is Lewy Body Dementia?
Stiff with visual hallucinations
What is Normal Pressure Hydrocephalus?
Incontinence, ataxia “magnetic gait” dementia
What is Korsakoff Psychosis?
Alcoholic Thiamine deficiency. Presents with confusion, Opthalmoplegia, ataxia, memory loss, confabulation and personality change
Tx: Vit B1
What is Vascular “multi-infarct” dementia?
Sudden onset, uneven progression of deficits, “stair step” decline
What is Huntington’s?
Occurs in the caudate/putamen, Trinucleotide repeat disorder (Chromosome 4, CAG), choreiform movements, changes in personality, anticipation
What is Creutzfeldt-Jakob?
Prion induced disease, death within 1 year, post cornea transplant
What is Pick’s Disease?
Frontal lobe atrophy, disinhibition
What is Alzheimer’s disease?
Decreased Ach in nucleus basalis of Meynert,
bad Apo-E4,
Amyloid Plaques,
Neurofibrillary Tangles of Tau proteins
What is Parkinson’s disease?
Located in the Substantia Nigra (lack of dopamine)
bradykinesia (slowness of movement)
pill rolling tremor,
shuffling gait,
Lewy Bodies (abnormal protein deposits in the brain)
What is Somatization?
Psychological trigger gets them sick, but no medical finding (Pain in 4 parts, 2 GI problems)
(Recurrent and multiple medical symptoms with no discernible organic cause)
Tx: Psychotherapy
What is Hypochondriasis?
They worry about having a serious illness (specific disease) they seek medical attention. For constant reassurance
Tx: Psychotherapy
What is Body Dysmorphic Disorder?
Imagined physical defect, causing impaired function in a social or occupational activity
Tx: SSRI
What is Pain Disorder?
Prolonged pain not explained by physical causes
What is Conversion?
Neurological manifestations of internal conflict, indifferent to disability, blindness/mutism triggered by a stressor. Patient is unconcerned about his impairment
Tx: Psychotherapy
What is Malingering?
Fake illness for monetary gain or getting out of jail, avoids medical treatment
Tx: Supportive Psychotherapy
What is Factitious?
Fake illness to get attention, seeks medical treatment, have a lot of medical knowledge.
Tx: Supportive psychotherapy
What is Ficticious Disorder by Proxy?
Mom makes the child or another person ill for emotional support, noted to move frequently
What is Amnesia?
Can’t recall important facts
What is Dissociative Fugue?
No past memory at all, even if they see someone from the past - they have no idea
Travel to a new place, usually due to trauma
What is Multiple Personality Disorder?
They have 5-10 alters, usually associated with incest
What is Depersonalization Disorder?
“Out of Body” experiences, Deja Vu
What is Sublimation?
Where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior
What is Imitation?
Replicating another’s behavior
What is Identification?
To be like or to become like another (aspect, property or attribute of another)
What is Displacement?
Take anger out on an object or someone else. Not related with situation
What is Idealization?
They see only the good in someone despite evidence to the contrary
What is Transference?
Patient views doctor as parent
What is Countertransference?
Doctor views patient as child
What is Acting out?
expression of impulse, “Temper Tantrums”
What is Regression?
Immature behavior, go back in development
What is Reaction Formation?
Unconsciously act opposite to how you feel, “Tears on a clown”
What is Rationalization?
Make excuses for behavior in advance, (because of…)
What is Intellectualization?
Act like a “know it all” to avoid feeling situational emotions, gets all information available to be over-informed
What is Isolation of Affect?
Isolate feelings to keep on functioning
What is Suppression?
Consciously block memory
What is Repression?
Subconsciously block memory
What is Undoing?
Doing exact opposite of what you used to do to fix a wrong
What is Compensation?
Doing something different of what you used to do
What is Sadism?
Gives physical and psychological pain
What is Masochism?
Receives pain (Humiliation)
What is Exhibitionism?
Exposure to others
What is Voyeurism?
Watching other people without their permission
What is Telephone Scatologia?
Phone Sex
What is Frotteurism?
Rubs penis against fully clothed women
What is a Transvestite?
Dress up as opposite sex, no identity crisis
What is a Transsexual?
Gender Identity crisis
What is a fetish?
High attraction for inanimate objects
What is a Pedophile?
Attracted to children sexually, watching child pornography
What is a Necrophile?
Someone who has sex with corpses
What is a Beastophile?
Someone who has sex with animals, women prefer dogs, they can smell their estrogen
What is Justification?
Making excuses for behavior afterwards
Can you die during ETOH withdrawal?
Yes
Can you die during Opiod Withdrawal?
No, just very painful
What is Isocarboxazid?
Atypical depression: Hypersomnia, anxiety, sensitivity to rejection, hypochondriasis