Psychiatry Flashcards
Screening Qs for major Depression?
@MSIGE CAPS ( 5 of these including mood & anhedonia)
M- mood
S- sleep
I - interest
G- guilt
E- energy
C- concentration
A- appetite
P- psychomotor
S- suicide
Diagnosis criteria for BAD?
Should be more than 3 criteria such as:
- Grandiosity
- Lack of sleep
- Excessive talking
- Flight of ideas
- Distractibility
- Increased level of pleasurable activity ( sexuality/ goal-oriented activity)
Screening Qs: Have you ever had an episode in which you feel extremely happy and energetic?
DDx for patient coming with acute mania?
- BAD
- Schizophrenia
- Schizoaffective disorder
- Drug-induced psychiatric illness
- Delusional disorder
- Personality disorder
- OCD
- Organic disorder
How do you explain mania?
you have more energy, need less sleep, engage in risky activities such spending a lot of money, and exploring sexual activity.
What are the questions you need to ask in Grief cases?
- Do you have intense yearning or longing for your mother?
- Are you always preoccupied with thoughts & memories of your mother?
- Are you avoiding reminders of your mother?
- How is this affecting your life? Do you feel that life is worthless without her?
- Are you feeling lonely, numb?
- Are you finding it difficult to carry on with your life after your mothers death?
DDx for major depression with psychotic symptoms?
- Schizoaffective disorders
- Bipolar disorder
- Unipolar major depression
- Schizophrenia
- Drug induced psychotic disorder
- PTSD
- Adjustment disorder
- Organic cause
DDx for patient coming with grief after a loved one passing?
- Grief disorder / prolonged grief disorder
- Major depression
- PTSD( bereavement related PTSD)
How do you explain adjustment disorder?
It is an emotional and behavioral response/reaction to a stressful events .
19 year old girl/boy who has been referred to you by the dentist due to concerns regarding her dental caries. She has a history of binge eating and induces vomiting after eating. DDx?
- Binge eating disorder
- Obsessive compulsive disorder
- Body dysmorphic disorder
- Major depression
- Schizophrenia
DSM 5 Qs for Mania?
DIGFAST:
Distractibility: Easily distracted.
Irresponsibility: Impulsive and reckless behavior.
Grandiosity: Exaggerated self-esteem or belief in abilities.
Flight of ideas: Rapid, disjointed thoughts.
Activity increase: Increased activity or agitation.
Sleep deficit: Decreased need for sleep.
Talkativeness: Rapid speech and verbosity.
Screening Qs for dependence personality disorder?
DECIDEAR
D - Dependence: Excessive need for others to take care of them.
E - Excessive Fear: Fear of being left alone or abandoned.
C - Can’t Decide: Difficulty making decisions on their own.
I - Insecurity: Low self-esteem and constant need for validation.
D - Deference: Submissive and compliant in relationships.
E - Avoid Responsibility: Avoids responsibility and prefers subordinate roles.
A - Abuse Tolerance: Tolerates mistreatment to avoid being alone.
R - Reliance on One: Overly dependent on one specific person.
What’s Dysthymia?
- It’s persistent depressive disorder: > 2 yrs
- Symptoms same as MDD
- No episodes of mania during the period
State PTSD DDx?
- Acute stress disorder (<1 month )
- Adjustment disorder
- Panic disorder
- GAD
- MDD
- Concussion syndrome
- Schizophrenia
- OCD
- Drug intake
- Thyroid
DSM criteria for PTSD?
📌DSM-5 Criteria: Need 4
BAD STRESS:
- Bad memories: Repeated, distressing memories of the trauma.
- Avoidance: Avoiding reminders of the trauma.
- Disturbed mood: Negative changes in mood or beliefs.
- Stress reactions: Easily startled, on edge, or irritable. Anger outbursts
- Trauma reminder: Physical or emotional reactions to trauma reminders.
- Re-experiencing: Flashbacks, nightmares, or intrusive thoughts.
- Emotional numbness: Feeling detached or unable to feel
Qs that you ask to R/O PTSD?
- Have you ever had any traumatic events or experiences?
- Re-living:
- Have you had nightmares?
- Have you had flashbacks?/ Have you ever had flashbacks that you are reliving the events?
- Have you been avoiding places activities or people or talking about it?
- Do you feel that you are unable to remember some important aspects of the events ?/ Have you forgotten some information of the event?
- Anhedonia/moods
- Have you had an anger outburst?
How do you explain OCD to a patient?
OCD is a condition that you have unwanted / repetitive / intrusive thoughts which leads to repetitive behaviors or activities in response to the thoughts. Not following up with these thoughts result in extreme stress & anxiety.
What’s CBT in OCD?
- CBT - Exposure & Response Prevention
- The exposure component of ERP refers to practicing confronting the thoughts, images , objects , and situation that make you anxious or provoke your obsessions . The response prevention part of ERP refers to making choice not to do a compulsive behavior
- ERP encourages you to confront what makes you anxious and prevent yourself from doing the things that temporarily make the anxiety go away. Over time, this can help reduce the intensity of your anxiety and break the cycle of obsessive thoughts and compulsive behaviors.
DDx for OCD?
- GAD
- Specific phobias
- PTSD
- MDD
- Schizophrenia
- Substance abuse disorder
- Thyroid problem
What’s the difference between panic attack & Panic disorder?
Panic attack: somatic sym + fear of dying
Disorder: Multiple episodes + change lifestyle to avoid it
How do you explain panic attack?
- You have a condition called Panic disorder and agoraphobia
- Panic attack - sudden onset of somatic symptoms such as chest pain, palpitations, SOB, Dizziness & especially anxiety & intense fear of dying, although there is no problem in the body.
- Panic disorder -If you have a repeated panic attack and this creates some concern or worry about the other attack and you change your daily routine or behavior.
- When the body is feared with the immediate danger it triggers the “flight or fight response” by activating some nerves and releasing some chemicals.
- During a panic attack the fight and flight attack is triggered without an immediate reason and it causes extreme anxiety or fear of dying.
What are the screening Qs for social phobia?
- Do these symptoms happen in crowded places or situations where you have to talk to people or when you are observed?↳ Try to see whether it’s happening in multiple places
- Have you been trying to avoid these symptoms?
- How are these affecting your life? Social/ Occupation
Social phobia DDx?
- Panic attack
- GAD
- Adjustment disorder
- PTSD
- Schizophrenia
- Drug induced psychosis
How do you explain social phobia to a patient?
It’s a condition where you develop severe anxiety and distress as a response to social situations such as when you need to talk , meet people or when you get observed .
How due you explain post partum psychosis to a patient?
You have been diagnosed with a condition called postpartum depression with psychotic features, this is a serious condition that happen to mothers after delivering their child because of all the changes that happens to your mind and body during pregnancy. The first weeks of taking care of a newborn can be overwhelming& it affect your mental health.
One aspect of this conditions is depression which called baby blues. This is when you feel low, disturbed sleep, lose appetite, start having suicidal ideation or thinking about harming your baby. The other aspect is the psychotic features, which means you loose sense of reality and start hearing things, seeing things or feeling things that other people don’t and you may start having some strange thoughts or ideas.”
