Psychiatry Flashcards
Positive symptoms
- Characterized by the presence of unusual thoughts, perceptions, and behaviors
- Like hallucinations, delusions, agitation
Negative symptoms
- Characterized by the absence of normal social and mental functions
- Like lack of motivation, anergia, isolation, poor self-care
Diagnostic criteria for schizophrenia
2 or more of the following:
-Hallucinations
-Delusions
-Disorganized speech
-Grossly disorganized or catatonic behavior
-Negative symptoms
PLUS, there must also be social or occupational dysfunction
PLUS, symptoms must be present for at least 6 months
Syndrome that resembles schizophrenia, but with prominent mood disturbances. Also, the psychotic symptoms must persist for some time in the absence of any mood syndrome
Schizoaffective disorder
Syndrome that involves schizophrenic symptoms that fail to last for 6 months and does not involve social withdrawal
Schizophreniform disorder
Disorder involving nonbizarre delusions without other psychotic symptoms
Delusional disorder
Difference between Bipolar I and II
- Bipolar I is diagnosed after at least one episode of mania
- Bipolar II has no mania, but may involve hypomania
Tx options for social phobia
- MAOIs
- Beta blockers
- SSRIs
- Alprazolam
- Gabapentin
Disorder involving pervasive worry over virtually every aspect of life with physical manifestations of anxiety
Generalized anxiety disorder (GAD)
Obsessions (definition)
Recurrent intrusive ideas, thoughts, or images that cause significant anxiety and distress
Compulsions (definition)
Repetitive, purposeful physical or mental actions that are generally performed in response to obsessions
Good way to differentiate between delusions and obsessions
Obsessions are usually unwanted, resisted, and recognized by patients as coming from their own thoughts
Delusions are generally regarded as distinct from patients’ thoughts and are typically not resisted
Hallucinations (definition)
Seeing, hearing, or feeling things that are not there and have no basis in reality (like seeing someone standing in front of you when nothing at all is really there)
Delusions (definition)
A misinterpretation of something that is really there (like thinking a lamp is a person)
Describe cluster A personality disorders
Odd and eccentric
People with this personality disorder are distrustful, suspicious, and anticipate harm and betrayal
Paranoid
Individuals with this personality disorder are emotionally detached and prefer to be left alone; they have a profound difficulty experiencing or expressing emotion
Schizoid
People with this personality disorder have odd thoughts, affects, perceptions, and beliefs; Similar to schizophrenia but less severe and without sustained psychotic symptoms
Schizotypal
What personality disorders belong to cluster A?
Paranoid
Schizoid
Schizotypal
Describe Cluster B personality disorder
Dramatic and emotional
What personality disorders belong to cluster B?
Antisocial
Borderline
Histrionic
Narcissistic
What personality disorders belong to cluster C?
Avoidant
Dependent
Obsessive-compulsive
Individuals with this personality disorder repetitively disregard the rules and laws of society and rarely experience remorse for their actions
Antisocial
Individuals with this personality disorder suffer from instability in relationships, self-image, affect, and impulse control
Borderline
Individuals with this personality disorder have excessive superficial emotionality and a powerful need for attention
Histrionic
Individuals with this personality disorder appear arrogant and entitled, but suffer from extremely low self-esteem
Narcissistic
Individuals with this personality disorder desire relationships but avoid them because of the anxiety produced by their sense of inadequacy; They are hypersensitive to criticism
Avoidant
Individuals with this personality disorder are extremely needy, relying on others for emotional support and decision making
Dependent
Individuals with this personality disorder are perfectionists who require a great deal of order and control
Obsessive-compulsive
In an alcoholic, what can cause the development of Wernicke-Korsakoff’s syndrome?
Thiamine deficiency
How do you treat DTs?
IV Benzodiazepines and supportive care, usually in the ICU
Major difference between anorexia and bulimia
Anorexia involves low body weight (<85% ideal weight) and Bulimia does not
IQ requirements for a diagnosis of mental retardation
< 70
3 types of learning disorders
- Reading disorder
- Mathematics disorder
- Disorder of written expression
Triad of symptoms in autistic disorder
- Impaired social interactions
- Impaired ability to communicate
- Restricted repertoire of activities and interests
Pervasive developmental disorder that is a major cause of mental retardation in girls
Rhett’s disorder
Disorder characterized by a period of normal development followed by loss of function in multiple domains; Rare
Childhood disintegrative disorder
Probably the most common pervasive developmental disorder; Characterized by impaired social interactions and restrictive, repetitive, and stereotyped behaviors and interest
Asperger’s disorder
Repetitive and persistent pattern of behavior in which the basic rights of others or important age-appropriate societal norms or rules are violated
Conduct disorder
Disorder involving annoying, difficult, or disruptive behavior whose frequency significantly exceeds that of other children his or her mental age
Oppositional defiant disorder
Disorder that involves repeated episodes of defecation in inappropriate places
Encopresis
Reversible state of global cerebral cortical dysfunction characterized by alterations in attention and cognition and produced by a definable precipitant
Delirium
Laboratory workup for a patient with suspected deliurium
-Urinalysis
-CMP
-CBC
-O2 sat
Possibly also a CXR, ABG, neuroimaging, or electroencephalogram
Key features of delirium
- Identifiable precipitant
- Abrupt onset
- Variable course (can change throughout the day)
Are typical or atypical antipsychotics generally more effective in treating negative symptoms of schizophrenia?
Atypical
