Psychiatry Flashcards
What type of defense is throwing a tantrum?
Acting out
Expressing unacceptable feelings and thoughts through actions
What type of defense is temporary, drastic changes in personality, memory, consciousness, or motor behavior?
Dissociation
What age is associated with ADHD
onset before age 12
What is coprolalia?
Involuntary obscene speech- assoc with Tourettes
What is the treatment for tourettes?
antipsychotics, behavioral therapy
When is separation anxiety commonly seen? What is the treatement?
7-9 y; SSRIs
What presents as loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing? Commonly presents in girls
Rett syndrome
X-linked (males die in utero)
What neurotransmitter changes are associated with depression?
decr norepinephrine
decr 5-HT
decr dopamine
What neurotransmitter changes are associated with anxiety?
incr norepinephrine
decr GABA
decr 5-HT
What neurotransmitter changes are associated with schizophrenia?
Incr dopamine
What is korsakoff amnesia?
anterograde amnesia, assoc with thiamine deficiency, damage to mamillary bodies; seen in alcoholics
What are hypnagogic and hypnopompic hallucinations?
Hypnogogic- occur when going to sleep
Hypnopopmic- occur when waking form sleep
What are EEG findings for delirium vs dementia?
delirium- EEG abnormal
dementia- EEG normal
What is a distorted perception of reality characterized by delusions, hallucinations and/or disorganized thinking?
Psychosis
What are the causes of visual, auditory, oflactor, and tactile hallucinations?
Visual- medical illness
Auditory- psychiatric illness
Olfactory- psychomotor epilepsy, brain tumor
Tactile- alcohol withdrawal, cocaine
How is delusional disorder characterized?
fixed, persistent, untrue belief system, lasting >1mo
Compare schizphrenia, brief psychotic disorder, schizophreniform disorder, schizoaffective disorder?
schizophrenia: >6mo, 2 of (delusion, hallucination, disorganized speech, disorganized behavior, neg sx)
breif psychotic: <1mo
schizophreniform: 1-6 mo
schizoaffective: at least 2 weeks; psychotic sx with major depressive/manic
Compare bipolar I vs bipolar II
bipolar I: at least 1 manic episode with or without hypomanic or depressive episode
bipolar II: presence of a hypomanic and depressive episode
Treatment of bipolar disorder
mood stabilizers
atypical antipychotics
cylcothymic disorder
dysthymia and hypomania
milder form of bipolar disorder lasting at least 2 years
Characterized by mood reactivity, reversed vegetative symptoms, leaden paralysis, long-standing interpersonal rejection sensitivity
atypical depression
what sleep changes are associated with depression?
decr slow wave sleep
dcr REM latency
incr total REM
repeated/early morning awakenings
What is the treatment of social anxiety disorder?
SSRI
What are the treatments for OCD?
SSRI, clomipramine
Compare post-traumatic stress disorder vs acute stress disorder?
PTSD: >1mo
acute stress disorder: 3 days- 1mo
Describe Munchausen syndrome
chronic factitious disorder; hx of multiple hospital admissions, willingness to receive invasive procedures
Compare malingering vs factitious disorder
Malingering- faking or exaggerating for secondary gain (eg avoid work, compensation); complaints often cease after gain
Factitious- consciously creats sx for attention (primary gain)
schizoid vs schizotypal vs paranoid personality disorder
schizoid- voluntary social withdrawal, limited emotional expression
paranoid- pervasive distrust and suspiciousness; projection common
schizotypal: eccentric appearance, magical thinking, interpersonal awkwardness
Cluster of personality disorders associated with odd or eccentric; inability to develop meaningful social relationships, no psychosis
Cluster A
Cluster of personality disorders assocaited with dramatic, emotional, or erratic behaviors
Cluster B
Cluster of personality disorder associated with anxiousness or fearfullness
Cluster C
Personality disorder:
excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance
Histrionic personality disorder
Personality disorder:
grandiosity, sense of entitlement, lack of empathy, reacts to criticism with rage
narcissistic
Personality disorder:
unstable mood and interpersonal relationships, impulsiveness, self-mutilation, boredom, sense of emptiness
borderline
Compare sleep terror disorder vs nightmares?
sleep terror: occurs during slow-wave sleep
nightmare: during REM
What is the pathophysiology and treatment of narcolepsy?
pathophysiology: decr orexin production in lateral hypothalamus
Treat: daytime stimulants (amphetamines, modafinil); nighttime sodium oxybate
Intoxication associated with low safety margin and marked respiratory depression
barbiturates
Withdrawal: delirium, life-threatening cardiovascular collapse
barbiturates
Intoxication: ataxia, minor resp depression
benzodiazepines
What serum test and LFTs indicate alcohol use?
GGT- sensitive indicator of alcohol use
AST 2x ALT
Intoxication: euphoria, respiratory and CNS depression, decr gag reflex, pupillary constriction, seizures
opioids
Intoxication: euphoria, grandiosity, pupil dilation, hypertension, anorexia, paranoia, fever
amphetamines
intoxication: impaired judgement, pupillary dilation, halluciantion, angina, paranoid ideations
cocaine
intoxication: restlessness, diuresis, muscle twitching
caffeine
intoxication: belligerence, impulsiveness, fever, psychomotor agitation, analgesia, vertical and horizontal nystagmus, psychosis, homicidality
PCP
intoxication: perceptual distortion, depersonalization, psychosis, paranoia
LSD
intoxication: euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, dry mouth
marijuana
Dronabinol
prescription form of marijuana
Methadone
long-acting oral opiate; used for long-term maintenance
naloxone + buprenorphine
partial agonist; long acting with fewer sx of withdrawal
naltrexone
long acting antagonist; prevent relapse once detoxified
What are the treatments for alcoholism?
disulfram (neg effects when take)
naltrexone
What is the treatment for DTs?
benzodiazepines
