Psychiatry Flashcards
- delusions (mostly bizarre)
- disorganized speech/behavior
- hallucinations
positive symptoms
- flattened affect
- social withdrawal
- anhedonia
- apathy
- poverty of thought
negative symptoms
schizophrenia
more than 6 months
schizophreniform d/o
more than 1 month, less than 6 months
- occurs in the first week
- muscle spasms (e.g. torticollis)
- difficulty swallowing
acute dystonia
- w/i weeks
- bradykinesia
- tremors
- rigidity
parkinson’s
- weeks to chronic use
- motor restlessness
- do not mistake for anxiety or agitation
akathisia
- months to years
- choreoathetosis
- often irreversible
tardive dyskinesia
- anytime
- muscle rigidity
- hyperthermia
- volatile vital signs
- altered LOC
- increased WBC and CK
neuroleptic malignant syndrome
normal psychological reaction to profound changes in person’s life (divorce, migration, birth of handicapped child)
adjustment d/o
- brief attacks of intense anxiety w/ autonomic symptoms
- occur regularly
panic d/o
treatment for adjustment d/o
COUNSELING
treatment for panic d/o
cognitive-behavioral therapy and/or relaxation training and desensitization
fear or avoidance of places d/t anxiety about not being able to escape
agoraphobia
fear or avoidance of objects or situations
social anxiety d/o
excessive, poorly controlled DAILY anxiety for more than 6 months
generalized anxiety d/o (GAD)
- recurrent obsessions or compulsions
- individual recognizes that the behavior is unreasonable and excessive
obsessive-compulsive d/o (OCD)
- severe anxiety symptoms that follow a life-threatening event
- symptoms less than 1 month w/i 1 month of stressor
acute stress d/o
- severe anxiety symptoms that follow a life-threatening event
- symptoms last longer than 1 month
posttraumatic stress d/o (PTSD)
- depressed mood, or anhedonia
- last at least 2 weeks
major depressive d/o
- low-level depression symptoms
- present on most days for at least 2 years
dysthymic d/o
depressive symptoms in the winter months
seasonal affective d/o
- depression
- mania
- mixed symptoms for at least 1 week
BP d/o
rapid cycling BP
more than 4 episodes of mania per year
management of acute mania in BP d/o
- hospitalize
- mood stabilizers
- antipsychotics
- phenothiazine IM depot (noncompliant, severely manic patients)
- antidepressants ONLY in patients w/ recurrent episodes of depression
recurrent episodes of depressed mood and hypomanic mood for at least 2 years
cyclothymia
- elderly taking lithium
- renal failure
- hyponatremia
lithium toxicity
- recently started taking antipsychotics
- recently stopped levodopa
- high fever
- tachycardia
- muscle rigidity
- altered consciousness
- elevated CPK
- autonomic dysfunction
neuroleptic malignant syndrome (NMS)
- h/o SSRI use AND use of triptans (migraine medication) or a MAOI
- agitation
- hyperreflexia
- hyperthermia
- muscle rigidity w/ volume contraction
serotonin syndrome
- acute HTN
- h/o MAOI use and either antihistamines, nasal decongestants, or tyramine-rich foods
MAOI-induced hypertensive crisis
one or more neurologic symptom(s) that CANNOT be explained by any medical or neurological d/o
conversion d/o
- see many doctors
- visit many hospitals
- large amount of medical knowledge
factitious d/o
signs and symptoms faked by another person
factitious d/o by proxy
- when there’s obvious gain from feigned symptoms
- preoccupied w/ rewards or gain
malingering
- distrust and suspiciousness
- often confused w/ paranoid schizophrenia
- main defense mechanism is projection
paranoid PD
- detachment and restricted emotionally
- main defense mechanism is projection
schizoid PD
- discomfort w/ social relationships, thought distortion, eccentricity
- symptoms aren’t severe enough for classification of schizophrenia
schizotypal PD
- colorful, exaggerated behavior and excitable, shallow expression of emotions
- use of physical appearance to draw attention to self
- sexually seductive
histrionic PD
- unstable affect, mood swings, marked impulsivity, unstable relationships, recurrent suicidal behaviors, chronic feelings of emptiness, identity disturbance, and inappropriate anger
- main defense mechanism is splitting
borderline PD
- criminal acts
- inability to conform to social rules
- disregard for the rights of others
- aggressiveness
antisocial PD
- sense of self-importance, grandiosity, and preoccupation with fantasies of success
narcissistic PD
- social inhibition
- feelings of inadequacy
- hypersensitivity to criticism
avoidant PD
submissive and clinging behavior related to a need to be taken care of
dependent PD
- individuals are preoccupied w/ orderliness, perfectionism, and control
- differentiated from obsessive-compulsive d/o
obsessive-compulsive PD
frequent use of alcohol resulting in tolerance and physical and psychological dependence
alcohol dependence
when episodes of alcohol use result in failure to fulfill obligations, craving or strong urge to use a substance, or exposure to physically dangerous situations
alcohol abuse
onset after last drink if: minor withdrawal symptoms
6 hours
onset after last drink if: alcoholic hallucinosis
12-24 hours
onset after last drink if: withdrawal seizure
48 hours
onset after last drink if: delirium tremens
48-96 hours
substance of abuse
- talkative
- sullen
- gregarious
- moody
alcohol
substance of abuse
- euphoria
- hypervigilance
- autonomic hyperactivity
- weight loss
- pupil dilation
- disturbed perception
- stroke
- MI
- amphetamines
- cocaine
substance of abuse
- impaired motor coordination
- impaired time perception
- increased appetite
- dry mouth
- conjunctival redness
cannabis
substance of abuse
- hallucinations
- impaired judgement
- pupil dilation
- panic
- tremors
- incoordination
hallucinogens (e.g. LSD)
substance of abuse
- belligerence
- apathy
- assaultiveness
- blurred vision
- stupor
- coma
inhalants
substance of abuse
- apathy
- dysphoria
- constricted pupils
- drowsiness
- slurred speech
- impaired memory
- coma
- death
opiates
substance of abuse
- panic reactions
- assaultiveness
- agitation
- NYSTAGMUS
- HTN
- seizures
- coma
- hyperacusis
PCP
substance of abuse
- inappropriate sexual or aggressive behavior
- impaired memory or concentration
barbiturates/benzodiazepines
