psychiatry disorders Flashcards
basis of cognitive behavior therapy
thoughts determine emotions
recognize unrealistic perceptions + behavior patterns
replace negative thoughts with images/actions that facilitate recovery
journaling
challenging beliefs
mindfulness of thoughts and how affecting emotions
relaxation
cognitive behavior therapy treatment tools
analysis of dreams, fantasies, associations, as well as verbal and physical expression of thoughts
therapist helps client to recognize and confront the inner conflicts responsible for symptoms and behavior problems
psychoanalysis
fractures at various phases of healing rib fractures spiral fracture: twist arms subdural hematoma: blunt trauma or shaking child retinal detachment: shake baby
child abuse
physician is legally obligated to report to CPS suspected
child abuse
child neglect
if suspect sexual abuse
look for evidence of anal or genital trauma
if + STD = sexual abuse
sexual knowledge or behavior
failure to provide food shelter supervise medical neglect failure to send to school
child neglect
poor socialization skills poor language skills inability to trust others poor feeding weight loss poor muscle tone
child neglect
consequence of child neglect: emotionally withdrawn sadness fearfulness irritability
reactive attachment disorder (> 9 mo)
onset: 3-4 yo
1) deficits in social communication and social interaction: “living in his own world”, lack of responsiveness to others, delayed language, poor eye contact, no social smile
2) restricted or repetitive behavior:
rocking, spinning, hand flapping
insistence on sameness, inflexible adherence to routine
fixation or fascination of objects: vacuum cleaner, sprinklers
hyperreactivity or hyporeacivity to sensory input (don’t notice extreme of temperature)
autism spectrum disorder
onset must be
ADHD
treatment of ADHD
CNS stimulants:(amphetamines ↑ release of NE) methylphenidate (ritalin) dexmethylphenidate dextroamphetamine (adderall) NE reuptake inhibitor: atomexetine
onset: school-age
fear of separation from:
parents, home, blanket
impairs functioning: won’t go to school
separation anxiety disorder
related to OCD
chronic, compulsive, nervous hair pulling
young girls
broken hairs of varying length
relieves stress
treatment: education (stop pulling hair) → CBT: mindful, what is the stress, deal with it → fluoxetine (SSRI) or clomipramine (TCA)
hair-pulling disorder (trichotillomania)
impulse-control disorder pattern of behaviors that violate social norms and RIGHTS OF OTHERS - don't care if society says its wrong to do: aggressive violent threatening/bullying destruction of property deceitful theft: blow up car cruelty to ANIMALS
conduct disorder (
impulse-control disorder
pattern of disobeying authority and hostile behavior (talk back to teacher)
hostility, annoyance, vindictiveness, disobedient, resentfulness
NO serious violations of social norms
NO disregard for rights of others (vs conduct disorder)
oppositional defiant disorder (less severe than conduct disorder)
onset: 10-11 yo
tics: stereotyped motor
movements (facial, vocal - coprolalia = obscene speech in 20%)
tics must last >1 yr
usually resolves by 18 yo, but may persist
Tourette syndrome
treatment of Tourette syndrome
antidopamine:
fluphenazine (high potency typical)
pimozide (high potency typical)
tetrabenazine (degrade dopamine)
types of eating disorders
all more common in women
anorexia nervosa
bulimia nervosa
binge-eating disorder
diagnosis of anorexia nervosa
low body weight: BMI
excessive dieting \+/-purging excessive exercising high achieving, self-conscience body weight: BMI
anorexia nervosa
treatment of anorexia nervosa
supportive therapy: nutritional education
CBT
counseling
treat depression: indirectly help anorexia
diagnosis of bulimia nervosa`
BMI within normal range
1) episodes of binge eating: perceives as uncontrollable (eat faster than normal, unbearably full, large meal when not hungry, eating alone, feeling disgusted after fact)
2) inappropriate, compensatory behavior to prevent weight gain: purging or laxatives, or strict caloric restriction (for a few days), or intense exercise
3) unhealthy preoccupation with weight
enlarged parotid glands: induced vomiting, ↑ serum amylase (inflammation)
erosion of enamel of teeth
bulimia nervosa
treatment of bulimia nervosa
SSRI: fluoxetine + pyschotherapy
become OBESE
episodes of binge eating: at least 1/week for 3 mo
may not like to eat but it soothes them - feel compelled, un controllable
NO compensatory behavior: purging
binge-eating disorder
complication of purging/chronic vomitting: electrolyte imbalance
hypokalemic hypochloremic metabolic alkalosis:
purge HCl → hypochloremic, ↓H+ → HCO3 in serum from gastric parietal cell without any H+ to buffer and allow for HCl reabsorption →metabolic alkalosis
compensation: cells have K/H countertransporter: H+ into serum for K+ out of serum and into cells→ hypokalemic
mood disorder
episodes of depressed mood + episodes of elevated mood (manic episode)
bipolar disorder
at least 1 week of abnormally and persistently elevated, expansive, or irritable mood
abnormally and persistently increased goal-directed activity or energy
DISRUPTS functioning socially or occupation, may require hospitalization, may have psychotic features (delusions: thinks superhero)
manic episode
diagnosis of manic episode
at least 3 of following for at least 1 week (DIG FAST)
Distractability
Irresponsibility (sexual, buy)
Grandiosity (↑ self-esteem)
Flight of ideas
Activity (goal-directed)/agitation (may be happy or irritated, due to ↑energy)
Sleep (↓ need)
Talkativeness (pressured speech, talk louder)
