psychiatry (F.A.) Flashcards
Schitzophrenia vs Schitzoaffective vs Bipolar Disorder Type I
- schitzophrenia= mania but NO MOOD disorder (ex: “mood is terrific”
- schitzoaffective= mania AND MOOD disorder (but has the be one instance he had MANIA without MOOD disorder)
- bipolar disorder type I- mania and mood must ALWAYS go together
Ego defense: fixation
partially remaining at a more childish level
Ego Defense: Idealization
thinking of yourself and everyone extremely positively.
while ignoring any flaws
Ego Defense: splitting
people are either “all good” or “all bad” at times
Ego Defense: sublimation VS reaction formation
sublimation- mature; replacing unacceptable wish with action that does not conflict with wish (ex:channel agression into sports)
reaction formation- immature; doing the opposite of how you feel
Ego defense: suppression vs repression
suppression- mature; temporary; intentional
repression- immature, unintentional witholding of an idea from conscious
ego defense: isolation
removing your affect/feelings from idea/events
-like retelling a murder with no affect
Rett Syndrome
X-linked dominant, only seen in girls, mutation of MECP2, causes regression around 1-4 yo and characterized by hand wringing
Oppositional Defiant Disorder
defiant behavior against authority
disruptive mood dysregulation disorder
onset before age 10, severe/recurrent tantrums, with constant irritability in between
Learning Disorder
difficulty in ONE subject with success in others
depersonalization/derealization disorder vs dissociative amnesia
detachment from one’s body and environment.
vs forgetting key features of your identity and other personal information
schitzophrenia vs schitzophreniform vs bried psychotic
brief psychotic lasts less than a month (but v rare so always check for substance abuse)
shizophreniform lasts 1-6 mo
Delusional disorder
delusional symptoms (false belief) for greater than 1 month without any other functioning problems.
Manic symptoms
DIG FAST Disorganized speech Irresponsibility Grandiosity Flight of thoughts increased Activity/Agitation Sleep decreased Talkative
Cyclothymic Disorder
milder Bipolar Disorder lasting atleast 2 years
postpartum blues vs post partum depression
blues is less than 10 days
depression is greater than 2 weeks
blues just need followup
depression can warrant SSRIs and CBT
Dysthmic Disorder
milder depression for 2+ years
PTSD vs Acute Stress Disorder
PTSD is greater than 1 month of symptoms (treat with CBT or SSRIs or venlafaxine)
Acute Stress Disorder lasts between 3 days and 1 month (pharmacotherapy not indicated but CBT maybe)
Cluster A disorders
“weird”
paranoid
schitzoid- “aloof” but likes it that way
schitzotypal- magical thinking, weird clothing
Cluster B disorders
“wild”
antisocial - (under 18= conduct disorder), violent/criminal
borderline- splitting, suicide, unstable
histrionic- attention seeking, appearance obsessed
narcissistic- grandiosity
Cluster C disorders
“Worried”
avoidant- want interpersonal relationship but fear of rejection
Obsessive compulsive personality- perfection and order
dependent- clingy and submissive
malingering vs facitious disorders
both consciously FAKE an illness, but the motive differs
malingering is for external gain
facititous is for internal gain- to assume sick role
somatic symptom disorder
not consciously faking illness
constant illness/pain
do consistent out patient follow up
conversion disorder
stressor causes loss unrelated of sensory/motor function
- mutism
illness anxiety
preoccupation with having SERIOUS illness
anorexia vs bulemia nervosa vs binge
anorexia: BMI<18.5
BN: BMI> 18.5
bulemia and anorexia may show binge/purge pattern
Binge eating has no purge pattern (remember, purge is any compensatory behavior)
refeeding syndrome
occurs with anorexia
causes spike in insulin, leading to hypophosphatemia with cardiac consequences
electrolyte abnormalities of bulemia nervosa
hypokalemia
hypoCHLORemia
sleep terror disorder vs nightmare
sleep terror- deep sleep of Nonrem 3, screaming and no memory in the morning
nightmare- REM, with memory
alcohol withdrawal
3 hr+ = tremulousness
6hr+= withdrawal seizures
12 hr+= visual hallucinations
48 hr+= delirius tremens (autonomic hyperactivity- tachy/anxiety)
alcohol intoxication markers
increased serum GGT (gamma glutamyltransferase)
AST> 2ALT
opioid intoxication
pinpt pupils, respiratory/cns depression with lost gag reflex, euphoria
opioid withdrawal
diarrhea, sweating, yawning, sweating, dilated pupils, goosebumps
amphetamine intoxication
pupillary dilatation, htt and tachycardia, grandiosity and euphoria
cocaine intoxication
pupillar dilatation, hallucinations, angina/SCD
Phencyclidine intoxication (PCP)
violene, analgesia, nystagmus, tachy/htt
LSD (lysergic acid diethylamide) intoxication
perceptual distortion, depersonalization
MDMA (ecstacy)
hallucinations, teeth clenching, serotonin syndrome
what class of drugs in PIMOZIDE
1st gen antipsychotic
what are the suffixes for type 2 antipsychotics? an exception?
-“apine”, -“idone” exception: aripiprazole
Buspirone
clinical use?
features?
5HT1a agonist
GAD (2nd line)
non addictive, non sedative, no tolerance, acts within 1-2 weeks
-milnaciprans are what class of drugs?
SNRI (such as venlafaxine and duloxetine)
Varencicline
clinical use?
- partial nicotinic receptor ACh agonist
- smoking cessation
Vilazodone
clinical use?
5HT reuptake inhibitor, 5HT1a partial agonist,
GAD, MDD
Vortioxetine
clinical use?
inhibits 5HT reuptake, 5HT1 agonist, 5HT3 receptor antagonist
MDD
