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Mental Health > Psychiatry MNTH > Flashcards

Psychiatry MNTH Flashcards

1
Q

Criteria for Bipolar 1 diagnosis

A 
One week of elevated or irritable mood.
At least three of:
Grandiosity
Decreased need of sleep
Talkative
Flight of ideas
Distractibility
Impulsivity
Agitation

Then needs to be serious enough for severe functional consequences/hospitalization

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2
Q

What is the best treatment for Mania?

A

Lithium
Quetiapine
Divalproex

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3
Q

Treatment for Bipolar 1 depression

Can you use SSRI or SSNRI?

A

Quetiapine

No, it can lead to a bout of mania.

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4
Q

What is the best pharmalogical Tx for Bipolar 1 maintenance?

A

Quetiapine
Lithium
Lamotrigine

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5
Q

How is a bipolar 2 Dx different from a bipolar 1 Dx?

A

Hypomania instead of mania+ the current or past depression
The hypomania must last for at least 4 days.
Same need of 3 of 7 things

Not severe enough for hospitalization.

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6
Q

Tx for Bipolar type 2?

A

Quetiapine
Lithium
Lamotrigine

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7
Q

What is Cyclothymia?

A

Numerous periods with hypomanic symptoms over at least two years.
The full criteria for hypomania or depression are never met.

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8
Q

Which bipolar drugs are indicated and contraindicated during pregnancy?

A

Quetiapine is the agent of choice

Depakote is ALWAYS contraindicated for neural tube defects
Lithium is contraindicated in the 1st trimester due to Epstein’s Anomaly

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9
Q

What is catatonia, how is it diagnosed, and how is it treated?

A

Waxy Flexibility, impulsivity, posturing, rigidity

Diagnosed with a Busch-Francis Scale and a lorazepam challenge

Treated with high-dose benzodiazepines and/or ECT (Electroconvulsive Therapy)

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10
Q

What is the criteria for a Dx of Major Depression?

A

5 of the following over a 2-week period with changes from previous function.

Sleep Disturbance
Interest Decreased
Guilt
Energy changes
Concentration
Appetite or weight increase or decrease
Psychomotor changes
Suicidal Ideation
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11
Q

What is Dysthymia?

A

Sub clinical chronic depressive disorder lasting at least 2 years.
Doesn’t meet criteria for major depression

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12
Q

What is Premenstrual Dysphoric Disorder?

A

Meets the symptoms of Major Depression plus must be present in the final week before menses onset and improve within days of onset of menses.

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13
Q

What are Pharmacological and Non-pharmacological Tx for Major Depressive Disorder?

A

SSRIs, SSNRIs, Mirtazapine, Bupropion

Cognitive Behavioral Therapy
Psychotherapy
Transcranial Magnetic Stimulation
Electroconvulsive Therapy

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14
Q

Which populations are at high risk for MMD?

A 
Postpartum Women
Those with family history
Advanced Age
Neurological Disorders
Physical Illness
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15
Q

DSM-5 Criteria for Schizophrenia?

A

Two or more of the following for at least 6 months (one must be from first 3)

Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Negative symptoms (lowered emotional expression or abolition)

Must show severe loss of function.

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16
Q

What are the four dopamine pathways involved with SCZ?

A

Mesolimbic: Increase in DA causes Positive symptoms
Mesocortical: DA hypoactivity: negative and cognitive symptoms
Nigrostriatal: Drugs- EPS and TD drug side effects
Tuberohypophyseal: Drugs- Hyperprolactinemia

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17
Q

Dx criteria for Schizophreniform Disorder?

A

Same as SCZ by for duration of 1-6 months.

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18
Q

What is the treatment for Psychotic disorders?

A

D2 Blockers

LAIs for SCZ or if you are worried about compliance

Drugs to treat specific symptoms (depression, mood, anxiety)

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19
Q

Criteria for a delusional disorder?

A

One or more delusion with a duration of at least 1 month
Criteria for SCZ not met
Function isn’t impaired outside of direct impact of delusions.

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20
Q

What are the types of hallucinations and which disorders are they linked with?

A 
Auditory:  Psychosis
Visual: Neurological syndromes
Tactile:  Drug withdrawal
Olfactory: CNS lesion
Hypnagogic/hynapompic:  Sleep disorders
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21
Q

What are the primary and secondary psychotic disorders?

A

Primary: SCZ, Delusional disorder, brief psychotic disorder

Secondary: Substance-induced, due to another medical condition.

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22
Q

What is a schizoaffective disorder?

A

An uninterrupted period of illness in which there is a major mood episode concurrent with Criterior A of schizophrenia.

Delusions or hallucinations for 2 weeks or more in the absence of a major mood episode

These are overdiagnosed.

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23
Q

What are the components of a mental status exam?

A 
Appearance
Attitude
Speech
Mood
Affect
Though process
Though content
Perceptions
Cognition
Insight
Judgment
Reliability
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24
Q

In a mental exam, which items are added to your ROS always?

A 
Anxiety
Mood
Psychosis
Substance Use- Specific
SI/HI
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25
Q

Experiments of Harry Harlow?

A

Monkeys deprived of contact w/ mothers. They chose cloth over food.

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26
Q

Studies of Mary Ainsworth?

A

Strange Situation Test

  1. Anxious-Avoidant Insecure Attachment: Avoids or ignores caregiver, won’t explore
  2. Secure Attachment: Explores w/ caregiver, upset when they leave
  3. Anxious Resistant Insecure Attachment: Distress even before separation and hard to comfort on return
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27
Q

Theories of Konrad Lorenz

A

Imprinting

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28
Q

Theories of John Bowlby?

A

Maternal Deprivation Theory: No mother causes trouble

Built off Lorenz

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29
Q

What are the 8 virtues of Erik Erickson?

A

Hope, Basic Trust vs Basic Mistrust 0-18 months

Will, Autonomy vs Shame 1-3 years

Purpose Initiative vs guilt 3-5 years

Competence, Industry vs Inferiority 6-11 years

Fidelity, Identity vs Role Confusion 12-18 years

Love, Intimacy vs Isolation 18-40 years

Care, Generativity vs Stagnation: 40-65 years

Wisdom, Ego Integrity vs Despair: 65+

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30
Q

What are the 4 stages of Stage Theorists?

What are the Hallmarks of each stage?

A

Sensorimotor 18-24 months
- Object permanence

Preoperational 24 months to 7 years
- Symbolic thinking

Concrete operational: 7-11 years
- Acquisition of Conservation Hallmark

Formal Operational Adolescence to Adulthood
-Abstract thinking, creativity, Third eye question

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31
Q

What are the psychosocial stages and what changes can trauma make to them?

Whose theory is this?

A

Sigmund Freud

Oral 0-2
Anal 2-3
Phallic 3-7 
Latency 7-11
Sexual 11+

Trauma can cause fixation or regression on or to different stages.

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32
Q

What are the three types of anxiety based on Freud’s theories?

A

Neurotic Anxiety: Worry we loose control of the Id (our compulsions)

Reality Anxiety: Fear of real world events (dog bite)

Moral Anxiety: Fear of violating our own moral principles

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33
Q

Define a panic attack

A

Abrupt onset of intense fear or discomfort that peaks in minutes with at least 4 of the following:

Palpitations
Sweating
Short of breath
Chest pain
Dizziness
Paresthesias
Fear of loss of control
Shaking
Sensations of choking
Nausea
Chills
Fear of dying
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34
Q 
Trypanophobia 
Algophobia 
Glossophobia
Ophidiophobia
Nosecomephobia 
Arachnophobia
Coulrophobia
Iatrophobia
A 
Fear of needles
Fear of pain
Fear of public speaking
Fear of snakes
Fear of hospitals
Fear of spiders
Fear of clowns
Fear of doctors
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35
Q

How much is spent on anxiety each year?

A

42 billion

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36
Q

Social Anxiety Disorder DSM-5

A

Marked anxiety about humiliating or emabarrassing yourself in social situations for at least 6 months.

Symptoms are out of proportion to the threat

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37
Q

Specific Phobia

A

Perisitent unreasonable excessive fear cause by the presence or anticipation of a specific object or situation

Can cause panic attacks

The object or situation is generally avoided

May become GAD

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38
Q

Agoraphobia

A

Intense anxiety to or in anticipation of entering two or more situations where the person feels stuck, unable to escape, or not able to get help

Public transport
Open areas
Closed areas
Lines or crowds
Alone outside the house

For at least 6 months, fear out of proportion

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39
Q

Panic Disorder DSM

What is the only single social trigger?

A

Recurrent unexpected panic attacks followed by one or both of the following for 1 month:

Persistent concern of having more panic attacks
Maladaptive change in behavior in response to the panic attacks

Divorce/separation

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40
Q

Generalized Anxiety Disorder DSM-5

A

Excessive anxiety and worry about a number of activities or events in multiple contexts on a near daily basis for 6 months with three of the following:

Restlessness
Fatigue
Poor concentration
Muscle tension
Irritability
Sleep disturbance
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41
Q

Explain the Tx of GAD

A

Trusting relationship
Cognitive behavioral therapy
Exercise

SSRIs/Benzodiazepines
- Low dosage, slow titration

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42
Q

What are some medical conditions with anxiety-like symptoms?

A 
CAD, CHF, Arrhythmia, PE
Asthma, pneumonia
Thyroid dysfunction, Menopause, Cushing disease, Anemia
Seizure disorder
Substance Abuse
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43
Q

What are indications and contraindications of use of Benzodiazepines in anxiety disorders?

A

Indications:
Rapid symptom control
Lack of effect of multiple antidepressants
Infrequent symptoms

Contraindications/Risks:
Chronic opiate therapy
Subastance abuse disorder
Memory impairment
Elderly
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44
Q

Criteria for PTSD

A 
Exposure to actual physical or sexual trauma
With one from each group
1. Negative alterations in mood
2. Hyperarousal: Hypervigilence
3. Avoidance
4. Intrusion symptoms: Nightmares

All more than 1 month duration with impaired function

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45
Q

What is the treatment for PTSD?

A

Psychotherapy, Exposure Therapy

SSRI, SNRI, Prazosin, Clonidine, Quetiapine, TCA

Not Benzos

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46
Q

Acute Stress Disorder

A

Criteria are the same as PTSD but apply only if 3-30 days have elapsed.

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47
Q

Adjustment Disorder

A

Emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months of the onset of the stressors.

Distress out of proportion with significant impairment.

Once the stressor is gone, the symptoms leave within 6 months.

No anhedonia, they still enjoy the things they love unlike MDD

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48
Q

What is the Tx for Adjustment Disorder?

A

Psychotherapy

No Medications

49
Q

DSM-5 for OCD

A

Obesissions

  • Persistent thoughts or urges that are unwanted and cause anxiety
  • Individual attempts to ignore or suppress the thoughts by doing something

Conpulsions

  • Repetitive Behaviors
  • Behavior or mental acts are aimed at preventing or reducing anxiety.

Must take more than 1 hour a day and cause significant distress or impairment

50
Q

What is the Tx for OCD

A

Exposure and Response Therapy

SSRI/SNRI
Fluoxetine, Fluvoxamine

Atypical antipsychotics, TCA, Benzos

51
Q

What is the presumptive cause of OCD?

A

Orbitofrontal Cortex problems

52
Q

DSM-5 Obsessive-compulsive personality disorder

A

Pervasive pattern of preoccupation with orderliness, perfectionism, mental control, at the expense of flexibility, openness, and efficiency.

  • Preoccupied with details
  • Excessive devotion to work
  • Overconscientious
  • Unable to get rid of worn out things
  • Reluctant to delegate
  • Adopts frugalness, money only for future catastrophe
  • Stubbornness
53
Q

What are the personality disorders in clusters A, B, and C

A

A. Paranoid, Schizoid, Schizotypd

B. Antisocial, Narcissistic, Histrionic, Borderline

C. Dependent, Avoidant, Obsessive-compulsive

54
Q

Paranoid Personality

A

Humorless manner

Distrust: Everyone is out to get you

Affect is restricted and they appear to be unemotional

55
Q

Schizoid Personality

A

Cold and Aloof

Use the defense of fantasy

They appear normal, speech is goal oriented, but they may answer questions in short sentences

Make up that they know people well that they haven’t seen in a long time

56
Q

Schizotypal Personality

A

Distorted thinking

Linked with SCZ

Speech is distinctive or peculiar. They may claim to have special powers.

Use the defense of fantasy

57
Q

Antisocial Personality

A

Composed, but have tension, irritability and rage

Complete absence of delusions or other signs of irrational thinking, “normal”

Don’t tell the truth and can’t be trusted

Show no remorse for behavior

58
Q

Narcissistic Personality

A

Grandiose sense of self-importance

Can’t show empathy

May feign sympathy to get what they want

59
Q

Histrionic Personality

A

Attention Seeking

Uses defenses of repression and dissociation

Seductive Behavior

May through tantrums, or accuse people when they aren’t the center of attention

60
Q

Borderline Personality

A

Suicidal and Self Mutilitation

Chaotic sexual behavior, pansexuality

Outbursts of anger or violence

Intense and unstable relationships

Neuroses of anxiety, depression, depersonalization

Most challenging for physicians

61
Q

Avoidant Personality

A

Hypersensitivity to rejection

Socially inhibited

Shows lack of self confidence

Not willing to enter relationships

62
Q

Dependent Personality

A

Can’t be alone

Avoids responsibility

May stay in harmful relationships due to fear of void and loss of someone to take care of them

63
Q

Obsessive-Compulsive Personality

A

Preoccupied with rules, neatness, and perfection

Have stiff, formal demeanor that is constricted

Things that break their routine will cause anxiety

64
Q

What is the treatment for Borderline Personality Disorder?

A

DIALECTICAL BEHAVIOR THERAPY, TRANSFERENCE-Based psychodynamic psychotherapy

65
Q

What is the best treatment model for Personality Disorders

A

E=MC3

Empathy, can’t cure but can Manage, Comorbidities, Countertransference, Consistent

66
Q

Somatic Symptoms Disorder DSM-5

Tx

A

One or more somatic symptoms that are distressing or result in significant disruption of daily life for greater than 6 months.
With one of the following:
-persistent thoughts about the seriousness of symptoms
-Persistent high level of anxiety about health or symptoms
-Excessive time and energy devoted to the symptoms

Pain is the predominant somatic symptoms

Tx: CBT, regular visits

67
Q

Illness Anxiety Disorder DSM-5

A

Preoccupation with having or acquiring a serious illness
***Somatic symptoms not present or are only mild.

High level of anxiety about their health

At least 6 months of symptoms that are better explained by any other mental disorder.

68
Q

Conversion Disorder DSM-5

A

One or more symptoms of altered voluntary motor or sensory function:

Usually after Trauma (Abuse)*****

The symptoms cause clinically significant distress
(Visceral or motor symptoms, sensory deficits)

69
Q

Fictitious Disorder DSM-5

A

Imposed on self

Falsification of physical or psych signs or symptoms.

The deceptive behavior is evident even in the absence of obvious external rewards

Not better explained by delusional disorder or psychotic disorder

Gain comes from going to the Dr*

70
Q

Dissociative Identity Disorder DSM-5

Tx

A

Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. Multiple personalities

Recurrent gaps in the recall of everyday events or personal info

Symptoms cause clinically significant distress

Not a normal part of accepted cultural or religious practice

Not from substance abuse

Tx: Psychotherapy

71
Q

Dissociative Amnesia DSM-5

Tx:

A

Inability to recall important info, usually of a traumatic or stressful nature

Significant distress

No substance abuse

Not from any other dissociative identity disorder, PTST, or ASD.

Specified with Dissociative fugue: travel or bewildered wandering.

Tx: CBT, hypnosis, group therapy

72
Q

Depersonalization/Derealization d/o DSM-5

Tx:

A

Presence of persistent or recurrent experiences of depersonalization, derealization, or both.

Reality testing remains intact

Clinically significant distress

Not from substance abuse or another mental disorder

Tx: SSRIs
Psychotherapy

73
Q

Define Depersonalization

Derealization

A

Detached from body as an outside observer with respect to thoughts feelings, or body

Things around you don’t seem real (feature of PTSD)

74
Q

Anorexia Nervosa DSM-5

Tx

A

Restriction of energy intake

Intense fear of gaining weight

Disturbance in the way in which one’s body weight or shape is experienced

***Underweight. Lower than 18.5 BMI

Hospitalization, Weight Restoration, Psychotherapy (family)

75
Q

What is Refeeding Syndrome?

A

Seen in AN

Hypophosphatemia**

Hypocalcemia
CHF
Peripheral Edema
Rhabdomyolysis
Seizures
76
Q

Bulimia Nervosa DSM-5

Tx:

A

Binge eating (lots within 2 hours, lack of control)

Recurrent inappropriate compensatory behaviors for weight (vomiting, exercise, laxatives)

Once a week for at least 3 months

Self-evaluation is unduly influenced by body shape and weight

Not low body weight***** Over 18.5

Tx: CBI, SSRIs

77
Q

What are medical sequelae of Bulimia Nervosa?

A

Parotid Swelling

Dental erosion

Hypokalemic, hypochloremic metabolic acidosis

78
Q

Binge-eating d/o DSM-5

Tx

A

Episodes of binge eating (lots in 2 hrs, loss of control)

Eating until you are uncomfortably full, once a week for 3 months

Marked distress from the eating

NO compensatory mechanisms (vomiting, laxative, enema)

Tx: CBT, SSRIs

79
Q

Avoidant/Restrictive Food Intake Disorder DSM-5

A

Eating or feeding disturbance with one or more:

Significant weight loss <18.5 BMI
Significant nutritional deficiency
Dependence on enteral feeding or supplements

No cognitive distortions of body weight. Just doesn’t want to eat

Not explained by lack of available food or cultural practice

Not from another medical condition or mental disorder

80
Q

SCOFF Screening

A

Screening for eating disorders

S: Sick because your full?
C: Control of how much you eat?
O: One stone weight loss (14 lbs)
F: Fat belief when others say you are too thin?
F: Food dominates your life?
81
Q

Delirium DSM-5

A

Acute confusional state: impairment of memory, orientation, language, perception

A. Disturbance in attention
B. Develops over a short period of time that tends to fluctuate in severity during the course of a day
C. Additional disturbance in cognition (memory, disorientation, language)
D. A and C not better explained by preexisiting established neurocognitive disorder
E. Disturbance is a direct physiological consequence of another medical condition (meds)

82
Q

What are the causes of delirium

Types?

A

Substance intoxication or withdrawal

Medication-induced

Another medical cause

Multiple etiologies

Hypoactive, hyperactive, mixed

83
Q

How do you screen for delirium

A

Check serial 7’s, spell world backwards, ask about visual hallucinations (bugs), and the year that they are in

84
Q

What are the risk factors of delirium?

A 
Age of 65
Male 
Dementia
Depression
Immobility
Functional dependence
Dehydration
85
Q

Which meds can cause delirium

A 
Opioids
Benzos
Anticholinergics
Antifungals
Dopamine agonists
86
Q

When should restraints be used during delirium

A

Only as a last resort. It should be explained to the patient. You can also use 1:1 patient monitoring

87
Q

What can be used to cure delirium from

Alcohol or Benzo withdrawal

Anything else

A

ETOH or Benzo withdrawal: Benzos or barbiturates

Anything else: Haldo (monster QTc, check K+ and Mg+)

88
Q

How many people who commit or attempt suicide have a diagnosed mental disorder?

How many have just depression?

A

95%

80%

89
Q

How many people reported that they planned their suicide in less than 5 minutes?

A

75%

90
Q

What are the modifiable and nonmodifiable risk factors for suicide?

A 
Modifiable:
Major depressive episode, with prominent anxiety symptoms
Alcohol abuse
Hopelessness
Suicidal ideation and plan
Access to lethal means
Nonmodifiable:
Past suicide attempt
Male
Age over 65
Caucasian or Native American
Divorced, widowed
Unemployment
Childhood sexual and physical abuse
Alcohol dependence when facing losses
Chronic neurologic illness
Family history of suicide
91
Q

What are protective factors from suicide?

A 
Strong religious beliefs against suicide
Strong social network
Responsibility for children
Hope for the future
Good therapeutic alliance
Positive affect
92
Q

What are the types of suicidal ideation?

A

Passive: Morbid thinking

Active: “I want to jump in front of a bus)

93
Q

How do you determine Acute risk of Suicide?

Low, Medium, High

A

Low: + SI but no plan or no intention

Medium: +SI and +plan but no intention; or +SI and + intention but no plan

High: +SI, +plan, and +intention to kill him/herself

94
Q

What are some example of psychiatric emergencies?

A 
Suicide
Homicide/violence
Medication side effects:  Serotonin syndrome, NMS
Malignant Catatonia
Overdoses/Toxidromes
Delirium Tremens
95
Q

Where is the highest risk of Violence in the health care world?

A

ED

50% of health care providers experience violence in their careers

96
Q

What is the best violence risk assessment?

A

Broset Violence Checklist

97
Q

What are some tactics for De-escalation

What is the last line tactic?

A

Take and empathetic and non-judge mental stance
Allow for personal space
Don’t overreact
Pick your battles
Set limits
Validate or at least acknowledge the patient’s feelings

Offer oral medications (lorazepam, olanzapine)
Tell the pt why your are putting them in restraints, and how they can get out?
Then administer medications to reduce agitation: Haldol, lorazepam, diphenhydramine

98
Q

What increases the risk of violence in patients?

A

Substance use doubles the risk

Mental illness itself doesn’t increase the risk.

99
Q

What are the symptoms of anticholinergic toxicity?

Tx?

A 
Red as a beet- cutaneous vasodilation
Dry as a bone- anhydrosis
Hot as a hare- hyperthermia
Blind as a bat- blurry vision
Mad as a hatter- hyperactive delirium
Full as a flask- urinary retention

Tx: Physostigmine

100
Q

What are the differences between NMS and Serotonin Syndrome?

A

SS vs NMS

Abrupt vs Gradual onset
Rapid vs Prolonged course
Myoclonus and tremor vs Diffuse Rigidity
Increased vs Decreased Reflexes
Mydriasis vs Normal
101
Q

What is Malignant catatonia?

A

Catatonia that is hard to distinguish from NMS

Management is the same as NMS

Those with catatonia shouldn’t be given antipsychotics

102
Q

What is Delirium Tremens?

Tx

A

Alcohol Withdrawal Syndrome

Mortality for DTs is up to 20% without Tx

Tx:
Supportive interventions
Fluids and electrolyte depletion
Benzos or phenobarb

103
Q

Who are the partners in a collaborative care model?

A

PCP
BH care manager
Psychiatrist
Patient

104
Q

What are the steps of motivational interviewing?

A

Engaging w/ POARS
Focusing
Evoking
Planning

105
Q

POARS

A

Part of the engaging of motivational interviewing

P: Permission to talk
O: Open-ended questions
A: Affirm with positive comment
R: Reflect and restate what pt. Says
S: Summarize
106
Q

What are the steps of Focusing in a motivational interview

A

Find the Factual Premise (saying they feel fine with high BP)
Find the Motivational Premise (My life is hectic)

Those are the points that the patient has to work through

107
Q

Explain how Evoking is performed in a motivational interview?

A

Try to help the patient use elicit change talk

DARN mnemonic 
D: Desire
A: Ability
R: Reasons
N: Needs
108
Q

What are the steps of Planning in a motivational interview?

A

Mobilizing change talk

Commitment
Activation
Taking Steps
CATS

Use smart goals
Specific
Measurable
Attainable
Relevant
Timely
109
Q

DSM-5 Major Neurocognitive Disorder

Difference between major and minor

A

Evidence of significant cognitive decline in one or more:

  • Learning and memory
  • Language
  • Executive Function
  • Complex Attention
  • Perceptual-motor
  • Social cognition

For Major they must interfere with independence in everyday activities. Minor isn’t bad enough to interfere with those activities (paying bills, managing Meds)

Not delirium
Not MDD

110
Q

What are the main types of Dementia?

What are the 2 most common types?

A 
Alzheimer’s dementia
Dementia with Levy Bodies
Frontotemporal dementia
Vascular dementia
CJD

Alzheimer’s and Vascular

111
Q

What labs do you get for a dementia work up

A 
CBC
CMP
TSH
Head CT
HIV, RPR
B12/Folate, +/- Vitamin D
LFTs for hepatic dysfunction
112
Q

Alzheimer’s Disease Features

Cause

Tx

A

Rapid Forgetting
Declarative episodic memory
Loss in the hippocampus and medial temporal lobes

B amyloid and tau protein deposits

Tx:
NO real medications to stop dementia or AD

Can use SSRI for depression and Trazodone for sleep. NO antipsychotics

Control risk factors (vascular), Acetylcholinesterase inhibitors (early AD)
-Donepezil, Galantamine, Rivastigmine

Memantine (as augmentation for severe AD) +/- Vitamine E supplementation

113
Q

Frontotemporal dementia Features

Causes

Tx

A

Apathy and loss of empathy, Hyperorality, Compulsive behaviors, visual hallucinations, REM sleep behavior disorder

Pick Cells
Loss of frontal and temporal regions
Loss of driving

Tx:
Speech therapy, No Meds

114
Q

Vascular Dementia Features

Causes

Tx

A

Second most common dementia

Age, HTN, DM, Hyperlipidemia, CAD, Smoking

Treat symptoms and lower Vascular problems

115
Q

What is the best treatment of Levy-body Dementia visual hallucinations?

A

Clozapine

116
Q

What are the key features of Geriatric Depression?

A 
Low energy
Sleep disruption (AM awakening)
Decreased appetite
Weight loss
Somatic complaints/hypochondriasis
117
Q

Pseduodementia

Tx

A

Dementia syndrome of depression

“May answer many questions with “I don’t know”

Occurs in 15% of older patients with depression

118
Q

What is the Tx for depression in the elderly?

A

Psychotherapy

Use the Beers list!

SSRIs but be alert for hyponatremia. Meds are good Start low, go slow, but go!

ECT is a good option if 1st or 2nd line treatments fail.

Mental Health (6 decks)

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