Psychology Flashcards
Adjustment Disorder(not a medical disease) onset3mth / resolve6mth
the stressful event is not life threatening (e.g., divorce, death of a loved one, or loss of a job). In posttraumatic stress disorder (PTSD), it is.
unable to cope with a specific life event.
depression triggered by a significant change in a person’s life(death of someone close: husband ).
It is not the same as clinical depression
it is transient.
onset within 3 months
start to resolve within 6 months.
Anorexia Nervosa(static state/ no cycle) FOR DIAGNOSIS BMI must be 17.5 or less
Self starvation»_space; stop eating completely»Distorted wt goals (<17.5BMI)
Starvation» Catabolic state»Shut down Sex hormones» AMENORRHOEA and Osteoporosis
LANUGO (infant hairs) d/t ↓body heat (d/t ↓T3»_space;> heat regulation)
acute drop K and PO4 (d/t refeeding $)
↑Growth hormones and cortisol
Impaired glucose tolerance
↑Carotin(pigment)
↑Cholesterol (fat breakdown)
Tx- CBT
Bulimia Nervosa (Cycle of Binging n Purging ) Might have N weight (sometimes underweight but greater than AN ie > 17.5 )
Emotional relation to food
Stress is a Trigger
Look for BINGE and PURGE CYCLES
Might have NORMAL WEIGHT(BMI>27.5)
Purging Patterns ; Exercise Vomiting (Russell's Sign on knuckles / Erosion of back of incisors teeth) Laxatives Diuretics
Tx - CBT
Schizo-phrenia (splitting of mind)
only Auditory hallucination
(Visual Hallucination in Delirium )
May Commit Crime
TWO POINT THINKING
1st thought is realistic (the sun is bright)
2nd thought doesn’t make sense(the world will end)
Look for First Rank Symptoms
1. Auditory Hallucinations (Comment , Echo, Two ppl discussion )
2.Thought Disorder (Insertion, Stealing, Withdrawal, Broadcasting )
*******
3.Passivity Phenomenon(SOMEONE ELSE is controlling : action , feelings , impulses , bodily sensations)
The DEVIL MADE ME DO THE CRIME
Tx -
- Oral Antipsychotics
- Depot Preparation IM(a few months for non compliment pt )
- CBT (reserve the changes of mind )
- CVS risk Mgx
Somatization Disorder (S stand for SYmptoms )
Multiple Symptoms
At lest 2 year
Pt refuse to accept the reassurance or negative test results
Arrange trusting relationships with medical team
Hypo Chondral Disorder (H-HIV C- cancer and Multiple sclerosis )
Pt belief in presence of serious illness
Refusal to accept reassurance
They google it and know a lot of medical background (google patient )
Speech
Broca’s aphasia (baba mar pyit Frontal)
Frontal lobe
can’t get words out, UNDERSTAND EVERYTHING
Wernicke’s aphasia
Temporal lobe
May articulate FLUENTLY but the words NONSENSE.
Clang association(Cardi B )
Words used in a sentence connected by Rhyme rather than by meaning.
Seen in schizophrenia.
Neologism.
A newly created word whose meaning is unknown
(from Greek – neo = “new” + logos = “word”).
common in children,
indicative of brain damage or schizophrenia in adults.
Pregnancy and PSY
PP BLUE (Mostly Crying) >>>> 3-7 days / common in primiparas Anxious , Tearful , Irritable Cares for Baby
PP DEPRESSION (Worries abt baby health / being good mother)
»»
Peaks 3-4 weeks / within 6 months
Depression $
Mostly Cares / Frequent thoughts of HARMing the baby
Feels like she Cannot LOOK AFTER THE BABY
PP Psychosis (Auditory Hallucinations ) >>>> Begins 2 days and Peak at 2 weeks Severe Mood Swings Thoughts of Harming the baby Audi Hallu - baby is evil or has evil eyes Delusion - Baby is evil or deformed Insomnia / Disorientation Sucidal thoughts
Pregnancy
Postpartum Blues:
Normal ,
only reassurance,
a couple of days ,
crying for no reason
Postpartum depression:
a couple of weeks,
guilty feeling of not taking care of the baby,
loss of weigh and appetitie ,
feels that someone is harming her baby
Postnatal psychosis:
within 2 weeks ,
start with depression ,
thinks that the baby is evil or malformed ,
intention of killing the baby
Lithium Toxicity (Acute GI / Chronic confusion convulsion )
•Before starting lithium do .
RFT and TFT and Ca lvl
•Check lithium level - **12Hr AFTER Last TABLET(7th day) of the first week /
every 3 months
•Check RFT every 6 months
LiTHIUM side effects: Low thyroid Toxic with Thiazide Heart: ebstein anomaly Insipidus ( nephrogenic DI) Unwanted Movement: COARSE (fine) tremor
Tx - Fluid and dialysis
4 types of delusions
Types
Four types of delusions outlined in the DSM-5 include:1
Bizarre delusions
are implausible or impossible, such as being abducted by aliens.
Non-bizarre delusions
could actually occur in reality, such as being cheated on, poisoned, or stalked by an ex.
Mood-congruent delusions
are consistent with a depressive or manic state, such as delusions of abandonment or persecution when depressed, and delusions of superiority or fame when manic.
Mood-incongruent delusions
are not affected by the particular mood state.
They may include delusions of nihilism (e.g., the world is ending) and delusions of control (e.g., an external force controls your thoughts or movements).
People with delusions may also exhibit confusion, agitation, irritability, aggressiveness, depression, and self-referential thinking.
Themes of Delusions
Capgras delusion:
This is the belief that a loved one like a mother or sibling has been replaced by an imposter.
Cotard delusion: (Naihilistic + depression )
This occurs in Cotard’s syndrome, and is characterized by the belief that you are dead or your body or body parts have disintegrated or no longer exist.
Delusion of control:
This refers to the belief that an external entity is controlling your thoughts, behaviors, and impulses. This entity may be an individual like a manager, a group, or some undefined force.
Delusion of grandiosity:
This is an exaggerated or inflated self-belief regarding power, fame, knowledge, skill, talent, or strength. For example, a person may believe they are an Instagram influencer despite not having a following.
Delusion of guilt or sin:
This refers to unwarranted and extreme feelings of remorse or a severe sinking feeling that you’ve done something horribly wrong.
Delusion of thought insertion or thought broadcasting:
This refers to the belief that thoughts have been inserted into your mind or are being broadcasted to others.
Delusion of persecution:
This refers to the belief that you or someone close to you is being unfairly mistreated, harmed, or watched. The conviction is so strong that the person may seek help from the authorities.
Delusion of poverty:
This is the belief that you are or are about to become destitute, are destined to fall into poverty, or are impoverished.
Delusion of reference:
This refers to the belief that something like a poster, song, or advertisement has a direct reference to or a hidden meaning for you. A person with this delusion may see a sign that has nothing to do with them, but change their whole life plan as a result.
Delusional jealousy:
This is the belief that your sexual partner is being unfaithful.
Erotomanic delusion:
Also known as erotic or love delusion, this is the belief that someone, usually someone famous or otherwise out of reach, is in love with you. A person with this delusional disorder subtype may obsessively contact or try to connect with that person and make excuses for why they’re not together.
Nihilistic delusion:
This is the belief that you or parts of you do not exist, or that some object in external reality is not actually real.
Religious delusion:
This refers to any delusion involving a god, higher power, or spiritual theme (e.g., believing that you have special powers or are the embodiment of a prophet). This may be combined with other delusions such as the delusion of control or grandeur.
Somatic delusion: This refers to the belief that one or more of your bodily organs are functioning improperly, or are diseased, injured, or altered.
Depression and tx
Mild depression... CB Moderate depression... SSRIs(CSF citalopram/sertraline/fuloxetine) Severe depression..... ECT Psychotic depression... ECT Manic depression (bipolar).. Lithium.
SSRI contraindicated in BIOPOLAR and MANIA because they increase the cycle of mania and depression
Types of Phobia (spider , height , crowd , )
Agora(Market)phobia - fear of open spaces (Dev intense anxiety )
LEAVING HOME
and travelling in PUBLIC TRANSPORT
to go to SHOPPING CENTRE
Archnophobia(Arachnids - insects ) - SPIDERS (John whelsly )
Acrophobia - HEIGHT
Agoraphobia and Social anxiety disorder and Claustrophobia
Claustrophobia (Closed spaces ) being in and not able to get out
an irrational or disproportionate fear of being in CONFIMED or SMALL places and being unable to escape.
Agoraphobia: (CANNOT GO OUTSIDE ALONE)
- Person perceives their ENVIRONMENT to be unsafe with no easy way to escape.
- Intense fear of leaving the house or fear of going to public spaces ( open & enclosed) e.g malls, resturants, theatres, public transports, crowds, standing in line
- Not all agoraphobes are house bound some may have “safe zones” places they feel comfortable going to (in the stem the lady is going to her aunt’s) or a person they feel comfortable going out of the house with (the husband)
Social anxiety disorder: (CAN GO OUTSIDE ALONE BUT NO INTERACTION)
MEETING /PUBLIC SPEAKINGS + being judged
1. Fear of DIRECT INTERACTION with people that bring on feelings of self consciousness or BEING JUDGED & negatively evaluated (fear of rejection)
2. Worry about being CRITIZED / REJECTED (shaking, stammering or excessively blushing during interactions)
e.g: Raj’s GF Lucy on the Big Bang Theory :D
fear of interacting in a society. shy to face the society
GAD(Generalized Anxiety Disorder) vs PANIC attacks Vs Anxiety attacks
GAD Chronic Happens THROUGHOUT THE YEAR Excessive worry not related to cause/ NO SPECIFIC TRIGGERS Symptoms most days > 6months
Panic attacks (a type of Anxiety attack)
sudden and rapid / CANNOT FIND THE TRIGGER / so stay at home / less social and depression
2 attacks (no longer than 20-30 minutes / 1hr very rare )
At least 2 month of worry
Anxiety Attack
Know the trigger(if afraid of dog bit / stay away form dog)
Can avoid
➥Gad :at least 6months
➥PTSD: at least 1 month
➥adjustment disorder:within1/3months of stressor and no longer than 6 months
Alcohol withdrawal CY3142 Drug for wedding
Deterrent: Disulfiram
Craving: Acamprosate
With drawl: Chlordiazepoxide
Delirium tremens: :Lorazepam ( before operation develops signs of withdrawal)
Disulfiram does not reduce craving by nausea / vomiting
t acts as a deterrent because the patient fears the consequences.
Acamprosate and Naltrexone
first line treatment options for alcohol use disorder
markedly reduce craving.
Most people do not experience significant withdrawal when they stop or reduce drinking.
Disulfiram is a deterrent which means it makes the alcohol tastes bad and makes the patient feels horrible after drinking (not giving the patient the usual desirable buzz after drinking)
Neuro plastic Malignant S and Hyperthermia S
Neuroleptic malignant syndrome mnemonic:
Caused by : Antipsychotics and Anti Dopaminergic(Metoclopramide )
FALTER F--- Fever A--- Autonomic dysfunction L--- Leukocytosis T--- Tremor E--- Elevated liver enzymes R--- Rigidity
Hyperthermia
Caused by : Halothane and Succinylcholine (GA and Ms relaxant used in OT)
Parkinsonism – BRIT –
any condition that presents with many (but not all) of the movement abnormalities seen in Parkinson’s disease
– BRIT – bradykinesia, rigidity (cogwheel), instability (postural) and tremor (resting).
Possible causes include Medications, Infections and Carbon monoxide poisoning.
SIDE effects of Haloperidol
How to Know if Schizophrenia or PSY Depression (PY2006)
Duration is the key
Schizo is <6 months
Psychiatric Depression Dx has 2 major components-
criteria & time.
3 months-it does not fit the time requirement for schizophrenia despite having delusion & hallicination.
She has guilt and it probably hints depression.
Alcohol Withdrawal Vs Delirium Tremens
AW within 24 hr after stopping A Tremor anxiety nausea excessive sweating Hallucinations Severe to Delirium Tremens
Oral Chlordiazepoxide / Diazepam
Thiamine IV
Tx depending on severity
Community setting and hospital setting
DT **Medical Emergency **
1-3 days after stopping A
+ altered mental state
Hallucinations (with severe confusion/ non reality)
Oral Lorazepam / Diazepam
Thiamine IV
Only Hospital Setting
Drugs For different conditions
Alcoholics Sedation - Chlordiazepoxide (benzodiazepine) Seizures - Lorazepam Wernickes - Thiamine (Vit B1) Deterrent - Disulfiram Craving - Acamprosate
Lithium Toxicity
Diuretics and NSAIDs (ibuprofen) increase lithium renal reabsorption into blood; thus, leading to lithium toxicity.
Hyponatremia induces Li toxicity as Na competes with Li for reabsorption . Nsaids causes fluid retention and diuretics excrete Na thus causing hyponatremia and hence Li toxicity
Contraindicated with Lithium: 1. NSAIDs 2. Diuretics 3. SSRI Toxicity due to resulting hyponatremia. Lithium itself can cause hyponatremia and be toxic so levels have to be closely and frequently monitored.
Alcohol dependency Q AUDIT and CAGE
AUDIT questionnaire :
A: amnesia ( forgets what happened the night before )
U: Units ( no of units consumed on a typical day ) , Units more than 6 for females , more than 8 for males
D: Doing less work than normally expected bcz of drinking
I : Injured yourself or others
T: Times ( freq of drinks) , Termination ( difficult to stop drinking when started drinking )
CAGE : C: cut down thoughts ? A: Annoyed by friends or family asking to cut down G: guilt or remorse after drinking E: eye opener
Schizophrenia or Psychotic Depression
Delusions + Hallucinations = Schizophrenia
(Delusions + Hallucinations) + Depression = Psychotic Depression
Schizoid Personality Disorder( Schizoid always wants to be Single)
Lack of interest in social relationships /
will live a solitary life
CW 3422 Capgras vs Fregoli delusion
Capgras - believes that family member is a stranger / father has been replaced
Fregoli - identifies strangers as family / one person is shape-shifting as two person
Ganser = Gangster (A person that shd be in prison) Capgrass= The caps(heads) of the grass look identical but they are not.
Todd (The frog) = Alice in wonderland= The expanding & shrinking scene Fregoli = Mr Frargoli who changes his personality & appearance every episode.
CoTarD= Go Tuss me in the Dirt already!
cotard is dead , capgras is two , ottello is jealous
Hallucinations of 1 2 3 person
1st Person: I am evil
2nd Person: You are evil
3rd Person: S/He is evil
