Psychology #2 Flashcards
What is the time frame for PTSD in which the event could have occurred?
Any time in the past!
Treatment for PTSD
SSRI + CBT
In PTSD, what drug can be used for insomnia? Which drug for nightmares?
Trazodone
Prazosin
What is the time frame in which the event occurs in acute stress disorder?
Less than 1 month ago and symptoms last less than 1 month
Treatment for acute stress disorder
Counseling and psychotherapy
If the symptoms of acute stress disorder last longer than 1 month, what should you do?
Treat as PTSD = SSRI + CBT
What psych condition has the highest mortality rate?
Anorexia Nervosa
Explain anorexia nervosa and a patient that has the condition
-Failure to maintain normal weight
-Behaviors to keep low weight
-Ego-Syntonic
-Restrictive and Binge-Eating/Purging Types
What are some common exam findings in a patient with anorexia nervosa?
Lanugo (fine, downy hair)
Dry Skin
Salivary gland hypertrophy
Amenorrhea
Osteopenia
Hypotension
Bradycardia
Russel’s Sign: callouses on hand
BMI 17.5 or less
Body weight: <85% ideal
In anorexia nervosa, what is the weight of the patient?
BMI 17.5 or less
weight < 85% ideal
What do labs show in anorexia nervosa?
Hypokalemia
Metabolic alkalosis
From Vomiting
Treatment for anorexia nervosa
Admit if weight < 75%
Psychotherapy
SSRI’s (they help with weight gain)
What is the difference between anorexia and bulimia
Bulimia nervosa patients are able to maintain an normal weight or are overweight
Ego-dystonic
Exam findings of a patient with bulimia?
Teeth pitting or enamel erosion
Russell’s Sign
parotid gland hypertrophy
Lab findings of bulimia nervosa
Hypokalemia
Metabolic alkalosis
Increased amylase (parotid gland hypetrophy)
What are the two criteria for bulimia nervosa?
Recurrent episodes of binge eating followed by compensatory behaviors
Treatment for bulimia nervosa
Psychotherapy + Fluoxetine (only medication used in treating this)
What is refeeding syndrome?
Result of fluid and electrolyte shifts during aggressive nutritional rehabilitation
What is the HALLMARK symptom of refeeding syndrome?
Hypophosphatemia
Binge eating disorder is not associated with _______, but a treatment option, besides psychotherapy is ______
Compensatory behaviors
Topiramate, or appetite suppressants such as stimulants like Adderall
Schizophrenia is a disorder of abnormal thinking, emotion, and behavior. What is the difference in presentation (age wise) between men and women?
Men - early 20’s
Women - late 20’s
What are some things that show a better prognosis in schizophrenia?
Late onset, acute onset, positive symptoms, no family history, good support system
What are some things that show a worse prognosis in schizophrenia?
early onset, gradual onset, negative symptoms, male gender, family history, bad support system
What is the pathophysiology to explain the positive symptoms in schizophrenia?
Due to excess dopamine in the mesolimbic pathway
In schizophrenia, what is seen on a CT scan? Although not frequently done
Ventricular enlargement (lateral and third) and decreased grey matter and cortical volume
What are the diagnostic criteria for schizophrenia?
2 or more symptoms for at least 6 months. One must be positive (hallucinations, delusions, disorganized speech) and one negative (flat affect, alogia, avolition, anhedonia, asociality, absence of normal cognition)
First line treatment for schizophrenia
2nd gen (atypical) antipsychotics
–Risperidone
–Olanzipine
–Quetiapine
–Aripiprazole
–Ziprasidone
What is the MOA of 2nd gen antipsychotics and how long should you try them before determining efficacy?
Dopamine and serotonin antagonists
4 weeks
What is the MOA of 2nd gen antipsychotics and how long should you try them before determining efficacy?
Dopamine and serotonin antagonists
4 weeks
