Psychology Flashcards
DSM-5 Criteria of Anorexia Nervosa
Restriction of energy intake to requirements
Fear of weight gain
Severe body image disturbance
Clinical Presentation of Anorexia Nervosa
Dry Skin Cold intolerance/hypothermia Blue hands/feet Constipation Bloating Delayed puberty Amenorrhea (primary/secondary) Fainting Orthostatic hypotension Lanugo hair Scalp hair loss Early satiety Weakness/fatigue Short stature Osteopenia Breast atrophy Atrophic vaginitis Pitting edema Cardiac murmurs (MVP) Sinus bradycardia Food related obsessions (hoarding)
Diagnostics of Anorexia Nervosa
CBC CMP Thyroid panel UA Prolactin FSH Bone density
Complications of Anorexia Nervosa
Hypokalemia Hyponatremia Metabolic alkalosis Elevated BUN Inability to concentrate urine Decreased GFR Ketouria Osteopenia Amenorrhea MVP Long QT syndrome Heart failure
Treatment of Anorexia Nervosa
CBT
Medications for co-morbid disorders
Atypical anti-psychotics (help with weight gain)
+/- hospitalization
DSM-5 Criteria for Bulimia Nervosa
Recurrent binge eating
Recurrent inappropriate compensatory behaviors
These items at least once/week for 3 months
Self evaluation influenced by body shape/weight
Clinical Presentation of Bulimia Nervosa
Mouth sores Pharyngeal trauma Dental caries Heartburn/chest pain Esophageal rupture Impulsivity Irregular periods Muscle cramps/weakness Bloody diarrhea Bleeding/easy bruising Weakness/fainting Swollen parotid glands Hypotension Russell's sign
Treatment of Bulimia Nervosa
CBT Fluoxetine (Prozac) TCAs Topiramate (Topamax) Ondansetron (Zofran)
Clinical Presentation of Obesity (Binge Eating Disorder)
BMI >30
Overeating
Lack of exercise
Loss of control over eating
Diagnostic Criteria of Obesity (Binge Eating Disorder)
Recurrent episodes of binge eating 2 days/week for 6 months
Eating larger amounts of food
Eating until uncomfortably full
Eating to excess when not hungry
Eating alone
Feeling disgusted, guilty, depressed after eating episode
Treatment of Obesity (Binge Eating Disorder)
Behavior modification therapy Food diaries Develop new eating patterns Group therapy SSRIs: paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) Sympathomimetics: amphetamine, dextroamphetamine, phentermine, phedimetrazine, benzphateamine Orlistat (Xenical) Surgery: gastric bypass, gastric sleeve
Define Addiction
Psychological and/or physical dependence that results in substance seeking behavior
Define Physical Dependence
Physiological changes that occur with drug use and result in withdrawal symptoms with abstinence
Define Psychological Dependence
The craving/desire for the substance independent of the physiologic withdrawal symptoms
Clinical Presentation of Alcohol Use/Abuse
Slurred speech Ataxia Facial flushing Erratic behavior Loss of inhibition Euphoria Acne rosacea, palmar erythema, hepatomegaly, Dupuytren contracture Testicular atrophy, gynecomastia
Withdrawal Symptoms of Alcohol Abuse
Tremulousness Psychomotor symptoms Abnormal perception N/V Seizures Hallucinations Delirium tremens
Diagnostics of Alcohol Abuse
Elevated GGT Elevated AST Elevated ALT Elevated LDH Elevated MCV Decreased BUN Decreased LDL Decreased RBC volume
Treatment of Alcohol Use/Abuse
Education Coping skills Relaxation therapy Health/nutritional counseling Lifestyle changes AA Benzodiazepines (Valium, Librium) Thiamine, folic acid, multivitamin \+/- antipsychotic Disulfiram (Antabuse)
CAGE Questionnaire
Cut down on drinking
Annoyed by criticism of drinking
Guilty feelings about drinking
Eye-opener
Clinical Presentation of Opioid Use/Abuse
Drowsiness Impaired concentration Bradycardia Hypotension Constricted pupils Slurred speech Flushing
Withdrawal of Opioid Use/Abuse
Lacrimation Rhinorrhea Diaphoresis Yawning Anxiety HTN Tachycardia N/V Abdominal cramps Muscle/joint pain Diarrhea
Treatment of Opioid Use/Abuse
Naloxone Slow taper of methadone or clonidine Promethazine/dicyclomine (GI distress) Naltrexone Buprenorphine
Clinical Presentation of Acute Intoxication of Stimulants
Agitation/aggression Impaired judgment Euphoria HTN Tachycardia Dilated pupils Hallucinations
Withdrawal Symptoms of Stimulant Use/Abuse
Fatigue Headache Diaphoresis Muscle cramps Hunger
Treatment of Stimulant Use/Abuse
Benzodiazepines
+/- antipsychotics
Treatment of Nicotine Use/Abuse
Transdermal patches
Gum/lozenges
Bupropion
Chantix
DSM-5 Criteria for Schizophrenia
Delusions Hallucinations Bizarre behavior Disorganized speech Grossly disorganized behavior Social/occupational dysfunction
Positive Symptoms of Schizophrenia
Delusions
Hallucinations
Bizarre behavior
Negative Symptoms of Schizophrenia
Flat affect Apathy Poor grooming Social withdrawal Anhedonia Poor eye contact Poverty of speech
Treatment of Schizophrenia
Second generation antipsychotics
Family psychoeducational intervention
Social skills training
CBT
Examples of Second Generation Antipsychotics
Rispiridone (Risperdal) Olanzapine (Zyprexa) Quetiapine (Seroquel) Aripripraole (Abilify) Clozapine (Clozaril)
Major Side Effect of Clozapine (Clozaril)
Agranulocytosis
Examples of First Generation Antipsychotics
Haloperidol (Haldol)
Chlorpromazine (Thorazine)
Thioridazine (Mellaril)
