Psychosomatic Disorders

Question 1

What somatic disorder can present with psychosis or psych sx?

Answer 1

Lupus (SLE)

Question 2

What can hyponatremia cause?

Answer 2

sx: excessive thirst, stupor coma

SEIZURES!!!!

Question 3

What is depression an independent risk factor for?

Answer 3

coronary heart disease

stroke

DM

Question 4

What is anxiety a risk factor for?

Answer 4

CAD

asthma

specific phobias

Question 5

Response to stress

Answer 5

release of catecholamines

serotonin turnover (less)

glucocorticoids

dopamine

corticotropin releasing factor–> releases ACTH

inhibits immune fxn

Question 6

What can produce psychosis, confusion, catatonia-like states and bizarre behavior?

Answer 6

seizures

Question 7

What can asthma produce?

Answer 7

anxiety

30% have panic disorder

Question 8

Sx of hyperthyroid

Answer 8

heat intolerance
excessive sweating
diarrhea
weight loss
tachy
palpitations
vomiting
fine tremor
hyperactivity
short attention span
impaired recent memory
exaggerated startle response
bulging eyes

Question 9

Psych sx of hyperthyroid

Answer 9

nervousness
excitability
irritability
pressured speech
insomnia
psychosis
visual hallucinations

Question 10

Sx of hypothyroid

Answer 10

cold intolerance
dry skin
constipation
weight gain

Question 11

Psych sx of hypothyroid

Answer 11

lethargy
depression
personality change
paranoia

Question 12

Diabetes is associated with

Answer 12

depression

Question 13

Sx of hyponatremia

Answer 13

excessive thirst
polydipsia
stupor
coma
seizures

Question 14

Psych sx of hyponatremia

Answer 14

confusion/delirium
lethargy
personality changes

Question 15

Psych sx of thiamine deficiency

Answer 15

poor concentration
confusion
confabulation

–>Wernicke-Korsakoff

Question 16

Psych sx of Vitamin B12/cobalamin deficiency

Answer 16

irritability
inattentiveness
psychosis
dementia

Question 17

Sx of cobalamin/B12 deficiency

Answer 17

pallor
dizziness
peripheral neuropathy
dorsal column signs
ataxia

–>treat if under 400

Question 18

Sx of thiamine deficiency

Answer 18

neuropathy
cardiomyopathy
Wernicke-Korsakoff
malaise

–>common alcoholics

Question 19

What should you avoid in elderly hospitalized patients/

Answer 19

benzos

Question 20

What can corticosteroids cause?

Answer 20

mania

psychosis/hallucinations

Question 21

What can benzos cause?

Answer 21

sedation
paradoxical agitation

avoid in elderly with delirium

Question 22

What can antidepressants cause?

Answer 22

mania (bipolar patient)
anxiety
insomnia

Question 23

Psych sx of PCP

Answer 23

agitation with blank stare
stupor
anxiety
aggression
panic
bizarre behavior

med sx:
elevated BP
tachy
nystagmus (vertical)
muscular rigidity
vomiting

Question 24

What is the most common cause of hallucinations?

Answer 24

delirium tremens

Question 25

What is the most common cause of confusion or disorientation among hospitalized patients?

Answer 25

delirium

Question 26

Sx of frontal lobe tumor

Answer 26

mood changes
irritability
facetiousness
impaired judgement
impaired memory
delirium
loss of speech
loss of smell

Question 27

Sx of pancreatic carcionma

Answer 27

weight loss
abd pain
depression
lethargy
anhedonia
apathy
decreased energy

Question 28

Sx of acute intermittent porphyria

Answer 28

abd pain 
F
N/V
constipation
peripheral neuropathy
paralysis

Question 29

Psych sx of acute intermittent porphyria

Answer 29

acute depression
agitation
paranoia
visual hallucinations

Question 30

Sx of hepatic encephalopathy

Answer 30

asterixis
hyperreflexia
spider angioma
palmar erythema
ecchymosis
liver
enlargement/atrophy

Question 31

Psych sx of hepatic encephalopathy

Answer 31

euphoria
disinhibition
psychosis
depression