Psychosomatic Medicine Flashcards
Name three psychological factors affecting medical conditions (DSM 5)
- Mental disorder affecting…[general medical condition]. – e.g. major depressive disorder delaying recovery from MI
- Psychological symptoms affecting…[general medical condition]. – e.g. depressive symptoms delaying recovery from surgery; anxiety exacerbating asthma
- Personality trains or coping style affecting…[general medical condition]. – e.g. pathological denial of need for surgery in patient with cancer
- Maladaptive health behaviors affecting…[general medical condition]. – e.g. overeating, lack of exercise, unsafe sex
- Stress-related physiological response affecting…[general medical condition]. – e.g. stress-related exacerbations of ulcer, hypertension, arrhythmia, HA
- Other/unspecified psychological factors affecting…[general medical condition. – e.g. interpersonal, cultural, or religious factors
Components of Stress Theory
• Stimulation of autonomic nervous system, particularly the sympathetic nervous system,
readied the organism for “fight or flight.” – Tachycardia, Hypertension, Increased CO
– Result: Stress
• Body puts into motion a set of responses that seeks
to diminish the impact of the stressor and restore
homeostasis
Name the main responses to stress:
NT responses
Endocrine responses
Immune responses
NT: cats, 5HT, GC, Dop
Endocrine: CRF (hypoth) triggering ACTH release
Immune Responses: inhibition of immune fxn by GC OR activation of immune system via release of cytokines.
Psych sx in MSK:
SLE (Fever, photosensitivity, butterfly rash, joint
pains, headache.)
MS (Transient motor/sensory disturbances, impaired
vision, diffuse neurological signs with remissions and exacerbations, slurred speech, incontinence.)
SLE - Depression, mood disturbances, psychosis, delusions, hallucinations.
MS - Anxiety, euphoria, mania
** Illness associated with what disorder:
Confusion, psychosis, dissociative states, catatonic like state, bizarre
behavior.
Those who have never had psych history. Acute onset.
seizure
- Illness associated with what disorder:
- *DEPRESSION, anxiety, type A behavior, hostility, anger, and acute mental stress have been evaluated as risk factors for the development and expression of coronary disease.
CV-system
*** Illness associated with what disorder; PANIC disorder/anxiety
asthma
**** Illness associated with Nervousness, excitability,
irritability, pressured speech, insomnia, psychosis, visual hallucinations.
*****hyperthyroid
Heat intolerance, excessive
sweating, diarrhea, weight loss, tachycardia,
palpitations, vomiting, fine tremor, hyperactivity,
short attention span, impaired recent memory,
exaggerated startle response, bulging eyes.
*** Illness associated with Lethargy, depressed,
personality change, paranoia.
hypotherthyroid
Cold intolerance, dry skin,
constipation, weight gain.
*** Illness associated with frustration, loneliness, dejection, depression
DM with poorly controlled blood sugars
Increased urination/thirst,
high glucose levels.
***Illness associated with Confusion, lethargy, personality changes. Mental status changes.
Excessive thirst, polydipsia, stupor,
coma, seizures.
tx?
**hyponatremia
fluid restriction and stop SSRI/antidepressant
Illness associated with Poor concentration, confusion,
confabulation (so chatty).
Neuropathy, cardiomyopathy,
Wernicke-Korsakoff syndrome, malaise, common in
alcoholics.
Thiamine deficiency causing Wernike-Korsakoff.
Illness associated with Irritability, inattentiveness, psychosis, dementia.
Pallor, dizziness, peripheral neuropathy, dorsal column signs, ataxia.
Treatment.
Cobalamin (Vitamin B12) Deficiency
Tx: B12 injection
SSRI meds have highest rate of GI disturbances due to ____ in GI tract.
What sx?
serotonin in GI tract
N/D usually early on after starting SSRI
illness associated with – Weight loss, abdominal pain, depression, lethargy, anhedonia,
apathy, decreased energy
Pancreatic Carcinoma
