Psychosomatic Medicine

Question 1

What ar the 2 basic assumptions with psychosomatic medicine?

Answer 1

• Unity of mind and body

- Physiological factors

Question 2

Can psychiatric factors affect the medical condition?

Answer 2

• hell yes!

- that’s kinda what this lecture is about

Question 3

What is stress?

Answer 3

• a circumstance that disturbs, or is likely to disturb, the normal physiological or psychological functioning of a person
• stimulation of autonomic nervous system (sympathetic) to fight or flight

Question 4

What happens with Serotonin in stress?

Answer 4

-increased serotonin turnover

Question 5

SLE, what is it?

Answer 5

-Fever, photosensitivity, butterfly rash, joint pains, headache
-Depression, mood disturbances, psychosis, delusions, hallucinations
-

Question 6

What is MS?

Answer 6

• transient motor/sensory disturbances, impaired vision, difuse neurological signs with remissions and exacerbations, slurred speech, incontinence
• Anxiety, euphoria, mania

Question 7

What is Seizure disorder?

Answer 7

• Sensory distortions, violence, belligerence

- Sonfusion, psychosis, dissociative states, cataoniclike state, bizzarre behavior

Question 8

What will asthmatics have?

Answer 8

• panic disorder!

- fear of dypnea can trigger asthma attacks and high levels of anxiety

Question 9

Will hyperthyoridism/hypo have psych symtpoms?

Answer 9

• yes!
• Hyper: pressured to keep talking ha ha, nervousness, excitability, irritability, psychosis, visual hallucinations
• Hypo: lethargy, depressed, personality change, paranoia

Question 10

What psych sx will diabetes ppl have?

Answer 10

-frustration, loneliness, dejection, depression

Question 11

What will hyponatremia ppl look like?

Answer 11

• excessive thirst, polydipsia, stupor

- confusion, lethargy, personality changes

Question 12

Thiamine deficiency?

Answer 12

• they cannnoooottttttt answer a question straightforward!
• poor concentrations
• wernicke korsakoff syndrome

Question 13

Cobalamin (vit B12 deficiency)

Answer 13

• pallor dizziness, peripherral neuropathy, dorsal column signs, ataxia
• Irritability, inattentiveness, psychosis, dementia

Question 14

What will ppl with UC have?

Answer 14

-increased prevalence of dependent personalities

Question 15

Crohns disease psych things?

Answer 15

-high rates of preexisting panic disorder

Question 16

Side effects of SSRI?

Answer 16

• GI disturbances due to serotonin in the GI tract
• Nausea and diarrhea
• usually early on and dose related

Question 17

What psych disorder will pancreatic cancer pts have?

Answer 17

-depression

Question 18

What side effects will TCA’s have?

Answer 18

-anticholinergic kind

Question 19

Acute intermittent porphyria

Answer 19

• ab pain, fever, nausea, comiting, constipation, peripheral neuropathy, paralysis
• acute dperession, agitation, paranoia, visual hallucination

Question 20

Hepatic Encephalopathy

Answer 20

• asterixis, hyperreflexia, spider angiomata, palmar erythema, ecchymoses, liver enlargement/atrophy
• euphoria, disnihibition, psychosis, depresssion

Question 21

Frontal lobe tumor

Answer 21

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

Question 22

If someone has head trauma, what will we have trouble doing?

Answer 22

• keeping them in the bed

- confusion, personality changes, memory impairment

Question 23

Stress management

Answer 23

• self observation: daily diary to keep record of stressors and rxns to stressors
• Cognitive restructuring: includes cognitive behavior therapy to substitute negative assumptions with positive assumptions
• Relaxation exercises: muscle relaxation techniques to teach relaxation to stresed/tense muscles
• Hypnosis

Question 24

What is the most common cause of confusion or disorientation among hospticalized pts in general hospitals?

Answer 24

• Delirium, has quick onset, super altered mental status

- dementia has longer onset, steady course

Question 25

what do we not give elderly ppl?

Answer 25

• benzodiazepines!

- “AVOID BENZOS IN ELDERLY HOSPITALIZED PATIENTS”

Question 26

PCP

Answer 26

• elevated BP, tachycardia, nystagmus, muscular rigidity, vomiting
• Agitation with blank stare, anxiety, stupor, aggression, panic, bizarre behavior

Question 27

What can antidpressants turn bipolar people into?

Answer 27

-mania!!!

Question 28

What will corticosteroids do?

Answer 28

-mania, psychosis

Question 29

Who do we not give benzos to?

Answer 29

-elderly ppl with delirium