Psychosomatic Medicine Flashcards
What ar the 2 basic assumptions with psychosomatic medicine?
- Unity of mind and body
- Physiological factors
Can psychiatric factors affect the medical condition?
- hell yes!
- that’s kinda what this lecture is about
What is stress?
- 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
What happens with Serotonin in stress?
-increased serotonin turnover
SLE, what is it?
-Fever, photosensitivity, butterfly rash, joint pains, headache
-Depression, mood disturbances, psychosis, delusions, hallucinations
-
What is MS?
- transient motor/sensory disturbances, impaired vision, difuse neurological signs with remissions and exacerbations, slurred speech, incontinence
- Anxiety, euphoria, mania
What is Seizure disorder?
- Sensory distortions, violence, belligerence
- Sonfusion, psychosis, dissociative states, cataoniclike state, bizzarre behavior
What will asthmatics have?
- panic disorder!
- fear of dypnea can trigger asthma attacks and high levels of anxiety
Will hyperthyoridism/hypo have psych symtpoms?
- yes!
- Hyper: pressured to keep talking ha ha, nervousness, excitability, irritability, psychosis, visual hallucinations
- Hypo: lethargy, depressed, personality change, paranoia
What psych sx will diabetes ppl have?
-frustration, loneliness, dejection, depression
What will hyponatremia ppl look like?
- excessive thirst, polydipsia, stupor
- confusion, lethargy, personality changes
Thiamine deficiency?
- they cannnoooottttttt answer a question straightforward!
- poor concentrations
- wernicke korsakoff syndrome
Cobalamin (vit B12 deficiency)
- pallor dizziness, peripherral neuropathy, dorsal column signs, ataxia
- Irritability, inattentiveness, psychosis, dementia
What will ppl with UC have?
-increased prevalence of dependent personalities
Crohns disease psych things?
-high rates of preexisting panic disorder
Side effects of SSRI?
- GI disturbances due to serotonin in the GI tract
- Nausea and diarrhea
- usually early on and dose related
What psych disorder will pancreatic cancer pts have?
-depression
What side effects will TCA’s have?
-anticholinergic kind
Acute intermittent porphyria
- ab pain, fever, nausea, comiting, constipation, peripheral neuropathy, paralysis
- acute dperession, agitation, paranoia, visual hallucination
Hepatic Encephalopathy
- asterixis, hyperreflexia, spider angiomata, palmar erythema, ecchymoses, liver enlargement/atrophy
- euphoria, disnihibition, psychosis, depresssion
Frontal lobe tumor
-mood changes, irritability, facetiousness, impaired judgement, impaired memory, delirium, loss of speech, loss of smell
If someone has head trauma, what will we have trouble doing?
- keeping them in the bed
- confusion, personality changes, memory impairment
Stress management
- 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
What is the most common cause of confusion or disorientation among hospticalized pts in general hospitals?
- Delirium, has quick onset, super altered mental status
- dementia has longer onset, steady course
what do we not give elderly ppl?
- benzodiazepines!
- “AVOID BENZOS IN ELDERLY HOSPITALIZED PATIENTS”
PCP
- elevated BP, tachycardia, nystagmus, muscular rigidity, vomiting
- Agitation with blank stare, anxiety, stupor, aggression, panic, bizarre behavior
What can antidpressants turn bipolar people into?
-mania!!!
What will corticosteroids do?
-mania, psychosis
Who do we not give benzos to?
-elderly ppl with delirium
