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Psych Final > Psychosomatic medicine > Flashcards

Psychosomatic medicine Flashcards

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1
Q

psychological factors affecting medical conditions

A
  • mental disorder
  • psychological sx’s
  • personality traits or coping style
  • maladaptive health behaviors
  • stress-related physiological response
  • other psychological factors
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2
Q

Stress theory

A
  • a circumstance that disturbs the normal physiological or psychological fxning of a person
  • stim of SNS- tachycardia, HTN, inc CO- stress!!
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3
Q

Responses to stress

A
  • inc serotonin turnover

- inhibition of immune fxning

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4
Q

Musculoskeletal system- what presents w psychiatric illness/sx’s?

A
  • SLE
  • MS
  • seizure disorder
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5
Q

SLE

A
  • fever, photosensitivity, butterfly rash, joint pains, HA

- depression, psychosis, delusions, halucinations

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6
Q

MS

A
  • motor/sensory disturbances..etc

- anxiety, euphoria, mania

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7
Q

seziure disorder

A

-confusion, psychosis, dissociative states, catatonic like state, bizzare behavior

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8
Q

CV system- affected by? affected how?

A
  • depression, anxiety, type A behavior, acute mental stress- risk for coronary dz!!!
  • cardiac arrhythmias and sudden cardiac death
  • HTN
  • heart transplantation response
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9
Q

Resp system- what presents w psychiatric illness/sx’s?

A
  • Asthma

- COPD

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10
Q

Asthma

A

-30% have panic disorder!!

Fear of dyspnea can trigger anxiety

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11
Q

COPD

A

-anxiety disorder, panic disorder

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12
Q

Endocrine system- what presents w psychiatric illness/sx’s?

A
  • Hyperthyroidism
  • hypothyroidism
  • diabetes mellitus
  • hyponatremia
  • vit def- thiamine (B1), B12
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13
Q

Hyperthyroidism

A

-nervousness, excitability, irritability, pressured speech, insomnia, psychosis, visual hallucinations
(anxiety)

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14
Q

Hypothyroidism

A

-lethargy, depressed, personality change, paranoia

depression

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15
Q

diabetes mellitus

A

depression!!!!

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16
Q

hyponatremia

A

-confusion, lethargy, personality changes

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17
Q

Thiamine def

A

(in alcoholics)

-poor concentration, confusion, confabulation (cant remember things!!)

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18
Q

cobalamin (vit B12) def

A

-irritability, inattentiveness

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19
Q

GI- what presents w psychiatric illness/sx’s?

A
  • peptic ulcer dz
  • UC
  • CD
20
Q

peptic ulcer dz

A

-assoc w stress

21
Q

ulcerative coliits

A

-inc prevalence of dependent personalities

22
Q

crohn’s dz

A

-high rates of panic disorder

23
Q

GI- drug SE’s

A

Antidepressants!!!

  • SSRIs- nausea, diarrhea
  • TCAs- anticholinergic effects- constipation, dry mouth
24
Q

Hepatic/Pancreatic system- what presents w psychiatric illness/sx’s?

A
  • pancreatic carcinoma
  • acute intermittent porphyria
  • hepatic encephalopathy
25
Q

Pancreatic carcinoma

A

-depression!!!

26
Q

acute intermittent porphyria

A

abd pain + psychosis!

27
Q

Skin- what presents w psychiatric illness/sx’s?

A
  • atopic dermatitis
  • psoriasis
  • urticaria
28
Q

atopic dermatitis

A

-anxiety, depression

29
Q

psoriasis

A

-anxiety, depression

30
Q

Tumors- what presents w psychiatric illness/sx’s?

A
  • brain neoplasms
  • frontal lobe tumor
  • occipital lobe tumor
31
Q

brain neoplasms

A

-personality changes!

32
Q

frontal lobe tumor

A

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

33
Q

occipital lobe tumor

A

-aura, visual hallucinations

34
Q

Head trauma- sx’s

A

-confusion, personality changes, memory impairment

aggressive, impulsive

35
Q

Treatments- stress management

A
  • self-observation (diary- stressors)
  • cognitive restructuring
  • relaxation exercises
  • hypnosis
36
Q

Consultation-liason psychiatry

A

-relation b/w medical and psychiatric disorders

37
Q

Common consultation-liason problems

A
  • suicide attempt/threat- risk factors: men, >45yo, no social support, alcohol dependence, prev suicide attempt, incapacitating medical illness
  • depression
  • agitation- dementia (#2!)
  • hallucinations- DT is most common cause!
  • sleep disorder
  • confusion- delirium is most common cause! (#!)
38
Q

delirium

A
  • in elderly, surgical, ICU pts
  • educate pt and family PRIOR to hospitalization/surgery!!
  • reversible, acute onset of impaired cognition, attention, consciousness, perception, sleep patterns that fluctuate over course of day
39
Q

Delirium- interventions to mitigate risk factors

A

-orientation protocols (use of clocks, calendars, windows)
-cognitive stimulation
-facilitate physio sleep
AVOID BENZODIAZEPINES IN ELDERLY HOSPITALIZED PTS (makes them more confuseD)

40
Q

Substance-induced mental disorders

A
  • PCP
  • amphetamine/cocaine
  • LSD
  • corticosteroids
  • benzodiazepines
  • anti-parksinson’s meds
  • antidepressants
41
Q

PCP

A
  • elevated BP, tachycardia, nystagmus, muscular rigidity, vomiting
  • agitation w blank stare, anxiety, stupor, aggression, panic, bizarre behavior
42
Q

Amphetamine/cocaine

A
  • inc BP, tachycardia, mydriasis, diaphoresis, tremor

- agitation, delusions, euphoria

43
Q

LSD

A
  • sympathetic excess

- hallucinations!!

44
Q

corticosteroids

A

-mania, psychosis (hallucinations!!)

45
Q

benzodiazepines

A

-avoid use in elderly w delirium!!!!

46
Q

antidepressants

A
  • mania (in bipolar pts)

- insomnia

Psych Final (2 decks)

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