Psychosomatic Medicine Flashcards
SLE is associated with fever, photosensitivity, butterfly rash, joint pains, and headache. What are some psychiatric symptoms associated with SLE?
Depression Mood disturbances Psychosis Delusions Hallucinations
[supportive psychotherapy can help pts acquire knowledge and maturity to cope and promote positive interactions]
Multiple sclerosis is associated with transient motor/sensory disturbances, impaired vision, diffuse neurological signs with remissions and exacerbations, slurred speech, and incontinence. What are some associated psychiatric symptoms?
Anxiety
Euphoria
Mania
Medical and psychiatric associations with complex partial seizure disorders
Medical — sensory distortions, violence, belligerence
Psychiatric — confusion, psychosis, dissociative states, catatonic like state, bizarre behavior
What are some psychological characteristics that contribute to an increased risk for the development of and expression of coronary disease?
Depression Anxiety Type A behavior Hostility Anger Acute mental stress
Autonomic cardiac modulation is profoundly sensitive to acute emotional stress, increasing risk of cardiac ____ and sudden cardiac death
Arrhythmias
Stages of adaption while going through ____ transplantation process elicit anxiety, depression, elation, and coping with grief
Heart
30% of asthmatics meet criteria for _______ or agoraphobia
Panic disorder
[fear of dyspnea can trigger asthma attacks and high levels of anxiety]
In what other respiratory condition is prevalence of both anxiety disorder and panic disorder very high?
COPD
Medical symptoms of hyperthyroidism include heat intolerance, excess sweating, weight loss, tachycardia, palpitations, vomiting, fine tremor, hyperactivity, short attention span, impaired recent memory, exaggerated startle response, bulging eyes.
What are some associated psychiatric symptoms?
Nervousness Excitability Irritability Pressured speech Insomnia Psychosis Visual hallucinations
Hypothyroidism may present with cold intolerance, dry skin, contipation, and weight gain. What are some associated psychiatric symptoms?
Lethargy
Depression
Personality change
Paranoia
Diabetes may present with increased urination/thirst and high glucose levels. What are some associated psychiatric symptoms?
Frustration
Loneliness
Dejection
Depression
Medical symptoms of pheochromocytoma include paroxysmal HTN, headache, diaphoresis, and tremor. What are some associated psychiatric symptoms?
Anxiety
Apprehension
Feeling of impending doom
Panic
Hyponatremia may present with excess thirst, polydipsia, stupor, coma, and seizures. What are some associated psychiatric symptoms?
Confusion
Lethargy
Personality changes
Thiamine deficiency may present with neuropathy, cardiomyopathy, Wernicke-Korsakoff syndrome, and malaise in the setting of alcohol abuse. What are some associated psychiatric symptoms?
Poor concentration
Confusion
Confabulation
Cobalamin (Vit B12) deficiency may present with pallor, dizziness, peripheral neuropathy, dorsal column signs, and ataxia. What are some associated psychiatric symptoms?
Irritability
Inattentiveness
Psychosis
Dementia
Vitamin A, D, and iron toxicity may present with what psychiatric sign?
Confusion
Copper toxicity —> what psychologic sign?
Psychosis
B6 and B12 toxicity affect peripheral nerve function, while lead leads to _____ dysfunction
Cognitive
How is peptic ulcer disease related to psychiatry?
Increased gastric acid secretion associated with psychological stress
There is some evidence to show increased prevalence of _______ personality disorder among ulcerative colitis pts
Dependent
Crohn’s disease pts show high rates of preexisting _____ disorder
Panic
What psychiatric medication class has highest rate of GI disturbance?
SSRIs — due to serotonin in GI tract
GI side effects of TCAs
Constipation
Dry mouth
Pancreatic carcinoma may present with weight loss, abdominal pain, and fatigue. What are some associated psychiatric symptoms?
Depression
Lethargy
Anhedonia
Acute intermittent porphyria may present with abdominal pain, fever, nausea, vomiting, constipation, peripheral neuropathy, and paralysis. What are some associated psychiatric symptoms?
Acute depression
Agitation
Paranoia
Visual hallucinations
Hepatic encephalopathy may present with asterixis, hyperreflexia, spider angioma, palmar erythema, ecchymosis, and liver enlargement/atrophy. What are some associated psychiatric symptoms?
Euphoria
Disinhibition
Psychosis
Depression
What psychiatric conditions are associated with atopic dermatitis?
Anxiety
Depression
_______ is a skin condition related to anxiety, depression, and personality disorders, and episodes are often related to stressful events
Psoriasis
[note: urticaria is also related to anxiety, depression, and stress]
_____ ______ tumor may present with mood changes, irritability, facetiousness, impaired judgment, impaired memory, delirium, loss of speech, and/or loss of smell
Frontal lobe
Psychiatric symptoms associated with head trauma
Confusion
Personality change
Memory impairment
4 major strategies for stress management in conditions with psychiatric comorbidities
Self-observation — daily diary
Cognitive restructuring (includes CBT)
Relaxation exercises
Mindfulness
The study, practice, and teaching of the relation between medical and psychiatric disorders; i.e., the profession in which psychiatrists serve as consultants to medical colleagues or to other mental health professionals
Consultation-Liaison Psychiatry
Phencyclidine (PCP) use may present with elevated BP, tachycardia, nystagmus, muscle rigidity, and/or vomiting. What are some associated psychiatric symptoms?
Agitation with blank stare
Anxiety
Stupor
Aggression
Panic
Bizarre behavior
What psychiatric symptoms may be triggered by corticosteroids?
Mania
Psychosis (hallucinations)
What psychiatric symptoms may be elicited by antidepressants used in bipolar pts?
Mania
76 y/o man is admitted for COPD exacerbation with SOB. He is alert and oriented on admission, but appears anxious. He begins treatment and on day 2 begins to experience extreme paranoia and visual hallucinations. The most likely cause of his symptoms are:
A. Alprazolam B. Albuterol tx C. IV steroids D. Acetaminophen E. Oxygen
C. IV steroids
46 y/o female is admitted for poorly controlled DM. She has noticed that along with increased thirst, nausea, and vomiting, she is having additional significant symptoms of depression. Along with managing her hyperglycemia, you also initiate therapy with:
A. Valproic acid B. Olanzapine C. Lorazepam D. Sertraline E. Lithium
D. Sertraline
Common consultation-liaison psychiatry problems
Suicide attempt or threat
Depression
Agitation (e.g., dementia)
Hallucinations (delirium tremens is MCC)
Sleep disorder
Confusion (delirium is MCC)
