Pyschopathology Flashcards
What reference book is used to diagnose mental disorders?
Diagnostic and Statistical Manual of Mental Disorders V (DSM V)
What are the 5 Axis of DMS-V?
- Axis 1: Psychological
- Axis 2: Personality disorders and mental retardation
- Axis 3: Medical conditions (incident related)
- Axis 4: Psychosocial and environmental disease
- Axis 5: Global assessment
Depression, anxiety, bipolar, ADHD, autism, Anorexia, and schizophrenia Are all examples of which axis?
Axis 1
Paranoid presonality disorder, narcisism, OCD and intellectual disabilities are which axis?
Axis 2
Brian injuries and medical disorders like alzheimers are which axis?
Axis 3
What are 5 components of the Mental status examination?
1-Mood (extremes) 2-Affect 3-Thought 4-Appearance 5-Cognitive function
What test measures surface activity of the brain by placing electrodes all over the head?
EEG (electroencephalogram)
What are 3 brain imaging techniques?
1-CT (Computed tomograph)
2-MRI (Magnetic resonance imaging)
3-PET (Positron emission tomography)
Which psychotic disorder is the most common and is Dopamine based?
Schizophrenia
*1% of pop. Usually in Poor urban pop.
Having a hard time enjoying yourself and feeling like the world is against you is called?
Anhadonic
Combining words is called?
Neologism
What are the 4 requirements to diagnose Schizophrenia according to DSM-V?
1-Symptoms for more than 6 months
2-Associated with deteriorating functions
3-Active pyschosis
4-Organic, no drug habit involved
What are the 4 subtypes of Schizophrenia?
1-Disorganized (blunt affect, incoherent, Bizarre motor patterns)
2-Catatonic (Rigid posture, gumby like)
3-Paranoid (positive symptoms, persucatory delusions)
4-Residual type (Negative symptoms, non-responsive)
Which type of Schizophrenia responds best to antipsychotics though it may be the scariest to be around?
Paranoid
What 4 things contribute to a poor prognosis for schizophrenia?
1) Chronic onset
2) Negative symptoms
3) Chronic/early onset need care with time
4) Life expectancy shortens (10-20 years shorter, many attempt suicide)
What 4 things are give the best prognosis for schizophrenia?
- Reactive/fast onset (manage stresses, quality of life improves)
- Positive symptoms (delusions, violence etc.)
- Onset late in life (over 30 yr old)
- No family history
What are 5 physical findings in those with Schizophrenia?
1-Enlarged ventricle pattern (atrophy) 2-Decrease in the corpus colusum (connecting hemispheres) 3-Frontal lobe perfusion 4-Altered startle reflex 5- Don’t Yawn
Which 3 neurotransmitters are most involved with schizophrenia?
1-Dopamine (D2 blockers to treat)
2-Serotonin/glutamate (H2 receptors)
3-Nicotine (agonists help with symptoms)
The general population has 1% Schizo, what are the percetanges for mono zygote towns, siblings, and children of Schizo?
1-Monozygote twins: 40-50%
2-Sibling/dizygote twin: 10%
3-1 parent: 10-15%
4-Both parents: 30-40%
“Atypical” antipsychotics block which receptors?
5HT2 (serotonin)
What are the 3 main side effects of D2/5HT2 receptor blockers?
1-Extrapyramidal side effects such as Tardive dyskinesia and Parkinson’s like tremors
2-Psychological (sleepiness)
3-Weight Gain
Which type of schizo drugs are the oldest, least expensive, have less extrapyramidal side effects and are more sedative and weight gaining?
Phenothiazines
*also have antiemetic (nausea) action
Chlorpromazine and Thioridizine are examples of what?
Phenothiazines
Which type of schizo drug has high extrapyramidal side effects, is widely used and lacks anticholinergic action?
Butyrophenones
*Haloperidol is an example
Which group of drugs have little extrapyramidal side effects and are most effective against the negative symptoms in some forms of schizophrenia?
Atypical antipsychotics
Clozapine, an atypical antipsychotic, users need to have blood tested to check for what?
Can cause Agranulocytosis in 1-2%
Clozapine, Quetiapine (Seroquel) and olanzepine (Zyprexa) are examples of what?
Atypical Antipsychotics
*Quetiapine and olanzepine are newer, fewer side effects but expensive
What are two other schizophrenic types that may not be permanent?
1-Acute psychotic disorder
2-Schizoaffective (severe depression, Lincolns wife)
Though we all experience normal sadness, grief and bereavement what percentage of the population suffer from mood disorders?
5%
What are two minor affective disorders?
1-Depression/dysthymia (6% pop, general unhappiness, female gender bias)
2-Cyclothymia (minor bipolar)
What are two major subtypes of major depressive disorders?
1-Post Partum (1-3 weeks after second child)
2-SADS (Seasonal Affective Disorder)
What is the main inconvenience with antidepressant treatments?
- Delayed onset (4-6 weeks)
- about 70% effective
Which antidepressants are the 1st modern drugs and block metablosm of monoamines like serotonin, dopamine, and norepinephrine?
Monoamine Oxidase Inhibitors
What are 5 side effects of Monoamine Oxidase inhibitors?
1-Alter ANS activity 2-Orthostatic hypotension 3-Weight gain 4-Some act as stimulants 5-May interact with certain foods or OTC cold decongestants
Phenelzine and Selegiline are examples of what?
MAO inhibitors
Which group of antidepressants have a long half life and block the uptake of NE and varying affinity for 5HT transporter?
Tricyclic Antidepressants
What are 4 side effects of Tricyclic Antidepressants?
1-Dry mouth (anticholinergic effect)
2-H1 blockade, (hypnotic and antihistamine for itching)
3-Orthostatic hypotension
4-Withdrawal if discontinued abruptly
Amytriptyline, Desipramine and Doxepin are examples of what type of drug?
Tricyclic Antidepressant
Which group of drugs are better tolerated, have mixture of selectivity, minimal withdrawls and are the most popular antidepressants?
Monoamine uptake blockers
Which group of drugs are popular, well tolerated, have a relatively wide margin of safety and no anticholinergic activity?
5HT (SSRIs)
What are 4 side effects of SSRIs?
1-GI upset
2-Sexual dysfunction
3-Depression in adolescents
4-Headaches
Fluoxetine (prozac) and Sertraline (zoloft) are examples of what type of drugs?
5HT (SSRIs)
Which type of antidepressant is reasonably well tolerated, has more cardiovascular side effects and moderately a CNS stimulant?
NE or mixed transport blockers
Venlafaxine (effexor) and Duloxetine (cymbalta) are examples of what?
NE or mixed transport blockers
Manic/depressive swings are characteristic of what disorder?
Bipolar disorder
What are two types of Bipolar disorders?
1-Cyclothymia (minor form)
2-Major Manic depressive (big swings)
Which two types of drugs are used for bipolar disorder?
1-Lithium carbonate (first effective drug)
2-Antiepileptic agents
Often combined with antidepressants, slow onset, likely working by 2nd messenger systems and having varied side effects are characteristic of which group of bipolar drugs?
Lithium carbonate
*narrow therapeutic window, potential kidney damage, weight gain
Valproic acid and carbamazepine are examples of epileptic drugs with fewer side effects that are used for what?
Bipolar disorder
*usually used for maintenance after lithium start
