Pyschosomatic Medicine Flashcards by Kolbie Chancellor

What are the 2 assumptions of Psychosomatic Medicine?

Unity of mind and body

2. Psychological factors must be considered in all disease states

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A medical condition separate from the mental disorder is present? What adversely affects the medical condition?

Psychosomatic Medicine

– psychological factors adversely affect the medical condition

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The Stress Theory involves activation of the?

Sympathetic Nervous system

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When stress activates the sympathetic nervous system, what things occur?

Suppression of immune functioning
Release of catecholamines
Increased 5-HT and DA
CRF triggers release of ACTH

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PCP (phencyclidine) can induce mental disorders. What symptoms will be present?

Agitation with blank stare and Aggression

- Bizarre behavior and stupor

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Corticosteroids can also induce Mental Disorders. What are the symptoms?

Mania

Psychosis with Hallucinations

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Antidepressants can also induce Mental Disorders. What may present in a bipolar patient?

Mania

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Agitation with a blank stare, aggression, bizarre behavior is likely what substance induced mental disorder?

PCP (phencyclidine)

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Mania and Hallucinations is likely what substance induced mental disorder?

Corticosteroids

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Practice and teaching of relation between medical and psychiatric disorders

Consultation-Liason Psychiatry

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What kind of knowledge is essential to Consultation-Liason Psychiatry?

Knowledge of medical AND diagnosis

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Most common reason for Hallucinations?

Delirium Tremems

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What is Delirium?

Reversible confusion, altered sleep patterns and perceptions that fluctuates

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In who is Delirium common?

Elderly

Surgical and ICU patients

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What should you avoid in elderly hospitalized patients and why?

Avoid BENZODIAZEPINES

– Can cause Delirium

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What medication can cause Delirium in elderly hospitalized patients?

Benzodiazepines

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What are some ways to treat Delirium?

Orientation
Cognitive stimulation with family and friends
Inducing normal sleep patterns

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Adjustment Disorders

Development of emotional behavior in response to stressor

- occurs within 3 months of stressor and usually lasts < 6 months

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Emotional behavior in response to an identifiable stressor

Adjustment Disorder

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Onset and Duration for Adjustment Disorders?

Onset: Within 3 months of stressor
Duration: Less than 6 months

What is a Factitious Disorder and example?

Voluntary control of symptoms

– Munchausen’s +/- by proxy

What MSK abnormality can present with psych symptoms?

SLE

– fever, butterfly rash, photosensitivity, joint pains

What psych symptoms can present with SLE?

Mood disturbances, delusions, hallucinations

What psych disorders can increase risk of CAD and MI?

Depression!!!

– Anxiety, type A behavior, anger and mental stress also

Depression can increase risks of what things to occur in the Cardiovascular system?

CAD Stroke MI

What Respiratory abnormality can present with psych symptoms?

Asthma

What psych symptoms may present with Asthma?

Panic disorder/Anxiety | -- Fear of dyspnea makes it worse

What is the cycle that can occur with Asthma and Anxiety/Panic Disorder?

``` Anxiety about dyspnea --> Short of breath or Short of breath --> Anxiety about dyspnea ```

What 3 Endocrine abnormalities may present with psych symptoms?

Hyperthyroidism Hypothyroidism Diabetes

What psych symptoms may present with Hyperthyroidism?

Nervousness Excitability Pressured speech Insomnia

What are the signs of Hyperthyroidism?

Sweating Weight loss Palpitations and increased HR Bulging eyes

What psych symptoms may present with Hypothyroidism?

Lethargy Depressed Paranoia and personality changes

What are the signs of Hypothyroidism?

Cold intolerance Dry skin Weight gain Constipation

What are the signs of Diabetes?

Polydipsia Polyuria Increased levels of Glucose

What psych symptom can present with Diabetes?

DEPRESSION! | -- also frustration/loneliness

What Metabolic abnormality may present with psych symptoms?

Hyponatremia

What are the signs of hyponatremia?

Thirst, polydipsia, coma, seizures

What psych symptoms may present with Hyponatremia?

Confusion Lethargy Personality changes

What vitamin deficiency can present with irritability, psychosis or dementia?

B12

What are the psych symptoms of decreased B12?

Dementia Irritability Psychosis

If B12 is less than ____ you should treat it

< 400

What 2 vitamin deficiencies can present with psych symptoms?

Thiamine (B1) | Cobalamin (B12)

What 3 Hepatic/Pancreatic abnormalities can present with psych symptoms?

1. Pancreatic Carcinoma 2. Acute Intermittent Porphyria 3. Hepatic Encephalopathy

What psych symptoms may present with a Pancreatic Carcinoma?

Depression Anhedonia Apathy and Lethargy

What psych symptoms may present with Acute Intermittent Porphyria?

Depression Agitation, paranoia Hallucinations

What psych symptoms may present with Hepatic Encephalopathy?

Euphoria Disinhibition Psychosis

What type of tumor could present with psych symptoms?

Frontal Lobe Tumor

What are the signs of a Frontal Lobe Tumor?

Mood changes Impaired judgement and memory Loss of speech/smell