Pyschosomatic Medicine Flashcards
What are the 2 assumptions of Psychosomatic Medicine?
- Unity of mind and body
2. Psychological factors must be considered in all disease states
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
The Stress Theory involves activation of the?
Sympathetic Nervous system
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
PCP (phencyclidine) can induce mental disorders. What symptoms will be present?
Agitation with blank stare and Aggression
- Bizarre behavior and stupor
Corticosteroids can also induce Mental Disorders. What are the symptoms?
Mania
Psychosis with Hallucinations
Antidepressants can also induce Mental Disorders. What may present in a bipolar patient?
Mania
Agitation with a blank stare, aggression, bizarre behavior is likely what substance induced mental disorder?
PCP (phencyclidine)
Mania and Hallucinations is likely what substance induced mental disorder?
Corticosteroids
Practice and teaching of relation between medical and psychiatric disorders
Consultation-Liason Psychiatry
What kind of knowledge is essential to Consultation-Liason Psychiatry?
Knowledge of medical AND diagnosis
Most common reason for Hallucinations?
Delirium Tremems
What is Delirium?
Reversible confusion, altered sleep patterns and perceptions that fluctuates
In who is Delirium common?
Elderly
Surgical and ICU patients
What should you avoid in elderly hospitalized patients and why?
Avoid BENZODIAZEPINES
– Can cause Delirium
What medication can cause Delirium in elderly hospitalized patients?
Benzodiazepines
What are some ways to treat Delirium?
Orientation
Cognitive stimulation with family and friends
Inducing normal sleep patterns
Adjustment Disorders
Development of emotional behavior in response to stressor
- occurs within 3 months of stressor and usually lasts < 6 months
Emotional behavior in response to an identifiable stressor
Adjustment Disorder
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?
- Pancreatic Carcinoma
- Acute Intermittent Porphyria
- 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
