qbank question review Flashcards
schizophrenic pt imaging findings
EEG studies may also show increased theta and delta activity, in addition to decreased alpha activity. On PET scan, there is found an increase in D 2 receptors in the caudate nucleus of drug-free schizophrenics. Eye movement dysfunction may be a trait marker for schizophrenia. CT scans have consistently shown enlarged lateral and third ventricles, as well as reductions in cortical volume.
contraindications to hypnosis
Paranoid delusions and hx of brain trauma
Flumazenil
Flumazenil decreases seizure threshold.
Caffeine induced sleep disorder
The sleep disorder caused by caffeine can produce a delay in falling asleep, an inability to remain asleep, and/or early morning awakening.
Time frame for risk of depression disorder after CVA
2 years
Benzo’s independent of liver function/metabolism
Lorazepam
Oxazepam
Tamazepam
Opiate withdrawal
Craving, anxiety, dysphoria, yawning, lacrimation, pupil dilatation, rhinorrhea, and restlessness followed by piloerection (cold turkey), twitching muscles and kicking movements of the lower extremities (kicking the habit), nausea, vomiting, diarrhea, low-grade fever, and increased blood pressure, pulse, and respiratory rate.
Normal beravament
Guilt about things other than actions taken or not taken by the survivor at the time of the loved one’s death,
Thoughts of death other than the survivor feeling he/she would be better off dead without the loved one,
A morbid preoccupation with worthlessness.
Marked psychomotor retardation
Marked and prolonged functional impairment
Hallucinations other than the survivor believing he/she can hear the voice or see the loved one.
Mature defense mechanism
Sublimation, humor, altruism, asceticism (abstinence from pleassure), anticipation, and suppression
Hereditary Alzheimer’s disease age of presentation and gene involved
Presents between ages 40-50.
Majority due to mutation in Presinilin 1 on chromosome 14
Minority due to mutation in Presinilin 2 on chromosome 1
Preferred treatment for psychosis in Parkinson’s disease
Clozapine.
Because of its relative sparing of the nigrostriatal dopaminergic system and its anti-cholinergic effects, clozapine does not worsen and may in fact ameliorate parkinsonian symptoms.
Amphetamine intoxication
Can result in psychosis resembling acute paranoid schizophrenia. Symptoms include paranoid delusions and visual hallucinations.
Histrionic personality disorder
Characterized by a chronic pattern of excessive emotionality and attention seeking. Pts need attention and act inappropriately seductive. Pts may use physical appearance to draw attention to themselves. Speech is dramatic an superficial, lacking in detail.
Dependent personality disorder
Chronic and excessive need to be taken care of. Leads to submissive, clinging behavior. Tend to have unrealistic fears/preoccupation with being alone.
SADPERSONS
Risk factors for suicide. Sex Age Depression or hopelessness (2) Previous attempt/psych care Excessive etoh/drugs Rational thinking loss (2) Organized/serious attempt (2) No social support Stated future attempt (2)
Common complaints of long term lithium use
Weight gain, metallic taste, acne, hypothyroidism, and polyuria
Treatment for cataplexy
SSRI
TCA
MAOI
Main defense mechanism in OCD
Undoing, a compulsive act perform in attempt to negate/avoid consequences of fantasized action from obsessional impulse.
Isolation:
Reaction formation:
Psychosis in pt with hypotension?
High potency neuroleptics such as Haloperidol and Fluphenazine are preferred. These have less anticholinergic effects, thus decreased chance of orthostatic hypotension
Capgras syndrome
Delusion in which pt believes that familiar people have been replaced by impostors.
Cocaine intoxication
High blood pressure, mydriasis (dilated pupils), cardiac arrhythmias, coronary artery spasms, and myocardial infarcts.
List of MAOI
Tranylcypromine
Phenelzine
Isocarboxazid
Tyramine reaction
MAOI + tyramine, leads to sympathomimetic reaction. Presents as headache, hypertension, diaphoresis, mydriasis, neck stiffness, pallor, neuromuscular excitation, palpitations, and chest pain.
Abrupt d/c SSRI
common physical symptoms are dizziness, nausea, vomiting, lethargy, flu-like symptoms (chills and aches), and sensory and sleep disturbances.
Commonly reported psychological symptoms are irritability, anxiety, and crying spells. Symptoms usually emerge 1 to 3 days after the last dose.
Drugs to avoid in EtOH withdrawal
Antipsychotics, they can further lower the seizure threshold.
