Quick Learn UWorld Flashcards
Define displacement
Transfer of another’s attack on you onto a more acceptable object
Define conversion disorder:
Altered neuro function precipitated by psychological stressor
Treatment for conversion disorder?
Education + self-help techniques = 1st line
Cognitive behavioral therapy = 2nd line
What makes somatic symptom disorder different from conversion disorder?
Somatic: 1+ persistent physical symptoms
- with disproportionate and excessive anxiety
Underlying symptoms are physiologic, but minor
Symptoms of postpartum psychosis?
Delusions
Hallucinations
Disorganized thought
Bizarre behavior
Believe a famous actor loves them in absence of other psychotic symptoms?
Delusional disorder
- firmly held beliefs despite conflicting evidence
Thoughts in other areas are normal (able to hold down a job)
Brain changes in schizophrenia?
Lateral ventricular enlargement
Predictors of future suicide?
1 - prior suicide attempt
Elderly white men high risk
Suicide protective factors:
Social support/family connectedness
Pregnancy
Parenthood
Religion & religious participation
When think schizoaffective disorder?
When 2+ weeks absence of MDD or manic episode when did have psychotic symptoms
Lifetime history delusions or hallucinations > 2 weeks
Clozapine vs. Clonidine?
Clonidine - alpha2 agonist - treat HTN, ADHD, anxiety
Clozapine - 2nd gen atypical antipsychotic; agranulocytosis
If maybe diagnosis but no impairment of social and occupational functioning…
…not a psychiatric disorder
Marijuana intoxication?
Bloodshot eyes (conjunctival injection) Dry mouth Tachycardia Slow reaction time Euphoria/relaxation Anxiety/paranoia
Heroin/Opioid intoxication?
Depressed mental status
Miosis - pinpoint pupils (normal is 2-4mm)
Respiratory depression
Euphoria
Opioid/Heroin withdrawal?
Lacrimation Pupillary dilation Yawning Diaphoresis N/V/Diarrhea
Major depressive episode
- length?
- symptoms?
2+ weeks of
- depressed mood
- anhedonia
- sleep disturbance
- guilt
- impaired energy, motivation, concentration
Treatment for major depressive episode?
Bupropion - NE & D reuptake inhibitor
- mild stimulant effects
- NO sexual SE’s
Tardive dyskinesia
- describe
Hyperkinetic / Dyskinesia
Orofacial: tongue protrusion, lip smacking
Limb: foot tapping, chorea
Trunk: rocking, thrusting, shoulder shrug
Tardive dyskinesia
- treatment?
Prolonged exposure to dopamine receptor blocking drugs
- reduce dose
- switch to clozapine
Which antipsychotic is least likely to cause EPS?
Clozapine
Can you treat TD with:
- anti-cholinergics
- dopaminergic meds
- beta blockers
No, no, no
Those can be used to treat EPS
Acute dystonia
- timing
An EPS
- occurs shortly after starting antipsychotic med
Acute dystonia
- describe
Muscle spasm or stiffness
Torticollis: wry neck
Opisthotonus: body arching
Oculogyric crisis: upward deviation of eyes
How treat EPS (but not TD)?
- anti-cholinergics (benztropine - acute dystonia, parkinsons)
- dopaminergic meds (amantadine - parkinsons)
- beta blockers
- antihistamine (diphenhydramine - has strong anti-cholinergic - acute dystonia)
