REVIEW Flashcards
“the complex somatic, cognitive, affective, and behavioral effects of psychological
trauma”
PTSD
PTSD
Several behavior responses in response to regular stimuli
1) Flashbacks
2) Severe anxiety symptoms
3) Fleeing
4) Combative behaviors
Focus of the Independent Duty Corpsman for PTSD
screening
PTSD
Symptoms must be present for at least ___following trauma for psychiatry
to make the diagnosis
four weeks
PTSD
Treatment
(a) Psychotherapy
1) Exposure therapy
2) CBT (Cognitive Behavioral Therapy)
3) EMDR (Eye Movement Desensitization and Reprocessing
PTSD
Treatment
Medications
Antidepressant medications (SSRIs) are the first line therapy of choice
a) Ie: Sertraline
2) Other adjuncts may be used based on symptoms
a) Prazosin for nightmares
b) Beta blockers for tremors and sympathetic responses
c) Antipsychotics for comorbid psychosis if needed
Avoid benzodiazepines due to safety and dependency issues
Consider a broad differential when evaluating a patient with weight loss, examples
include but not limited to:
(a) Hyperthyroidism
(b) Malignancy
(c) Diseases of the GI tract
(d) Chronic Infectious diseases
(e) Affective disorders (depression)
Common physical exam findings for Anorexia Nervosa
(a) Low BMI (<17.5)
(b) Emaciation
(c) Hypothermia
(d) Bradycardia
(e) Hypotension
(f) Hypoactive bowel sounds
(g) Xerosis (dry and scaly skin)
(h) Brittle hair and hair loss
(i) Lanugo body hair
(j) Abdominal distention
Diagnostic Criteria for Bulimia nervosa
1) Self-induced vomiting
2) Misuse of laxatives
3) Diuretic use
4) Enemas
5) Fastin
6) Excessive exercise
Time frame for bulimia
on average at least once per week for three months
Associated features for bulimia
(a) Mild psychosocial impairment seen in about 78% and severe impairment in 16%
(b) Body weight usually within or above normal range***
(c) Neurocognitive functioning (decision making) impaired
(d) Emotional dysregulation is common
(e) Self- harm is often seen
(f) Additional psychiatric disorders are common:
1) Anxiety, depression, PTSD, substance abuse, ADHD, conduct disorders,
personality disorders
(a) Eating of nonfood substances
1) Chalk, dirt, hair, metal, etc
(b) Inappropriate eating behavior for developmental level
PICA
PICA Associated with
iron deficiency anemia
substance abuse triad
(1) Psychological dependence or craving
(2) Physiologic dependence
(3) Tolerance
Alcohol Use Disorder
Nation Institute of Alcohol Abuse and Alcoholism (NIAAA) has estimated
consumption amounts of alcohol that increase health risks:
1) Men under age of 65
a) More than 14 standard drinks per week on average
(1 Standard drink: 5 oz of wine, 12 oz beer
b) More than 4 drinks on any day
Alcohol Use Disorder
Nation Institute of Alcohol Abuse and Alcoholism (NIAAA) has estimated
consumption amounts of alcohol that increase health risks:
1) women under age of 65
a) More than 7 standard drinks per week on average
b) More than 3 drinks on any day
Screening pneumonic for alcoholism
CAGE
a) Have you ever felt you should Cut down on your drinking?
b) Have people Annoyed you by criticizing your drinking?
c) Have you ever felt bad or Guilty about your drinking?
d) Have you ever taken a drink first thing in the morning (Eye opener) to steady
your nerves or get rid of a hangover?
Wernicke Korsakoff syndrome caused by
Due to a deficiency of Thiamine (Vitamin B1)
(1 Direct damage to the brain caused by thiamine deficiency
(a Demyelination, atrophy, hemorrhages, vascular congestion
Wernicke encephalopathy
Wernicke encephalopathy Triad
Encephalopathy
Oculomotor dysfunction
Gait ataxia
Wernicke encephalopathy
Most common symptom
Confusion
Chronic neuro condition
(1 Usually a consequence of WE
Korsakoff syndrome
Korsakoff syndrome Causes
anterograde and retrograde amnesia
a potentially life threatening problem
Alcohol Withdrawal
