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CLASS 22005 PSYCH > REVIEW > Flashcards

REVIEW Flashcards

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1
Q

“the complex somatic, cognitive, affective, and behavioral effects of psychological
trauma”

A

PTSD

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2
Q

PTSD

Several behavior responses in response to regular stimuli

A

1) Flashbacks
2) Severe anxiety symptoms
3) Fleeing
4) Combative behaviors

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3
Q

Focus of the Independent Duty Corpsman for PTSD

A

screening

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4
Q

PTSD

Symptoms must be present for at least ___following trauma for psychiatry
to make the diagnosis

A

four weeks

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5
Q

PTSD

Treatment
(a) Psychotherapy

A

1) Exposure therapy
2) CBT (Cognitive Behavioral Therapy)
3) EMDR (Eye Movement Desensitization and Reprocessing

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6
Q

PTSD

Treatment
Medications

A

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

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7
Q

Consider a broad differential when evaluating a patient with weight loss, examples
include but not limited to:

A

(a) Hyperthyroidism
(b) Malignancy
(c) Diseases of the GI tract
(d) Chronic Infectious diseases
(e) Affective disorders (depression)

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8
Q

Common physical exam findings for Anorexia Nervosa

A

(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

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9
Q

Diagnostic Criteria for Bulimia nervosa

A

1) Self-induced vomiting
2) Misuse of laxatives
3) Diuretic use
4) Enemas
5) Fastin
6) Excessive exercise

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10
Q

Time frame for bulimia

A

on average at least once per week for three months

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11
Q

Associated features for bulimia

A

(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

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12
Q

(a) Eating of nonfood substances
1) Chalk, dirt, hair, metal, etc
(b) Inappropriate eating behavior for developmental level

A

PICA

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13
Q

PICA Associated with

A

iron deficiency anemia

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14
Q

substance abuse triad

A

(1) Psychological dependence or craving
(2) Physiologic dependence
(3) Tolerance

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15
Q

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

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

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16
Q

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

a) More than 7 standard drinks per week on average

b) More than 3 drinks on any day

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17
Q

Screening pneumonic for alcoholism

A

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?

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18
Q

Wernicke Korsakoff syndrome caused by

A

Due to a deficiency of Thiamine (Vitamin B1)

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19
Q

(1 Direct damage to the brain caused by thiamine deficiency

(a Demyelination, atrophy, hemorrhages, vascular congestion

A

Wernicke encephalopathy

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20
Q

Wernicke encephalopathy Triad

A

Encephalopathy
Oculomotor dysfunction
Gait ataxia

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21
Q

Wernicke encephalopathy

Most common symptom

A

Confusion

22
Q

Chronic neuro condition

(1 Usually a consequence of WE

A

Korsakoff syndrome

23
Q

Korsakoff syndrome Causes

A

anterograde and retrograde amnesia

24
Q

a potentially life threatening problem

A

Alcohol Withdrawal

25
Q

Alcohol Withdrawal

Mild Withdrawal symptoms

A 
Symptoms generally begin within 6 to 24 hours of last drink 
(1 Anxiety 
(2 Minor agitation 
(3 Restlessness 
(4 Insomnia 
(5 Tremor 
(6 Diaphoresis 
(7 Palpitations 
(8 Headache 
(9 Alcohol craving
26
Q

Alcohol Withdrawal

More severe symptoms

A

hallucinations (12-24 hours and resolves in another 1-2 days )
seizures (Occur within about 6 to 48 hours of last drink)
delirium (Begins within 72-96 hours after last drink )

27
Q

Leading preventable cause of mortality worldwide

A

Tobacco

28
Q

Smoking cessation has mortality benefit for

A

both men and women of all ages

29
Q

Treatment of nicotine withdrawal

A

1) Nicotine replacement therapy
2) Buproprion (Wellbutrin)
3) Varenicline (Chantix)

30
Q

Nicotine replacement therapy

Long acting

A

Nicotine patch

31
Q

Nicotine replacement therapy

Short acting

A

Gum or lozenges available

32
Q

a) Used for both depression and smoking cessation
b) Considered an atypical antidepressant
c) Inhibits reuptake of norepinephrine and dopamine as well as act as
nicotinic receptor antagonist
d) Reduces nicotine cravings and withdrawal symptoms

A

Buproprion (Wellbutrin)

33
Q

a) Partial nicotine agonist
b) Stimulates dopamine activity but to a much smaller degree than nicotine
c) Reduces cravings and withdrawal symptoms

A

Varenicline (Chantix)

34
Q

Withdrawal can cause insomnia, nausea, myalgia, and irritability

A

Cannabis Use Disorder

35
Q

(a) Vital signs changes include change in heart rate (decreased or increased) and
decreased blood pressure, respiratory rate, and temperature
(b) GI: Decreased bowel sounds
(c) Neuro: Sedation
(d) Ophthalmologic: Miosis

A

acute opioid toxicity

36
Q

Always check a ____ in suspected opioid intoxication

A

serum glucose concentration

37
Q

____is the treatment of choice for acute opioid intoxication

A

Naloxone

38
Q

Bipolar disorder is a mood disorder that is characterized by three different mood states

A

(1) Mania
(2) Hypomania
(3) Major depression

39
Q

A distinct period of abnormally or persistently elevated, expansive, or irritable mood
and persistently increased activity or energy, lasting at least one week and present mods
of the day, nearly every day

A

Mania

40
Q

Bipolar Disorder

Three or more of the following symptoms must be present

A

(a) Inflated self-esteem or grandiosity
(b) Decreased need for sleep
(c) More talkative than usual or pressured speech
(d) Flight of ideas/racing thoughts
(e) Distractibility (easily distracted by stimuli)
(f) Increased goal directed activity
(g) Involvement in activities that carry negative potential (spending sprees, sexual
indiscretions)

41
Q

The acronym to remember the symptoms of mania

A

“DIG FAST”

D - Distractibility 
I - Indiscretions 
G - Grandiosity 
F - Flight of ideas 
A - Activity increase 
S - Sleeplessness 
T – Talkativeness
42
Q

(1) Similar characteristics of mania only far less severe

A

Hypomania

43
Q

Major Depression

(1) Five or more of the following symptoms present during the same two week period

A

(a) Depressed mood (sad, empty, hopelessness)
(b) Diminished interest in pleasurable activities
(c) Weight loss or weight gain
(d) Insomnia or hypersomnia
(e) Psychomotor agitation (tapping, fidgeting, pacing, hand-wringing) or retardation
(reduced physical movements and slowing of thoughts)
(f) Decreased energy
(g) Guilt or feelings of worthlessness
(h) Impaired concentration
(i) Thoughts of death or thoughts of suicide

44
Q

IDC management of Bipolar Disorder

A

(1) Immediately refer and manage acute symptoms while awaiting referral
(a) If agitated may try to talk them down or give an antipsychotic medication for
assistance
1) Haloperidol if needed prior to MEDEVAC

45
Q

Most common psychiatric disorder in the general population

A

Depression

46
Q

Risk factors for Depression

A

(a) Family history
(b) Female gender
(c) Childbirth (postpartum depression)
(d) Childhood trauma
(e) Stressful life events
(f) Poor social support
(g) Serious medical illness
(h) Substance abuse

47
Q

depression screening template

A

PHQ-9 Depression Questionnaire

48
Q

pneumonic used by primary care clinicians to quickly screen for
depression when forms such as PHQ-9 are not utilized or available

A

SIGECAPS

S- Sleep changes: Increased during day or decreased at night
I- Interest (loss): Of interest in activities that used to interest them
G- Guilt (worthless): Depressed people tend to devalue themselves
E- Energy (lack): Common presenting symptom is fatigue
C- Concentration: Reduced concentration and cognition
A- Appetite: Usually declined appetite. Sometimes also increased
P- Psychomotor agitation: Anxious feelings or lethargic feelings
S- Suicide/death preoccupation

49
Q

The mainstays of therapy for depression

A

psychotherapy, pharmacotherapy, or both

50
Q

There are two classes of medications that are typically used for depression

A

1) SSRIs: Selective Serotonin Reuptake Inhibitors
a) Fluoxetine, paroxetine, sertraline, escitalopram, citalopram
2) SNRIs: Serotonin- Norepinephrine Reuptake Inhibitors
a) Venlafaxine, duloxetine

51
Q

Common side effects include of SSRIs and SNRIs

A

a) Sexual dysfunction
b) Drowsiness
c) Weight gain
d) Insomnia
e) Anxiety
f) Dizziness
g) Headache
h) Dry mouth
i) Blurred vision
j) Nausea
k) Rash
l) Tremor
m) Constipation
n) Abdominal pain/stomach upset

52
Q

Time period varies but usually described as depression occurring within the first 12
months after delivery.

A

Post-Partum Depression

CLASS 22005 PSYCH (6 decks)

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