Second Flashcards
Cotards syndrome
Nihilistic delusional belief associated with psychotic depression and schizophrenia.
Folie a deux
Shared delusion of one person influenced by another in which the treatment is to separate the two parties.
Post partum depression time frame
Within 4 weeks of delivery
Sexual masochism
Characterized by arousal caused by psychological or physical punishment to self by others.
Sexual sadism
Arousal caused by giving punishment.
What condition is commonly comorbid with microvascular ischemia such as CVA
Depression
Time frame for GAD
6 months
Lifetime prevalence of GAD
33%
What do insufficient serotonin levels lead to in GAD
Insufficient Inhibition of the hypothalamic pituitary axis (HPA) (body’s stress response)
Methylmalonic acid blood test is more sensitive to
Vitamin B12 deficiency
Homocysteine blood test more sensitive to
Folic acid deficiency
Homocysteine is an amino acid that your body naturally breaks down into other substances with the help of vitamin B6, B12, and folic acid.
Adonis complex
Perceive muscles are inadequate
Circumstantial speech
Overly inclusive and includes a lot of unnecessary detail and digressions** but eventually reaches the point.
Tangential Speech
Speech pattern with lots of unecessary details and digressions and never reaches the point
Flight of ideas
Erratic direction changes with an identifiable connection between thoughts
Loosening of Associations
An illogical connection between thoughts, digressing in multiple directions, but sentence structure remains intact.
Somatization disorder
Characterized by multiple complaints not from specific disease states or organs. Symptoms are numerous, unrelated and difficult to measure.
Conversion disorder
sudden onset of single neurological symptom after a significant stress.
when patient presents with anxious/panic cardiac type symptoms, what must be ruled out first and why
Cocaine induced mood disorder b/c it may lead to MI and if you give a BB to reduce anxiety, in the setting of MI due to unopposed alpha beta effects on heart and potential worsening of myocardial ischemia.
What does interpersonal therapy focus on
personal relationships and how they contribute to depression
Supportive psychotherapy
Focuses on strengthening defense mechanisms to restore function and is usually reserved for those with more primitive coping mechanisms.
Koro
A korean delusion that their penis is shrinking into their abdomen
Zar
belief that spirit is posessed (North African & Middle East)
Taijin Kyofusho
Japanese - belief their body is offensive to others
Kuru
Prion disease with neurolodegenerative effects leading to death caused by ritualistic cannabilism of eating brains of deceased.
2 month old behavioral red flags
- Does not respond to loud sounds
- Does not track light or faces around the room
- Does not reciprocate smile
- No hands to mouth
- doesnt hold up head while on tummy
4 month old behavioral red flags
- Shows no affection to caregivers
- No symmetrical eye movement in all directions
- Does not push legs down when placed on a hard surface
- Difficulty bringing things to mouth
- No vowel sound production
- No ability to roll in either direction
- Excessive rigidity or laxed muscle tone
- No laughter or squeeling sounds
6-8 month red flags
- No stringing vowels or consonants together
- no interest in exploring
- No interest in reaching things
Etiology of Rett syndrome
Genetic mutation MECP 2- metabolic disorder
Stage 1 of Retts Syndrome
- 6-18 months gross developmental delay, muscle flacidity, loss of eye contact breath holding
Stage 2of Rett’s Syndrome
Ages 1-4 years - stereotypical hand movements, absence seizures, sleep disorders, irritability, irregular breathing
Stage 3 of Rett’s syndrome
Age 2-10 years, increased rigidity, bruxism, EPS head and neck, seizures, weight loss
Stage 4 Retts syndrome
Older than 10 years - loss of trunk control, plateau of deterioration and seizure activity. Unable to walk.
Demographics of ASD
Onset before age 3, Male to females 4 to 1.
Characteristics of DMDD
- Disruptive Mood dysregulation disorder
- temper outbursts three times per week for at least 12 months with at least a 3 month period that is asymptomatic
- Persistent angy, irritable mood nearly every day between outbursts
- Verbal or physical aggression towards people grossly out of proportion to provocation
Reactive attachment disorder characteristics
severely disturbed relationships usually beginning before age 5
Which symptom is more commonly associated with children and not adolescence with MDD
psychomotor agitation, anxious, irritable, selective mute, flat affect
Examples of tasks a 3 year old can complete
ride a tricycle, know age and gender differences
Which age can chidren copy a circle, square
- circle - 24 months
- square - 5 years old
What is the differentiation stage and what disorder can arise if this stage is not successfully accomplished
Starting at age 6 months, child goes from checking in to playing nearby. Child may use a transitional object to soothe themselves. Difficulties in this stage may lead to borderline personality disorder.
What is the practicing stage and what disorder can arise due to difficulties in accomplishing this stage.
Overlaps from age 6 months to 18 months of age, developing a sense of autonomy, walkng and exploring the world. Engages in games that reassurance of caregiver and independence of child. Issues during this stage can give rise to narccistic personality disorder.
What is the stage of rapproachment and what can arise with difficulties during this stage. (Mahler)
Overlaps from age 15 months to 24 months. Characterized by child realizing their limits. Pulling away from aggression and running towards caregivers. Child attempts to reconcile autonomy with need for others. Issues in this stage can lead to borderline personality traits of splitting and projection.
What is object constancy stage and which disorder can arise.
Age 24-36 months. The child can hold a picture of the caregiver in mind while differentiating self and others. Consolidates dependency and consistency of caregivers. Problems may give rise to schizoid personality disorder.
Cluster A personality disorders
- Characterized by unusual thoughts or eccentric behaviors
- Includes paranoid personality disorder, schizoid, and schizotypical.
Paranoid personality disorder
Pervasive, persistent, and consistent mistrust of people.
Schizoid personality disorder
Pervasive detachment from social relationships and restricted range of expression of emotions in interpersonal settings.
Schizotypal personality disorder
Persistent pattern of social deficits characterized by acute discomfort and reduced capacity for close relationships complicated by cognitive and perceptual distortions and eccentric behaviors.
Cluster B personality disorders
Dramatic expression of fluctuating emotions, affective instability.
* Borderline personality disorder
* Narccistic personality disorder
* Antisocial personality disorder
* Histrionic
Antisocial personality disorder and ages for dx
A consistent disregard for the rights of others since the age of 15. Cannot be diagnosed until age 18.
Borderline personality disorder
Unstable sense of self, unstable interpersonal relationships, chronic feelings of emptiness, exacerbated by extreme separation anxiety, inability to be alone and persistent concern for the availability of others to help reduce the internal distress.
Histrionic personality disorder
Pervasive, persistent pattern of excessive emotionality and other attention-seeking behaviors.
Narcisstic Personality Disorder
Peristent inferiority complex overcompensated by the overinflated sense of importance and being perceived as special. Feel entitled yet depended on other with whom they often lack empathy and concern. The grandiosoty serves as a defense against not feeling valued while defensively putting off their need for others, despite craving constant admiriation and reassurance.
Cluster C personality Disorders
Consistent and persistent pattern of fear and anxiety with maladaptive coping mechanisms (avoidance, procrastination, difficulty in following through, difficulty unwinding) motivated by fear of rejection or criticism.
OCD, Dependent, avoidant
Avoidant personality disorder
Cluster C - pervasive pattern of social inhibition, feelings of inadequacy, hypersensitivity to perceived criticism or real.
Dependent personality disorder
Cluster C - consistent and pervasive pattern of maladaptive behaviors from an excessive need to be cared for leading to submissive and clinging behaviors. Hoping to reduce the chance of separation.
What is psychoanalysis best suited for
People in late adolescence and early adulthood to examine unconcious motivations of past and present situations which takes place over the course of several years.
Failing to master what stage inhibits the development of purpose and, virtue leading to children remain followers, lack self-initiative, and can feel like they are a bother to others.
Failure to master initiative versus guilt.
What developmental stage are middle school children in?
Industry versus inferiority and moving toward identity versus role confusion.
Dysdiadochokinesia and what part of brain is effected
Inability to perform rapidly alternating hand movements, cerebellum
Astereognosis
Unable to discriminate between objects based on touching
Reaction formation
When a person reacts in the opposite way of how they feel or they want to feel in order to hide their true feelings.
Sublimation
Substituting a socially acceptable constructive activity for a robust contrasting impulse. “A woman puts negative energy into a home improvement project after a breakup”
Name most common tricyclics
End in tryptaline, pramine, franil
“at the pramiere, fran tryped”
1. amitriptyline (elavil)
2. nortriptyline (Pamelor)
3. imipramine (tofranil)
4. clomipramine (anafranil)
5. desipramine (norpramin)
6. doxepin (silenor)
MAOI - most common
- tranylcypromine (parnate)
- isocarboxazid (marplan)
- phenelzine (nardil)
- slegeline
“TIPS”
Name a purpose of a defense mechanism
resolve conflict associated with ego-dystonic stimuli
Primary prevention
Reduce incidence of disease or condition
Secondary prevention
aims to detect a condition early and prevent it from getting worse
Tertiary prevention
Enhance the quality of life after the disease or condition occurs
What does medicare part B cover
durable medical equipment, outpatient appointments, and ambulance services
DBT involvrd reconciling the tension to find the truth between
Radical acceptance and change
Strategic therapy
uses the paradoxical directive to effect a change in behavior
Just Culture
ANA’s statement on promoting open and fair interprofessional collaboration aimed at reducing human error.
What teratogenic effect does depakote have and when
1st trimester- Neural tube defect - spina bifida most common (also heart defect, cleft lip and palate.)
Lithium causes what type of teratogenic effect and when
Cardiac malformations first trimester (ebstein anomaly - tricuspid valve)
Clozapine and ANC requirements
- Must be stopped for an ANC less than 1000.
- Prior to starting the ANC should be greater than 1500
cluster B personality disorders
The dramatic type - antisocial, narcisstic, borderline, histrionic