SJSM Block 3 Flashcards
Sex:
Describe the 4 categories of sexual dysfunctions
- Sexual desire disorder.
- Sexual arousal disorder
- Orgasmic disorder
- Sexual pain disorders
Sex:
Differential diagnosis
PENIS
Psychological (erection during REM)
Endocrine (diabetes or low testosterone)
Neurological (Post-op or spinal cords injury)
Insufficient blood flow (Atherosclerosis)
Substances (drugs)
Sex:
Drugs to treat vaginal dryness
Antihistamine (diphenhydramine)
&
Anticholinergics (atropine)
Sex:
Antihistamine (diphenhydramine)
&
Anticholinergics (atropine)
Drugs for vaginal dryness
Sex:
Drugs to treat inhibited orgasm in males & females
Antidepressants (Fluoxetine)
Sex:
Drugs to treat priapism
Antidepressants (Trazodone: Atypical)
&
Cocaine
Sex:
Antihistamine (diphenhydramine)
&
Anticholinergics (atropine)
Drugs to treat priapism
Sex:
Drugs to treat ejaculation
Antidepressants (Fluoxetine)
&
Antipsychotics (Thioridazine)
Sex:
Antidepressants (Fluoxetine)
&
Antipsychotics (Thioridazine)
Drugs to treat ejaculation
Sex:
Short term effects of alcohol & weed
High sexuality because lowered inhibitions
Sex:
Long term effects of alcohol
Liver dysfunction & higher estrogen causing sexual dysfunction in men
Sex:
Long term effects of weed
Low testosterone in males
Sex:
Describe the effects of SSRIs
Low dopamine
Low arousal
Low NO
Low libido
High serotonin
Vasoconstriction
Sex:
Heroin & methadone are used to treat
Suppress libido
Retarded ejaculation
Failure to ejaculate
Sex:
Amyl nitrate is used as a
an aphrodisiac (because its a vasodilator)
Sex:
Amphetamines & cocaine have what effect
Increase sexuality because they stimulate dopaminergic systems. They can be used to treat priapism
Sex:
Describe urophilia
aka a golden shower, when someone has a sexual desire to pee on their partner or get peed on
Sex:
Pedophilia
Sexual attraction to kids
The golden shower, when someone has a sexual desire to pee on their partner or get peed on
Urophilia
Sexual attraction to kids
Pedophilia
Sexual sadism
Arousal when inflicting pain/humiliation
Masochism
Arousal when receiving pain or being humiliated
Arousal when receiving pain or being humiliated
Masochism
Arousal when inflicting pain/humiliation
Sexual sadism
Describe voyeurism
A peeping tom, someone who gets off on watching others get frisky
A peeping tom, someone who gets off on watching others get frisky
voyeurism
Describe incest
Sexual attraction to a family member (daddy issues to the max)
Describe Telephone scatologia
when someone calls unsuspecting strangers to initiate sexual conversation (NOT CONSENSUAL!)
when someone calls unsuspecting strangers to initiate sexual conversation (NOT CONSENSUAL!)
Telephone scatologia
Describe Zoophilia
Arousal associated with animals (especially if they’ve been trained to participate in sexual activity ~ew)
Arousal associated with animals (especially if they’ve been trained to participate in sexual activity ~ew)
Zoophilia
Coprophilia
(crap-o-phile) someone who gets pleasure from poop, either pooping on their partner, getting pooped on, or even eating
(2 girls & a cup =gross)
(crap-o-phile) someone who gets pleasure from poop, either pooping on their partner, getting pooped on, or even eating
(2 girls & a cup =gross)
Coprophilia
Describe coprolalia
When someone gets off on compulsive utterance of obscenities (usually fixated in anal stage)
When someone gets off on compulsive utterance of obscenities (usually fixated in anal stage)
coprolalia
Describe klismaphilia
When someone incorporates enemas into sexual activities
When someone incorporates enemas into sexual activities
klismaphilia
Medical conditions associated with sexual dysfunction:
Explain how MI’s have the capacity to impair sexual functioning for males/females in a psychological & physical way
MIs can make someone worried about fear of having another MI or experiencing the negative side effects of their medications (prescribed for the MI)
This can lower libido and lead to erectile dysfunction
If patients are able to maintain activity around 110-130HR without SOB & choose less exertive positions during sex they may be more inclined to engage in sexual behavior
Medical conditions associated with sexual dysfunction:
Explain how diabetes has the capacity to impair sexual functioning for males in a psychological & physical way
Mostly physical:
Erectile dysfunction
Vascular insufficiency
both can be treated with Sildenafil (viagra)
Medical conditions associated with sexual dysfunction:
Explain how spinal cord injuries have the capacity to impair sexual functioning for males/females in a psychological & physical way
Males:
Erectile & orgasmic dysfunctions leading to retrograde ejaculation (cum into the bladder), & long refractory periods
Females:
Vaginal lubrication dryness, pelvic Vaso-congestion, & orgasmic dysfunction
Sex:
Antidepressants (Fluoxetine)
&
Antihypertensives (Propanolol & methyldopa)
are used to treat
Low libido
What drugs are best to treat low libido?
Antidepressants (Fluoxetine)
&
Antihypertensives (Propanolol & methyldopa)
What are the drugs to treat high libido?
Antiparkinsonian (L-Dopa)
Antiparkinsonian (L-Dopa) is used to treat what?
high libido
What drugs are used to treat erectile dysfunction
Antidepressants (Fluoxetine)
Antihypertensive (Propranolol & Methyldopa)
Antipsychotic (Thioridazine)
Antidepressants (Fluoxetine)
Antihypertensive (Propranolol & Methyldopa)
Antipsychotic (Thioridazine)
are used to treat what?
erectile dysfunction
Sexual pain disorders:
Painful spasms of the 1/3 outer vagina causing difficult penetration or vaginal exams
Primary (psychological: sexual abuse, taught immorality, & fear of pain upon penetration)
Secondary (Physical infection or birth trauma)
Vaginismus
Vaginismus
Painful spasms of the 1/3 outer vagina causing difficult penetration or vaginal exams
Primary (psychological: sexual abuse, taught immorality, & fear of pain upon penetration)
Secondary (Physical infection or birth trauma)
Painful sexual disorders:
Pain during penetration
PID (Chlamydiosis or gonorrhea)
Retroverted uterus, endometriosis, or drugs
Dyspareunia
Describe Dysparenunia
Painful sexual disorders:
Pain during penetration
PID (Chlamydiosis or gonorrhea)
Retroverted uterus, endometriosis, or drugs
Describe fetishism
Sexual attraction to inanimate objects (shoes)
Sexual attraction to inanimate objects (shoes)
Describe fetishism
Describe Transvestic fetishism
Arousal when cross-dressing
Describe fetishism
Transvestic fetishism
Describe Exhibitionism
Someone gets sexual gratification from exposing their genitals to strangers
Someone gets sexual gratification from exposing their genitals to strangers
Exhibitionism
Describe Frotteurism
Someone rubbing their penis against a clothed & unaware/un-consenting person
Someone rubbing their penis against a clothed & unaware/un-consenting person
Frotteurism
Describe necrophilia
Somone doing sexual activities with dead bodies
What is Sildenafil citrate used to treat
treats erectile disfunctions by inhibiting PDE’s
Psychological treatments:
Masturbation is used to treat
Orgasm dysfunction
Yahimbine is used to treat what
Erectile dysfunction
SSRI’s (Fluoxetine are used to treat
premature ejaculation
Psychological treatments:
Squeeze technique is used to treat
Premature ejaculation
Psychological treatments:
Sensate focus exercise is used to treat
Arousal, Desire, & Orgasm disorders
Snap Guage aka Nocturnal Penile Tumescence testing is used to determine what?
If erectile dysfunction is psychological or physical, ex. if they get an erection during REM the problem is likely psychological
Stages of the sexual response cycle includes
- Excitement/arousal stage
- Plateau phase (pre-orgasm)
- Orgasm
- Resolution (arousal decreases aka post orgasm)
- Desire (sexual cues/desires/fancies)
- Refectory period (men can’t be stimulated immediately post orgasm)
Female sexual cycle
Male sexual cycle & refractory period
Describe female sexual arousal disorder (FRIGIDITY)
Can’t maintain vaginal lubrication during sex despite stimulation
Describe male sexual arousal disorder (Impotence)
Can’t maintain an erection
primary: life-long
secondary: acquired used to be able to but now can’t maintain an erection
Situational: turn off
Sexual desire disorder (low libido)
Describe hypoactive sexual desire disorder
Lower interest in sex
Sexual desire disorder (low libido)
Describe sexual aversion disorder
Disordered excitement phase
Lower testosterone/estrogen
Triggers (stress, aging, fatigue, pregnant, SSRI’s, & depression etc)
Hitting someone can be described as
Physical + Active
Not shaking someone’s hand is described as
Physical + Passive
Name calling someone is described as
Verbal + Active
Not saying hello is described as
Verbal + Passive
Describe instinct theory
The idea that evolution has made humans inherit fighting instinct like animals (we exert aggression on others as catharsis)
Describe social learning theory
The idea that human aggression is mostly learned from watching others behaviors either in person or in movies or its also learned when our aggressive behavior is rewarded
Describe frustration-aggression hypothesis
Our motivation for aggression increases when our ongoing behavior is interrupted or we’re prevented from reaching a goal
Our motivation for aggression increases when our ongoing behavior is interrupted or we’re prevented from reaching a goal
frustration-aggression hypothesis
The idea that human aggression is mostly learned from watching others behaviors either in person or in movies or its also learned when our aggressive behavior is rewarded
social learning theory
The idea that evolution has made humans inherit fighting instinct like animals (we exert aggression on others as catharsis)
instinct theory
Sleep Stages:
Awake
When we are conscious & aware of our environment, our brains show Beta & alpha waves
Describe Beta & Alpha waves & what stage of the sleep cycle are they involved in?
Alpha waves: Come from the occipital & parietal lobes when we’re relaxed with closed eyes
Beta waves: Come from the frontal lobes they’re present when we’re actively concentrating
Awake stage
Sleep Stages:
Stage 1
aka Light sleep this accounts for 5% of sleep. It has Theta waves
Describe the characteristics of stage 1 sleep
Light sleep 5%
- Slow pulse
- Slow respiration
- Slow eye movements
- Low BP
- Episodic body movements
- Peaceful
Sleep stages:
Theta waves are indicative of what stage of sleep?
Stage 1 aka light sleep 5%
Sleep stages:
Describe Stage 2 of the sleep cycle
Relaxed stage 45% (largest stage)
Has sleep spindles & K complexes
Sleep stages:
Describe the characteristics of Stage 2 sleep
Aka relaxed sleep 45%
It has sleep spindles & K complexes
- BRUXISM (teeth grinding)
- No eye movement
- No conscious awareness of the environment
- Slowed body functions
- Reduced muscular activity
Sleep stages:
Describe stages 3-4
aka Slow-wave sleep 25%, it has Delta waves & is our deepest most relaxed stage
Sleep stages:
Describe the characteristics of Stages 3-4
Aka slow-wave sleep 25%, with Delta waves:
- Night terrors
- Sleep walking (Somnambulism)
- Enuresis (bed wetting)
- Slow Heart & Respiratory rate
Sleep stages:
Waking someone in stage 3-4 (slow-wave sleep) will cause them to experience what?
Sleep inertia or sleep drunkenness, they will be disoriented/confused and likely won’t be able to function right away
Sleep stages:
Describe REM sleep wave types
A sawtooth pattern with Beta, Alpha, & Theta waves 25% intervals happen every 90 minutes
Sleep stages:
Describe the characteristics of REM sleep stage
A sawtooth pattern with Beta, Alpha, & Theta waves 25%:
-Dreams
- Penile/clitoral erection
- High Ach
- High pulse
- High respiratory rate
- High BP
- No skeletal muscle movement
Sleep stages:
Sedatives that reduce REM
Alcohol
Barbiturates
Benzodiazepines
Sleep Stages:
Beta waves have the ___________ & __________
Highest frequency & lowest amplitude
Sleep:
Describe REM rebound
When someone loses REM during sleep their body makes up the lost REM the next night (10-40 mins of REM every 90 mins)
- High brain & cardiovascular activity
Sleep stage:
Describe the change in an elderly persons sleep stages
Decreased REM
Decreased stage 3-4
Increased Sleep latency
Earlier waking
Sleep stage:
Describe the change in an depressed persons sleep stages
Increased REM sleep time
Decreased REM latency
Decreased stage 3-4
Repeated waking
Earlier waking
Sleep stage:
Describe the change in an Narcoleptic persons sleep stages
Decreased REM Latency
Sleep latency in a young adult
10 minutes
Sleep latency in a depressed young adult
over 10 minutes
Sleep latency in an elderly person
over 10 minutes
REM latency in a young person
90 minutes
REM latency in a depressed person
45 minutes
REM latency in a elderly person
90 minutes
% of REM time in a young person
25%
% of REM time in a depressed person
over 25%
% of REM time in an elderly person
under 25%
% of Delta aka slow-wave sleep in a young person
25%
% of Delta aka slow-wave sleep a depressed person
under 25%
% of Delta aka slow-wave sleep in elderly persons
under 25%
Sleep efficacy in a young person
100%
Sleep efficacy in a depressed person
less than 100%
Sleep efficacy in an elderly person
less than 100%
High Acetylcholine means what for sleep?
High REM
High sleep efficacy
High Dopamine means what for sleep?
High sleep efficacy
High Norepinephrine means what for sleep?
Low REM
Low Sleep efficacy
High Serotonin means what for sleep?
High sleep efficacy
High Delta aka slow-wave sleep
Describe parasomnias
abnormal physiology or behaviours associated with sleep i.e
- sleep walking
- bruxism
- sleep terror
- REM sleep behaviour
- Nightmare disorders
Sleep:
Describe Insomnia
When people find it difficult to fall asleep or stay asleep for 1 or more months. It leads to daytime sleepiness & disrupts social life or work
Sleep:
Describe the psychological causes of insomnia
Major depressive disorder:
- long sleep latency
- Repeated/earlier waking
- Longer overall REM
- Shorter REM latency
- Earlier REM
- Low delta sleep
Sleep:
Describe the physical causes of insomnia
- CNS stimuli (caffeine)
- Withdrawal of sedative agents (alcohol & benzodiazepines)
Sleep:
Describe how to manage Insomnia
- Avoid caffeine
- Develop sleep rituals & a normal sleep schedule
- Daily exercise (not before bed)
- Antidepressants or antipsychotics if necessary
Sleep:
Describe a Sleep-terror disorder
Repeated frightful fits (screaming in fear) during sleep, the person won’t remember any dream or the fit
It happens during N3-4 slow-wave sleep Delta waves
Sleep:
Onset of a sleep terror disorder in adolescence may indicate what condition?
Temporal lobe epilepsy
Sleep:
Repeated frightful fits (screaming in fear) during sleep, the person won’t remember any dream or the fit
It happens during N3-4 slow-wave sleep Delta waves
What is the condition?
Sleep-terror disorder
Sleep:
Describe what a Nightmare disorder is?
Brent & Barbie
Repeated nightmares that wake someone up & that they can remember
It happens during REM
Repeated nightmares that wake someone up & that they can remember
It happens during REM
What is the condition?
Nightmare disorder
Sleep:
Describe sleepwalking
When a person repeatedly walks around during sleep.
It happens during N3-4 (slow-wave sleep) Delta waves
Onset is 4-8yrs old
When a person repeatedly walks around during sleep.
It happens during N3-4 (slow-wave sleep) Delta waves
Onset is 4-8yrs old
What is the condition?
Sleepwalking
Sleep:
Describe circadian rhythm disorder
Someone who can’t sleep at normal times & has delayed sleep latency (trouble falling asleep)
Happens during:
- Jet lag (2-7 days)
- Shift workers
Sleep:
Describe Nocturnal myoclonus
Repeated & abrupt muscular contractions in the legs that wake someone up
Someone who can’t sleep at normal times & has delayed sleep latency (trouble falling asleep)
Happens during:
- Jet lag (2-7 days)
- Shift workers
Circadian rhythm disorder
Repeated & abrupt muscular contractions in the legs that wake someone up
Nocturnal Myoclonus disorder
Sleep:
what drugs would you use to treat someone with Nocturnal myoclonus disorder?
A few choices
- Benzodiazepine
- Quinine
-Antiparkinsonians (aka dopaminergics like levodopa or pinirole)
Sleep:
Describe Restless leg syndrome
An uncomfortable feeling in the leg that makes someone feel like they need to move it to get relief (repeated jerky leg movements). This makes it harder to fall asleep (more sleep latency) & they wake up more
An uncomfortable feeling in the leg that makes someone feel like they need to move it to get relief (repeated jerky leg movements). This makes it harder to fall asleep (more sleep latency) & they wake up more
What’s the condition?
Restless leg syndrome
Sleep:
What would you give to a person with restless leg syndrome to relieve their symptoms?
- Antiparkinsonians
- Iron supplements
- Magnesium supplements
Sleep:
Restless leg syndrome is more common in what groups of people?
Elderly
People with Parkinson’s
Pregnant women
People with kidney disease
Sleep:
Describe Klein-Levin & menstrual associated syndromes (both are basically the same)
Someone with recurrent episodes of daily sleepiness that persists for weeks-to-months long.
NAPS DON’T HELP
&
Person likely overeats (hyperphagia)
Klein-Levin is more common in adolescent men
&
MAS = women
Someone with recurrent episodes of daily sleepiness that persists for weeks-to-months long.
NAPS DON’T HELP
&
Person likely overeats (hyperphagia)
What are the 2 associated conditions?
Describe Klein-Levin & menstrual associated syndromes (both are basically the same)
Sleep:
Describe sleep drunkenness
A rare condition were its hard for someone to wake up after getting adequate sleep.
Note it might be genetic
A rare condition were its hard for someone to wake up after getting adequate sleep.
Note it might be genetic
What’s the condition?
Sleep drunkeness
Sleep:
What is Bruxism & what stage of sleep is it seen in?
Aka teeth grinding (ouch!) that happens in N2 (relaxed stage of sleep)
Sleep spindles & K complexes
Sleep:
Describe REM-sleep behavior disorder
When someone experiences REM sleep without skeletal muscle paralysis (aka they’re likely to hurt themselves & others) its mostly associated with parkinson’s & Lewy body disease
When someone experiences REM sleep without skeletal muscle paralysis (aka they’re likely to hurt themselves & others) its mostly associated with parkinson’s & Lewy body disease
REM-Sleep Behavior disorder
Sleep:
How would you treat someone with REM-Sleep Behavior disorder?
- Antiparkinsonians
- REM suppressors (Benzodiazepines)
- Anticonvulsants (Carbamazepine)
Sleep:
Describe sleep apnea
When someone stops breathing for brief periods throughout sleep. During these episodes low blood O2 or high CO2 wakes the person up to breath
It leads to daytime sleepiness & respiratory acidosis
Can be central or obstructive
Sleep:
Describe Central sleep apnea
Usually in the elderly, when there’s no brain signals to the respiratory muscles so there is little/no respiratory effort to get air into the lungs
Sleep:
Describe obstructive sleep apnea
Usually in over-weight people, people ages 40-60, or men
Typically their tongue blocks their airway
Sleep:
Describe Pickwickian syndrome
A form of obstructive sleep apnea that leads to daytime sleepiness (not a weight issue!)
Sleep:
What are the treatment options for addressing sleep apnea?
- Weight loss (if they’re overweight)
- CPAP (Continuous Positive Air Pressure)
- Breathing stimulants (Medroxyprogesterone-acetate, Protriptyline (Vivactil), Fluoxetine (Prozac))
- Surgery (Uvulopalatoplasty to increase airway size)
- Tracheotomy LAST RESORT
Testing:
The Rorschach test evaluates what in patients?
A projective ink blot interpretation test to evaluate thought disorders & defense mechanisms
Testing:
Describe what the Minnesota Multiphasic Personality Inventory (MMPI-2) evaluates
An objective T/F questionnaire that assesses:
-Depression
- Schizophrenia
- Hypochondriasis
- Paranoia
Testing:
Describe what the Thematic Apperception Test (TAT) evaluates
A projective test that makes the patient make up stories to evaluate unconscious emotions & conflicts (Motivational state)
Testing:
Describe what the Scentence Completion Test (SCT) evaluates
A projective test identifies any problems with verbal association, patient will be asked to finish a started sentence
A projective test identifies any problems with verbal association, patient will be asked to finish a started sentence
What’s the test?
Personality Sentence Completion Test (SCT)
A projective test that makes the patient make up stories to evaluate unconscious emotions & conflicts (Motivational state)
What’s the test?
Personality, Thematic apperception Test
An objective T/F questionnaire that assesses:
-Depression
- Schizophrenia
- Hypochondriasis
- Paranoia
What’s the test
Personality; Minnesota Multiphasic Personality Inventory (MMPI-2)
A projective ink blot interpretation test to evaluate thought disorders & defense mechanisms
Personality; Rorschach test
Patient can’t reason abstractly, can’t be flexible in problem solving or adapt to changed situations.
What might this indicate?
Cerebral disease
Impaired abstract reasoning might indicate damage to what
Frontal lobe
Testing:
Describe what the Wisconsin Card Sorting Test (WCST) evaluates
It assesses abstract reasoning and flexible thinking in problem solving
Abnormal responses on the WCST indicates which two conditions?
Frontal lobe damage
or
Schizophrenia
Testing:
Describe what the Neuropsychological Assessment of adults evaluates
It assesses the relationship between behaviour and the brain
Neuropsychological Assessment of adults:
Defects in visual and non-verbal tasks indicate what
Lesions on the right hemisphere
Neuropsychological Assessment of adults:
Severe deficits in audio-verbal tasks might indicate what
Left hemisphere disease
Testing:
Describe what achievement tests evaluate
Specific subject areas (math, spelling ect)
USMLE, SAT etc…
Describe what Wechster IQ test evaluates
Verbal & Performance
Describing what Sternberg’s model of Triarchic theory of IQ theorizes that IQ is made up of
Analytical, Creative, & Practical skills
Spearmans theory believes there are 2 factors of intelligence
General abilities
&
Group of special abilities
What is the equation for IQ?
Mental Age / Chronological age * 100
Objective tests evaluate ______ while projective tests evaluate _______
Individual characteristics (Mutiple choice)
Personality (interpretable Qs)
IQ scale:
50-69
Mild IQ deficit
IQ scale:
35-49
Moderate IQ deficit
IQ scale:
20-34
Severe IQ deficit
IQ scale:
below 20
Profound IQ deficit
IQ scale:
90-110
Normal/average IQ
IQ scale:
over 130
Savants
Describe the features of Prosopagnosia
Impaired complex visual discrimination (aka they can’t recognize faces)
Due to a right-sided hemisphere lesions
Which 2 memory types don’t regress with aging?
Semantic & Implicit
Describe the features of episodic memory
Specific memory (telephone messages)
Specific memory (telephone messages)
Episodic memory
Describe the features of Semantic memory
Knowledge & facts
Knowledge & facts are stored as what kind of memory type
Semantic
Describe the features of implicit memory
Automatic skills (driving a car)
Describe the features of the Wechsler Memory scale
Memory test for adults which uses a memory quotient as a measure
Korsakoff and other amnestic conditions tend to score ____ on Wechsler memory scale but have preserved ____
Lower memory quotient but preserved IQ
Describe the features of the Hemispheric Dominance localization test
It determines what side potential brain lesions are on
Left sided brain lesions typical present with
- Language problems (Gerstmann syndrome) &
- Limb praxis
- Aphasia
Right sided brain lesions tend to present with
visuospatial problems & Hemispatial attention issues
Describe some of the functions of the dominant hemisphere
Language function
Logical thinking
Reading/writing
Describe some of the functions of the non-dominant hemisphere
affective part of speech (mood & prosody)
Dominant sided lesions can cause which 2 conditions?
Dyslexia & dysgraphia
Testing:
Mini Mental state examination (MMSE) score of 0-9
late alzheimers
Testing:
Mini Mental state examination (MMSE) score of 10-19
moderate alzheimers
Testing:
Mini Mental state examination (MMSE) score of 20-23
Early Alzheimer’s or mild cognitive dysfunction
Testing:
Mini Mental state examination (MMSE) score of 24-30
Normal Cognitive functioning
Testing:
Mini Mental state examination (MMSE) score of below 20
definite cognitive impairment
Testing:
Mini Mental state examination (MMSE) score of below 25
Possible cognitive impairment
Personality types:
- Suspicious of others without unjust cause
- Have ideas of reference (think others talk about them)
- Use projection as defence
Type A Paranoid
Type A Paranoid
- Suspicious of others without unjust cause
- Have ideas of reference (think others talk about them)
- Use projection as defense
More common in men
Personality types:
- Solitary loner
- Little/no sex interest
- Emotionally cold, detached, quiet, & seclusive behaviors
- Indifferent to others criticism/praise
More common in men
Type A Schizoid
Type A Schizoid
Personality types:
- Solitary loner
- Little/no sex interest
- Emotionally cold, detached, quiet, & seclusive behaviors
- Indifferent to others criticism/praise
More common in men
Personality types:
- Weird/eccentric behavior, thoughts, or speech
- Believes in superstitions & that they have magical powers
- Have ideas of reference
More common in men
Type A Schizotypal
Type A Schizotypal
Personality types:
- Weird/eccentric behavior, thoughts, or speech
- Believes in superstitions & that they have magical powers
- Have ideas of reference
More common in men
Personality types:
- Needs to be the center of attention
- Has seductive/promiscuous behavior
- Drama queen
- They’re unaware of their inner/actual feelings & will throw tantrums, accusations & tears when they’re not the center of attention
More common in women
Type B Historinic
Type B Historinic
Personality types:
- Needs to be the center of attention
- Has seductive/promiscuous behavior
- Drama queen
- They’re unaware of their inner/actual feelings & will throw tantrums, accusations & tears when they’re not the center of attention
More common in women
Personality type:
- A grandiose sense of self importance
- Entitled & ambitious
- Can’t show empathy but can feign sympathy for self-gain
- Doesn’t take criticism well
Type B Narcissistic
Type B Narcissitic
Personality type:
- A grandiose sense of self importance
- Entitled & ambitious
- Can’t show empathy but can feign sympathy for self-gain
- Doesn’t take criticism well
Personality type:
- Timid
- Avoid people because they have a huge fear of criticism, disapproval, & rejection
- They often perceive themselves as socially inept or unappealing
- They desire companionship but are limited by their fear
Type C Avoidant personality disorder
Type C Avoidant personality disorder
Personality type:
- Timid
- Avoid people because they have a huge fear of criticism, disapproval, & rejection
- They often perceive themselves as socially inept or unappealing
- They desire companionship but are limited by their fear
Personality type:
- Difficult making decisions without the input from others
Type C Dependent personality disorder
Personality types:
- Perfectionists (to the point it can interfere without completing a task)
- Excessive devotion to work & productivity
- Limited interpersonal skills
- Tend to be formal & serious
Type C Obsessive-Compulsive disorder
Type C Obsessive-Compulsive disorder
Personality types:
- Perfectionists (to the point it can interfere without completing a task)
- Excessive devotion to work & productivity
- Limited interpersonal skills
- Tend to be formal & serious
Personality type:
- Tend to procrastinate
- Will find faults in the people they depend on
- Never get joy from life
- Lack self confidence
- Are often pessimistic about the future
Passive-aggressive personality disorder
Passive-aggressive personality disorder
Personality type:
- Tend to procrastinate
- Will find faults in the people they depend on
- Never get joy from life
- Lack self confidence
- Are often pessimistic about the future
Personality types:
- Very pessimistic
- Experiences anhedonia (no pleasure)
- Often duty bound
- Doubt themselves
- Are chronically unhappy
Depressive personality disorder (Life long)
Depressive personality disorder (Life long)
Personality types:
- Very pessimistic
- Experiences anhedonia (no pleasure)
- Often duty bound
- Doubt themselves
- Are chronically unhappy
Personality types:
- Get pleasure/want to cause others pain (phys/psych/sexual abuse)
Sadomasochism: Sadism
Sadomasochism: Sadism
Personality types:
- Get pleasure/want to cause others pain or humiliation (phys/psych/sexual abuse)
Personality types:
- Get pleasure/desire from being hurt or humiliated
Sadomasochism: Masochism
Sadomasochism: Masochism
Personality types:
- Get pleasure/desire from being hurt or humiliated
Personality types:
- Unstable mood, self image, & relationships
- Tend to self mutilate
- Have thoughts of suicide over minor things
- Use splitting as a defense mechanism to define people as either all good or all bad
More common in women (with a family history of mood disorders)
Type B Borderline Personality disorder
Type B Borderline Personality Disorder
Personality types:
- Unstable mood, self image, & relationships
- Tend to self mutilate
- Have thoughts of suicide over minor things
- Use splitting as a defense mechanism to define people as either all good or all bad
More common in women (with a family history of mood disorders)
Personality type:
- They don’t recognize the rights of others or laws
- They DON’T feel remorse
- Tend to be deceitful, extremely manipulative, promiscuous, and abusive
- Be careful they can seem very charming or normal
- Their defense mechanism is a superego lacunae
Type B Antisocial Personality disorder
Type B Antisocial Personality disorder
Personality type:
- They don’t recognize the rights of others or laws
- They DON’T feel remorse
- Tend to be deceitful, extremely manipulative, promiscuous, and abusive
- Be careful they can seem very charming or normal
- Their defense mechanism is a superego lacunae
Describe the difference between anxiety & fear
Fear= an emotional response to a known stimuli
Anxiety= An uncontrolled response to minor or things that don’t exist
What are the neurotransmitter changes in anxiety?
Low GABA & Serotonin
High Norepinephrine
Describe the features of a panic disorder
Category 1:
Recurrent & unprovoked panic attacks that can’t be predicted
P will have anxiety about future attacks and they tend to happen episodically (i.e x2 a week)
- Sudden onset of 4 of these :(sweating, trembling, SOB, chest pain, nausea, dizziness, derealization, depersonalization)
Recurrent & unprovoked panic attacks that can’t be predicted
P will have anxiety about future attacks and they tend to happen episodically (i.e x2 a week)
- Sudden onset of 4 of these :(sweating, trembling, SOB, chest pain, nausea, dizziness, derealization, depersonalization
Panic disorder category 1
Describe derealization
When you experience the unreality of the world
Describe Depersonalization
When you feel detached from you body/mind/or situation
Describe what a phobia is
A category 1 condition:
An irrational & intense fear towards something that often causes someone to avoid the feared thing
Intense fear of public spaces
can be general or specific
Social phobia
Treating social phobia
Beta blockers & systematic desensitization
Fear of open spaces
Agoraphobia
Fear of teens
Ephenophobia
Fear of artificial chemicals
Chemophobia
Fear of strangers or the unknown
Xenophobia
Fear of spiders
Arachnophobia
Fear of snakes
Ophidiophobia
Fear of tight spaces
Claustrophobia
Fear of medical procedures involving needles or injections
Aichmophobia
Fear of heights
Acrophobia
Fear of the dead or death
Necrophobia
Fear of men
Androphobia
Fear of sex
Geno/coito-phobia
Fear of speaking in public
Glossophobia
- Excessive worry or anxiety plus some of the following for a minimum of 6 months
(Restlessness, Easy fatigue, Irritability, Muscle tension, Difficulty falling/staying asleep, & difficulty concentrating (only need 1 for kids)
Generalized anxiety disorder Category 1
Generalized anxiety disorder Category 1
- Excessive worry or anxiety plus some of the following for a minimum of 6 months
(Restlessness, Easy fatigue, Irritability, Muscle tension, Difficulty falling/staying asleep, & difficulty concentrating (only need 1 for kids)
Recurrent/intrusive obsessions, thoughts, or feelings that cause anxiety which can be relieved with compulsions
i.e excessive handwashing
Obsessive compulsive disorder Category 2
OCD Category 2
Recurrent/intrusive obsessions, thoughts, or feelings that cause anxiety which can be relieved with compulsions
i.e excessive handwashing
A traumatic event (self/close loved one experienced) that causes symptoms AFTER the event
- Nightmares/flashbacks
- Disassociation
- Social withdrawal’
- Anxiety
- Intrusive thoughts
- Survivor guilt
Symptoms last more than 1 month & are more severe
PTSD Category 3
PTSD Category 3
A traumatic event (self/close loved one experienced) that causes symptoms AFTER the event
- Nightmares/flashbacks
- Disassociation
- Social withdrawal’
- Anxiety
- Intrusive thoughts
- Survivor guilt
Symptoms last more than 1 month & are more severe
A traumatic event (self/close loved one experienced) that causes symptoms AFTER the event
- Nightmares/flashbacks
- Disassociation
- Social withdrawal’
- Anxiety
- Intrusive thoughts
- Survivor guilt
Symptoms last 2 days to a month & are less severe
Acute Stress Disorder Category 3
Acute Stress Disorder Category 3
A traumatic event (self/close loved one experienced) that causes symptoms AFTER the event
- Nightmares/flashbacks
- Disassociation
- Social withdrawal’
- Anxiety
- Intrusive thoughts
- Survivor guilt
Symptoms last 2 days to a month & are less severe
First line of treatment for anxiety (medication-wise)
Antidepressants:
- SSRI’s (Fluoxetine, Paroxetine, & Sertraline)
- SNRs (Venflaxine)
Antidepressants:
- SSRI’s (Fluoxetine, Paroxetine, & Sertraline)
- SNRs (Venflaxine)
First line of treatment for anxiety (medication-wise)
- SSRIs (Fluoxetine, Paroxetine, & Sertraline)
- Benzodiazepines (Diazepam or Lorazepam)
- Tricyclics
- MAO-inhibitors
Drug treatment for Panic attacks
Drug treatment for Generalized anxiety
- Benzodiazepines (Diazepam or Lorazepam)
- Buspirone (Buspar-5-HT agonist)
- Tricyclics
Drug treatment for Panic attacks
- SSRIs (Fluoxetine, Paroxetine, & Sertraline)
- Benzodiazepines (Diazepam or Lorazepam)
- Tricyclics
- MAO-inhibitors
Drug treatment for Phobias
- Benzodiazepines (Diazepam or Lorazepam)
- Beta-blockers
- SSRIs (Fluoxetine, Paroxetine, & Sertraline)
- Antidepressants
- SSRIS (Fluoxetine, Paroxetine, & Sertraline)
- SNRs (Venflaxine)
with Clonide
Drug treatment for PTSD
Drug treatment for OCD
- SSRI (Fluoxetine, Paroxetine, & Sertraline)
- Tricyclic (Clomipramine)
- MAO-inhibs (last resort)
Drug treatment for PTSD
- Antidepressants
- SSRIS (Fluoxetine, Paroxetine, & Sertraline)
- SNRs (Venflaxine)
with Clonide
Psychotherapy for Generalized anxiety
- Cognitive interpersonal therapy
- Stress management
- Biofeedback
Psychotherapy for Phobias
- CBT
- Systematic desensitization
Psychotherapy for OCD
- CBT (exposure & response therapy)
Describe the features of Somatization disorder (Briquets/somatoform syndrome)
Psychological problems manifest as physical symptoms before 30yrs old and last minimum 6 months
Need min 1 somatic symptom
- pain
- excessive worry
- fear
- stress/behavior change
&
pain in 4 different sites
2 Gi
1 sexual
1 Pedogeological (fainting/blindness)
Psychological problems manifest as physical symptoms before 30yrs old and last minimum 6 months
Need min 1 somatic symptom
- pain
- excessive worry
- fear
- stress/behavior change
&
pain in 4 different sites
2 Gi
1 sexual
1 Pedogeological (fainting/blindness)
Describe the features of Somatization disorder (Briquets/somatoform syndrome)
Describe the features of Hypochondriasis (illness anxiety disorder)
They have anxiety about having a disease (despite medical eval & assurance)
They usually have minor or no somatic symptoms & exaggerated concern about their health
Common in middle age- old age
They have anxiety about having a disease (despite medical eval & assurance)
They usually have minor or no somatic symptoms & exaggerated concern about their health
Common in middle age- old age
Describe the features of Hypochondriasis (illness anxiety disorder)
Describe the features of conversion disorder
One or more symptoms or deficits affecting voluntary motor or sensory functions (i.e blindness/paralysis)
That they don’t produce on purpose!
One or more symptoms or deficits affecting voluntary motor or sensory functions (i.e blindness/paralysis)
That they don’t produce on purpose!
Describe the features of conversion disorder
Describe the features of body dysmorphic disorder
They’re preoccupied with an imaged defect on the body (causes distress or impairs functioning)
- compulsive checking/touching
- Need constant reassurance from loved ones
- Excessive grooming
- Obsession with plastic surgery
They’re preoccupied with an imaged defect on the body (causes distress or impairs functioning)
- compulsive checking/touching
- Need constant reassurance from loved ones
- Excessive grooming
- Obsession with plastic surgery
Describe the features of body dysmorphic disorder
Describe the features of pain disorder
Chronic or constant pain in one or more areas that can’t be completely explained by physical disease
it can last days or years and may be caused by psychological stress
The pain is severe and impairs functioning
Chronic or constant pain in one or more areas that can’t be completely explained by physical disease
it can last days or years and may be caused by psychological stress
The pain is severe and impairs functioning
Describe the features of pain disorder
Treating somatoform disorders
- Case management
- Psychotherapy (CBT/Group)
- Medications (Antidepressants **SSRIs & short-term anxiety medication use)
Describe the features of Factious disorder (munchausen)
Someone who fakes symptoms on purpose without secondary gain
They’ve usually worked in the medical field and know how to mimic diseases
Common signs:
- Unnecessary procedures
- Grid abdomen (many surgical scars)
- Abdominal pain, fever, hematuria, tachycardia, skin lesions, & seizures
Someone who fakes symptoms on purpose without secondary gain
They’ve usually worked in the medical field and know how to mimic diseases
Common signs:
- Unnecessary procedures
- Grid abdomen (many surgical scars)
- Abdominal pain, fever, hematuria, tachycardia, skin lesions, & seizures
Describe the features of Factious disorder (munchausen)
Describe the features of Factitious/Munchausen’s by proxy
A serious form of abuse were a carer or parent will make their child/ward look ill (injury, false med history, poisoning etc)
A serious form of abuse were a carer or parent will make their child/ward look ill (injury, false med history, poisoning etc)
Describe the features of Factitious/Munchausen’s by proxy
Describe the features of malingering
Knowingly faking symptoms for secondary gain (&, drugs etc)
there’s a marked discrepancy between the claimed stress of disability and objective findings
Knowingly faking symptoms for secondary gain (&, drugs etc)
there’s a marked discrepancy between the claimed stress of disability and objective findings
Describe the features of malingering
- Persistent pain min 6 months
- occurs during sexual intercourse it also be caused by pelvic inflammatory disease, (chlamydia infection or gonorrhea)
- Painful spasms occur in the outermost part of the vagina
Genitopelvic pain–penetration disorder
Genitopelvic pain–penetration disorder
- Persistent pain min 6 months
- occurs during sexual intercourse it also be caused by pelvic inflammatory disease, (chlamydia infection or gonorrhea)
- Painful spasms occur in the outermost part of the vagina
A 65-y-old former banker
cannot remember to turn
off the gas jets on the
stove nor can he name
the object in his hand
(a comb)
Alzheimer’s
disease
A 65-y-old dentist cannot
remember to pay her
bills. She also appears
to be physically “slowed
down” (psychomotor
retardation) and very sad
Pseudodementia
(depression
that mimics
dementia)
A 65-y-old woman forgets
new phone numbers and
names but functions well
living on her own
Normal aging
Dramatic, emotional, inconsistent
Depressive, bipolar, substance use, and somatic symptom disorders
Theatrical, extroverted, emotional, sexually provocative, “life of the party”
Shallow, vain
In men, “Don Juan” dress and behavior
Cannot maintain intimate relationships
Cluster B
Histrionic
Peculiar appearance
Magical thinking (i.e., believing that one’s thoughts can affect the course of events)
Odd thought patterns and behavior without frank psychosis
Schizotypal Cluster A
Long-standing pattern of voluntary social withdrawal
Detached, restricted emotions, lacks empathy, has no thought disorder
Schizoid Cluster A
Avoids social relationships and is “peculiar” but not psychotic
Distrustful, suspicious, litigious
Attributes responsibility for own problems to others
Interprets motives of others as malevolent
Collects guns
CLUSTER A
Paranoid
Pompous, with a sense of special entitlement
Lacks empathy for others
Narcissistic Cluster B
Refuses to conform to social norms and shows no concern for others
Associated with conduct disorder in childhood and criminal behavior in adulthood
(“psychopaths” or “sociopaths”
Antisocial Cluster B
Erratic, impulsive, unstable behavior, and mood
Feeling bored, alone, and “empty”
Suicide attempts for relatively trivial reasons
Self-mutilation (cutting or burning oneself)
Often comorbid with depressive, bipolar, and eating disorders
Mini-psychotic episodes (i.e., brief periods of loss of contact with reality)
Borderline Cluster B
Fearful, anxious
Anxiety disorders
Overly sensitive to criticism or rejection
Feelings of inferiority, socially withdrawn
Cluster C
Avoidant
Perfectionistic, orderly, inflexible
Stubborn and indecisive
Ultimately inefficient
Obsessive–compulsive Cluster C
Allows other people to make decisions and assume responsibility for them
Poor self-confidence
May tolerate abuse by domestic partner because of fear of being deserted and alone
Dependent Cluster C
Procrastinates and is inefficient
Outwardly agreeable and compliant but inwardly angry and defiant
Unspecified
Passive–aggressive
Failure to remember important information about oneself after a stressful life
event
Amnesia usually resolves in minutes or days but may last years
Fugue involves amnesia combined with sudden wandering from home after a
stressful life event
Fugue may also involve adoption of a different identity
Dissociative amnesia with or without
dissociative fugue
At least two distinct personalities (“alters”) in an individual
More common in women (particularly those sexually abused in childhood)
In a forensic (e.g., jail) setting, malingering and alcohol use must be considered
and excluded
Dissociative identity disorder (formerly
multiple personality disorder)
Recurrent, persistent feelings of detachment from one’s own body, the social
situation (depersonalization), or the environment (derealization) when
stressed
Understanding that these perceptions are only feelings, that is, normal reality
testing
Depersonalization/derealization
disorder
Dissociative symptom (e.g., trance-like state, memory loss) (1) in persons
exposed to intense coercive persuasion (e.g., brainwashing) or (2) indigenous
to particular locations or cultures (e.g., “Amok” in Indonesia)
Identity disruption
Test to evaluate
- Depression
- Anxiety
- Schizophrenia
- Paranoia
MMPI-2
Test to evaluate self-care skills
Vineland social maturity scale
Test to evaluate defense mechanisms
Rorschach test
Self rating scale to measure depression
Beck Depression Inventory II (BDI-II)
Test to evaluate IQ
Wechsler Adult Intelligence Scale
Episodic (about twice weekly) periods of intense anxiety (panic attacks)
Cardiac and respiratory symptoms and the conviction that one is about to die or lose one’s mind
Sudden onset of symptoms, increasing in intensity over a period of approximately 10 min, and lasting about 30 min (attacks
rarely follow a fixed pattern)
Attacks can be induced by administration of sodium lactate or CO2
(see Chapter 5)
Strong genetic component
More common in young women in their 20s
Panic Disorder
Persistent anxiety symptoms including hyperarousal and worrying lasting 6 mos or more
Gastrointestinal symptoms are common
Symptoms are not related to a specific person or situation (i.e., free-floating anxiety)
Commonly starts during the 20s
Generalized Anxiety Disorder
Recurring, intrusive feelings, thoughts, and images (obsessions) that cause anxiety
Anxiety is relieved in part by performing repetitive actions (compulsions)
A common obsession is avoidance of hand contamination and a compulsive need to wash the hands after touching things
Obsessive–Compulsive Disorder (OCD)
In PTSD, symptoms last for more than________ and may have a delayed onset
In ASD, symptoms last only between ______
1 mo (sometimes years) & 2 d and 4 weeks
One or more physical symptoms that disrupt daily life with excessive focus on the
symptoms
Being symptomatic for more than 6 mo
Somatic symptom disorder
Exaggerated concern with health and illness lasting at least 6 mos in the absence of
somatic symptoms
Concern persists despite medical evaluation and reassurance
Care-seeking type goes to many different doctors seeking help (“doctor shopping”)
Illness anxiety disorder
Sudden, dramatic loss of sensory or motor function (e.g., blindness, paralysis), often
associated with a stressful life event
Patients appear relatively unworried (“la belle indifférence”)
Conversion disorder
(functional neurological
symptom disorder)
Intense acute or chronic pain not explained completely by physical disease and closely
associated with psychological stress
Onset usually in the 30s and 40s
Somatic symptom disorder
with predominant pain
Conscious simulation of physical or psychiatric illness
Aim is to gain attention for being “sick”
Undergoes unnecessary medical and surgical procedures
Has a “grid abdomen” (multiple crossed scars from repeated non-necessary
surgeries)
Factitious disorder
Conscious simulation of illness in another person, typically in a child by a
parent, to obtain attention from medical personnel
Is a form of child abuse (see Chapter 18) because the child undergoes
unnecessary medical and surgical procedures
Must be reported to state child welfare authorities
Factitious disorder imposed on another
Conscious simulation or exaggeration of physical or psychiatric illness for
financial (e.g., insurance settlement) or other obvious gain (e.g., avoiding
incarceration)
Avoids treatment by medical personnel
Health complaints cease as soon as the desired gain is obtained
Malingering
While the most effective
immediate treatment for panic attacks is _______ the most effective management (long term is ) ________
benzodiazepine
antidepressant (SSRI like paroxetine
Phobias involve a hypersensitive ____________
locus ceruleus
Best long term management for PTSD
Support group
Best management for Generalized anxiety disorder
Antidepressants (venlafaxine & duloxetine) & SSRIs
Effective drug management for OCD includes
Antidepressant
SSRI (fluvoxamine)
Describe the Sternburg’s model
Aka the triarchic theory of IQ breaks IQ down into 3 parts:
1) Analytical IQ (ability to compare, evaluate & analyze information)
2) Creative IQ (capacity to make insights & come up with new ideas)
3) Practical IQ (ability to apply what you learned in everyday life)
Aka the triarchic theory of IQ breaks IQ down into 3 parts:
1) Analytical IQ (ability to compare, evaluate & analyze information)
2) Creative IQ (capacity to make insights & come up with new ideas)
3) Practical IQ (ability to apply what you learned in everyday life)
Sternburg’s model
Describe group testing
Given to a group of people simultaneously it’s
- efficient administration
- grading
- statistical analysis
Mild IQ
50-69
Moderate IQ
35-49
Severe IQ
20-34
Profound IQ
Under 20
IQ 2 std. above 120
Savants
Describe objective tests
Assess someone’s traits without being influenced by personal bias & belief
Assess someone’s traits without being influenced by personal bias & belief
objective tests
Describe Projective tests
Personality tests that lets participants interpret questions & potentially reveal their hidden emotions, internal conflicts, & individual thought processes
Personality tests that lets participants interpret questions & potentially reveal their hidden emotions, internal conflicts, & individual thought processes
Projective tests
Describe the feature of Rett’s syndrome at 6m to 2yrs old
- Progressive encephalopathy
- Slowed head growth
- Purposeful hand movements are replaced by stereotyping (wringing hands)
- Speech loss, repetitive hand movements like finger licking, grabbing clothing, tapping, or slapping
- Progressive encephalopathy
- Slowed head growth & microencephaly
- Purposeful hand movements are replaced by stereotyping (wringing hands)
-Language skills are lost, repetitive hand movements like finger licking, grabbing clothing, tapping, or slapping
Rett’s syndrome at 6m to 2yrs old
Describe the feature of Rett’s syndrome during the first 5m post birth
- Infants have normal motor skills, head size, and growth. Social interactions are reciprocated as expected.
- Infants have normal motor skills, head size, and growth. Social interactions are reciprocated as expected.
Rett’s syndrome during the first 5m post birth
Describe the etiology of Rett’s syndrome
Mutation in the MECP2 gene, needed for maintaining synapses between neurons causing the condition
Mutation in the MECP2 gene, needed for maintaining synapses between neurons causing the condition
etiology of Rett’s syndrome
Describe the features of Rett’s syndrome
- Rare non-inherited postnatal neurological disorder
- Affects girls
- Normal development followed by decline in social, verbal, and cognitive skills
- Characterized by repetitive hand movements
- Mental retardation is common
- Fatal in males (X-linked dominant)
- Some individuals may exhibit savant syndrome
- Rare non-inherited postnatal neurological disorder
- Affects girls
- Normal development followed by decline in social, verbal, and cognitive skills
- Characterized by repetitive hand movements
- Mental retardation is common
- Fatal in males (X-linked dominant)
- Some individuals may exhibit savant syndrome
features of Rett’s syndrome
In Rett’s syndrome communicative and social skills seem to plateau at developmental levels between____ months and __year.
6m & 1 yr
Describe the prognosis of Rett’s syndrome
- Children with Rett’s disorder may live for over a decade after onset
- After 10 years, many become wheelchair-bound with muscle wasting and rigidity
- Language ability is severely impaired
- Long-term communication and socialization abilities remain below 1 year level
- Regression of cognitive and motor skills occurs.
- Children with Rett’s disorder may live for over a decade after onset
- After 10 years, many become wheelchair-bound with muscle wasting and rigidity
- Language ability is severely impaired
- Long-term communication and socialization abilities remain below 1 year level
- Regression of cognitive and motor skills occurs.
prognosis of Rett’s syndrome
Describe the features of Aspergers
1) Difficulties in social interaction
2) Restricted and repetitive behavior
3) No delay in language or cognitive development
4) Mild form of autism
Describe the etiology of Aspergers
- Possible relationship to autistic disorder based on family studies
- Similarity to autistic disorder suggests genetic, metabolic, infectious, and perinatal factors may contribute.
Describe the features of Childhood Disintegrative Disorder
- “Heller’s syndrome”: Skills deteriorate, resembling Autism.
- Falls under Autism spectrum disorders.
- Regression in development is a characteristic.
- Onset after 3 years of normal development.
- Affects both boys and girls.
Impairment happens in at least two of the three following areas regarding childhood disintegrative disorder
- Social interaction
- Communication
- Repetitive behavior and interest patterns
Describe the features of Pervasive Development Disorder NOS
- Impaired social interaction.
- Either impaired communication or behavioral challenges.
- Less severe cases do not meet criteria for other forms of Autism.
- Symptoms present after the age of 3
- Impaired social interaction.
- Either impaired communication or behavioral challenges.
- Less severe cases do not meet criteria for other forms of Autism.
- Symptoms present after the age of 3
features of Pervasive Development Disorder NOS
- “Heller’s syndrome”: Skills deteriorate, resembling Autism.
- Falls under Autism spectrum disorders.
- Regression in development is a characteristic.
- Onset after 3 years of normal development.
- Affects both boys and girls.
features of Childhood Disintegrative Disorder
- Possible relationship to autistic disorder based on family studies
- Similarity to autistic disorder suggests genetic, metabolic, infectious, and perinatal factors may contribute.
Describe the etiology of Aspergers
1) Difficulties in social interaction
2) Restricted and repetitive behavior
3) No delay in language or cognitive development
4) Mild form of autism
features of Aspergers
Describe the features of Attention Deficit Hyperactivity Disorder (ADHD) (disruptive behavior disorder)
- ADHD and Disruptive behavior disorders cause inappropriate behavior affecting social relationships.
- More prevalent in boys.
- Not associated with mental retardation
- cause inappropriate behavior affecting social relationships.
- More prevalent in boys.
- Not associated with mental retardation
features of Attention Deficit Hyperactivity Disorder (ADHD) (disruptive behavior disorder)
Describe the etiology of ADHD
- ADHD more prevalent in boys, ratios from 2:1 to 9:1.
- First-degree biological relatives at high risk of ADHD and related disorders.
- Related disorders may include disruptive behavior disorders, anxiety disorders, and depressive disorders.
- Food additives, colorings, preservatives, and sugar suggested as causes of hyperactive behavior.
- No scientific evidence supporting causal link between these factors and ADHD.
Describe the features of ADHD:
Symptoms of inattention
Onset before age 7yrs
- Inattentiveness, careless mistakes, and poor organization.
- Trouble focusing and maintaining attention.
- Lack of active listening when directly spoken to.
- Avoidance of mentally challenging tasks.
- Frequent loss of necessary items.
Describe the features of ADHD:
Symptoms of Hyperactivity
- Difficulty staying seated when expected.
- Frequent running or climbing in inappropriate situations.
- Trouble playing or participating in activities quietly.
- Exhibiting restlessness and excessive movement.
- Excessively talkative behavior
- Difficulty staying seated when expected.
- Frequent running or climbing in inappropriate situations.
- Trouble playing or participating in activities quietly.
- Exhibiting restlessness and excessive movement.
- Excessively talkative behavior
Describe the features of ADHD:
Symptoms of Hyperactivity
Onset before age 7yrs
- Inattentiveness, careless mistakes, and poor organization.
- Trouble focusing and maintaining attention.
- Lack of active listening when directly spoken to.
- Avoidance of mentally challenging tasks.
- Frequent loss of necessary items
Describe the features of ADHD:
Symptoms of inattention
Describe the features of ADHD
Symptoms of impulsiveness
- Frequently interrupts or blurts out answers prematurely.
- Difficulty waiting for one’s turn.
- Often interrupts or intrudes on others’ conversations or activities.
- Frequently interrupts or blurts out answers prematurely.
- Difficulty waiting for one’s turn.
- Often interrupts or intrudes on others’ conversations or activities.
Describe the features of ADHD
Symptoms of impulsiveness
Describe the features of Conduct disorders
- Chronic Disorder impacting multiple areas of life.
- Violation of others’ rights and societal norms/rules.
- Onset usually occurs between ages 6-10.
- Potential for developing antisocial personality disorder and substance abuse in adulthood.
Describe the symptoms of Conduct disorders
Aggression to people and animals(Fights,bullying)
Destruction of property
Deceitfulness or theft
Serious violations of rules
- Chronic Disorder impacting multiple areas of life.
- Violation of others’ rights and societal norms/rules.
- Onset usually occurs between ages 6-10.
- Potential for developing antisocial personality disorder and substance abuse in adulthood.
Conduct disorders
Aggression to people and animals(Fights,bullying)
Destruction of property
Deceitfulness or theft
Serious violations of rules
symptoms of Conduct disorders
Describe the features of Oppositional Defiant Disorder (ODD)
- Ongoing pattern of disobedient, hostile, and defiant behavior.
- More prevalent in boys than girls.
- Typically begins before the age of 8
Describe the Symptoms of Oppositional Defiant Disorder (ODD)
Diagnostic criteria include:
- Losing temper.
- Arguing with adults.
- Refusing to follow rules.
- Deliberately annoying people.
- Blaming others for own mistakes.
- Easily annoyed.
- Angry and resentful.
- Spiteful or vengeful.
- Frequently getting into trouble.
Diagnostic criteria include:
- Losing temper.
- Arguing with adults.
- Refusing to follow rules.
- Deliberately annoying people.
- Blaming others for own mistakes.
- Easily annoyed.
- Angry and resentful.
- Spiteful or vengeful.
- Frequently getting into trouble.
Symptoms of Oppositional Defiant Disorder (ODD)
- Ongoing pattern of disobedient, hostile, and defiant behavior.
- More prevalent in boys than girls.
- Typically begins before the age of 8
features of Oppositional Defiant Disorder (ODD)
Treatment of ADHD includes
CNS Stimulants:
Methylphenidate (Ritalin)
Dextroamphetamine sulfate (Dexedrine)
Reduce activity level &
Increase attention/concentration.
Treatment of Conduct Disorder & oppositional defiant disorder
Family therapy & Behavioral therapy
Describe the features of Tourette’s Disorder
- Childhood-onset disorder with physical and vocal tics.
- Tics are sudden, repetitive, nonrhythmic movements or sounds.
- Motor tics involve specific muscle groups (e.g., eye blinking, shoulder shrugging).
- Phonic tics are involuntary sounds produced through nose, mouth, or throat (e.g., throat clearing, coughing, sniffing, grunting).
- Childhood-onset disorder with physical and vocal tics.
- Tics are sudden, repetitive, nonrhythmic movements or sounds.
- Motor tics involve specific muscle groups (e.g., eye blinking, shoulder shrugging).
- Phonic tics are involuntary sounds produced through nose, mouth, or throat (e.g., throat clearing, coughing, sniffing, grunting).
features of Tourette’s Disorder
Describe the etiology of Tourette’s syndrome
- Dysfunctional dopamine regulation in caudate nucleus.
- Predominantly affects males.
- Lifelong and chronic condition
- Dysfunctional dopamine regulation in caudate nucleus.
- Predominantly affects males.
- Lifelong and chronic condition
etiology of Tourette’s syndrome
Describe the treatment of Tourette’s syndrome
Atypical neuroleptics (Risperidone)
Tricyclic antidepressants
Behavior therapy.
Describe the features of Separation anxiety
- Separation anxiety disorder causes excessive anxiety when apart from home or attachment figures.
- Physical symptoms may be complained about to avoid school and leaving the mother.
- Typically diagnosed after 3 years of age with a duration of 6 weeks.
- Higher risk for anxiety disorders in adulthood.
- Separation anxiety disorder causes excessive anxiety when apart from home or attachment figures.
- Physical symptoms may be complained about to avoid school and leaving the mother.
- Typically diagnosed after 3 years of age with a duration of 6 weeks.
- Higher risk for anxiety disorders in adulthood.
features of Separation anxiety
Describe the features of Selective mutism
A social anxiety disorder
1) Persistent failure to speak in specific social settings (e.g., school) despite speaking elsewhere.
2) More prevalent among girls.
3) Interferes with education, work, and social communication.
4) Lasts for at least 1 month (not limited to the first month of school).
5) Not caused by lack of language knowledge or comfort in the situation
A social anxiety disorder
1) Persistent failure to speak in specific social settings (e.g., school) despite speaking elsewhere.
2) More prevalent among girls.
3) Interferes with education, work, and social communication.
4) Lasts for at least 1 month (not limited to the first month of school).
5) Not caused by lack of language knowledge or comfort in the situation
features of Selective mutism
Describe the features of PICA
Unusual pattern of eating inedible objects (bricks, dirst etc) for at least 1 month, typically in kids with mental retardation. It’s mostly self limiting
Complications
- Lead poisoning
- Dental issues
- Nutrition issues
- Infections
Unusual pattern of eating inedible objects (bricks, dirst etc) for at least 1 month, typically in kids with mental retardation. It’s mostly self limiting
Complications
- Lead poisoning
- Dental issues
- Nutrition issues
- Infections
features of PICA
PICA is associated with which conditions?
“DISMALM”
Autism
Intellectual disabilities
Schizophrenia
Low mineral/zinc/iron levels
Maternal deprivation
Developmental delay
Malnourishment
Describe the features of Enuresis (bedwetting)
- Repeated episodes (2 times a week for at least 3 consecutive months) of peeing the bed/clothes
- Least 5 years old or at an equivalent developmental level
- Not caused by any medical condition or substance use.
- Repeated episodes (2 times a week for at least 3 consecutive months) of peeing the bed/clothes
- Least 5 years old or at an equivalent developmental level
- Not caused by any medical condition or substance use.
features of Enuresis (bedwetting)
Describe primary enuresis
kids that were never taught how to control urination
kids that were never taught how to control urination
primary enuresis
Describe secondary enuresis
kids that are trained to control their urination for at least 6m but they then revert to wetting after a stressful situation
kids that are trained to control their urination for at least 6m but they then revert to wetting after a stressful situation
secondary enuresis
What are the treatment options for enuresis?
Desmopressin (synthetic vasopressin) & Behavioral therapy (conditioning with alarm)
Describe the effects of use of Alcohol
Mild elevation of mood
Decreased anxiety
Somnolence
Behavioural disinhibition
Sedation
Poor coordination
Respiratory depression
Describe the definition criteria of alcohol abuse
Alcohol use causes distress/impairment within a one-year period, via:
- Failure to meet work, home, or school responsibilities
- Continued use of alcohol despite awareness of physical risks.
- Repeated legal issues related to alcohol.
- Continued alcohol use despite causing or worsening social or interpersonal problems.
Alcohol use causes distress/impairment within a one-year period, via:
- Failure to meet work, home, or school responsibilities
- Continued use of alcohol despite awareness of physical risks.
- Repeated legal issues related to alcohol.
- Continued alcohol use despite causing or worsening social or interpersonal problems.
Describe the definition criteria of alcohol abuse
Describe the definition criteria of alcohol dependence
A maladaptive pattern of alcohol use leading to distress or impairment within a one-year period, via:
1. Tolerance - (needing more alcohol to achieve the same effects)
- Withdrawal
- Excessive use - (consuming larger quantities or for a longer duration than intended)
- Failed attempts to control or reduce alcohol use.
- Significant time spent on alcohol-related activities (using, recovering, obtaining).
- Neglected important responsibilities or activities due to alcohol use.
- Continued alcohol use despite knowing it has caused ongoing physical or psychological issues.
A maladaptive pattern of alcohol use leading to distress or impairment within a one-year period, via:
1. Tolerance - (needing more alcohol to achieve the same effects)
- Withdrawal
- Excessive use - (consuming larger quantities or for a longer duration than intended)
- Failed attempts to control or reduce alcohol use.
- Significant time spent on alcohol-related activities (using, recovering, obtaining).
- Neglected important responsibilities or activities due to alcohol use.
- Continued alcohol use despite knowing it has caused ongoing physical or psychological issues.
definition criteria of alcohol dependence
List the differences between Alcohol abuse vs dependence
abuse:
- less severe
- interferes with responsibilities
- dangerous use (drinking & driving)
- legal problems with alcohol
dependence:
- More severe
- higher tolerance
- withdrawal
- drink more/longer then intended
- can’t limit/control
- lot’s of time committed to getting/using it
- lost interest in old passions in favor of booze
Effects of dinking alcohol
Loss of coordination
Poor judgment
Slowed reflexes
Distorted vision
Memory lapses/ Blackouts
Lowered inhibitions
Impaired judgment
Loss of coordination
Poor judgment
Slowed reflexes
Distorted vision
Memory lapses/ Blackouts
Lowered inhibitions
Impaired judgment
effects of drinking alcohol
What classifies as binge drinking
having 5 or more drinks on one occasion (even if you don’t do it often!)
Describe the clinical impacts of alcohol abuse
1) Thiamine deficiency
(Wernicke and Korsakoff)
2) Liver failure
3) Gastric ulcers
4) lower life expectancy
5) Fetal alcohol syndrome
(microcephaly, delayed developmental milestones)
6) Intoxication – coma
1) Thiamine deficiency
(Wernicke and Korsakoff)
2) Liver failure
3) Gastric ulcers
4) lower life expectancy
5) Fetal alcohol syndrome
(microcephaly, delayed developmental milestones)
6) Intoxication – coma
clinical impacts of alcohol abuse
Describe the features of Delirium tremens (aka 1st week withdrawal symptoms from alcohol)
confusion,
disorientation,
tremors,
tachycardia,
hypertension,
hallucinations (pink elephants)
confusion,
disorientation,
tremors,
tachycardia,
hypertension,
hallucinations (pink elephants)
features of Delirium tremens (aka 1st week withdrawal symptoms from alcohol)
Describe the features of Wernickes encephalopathy
usually malnourished alcoholics that present with
- ophthalmoplegia
- ataxia
- confusion/Demetia
Rx Thiamine
Describe the features of Korsakoff syndrome
Chronic alcoholics present with
- memory loss
- confabulation
- confusion
- personality changes
- peripheral neuropathy
Chronic alcoholics present with
- memory loss
- confabulation
- confusion
- personality changes
- peripheral neuropathy
features of Korsakoff syndrome
usually malnourished alcoholics that present with
- ophthalmoplegia
- ataxia
- confusion/Demetia
Rx Thiamine
features of Wernickes encephalopathy
Hallucinogens are classified as
alter time, reality & the environment:
LSD (acid) injected
PCP (Phencyclidine aka angel dust) smoked
Mushrooms
Cannabis
What’s the average age of first time use of weed
14
Describe the physical effects of marijuana use
- Dry mouth.
- Nausea.
- Headache.
- Decreased coordination.
- Increased heart rate.
- Reduced muscle strength.
- Increased appetite and eating.
- Reddening of the eyes (vasocongestion).
- Dry mouth.
- Nausea.
- Headache.
- Decreased coordination.
- Increased heart rate.
- Reduced muscle strength.
- Increased appetite and eating.
- Reddening of the eyes (vasocongestion).
- Reproductive problems
physical effects of marijuana use
Describe the psychological effects of pot use
- Anxiety.
- Paranoia.
- Confusion.
- Anger.
- Hallucinations.
- Tiredness.
- Possible suicidal thoughts.
Describe the impact weed has on the male reproductive system
- Smaller testicular size.
- Lower testosterone hormone levels.
- Impotence.
- Decreased sexual desire.
- Change in sperm size, amount, and strength.
Describe the effects of weed on female reproductive health
- Period problems.
- Abnormal eggs.
- Decreased sexual desire.
- Reduced fertility in future children.
what are the effects of wee d during pregnancy?
- Decreased baby size.
- Increased risk of childhood leukemia
Describe the physical effects of PCP
Blurred vision
Numbness
Tachycardia
Fever
Arrythmia
Vomiting
Jerky eye movements
Heavy sweating
Speech impediments
Describe the intoxication/overuse symptoms of PCP
Seizures
Brain hemorrhaging
Kidney failure
Respiratory failure
Stroke
Coma
Death
Describe the psychological effects of taking PCP
Anxiety
Euphoria
Confusion
Amnesia
Opioids (aka narcotics) include what drugs?
Morphine
Heroine
What drug is used to treat heroin addiction?
methadone (a synthetic opioid)
Effects of Heroine & Methadone use
- Elevation of mood.
- Relaxation.
- Somnolence.
- Sedation.
- Analgesia.
- Respiratory depression.
- Constipation.
- Pupil constriction
Describe the clinical manifestations of an opioid overdose
Triad:
1) apnea
2) stupor
3) miosis
- respiratory depression (less than 12 breaths per min)
- Elevation of mood.
- Relaxation.
- Somnolence.
- Sedation.
- Analgesia.
- Respiratory depression.
- Constipation.
- Pupil constriction
Effects of Heroine & Methadone use
Treating opioid overdose typically involves
- Maintain Airway, breathing, circulation
- stomach lavage
- Administer Naloxone as an antidote (0.2-0.4mg)
- repeat doses every 2-3 minutes if there’s no response for a suspected heroine OD
- Does up to 10-20mg if an opioid OD is strongly suspected
Describe the effects of opioid withdrawal
Depression of mood
Anxiety
Insomnia
Sweating and fever
*Rhinorrhea
*Piloerection ( goose bumps)
Yawning
Abdominal cramps and diarrhea
*Pupil dilation
Amphetamines physical effects on the body
Hypertension
Tachycardia
Arrythmia
Hyperpyrexia
Delirium
Psychosis
Coma
Rhabdomyolysis
Muscle rigidity
Tachypnoea
Mydriasis
Heroin/Opiates effects on the body
Hypotension
Bradycardia
Hypothermia
Coma
Rhabdomyolysis
Respiratory depression
Pinpoint pupils
What are used to treat alcohol abuse/dependence
Disulfiram (prevent use)
Benzodiazepines (withdrawal)
Thiamine
What are used to treat Benzodiazepines and barbiturates
Replace it with Buspirone or zolpidem
Replace it with Buspirone or zolpidem
treat Benzodiazepines and barbiturates
Disulfiram (prevent use)
Benzodiazepines (withdrawal)
Thiamine
treat alcohol abuse/dependence
Treating Heroin addiction
Naloxone (blocks opiate receptors)
Clonidine (withdrawal)
Naloxone (blocks opiate receptors)
Clonidine (withdrawal), areused to rx what substace abuse?
Treating Heroin addiction
Pupil dilation seen with which drug uses (3)
Cocaine
Amphetamines
LSD
Pupil dilation seen with dilation from these drugs
Heroin
Methadone
Alcohol
Pupil constriction is seen with use of which drugs
Heroin
Methadone
Pupil constriction is seen with withdrawal of which drugs
Cocaine
Amphetamines
Drug use that cause Psychotic symptoms like hallucinations and delusions
Cocaine
Amphetamines
Alcohol
Hallucinogens
Drug withdrawal that causes Psychotic symptoms like hallucinations and delusions
Alcohol
Benzodiazepines
Barbituates
Immediate treatment of amphetamines and cocaine use
Benzodiazepines (decrease agitation)
Antipsychotics
Immediate treatment of sedatives like alcohol, benzodiazepines, & barbiturate use
Flumazenil (reverse benzo effects)
Thiamine (alcohol vitamin def)
Immediate treatment of opioids like heroin and methadone use
Naloxone (OD)
Clonidine (withdrawal)
long term treatment of opioids like heroin and methadone use
methadone
Buprenorphine
Immediate treatment of hallucinogens like Marijuana, LSD & PCP use
Benzodiazepine (lower agitation)
Antipsychotics
alcohol, barbiturate, and benzodiazepine effects of use includes
Mild elevation of mood
Decreased anxiety
Somnolence
Behavioural disinhibition
Sedation
Poor coordination
Respiratory depression
Withdrawal symptoms of alcohol, barbiturates, and benzodiazepines includes
Mild depression of mood
Increased anxiety
Insomnia
Psychotic symptoms (delusions and formication)
Disorientation
Tremor
Seizures
Tachycardia and hypertension
withdrawal effect of amphetamine & cocaine includes
Significant depression of mood
Irritability
Hunger
Pupil constriction ( Miosis )
Fatigue
Effects of use of amphetamines & cocaine include
- Elevation of mood (followed by crash - cocaine).
- Increased attention.
- Aggressiveness, impaired judgement.
- Psychotic symptoms (paranoid delusions - amphetamine, tactile hallucinations - cocaine).
- Loss of appetite and weight.
- Insomnia.
- Seizures.
- Tachycardia.
- Hypersexuality.
- Mydriasis (pupil dilation).
Physiological effects of nicotine
- Central nervous system stimulant.
- Increases heart and respiratory rates.
- Constricts blood vessels and raises blood pressure.
- Increases blood sugar levels.
- Decreases stomach contractions that signal hunger.
- Symptoms of nicotine poisoning: - Dizziness.
- Lightheadedness.
- Rapid and erratic pulse.
- Nausea
Impaired motor coordination
Slowed sense of time
Social withdrawal
Munchies
Conjunctival injection
Psychosis
WEEEEEEEEEEEEEED
Ideas of reference
Perceptual disturbances
Impaired judgement
Dissociative symptoms
Signs of Hallucinogenic intoxication (LSD, PCP, mushrooms, etc)
Euphoria
Hypervigilance
Autonomic hyperactivity
Weight loss
Pupil dilation
Perceptual disturbances
Amphetamine use = cocaine
Talkative
Gregarious
Moody
Disinhibited
Alcohol use
Apathy
Dysphoria
Pinpoint pupils
Drowsiness
Slurred speech
Coma
Death
Opiate use
Naloxone is used to treat
Opiates
Belligerence
Psychomotor agitation
Violence
Nystagmus
Hypertension
Seizures
PCP (Phencyclidine) use
Place in a quiet room
Antipsychotics
Benzodiazepines
used to treat
PCP OD
Irritability
Aggression
Mood instability
Psychosis
Anabolic steroid use
Euphoria
Mild hallucinations
Visual distortions
Enhanced sensations
Hyperthermia
Bruxism
Autonomic Hyperactivity
Dry mouth
Ecstasy use
Dantrolene
Benzodiazepines
Hydration
used to treat
Ecstasy (MDMA, MOLLY, E, or X)
Withdrawal symptoms:
Depression
Anxiety
Panic attacks
Ecstasy
Withdrawal symptoms:
Depression
Headaches
Anxiety
Anabolic steroids
Withdrawal symptoms:
Elevated body temperature
Seizures
Muscle breakdown
Muscle twitching
Agitation
Hallucinations
PCP (Phencyclidine)
Withdrawal:
Fever
Chills
Runny nose
Diarrhea
Muscle spasms/cramps
opiates
Slurred speech
Confusion
Memory deficits
Falls
Respiratory depression (rare)
Benzodiazepine intoxication signs
Flumazenil & ventilation if needed is treatment for
Benzodiazepine intoxication
Withdrawal signs:
Increased anxiety
Insomnia
Seizures
Benzodiazepine intoxication
Withdrawal symptoms:
Anxiety
Depression
Cognitive impairments
Memory deficits
Lack of attention
Seizures
Delirium
Barbiturates
What the treatment for barbiturate withdrawal?
Phenobarbital
Describe the features of fetal alcohol syndrome
low nasal bridge
Small eyes
Small/underdeveloped jaw
Short nose
Epicanthal folds
Flat midface
Smooth philtrum
Thin upper lip
Small head + microcephaly
low nasal bridge
Small eyes
Small/underdeveloped jaw
Short nose
Epicanthal folds
Flat midface
Smooth philtrum
Thin upper lip
Small head + microcephaly
features of fetal alcohol syndrome
Dopamine _______ desire for stimulus & serotonin ________ desire for stimulus
Dopamine = Increases stimulus desire
Serotonin gives impression of satisfaction
Describe the features of wilson disease
Ceruloplasmin deficiency
Hepatolenticular degeneration
Kayser-Fleischer rings in the eyes
Asterixis
Ceruloplasmin deficiency
Hepatolenticular degeneration
Kayser-Fleischer rings in the eyes
Asterixis
features of wilson disease
Enlarged ventricles
Normal pressure
Neurocognitive disorder
Urinary incontinence
Gait apraxia
Normal hydrocephalus
Describe the features of normal pressure hydrocephalus
features of wilson disease
Lewy body cognitive disorder
Hallucinations
Parkinsonian features
Extrapyramidal signs
Antipsychotics can make it worse
Fluctuating condition & REM sleep behaviour disorder
Hallucinations
Parkinsonian features
Extrapyramidal signs
Antipsychotics can make it worse
Fluctuating condition & REM sleep behaviour disorder
Lewy body cognitive disorder
Describe the features of Neurocognitive disorder due to an HIV infection
- Infection directly & progressively destroys the brain parenchyma
- Starts with subtle personality changes
- Diffuse and rapid multifocal destruction of brain structures and delirium
- Infection directly & progressively destroys the brain parenchyma
- Starts with subtle personality changes
- Diffuse and rapid multifocal destruction of brain structures and delirium
features of Neurocognitive disorder due to an HIV infection
Neurocognitive disorder due to Parkinson’s disease
- Progressive loss of dopaminergic neurons in the substantia nigra
- Clinical onset 50-65yrs old
- Depressive symptoms
Rx. Levodopa, carbidopa, dopamine agonists, anticholinergic meds (benzotropine etc)
- Progressive loss of dopaminergic neurons in the substantia nigra
- Clinical onset 50-65yrs old
- Depressive symptoms
Rx. Levodopa, carbidopa, dopamine agonists, anticholinergic meds (benzotropine etc)
Neurocognitive disorder due to Parkinson’s disease
Neurocognitive Disorder Due to Huntington Disease
- Rare, progressive loss of GABAergic neurons of the basal ganglia
- Choreoathetosis
- Neurocognitive disorder
- Psychosis
- Onset age 40yrs
- Atrophy of caudate nucleus
- Suicidal behaviour is common
- Rare, progressive loss of GABAergic neurons of the basal ganglia
- Choreoathetosis
- Neurocognitive disorder
- Psychosis
- Onset age 40yrs
- Atrophy of caudate nucleus
- Suicidal behaviour is common
Neurocognitive Disorder Due to Huntington Disease
Neurocognitive disorder due to prion disease
- Rare, spongiform encephalopathy
- Neurocognitive disorder
- Myoclonus
- EEG abnormalities
- Symptoms progress over months
- Malaise
- Personality changes
- Death
- Rare, spongiform encephalopathy
- Neurocognitive disorder
- Myoclonus
- EEG abnormalities
- Symptoms progress over months
- Malaise
- Personality changes
- Death
Neurocognitive disorder due to prion disease
Describe the features of Neurocognitive disorder (Picks Disease)
- Atrophy of the frontal and temporal lobes
- Pick bodies & Pick cells in brain
- More common in men
- Kluver-Bucy syndrome (hypersexuality, hyperphagia, & passivity)
- Atrophy of the frontal and temporal lobes
- Pick bodies & Pick cells in brain
- More common in men
- Kluver-Bucy syndrome (hypersexuality, hyperphagia, & passivity)
Describe the features of Neurocognitive disorder (Picks Disease)
Neurocognitive disorder due to Alzheimer’s disease
- Cortical atrophy, flattened sulci, & enlarged ventricles
- Amyloid deposits
- Neurofibrillary tangles
- Associated with X-21
- Decrease Ach & NE
- Gradual deterioration
- Cortical atrophy, flattened sulci, & enlarged ventricles
- Amyloid deposits
- Neurofibrillary tangles
- Associated with X-21
- Decrease Ach & NE
- Gradual deterioration
Neurocognitive disorder due to Alzheimer’s disease
Vascular neurocognitive disorder (multi-infarct neurocognitive disorder)
- Pseudo cerebellar palsy
- Dysrhythmia
- Dysphagia
- Abnormal reflexes
- Gait disturbances
- Stepwise or gradual progression
- Pseudo cerebellar palsy
- Dysrhythmia
- Dysphagia
- Abnormal reflexes
- Gait disturbances
- Stepwise or gradual progression
Vascular neurocognitive disorder (multi-infarct neurocognitive disorder)
Describe delirium
Acute onset of impaired cognitive functioning that’s brief and reversible
- loss of cognitive abilities
- impaired social functioning
- memory loss
- Personality changes
Personality
IQ
Attention
Judgement
Movement
Problem-solving
Speech
Frontal lobe functions
Personality
IQ
Attention
Judgement
Movement
Problem-solving
Speech
Frontal lobe functions
Paralysis
Repeated single thought
Can’t focus
Mood swing, impulsiveness
Personality changes
Difficulty problem solving
Difficulty with language (aphagia
Damaged frontal lobe
Damaged frontal lobe
Paralysis
Repeated single thought
Can’t focus
Mood swing, impulsiveness
Personality changes
Difficulty problem solving
Difficulty with language (aphagia
Sense of touch, pain, & temperature
Distinguishing size, shape, & colour
Visuospatial perception
Parietal lobe function
Parietal lobe functions
Sense of touch, pain, & temperature
Distinguishing size, shape, & colour
Visuospatial perception
Difficulty distinguishing left vs right
Lack of awareness of body parts
Difficulty with hand-eye-coordination
Problems reading, writing, & naming things
Difficulty with math
damage to parietal lobe
Damage to parietal lobe
Difficulty distinguishing left vs right
Lack of awareness of body parts
Difficulty with hand-eye-coordination
Problems reading, writing, & naming things
Difficulty with math
Vision
Occipital lobe
Occipital lobe
vision
Defects in vision or blind spots
Blurred vision
Visual illusions/hallucinations
Problems reading/writing
Damage to occipital lobe
damage to occipital lobe
Defects in vision or blind spots
Blurred vision
Visual illusions/hallucinations
Problems reading/writing
Speech (wernickes aphasia understanding)
memory
hearing
sequencing
organization
functions of the temporal lobe
functions of the temporal lobe
Speech (wernickes aphasia understanding)
memory
hearing
sequencing
organization
Difficulty understanding language & speaking
Difficulty recognizing faces
Difficulty ID objects
Problems with short/long term memory
Changes in sexual behavior
Increased behaviour
damaged temporal lobe
Damaged temporal lobe
Difficulty understanding language & speaking
Difficulty recognizing faces
Difficulty ID objects
Problems with short/long term memory
Changes in sexual behavior
Increased behaviour
Balance & coordination
Cerebellum
Function of the cerebellum
Balance & coordination
Difficulty coordinating fine movements & walking
Tremors
Dizziness (Vertigo)
Slurred speech
Damaged Cerebellum
Damaged Cerebellum
Difficulty coordinating fine movements & walking
Tremors
Dizziness (Vertigo)
Slurred speech
Breathing
Heart rate
Alertness/consciousness
Functions of the brainstem
Functions of the brainstem
Breathing
Heart rate
Alertness/consciousness
Changes in breathing
Difficulty swallowing food & water
Problems with balance & movement
Damage to the brainstem
Damage to the brainstem
Changes in breathing
Difficulty swallowing food & water
Problems with balance & movement
Aphasia
Impairment of language affecting one’s ability to speak/understand speech, read, or write
Dominant (Left)
- Parietal lobe dysfunction (most right-handed plp)
- Language disorders (aphasia & alexia)
- Gerstmann syndrome (Dyscalculia, dysgraphia, finger agnosia, right-left confusion)
- Apraxia
- Parietal lobe dysfunction (most right-handed plp)
- Language disorders (aphasia & alexia)
- Gerstmann syndrome (Dyscalculia, dysgraphia, finger agnosia, right-left confusion)
- Apraxia
Dominant (Left)
Non-Dominant (Right)
- Parietal lobe dysfunction
- Hemispatial neglect
- Sensory & visual inattention
- Constructional & dressing apraxia (more severe for right-sided lesions)
- Parietal lobe dysfunction
- Hemispatial neglect
- Sensory & visual inattention
- Constructional & dressing apraxia
(indicate_______-sided lesions)
Non-dominant (right)
Common Symptoms use of Opiates:
Methadone
Morphine
Heroin
1) Decreased heart rate
2) Decreased breathing
3) Deeping voice
4) Chang in sleep
5) Pin point pupils
Common signs of effects of use of _______include
1) Decreased heart rate
2) Decreased breathing
3) Deeping voice
4) Chang in sleep
5) Pin point pupils
Common Symptoms use of Opiates:
Methadone
Morphine
Heroin
Common signs of withdrawal of opiate use: Methadone, Morphine, & Heroin
1) Mood swings
2) Rapid pulse
3) Dilated pupils
4) Signs can last up to 18 months
Common withdrawal signs of _______ use:1) Mood swings
2) Rapid pulse
3) Dilated pupils
4) Signs can last up to 18 months
Common signs of withdrawal of opiate use: Methadone, Morphine, & Heroin
Common signs of opiate overdose:
Methadone
Morphine
Heroin
1) Decreased respiratory rate
2) Arrythmia
3) Clammy skin
4) Coma
5) Nausea/vomiting
6) Anxiety
Common overdose signs from ______ use1) Decreased respiratory rate
2) Arrythmia
3) Clammy skin
4) Coma
5) Nausea/vomiting
6) Anxiety
Common signs of opiate overdose:
Methadone
Morphine
Heroin
Common signs of benzodiazepine overdose:
1) depressed respiratory rate
2) clammy skin
3) Dilated pupils
Common signs of ________overdose:
1) depressed respiratory rate
2) clammy skin
3) Dilated pupils
Benzodiazepine overdose
Common signs of Benzodiazepine withdrawal:
1) Dilated pupils
2) Possible Death
3) Headaches/tremors
4) Muscle twitches
5) Can’t focus
Common signs of ________ withdrawal:
1) Dilated pupils
2) Possible Death
3) Headaches/tremors
4) Muscle twitches
5) Can’t focus
Benzodiazepine withdrawal
Common signs of effects of use of Benzodiazepines
1) Double vision
2) Drowsiness
3) Change in behavior
4) Slowed speech
5) Loss of memory
Common signs of effects of use of _______
1) Double vision
2) Drowsiness
3) Change in behavior
4) Slowed speech
5) Loss of memory
Benzodiazepines effects of use
Common signs of effects of alcohol use
1) Blurred vision
2) Unsteady gait
3) Slowed/Slurred speech
4) Vomiting
5) Blackouts
Common signs of effects of________use
1) Change in behaviour
2) Hunger
3) Red eyes
3) Dilated pupils
4) Slowed Speech
5) Slowed Heart rate
Weed effects of use
Common signs of effects of weed use
1) Change in behaviour
2) Hunger
3) Red eyes
3) Dilated pupils
4) Slowed Speech
5) Slowed Heart rate
Common signs of withdrawal of weed use
1) Headache
2) Shakiness
3) Sweating
4) Stomach pain/nausea
Common signs of withdrawal of using _________
1) Headache
2) Shakiness
3) Sweating
4) Stomach pain/nausea
weed withdrawal
Common signs of weed overdose is when it’s
mixed with other drugs son!
Common signs of LSD use
1) Blurred vision
2) Flashbacks after long use
3) Tremors
4) Facial flushing
5) loss of consciousness
6) anxiety + mood swings
Common signs of LSD use
1) Blurred vision & Dilated pupils
2) Flashbacks after long use
3) Tremors
4) Facial flushing
5) loss of consciousness
6) anxiety + mood swings
Common signs of effects of use for MDMA
1) Shutter vision
2) Insomnia + wakefulness
3) Uncontrolled movements
4) Talkative
5) Bruxism
Common signs of effects of use of _________
2) Insomnia + wakefulness
3) Uncontrolled movements
4) Talkative
5) Bruxism
6) Increased Heart rate
MDMA
Common signs of withdrawal of MDMA
1) Agitation
2) Increased body temperature
3) Hallucinations
4) High blood pressure
5) Severe depression that can last for months
Common signs of withdrawal of ______ use
1) Agitation
2) Increased body temperature
3) Hallucinations
4) High blood pressure
5) Severe depression that can last for months
withdrawal of MDMA
Common signs of overdose of MDMA
1) High body temperature
2) Fainting spells
3) Seizures
4) Loss of consciousness
Common signs of overdose of _______
1) High body temperature
2) Fainting spells
3) Seizures
4) Loss of consciousness
overdose of MDMA
Common signs of effects of use of Amphetamines (Ritalin) & cocaine
1) Shutter vision + Dilated pupils
2) Insomnia + wakefulness
3) Uncontrolled movements
4) Talkative
5) Bruxism
6) Increased Heart rate
7) Loss of appetite
Common signs of effects of use of _________ use
1) Shutter vision + Dilated pupils
2) Insomnia + wakefulness
3) Uncontrolled movements
4) Talkative
5) Bruxism
6) Increased Heart rate
7) Loss of appetite
Common signs of withdrawal of ______ use
1) Agitation + Dilated pupils
2) Increased body temperature
3) Hallucinations
4) Convulsions & apathy
5) Long periods of sleep
6) Disorientation
7) High blood pressure
8) Severe depression that can last for months
Amphetamines (Ritalin) & Cocaine withdrawal
Common signs of overdose of Amphetamines (Ritalin) & Cocaine
1) Cardiac issues
2) Stroke
3) Seizures
4) Hallucinations
5) Fainting
6) Coma
