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Mental > Thought Disorders (psychosis, schizophrenia), Situational Crisis (terminal dx, job loss, relationship issues, unexpected death), Intentional Overdose & Ingestions > Flashcards

Thought Disorders (psychosis, schizophrenia), Situational Crisis (terminal dx, job loss, relationship issues, unexpected death), Intentional Overdose & Ingestions Flashcards

1
Q

a mental disorder in which thought and emotions are so impaired that contact w external reality is lost

A

psychosis

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2
Q

a long-term mental disorder of a type involving a breakdown in the relation btwn thought, emotion, and behavior, leading to a faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships, fantasy and delusion, and a sense of mental fragmentation

A

schizophrenia

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3
Q

symptoms that a patient w schizophrenia will exhibit but are not exhibited by those w/o the disorder

hallucination/delusions, thought disorganization, bizarre dress or behavior, perseveration, ideas of reference, ambivalence

A

positive symptoms of schizophrenia

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4
Q

persistent adherence to a single idea or topic

A

perseveration

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5
Q

false belief that external events have a special meaning

A

ideas of reference

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6
Q

behaviors that are likely to exist in the patient w/o schizophrenia but may be absent in the patient w the disorder

apathy, alogia, flat affect, anhedonia, avolition

A

negative symptoms of schizophrenia

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7
Q

speaking w minimal content

A

alogia

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8
Q

feeling no joy or pleasure

A

anhedonia

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9
Q

lack of will, ambition or drive to accomplish a task

A

avolition

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10
Q

form of psychosis related to a physiological cause

A

delirium

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11
Q

false personal beliefs about oneself

A

delusions

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12
Q

intermittent, uncoordinated, involuntary contractions of muscled of the face, neck, trunk, extremities

place patient in quiet room w/ minimal stimulation, diphenhydramine or benztropine

A

acute dystonia

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13
Q

subjective sensation of motor restlessness (may mimic increased agitation/anxiety)

place patient in quiet room w/ minimal stimulation, diphenhydramine or benztropine

A

akathisia

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14
Q

potentially life-threatening complication causing altered mental status, muscular rigidity, fever, sympathetic nervous system lability

withdraw offending medications, cooling measures, airway protection, stabilize BP and pulse, reduce muscular rigidity (dantrolene, bromocriptine, amantadine)

A

neuroleptic malignant syndrome

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15
Q

ineffective coping due to stressors (leaving the individual to solve problems and deal w internal or external stressors)

exacerbation of chronic illness, change in employment, move to a new geographical area, demands of school or job, maturational crisis (birth, marriage, retirement), and/or reliance of ineffective or inappropriate coping strategies, natural disaster, unexpected death, terminal dx

A

situational crisis

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16
Q

mimics or stimulates the sympathetic nervous system

illegal street drugs (cocaine, amphetamines, methamphetamines, ecstasy, LSD) certain rx drugs (albuterol, dopamine, TCAs, MAOIs)

increased BP, HR, RR, diaphoresis, agitation, temperature and pupil size

A

sympathomimetics toxidrome

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17
Q

suppresses the parasympathetic nervous system

atropine, antihistamines, TCAs, cyclobenzaprine, drugs to treat Parkinson’s, anti-spasmodic, certain plants (jimsonweed, nightshade, leaves of the potato plant)

increased BP, HR, temperature, pupil size, confused/seizures, hallucinations

decreased diaphoresis, bowel sounds

blind as a bat, red as a beet, dry as a bone, mad as a hatter, hotter than hades

A

anticholinergics toxidrome

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18
Q

refers to parasympathetic nervous system (stimulates or mimics)

insecticides, organophosphorus, warfare agents (sarin, soman, tuban), physostigimine, certain mushrooms, pilocarpine, nicotine

Diarrhea/diaphoresis
Urination
Miosis
Bradycardia/bronchorrhea
Emesis
Lacrimation
Salivation
A

cholinergics toxidrome

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19
Q

heroin, morphine, dilaudid

decreased BP, HR, RR, mental status, temperature, pupil size, bowel sounds

triad of respiratory depression, CNS depression, mitosis

A

opiate toxidrome

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20
Q

brief intense withdrawal which begins 4-6 hrs after the last dose, peaks in 48-72 hours, lasts 5-10 days

yawning, lacrimation, rhinorrhea, diaphoresis, mydriasis, myalgia, tremors, n/v, diarrhea, abd cramps, fever, chills, tachycardia, hypertension, piloerection, muscle cramping, involuntary leg movements

A

short acting opiate withdrawal (heroin, morphine)

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21
Q

milder withdrawal which begins 24-48 hrs after last dose but may last for weeks

yawning, lacrimation, rhinorrhea, diaphoresis, mydriasis, myalgia, tremors, n/v, diarrhea, abd cramps, fever, chills, tachycardia, hypertension, piloerection, muscle cramping, involuntary leg movements

A

long acting opiates withdrawal (methadone)

22
Q

barbiturates (end in tal) benzos (end in pam), antihistamines, alcohol

decreased BP, HR, RR, mental status, temperature, bowel sounds

A

sedative/hypnotic toxidrome

23
Q

benzo antidote

may cause seizures in patients w dependence on benzos or @ high risk for seizures - should be avoided or used w extreme caution in these patients

A

flumazenil (romazicon)

24
Q

alcoholic beverages

hypoglycemia (esp in children), AMS, hypomag (chronic alcoholism), wernicke-korsakoff syndrome

tx - airway protection, glucose and mag PRN, 100 mg IV thiamine

A

ethanol

25
Q

windshield wiper fluid, canned fuels (eg. sterno), paint removers

profound metabolic acidosis, n/v abd pain, destruction of optic nerve (blurred vision -> blindness)

tx - sodium bicarb (for acidosis), fomepizole (4-MP) - inhibits metabolism of toxic metabolites, HD

A

methanol

26
Q

anti-freeze, de-icing agents, coolants

metabolic acidosis w tachycardia, HTN, and hyperventilation, renal failure

tx - sodium bicarb (for acidosis), fomepizole (4-MP) - inhibits metabolism of toxic metabolites, HD

A

ethylene glycol

27
Q

rubbing alcohol and glass cleaners

hyperglycemia, ketones in urine, fruity odor to breath, profound CNS depression

tx- supportive therapy

A

isopropanol

28
Q

dysphoric mood

autonomic hyperactivity (tachycardia, HTN, fever, diaphoresis, fine tremor

GI upset

A

12-24 hrs post drink

29
Q

increased autonomic hyperactivity, coarsening of tremors, mild auditory, visual or tactile hallucinations

A

24-36 hrs post drink

30
Q

generalized tonic-clonic seizures (single or multiple), status epilepticus is uncommon with alcohol withdrawal

A

36-72 hrs post drink

31
Q

delirium termens (extreme autonomic instability, CV collapse, fluctuating LOC, delirium, coarse tremor, elevation in VS, n/v

may last 3-5 days

A

72-96 hrs post drink

32
Q

antidote for CCBs

1 gram over 5 minutes, may be repeated q 15-30 min for 3-4 doses

A

calcium chloride

33
Q

antidote for BBs

enhances cardiac contractility (can be considered for CCBs but will exacerbate hyperglycemia)

A

glucagon

34
Q

antidote for digitalis ( may OD on medication or plants (foxglove, oleander, Lilly of the valley))

2 of the following:

  • life threatening arrhythmias
  • serum K above 5
  • serum dig > 10
A

digoxin immune fab (digibind)

35
Q

antidode for sulfonylureas, meglitinides

adult dose - 50mcg subq or IV q 6 hrs PRN
pediatric dose 1 mcg/kg subq or IV q 6 hrs PRN

A

octreotide

36
Q

antidote for biguanide (metformin)

A

sodium bicarb and HD

37
Q

warfarin antidote

A

vitamin K

38
Q

heparin, dalteparin, tinzaparin antidote

A

protamine

39
Q

dabigatran antidote

A

idarucizumab

40
Q

clopidogrel, prasugrel, ticgrelor antidote

A

platelet transfusion

41
Q

fondaparinux antidote

A

factor VIIa

42
Q

abciximab, eptifibatide, tirofiban antidote

A

platelet transfusion

43
Q

volume replacement (may require 4-6L crystalloids) serum bicarb (goal ph 7.5), IV K+ (goal 4-4.5)

A

treatment for salicylate OD

44
Q

rarely causes severe illness, PPI to protect stomach, IV fluids/vasopressors for hypotension, benzos for seizures

A

treatment for NSAID OD

45
Q

anorexia, n/v, malaise

A

0-24 hrs post ingestion of Tylenol

46
Q

abd pain, hepatic tenderness, increased transaminase and bilirubin, increased PT

A

2-3 days post ingestion of Tylenol

47
Q

new onset anorexia, n/v, encephalopathy, anuria, jaundice, metabolic acidosis, coagulopathies, renal failure, pancreatitis

A

3-4 days post ingestion of Tylenol

48
Q

multi organ dysfunction syndrome

A

> 5 days post ingestion of Tylenol

49
Q

n-acetylcysteine (mucomyst)

A

Tylenol antidote

50
Q

sodium bicarb (ph 7.5-7.55), may need to administer K+

A

TCA antidote

Mental (2 decks)

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