Vignettes Flashcards
what are absolute contraindications to ECT?
NONE
What is the length of time for seizure in ECT to be effective?
25 sec
what meds have to be tapered for ECT?
Benzos
Lithium - postictal delirium
Bupropion - late appearing seizures
Clozapine - late appearing seizures
can you use propofol for anesthesia for ECT?
no - raises seizure threshold
what med conditions associated with mania?
glioma
cushing’s dz
MS
what % of patients with bipolar d/o have co-occurring substance d/o?
60%
actus reus definition in legalese
voluntary conduct
mens rea in legalese
evil intent
M’Naghten rule
did the defendant understand the nature of the act and the difference of right and wrong? if mentally ill, then not guilty
glossolalia
unintelligible jargon that has meaning to the speaker (made up words)
laconic speech
reduction in quality of spontaneous speech
mesocortical pathway responsible for
negative symptoms of schizophrenia
mesocortical pathway goes from what to what
VTA –> frontal lobe
transient global amnesia – do people typically retain personal information and identity?
yes
transient global amnesia demographics
affects men>women
over 50 y/o
transient global amnesia prognosis
benign - no work up needed
lasts a few hours - 12 hrs
average survival expectancy range from initial onset of Alzheimer’s dz
5-10 years (8 avg)
gender ratio of DID
female 5-10: male 1
what % of DID patients meet criteria for somatization disorder?
40-60%
therapy modalities that may be helpful for DID
supportive, dynamic, CBT, hypnotherapy
Is HTN a risk factor for delirium?
no
is smoking a risk factor for delirium?
yes
what area of the brain implicated in delirium?
reticular formation - arousal
triphasic waves associated with
hepatic encephalopathy
psychodynamic explanation of body dysmorphic disorder
displacement of sexual or emotional conflict onto nonrelated body parts
body dysmorphic disorder has high comorbidity with
MDD
biological contributors to somatic symptom disorder
- heritable in first degree female relatives
- decreased activity in frontal lonbe and nondom hemisphere (bad attention to detail)
- abnormal cytokine regulation
lifetime prevalence of somatic symptom disorder
1-2%
what age does somatic symptom disorder usually begin
adolescence
somatic symptom disorder prognosis
chronic, undulating, relapsing disorder
rarely remits, poor prognosis
best treatment for somatic symptom disorder
individual or group psychotherapy
how much time do you have to be off of alcohol before starting disulfiram?
12 hours
dosing of disulfiram
500 mg daily for first 1-2 weeks, then 250 mg daily thereafter
how would phenytoin affect methadone level?
decreases it
how would dextromethorphan affect methadone levels?
decreases it
how would cocaine affect methadone levels?
decreases it
how would tobacco affect methadone levels?
decreases it
