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Psychiatry > Feb. 25 > Flashcards

Feb. 25 Flashcards

1
Q

Sleep

A
  • one of the few markers in psychiatry

- characteristic sleep patterns that correlate with certain diagnoses

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2
Q

Sleep with Major Depression

A

-shortened REM latency; early AM awakening, fitful sleep, hypersomnia also possible in mood disorders

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3
Q

PTSD and Sleep

A

-nightmares

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4
Q

Sleep and Bipolar

A

-manic: drastically decreased need for sleep, highly irritable, manic episode can be precipitated by sleep deprivation (jet travel)

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5
Q

Sleep Apnea

A

-manifests as daytime lethargy; can be mistaken for depression or lack of motivation

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6
Q

Schizophrenia and Sleep

A

-patient is often up all night, in agitated aimless activity, driven by delusional thinking

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7
Q

Eating

A
  • typically patients do not seek psychiatric help for eating disorders, but the medical symptoms bring the patient to the attention of dentists, pediatricians, & internists
  • consequences can be life threatening
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8
Q

Medical Manifestations of Eating Disorders: anorexia

A

hypometabolic (cold, tired, weak, lacking energy), cyanotic extremities, dry, delayed healing, easy brusing, lanugo-type hair on face/upper body; alopecia of scalp hair
heart: dizziness, fainting, palpitations
full, bloated, discomfort after eating small amounts, constipation
-depression, anxiety, OCD

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9
Q

Sexual Issues

A
  • homosexuality is not considered a mental disorder
  • “significant impairment or distress” to qualify
  • sexual dysfunctions due to med side effects may result in medication noncompliance
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10
Q

Paraphilic Disorders

A

-intense & persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners

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11
Q

Intense & Persistent Erotic Interest

A
  1. Erotic Activities (spanking, bondage, whipping, strangulation, autoerotic asphyxiation, frottage)
  2. Erotic Targets (children, animals, corpses, amputees, inanimate objects)
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12
Q

Anorexia Nervosa

A
  • characterized by overestimation of body size & shape, with relentless pursuit of thinness that typically combines excessive dieting & compulsive exercising
    1. restrictive: limited caloric intake
    2. binge-purge: overeat then throw up or laxatives
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13
Q

Bulimia Nervosa

A

-episodes of eating large amounts of food in brief period (binge), then intended eliminate or reduce effects of ingestion by vomiting, laxative, exercise, or fasting

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14
Q

Binge Eating Disorder

A
  • not followed by compensatory behavior

- causes obesity

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15
Q

Anorexia Nervosa Epidemiology

A

-white, adolescent females
-intelligent, high socioeconomic status
-conflict-avoidant, risk-aversive, anxious, & perfectionist
-depressed mood or OCD traits
0.5-1%
48-76% heritability

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16
Q

Bulimia Nervosa Epidemiology

A
  • older adolescence
  • impulsivity & difficulty in maintaining stable relationships & depression
  • 3-5%
  • 54-85% heritability
17
Q

Dysmorphis

A

“reverse anorexia”

-desire to increase muscle & get bigger

18
Q

What is involved in the development & maintenance of eating disorders?

A

-dysregulation of serotonin

19
Q

Precipitating Factors for eating disorders?

A
  • dieting

- (negative social comparisons, family/peer pressure to be thin, peer teasing)

20
Q

Lab Abnormalities in Eating Disorders

A
  • low WBC count
  • hypokalemic, hypochloremic metabolic alkalosis
  • mildly elevated liver enzymes, cholesterol, & cortisol levels
  • low gonadotropin & blood glucose levels with marked weight loss
  • generally normal serum protein, albumin, renal function
21
Q

Eating Disorder EKG

A
  • low voltage, non-specific ST & T wave changes

- bradycardia or arrhythmia

22
Q

Medical Manifestations of Eating Disorders: Bulimia

A
  • self-injurious behavior (cutting, scratching) may occur
  • subconjunctival hemorrhage from vomiting
  • enamel erosion with tooth decay/fracture/loss due to stomach acid
  • enlargement of parotid and/or submandibular glands
  • dizziness, fainting, palpitations
  • discomfort after a binge; cramps/diarrhea with laxative abuse
  • depression, anxiety, borderline personality traits; substance use
23
Q

Dysfunctional Cognitions

A
  • “all or none thinking”
  • jump to catastrophic conclusions
  • body is governed by rules that don’t apply to others
  • bad day because of one unexpected “bad” food
24
Q

Bulimia Treatment

A

-once weight is restored: SSRI

25
Q

Substance Intoxication

A

-soon after ingestion of drug & reverses once the drug is metabolized & excreted

26
Q

Substance Abuse

A
  • maladaptive use that disrupts or impairs functioning at work, home, or leisure
  • causes or precipitates physical & psychological harm & persistent legal, social, interpersonal problems
27
Q

Substance Dependence

A

-reflects the need to rely on a substance, marked by substance tolerance, substance withdrawal, & preoccupation with obtaining or recovery from the substance

28
Q

Tolerance

A

-state of need for increased amounts of the substance to achieve a desired effect or in which the same amount of substance produces a diminished effect

29
Q

Withdrawal

A

-physical & psychological signs & symptoms that occur when a person dependent on a substance stops using it for a period of time

30
Q

Alcohol

A

50% of worlds population

-most commonly use psychoactive substance

31
Q

Sexual Desire Disorders

A
  • hypoactive desire disorder (20% adults)
  • sexual aversion disorder
  • reduced desire for sexual contact or total aversion to sexual activity
32
Q

Sexual Arousal Disorders

A
  • Female sexual arousal disorder (33% married girls)
  • Male erectile disorder (2-4%80)
  • inability to attain or maintain sexual arousal sufficient to initiate or complete sexual acts
33
Q

Orgasmic Disorders

A
  • female orgasmic disorder (5% adult women)
  • male orgasmic disorder (4% adult male)
  • premature ejaculation (30% adult male)
  • excessive orgasmic delay, absence of orgasmic response, or premature orgasm
34
Q

Sexual Pain disorders

A
  • Dyspareunia
  • Vaginismus
  • pain in sexual organs during sexual activity that interferes with or prevents sexual activity
35
Q

Paraphilia

A
  • Exhibitionism
  • Fetishism
  • Frotteurism
  • Pedophilia
  • Masochism/sadism
  • Tranvestic fetishism
  • Voyeurism
  • deviant arousal patterns & object choices
36
Q

Gender identity disorders

A

-discomfort with or nonacceptance of primary sexual identification & desire to change sexual identification to the opposite gender

37
Q

Sexual Dysfunction due to medical conditions

A
  • common

- variable sexual dysfunction resulting from identified medical conditions or treatment

Psychiatry (7 decks)

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