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NMSP Exam 3 > Approach to Psychosomatic Disorders > Flashcards

Approach to Psychosomatic Disorders Flashcards

1
Q

What are the two basic assumptions in Psychosomatic medicine ?

A
  1. unit of mind and body
  2. psychological factors must be considered in all disease states

a holistic approach to medicine!

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2
Q

what is psychosomatic medicine?

A

a medical condition separate from a mental disorder that is present

mental/psychological factors adversely affect general medical conditions

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3
Q

what is an independent risk factor for coronary heart disease, is associated with increased risk of subsequent stroke and diabetic symptoms

A

depression

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4
Q

what mood disorder is a risk factor for asthma, coronary artery disease, and specific phobias

A

anxiety

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5
Q

what mood disorder impaired presentation and treatment of symptoms of a plethora of health conditions

A

schizophrenia

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6
Q

what disorder can cause maladaptive health behaviors like over eating, unsafe sex or be in denial of the need for surgery even with cancer

A

personality disorders

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7
Q

what is stress

A

a circumstance that disturbs or is likely to disturb normal physiological/psychological functioning of a person

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8
Q

describe the stress theory: what is set into motion first

A

the sympathetic nervous system increases, heart rate, blood pressure, and cardiac output

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9
Q

how does the body respond to stress

neurotransmitters:

endocrine response:

immune response:

life events:

A

tries to maintain homeostasis

neurotransmitters: release catecholamines, increase serotonin, increase steroids, increase dopamine

endocrine response: increase ACTH, promotes energy

immune response: inhibited

life events: increased chance of mental illnesses

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10
Q

medical symptoms of lupus

psychiatric symptoms of lupus

A

medical: photosensitivity, butterfly rash, joint pain, fever

psych: depression, mood disturbances, psychosis, delusions

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11
Q

medical symptoms of MS:

psychiatric symptoms of MS:

A

medical: motor and sensory disturbances, impaired vision (optic neuritis) ,remissions and exacerbations, slurred speech

psych: anxiety, euphoria, mania

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12
Q

medical symptoms of seizure

psychiatric symptoms of seizure:

A

medical: sensory distortions, delirium, memory loss

psychiatric symptoms: confusion, psychosis, dissociative states, belligerence, catatonic like state

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13
Q

_ can cause CAD/MI and CAD/MI can cause _

A

depression

depression

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14
Q

30% of asthmatics meet criteria for _

A

agoraphobia/panic disorder

fear of dyspnea can trigger asthma attacks and anxiety

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15
Q

anxiety disorder and panic disorder have a high level in what chronic respiratory disease

A

COPD

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16
Q

hyperthyroidism medical symptoms

hyperthyroidism psychiatric symptoms

A

medical symptoms: heat intolerance, excessive sweating, diarrhea, weight loss, tachycardia, palpitations, vomiting, tremor , short attention span. bulging eyes

psy: nervousness, excitability, irritability, psychosis, visual hallucinations, insomnia

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17
Q

hypothyroidism medical symptoms

hypothyroidism psychiatric symptoms

A

medical: cold intolerance, dry skin, constipation, weight gain

psych: leathery, depressed, personality change, paranoia

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18
Q

medical and psych symptoms of diabetes

A

medical: increased urination/thirst, glucose is high

psych: depression

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19
Q

pheochromocytoma medical and psych symptoms

A

medical: paroxysmal hypertension, headaches, sweating, tremor

psych: anxiety, apprehension, feeling of impeding doom, panic

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20
Q

hyponatermia medical and psych symptoms:

A

medical: excessive thirst, polydipsia, stupor, coma, seizures

psych: confusion, lethargy, personality changes

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21
Q

thiamine def medical and psychiatric symptoms

A

medical: neuropathy, cardiomyopathy, wernicke syndrome

psych: poor concentration, confusion, confabulation

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22
Q

cobalamin vitamin B12 def medical and psych symptoms

A

medical: pallor, dizziness, peripheral neuropathy, dorsal column signs, (if levels less than 400)

psych: irritability, inattentiveness, psychosis, dementia

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23
Q

copper can cause

A

psychosis

24
Q

vitamin A and D, and iron can all cause

A

confusion

25
Q

B6 and B12 affect

A

peripheral nerve function

26
Q

lead can cause

A

cognitive dysfunction

27
Q

Peptic ulcer disease leads to increase _ _ excretion which can be associated with psychological stress

A

gastric acid

28
Q

ulcerative colitis shows increased prevalence of

A

dependent personality disorders

29
Q

churns disease has high rates of preexisting

A

panic disorder

30
Q

some of the most common side effects of antidepressants are

A

gi disturbances; nausea and diarrhea

31
Q

TCA side effects

A

constipation and dry mouth

32
Q

medical symptoms and psychiatric symptoms of acute intermittent porphyria

A

medical: abdominal pain, consitpation, peripheral neuropathy, paralysis

psych: acute depression, agitation, paranoia

33
Q

medial symptoms and psych symptoms of hepatic encephalopathy

A

medical: asterisks, spider angioma, polar erythema, lover enlargement, ecchymosis

psy: supporta, disinhibition, psychosis, depression

34
Q

psoriatic episodes are related to _ events

A

stressful

35
Q

medical symptoms of brain neoplasms

psych symptoms

A

medical: headache, papilledema, vomiting, focal neurological deficit

psych: personality changes depending on location

36
Q

frontal lobe tumor causes changes in what

A

mood, irritability, judgement, speech, smell, memory

37
Q

occipital lobe tumors present with

A

visual hallucinations and aura

38
Q

head trauma medical and psych symptoms

A

medical: headache, bleeding from ear, altered LOC, neurological findings (location based as well)

psych: confusion, personality changes, memory problems, agitation

39
Q

PCP intoxication

medical symptoms

psych symptoms

A

medical: elevated BP, vertical and horizontal nystagmus, muscular rigidity, vomiting

psych: agitation with a blank stare, anxiety, stupor, aggression, panic, bizarre strength (pick up car?)

40
Q

cocaine/amphetamine inoxication

medical symptoms:

psych symptoms:

A

medical: elevated BP, tachycardia, dilated pupils, sweating, tremor

psych: agitation with delusions, euphoria with irritability

41
Q

LSD intoxication

medical symptoms

psych symptoms

A

medical : sympathetic overdrive

psychL sensory distortion, hypersensitivity of senses, hallucinations

42
Q

the study, practice, and teaching of the relationship between medical and psychiatric disorders

psychiatrists serve as consultants in hospital settings to bridge between psychiatry and other specialties

A

consultation liaison

43
Q

what are some common reasons a consultation liaison would be used

A

suicide attempt/threat
depression
agitation
hallucinations
sleep disorder
confusion

44
Q

_ is the most common cause of hallucinations

A

delirium tremens

45
Q

_ is the most common cause of confusion or disorientation among hospitalized patients

A

delirium

46
Q

delirium is common in what population

A

elderly, ICU patients

educate pt and family about this proper to hospitalization

47
Q

reversible acute onset of impaired cognition , attention, consciousness, perception, sleep patterns (day vs. night) , and emotional states that fluctuate

A

delirium

48
Q

what are some interventions we can use to mitigate delirium

A

orientation protocols with the use of clocks and calendars

cognitive stimulation ( vitas from friends/family during the day)

facilitate psychologic sleep (avoid at night)

49
Q

avoid _ (medication) in elderly hospialized patients

A

benzodiazepines

50
Q

1.One or more somatic symptoms that are distressing or result in significant disruption of daily life.
2.Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following:
1. Disproportionate and persistent thoughts about the seriousness of one’s symptoms. 2. Persistently high level of anxiety about health or symptoms.
3. Excessive time and energy devoted to these symptoms or health concerns.
3.Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).

A

somatoform disorder (pain disorder)

-somatic symptom disorder

51
Q

how do we treat somatoform disorder

A

have a good relationship with the patient

have a team approach

CBT

anti anxiety medications

52
Q

conversion disorder

A

following times of high stress neurological voluntary motor or sensory problems arise

53
Q

symptoms of conversion disorders

A
  • Paresthesias and anesthesias
  • Weakness
  • Paralysis
    *Pseudoseizures/psychogenicseizures
  • Involuntary movements (e.g. tremors, tics)
  • Sensory disturbances * Blindness
  • Mutism
54
Q

illness anxiety disorder

A

hypochondriac (ME) fear of something being medically wrong for no reason essentially

or I have a cold, and think I have cancer (out of proportion)

55
Q

factitious disorders

A

intention fabrication of medical symptoms not for secondary gain

56
Q

munchausens

A

factious disorder where you are giving yourself medical symptoms

vs

proxy- giving medical conditions to someone else

57
Q

malingering

A

intention fabrication of medical symptoms with evidence of secondary gain ( fabricating symptoms to get disability approved)

NMSP Exam 3 (11 decks)

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