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EOR- Psychiatric Flashcards

(60 cards)

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1
Q

Generalized Anxiety:

Treatment Protocols
Names of Medications

A

Treatment Protocol:

Psychosocial intervention- You can find another job

Psychotherapy

CBT

EMDR

Relaxation

Yoga

Meditation

Spiritualism

Family Therapy/Psychoeducation

CBT vs. Pharmacotherapies:

Serotonergic Antidepressants show similar efficacy to CBT. It is pt preference.

GAD & MDD

Benzos,

Medications :

SSRI

Paroxetine

Sertraline

Citalopram

Escitalopram

SNRI

Venlafaxine

Duloxetine

Pristiq

Buspirone (Antianxiety Agent)

Generalized Anxiety Disorder

Longer onset of action than Benzos

Monotherapy: w/ absence of MDD

Augmentation

Vistirl- (Hydroxyzine)

Hydroxyzine

Propranolol

Not approved for GAD

Do not give with Asthma or history of smoking

Benzodiazepines

Acute Anxiety/Maintenance Long Term

Can be used for adjunct when SSRI/SNRI have not reached efficacy.

DEPRESSION PRESENT: SRI are favored over Benzo’s.

Medications:

Clonazepam(Long Acting) -> Lorazepam( Mid Acting) -> Alprazolam (Xanax) (Short Acting but the strongest and most addictive)

Clonazepam- Long acting and less addicting

Librium- Alcohol related anxiety

Diazepam

Lorazepam- Mid acting

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2
Q

Panic Disorders

  1. Definition
  2. Time period of symptoms
  3. Time to reach peak symtpoms
  4. Treatment
A
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3
Q

Specific Phobias

  1. Management
  2. Predictable situations-Treatment vs Unpredictable
A
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4
Q

Bipolar

  1. Difference between bipolar I and bipolar II
  2. Treatment:
    1. Bellagio Method
  3. Pneumonic for Mania
A
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5
Q

Major Depressive Disorder

  1. Pneumonic for Presentation:
  2. Management
  3. Dosing Regimine?
A
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6
Q

Persistent Depressive Disorder

A
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7
Q

Suicidal Behaviors:

  1. Who is more likely to complete suicide
  2. Who attempts suicide more often?
A
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8
Q

Conduct Disorder vs Oppositional Defiant Disorder

A
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9
Q

Dissociative Disorders:

  1. Dissociative Disorders:
  2. Dissociative Amnesia
  3. Dissociative Fugue
  4. Dissociative Identity
A
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10
Q

Anorexia Nervosa:

1.

A
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11
Q

Binge Eating Disorder

A
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12
Q

Bulimia Nervosa

A
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13
Q

Exhibitionistic Disorder

A
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14
Q

Female Sexual Interest and Arousal Disorder

A

• A female dysfunction marked by a persistent reduction or lack of interest in sex and low sexual activity, as well as, in some cases, limited excitement and few sexual sensations during sexual activity

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15
Q

Fetishistic Disorder

A

• A paraphilic disorder consisting of recurrent and intense sexual urges, fantasies, or behaviors that involve the
use of a nonliving object or nongenital part, often to the exclusion of all other stimuli, accompanied by clinically significant distress or impairment

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16
Q

Male Hypoactive Sexual Desire Disorder

A

A male dysfunction marked by a persistent reduction or lack of interest in sex and hence a low level of sexual activity

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17
Q

Pedophilic Disorder

A

A paraphilic disorder in which a person has repeated and intense sexual urges or fantasies about watching, touching, or engaging in sexual acts with children,
and either acts on these urges or experiences clinically significant distress or impairment

• Person is greater than age 16 and age gap is greater than five years

  • Use of pornography • Psychotherapy
  • Medical management
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18
Q

Sexual Masochism Disorder

A

A paraphilic disorder characterized by repeated and intense sexual urges, fantasies, or

behaviors that involve being humiliated, beaten, bound, or otherwise made to suffer

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19
Q

Voyeuristic Disorder

A

• A paraphilic disorder in which sexual arousal is derived from observing unsuspectin

individuals undressing or naked

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20
Q

Obsessive-Compulsive

A

Presentation
• Repetitive thoughts (obsessions) or behaviors

(compulsions) that are disabling and cause anxiety or

distress
• Difficult to control
• Disruption of daily living • Need to perform rituals

Diagnostic Studies

• Yale-Brown Obsessive Compulsive Scale

Management
• Medications and therapy

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21
Q

Body Dysmorphic Disorder

A

• Obsession with some perceived or imagined flaw or flaws in one’s appearance

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22
Q

Attention-Deficit Hyperactivity Disorder (ADHD)

  1. Presentation
  2. Duration of Symptoms to make a diagnosis
  3. Number of Setting?
  4. Treatment:
A
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23
Q

Autism Spectrum Disorder

  1. What are the 3 areas of life that Autism affects?
  2. When do we screen for autism?
  3. Treatment:
A

• Developmental delay in socialization, language, and cognition

• Autism spectrum disorders (ASD) encompasses:
o Autistic disorder: disruption of social interaction and

language at age 3 or earlier
o Childhood disintegrative disorder: pervasive

developmental disorder - not otherwise specified

o Asperger disorder: a child has normal cognitive

development but poor relationships and does not spontaneously seek activities with others

Treatment
• Refer to autism specialists, speech & language

pathologist
• Second-generation antipsychotics (risperidone,

aripiprazole) for aggression or hyperactivity, mood lability;

can also use haloperidol, carbamazepine
• SSRIs for stereotyped or repetitive behavior

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24
Q

Personality Disorders Overview

  1. Cluster A
  2. Cluster B
  3. Cluster C
A
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Histrionic 1. Presentation 2. Treatment 3. Pneumonic for Histrionic
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Schizotypal
Presentation • Discomfort with social and interpersonal relationships • Odd, eccentric behavior (“magical thinking”) • Few friends • Social anxiety Management • Psychotherapy, antipsychotics
27
Schizoid
Inability to form and maintain meaningful personal relationships; **neither desires nor enjoys** close relationships, including being part of a family
28
Borderline
• Poor impulse control, poor self-image, unstable interpersonal relationships * Self-harming behaviors, suicide threats without attempts * Demonstrates “splitting” between providers
29
Narcissistic
Presentation • Need for admiration, grandiose thoughts, concerned about what others think yet lack empathy * Arrogant, entitled * Lack empathy * Self-importance and superiority Management • Psychotherapy, antidepressants
30
Antisocial
• No concern for others, neglect of dependents; lack of remorse, morals, or empathy
31
Obsessive-Compulsive Personality Disorder
* **Preoccupation with perfectionism** * Attempts to control interpersonal relationships, obsessive thoughts, and performance of compulsions impede daily functioning • Inflexible and rigid • No one specific irrational or recognized obsession **(different from OCD)**
32
Paranoid Personality disorder
• Persistent feelings of suspiciousness and mistrust of other people
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Dependent Personality disorder
• Characterized by behaviors demonstrating an excessive need to be taken care of
34
Avoidant Personality disorder
• A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts
35
Schizophrenia 1. Positive Symptoms? 2. Negative Symptoms 3. Management 4. Time frame for Diagnosis
**_Presentation_** • **Two** of the following in a one month period and continuous signs for more than **six months**; hallucinations/delusions not needed for diagnosis • Delusions • Hallucinations: auditory (most common), tactile, olfactory, visual • Disorganized speech or thought processes, unable to stay on topic (loose associations) unable to provide answer related to questions (tangential response) • Disorganized behavior: unpredictable agitation, inappropriate sexual behavior, childlike silliness, catatonic motor behavior, lacking self-care or hygiene • Negative symptoms: blunted affect, poor posture, lack goal-directed activities or initiative • Impairment: inability to hold job or maintain relationships **_Management_** • Hospitalize if suicidal, unable to care for self, or pose a threat to self or others • First line: serotonin and dopamine antagonists (SDAs); atypical antipsychotics (risperidone, olanzapine, aripiprazole, ziprasidone, quetiapine, asenapine, paliperidone) for negative symptoms & fewer side effects
36
Narcolepsy
**Pathophysiology** • Caused by a hypocretin deficiency in lateral the hypothalamus (per DSM-V) **_Presentation_** • Classic tetrad: o Excessive daytime sleepiness: naps can be refreshing o Hallucination: hypnagogic (just before sleep) and hypnopompic (just before waking) o Cataplexy: loss of muscle tone following strong emotional stimulus o Sleep paralysis: short paralysis with awakening **_Diagnostic Studies_** • Polysomnography **_Management_** • Modafinil, methylphenidate, or amphetamines
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Somatization Disorder 1. Somatic Symptom Disorder 2. Malingering 3. Factitious Disorder
Illness Anxiety Disorder **Presentation** • Hypochondriasis • Preoccupied with serious illness, despite negative exam/ testing • Evaluate for other medical diagnosis **Management** • Management is CBT, psychotherapy, antidepressants
38
Adjustment Disorder
**Presentation** • Disproportionate response to a stressor than would normally be expected (e.g., job loss, physical illness) which begins within three months of the stressful event • Remission of symptoms usually within six months • Stressors o Marital conflict o Financial conflict o Family conflict or parental separation o School problems or changing schools o Sexuality issues o Death or illness in the family **Management** • Psychotherapy
39
Post-Traumatic Stress Disorder 1. Nightmare treatment 2. 1st line
**Presentation** • Recent traumatic event which causes an acute stress reaction • Once the symptoms persist past one month it is now considered post-traumatic stress disorder (PTSD) **Management** • **SSRIs** are first line • **CBT** • **Prazosin** for nightmares • Benzodiazepines, if used, should not be continued more than two weeks after a traumatic event
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Vulvovaginitis Causes Treatment
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Erythema infectiosum, also known as fifth disease,
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Rubella
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Psychiatrics (2 decks)

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