Exam 4: Psych/SUD/Repro Flashcards
Stress-Diathesis Theory
Trauma because of a variety of reasons underlies a wide range of psychiatric disorders
Schizophrenia
Patho: affects thoughts feelings, perceptions and overall behavior while interfering with filtering of stimuli from the environment
Epi: onset between 16-30, increased in men but it does equalize later in life
Clinical manifestations: incomprehensible speech, hallucinations, delusions, grossly disorganized or catatonic behavior
Major Depressive Disorder
Patho: loss of interesting in previously enjoyed activities
Etiology: early life stressor, trauma, vitamin D issues
Epi: women are twice as likely, numbers are increasing in all age groups
Bipolar disorder
Patho: a mood disorder with depressive components plus mania
Etiology: the book outlines 4 types of bipolar disorder. occur from genetic, neuroendocrine, autonomic and immune dysregulation.
Substance Use Disorder (SUD)
epidemiology: men more likely than women, but closing gap
etiology:
D2 dopamine receptor (DRD2) gene located at 11q23 is associated with addictive behaviors
Mu-opioid receptor, Delta-opioid receptor, brain-derived neurotrophic factor, Pre-existing psychological disease like anxiety, PTSD, depression, Exposure to substance use, Childhood abuse or trauma
Mesolimbic dopamine pathway
Goes to the Nucleus accumbens and is associated with the reward system
Normal reinforcement of adaptive behaviors get a natural high/release of dopamine
Drugs lead to abnormal message being sent through the network
Hypofunctioning reward system
Makes it harder to get a high
Drug tolerance
occurs when a subject’s reaction to a specific drug and concentration of the drug is progressively reduced, requiring an increase in concentration to achieve the desired physiological and psychological effects.
Withdrawal symptoms
, specific noxious physiological effects, occur if the individual does not maintain regular use of the drug.
Alcohol (ETOH)
mainly a CNS depressant
↓GABA receptors
↑NMDA receptors
Clinical manifestations
In low doses, alcohol disinhibits the individual, which may lead to out-of-character activities.
At higher doses, individuals show irrational thinking, lack of judgment, and absence of motor coordination.
AWS
alcohol withdrawal symptoms
Sympathetic stimulation initially
Hallucinations
Withdrawal seizures - gen. tonic/clonic, short
Delirium tremens - change in LOC
Opioids
heroine, oxycodone, morphine, codeine
Opioid clinical manifestations:
Respiratory depression, analgesia, euphoria, and miosis
Slurred speech or sedated
Opioid use and specific risk factors chronic use
Risk for infection related to inadequate sterile technique and contaminated drugs
Opioid withdrawal
Dysphoria and restlessness
Rhinorrhea and lacrimation, mydriasis, diaphoresis
Myalgias and arthralgias
Nausea, vomiting, abdominal cramping, and diarrhea
Abnormal uterine bleeding
“PALM-COEIN”
polyp, adenomyosis, leiomyoma, malignancy & hyperplasia, coagulopathy, ovulatory dusfunction, endometrial, iatrogenic, not otherwise classified
Polycystic ovary syndrome
vaginitis,
Inflammation or infection of vagina
Most common cause is bacterial vaginosis in childbearing years
Atrophic most common for post menopausal: lack of regenerative growth of vaginal epithelium
Clinical manifestations Burning, itching, redness, swelling vaginal tissues
cervicitis
Acute or chronic inflammation of the cervix
Reddened and edematous
Direct infection
C trachomatis: mucopurulent cervicitis
Secondary
Vaginal or uterine infection
Asymptomatic or mucopurulent drainage
Untreated can extend to pelvic cellulitis, cervical stenosis, infection into uterus or fallopian tubes
Disorders of Pelvic Support
- cele = prolapse
Pelvic inflammatory disease (PID)
An acute inflammatory process caused by infection of upper reproductive tract (uterus, fallopian tubes, ovaries)
Pathophysiology
Infection (STI or UTI)→enters uterus and surrounding structures→ inflammatory response → necrosis→ repeated infections
Asymptomatic
Lower abdominal pain
Fever
Symptoms occur during or end of menstruation
Increased pain with exercise
Cervical motion tenderness
Polycystic ovarian syndrome
Epidemiology
Affects 6-15% of women
50% are obese
Hyperinsulinemia and insulin resistant play a part
Leading cause of infertility in US, affecting young women
Diagnosis: need at least 2 out of 3
Few or anovulatory menstrual cycles
Elevated levels of androgens (hyperandrogenism)
Polycystic ovaries via ultrasound
Complications
Cardiovascular disease, Diabetes, Sleep apnea, Fatty liver, Association between breast, & endometrial CA
*maybe ovarian CA it is controversial
Infertility
Endometriosis
Functional endometrial tissue is found in ectopic sites outside of the uterus
In reproductive years ovarian hormones stimulate endometrial to proliferate and breakdown→ bleed into surrounding structures → no exit for blood surrounding tissue irritated and develops fibrous tissues
clinical manifestations: Dysmenorrhea, Dyspareunia,
Infertility, Pain* 80% will present with pain, Strongest premenstrual, subsiding after cessation of menstruation, Pain with defection (bowel movement) or urination, Asymptomatic
Cervical cancer
Etiology: Human papillomavirus (HPV) is central to the development of cervical neoplasia and can be detected in 99.7% of cervical CAs
3rd most common cancer for people with uteruses
Patho: Oncogenic HPV infection of epithelium -> Persistence of the HPV infection -> Progression from persistent viral infection to pre-cancer -> Development of carcinoma and invasion through the basement membrane
Menopause
HRT
Varicoele
dilation of testicular veins, feeling of fullness,
scrotal abnormalities among infertile men
hydrocele
scrotal swelling due to excess fluid
