Intro to Psychiatry Flashcards

(39 cards)

1
Q

negative psychosocial outcomes of bipolar disorder

A

suicidality
substance abuse
employment and family problems

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2
Q

what are bipolar patients often incorrectly diagnosed with

A

unipolar depression
anxiety
schizophrenia

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3
Q

common physical care problems seen in people with serious psychiatric disorders

A
poverty 
unemplyment 
homelessness
violence
incarceration 
stigma 
lifestyle 
suicide
physical health
rising death rate
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4
Q

what happens to the life expectancy to people with schizophrenia

A

decreases

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5
Q

what contributes to the increased mortality in the mentally ill

A
vulnerability genes 
smoking
obesity 
diet
sedentary 
diabetes
stress
polysubstance abuse
poverty 
isolation 
access to medical care
antipsychotic meds
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6
Q

people with schizophrenia are at an increased risk of what

A

CHD
smoking
diabetes
hypertension

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7
Q

how does disease alter neurotransmission

A

loss of neuronal plasticity
excitotoxicity
absence/excess/imbalance of neurotransmitters
wrong neuronal wiring

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8
Q

neurotransmitter sites of drug action

A
NE 
serotonin 
dopamine
Ach 
GABA
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9
Q

which NT do you want to increase in depression

A

NE , 5HT, DA

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10
Q

which NT do you want to block in psychosis /schizophrenis

A

DA, 5HT

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11
Q

what do you wanna increase in bipolar affective disorder and anxiety

A

GABA

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12
Q

why is dopamine considered non selective

A

influences function of other NT pathways

inhibited by other neurotransmitters

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13
Q

what are some challenges of psychopharmacotherapy

A
time for meds to start working 
effective regimen for patient 
management of adverse effects
drug interactions 
adherance
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14
Q

what are some factors affecting adherence to treatment

A
insight into disease and need for medication 
personal belief about meds
therapeutic effects
management of adverse effects
complicated regimens
quality of therapeutic regimen
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15
Q

what to enhance adherence to treatment

A
enhance education 
communication 
collaboration 
reminder systems 
med reviews
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16
Q

why might communicating with these patients be difficult

A
emotionally not responsive 
may be slow to respond
decreased concentration 
agitated 
not interested
negativ outlook
17
Q

3 things that contribute to treatment effectiveness

A

adherence
efficacy
tolerability

18
Q

goals of treatment

A

non curative
acute: reduce and resolve symptoms
chronic: prevent recurrence
want to improve functioning

19
Q

what happens if youre deprived of REM sleep

A

less serotonin and NE synthesis
increased appetite, sexual activity, aggression, anxiety, depression
increase cortisol and stress hormones

20
Q

what is the result of poor nutrition

A

decreased NT synthesis, storage and release

21
Q

result of not exercising

A

decreased NT release

22
Q

result of high chronic stress

A

increase stres hormones and deplete NTs

23
Q

where can you go for diagnosis of mental disorders

24
Q

what is axis 1 in the multi axial assessment

A

all psychiatric diagnosis

25
what is axis 2
personality disorders and mental retardation
26
what is axis 3
general medication conditions
27
what is axis 4
environmental and psychosocial stressors | positive and negative
28
what is axis 5
global assessment of function - psychological, social, occupational scale of 1-100
29
what are the 8 components of the mental status exam *
1 appearance 2. speech 3. mood, affect (emotional response) 4. thinking 5. perceptions (hallucinations) 6. sensorium - MMSE 7. insight 8. judgement
30
what are delusions
fixed false beliefs out of keeping with patients cultural background
31
what is the mini-mental state examination (MMSE)
assess cognitive performance in a clinical setting 30 point scale orientation, attention, memory, language
32
what are the values for the severity of alzeihmers using the MMSE
``` mild = 21-26 moderate = 10-2- severe = <10 ```
33
whats in the psychiatric report
``` history mental status exam diagnostic studies to be ordered positive and negative findings diagnosis prognosis recommendations ```
34
what do rating scales show
objective description of the condition | snapshot - how theyre doing at that time
35
whats the clinical global impression scale
observational | severity of illness and global improvement both on a 7 point scale
36
what are the 2 schizophrenia rating scales
brief psychiatric rating scale (18 items) | positive and negative syndrome scale (PANSS) 30 items
37
what are the depression rating scales
hamilton psychiatric rating scale for depression | beck depressive inventory
38
describe the beck depressive inventory
patient rated | measure change due to treatment
39
describe the hamilton psychiatric rating scale for depression
gold standard | clinician rated