Lecture 8: Psychosomatic Medicine

Question 1

Pt’s with depression, anxiety, type A behavior, hostility, anger, and acute mental stress are at an increased risk for what?

Answer 1

• 2-fold ↑ risk of incident MI and CAD-related mortality
• Strongest evidence shows ↑ incidence of depression

Question 2

Asthmatics are at an increased risk for which psych disorders?

Answer 2

• Panic disorder or agoraphobia
• Fear of dyspnea can trigger asthma attacks and high levels of anxiety

Question 3

Diabetes is associated with an increased risk for what psych conditions?

Answer 3

Frustration, loneliness, dejection, and depression

Question 4

What are some of the psych sx’s associated with hyponatremia?

Answer 4

Confusion, lethargy, personality changes (Delirium)

Question 5

Which medications have the highst rate of GI disturbances as AE’s; why?

Answer 5

SSRIs due to serotonin in the GI tract

Question 6

Which psych sx’s are very common with pancreatic carcinoma?

Answer 6

Depression, lethargy, anhedonia, apathy, and ↓ energy

Question 7

Abdominal pain + psychosis should make you think of what underlying disease?

Answer 7

Acute Intermittent Porphyria

Question 8

What are some of the psych sx’s associated with hepatic encephalopathy?

Answer 8

Euphoria, disinhibition, psychosis, anddepression

Question 9

What are some of the psych sx’s associated with frontal lobe tumors?

Answer 9

• Mood changes + irritability + facetiousness
• Impaired judgement + Impaired memory
• Delirium
• Loss of speech
• Loss of smell

Question 10

What medication should be avoided in elderly hospitalized pt’s especially those with delirium?

Answer 10

AVOID benzodiazepines

Question 11

Which commonly used drug is associated with mania + psychosis (hallucinations)?

Answer 11

Corticosteroids

Question 12

Which drugs can cause mania in a bipolar patient?

Answer 12

Antidepressants

Question 13

Psych symptoms associated with lupus (photosensitivity, butteryfly rash, joint pain)

Answer 13

• depression
• mood disturbances
• psychosis
• delusions
• hallucinations

Question 14

Cold intolerance, weight gain, personality change, lethargy, paranoia. Dx?

Answer 14

hypothyroidism

Question 15

Psychiatric Sx thiamine deficiency (3)

Answer 15

• poor concentration
• confusion
• confabulation

Question 16

Psychaitric Sx Cobalamin (B12) deficiency (4)

Answer 16

• irritability
• inattentiveness
• psychosis
• dementia

Question 17

Medical symptoms: elevated BP, tachycardia, nystagmus, muscular rigidity, vomiting

Psychiatric symptoms: agitation with blank stare, anxiety, stupor, aggression, panic, bizarre behavior

What substance caused this?

Answer 17

Phenyclidine (PCP)