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Flashcards in Psych Deck (102)
1

Fever, tachycardia, HTN, diaphoresis, tactile or liliputian hallucinations

DTs - 48-96 hrs

2

Skin popping, pinpoint pupils, drowsiness, constipation intoxication

Heroin

3

SLUDGE - sweating, lacrimation, pupillary dilation, diarrhea, rhinorrhea withdrawal

Heroin
- tx w/ clonidine, methadone

4

Agression, paranoia, VERTICAL NYSTAGMUS, HTN, tachycardia, hyperacusis intoxication

PCP

5

Visual hallucinations, SENSORY INTENSIFICATION, illusions, sweating, tachycardia intoxication

LSD

6

Pupillary dilation, insomnia, delusions, paranoia intoxication

Amphetamines

7

Tx for agitation w/ & w/o psychosis

With = haldol
Without = diazepam

8

Erythema of turbinates, EPISTAXIS, pupillary dilation, bugs crawling on skin, aggression, insomnia intoxication

Cocaine

9

INC appetite, hypersomnia, vivid dreams withdrawal

Cocaine

10

Unexpected travel, can't remember past, hx of head trauma

Dissociative fuge

11

2+ distinct identities

Dissociative identity

12

1+ episode of amnesia related to stressful event

Dissociative amnesia

13

Observing own body from afar

Depersonalization

14

Experiencing familiar persons and surroundings as if strange or unusual

Derealization

15

<85% IBW, fear of becoming fat, absence of 3 periods, show great concern with appearance

Anorexia
- arrhythmia --> death
- hospitalization, psychotherapy, SSRIs

16

GLOBAL body desire, low K, acidosis, inc LFTs, dec grey matter in anterior cingulate gyrus

Lanugo
- assess severity w/ low albumin

17

Normal weight, large eating volumes, use of exercise, fasting, vomiting, laxative, diuretics, enemas, HX of obesity

Bulimia

18

Parotid enlargement, inc amylase, gastric dilation or tear, HX OF PICA, excessive exercising

Bulimia

19

Tx for anorexia

1. Olanzapine
2. CBT & FAMILY therapy

20

Tx for bulimia

1. CBT
2. FLUOXITINE (prozac = no weight gain)

21

Dependence vs. Abuse

Dependence
- withdrawal sx, can't cut down but trying, time spent recovering, interferes w/ normal life

Abuse
- don't fulfill obligations, use in dangerous situations, legal and social problems, CONTINUED use despite adverse consequences, ELEVATED GGT

22

Neurotransmitter that initiates sleep

Serotonin

23

Neurotransmitter that produces arousal/wakefulness

DA

24

Levels of Ach and NE during REM

Ach = high
NE = low

25

Stage 1 sleep waves

Theta (3-7hz)

26

Stage of sleep with sleep spindle and K complexes

Stage 2

27

Abrupt awakening in early sleep, intense, can't be calmed, NO memory, assoc w/ RLS, precursor to temporal epilepsy

Night terrors
- tx w/ benzos

28

Tx for enuresis

1. Alarms
2. Imipramine, & DDAVP

29

Previously toilet trained now wetting bed after north of new sibling

Regression

30

IVDU gets HCV and blames poor control of HCV in community

Distorsion - altered perception of disturbing aspects of reality

31

Angry w/ person - believes person is angry at them

Projection

32

Classifies things as all good or bad

Splitting = borderline personality

33

Abused child identifies themselves as an abuser

Identification

34

Angry at person, instead goes and wrecks car

Displacement

35

Pt rescued from burning building now denies memory of event

Dissociation - block memory or drastic change in behavior to avoid emotional distress

36

Involuntary withholding idea or feeling from consciousness

Repression

37

Got fired - now claims job was not that important anyway

Rationalization - avoid self blame

38

Replacing behavior/thoughts/feelings opposed to their own with OPPOSITE behavior

Reaction formation

39

Explosive anger channeled into athletic pursuits

Sublimation

40

Kid focuses on homework rather than dad's cancer dx

Suppression - VOLUNTARY postponement of anxiety producing thought

41

3 months of stressful situation, last NO LONGER than 6mo, somatic sx in kids, irritable, short temper, anxiety, depression

Adjustment disorder
- psychotherapy

42

Abrupt feeling of intense anxiety, palpitations, sweating, SOB, dizziness, hot flashes, following a particular stimuli

Panic attack --> alprazolam

43

UNEXPECTED, out of the blue intense anxiety, worrying about future attacks, behavior change after attack
Lasts >15min but

Panic disorder --> SSRIs
- w/ agoraphobia

44

Work-up/DDx for panic disorder

1. Thyroid - ? high thyroxine or hypothyroid
2. #1 = depression
3. Agoraphobia

45

>6mo
Worry about multiple things that may not have happened yet, no trigger
Restless, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

Generalized anxiety disorder
- Major depression in 50-90%, Sjogren's, Grave's, hyperthyroid
- SSRIs, also venlafaxine, buspirone

46

Stressful event + in a daze/numbing + derealization/depersonalization + dissociative amnesia and re-experiencing event, avoidance of certain stimuli, MAXIMUM 4 WEEKS

Acute stress disorder
- support
- propanolol to prevent PTSD

47

Re-experience traumatic event, LONGER than 4 WEEKS, hallucinations, intense fear, horror,

PTSD
- paroxetine or sertraline
- prazosin for nightmares
- relaxation, hypnosis, psychotherapy

48

Co-morbidities w/ PTSD

MDD, anxiety, substance abuse

49

Fear of being in places from which escape may be difficult or embarrassing - crowds, public places, traveling

Agoraphobia
- 91% have MDD, complication of PANIC DISORDER

50

Fear of being humiliated or embarrassed + blushing, shaking, vomiting, urgency or fear of micturition or defecation + >6mo under 18 y/o
Public restrooms, public speaking or eating in public

Social phobia
- BBs, assertiveness + SSRI

51

Fear of reptiles, blood, heights, tunnels, closed spaces, fear of CONTRACTING disease, even anticipation provokes anxiety + recognized as irrational

Specific phobia disorder
- desensitization, relaxation
- BBs and SSRIs

52

Intrusive thoughts and repetitive behaviors - cleaning, hand washing, ordering, counting, meditating, toe tapping + aware of unreasonableness

OCD --> SSRI
- 2/3 have MDD
- Tourette disorder
- other tx = clomipramine, behavior therapy

53

2 weeks
Sleep disturbance, dec interests, guilt, dec energy, dec concentration, appetite disturbance, psychomotor changes, suicidal thoughts

Major depressive episode - disorder w/ >1 episodes
- ***SSRIs***
- Duloxetine w/ neuropathic pain
- Bupropion if scared of sexual SE or weight gain
- r/o Parkinson, dementia, hypothyroidism

54

1+ week
Distracted, indiscretion, grandiosity, flight of ideas, activity inc, sleep deficit, talkative/pressured speech

Manic episode
- r/o medical condition/drugs
- OLANZAPINE, haldol, lithium for acute
- ***LITHIUM***, lamotrigine, valproic acid, quetiapine maintenance
- NEVER "refer to psychiatrist"

55

1+ manic episodes, CAN have delusions or hallucinations, low risk of suicide

Bipolar 1
- Lithium, valproic (<12) for non-psychotic
- kids never calm down after they get their way (vs. ODD)

56

1+ MDD + hypomanic episode, higher risk of suicide, no delusions or hallucinations

Bipolar 2
-

57

<30 y/o, pain + GI + sexual or reproductive + weakness or sensory loss

Somatization disorder
- weekly psychotherapy

58

Loss of specific bodily function or part of body, hemianesthesia, seizures w/ no LOC or incontinence, UNCONCERNED about seriousness

Conversion disorder
- reassurance of sensory deficits

59

Preoccupation of HAVING an illness, CAN be reassured (vs. somatic), >6mo

Hypochondriasis
- regularly scheduled appts

60

Pain without cause, anatomic or imaging findings

Pain disorder
- validation, TCAs, SSRIs

61

Health care worker, poor parental relationships, borderline personality, intentional feigning of illness to assume sick role - injecting insulin

Factitious disorder

62

Consciously making up an illness for secondary gain - avoiding difficult things, responsibilities, punishment, compensation, drugs, lack of cooperation/compliance, anti-social disorder, common in prisoners and military personnel

Malingering

63

Lack peer relationships, eye contact, social smile & lack separation anxiety.
Routines, rituals, repetitive manners - spinning, banging head, self-injurious.
Impaired non verbal behaviors, NO speech b4 3 y/o, tantrums

Autism
- greater in BOYS
- r/o deafness if child doesn't respond to name

64

Girls w/ progressive encephalopathy, microcephaly - deceleration of head growth after 5th mo
Hang wringer, toe walkers, loss of social engagement/peek a boo, poorly coordinated gait or trunk movements

Rhett disorder

65

NO delay in language, impaired peer relationships, doesn't share, no emotional reciprocity, struggle with peer pressure, drugs -- depression, bullying

Asperger's
- SSRIs

66

Normal development to age 2 --> Loss of expressive language, bowel/bladder control, motor skills, social skills
May have repetitive, stereotyped behaviors

Childhood disintegrative disorder

67

Pathogenic caregivers, no respect for personal boundaries, indiscriminate

Reactive attachment disorder

68

Cruelty toward animals, destruction of property, theft, setting fires, vandalism, truancy, running away

Conduct disorder
- atomoxetine or guanfacine
- parents have anti-social or etOH dependence

69

Age 8
Loses temper, argues w/ authority, refuses requests, blames others, easily annoyed, spiteful, resentful

Oppositional defiant disorder
- teach parents child management skills

70

ADHD can lead to?

Bi-polar
Oppositional defiant disorder

71

Tx for ADHD

1. Methylphenidate, dextroamphetamine --> insomnia, HA, dec appetite
2. ***Atomoxetine***
3. Clonidine, guanfacine (w/ sleep problems)

72

Delusions, hallucinations, disorganized speech, catatonic behavior, brief mood disorder, >6mo

Schizophrenia
- if no time-frame is mentions = pick this

73

Brain findings in schizophrenia

Inc ventricle size
Prominent sulci
Hippocampal disarray
5HT --> suicidal & impulsive

74

2+ weeks of delusions, hallucinations with or without mode disorders. Depression only present with psychotic features.

Schizoaffective disorder
- haldol, risperidone

75

Psychotic features only present during mood disorders

Mood w/ psychotic features

76

Magical thinking, transient psychosis, dresses oddly

Schizotypal
- fam hx of schizophrenia

77

NO affect, LONERS, NO bizarre cognition or psychosis, NO family hx, NO friends, NO desire for friends, successful at work if isolated

Schizoid personality disorder

78

False beliefs that others want to harm them, ppl will take advantage of them, suspicious

Paranoid personality disorder

79

Schizophrenia that lasts >1mo but <6mo

Schizophreniform

80

Schizophrenia that lasts 1 day to 1 month

Brief psychotic disorder

81

NON-bizzare delusions (vs. schizo) - being followed, poisoned, loved, deceived, or have a disease and see that as normal. NO impairment

Delusional disorder --> atypical anti-psychotic
- erotomatic, grandiose, jealous, persecutory, somatic types

82

Sense of entitlement, aggressive toward others, violate social norms, >18 and had conduct disorder

Anti-social
- common to develop somatization disorder when older

83

Can't be alone but has short-lived relationships, EMPTINESS, things are all good or all bad, cut/burn themselves, hx of childabuse/neglect

Borderline personality disorder
- may have short psychotic episodes

84

Overly emotional, dramatic, hungry for ATTENTION, afraid of intimacy but appear seductive, theatrical

Histrionic personality disorder

85

Self-important, crave ADMIRATION, exploitive, unrealistic inflated views of their accomplishments, grandiose

Narcissistic personality disorder

86

Hypersensitive to criticism, fear of rejection, shy away from situations that expose INADEQUACY, WANT friends but unwilling to get involved --> become isolated

Avoidant personality disorder
- co-morbid dependent personality disorder

87

Afraid of being on their own, submissive in order to avoid displeasing people, can't make decisions, don't question authority, cling to ONE person

Dependent personality disorder
- regular but brief appts
- group psychotherapy

88

Must attain perfection, adhere to plans, schedules, workaholics, stiff, stubborn, do NOT realize this causes them more distress

Obsessive-compulsive personality disorder
- perfection & inflexibility

89

Dec DA in tuberoinfundibular

Hyperprolactinemia

90

Dec DA in nigrostriatal

Chorea/tics

91

Inc DA in nigrostriatal

EPS & parkinson

92

Inc DA in mesolimbic

Drug use & hallucinations

93

Dec DA in mesolimbic

Anti-psychotics

94

Anti-psychotic binds DA in nigrostriatal --> brief painful muscle contractions, TORTICOLLIS, eyes, larynx in a matter of HOURS to DAYS

Acute dystonic rxn --> benztropine or benadryl IM

95

Restlessness, anxiety, pacing, rocking, leg crossing, can't get out of chair days to WEEKS after anti-psychotic start

Akathisia --> BBs

96

Increased sleep, weight, appetite, mood worse in evening and feels "heavy."

Atypical depression --> MAOIs

97

Immediate sadness, lability, tearfulness lasting 2 WEEKs after birth

Post-partum blues

98

Depressed mood, weight changes sleep disturbances, excess anxiety, may have negative feelings toward baby for 1-3 months after birth

Post-partum depression --> SSRI

99

Depression, delusions and thoughts of harming baby 2-3 WEEKs after birth

Post-partum psychosis --> anti-psychotic, lithium, SSRI

100

Bereavement vs. Depression

Depression has thoughts of death, WORTHLESSNESS, >2months affecting function, psychomotor retardation, psychosis

101

agitation, confusion, hallucinations, sweating, hyperthermia, nausea, diarrhea, tremor, myoclonus

Serotonin syndrome --> stop SSRI + cyproheptadine

102

1. Schizophrenia w/ persecution, delusions
2. Schizophrenia w/ mutism, stupor, rigidity
3. Schizophrenia w/ disheveled, EARLY age, bizarre emotional responses
4. Schizophrenia w/ no + sx, only flat affect

1. Paranoid = most common
2. Catatonic
3. Disorganized
4. Residual
*choose atypical anti psych for acute psychosis, not haldol*