Psych 5 Flashcards by Giselle McIntyre

What are the 3 clusters of personality disorders?

Cluster A = weird
Cluster B = wild (B = bad)
Cluster C = worried

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What are the 3 types of Cluster A

Paranoid, Schizoid, Schizotypal

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What are the 4 types of Cluster B

Antisocial, borderline, histrionic, narcissistic

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What are the 3 types of Cluster C

Avoidant, Dependent, Obsessive-compulsive

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Tx of personality disorders

Very difficult to treat because patients are not aware they need help

Psychotherapy is usually most helpful

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Personality disorder: emotional, sexual, attention seeking

Histrionic

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PD: eccentric, magical thinking

Schizotypal

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PD: grandiosity, lack of empathy, demands the “best”

Narcissistic

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PD: voluntarily avoidant and content with social isolation

Schizoid

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PD: hypersensitive to rejection, socially timid but desires relationships with others

Avoidant

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PD: suspicious, distrusting, hypervigilant

Paranoid

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PD: disregard for and violation of rights of others without guilt or remorse; criminal; impulsive

Antisocial

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PD: want things perfectly but don’t see a problem with it

Obsessive-compulsive

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PD: unstable, self-mutilation, suicidal, use splitting as major defense mechanism, unstable and intense personal relationships

Borderline

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PD: submissive and clingy

Dependent

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Diagnostic criteria for schizophrenia

2 or more of the following must be present for at least 1 month:

Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behavior
Negative sx

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Describe a person with antisocial personality disorder

Exploitive of others and break the rules to meet their own needs. Lack empathy and remorse. Impulsive, deceitful and violate the law. Skilled at reading social cues and can appear charming and normal to others

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Diagnose a 15 y/o with all signs of antisocial personality disorder

Conduct disorder (must be 18 y/o to be diagnosed with Antisocial personality disorder)

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Tx of choice for borderline personality disorder

Dialectical Behavior Therapy (DBT)

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At what blood alcohol level (BAL) do signs of intoxication begin

BAL > 100 = some signs of intoxication

BAL > 150 = obvious signs of intoxication

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How long does it take to for symptoms for alcohol withdrawal to begin

6-24 hours

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At what point of alcohol withdrawal do seizures occur

12-48 hours

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At what point of alcohol withdrawal does delirium tremens occur?

48-96 hours

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Tx of alcohol withdrawal seizures

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Benzodiazepines (e.g. Ativan/Lorazepam)

Sx of delirium tremens

Delirium, hallucinations, agitation, gross tremor, autonomic instability, fluctuating levels of psychomotor activity

Tx of delirium tremens

Benzos

What supplements should be given to a pt with alcohol withdrawal

Thiamine, folic acid, and multivitamin to treat nutritional deficiency ("banana bag")

How many average drinks per day / per week = heavy drinking for men

> 4 drinks / day | > 14 drinks / week

How many average drinks per day / per week = heavy drinking for women

> 3 drinks / day | > 7 drinks / week

First line tx for alcohol use disorder

Naltrexone (opioid receptor blocker, decreases desire/craving and "high" from alcohol)

What is potential fear of Naltrexone use

Will precipitate withdrawal in patients with dependence

How does Disulfiram/Antabuse work?

Blocks aldehyde dehydrogenase, causing aversion to alcohol

How does Topiramate work?

Anticonvulsant that potentiates GABA and inhibits glutamate receptors Reduces cravings for alcohol and decreases alcohol use

Describe presentation of Wernicke's encephalopathy

Ataxia, confusion, ocular abnormalities Can be reversed with Thiamine therapy

Describe presentation of Korsakoff syndrome

Impaired recent memory, anterograde amnesia, compensatory confabulation Reversible in only about 20% of pts

How can cocaine intoxication lead to death?

Vasoconstrictive effect may result in MI, intracranial hemorrhage, or stroke

What are other dangerous effects of cocaine intoxication

Respiratory depression, seizures, arrhythmias, hyperthermia, paranoia, hallucinations

Sx of cocaine withdrawal

"Crash" = fatigue, hypersomnolence, depression, anhedonia, hunger, constricted pupils, vivid dreams, psychomotor agitation or retardation

Dangers of amphetamine overdose

Hyperthermia, dehydration (especially after dancing), rhabdomyolysis, renal failure

Tx of amphetamine overdose

Rehydrate, correct electrolyte balance, treat hyperthermia

MOA of Phencyclidine

PCP is a dissociative, hallucinogenic drug that antagonizes NMDA receptors

Presentation of PCP intoxication

Agitation, depersonalization, hallucinations, synesthesia (one sensory stimuli evokes another), impaired judgement, memory impairment, assaultiveness, nystagmus, ataxia, HTN, tachycardia,high tolerance to pain

Dangers of PCP overdose

Seizures, delirium, coma, death

Describe withdrawal of PCP

No withdrawal syndrome, but "flashbacks: can occur (recurrence of intoxication due to release of drug from lipid stores)

Tx of barbiturate overdose

ABCs, activated charcoal to prevent further absorption Alkalanize urine with NaHCO3 to promote renal excretion

Tx of benzo overdose

ABCs, activated charcoal Flumazenil

Tx of barb or benzo withdrawal

Benzo taper

What type of drug is heroin?

Opioid

Clinical presentation of opioid intoxication

Drowsiness, nausea/vomiting, constipation, slurred speech, constricted pupils, seizures, respiratory depression

Tx of opioid overdose

Naloxone (opioid antagonist) Will improve respiratory depression but may cause severe withdrawal

Name 3 drugs used to treat opioid use disorder

(1) Methadone (2) Buprenorphine (3) Naltrexone

MOA of Methadone

Long-acting opioid receptor agonist

MOA of Buprenorphine

Partial opioid receptor agonist

MOA of Naltrexon

Competitive opioid antagonist Can precipitate withdrawal if used within 7 days of heroin use

Withdrawal sx of opiates

NOT life-threatening Anxiety, insomnia, anorexia, fever, rhinitis, piloerection, sweating, lacrimation, yawning

Withdrawal sx of hallucinogens

None. But long-term LSD use may cause "flashbacks"

Sx of marijuana overdose

No overdose symptoms Can cause cannabis-induced psychotic disorder with paranoia, hallucinations, and/or delusions

Withdrawal sx of marijuana

Irritability, anxiety, restlessness, aggression, strange dreams, depression, headaches, sweating, chills, insomnia, and decreased appetite

Tx of Nicotine dependence

Varenicline/Chantix = nicotinic cholinergic receptor partial agonist Bupropion = antidepressant that is an inhibitor of dopamine and NE reuptake

Psych 5 Flashcards

(59 cards)