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Psych Flashcards

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1
Q

schizophreniform disorder

A

schizophrenia sxs < 6 months

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2
Q

schizoaffective disorder

A

schizophrenia + mood disturbance (mania or depression)

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3
Q

schizophrenia symptoms

A

positive - hallucinations, delusions, disorganized speech & thinkings, abnormal behavior

negative - flat affect, avolition, social withdrawal, poor eye contact

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4
Q

schizophrenia treatment

A

1st line - 2nd gen antipsychotics (risperidone, olanzapine, quetiapine); dopamine and serotonin antagonists

2nd line - 1st gen antipsychotics (haloperidol, chlorpromazine)

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5
Q

“typical” 1st gen antipsychotics (names, MOA, s/e)

A

haloperidol, droperidol, fluphenazine, perphenazine, chlorpromazine, thioridazine

MOA - dopamine antagonists

S/E - extrapyramidal symptoms (rigidity, bradykinesia, tremor, akathisia; dystonic reactions (dyskinesia), tardive dyskinesia, parkinsonism)

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6
Q

“atypical” 2nd gen antipsychotics (names, MOA, s/e)

A

clozapine, quetiapine, olanzapine, loxapine

MOA - dopamine and serotonin antagonists

S/E - clozapine = agranulocytosis; lower incidence of EPS than 1st gen because their bind to dopamine receptors is weaker

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7
Q

risperidone (class, MOA, s/e)

A

class - benzisoxazoles

MOA - partial dopamine and serotonin receptor antagonist

s/e - EPS, increased prolactin

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8
Q

lithium (MOA, s/e)

A

MOA - increases NE and serotonin receptor sensitivity

s/e - hypothyroidism, hyperparathyroidism, increased urination and thirst, arrhythmias

**narrow therapeutic index; monitor level q 4-8wks

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9
Q

major depressive disorder

A

depressed mood or anhedonia w/ >= 5 associated symptoms almost every day for most of the days for at least 2 weeks with the symptoms causing clinical distress or impairment

tx - psychotherapy, meds (SSRIs 1st line - continue 3-6 wks to determine efficacy; SNRIs, bupropion)

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10
Q

seasonal affective disorder

A

presence of depressive symptoms at the same time each year

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11
Q

atypical depression

A

typical symptoms of major depression but patients experience mood reactivity (improved mood in response to positive events)

tx - MAOI

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12
Q

SSRIs (names, MOA, s/e)

A

names - citalopram (celexa), escitalopram (lexapro), paroxetine (paxil), fluoxetine (prozac), sertraline (zoloft), fluvoxamine (zyvox)

MOA - serotonin reuptake inhibitor

s/e - GI upset, sexual dysfunction, headache, serotonin syndrome

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13
Q

serotonin syndrome symptoms

A

neuro sxs - acute AMS seizure, coma, death

autonomic - restlessness, diaphoresis, tremor, hyperthermia, nausea, vomiting, abdominal pain, mydriasis, tachycardia

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14
Q

SNRIs (names, MOA, s/e)

A

names - venlafaxine (effexor), desvenlafaxine (pristiq), duloxetine (cymbalta)

MOA - serotonin, NE, and dopamine reuptake inhibitors

s/e - similar to SSRI, HTN

**useful in patients w/ significant fatigue or pain syndromes in association with depression

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15
Q

TCAs (names, MOA, s/e)

A

names - amitriptyline (elavil), clomipramine (anafranil), desipramine (norpramin), doxepin (sinequan), imipramine (tofranil), nortriptyline (pamelor)

MOA - serotonin and NE reuptake inhibitors

s/e - anticholinergic effects, severe toxicity w/ overdose, prolonged QT interval

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16
Q

bupropion (Wellbutrin) MOA, s/e

A

MOA - inhibits neuronal uptake of dopamine and NE

s/e - weight loss, agitation

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17
Q

MAOIs (names, MOA, s/e)

A

nonselective (MAO A & B) - phenelzine (nardil), tranylcypromine (parnate), isocarboxazid (marplan)

selective (MAO B) - selegiline (eldepryl); less chance of HTN crisis

MOA - inhibits monoamine oxidase, blocking the breakdown of neurotransmitters (serotonin, dopamine, EPI, and NE)

s/e - HTN crisis (must avoid tyramine-containing foods), serotonin syndrome

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18
Q

bipolar I disorder

A

> = 1 manic or mixed episode, often cycling with occasional depressive episodes

mania - abnormal and persistently elevated, expansive, or irritable mood at least 1 week (or requiring hospitalization) WITH MARKED IMPAIRMENT of social/occupational function (mood, thinking, behavior)

management - mood stabilizers (lithium 1st line; 2nd gen antipsychotics, 1st gen antipsychotics, benzos)

**antidepressants may precipitate mania

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19
Q

bipolar II disorder

A

> = 1 hypomanic episode + >= 1 major depressive episode

hypomania - period of elevated, expansive, or irritably mood at least 4 days which DOES NOT cause marked impairment, no psychotic features, and does not require hospitalization usually

management - antipsychotics, mood stabilizers (lithium), and benzos

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20
Q

persistent depressive disorder

A

chronic depressed mood > 2 years in adults (1 yr in children) that is usually milder than major depression (patients usually able to function); patient not symptom free for > 2 months at a time)

mgmt - psychotherapy, SSRIs

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21
Q

cyclothymic disorder

A

recurrent episodes of hypomanic symptoms cycling with relatively mild depressive episodes for at least a 2-year period in adults (1 yr in children); similar to bipolar II but less severe

mgmt - mood stabilizers and neuroleptics (similar to bipolar I)

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22
Q

panic attacks

A

not a disorder in and of itself but a feature of many different anxiety disorders

episode of intense fear or discomfort that develops abruptly, usually peaks w/in 10 minutes, and usually lasts < 60 minutes

mgmt - benzos

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23
Q

panic disorder

A

recurrent, unexpected panic attacks (>=2) with at least one of the following occurring for at least one month: attack followed by concern about future attacks, worry about the implication of attacks (losing control), or significant change in behavior related to the attacks

mgmt - SSRI, CBT, benzos for acute attacks

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24
Q

generalized anxiety disorder

A

GAD - excessive anxiety or worry a majority of days >6 month period about various aspects of life

mgmt - SSRIs, psychotherapy

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25
social anxiety disorder
persistent (>6 mo) intense fear of social or performance situations in which the person is exposed to scrutiny of others for fear of embarrassment mgmt - SSRI, BB for performance anxiety, psychotherapy
26
specific phobias
persistent (>6mo), intense fear/anxiety of a specific situation, object, or place in which the phobic object or situation is actively avoided or endured with intense fear or anxiety so as to impair everyday activities with distress or avoidance mgmt - exposure/desensitization therapy
27
PTSD
>=1 (lasting >1mo) re-experiencing event (>1mo as repetitive recollections and dissociative reactions), avoidance of stimuli associate w/ the traumatic event, negative alterations in cognitions and mood, arousal & reactivity mgmt - SSRIs, CBT
28
acute stress disorder
similar to PTSD but sxs lasting <1mo mgmt - couseling/psychotherapy; treat as PTSD if persistent
29
adjustment disorder
emotional or behavioral reaction to an identifiable stressor (job loss, physical illness, leaving home, divorce, etc.); marked distress out of proportion to the severity of stressor and/or significant impairment in areas of functioning mgmt - psychotherapy; meds not preferred
30
dissociative identity disorder
presence of >= 2 distinct identities or states of personalities mgmt - psychotherapy
31
depersonalization/derealization disorder
persistent feelings of detachment or estrangement from oneself and/or surrounding environment reality testing is intact and symptoms cause distress mgmt - psychotherapy
32
dissociative amnesia
inability to recall personal/autobiographical information; causes significant impairment in functioning mgmt - psychotherapy
33
obsessive compulsive disorder
combination of thoughts (obsessions) that are inappropriate, intrusive, and unwanted and behaviors (compulsions) that often interfere with patient's lifestyle and are time consuming major patterns - contamination, pathologic doubt, symmetry/precision, intrusive obsessive thoughts mgmt - SSRIs, CBT
34
body dysmorphic disorder
excessive preoccupation that >1 body part is deformed or an over-exaggerations of a minor flaw, often causing patient to have functional impairment mgmt - SSRI, psychotherapy
35
somatic symptom disorder
(formerly somatization disorder) one or more vague somatic symptoms that are distressing or result in significant disruption of daily life, with symptoms not explained by a physical or medical cause mgmt - regularly scheduled visits to a healthcare provider
36
illness anxiety disorder
(formerly hypochondriasis) preoccupation with the fear or belief one has or will contract a serious, undiagnosed disease; somatic symptoms not usually present mgmt - regularly scheduled visits to healthcare provider
37
functional neurological symptom disorder
(conversion disorder) neurological dysfunction (motor or sensory) suggestive of a physical disorder that cannot be explained clinically; symptoms cause significant distress or impairment and tend to be episodic, recurring during times of stress mgmt - psychotherapy
38
factitious disorder
intentional falsification or exaggeration of signs and symptoms of medical or psychiatric illness for primary gain (assuming the sick role to get SYMPATHY) mgmt - nonspecific treatment
39
malingering
intentional falsification or exaggeration of s/s of medical or psychiatric illness for secondary gain (financial, food, shelter, avoidance of prison/school/work, to obtain drugs, etc.)
40
obesity
BMI >30kg/m2 or body weight >=20% over ideal weight mgmt - behavior modification, meds (orlistat, lorcaserin)
41
anorexia nervosa
refusal to maintain a minimally normal body weight (patient is UNDERWEIGHT; BMI <17.5) and has a morbid fear of fatness or gaining weight; restrictive type or purging type mgmt - medical stabilization, psychotherapy, pharmacotherapy if depressed **refeeding syndrome - watch for hypophosphatemia which occurs if refed too quickly (phos driven into cells)
42
bulimia nervosa
binge eating (at least weekly x 3mo) with compensatory behavior (purging or non-purging); patients have NORMAL weight or are overweight mgmt - psychotherapy, pharmacotherapy (fluoxetine has been shown to reduce binge-purge cycle)
43
schizoid personality disorder
voluntary social withdraw, anhedonic introversion, hermit-like behavior, inability to form relationships, prefers to be alone mgmt - psychotherapy
44
schizotypal personality disorder
odd, eccentric behavior and peculiar thought patterns (magical thinking but without psychosis (delusions)); pervasive discomfort with close relationships mgmt - psychotherapy
45
paranoid personality disorder
pervasive pattern of distrust and suspiciousness of others; preoccupation with doubt regarding the loyalty of others mgmt - psychotherapy
46
antisocial personality disorder
inability to conform to social norms with disregard and violation of the right of others; pattern of criminal behavior may begin in childhood as conduct disorders but must be >=18 to diagnose mgmt - psychotherapy
47
borderline personality disorder
unstable, unpredictable mood and affect; extreme pattern of instability in relationships, fear of abandonment, black and white thinking, impulsivity in self-damaging behaviors mgmt - psychotherapy
48
histrionic personality disorder
overly emotional, dramatic, seductive, attention-seeking; need to be the center of attention; often inappropriate, sexually provocative, seductive mgmt - psychotherapy
49
narcissistic personality disorder
grandiose, often excessive sense of self-importance but needs praise and admiration (fragile self-esteem) mgmt - psychotherapy
50
avoidant personality disorder
desires relationships but avoids them due to inferiority complex (timid, shy, lacks confidence) mgmt - psychotherapy
51
dependent personality disorder
dependent, submissive behavior; constantly needs to be reassured, relies on others, will not initiate things mgmt - psychotherapy
52
obsessive-compulsive personality disorder
perfectionists who require a great deal of order and control, preoccupied with minute details mgmt - psychotherapy
53
autism spectrum disorder
social interaction difficulties, impaired communication, and restricted/repetitive/stereotyped behaviors
54
oppositional defiant disorder
persistent pattern of negative, hostile, and defiant behavior towards adults at least 6 months of angry/irritable mood, argumentative/defiant behavior, and vindictiveness mgmt - psychotherapy
55
conduct disorder
persistent pattern of behaviors that deviate sharply from the age-appropriate norms and violate the rights of others; social and academic difficult 4 main areas - serious violations of laws, aggressive/cruel to animals, deceitfulness, and destruction of property **40% develop antisocial personality disorder
56
ADD and ADHD
hyperactivity, impulsivity, and/or inattentiveness leading to impairment; must have onset before 12 y/o, be present for at least 6 months, and symptoms must occur in at least two settings mgmt - behavior modification, sympathomimetic meds (stimulants; ritalin, adderall), non-stimulants (atomoxetine)
57
sympathomimetic medications (names, MOA, s/e)
methylphenidate (ritalin), amphetamine/dextroamphetamine (adderall) block NE and dopamine reuptake, increase release of NE and dopamine in extraneuronal space s/e - anxiety, HTN, tachycardia, weight loss, addiction
58
alcohol dependence (CAGE questions, treatment)
CAGE - cutdown, annoyed, guilt, eye opener tx - psychotherapy, disulfiram (antabuse; produces uncomfortable symptoms when couples with alcohol intake)
59
strongest predictive factor of suicide
previous attempt or threat
60
population with highest suicide rate in US
elderly white men
61
normal grief reaction
DABDA - denial, anger, bargaining, depression, acceptance resolves w/in 1 year patient may have illusions/hallucinations but perceives these as not being real
62
abnormal grief
severe symptoms, continued symptoms after 1 year, positive suicide ideation illusions/hallucinations that patient perceives as being real

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