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Flashcards in Psych Diagnoses (Ddx) Deck (33):
1

Delusional Disorder:

Def: Persistent delusions (1+ delusion for 1+ month or more) in absence of other psychotic sx; able to function apart from delusion.

Ddx: Schizophrenia (other psychotic sx present), Personality disorders (no clear delusions)

Delusion subtypes:
-Delusions of persecution (most frequent)
-Erotomanic delusions (false belief that someone of higher status is in love with pt)
-Grandoise delusions (great, talent, insights, or achievements)
-Jealous delusions (unfaithful partners)
-Somatic delusions (bodily functions/sensations)

2

Anorexia

-Significantly low body weight (BMI <18.5 or <17)
-Intense fear of wt gain
-Distorted views of body wt/shape
-Subtypes: Binge/purge vs. Restricting
-PE: Emaciation, bradycardia, hypotension, hypothermia, hair loss, dry skin, lanugo (fine, downy body bair), amenorrhea often. If vomiting: Puffy cheeks/parotic gland hypertrophy, dental cavities, halitosis, scars/calluses on hand from contact with teeth (Russell sign), electrolyte abnormalities

3

Bulemia

-Recurrent episodes of binge eating
-Compensatory behavior (vomiting, exercise) to prevent wt gain
-Excessive worry about body shape/wt
-Maintains normal body weight
-PE: Puffy cheeks/parotic gland hypertrophy, dental cavities, halitosis, scars/calluses on hand from contact with teeth (Russell sign), electrolyte abnormalities

4

Binge Eating Disorder

-Recurrent binge eating w/lack of control
-No compensatory behaviors

5

Anorexia vs. Bulemia key difference:

-Anorexia has low body wt vs. Bulemia has nl body wt.

6

Adjustment Disorder vs. GAD

Adjustment Disorder is mood disturbance within 3 months of an identifiable stressor vs. Generalized Anxiety Disorder is >6 months of persistent worry about multiple issues.

7

Social Anxiety Disorder (Social Phobia)

-Marked anxiety about >1 social situations for >6 months
-Fear of scrutiny by others, humiliation, embarrassment
-Social situations avoided or endured w/intense distress
-Marked impairment (social, academic, occupational)
-Subtype specifier - Performance only

8

Social Anxiety Disorder/Social Phobia Tx:

-SSRI/SNRI
-CBT
-Beta-blocker or Benzos - for performance-only subtype

9

Performance Anxiety Tx:

-Beta-blocker or Benzos

10

Cluster A Personality Disorders:

"Wierd" (odd/eccentric)
1) Paranoid PD
2) Schizoid PD
3) Schizotypal PD

11

Cluster B Personality Disorders:

"Wacky" (dramatic/erratic)
1) Borderline PD
2) Antisocial PD
3) Narcissistic PD
4) Histrionic PD

12

Cluster C Personality Disorders:

"Worried" (anxious/inhibited)
1) Dependent PD
2) Avoidant PD
3) Obsessive-Compulsive PD

13

Narcolepsy

DSM-5 Criteria:
1. Recurrent lapses into sleep/naps (at least 3x/wk for 3 months)
2. At least 1 of these:
-Cataplexy: Brief loss of muscle tone precipitated by strong emotion (ie. laughter, excitement)
-Low CSF level of hypocretin-1/orexin-A
-Shortened REM sleep latency

2. Other features:
-Hypnagogic or hypnopompic hallucinations (upon falling asleep or awakening)
-Sleep paralysis (can't move upon waking up)
-Excessive daytime sleepiness

-Onset = usually teens-early 20s

14

Brief Psychotic Disorder

-1 or more positive psychotic sx that last 1 day to 1 month and aren't due to another medical disorder or substance use.

15

Oppositional Defiant Disorder

-Pattern of angry/irritable mood and defiant behavior towards authority figures
-ONLY IN KIDS

16

Conduct DisorderAn

-Persistent and pervasive pattern of violating major societal rules or rights of others, including aggression, deceitfulness, theft.
-ONLY IN KIDS

17

Antisocial Personality Disorder

-Pattern of violating basic societal rules and rights of others
-Requires hx w/sx of conduct disorder b/f age 15
-ONLY IN 18+ (ADULTS)

18

Obsessive-Compulsive Disorder

-Numerous compulsive acts that occur in response to obsessive thoughts

19

Specific Phobia

-Marked anxiety about a specific object or situation for >6 months (esp. Flying, heights, animals, injections, blood)
-Avoidance behavior (avoiding bridges, elevators, airplanes)
-Common (10% of population)
-Usually develops in childhood or after a traumatic event

Tx: 1) CBT, involving exposure to specific stimulus, 2) Short-acting Benzo (only acutely)

20

PTSD


Tx: 1) SSRI (Fluoxetine), 2) Eye Movement Desensitization

21

Acute Mania:

Sx:
-Elevated, irritable, labile mood
-Increased energy/activity, decreased sleep
-Pressured speech, racing thoughts, distractable
-Grandiosity, risky behavior
-Marked impairment, maybe psychotic sx

Tx:
1. Antipsychotic (Respiridone) - rapid onset of action
2. Lithium, Valproate, Lithium also tx acute mania, by take several days to be effective d/t need for gradual titration

22

Adjustment Disorder:

-Mood disturbance occurring within 3 months in response to an identifiable stressor

23

Generalized Anxiety Disorder:

-6 or more months of persistent worry about MULTIPLE issues (vs. adjustment disorder = shorter, 1 issue)

24

Acute Stress Disorder:

-Involves exposure to a traumatic event, followed by development of anxiety, hyperarousal, and dissociative/intrusive symptoms >3 days to <1 month

25

Panic Disorder

-Recurrent, unexpected panic attacks, fears of future attacks, and avoidance behavior
-Attacks must have 4+ of these sx:
-CP, palpitations, SOB
-Trembling, sweating, nausea
-Dizziness, paresthesias
-Derealization, depersonalization
-Fear of losing control, dying

Tx:
1. Immediate = Benzos
2. Long-term = SSRIs/SNRIs and/or CBT

26

Schizophrenia:



Tx: Antipsychotics

27

Schizoaffective Disorder

-Psychotic sx for 2+ weeks in the absence of a mood episode

Tx:

28

Schizophreniform Disorder:



Tx:

29

Major Depressive Disorder:

DEF:

-Subtype: MDD w/psychotic features - unipolar depression with delusions/hallucinations w/depressive themes -.-> Tx: Antidepressant + Antipsychotic or ETC

Tx:

30

Illness Anxiety Disorder:

-Excessive concern about having a serious, undiagnozed general medical condition, without being delusional

Tx:

31

Delirium:

Precipitating factors:
-CNS insult (stroke/seizure)
-Infection (ie. PNA, UTI)
-Meds (ie. Sedatives, Benzos)
-Metabolic disturbances (ie. Electrolytes, uremia)

Tx:
-Avoid polypharmacy, physical restraints if needed
-Maintain normal sleep-wake cycle
-Provide frequent reorientation
-Tx underlying cause (ie. Abx for infxtn)

32

Obsessive-Compulsive Disorder

Sx include:
1. Obsessions - recurrent, intrusive, anxiety-provoking thoughts/urges/images
2. Compulsions - response to obsessions w/repeated behaviors or mental acts, behaviors not connected realistically w/preventing feared event
-Takes >1 hr/day or causes significant distress/impairment

Tx: SSRI and/or CBT (exposure/response prevention)

33

ADHD

-Mostly dx in children - must have sx of inattention, impulsivity and hyperactivity in 2+ settings

ADD FROM QBank

1. Inattention (careless mistakes, forgetfulness, not listening, avoidance/lack of follow-through of tasks)
2. Hyperactivity/Impulsivity (can't stray seated, talkative, difficulty waiting turn, interrupting)