Psych Review Dx

Question 1

Diagnosis

Answer 1

Mood Disorders
Psychotic Disorders
Substance Disorders
Personality Disorders
Anxiety Disorders
Childhood Disorders
Dementias

Question 2

Mood Disorders

Answer 2

Major Depressive Disorder (MDD)

Bipolar Disorder

Adjustment Disorder

Question 3

Major Depressive Disorder Dx

Answer 3

SIG E CAPS (+Depressed mood)

MUST have either depressed mood or anhedonia

MUST last for longer than two weeks

MUST have at least 5/9 symptoms

Question 4

Major Depressive Disorder Treatment

Answer 4

Antidepressant (usually SSRI)

Therapy (CBT)

Electroconvulsive Therapy (ECT)

Question 5

Atypical Depression

Answer 5

Mood Reactivity (can become temporarily happy but short lived)

Increased sleep and appetite

“Leaden” Paralysis

TRAP!!: Treatment is still the same, MAOI can be used but are generally avoided because of side effects

Question 6

Bipolar Disorder

Answer 6

Bipolar I or Bipolar II

Difference is Manic vs. Hypo (almost) manic

Bipolar II must have a depressive episode also

Question 7

Manic Episode

Answer 7

DIG FAST lasting at least a week (unless hospitalized)

Causes impairment

Can have psychotic features

Question 8

Hypomanic

Answer 8

No impairment, hospitalization or psychotic features

Question 9

Bipolar DisorderTreatment

Answer 9

Mood Stabilizer

Question 10

Adjustment Disorders

Answer 10

With Depression

Related to a very specific trigger (divorce, termination, etc).

Symptoms disappear with resolution of trigger

Does not meet criteria for MDD

Question 11

Psychotic Disorders

Answer 11

Schizophrenia

Schizophreniform

Brief Psychotic Disorder

Schizoaffective Disorder

Delusional Disorder

Question 12

Schizophrenia Diagnosis

Answer 12

MUST last 6 months

MUST have 2/5 symptoms

MUST have Delusions or Hallucinations or Disorganized Speech

Cannot be do to other problems (depression, drugs, bipolar etc.)

Question 13

Schizophrenia Symptoms

Answer 13

Delusions
Fixed false belief outside cultural norm

Hallucinations
False sensory (i.e. auditory, visual) perception

Disorganized Speech

Disorganized Behavior

Negative Symptoms
Flattened affect, avolition, anhedonia, asociality, alogia

Question 14

Psychotic DisordersTimeframe

Answer 14

1 month - Brief Psychotic Disorder

2-6 months - Schizophreniform

6 months of longer - Schizophrenia

Question 15

Delusional Disorder

Answer 15

Delusion lasting > 1 month

No other impairment

Question 16

Substance Disorders

Answer 16

Intoxication

Withdrawal

Dependence

Question 17

Substance Withdrawal

Answer 17

Deadly:
Alcohol, Benzos and Barbiturates
Same mechanism (GABA and Glutamate dysregulation)
Seizures and autonomic instability (HTN, Tachycardia, fever, diaphoresis)

Not Deadly
Everything else (opiates!!)
Opiate Withdrawal
Dilated pupils
N/V/Diarrhea
Piloerection
Yawning

Question 18

Substance Dependence

Answer 18

Diagnosis usually involves details of long term pattern of misuse:
Legal, social and occupational problems
Withdrawal
Tolerance

Question 19

Substances Categories

Answer 19

Uppers

Downers

Hallucinogens

Question 20

Uppers

Answer 20

Amphetamines

Cocaine

Caffeine

Nicotine

Question 21

Downers

Answer 21

Alcohol

Opiates

Benzodiazepines

Barbiturates

Question 22

Hallucinogens

Answer 22

Phencyclidine (PCP)

Lysergic Acid Diethylamide (LSD)

Marijuana (THC)

Ecstasy (MDMA)

Question 23

Substance Intoxication

Answer 23

Alcohol
Ataxia
Slurred Speech

Opiates
CNS depression
Pinpoint Pupils

Cocaine
Pupillary dilation

PCP
Crazy Violent

Question 24

Personality Disorders Categories

Answer 24

Cluster A “Wacky”

Cluster B “Weird”

Cluster C “Worried”

Question 25

Personality DisordersCluster A

Answer 25

Paranoid Personality Disorder Mistrust, likely NOT Delusional Schizoid Loner and likes it Schizotypal Magical thinker

Question 26

Personality Disorders Cluster B

Answer 26

Borderline Personality Disorder Cutters!!! Intense interpersonal relationships Antisocial Personality Disorder Must have evidence of conduct disorder Pervasive pattern of violating societal norms Narcissistic Personality Disorder Name dropping Demanding Histrionic Personality Disorder Attention Seeking

Question 27

Personality Disorders Cluster C

Answer 27

Avoidant Personality Disorder Loner…doesn’t like it Obsessive Compulsive Personality Disorder Obessed with order, not bothered by it but bothers everyone else Dependent Personality Disorder Submissive

Question 28

Anxiety Disorders

Answer 28

Generalized Anxiety Disorder -“Worry Wort”, MULTIPLE areas of worry Specific Phobia -Anxiety about just one thing Social Anxiety Disorder -Anxiety being in public because of fear of public scrutiny Panic Disorder -Panic attack with NO TRIGGER “out of the blue” Separation Anxiety Selective Mutism

Question 29

Posttraumatic Stress Disorder

Answer 29

``` Nightmares Recurrent intrusive memories Hypervigelence Flashbacks Related to a traumatic experience MUST last longer than 1 month 3 days to 1 month is Acute Stress Disorder ```

Question 30

Obsessive Compulsive Disorder

Answer 30

Obsessions Recurrent intrusive thoughts “Germs are everywhere” Compulsions Repetitive act to relieve anxiety Hand washing Bothers patient (compare to OCPD)

Question 31

Childhood Disorders

Answer 31

Autism No Eye Contact, preoccupation on one thing Oppositional Defiant Disorder Temper Tantrums Conduct Disorder Rule breaker ADHD

Question 32

Dementia

Answer 32

All Dementia’s must have memory loss and change in executive functioning Alzheimer’s Dementia - Slow progressive decline - Most Common - Neurofibrillary tangles and amyloid plaque Vascular Dementia Frontotemporal or “Pick’s Disease” -Behavior changes, inhibition, socially inappropriate Lewy Body Dementia -Visual hallucinations Huntington's Disease HIV Dementia