Psychiatric/Behavioral Flashcards
strategies for safe opioid prescribing
most pts w acute pain (trauma/post-operative) have significant improvement within 3-5 days and may be prescribed a brief course of meds for breakthrough pain w low risk addiction
common antipsychotic side effects
2nd gen antipsychotics are associated w a lower risk of extrapyramidal side effects (ex: Parkinsonism, tardive dyskinesia) compared w 1st gen (1st gen - WEIGHT gain!)
Delusional disorder
delusional disorder is characterized by >1 months in the absence of other psychotic symptoms; behavior is not obviously bizarre and functioning is not significantly impaired apart from the direct impact of the delusions
schizophrenia
the diagnosis of schizophrenia requires >2 of the following 5 symptoms: delusions, hallucinations, disorganized speech, grossly disorganized behavior and negative symptoms; the total impairment duration must be >6 months
fetal alcohol syndrome
typical features of fetal alcohol syndrome include facial dysmorphism (short palpebral fissures, thin upper lip, smooth philtrum), growth retardation, neurological abnormalities and behavioral difficulties
neonatal exposed to heroin
presents in the first few days of life; it is characterized by irritability, a high-pitched cry, poor sleeping, tremors, seizures, sweating, sneezing, tachypnea, poor feeding. vomiting, and diarrhea
neonatal exposed to cocaine
presents in the first few days of life; it is characterized by jitteriness, excessive sucking and a hyperactive Motor reflex (due to the toxic effects of cocaine); usually not as severe as opiates (heroin); long-term effects on behaviors, attention level and intelligence may be seen
post traumatic stress disorder treatment
1st line tx for PTSD includes trauma-forced cognitive-behavioral therapy and antidepressant meds; Selective serotonin reuptake inhibits (SSRIs) have the best evidence for efficacy
falling risk in the elderly
falls are a common problem in elderly nursing home pts; optimal management includes a careful medication review w the goal of limiting the use of agents associated w increased fall risk
Schizotypal personality disorder
characterized by a long-standing pattern of eccentric behavior, odd beliefs, perceptual distortions and social anxiety despite familiarity
bipolar disorder, maniac w psychotic features
indications for monoamine oxidase inhibitors (MAOis)
monoamine oxidase inhibitors (MAOis) are particularly useful in pts w treatment-resistent major depressive disorder w atypical features; increased appetite and sleep, leaden paralysis, rejection sensitivity and mood reactivity are hallmarks of the atypical subtype
Generalized anxiety disorder
6+ months; symptoms of worry, irritability, fatigue and tension NOT associated w a specific person/event (Deja); tx w SSRI, SNRI, CBT
Adjustment Disorder
there is a trigger (some event) that leads to mood symptoms; next questions is how long? less than 6 months think Adjustment; more than 6 months GAD
Panic Disorder
1+ month with symptoms of “panic attacks” palpitations, SOB, impending, tachycardia with fear, worry or behavioral changes related to having another attack; tx w maintenance w SSRI, SNRI, CBT tx acutely w benzodiazepines
