Psychiatry Flashcards Preview

Medical Terminology > Psychiatry > Flashcards

Flashcards in Psychiatry Deck (93):
1

Anxi/o

uneasy, distressed

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Hypn/o

sleep

3

Iatr/o

treatment

4

Ment/o

mind

5

Phren/o
Psych/o

mind

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Schiz/o

split

7

Somat/o

body

8

-genic

produced by

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-leptic

to seize hold of

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-mania

obsessive preoccupation

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-phobia

fear

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-phoria

feeling

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-thymia

mind

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A-
an-

no, not

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Cata-

down

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Hypo-

deficient, less than, below

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Para-

abnormal

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Affect

external expression of emotion

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Amnesia

loss of memory

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Apathy

absence of emotions

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Compulsion

uncontrollable urge to perform an act repeatedly

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Conversion

anxiety becomes a bodily symptom that has no physical basis

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Fugue

flight from customary surroundings, dissociative disorder

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Delirium

confused thinking, disorientation, changes in alertness, difficulty paying attention, fearfulness. Usually reversible

25

Delusion

fixed false belief that cannot be changed by logical thinking

26

Dementia

loss of intellectual abilities w/ impairment of memory, judgement, and reasoning

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Labile

unstable, undergoing rapid emotional change

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Paranoia

overly suspicious thinking w/ fixed delusions of being harrassed, persecuted, or unfairly treated

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Psychosis

a disorder marked by loss of contact w/ reality, often associated w/ delusions and hallucinations

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Psychiatrist

Medical doctor, able to prescribe medications. Oversees diagnosis and treatment of psychiatric patients.

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Psychologist

Advanced degree but not a medical doctor, often w/ extensive training in research. Treat patients w/ psychotherapy. May aid in evaluation of disorders.

32

Psychotic disorder characterized by gross distortion of reality, disturbances of language & communication, withdrawal from social interaction, disorganization & fragmentation of thought, perception, and emotional reaction. Prevalence in men=women, mostly from 18-25 yo. 50% mz concordance. Unknown causes, although genetic factors are implicated.

Schizophrenia

33

Positive symptoms of Schizophrenia

-Delusion (false beliefs)
-Hallucination (false perception, usually auditory, "voices" commenting on patient's behavior)
-Thought disorder (disorganized thinking manifested in non-goal-directed speech)
-Bizarre behavior (silliness, agitation, inappropriate appearance/conduct, poor hygiene, catatonic behavior, rigid posture)

34

Negative symptoms of Schizophrenia

-Flat affect
-Loose thought associations
-Anhedonia (diminished capacity to experience pleasure)
-Social withdrawal
-Loss of ego boundaries (inability to perceive self as a separate individual)
-Concrete thinking (inability to abstract)

35

Schizophrenic subtype in which patient is mute & does not move or react to external stimuli

Catatonic Schizophrenia

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Schizophrenic subtype in which patient exhibits disorganized speech and bizarre behavior

Disorganized Schizophrenia

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Schizophrenic subtype in which patient exhibits prominent delusions of grandeur or persecution and auditory hallucinations

Paranoid Schizophrenia

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Treatment of Schizophrenia & its posible side effects

-Antipsychotic medications are the treatment of choice, positive symptoms improve quickly but negative symptoms improve slowly.
-Side effects include sedation, dystonia, tremor, increased prolactin level, weight gain, akathisia (motor restlessness), tardive dyskinesia, neuroleptic malignant syndrome.

39

Disorders characterized by an unpleasant emotional state. Behavioral & psychological changes often accompany these disorders; fatigue & sleep disturbance are very common. Lack of a daily structure is commonly a contributing factor (ex. Sunday neurosis; inability to cope in an unstructured environment). Cause is generally unknown, although hyperthyroidism, drug usage (corticosteroids, cocaine, amphetamines), and mood disorders such as major depression have been associated.

Anxiety disorder

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A short-lived, recurrent, unpredictable, intense anxiety disorder associated w/ psychological manifestations

Panic disorder

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Fear of open, crowded, or public places. A common panic disorder.

Agoraphobia

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Signs/symptoms of an anxiety disorder (diagnosis based on the presence of at least 3-4 of these for 6 mos or greater)

-Motor tension (shakiness, jumpiness, trembling)
-Inability to relax
-Autonomic hyperactivity (sweating, palpitation, dry mouth, dizziness, hot/cold spells, frequent micturition, diarrhea)
-Apprehensive expectation (worry, anticipation of personal misfortune)
-Vigilance & scanning (distractibility, poor concentration, insomnia, edginess)

43

Management of Anxiety disorders

-Behavioral therapy (helps provide a more structured environment for mild condition)
-Anxiolytic medications (Benzodiazepines are the drug of choice, sometimes antidepressants as well)
-For panic attacks SSRIs are the initial drug of choice, sublingual doses of lorazepam or alprazolam for urgent treatment

44

The most common psychiatric disorder

Depressive disorder

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Depressive disorder associated w/ adverse life situation such as death of a loved one or any family/financial crisis

Adjustment disorder w/ a depressed mood

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Depressive disorder characterized by at least one episode of serious mood depression occurring at any time of life

Major depressive disorder

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Depressive disorder w/ symptoms milder than in major depressive episodes but longer lasting w/ two or more episodes in 1 year

Dysthmia

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Depressive disorder w/ a combination of depression and hypomania lasting for 2 years, resolving and recurring

Cyclothymia

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Depressive disorder associated w/ some drug; alcohol dependence, reserpine, corticosteroids, oral contraceptives, methyldopa, digitalis, beta blockers, sedatives etc.

Depression secondary to substance abuse

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Causes of depressive disorders

-Unknown
-Adverse life changes
-Divorce
-Financial & family crises
-Illness
-Drug/substance abuse
-Postpartum, premenstural, postmenopausal in women

51

Signs/symptoms of Depressive disorders

-Anhedonia (withdrawal from activities, loss of sexual desire)
-Feelings of guilt, worthlessness, melancholia
-Inability to concentrate, cognitive impairment
-Anxiety, fatigue, insomnia or hypersomnia
-Somatic complaints; anorexia, constipation
-Suicidal ideation
-Psychotic ideations (paranoid thinking & somatic delusions)

52

Management of depressive disorders

-Hospitalization for patients w/ suicidal ideation
-Antidepressants
-Electroconvulsive therapy

53

Disorder characterized by one or more manic episodes alternating w/ depressive episodes

Bipolar I Disorder

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Inflated self esteem, feelings of grandiosity, decreased need for sleep, increased energy, racing thoughts, excessive involvement in pleasurable activities that may have negative consequences

Mania

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Disorder characterized by one or more hypomanic episodes alternating w/ major depressive episodes

Bipolar II Disorder

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Hypomania vs Mania

In hypomania; self esteem may be inflated but not as much as mania, mental overactivity but more organized thoughts than mania (thoughts are quick, creative & productive as opposed to aimless overactivity). Speech can be loud & rapid but easier to interrupt than manic speech. Psychosocial functioning may be improved or just mildly impaired. Risk taking behavior is mild to moderate as opposed to severe.

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A group of disorders that manifest as maladaptive, rigid, and damaging to personal work and interpersonal relationships. May occur as a response to stress or as a way of dealing w/ other people.

Personality disorder

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Cluster A Personality disorders

-Schizoid personality
-Schizotypal personality
-Paranoid personality

59

A person who is functioning but shy, introverted, socially isolated, lonely, emotionally cold, afraid of closeness & intimacy, oversensitive & a daydreamer.

Schizoid personality

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A person who is socially isolated, emotionally detached, has ideas of reference or paranoid ideation, claims to use magical thinking, clairvoyance, and telepathy.

Schizotypal personality

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An extremely suspicious and distrustful person who blames others for his/her mistakes and goes to great lengths to find hostility, prejudice, and malevolence in other people's innocent actions

Paranoid personality

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Cluster B Personality Disorders

-Borderline personality
-Antisocial personality
-Narcissistic personality
-Histrionic personality

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The most common of personality disorders, which affects mostly women who are unstable in their self-image, interpersonal relationships and mood. The person feels empty, angry, and entitled to seek care

Borderline personality

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Previously called psychopathic or sociopathic. The person disregards the feelings and rights of others and exploits others for materialistic gain.

Antisocial personality

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A self-centered, self-absorbed individual w/ grandiose ideation, who constantly needs admiration and is sensitive to criticism, failure, or defeat

Narcissistic personality

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A very dramatic attention seeker, with exaggerated emotions and childish, superficial behavior usually evoking sympathetic or erotic attention in others

Histrionic personality

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Cluster C Personality Disorders

-Dependent personality
-Avoidant personality
-Obsessive-compulsive personality

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An insecure person who lacks self-confidence, is unable to make decisions, and depends on others

Dependent personality

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A person hypersensitive to rejection, who suffers from social phobias; unlike a schizoid person they are openly distressed by isolation.

Avoidant personality

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A perfectionist who is self-centered, rigid in thought patterns, and needs to control things. These feelings considerably affect his or her occupational, social, or interpersonal functioning.

Obsessive-compulsive personality

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A refusal to eat adequately resulting from a distorted body image. May produce profound weight loss, amenorrhea, and emotional disturbances. They're intensely fearful of becoming obese. Occurs primarily in adolescents, mostly in girls of middle & upper socioeconomic levels.

Anorexia nervosa

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Causes of Anorexia Nervosa

-Unknown (generally psychiatric origin)
-Achievement oriented family members w/ high goals
-Destructive interpersonal relationships
-Excessive family concerns in dietary matters

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Signs/symptoms of Anorexia nervosa

-Emaciation
-Cold intolerance
-Constipation
-Amenorrhea
-Bradycardia
-Hypotension
-Hypothermia
-Dry/scaly skin
-Increased lanugo body hair
-Parotid enlargement
-Edema

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Diagnosis of Anorexia nervosa

-History & physical exam
-Decreased luteinizing hormone & follicle stimulating hormone
-Anemia
-Leukopenia
-Increased levels of blood urea nitrogen & serum creatinine
-Electrolyte abnormalities

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Management of Anorexia nervosa

-Structural behavioral therapy
-Intensive psychotherapy
-Family therapy
-Medications
-Parenteral feeding may be necessary

76

Recurrent episodes of binge eating resulting from a loss of control over eating; patient then engages in self-induced vomiting, use of laxatives and/or diuretics, fasting and excessive exercise.

Bulimia nervosa

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Causes of bulimia nervosa

-Psychosocia, possibly stress related

78

Signs/symptoms of bulimia nervosa

-Binge eating
-Fluctuating body weight
-Self-induced vomiting
-Excessive use of diuretics & cathartics
-Strict dieting and/or vigorous exercise
-Impulsive antisocial behavior
-Gastric dilation
-Pancreatitis
-Poor dentition
-Infection of the pharynx/esophagus
-Aspirations
-Electrolyte abnormalities
-Dehydration

79

Diagnosis of bulimia nervosa

-Two uncontrolled episodes of binge eating in 1 week for at least 3 months
-Pt's marked concern about weight gain
-Wide fluctuation of body weight
-Excessive use of laxative
-Unexplained hypokalemia
-Swollen parotid gland
-Scars on knuckle of the hand
-Dental erosions

80

Management of bulimia nervosa

-Supportive care
-Psychotherapy (individual, group, family)
-Antidepressants
-Worse prognosis when bulimia is associated w/ anorexia nervosa

81

Acute onset fluctuating course of altered state of awareness and consciousness. May be accompanied by hallucinations, illusions, delusions, emotional lability, paranoia, alteration in sleep cycle, psychomotor changes. May be reversible if treating the underlying condition. May be related to external toxin, medications, metabolic abnormality, CNS abnormality, change in pt's usual routine. High risk groups include elderly pt's w/ medical illnesses, post CABG, pt's w/ brain damage, burn patients, HIV patients. Commonly >65yo.

Delirium

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Acquired, persistent impairment in mental function involving at least three of the folowing; memory, language, visuospatial skills, personality or mood, and cognition.

Dementia

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Dementia vs. Delirium

Delirium has acute onset, dementia is hard to tell exactly when it occurred, slow downhill course. Primary distinguishing feature is the retention and stability of alertness in demented patient.

84

The most common cortical dementia, can affect 20% of pts >80 yo.

Alzheimer's disease

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Dementia w/ gait disturbances; post-stroke, normal pressure hydrocephalus, Huntington's & parkinson's diseases.

Subcortical dementia

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Dementia seen in pt's w/ HIV, MS, ALS, B12 deficiency, hypothyroidism, Wilson's disease

HIV-related dementia

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Group of disorders including fugue, amnesia, somnambulism, multiple personality etc. The reaction is precipitated by emotional crisis; symptoms produce anxiety reduction and temporary solution of the crisis. Mechanisms include repression and isolation. Condition similar to symptoms seen in temporal lobe dysfunction.

Dissociative disorders

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Sudden, unexpected travel away from one's home w/ inability to recall one's past.

Fugue state

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Disorders in which the physical symptoms suggest a medical condition, yet the symptoms are also not fully explained by a medical condition, substance abuse, or by another mental disorder. Symptoms are severe enough to cause significant distress or impaired social, occupational, or other functioning. Symptoms are NOT intentionally produced (vs factitious disorders or malingering).

Somatoform disorders

90

Disorder characterized by many somatic symptoms that cannot be explained adequately on the basis of physical and lab findings. Usually begins before age 30. Distinguished by a combination of chronic symptoms; pain, GI, sexual, and pseudoneurological. Associated w/ significant psychological distress, impairment in social and occupational functioning. Excessive medical help-seeking behavior. Early name was "hysteria' condition, incorrectly thought to affect only women.

Somatization disorders (Briquet's Syndrome)

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Somatization disorder vs. Somatoform disorder

Somatization disorders have a multiplicity of complaints & multiple organ systems affected.

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Disorder characterized by the presence of one or more neurological symptoms that cannot be explained by a known neurological or medical disorder. Requires that psychological factors be associated w/ the initiation or exacerbation of the symptoms.

Conversion disorder

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Disorder in which a person has a preoccupation with the fear of contracting or the belief of having a serious disease. The fear or belief arises when a person misinterprets bodily symptoms or functions. Preoccupation results in significant distress, and impairs the ability to function in personal, social, and occupational roles.

Hypochondriasis (hypochondrium = below the ribs, common abdominal complaints)