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Psychiatry Flashcards

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1
Q

Delirium-DSM 5

A

A. Disturbance in attention and awareness

B. Disturbance develops over a short period of time, represents a change from baseline, and tends to fluctuate in severity over the course of a day

C. Additional disturbance in cognition (memory deficit, disorientation, language, visuospatial ability/perception).

D. Does not occur in the context of a severely reduced level of arousal (coma)

E. Evidence of physiological consequence as the cause

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2
Q

Causes of Delirium

A
  1. Substance Abuse
  2. Substance Withdrawal
  3. Medication-Induced
  4. Due to another medical condition
  5. Due to multiple etiologies
    • Nutritional deficiencies
    • Anemias
    • Electrolyte imbalance
    • Low ACh (Anticholinergics)
    • High DA (Opioids)
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3
Q

Clinical Findings in Delirium

A
  1. Acute onset
  2. Inattention
  3. Disorientation
  4. Fluctuation of mental status
  5. Memory impairment
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4
Q

Pathophysiology of Delirium

A
  1. Inflammation (pro-inflammatory cytokines)
  2. Stress Rxn
    • High coritsol
    • Sleep deprivation
  3. Neuronal injury
    • Disrupts BBB
  4. Neurotransmission abnormalities
    1. Decreased ACh
    2. Increased DA
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5
Q

Precipitating Factors of Delirium

A
  1. Medications: Anticholinergics/Opioids
  2. Hypoxia
  3. Hypoglycemia
  4. Hyperthermia/Fever
  5. Infection
  6. Metabolic Abnormalities
  7. Hypoalbuminemia (early sign)
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6
Q

Factors to reduce frequency of delirium

A
  1. Orientation protocol (write day/date/location/ID in sight)
  2. Noise reduction
  3. Visual aids
  4. Hearing aids
  5. Hydration
  6. Early mobilization
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7
Q

Drug Treatments for Delirium

A
  1. Benzodiazepines IF caused by withdrawal of ETOH or Benzodiazepines
  2. Pro-cholinergic drugs (AChE Inhibitors)
  3. DA antagonists (antipsychotics)
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8
Q

Major vs Minor neurocognitive disorder

A

Major: Substancial cognitive decline that interferes with independent living

Minor: Modest changes in cognition that do not yet interfere with independent living

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9
Q

Examples of major neurocognitive Disorders

A
  1. Alzheimer’s
  2. Vascular disease
  3. Prion Disease
  4. Parkinson’s
  5. Huntington’s
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10
Q

Changes in the brain in Alzheimer’s patients

A
  1. Amyloid plaques (beta amyloid peptides)
  2. Neurofibrillary tangles (tau protein)
  3. Loss of connections/cell death
  4. Loss of ACh
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11
Q

Symptoms of Alzheimer’s

A
  1. Memory loss***
  2. Loss of recognition
  3. language problems
  4. Anterograde amnesia
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12
Q

Drugs that treat alzheimer’s

A
  1. AChE inhibitors (inhibit ACh breakdown)
  2. NMDA antagonists
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13
Q

Risk Factors for Alzheimer’s

A
  1. Age
  2. Genetics for early-onset (chromosomes 1, 14, 21)
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14
Q

Most common cause of amnestic disorder

A

Alcohol abuse with chronic thiamine (B-1) deficiency

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15
Q

Symptoms of Wernicke’s Encephalopathy

A
  1. Ophthalmoplegia
  2. Ataxia
  3. Mental confusion
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16
Q

Symptoms of Korsakoff’s psychosis

A
  1. Amnesia (retrograde or anterograde)
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17
Q

What are the six cognitive domains in neurocognitive disorders?

A
  1. Attention
  2. Executivefunction
  3. Learning and memory
  4. Language
  5. Perceptual motor
  6. Social-cognition
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18
Q

Difference between Hallucination and Illusion

A
  1. Hallucination: seeing something that isn’t there (any of the 5 senses)
  2. Illusion: seeing something that is there but thinking that it is something else (see a rope but think it is a snake)
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19
Q

Mood vs Affect

A
  • Mood: emotional attitude that is relatively sustained, self-reported
  • Affect: the way the patient conveys their emotional state as perceived by others (how a patient “appears”)
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20
Q

Tegmentum: origin of which neurotransmitter?

A

Dopamine

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21
Q

Raphe nucleus: origin of which neurotransmitter?

A

Serotonin

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22
Q

Locus Ceruleus: origin of which neurotransmitter?

A

Norepinephrine

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23
Q

Tuberomammiliary nucleus: origin of which neurotransmitter?

A

Histamine

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24
Q

Nucelus Basalis of Meynert: origin of which neurotransmitter?

A

ACh

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25
Neurotransmitter mediating executive function, motivation,interpersonal and emotional behavior
Glutamate
26
Function of DA
Attention Pleasure Motivation
27
Function of NE
Energy Alertness Concentration
28
What part of the brain atrophies in depression?
Hippocampus
29
What are the changes in DA transmission in Schizophrenia?
* **Decreased** in prefrontal cortex * Due to excess stimulation of serotonin receptors on presynaptic neuron * **Increased** in Mesolimbic cortex * Inhibition of serotonin receptors on presynaptic neuron
30
Results of Glutamate Hypoactivity in the brain in Schizophrenia
1. Decrease DA downstream * if glutamate neuron directly connected to DA neuron * Prefrontal cortex in Schizophrenics * leads to negative symptoms (mood and cognitive) 2. Increase in DA downstream * connected to DA neuron through a GABA interneuron * Mesolimbic system in Schizophrenics * Leads to psychotic symptoms
31
Pavlovian conditioning definition
Pairing of stimuli
32
Operant conditioning definition
Positive reinforcement vs negative reinforcement where behavior can control its own consequences Unpredictable schedule of reinforcement works best
33
Behavioral therapy moto
work on observable behaviors, feelings to follow
34
Types of behavioral therapy 1. Relaxation training 2. Exposure 3. Flooding 4. Behavioral Activation
1. muscle relaxation to achieve control over feelings of tension and relaxation 2. imaginary or in vivo; gradual exposure to more and more fearful things; systematic desensitization 3. Constant exposure to most feared thing; Not used 4. Re-Engage person in social activities
35
What is a cognitive schema?
How you have learned to think
36
What is the cognitive triad and in what disorder is it mostly found?
1. Negative view of self 2. Negative view of future 3. Negative interpretation of experience Found in depression
37
What is arbitrary inference?
Drawing an erroneous conclusion from an experience
38
What is Selective abstraction?
Taking a detail out of context and using it to denigrate the entire experience
39
What is overgeneralization?
Making general conclusions about overall experiences and relationships based on a single instance
40
What is magnification and minimization?
Altering the significance of specific events in a way that is structured by negative interpretations Ex: a good grade explained by the test being easy but a bad grade being attributed to being a terrible student who will never succeed in life
41
What is personalization?
Interpreting events as reflecting on the patient when they have no relation to him or her Ex: a frown from a grouchy traffic policeman is seen as recognition of the patient's overall lack of skill as a driver and general worthlessness
42
What is Dichotomous thinking?
Seeing things in an all-or-nothing way Ex: An A- student gets a B in a course and concludes that it proves that they are a terrible student
43
What is free association?
In psychoanalytic therapy, spontaneous, uncensored verbalization by the patient of whatever comes to mind.
44
What is Transference?
In psychoanalytic therapy, feeling something toward the analyst that stems from a feeling toward someone else/an experience in life.
45
What is Couter-transference?
In psychoanalytic therapy, the transference/emotional reaction by the analyst of previous experience and feelings onto the patient
46
What is transference neurosis?
In psychoanalytic therapy, fully developed transference of the role of someone in the patient's life to the analyst
47
What is projection?
A defense mechanism in which the feelings one feels toward another is viewed as being felt by the other person towards oneself. Ex: I have negative feelings toward you but think you don't like me
48
What is Splitting?
A defense mechanism in which the self or others are viewed as all good or all bad, with failure to integrate the good and bad qualities into a cohesive image. The person alternatively idealizes and devalues the same person.
49
What is dissociation?
A defense mechanism consisting of an altered state of consciousness; separation of an idea from its emotional significance
50
What is Reaction formation?
A defense mechanism in which a person adopts affects, ideas, and behaviors that are opposites of impulses harbored either conscously or unconsciously. Ex: excessive moral zeal may be a reaction to strong but repressed asocial impulses.
51
What is intellectualization?
A defense mechanism in which the person engages in excessive abstract thinking to avoid confrontation with conflicts or disturbing feelings.
52
What is sublimation?
A defense mechanism by which instinctual drives, consciously unacceptable, are diverted into personally and socially acceptable channels. Ex: feeling agression toward someone so you beat them at a game rather than physically
53
Focus of insight-oriented psychotherapy
interpersonal relations in the present and intellectual understanding
54
Focus of interpersonal therapy
ID and work on problem areas that ma affect self esteem and interactions
55
Characteristics of Atypical Depression
1. Mood reactivity 2. Leaden paralysis (arms and legs) 3. Weight Gain, Excessive sleep 4. Treat w/MAOIs
56
Characteristics of Melancholic Depression
1. Guilt 2. Terminal insomnia 3. Anorexia
57
Characteristics of SAD
Depressed mood coincides with particular seasons **Spring-onset**: more sever, higher risk of suicide **Fall-onset**: rull remission in the summer months
58
Characteristics of Persistent Depressive Disorder
1. Longer duration and persistance (2 years) 2. Less severe symptoms * 2 symptoms of depression persist for 2 years
59
Characteristics of Psychotic Depression
1. Mood-congruent delusions More common in bipolar psychosis than unipolar Treat with antidepressant + antipsychotic
60
Causes of Depression
1. Genetics 2. Neurobiology * Decreased DA * Increased Serotonin * Prefrontal Cortex, Amygdala, and Hippocampus involved 3. Psychosocial * at first stimulated by large stressors but later by progressively small stressors or none at all
61
Disorder that is often a comorbidity with depression
Anxiety
62
Symptom domains of Bipolar Disorder
1. Manic (like stimulants) 2. Dysphoric 3. Psychotic * Delusions * Hallucinations 4. Cognitive * Racing thoughts * distractibility * Disorganization
63
Predictors of suicide (in bipolar patients)
1. Lack of sleep 2. Anxiety
64
Bipolar I vs Bipolar II
Bipolar I: full manic episodes followed by depressive episodes Bipolar II: at least one hypomanic episode followed by depressive episodes
65
Frequent comorbidity with Bipolar II
Migraines
66
Characteristics of Cyclothymic disorder
1. Cycles of mild depression followed by hypomania * manias are not socially or professionally incapacitating Mildest form of bipolar
67
Symptoms of Major Depression
Depressed Mood Interest Weight Sleep Motor activity Energy Guilt Concentration Suicide "Depression Is Worth Studiously Memorizing Extremely Grueling Criteria, Sorry"
68
What is the difference between delusions and hallucinations?
Delusions: beliefs Hallucinations: perceptual distortions
69
Characteristics of psychosis
1. Loss of reality testing 2. Delusions or hallucinations w/o insight into their pathological nature 3. Impaired social/personal functioning * Social withdrawal
70
Causes of Schizophrenia
1. Genetic\*\* 2. Environment * cannabis use * Maternal malnourishment/depression during pregnancy 3. Neurodegeneration * Gray matter loss * dendritic spine reduction
71
Prodromal symptoms of schizophrenia
1. Paranoia\*\*\* * Including ideas of reference 2. Perceptual distortions\*\*\* 3. Social withdrawal 4. Lack of appropriate affect 5. Unusual ideas/beliefs 6. Crippling Anxiety
72
Types of delusions in Schizophrenia
These are Positive signs 1. Fixed, false beliefs 2. Paranoid type 3. Grandiose type 4. Delusions of reference 5. Thought insertion (believe thoughts are not their own and are being broadcast in their mind) 6. Thought broadcasting (believe thoughts are being broadcast for others to hear 7. LACK OF INSIGHT
73
Neurobiology of delusions
Hippocampus retrieves old, irrelevant memories and the amygdala adds emotion
74
Types of hallucinations in schizophrenia
These are positive signs 1. Outer-space auditory hallucinations (heard outside head) 2. Inner-space auditory (heard inside head) 3. Elementary (indistinct sounds Unpleasant, difficult to control, distressing and disruptive
75
Neurobiology of hallucinations
overinterpreting spontaneous sensory activity that is commonly ignored in healthy brains
76
Neurobiology of auditory hallucinations
Failure of **corollary discharge** (responsible for distinguishing self-generated from externally generated perceptions) to alert temporal lobes that these thoughts are self-generated
77
Types of thought processing/speech in schizophrenia
Positive Symptoms 1. Tangential (respond to question in round-about manner or not at all) 2. Circumstantial (delayed in reaching goal idea; tangents, tedious details) 3. Flight of ideas (rapid, continousflow of speech with abrupt changes in topic; associations, distractions, word play 4. Derailing (Disjointed with many changes in topic) 5. Paucity of speech (scarcity, answer in two-word responses) 6. Increased response latency
78
Negative symptoms in schizophrenia
1. Flat/Blunted Affect 2. Lack of initiative/motivation 3. Anhedonia 4. Social withdrawal
79
Neurobiology of negative symptoms
Hypoglutamatergic state * Glutamate directly connected to DA neuron, causing **decreased DA** in prefrontal cortex (mesocortical)
80
Neurobiology of Positive symptoms
Hypoglutamatergic State * Glutamate neuron connected to GABA interneuron then DA neuron * **Increased DA** in mesolimbic system
81
Function of Atypical antipsychotics
1. Block D2 receptors in the mesolimbic system (where there is too much) 2. Block serotonin receptors in the prefrontal cortex (where there isn't enough DA) * DA release inhibited by serotonin
82
What are MUPS
Medically explained physical symptoms that are distressing/disrupt daily life
83
Characteristics and treatment of Somatic Symptom Disorder
1. Somatic symptoms disrupt daily life 2. Excessive thoughts/feelings/behavior focused on **symptoms** 3. State of being symptomatic is persistent Treatment: brief, scheduled visits
84
Characteristics and treatment of Illness Anxiety Disorder
1. Preoccupation with having/acquiring a serous illness 2. Symptoms not present or mild 3. excessive health-related behaviors (checking) 4. Distress that they have an **illness** (focus not on symptoms) Treatment: 1. Frequent scheduled appointments 2. Cognitive behavioral therapy 3. SSRIs (anti-obsessional effects)
85
Characteristics and Treatment of Conversion Disorder
Characteristics: 1. Altered voluntary motor or sensory function (paralysis/pseudoseizures) 2. Not compatible with recognized disease Treatment 1. "face-saving" treatment and symptoms remit spontaneously in 2 weeks
86
Psychodynamic interpretation of Conversion Disorder
Achieves a primary goal steming from unconscious conflicts (aggression, sexuality) Ex: aggression makes man want to shoot wife's lover but dominant hand and arm become paralyzed Secondary gain: benefits from the "sick role"
87
Characteristics of Malingering
Characteristics: 1. Intentional production of false/exaggerated symptoms 2. Motivated by external incentives (avoid military duty/criminal prosecution) Confrontation is correct response
88
Characteristics and Treatment of Separation Anxiety Disorder
1. Fear of being separated from places/people to whom one has strong emotional attachment 2. Worry of losing that person/being separated from that person by being kidnapped, ect. 3. School Phobia is one form Treatment: SSRI and cognitive behavioral therapy
89
Characteristics and Treatment of Selective Mutism
Characteristics: 1. Absence of expressive verbal speech in select situations Treatment: SSRI and behavioral therapy
90
Characteristics and Treatment of Social Anxiety Disorder
Characteristics 1. Fear of scrutiny 2. Avoidance and fear of social situations 3. Physical symptoms of anxiety (autonomic arousal) Treatment: 1. SSRI/MAOI/BZD 2. Beta blockers 3. Behavioral desensitization
91
Characteristics and treatment of Panic Disorder
Characteristics: 1. abrupt episodes with autonomic arousal 2. Chest pain or discomfort 3. Shortness of breath 4. Parasthesias 5. Derealization or depersonalization 6. Episodes followed by persistent worry or maladaptive change in behavior to avoid attack Treatment: 1. SSRI/MAOI/TCA/BZD 2. Cognitive behavior therapy
92
Pathophysiology of Panic Disorder
1. lactate metabolism abnormality 2. GABA abnormality 3. Locus Coeruleus abnormality (NE)
93
Characteristics and Treatment of Agoraphobia
Characteristics: fear of 1. public transportation 2. enclosed spaces 3. crowds 4. Being away from security of home base Treatment: Behavioral therapy
94
Characteristics and Treatment of Generalized Anxiety Disorder
Characteristics: 1. Anxiety 2. Restlessness 3. Fatigue 4. Sleep disturbance 5. Unrealistic fear Treatment: SSRI/MAOI/BZD/TCAs and cognitive behavioral therapy
95
What is excoriation?
An OCD syndrome characterized by skin picking
96
What is Trichotillomania?
An OCD disorder characterized by hair pulling
97
What is PANDAS?
Pediatric Auto-immune Neurologic Disorder from Streptococcal infection Causes an OCD-type disorder in children Causes Tourette's Syndrome
98
The following tests are used to test what? 1. WISC-IV 2. Bender-Gestalt 3. Iowa test 4. Draw a person test
1. IQ 2. Perceptual-Motor skills 3. Educational achievement to detect learning disabilities 4. Perceptual-Motor skills
99
What is speech sound disorder?
A language disorder involving problems with certain sounds (ex: "r"s or "w"s)
100
What is Child-onset fluency disorder?
Stuttering Usually grows out of it
101
What is social communication disorder?
Problems with communication, including: 1. Failure to change communication style with environment 2. Trouble taking turns in conversation 3. Poor ability to make inferences
102
Characteristics of Autism
1. Deficits in social-emotional reciprocity 2. Deficits in non-verbal communication * No eye contact * No gesturing while talking 3. Restricted repetitive patterns of behavior (need a set schedule) 4. Devoid of novelty-seeking
103
Characteristics of ADHD
1. Inattentive * Short attention * Misses details * Disorganized 2. Hyperactivity/impulsivity * Fidgets * Talks excessively Highly Inheritable
104
Characteristics of Tourette's Disorder
Vocal and motor tics before age 18 Can be caused by PANDAS
105
Characteristics of Anorexia nervosa
1. **Significantly low body weight** (\<17 kg/m2) 2. Fear of gaining weight or becoming fat 3. Disturbance in the way weight or shape is experienced 4. Lack of insight into the problem (denial) * Symptoms are **ego-systonic** (consistent with patient's ideals)
106
Acute and Chronic Medical Complications of Anorexia Nervosa
Acute 1. Electrolyte abnormalities (low K) 2. Refeeding hypophosphatemia 3. Cardiac abnormalities (Low bp, arrythmia) Chronic 1. Cognitive impairment 2. Changes in brain volume 3. Cardiac arrythmias 4. Osteoporosis 5. Amenorrhea
107
Types of Anorexia Nervosa
1. Restricting Type: primarily through diet, fasting, and excessive exercise 2. Binge-eating/purging type * Differentiate from bulemia by low weight
108
Characteristics of Bulemia Nervosa
1. Eating a larger amount of food than what most would eat (feel lack of control over eating) 2. Compensatory behaviors in order to prevent weight gain 3. Self-evaluation largely based on body shape/weight 4. **Normal/above normal weight** 5. Symptoms are **ego-dystonic** (in conflict with self image)
109
What is a russell sign? With which disorders is it associated?
A sore on the finger/knuckle due to contact with gastric acid from inducing vomiting
110
Acute and Chronic Medical Complications of Bulimia Nervosa
Acute 1. Electrolyte abnormalities (low K lvls) 2. Increased _serum amylase_ 3. Low _plasma insulin, low glucose_ Chronic 1. **Mallory-Weiss tears of esophagus** 2. **Fatty Liver** 3. Arrhythmias 4. Hypothermia 5. Amenorrhea
111
Treatment: Anorexia vs Bulimia
Anorexia 1. Focus on restoring weight 2. Calcium/Vit D supplement 3. Estrogen/Progesterone replacement Bulimia 1. Focus on metabolic balance 2. SSRIs (Not Bupropion due to reduced seizure threshold) Both: Psychoeducation!
112
Characteristics of Hypersomnolence Disorder
1. Excessive sleepiness despite main sleep period lasting at least 7 hours 2. Includes one of the following: * Recurrent periods of sleep or lapses into sleep within the same day * Prolonged main sleep of more than 9 hours per day that is unrefreshing * Difficulty being fully awake after abrupt awakening
113
Characteristics of Narcolepsy
1. Recurrent episodes of an irrepressible need to sleep 2. Decreased sleep and REM latency 3. May have cataplexy
114
Characteristics of Parasomnias
1. Incomplete awakening from sleep 2. Either Sleepwalking or Sleep Terrors
115
Aspects of Personality Disorders
ABC's 1. Affect 2. Behavior * interpersonal and impulse control 3. Cognition * Ways of perceiving and interpreting self and others
116
What disease-types are in each cluster of Personality Disorder? Cluster A Cluster B Cluster C
1. Cluster A: Odd (Psychosis) * Schizoid, Schizotypal, Paranoid 2. Cluster B: Dramatic (Affective) * Antisocial, Borderline, Histrionic, Narcissistic 3. Cluster C: Anxious * Avoidant, Dependent, OCpD
117
Characteristics of Paranoid Personality Disorder and Primary Defense
Characteristics: 1. Suspicious 2. Mistrustful 3. Preoccupied with being exploited or betrayed by others **Projection** is primary defense
118
Characteristics of Schizoid Personality Disorder
Characteristics: 1. Defect in ability to form personal relationships * Due to **lack of interest** 2. Indifferent, aloof 3. Unresponsive to feelings expressed by others
119
Characteristics of Schizotypal Personality Disorder
Characteristics: 1. Idiosyncratic speech patterns 2. eccentric beliefs 3. paranoid tendencies 4. withdrawn from society Like schizophrenia but person has never had a psychotic break
120
Characteristics of Antisocial Personality Disorder
Characteristics 1. Socially irresponsible 2. Deception/manipulation of others for personal gain 3. Lacks remorse 4. Fails to abide by the law
121
Characteristics of Borderline Personality Disorder and Major defense
1. Intense and chaotic relationships 2. Fluctuating and extreme attitudes toward others 3. Self-destructive behaviors in response to abandonment Major defense: Splitting
122
Characteristics of Histrionic Personality Disorder
1. Attention-seeking 2. seductive 3. exhibitionistic 4. shallow emotions
123
Characteristics of Narcissistic Personality Disorder
1. Egocentric 2. Crave admiring attention and praise * need external validation all the time 3. Feel "entitled" to special rights/attention/privileges
124
Characteristics of Avoidant Personality Disorder
1. Introverted 2. Low self-esteem 3. Social awkwardness 4. Self-conscious 5. Fears of being embarrassed or acting foolish \*\*Wants to socialize, but is afraid Differs from _Schizoid_ b/c **wants social interaction** similar to _social anxiety_ disorder, but is **long-term**
125
Characteristics of Dependent Personality Disorder
1. Excessive reliance on others 2. permit others to make important decisions
126
Characteristics of Obsessive-Compulsive Personality Disorder and Defenses
Characteristics 1. Perfectionistic 2. Emotionally distant 3. Driven/competitive Defenses: 1. reaction formation 2. intellectualization
127
Most common cause of sexual disorder
Psychological: Psych disorder Stress Relationship conflicts Abuse/trauma
128
Drugs that cause sexual dysfunction
1. Antipsychotics 2. SSRIs 3. MAOIs 4. TCAs 5. Alcohol 6. Opioids 7. Antihistamines
129
Hormones/Neurotransmitters that increase sexual desire
1. increased DA 2. increased testosterone
130
Hormones/Neurotransmitters that decrease sexual desire
Elevated: 1. Serotonin 2. Prolactin 3. Cortisol 4. Progesterone
131
Components of Dual Sex Therapy
Components: * Dyad as the object of therapy * Sexual problems reflect other areas of disharmony in relationship * Goal: improve sexual and nonsexual areas Techniques: * _sensate focus exercise_: focus on heightening sensory awareness of touch, sight, sound, and smell * _Squeeze technique:_ for premature ejaculation
132
Drug therapies for ED
1. Phosphodiesterase 5 inhibitor (enhances NO) 2. Prostaglandin E (vasodilation)
133
Drug therapy for premature ejaculation
1. SSRIs
134
Drug therapy to increase sex drive
1. Increased androgens
135
Characteristics of Paraphilic Disorder
1. Inability to resist an impulse for sexual act 2. Deviance 3. Cause harm to others
136
Drug therapy to reduce sex drive (ex: in paraphilic disorder)
Antiandrogens SSRIs
137
Behavioral treatment of Paraphilic disorder
1. Masturbation satiation (with own deviant fantasies) 2. Covert sensitization (replace patient's fantasies with unpleasant ones) 3. Masturbatory conditioning (paried with non-deviant fantasies) 4. Cognitive-behavior therapy (correct cognitive distortions, including minimizations, excuses, justification)
138
Quadrad of PTSD symptoms
1. Intrusive thoughts 2. Avoidant behaviors 3. Negative cognitions and mood 4. Hyperarousal
139
Treatment of PTSD
1. Re-establish circadian rhythms 2. Relieve nightmares 3. Dialectic behavioral psychotherapy 4. SSRIs
140
Characteristics of Substance Use Disorder
* Tolerance * Withdrawal * Use more than intended * Craving * Unsuccessful efforts to cut down * Spends excessive time in acquisition * Activities given up because of use * Uses despite negative effects
141
Stages of Changes in Overcoming Addiction
1. _Precontemplation_: not acknowledging that there is a problem 2. _Contemplation_: Acknowledgement but not ready to change 3. _Preparation/Determination_: Getting ready to change 4. _Action/Willpower_: Changing behaviors 5. _Maintenance_: Staying clean 6. _Relapse_
142
Major Withdrawal symptom of Depressants
Seizure | (not in opioids)
143
Major Withdrawal symptom of Alcohol
Delirium Tremens (hallucinations, Increased HR and BP, Confusion)
144
Sensitive indicator for alcohol in lab tests
GGT (Gamma-glutamyltransferase)
145
Detox drug used for alcohol
Benzodiazepines
146
Drug used to treat overdose of Opioids
Naloxone
147
Drug used for Detox in Opioid
Methadone (prevent symptoms) Suboxone (naltrexone + buprenorphine)
148
PCP intoxication key symptoms
1. Belligerence 2. Assaultiveness

ICM II (12 decks)

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