Psychiatry Flashcards Preview

ICM II > Psychiatry > Flashcards

Flashcards in Psychiatry Deck (148):
1

Delirium-DSM 5

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

2

Causes of Delirium

  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)

3

Clinical Findings in Delirium

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

4

Pathophysiology of Delirium

  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

5

Precipitating Factors of Delirium

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

6

Factors to reduce frequency of delirium

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

7

Drug Treatments for Delirium

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

8

Major vs Minor neurocognitive disorder 

Major: Substancial cognitive decline that interferes with independent living

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

9

Examples of major neurocognitive Disorders

  1. Alzheimer's
  2. Vascular disease
  3. Prion Disease
  4. Parkinson's
  5. Huntington's

10

Changes in the brain in Alzheimer's patients

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

11

Symptoms of Alzheimer's

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

12

Drugs that treat alzheimer's

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

13

Risk Factors for Alzheimer's

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

14

Most common cause of amnestic disorder

Alcohol abuse with chronic thiamine (B-1) deficiency

15

Symptoms of Wernicke's Encephalopathy

  1. Ophthalmoplegia
  2. Ataxia
  3. Mental confusion

16

Symptoms of Korsakoff's psychosis

  1. Amnesia (retrograde or anterograde)

17

What are the six cognitive domains in neurocognitive disorders?

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

18

Difference between Hallucination and Illusion

  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)

19

Mood vs Affect

  • 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")

20

Tegmentum: origin of which neurotransmitter?

Dopamine

21

Raphe nucleus: origin of which neurotransmitter?

Serotonin

22

Locus Ceruleus: origin of which neurotransmitter?

Norepinephrine

23

Tuberomammiliary nucleus: origin of which neurotransmitter?

Histamine

24

Nucelus Basalis of Meynert: origin of which neurotransmitter?

ACh

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