schizo phases: - subtle behavior changes, functional decline, social withdrawal, irritability - delusions, hallucinations, disorganized speech, bizarre behavior - blunted affect, other negative symptoms

- prodromal - psychotic - residual

Psychiatry Flashcards by Jenna Nicole

disordered thought content and thought processes, perceptual disturbances, illusions or hallucinations, delusions, impaired reality orientation

psychotic disorders

-memory and consciousness not impaired

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hallucinations, bizarre behavior, delusions

positive symptoms

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flat affect, poor grooming, social withdrawal, anhedonia, poor eye contact

negative symptoms

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persecutory or grandiose delusions or auditory hallucinations; MOST COMMON

paranoid schizo

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disorganized speech or behavior, flat or inappropriate affect

disorganized schizo

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delusions and hallucinations; ABSENT: paranoid, disorganized, catatonic symptoms

undifferentiated schizo

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no longer have prominent psychotic symptoms but have blunted affect/odd behavior

residual schizo

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schizo phases:

subtle behavior changes, functional decline, social withdrawal, irritability
delusions, hallucinations, disorganized speech, bizarre behavior
blunted affect, other negative symptoms

prodromal
psychotic
residual

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rare type of schizo- needs two of following: motor immobility, excess motor activity w/o purpose, extreme negativism or mutism, echolalia, echopraxia

catatonic schizo

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schizo- two of the five following symptoms present for a 1 month pd, persisting for 6 months ?

delusions, hallucinations, disorganized speech, grossly disorganized behavior, negative symptoms

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DOC for schizo?

dopamine and serotonin antagonists- atypical antipsychotics

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schizo:
best Tx for positive Sx?
negative Sx?

typical antipsychotics

atypical antipsychotics

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mixture of psychotic and mood symptoms i.e. depressive/manic/mixed episode during which criteria for schizo also met

schizo affective d/o

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char. by non-bizarre delusions (realistic) that occur for at least 1 month

delusional d/o

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common after catastrophic event, sx for 1 day to 1 month

brief psychotic d/o

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same sx as schizophrenia but sx last 1-6 months

schizophreniform d/o

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physical complaints involving many organ systems, no medical explanation

somatization d/o

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most common concerns are facial flaws, imagined defect in physical appearance or exaggeration of minor flaw? Tx?

body dysmorphic d/o, SSRI

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one or more neuro complaints that can’t be explained clinically; MC sx: shifting paralysis, blindness, and mutism

conversion d/o

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fake signs and Sx, assume the sick role

factitious d/o

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production of physical/psych sx for external gain

malingering

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pain in one or more area w/o identifiable cause, significant distress and impaired functioning; 1st line?

pain d/o; SSRI/TCAs

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major depressive episode- five or more depressive signs and sx during the same ?; at least one of Sx must be ? or ?

2 week period; depressed mood or anhedonia

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manic episode- lasts at least? needs at least three manic sx

one week

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SAD treatment?

light therapy, buproprion, SSRIs

char. by anhedonia, psychomotor retardation/agitation, anorexia, weight loss, depressed mood, feelings of guilt, sleep disturbance, may have suicidal ideation

melancholia

char. by overeating/weight gain, oversleeping, reactive mood, leaden paralysis, oversensitivity to interpersonal rejection

atypical depression

char. by motor immobility or stupor, blurred affect, purposeless motor activity, extreme withdrawal, negativism, bizarre mannerisms or posturing, echolalia, echopraxia, or 'waxy flexibility'

catatonic depression

PP depression occurs within ? Tx ?

4 weeks of delivery, SSRIs

side effects include GI upset, headache, sexual dysfunction

SSRIs s/e

s/e include weight gain, OH, antichol. effects, somnolence

TCAs

MAOIs and SSRIs can results in?

serotonin syndrome (acute MS changes, restlessness, diaphoresis, tremor, hyperthermia, seizures, muscle rigidity, coma/death (rare)

ECT safe in preggo and elderly; biggest concern?

memory loss

lithium- narrow therapeutic window- check levels ?

every 4-8 weeks

char. by 1+ major depressive episodes and at least one hypomanic episode

BPII

chronic mild depression; no psychotic or manic/hypomanic features

dysthymic d/o

less severe version of BPII, mild depressive and hypomanic episodes

cyclothymic d/o

maladaptive behavioral or emotional Sx that develop w/i 3 months and end within 6 months

adjustment d/o

schizoid, schizotypal, and paranoid personality d/o; weird/peculiar, associated with PSYCHOTIC d/o

Cluster A (mad)

antisocial, borderline, histrionic, narcissistic personality d/o; emotional, inconsistent, associated with MOOD d/o

Cluster B (bad)

avoidant, dependent, OCD personality d/o; fearful, anxious, associated with ANXIETY d/o

Cluster C (sad)

pervasive distrust and suspicion of other beginning by early adulthood; hostile and angry

paranoid personality d/o (PDO)

voluntary social withdrawal; eccentric and reclusive; no desire for close relationships

schizoid PDO

pervasive and eccentric behavior; most likely to progress to schizo

schizotypal PDO

magical thinking, special personal significance, belief in clairvoyance or telepathy, belief in superstitions or the occult

schizotypal PDO

inability to conform to social norms, strong tendency to commit unlawful acts

antisocial PDO

manipulative, deceitful, impulsive, and totally lacking empathy/remorse

antisocial PDO

may begin in childhood as conduct d/o, child may have Hx of physical and/or sexual abuse, starting fires, harming animals

antisocial PDO

poorly set self-image, mood swings, impulsivity, self-mutilation and manipulative suicide attempts

borderline PDO

Tx for borderline PDO includes?

dialectal behavior therapy (DBT)

overly emotional, dramatic, and seductive, excitable, attention seeking behavior

histrionic PDO

inflated self-image, pattern of grandiosity, arrogant, haughty attitude, self-esteem is fragile

narcissistic PDO

extreme sensitivity to rejection (inferiority complex), see themselves as unappealing, feelings of inadequacy, social phobia? Tx?

avoidant PDO; BB or SSRIs

submissive behavior, cannot make their own decisions, dislike being alone

dependent PDO

orderliness, perfectionism, and inflexibility, rigid, stubborn, and emotionally constricted; may develop MDD or schizo

O-C PDO

these pts have awareness of their PDO; egoSYNtonic

O-C PDO

pts who don't meet the full criteria for a specific PDO but have traits from many diff ones

personality d/o NOS (not otherwise specified)

excessive amounts of heightened arousal that impede daily function and interpersonal relationships

anxiety

physiologic sx include dizziness, palpitations, perspiration, loss of appetite, nausea, trembling

anxiety

anxiety DOC

SSRIs, SNRIs, or buspirone

recurrent thoughts, images, or impulses, no realistic connection to the events the patient avoids, egoDYStonic

OCD

MC obsessive compulsion

contamination

1st line for OCD?

SSRIs

sensations of helplessness, fear, and horror from a traumatic even that is out of range of normal human experience; Sx persist for more than 1 mo.; DOC?

PTSD; SSRIs

sx occuring w/i one month of an event lasting 2 days to 4 weeks, including sense of numbing or detachment, reduced awareness of surrounding, derealization, depersonalization, or dissociative amnesia, excessive anxiety or arousal

acute stress d/o

most common mental d/o in US

phobias

? phobias more common than social phobias

specific

fear of situations where embarrassment or humiliation in front of other people may occur

social phobia i.e. public speaking, using pubic BR, eating in public

fear of being in public places where escape may be difficult, may be unwilling/unable to leave home? 50-70% have coexisting ?

agoraphobia, panic d/o

anorexia less than ? expected weight for height; BMI?

85%, 17.5kg/m2

? CI in ED because it lowers the seizure threshold

Bupropion

electrolyte abnormalities in bulimia

hypomagnesemia, hypochloremic hypokalemic metabolic alkalosis

first treatment in ED?

restore nutritional state

obesity (binge eating d/o) ? over ideal body weight or BMI greater than ?; recurrent episodes at least ?

20%, 30; 2days/week x 6 months

Tx for BED- MC? appetite suppressant? pancreatic lipase inhibitor?

SSRIs, sympathomimetics, Orlistat (Xenical)

craving or desire for substance independent of physiologic w/drawal Sx

psychological dependence

substance use that has not met criteria for dependence but resulted in impairment w/in a 12-month period

substance abuse

elevated ? is a early sign of alc abuse

gamma glutamyl transpeptidase

w/drawal Sx include lacrimation, rhinorrhea, sweating, yawning, anxiety, hypertension, tachycardia, N/V, abdominal cramps, and muscle/joint pain

opioid use/abuse

constricted pupils w/ ? use

opioid

disruptive behavior may result in peer rejection and deflated self image; requests can become explosive and irritable; MC in firstborn son

ADD/ADHD

ADD/ADHD diagnosed w/ ? scales

Conners'

s/e of stimulants i.e. amphetamine/dextroamphetamine used to treat ADD/ADHD include?

growth retardation, weight loss

violation of the basic right of others or of social norms with at least three acts

conduct d/o

may progress to conduct d/o; at least 6 mo of negativistic, hostile, and defiant behavior

oppositional defiant d/o

impaired social interaction and restricted or stereotyped behavior, interests, or activities

asperger d/o

decreasing head circumference, loss of previously learned behaviors, social interactions, and motor and language development; almost exclusively seen in girls

Rett d/o

multiple motor and one or more vocal tics greater than 1 year

Tourette d/o

onset of Tourette syndrome after group A streptococcal infx ?

pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS)

retinal hemorrhages or hyphema in an infant?

shaken baby syndrome

abuse perpetrated by the mother; symptoms fabricated or clinical signs induced in child to receive attention as being an attentive or suffering mother

Munchausen syndrome by proxy

includes w/holding of food, meds, clothing, health care, etc. in elderly

neglect

forced acts of fellatio and anal penetration are considered?

sodomy

normal response to a major loss? Tx?

uncomplicated bereavement; social contact & reassurance

normal grief Sx resolve w/i ?

1 year

Psychiatry Flashcards

(95 cards)