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Neuro Part II > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Conversion Disorder

A

neurological symptoms + la belle indifference

sudden loss of sensory or motor function

often following an acute stressor

adolescents and young adult women

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2
Q

Somatic Symptom Disorder

A

somatic symptoms + worry

somatic = pain, GI complaints, sexual complaints, etc., usually multiple organ symptoms

low socioeconomic groups, older females

w/ depressive and anxiety disorders

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3
Q

Illness Anxiety Disorder (aka Hypochondriasis)

A

worry only, despite medical proof

is an exaggerated concern with having a single specific serious illness, without actually having symptoms

specifiers - care-seeking or care-avoidant

w/ anxiety disorders, life crisis

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4
Q

Body Dysmorphic Disorder

A

normal-appearing patients who believe they are physically abnormal

onset usually in the late teens

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5
Q

Malingering

A

intentional vague symptoms + secondary gain

is the conscious simulation of physical illness for financial or other obvious secondary gain (avoiding work, obtaining drugs)

complaints cease after gain (vs. factitious disorder)

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6
Q

Factitious Disorder Imposed on Self/Other

A

Munchausen Syndrome (by Proxy)

intentional vague/induced symptoms + primary gain

typically young women or in a child by a parent

w/ anxiety or personality disorders

Note - this form of child abuse must be reported to a child protection agency.

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7
Q

Pain Disorder

A

intense, prolonged pain not explained by physical disease

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8
Q

Pseudocyesis

A

“false pregnancy,” is based on the patient’s belief that they are pregnant when in reality they are not

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9
Q

Psychological Factors Affecting Other Medical Condition

A

pre-existing medical condition + negative effects

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10
Q

MSE - Four Dimensions

A
  1. General
  2. Mood
  3. Thought
  4. Safety
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11
Q

MSE - General

A
  1. Appearance - age, build, grooming, dress, posture
  2. Behavior - eye contact, gait, social conventions, interactions, psychomotor activity
  3. Speech - quality, rate, volume
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12
Q

MSE - Mood

A
  1. Mood - the patient’s words
  2. Affect - you assessment - range, intensity, lability, appropriateness, congruence
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13
Q

MSE - Thought

A
  1. Thought Content - perceptions, delusions
  2. Thought Process - coherent, logical, goal-directed
  3. Cognition - orientation to person, place, time, event
  4. Insight/Judgement
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14
Q

MSE - Safety

A

suicidal/homicidal ideation

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15
Q

Biopsychosocial Formulation

A
  1. Biological
  2. Psychological
  3. Social

The 4 P’s

Predisposing, Precipitating, Perpetuating, Protective

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16
Q

Anxiety Disorder Due to a General Medical Condition - Examples

A

Thyroid Disease, Hypo- or Hyper-
Hypoglycemia
Vitamin B-12 Deficiency
Cardiac Dysrhythmias
Endocrine Tumors (Pheochromocytoma)
Primary or Metastatic Brain Tumors
PANDAS (in children)

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17
Q

Substance Induced Anxiety Disorders

A

Many substances can cause anxiety.
Many persons with anxiety self-medicate.

18
Q

Primary Anxiety Disorders

A

Generalized Anxiety Disorder

Panic Disorder

Agoraphobia

Specific Phobias

Social Anxiety Disorder (Social Phobia)

Selective Mutism (kids)

Separation-Anxiety Disorder (kids)

19
Q

Generalized Anxiety Disorder

A

free-floating anxiety

3 of the following…

Macbeth Frets Constantly Regarding Illicit Sins

Muscle tension

Fatigue

difficulty Concentrating

Restlessness, feeling of being on edge

Irritability

Sleep disturbance

20
Q

Posttraumatic Stress Disorder (PTSD)

A

traumatic event + HARD symptoms > 1 month

Hyperarousal

Avoidance

Remember

Distress

21
Q

Acute Stress Disorder

A

traumatic event + HARD symptoms < 1 month

Hyperarousal

Avoidance

Remember

Distress

22
Q

Panic Disorder w/ or w/o Agoraphobia

A

Recurrent panic attacks (PANIC) with unknown trigger.

Palpitations

Abdominal Distress

Numbness, Nausea

Intense Fear of Death

Chocking, Chills, Chest Pain

Agoraphobia – extreme fear of being in a place where escape is difficult.

23
Q

Phobias

A

Social - extreme fear of social situations

Specific Phobia – extreme irrational fear of specific object or situation (situational, animal/insect/environmental, other)

24
Q

Obsessive-Compulsive Disorder

A

Ego-dystonic obsessions (thoughts causing anxiety) and/or compulsions (actions to alleviate anxiety).

25
Q

Selective Mutism

A

Common in infancy and childhood.

Consistent failure to speak in specific social situations in which speech is expected (e.g., at school), not due to lack of language skills.

26
Q

Separation Anxiety Disorder

A

Common in infancy and childhood.

Developmentally excessive fear or anxiety concerning separation, at least 3…

fear/anxiety when leaving home

refusal to leave home

excessive fear of being away (sleepover refusal)

nightmares of separation

repeated complaints of physical symptoms

27
Q

Personality Disorders - General

A

Caused by patterns of enduring, inflexible, and maladaptive personality traits.

Usually established by adolescence and associated with violence, depression, psychotic episodes, and suicide.

Note – patient must be > 18 years old to be diagnosed with a personality disorder.

28
Q

PDs - Cluster A

A

WEIRD, Odd, Eccentric

Paranoid - accusatory

Schizoid - aloof

Schizotypal - awkward

note - may overlap with psychotic disorders

29
Q

PDs - Cluster B

A

WILD, Bad

Borderline

Antisocial

Narcissistic

Histrionic

note - increased rates of mood disorders and substance abuse

30
Q

PDs - Cluster C

A

**WORRIED, **Anxious

Avoidant

Dependent

OCPD

31
Q

Paranoid PD (Cluster A)

A

Accusatory

pervasive distrust of others

32
Q

Schizoid PD (Cluster A)

A

Aloof

voluntary social withdrawal

no desire for relationships

flattened affect

33
Q

Schizotypal PD (Cluster A)

A

Awkward

behavior that is odd, eccentric, or peculiar

magical thinking, paranoid ideation, ideas of reference

34
Q

Paranoid, Schizoid, Schizotypal v. Schizophrenia

A

Paranoid and schizoid can be differentiated from paranoid schizophrenia because they do not have fixed delusions and are not psychotic. Schizotypal can be differentiated from paranoid schizophrenia by lack of gross psychosis.

35
Q

Schizoid v. Schizotypals

A

Schizoids avoid reality, and may daydream or be cold and introverted. Schizotypals are odd, eccentric, magical types.

36
Q

Antisocial PD (Cluster B)

A

begins as childhood conduct disorder

disregard for rights of others & lack remorse

deceitful, aggressive, impulsive

note - always consider substance abuse

treatment - limited due to self-serving motivation

37
Q

Borderline PD (Cluster B)

A

intense unstable relationships, idealization/devaluation

fear of abandonment

feeling of emptiness or boredom

unstable sense of self

suicidal gestures, self-injury

history of physical/sexual abuse?

history of childhood abuse or neglect?

PRAISE

Paranoid Ideas

Relationship Instability

Abandonment Fears, Angry Outbursts

Impulsiveness

Suicidal Gestures

Emptiness

38
Q

Narcissistic PD (Cluster B)

A

exaggerated sense of self-worth and entitlement

willing to exploit others for personal gain (for status and attention, not material gain as in antisocial PD)

lack of empathy for others

39
Q

Histrionic PD (Cluster B)

A

need to be the center of attention

inappropriately seductive, flirtatious

use physical appearance to attract attention

assume intimacy, consider relationships to be more meaningful than they are but are unable to maintain intimate relationships

think Scarlett O’Hara! or Julia Thead!

40
Q

Avoidant PD (Cluster C)

A

Cowardly

social inhibition due to a fear of humilitation, feelings of inadequacy, and hypersensitivity to negative evaluation

41
Q

Dependent PD (Cluster C)

A

Clingy

excessive need to be taken care of that leads to submissive and clingy behaviors + fears of separation

note -may tolerate abusive partners

42
Q

Obsessive Compulsive PD (Cluster C)

A

Compulsive

**ego-syntonic! **preoccupation with orderliness, perfectionism, and mental and interpersonal control at the expense of flexibility, openness, and efficiency

Neuro Part II (4 decks)

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