Psychiatry Flashcards
This deck covers Chapters 100-105 in Rosens, compromising all of psychiatry.
List 8 pharmacologic agents that can cause acute psychosis
- Steroids
- Anticholinergics
- Antihistamines
- Anticonvulsants
- Cocaine
- Amphetamine
- PCP
- LSD
- Mushrooms
- Benzos
- Isoniazid
- Rifampin
- TCAs
- Digoxin
List 8 medical disorders that can cause acute psychosis
- Hyperthyroidism
- Hypercalcemia
- Hyponatremia
- Hypoglycemia
- Hypoxia
- SLE
- Hepatic encephalopathy
- CVA
- Encephalitis
- MS
- Cancer
- Parkinson’s
- Addison’s
- Cushing’s
- Post-partum
- Vitamin B1/B2/B9/B12 deficiency
How do you differentiate organic vs functional psychosis?
MADFOCS
- Memory deficits
- Organic is more recent
- Functional is more remote
- Activity
- Organic is slower, ataxic, tremor
- Functional is repetitive, rocking
- Distortions
- Organic is visual
- Functional is auditory
- Feelings
- Organic is labile
- Functional is flat
- Orientation
- Organic is altered
- Functional is intact
- Cognition
- Organic has periods of lucidity
- Functional is persistent
- Some other findings
- Organic is usually older, AbN vitals
- Functional is usually younger, normal vitals
List an example of a high, intermediate, and low potency antipsychotic. List 3 atypical antipsychotics
- High = Haloperidol
- Intermediate = Loxapine
- Low = Chlorpromazine
Atypical
- Olanzapine
- Seroquel
- Abilify
List 6 complications from antipsychotic medication
- Tardive dyskinesia
- Pseudoparkinsonism
- Dystonia
- Akathisia
- Metabolic syndrome
- NMS
- Orthostatic hypotension
What is a useful mnemonic for symptoms of depression? Mania?
SIGECAPS: 5+ for 2+ weeks = MDD
- Sleep Issues
- Interest
- Guilt
- Energy
- Concentration
- Appetite
- Psychomotor
- Suicidal
DIG FAST: 3+ with > 1-week big mood (or irritable)
- Distractable
- Irritable
- Grandiose
- Flight of Ideas
- Activity increased
- Sleeping less
- Thoughtless (risky)
List 10 medical illnesses associated with causing depression
CNS
- MS
- Stroke
- Parkinson’s
- Head Trauma
Cancer
- Pancreatic
- Brain tumour
- Disseminated cancer
Endocrine
- Hypothyroid
- Hyperthyroid
- Cushing’s
- Diabetes
- Addison’s
Infectious
- HIV
Cardiac
- MI
Renal
- Dialysis
List 5 medications that can cause depressive symptoms. List 5 medications that can cause manic symptoms
Depressive
- Beta-blockers
- Clonidine
- Benzos
- Phenytoin
- Valproate
- Anabolic steroids
Manic
- Corticosteroids
- SSRIs
- Acyclovir
- Sulfa drugs
- NSAIDs
- Digoxin
What are 4 criteria for hospitalization of a patient with an acute psychiatric episode
- SI/HI
- Lacks capacity
- Inadequate social support for safe OP treatment
- Comorbid medical condition
List 10 somatic symptoms of anxiety
- Chest pain
- Palpitations
- Hyperventilation
- Dyspnea
- Headache
- Abdominal pain
- Sweating
- Tremor
- Dry mouth
- Frequent stooling
- Frequent micturition
- Erection failure
What are 6 predictors of organic anxiety?
- Age >35 onset
- No stressors
- No PMHx of anxiety
- No FHx of anxiety
- Lack of avoidance behavior
- Poor response to antianxiety medications
List 10 medical disorders that can present with anxiety
- Dysrhythmia
- Hypoxia
- MI
- Pheochromocytoma
- Hypercalcemia
- Hypoglycemia
- Seizure
- Asthma
- PE
- Hyperthyroidism
- Drug use
- Withdrawal
Differentiate somatoform disorder vs factitious disorder vs malingering
- Somatoform
- Believe they are ill
- Factitious
- Pretend to be ill for primary gain
- Like the sick role
- Malingering
- Pretend to be ill for secondary gain
- Avoiding work/jail
Give 5 DDx for somatoform disorder
- MS
- Myasthenia gravis
- GBS
- SLE
- Hyperparathyroidism
- Thyroid disorders
- Botulism
- CO poisoning
Differentiate primary vs secondary gain
Primary
- Internal motivations
- Using symptoms to avoid unpleasant emotions
- Conversion disorder (Functional Neurologic Disorder)
Secondary
- External motivations
- Using symptoms to benefit the patient (avoid jail, skip work)
- Malingering/Somatoform
- Which can be Functional, Illness Anxiety, or Somatic Symptom D/O