Psychiatry Flashcards
(67 cards)
1
Q
Generalized anxiety disorder Presentation
Dx, Tx
A
constant state of worry about MOST things on MOST days lasting for >6 months
Tx: Psychotherapy and combination with meds SSRIs
2
Q
GAD symptoms needed for diagnosis
A
at least 3 or more somatic changes Sleep changes Weight changes Irritability Concentration changes
3
Q
Panic Disorder Symptoms
STUDENTS PANIC
A
Acute, Overt, Catastrophic SOB Trembling Unsteady Depersonalization Excessive HR Numbness Tingling Sweating Palpitations Abdominal pain Nausea Intense fear Chest pain
4
Q
Panic Disorder
Dx, Tx
A
ECG and troponins
TSH
Asthma
Tx: BZDs
5
Q
Social Phobia
Tx
A
Usually in the form of public speaking
Non selective beta blockers
6
Q
Intermittent Explosive disorder
Presentation
Dx, Tx
A
Stressor that leads to violence, Disproportionate to the stressor
Mild: 2x/ week for 3 mo No harm
Severe: 3x/ ever for 12 mo Harm to others
7
Q
Kleptomania
Presentation
Dx, Tx
A
Steals things, there is rarely any value, patient can usually afford the object
Patient usually has guilt or remorse
8
Q
OCD
presentation
Dx, Tx
A
made of obsessions and compulsions
obsessions are internal, intrusive and unwanted
Compulsions: reduce anxiety
Tx: SSRI
9
Q
PTSD
Presentation
A
Mood Change Dissociation Avoidance Hypervigilance Stressor is severe, life threatening
10
Q
PTSD
Dx, Tx
A
> 6 months duration
Tx: SSRI/SNRI
11
Q
Adjustment disorder
Presentation
Dx, Tx
A
Stressor is non-life threatening
Mood changes
Dx: Onset >3 days but <1 month
Tx: Usually none
12
Q
RAD/DSFD
Presentation
Dx, Tx
A
Abuse/neglect in the family RAD=pairs too little DSFD=pairs too much Dx: <5 years old r/o Autism
13
Q
Major Depressive Disorder
Presentation
A
decreased mood or anhedonia and Duration > 2 wks and 5 SIG E CAPS Sleep decreased or (increased in atypical) Interest decreased Guilt Increased Energy Decreased Concentration Decreased Appetite decreased (increased Atypical) Psychomotor retardation decreased Suicide
14
Q
Major Depressive Disorder
Dx, Tx
A
R/o Suicidal ideation
SSRI/SNRI
15
Q
Suicidal ideation with a plan
A
Hospitalize
16
Q
Suicidal ideation with no plan
A
Contract the patients safety
17
Q
Bipolar I
Presentation
A
Manic predominant duration > 1 wk E + 3 Sx Distractability Insomnia Grandiosity Flight of ideas Agitation Sexua exploits Talkative Elevated Mood Racing thoughts
18
Q
Bipolar I
Dx, Tx
A
r/o Stimulants r/o bipolar II, cyclothymia Tx: Agitated=BZDs Mood stabilizer 1. Lithium 2. Valproic Acid 3. Lamotrigine 4. Quetiapine
19
Q
Bipolar II
Presentation
A
Hypomania with a MDE
20
Q
Shared features of Grief, PCBD, MDE
A
Dysphoria, Guilt, Anhedonia
21
Q
Grief Presentation
A
Onset anytime duration <1 year focus on the deceased Can imagine a happy time sadness waxes and wanes (+) insight no treatment
22
Q
Persistent complex bereavement disorder Presentation
A
Onset > 6 months after Duration >12 months focus on the deceased never happy ever, sadness is persistent Hallucinations, no insight Tx: SSRI/ SNRI
23
Q
MDE Presentation
A
onset at anytime duration >12 months Focus on themselves never happy, cannot see an end to sadness Hallucinations Tx: SSRI/SNRI
24
Q
Baby blues Presentation
A
Moms 1st baby and mom cares onset 2 weeks duration 2 weeks depressed mood no treatment
25
Postpartum depression presentation
```
second baby, mom doesnt care leading to neglect
onset within one month
duration-ongoing
MDD symptoms
Tx: SSRI
```
26
Postpartum psychosis presentation
```
second baby, mom fears baby
onset within 1 month
duration-ongoing
symptoms of psychosis
Tx: Antipsychotics
```
27
Schizophrenia
Presentation
Tx
```
(+) symptoms-too much dopamine
(-) symptoms-too much serotonin
>2 symptoms one being 1-3
1. delusions
2. hallucinations
3. disorganization
4. disorganization
5. flat affect/poverty of speech/movement
Tx: antipsychotics
```
28
Brief Psychotic disorder duration
>1 day but <1 month
29
Schizophreniform Duration
> 1 month but <6 months
30
Schizophrenia duration
>6 months
31
Schizoaffective disorder Presentation
Psychosis and mood symptoms
32
Atypical antipsychotics
| Normal patient
Quetiapine
olanzapine
risperidol
33
Combative patient which antipsychotic
Haloperidol
34
Non-compliant patient which antipsychotic
depot form-haloperidol
35
when all other antipsychotics fail what to use?
clozapine -can cause agranulocytosis
36
Cluster A personality Disorders
Weird
Paranoid
Schizoid
Schizotypal
37
Cluster B personality disorders
Wild
Histrionic
Narcissitic
Antisocial
38
Cluster C Personality Disorders
Weak, Shy, timid
Avoidant
Dependent
Obessive-compulsive
39
Neuroleptic Malignant Syndrome Presentation
Psych Disease
Positive Antipsychotic Medications
autonomic dysfunction- increased HR, BP, Temp
40
Serotonin Syndrome Presentation
Psych disease
SSRI
Hypertonicity/Hyperreflexia
41
Treatment durations in MDD
> 6 weeks at a single dose
> 6 months at effective dose
6 weeks of washout
42
SSRI medications
(es)Citalopram
Fluoxetine
Paroxetine
Sertraline
43
SSRI Adverse Effects
Sexual Dysfunction
decreased libido
Prolonged ejaculation
44
SNRI Medications
(des)venlafaxine
| Duloxetine
45
Atypical Antidepressants
Buproprion
Tx: Smoking
no weight gain
Do not use in bulimia
46
Mirtazapine uses
Appetite stimulation
47
Trazadone uses
sleep aid
| can cause priapism
48
CAGE questions
Cut down
Angry
Guilty
Eye opener
49
Alcohol intoxication presentation
| Chronic Presentation
```
AMS
Disinhibition
Slurred Speech
Cerebellar Dysfunction
Chronic: Wernicke's
Korsakoff (irreversible)
```
50
How to treat Alcoholic coma
1. Thiamine
| 2. D50
51
Acohol withdrawl=BZD withdrawl
Presentation
Tx
Diastolic HTN/Tachycardia, Termor, Diaphoresis, agitated, Confusion (delirium Tremens), Seizure
Tx: Long-Acting BZD-Chlordiapoxide, diazepam
and
Short-Acting BZD-Alprozolam/Lorazepam
52
Opiate use
Presentation
Tx
Intoxication-euphoria, coma, decreased RR, Constricted pupils
Long-term use-Constipation
Withdrawl-pain, N/V/D, cramping, irritability
Tx: acute-Naloxone
53
BZD
presentation
Withdrawl
Tx
Delirium in the elderly, decreased Resp rate, coma, amnesia
HTN, Tachycardia, Seizures, Psychosis
Flumazenil
54
Cocaine
presentation
withdrawl
Tx
Psychomotor agitation, HTN, Tachycardia, psychosis, dilated pupils, angina, HTN crisis
depression, cocain bugs
alpha blockade THEN beta Blockade
55
Amphetamines
presentation
withdrawl
Tx
dilated pupils, psychosis, overheating (fever/tachycardia), Water intoxication
Crash, Depression
Supportive treatment
56
PCP
presentation
withdrawl
tx
aggressive psychosis, vertical and horizontal nystagmus, impossible strength, blunted senses
severe random, violence
haldol, acidify the urine to increase excretion
57
LSD
Presentation
Withdrawl
Tx
Rare, hallucinations, flashbacks, increase senses
flashbacks
supportive treatment
58
Marijuana
Presentation
Withdrawl
Tx
tired, slowed reflexes, conjunctivitis, munchies, paranoia
no withdrawal symptoms
supportive treatment
59
Barbituates
Presentation
Withdrawl
Tx
decreased safety margin, decreased respiratory rate, coma
| redistributes into fat
60
OSA
presentation
Dx, Tx
```
Daytime Somnolence, Obese, snoring, large tongue, short neck
Dx: Polysomnography
>15 apnea spells/hr
>5 apnea + snoring
Tx: CPAP
Lose weight
```
61
Narcolepsy Dx test
CSF-Hypocretin 1
| polysomnography
62
Primary Insomnia treatment
Diphenhydramine
Trazadone
Quetiapine
Zolpidem
63
Illness Anxiety disorder
previously hypochondriasis
preoccupied with acquiring illness
unwanted
requires reassurance
64
Symptom Somatic disorder
Somatic symptoms such as fatigue or pain
| unwanted
65
Conversion disorder
Neurologic symptom occuring due to some stressor
wont harm self
unwanted
66
Factitous disorder
any kind of symptoms
patient wishes to fulfill a role possibly to achieve attention
intentionally deceive
67
Malingering
any kind of symptoms
patient is doing due to secondary gain
intentionally deceiving
