Week 7 (Exam 3) Flashcards by Stephen Cherny

Diagnose catatonic type schizophrenia

At least 2:
Motoric immobility (catalepsy or stupor)
Excessive motor activity
Excessive negativism or mutism
Peculiarity of movements
Echolalia or echopyrexia

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DM psychiatric sx

Frustration, loneliness, dejection, depression

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Operant conditioning vs classical conditioning

Classical: Together in time
Operant: sequential

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Panic attack

Peaks within 10 minutes, pick at least 4:

Palpitations, sweating, trembling, SOB, CP, Lightheadedness, Fear of losing control, Paresthesias, chills or hot flashes

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Toxicities causing confusions

Vitamin A and D, Iron

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Psychiatric effects of corticosteroids

Mania, psychosis (hallucinations)

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OCD vs OCPD

PD don’t perceive they have a problem

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Thiamine deficiency physical and psychiatric sx

Wernicke-Korsakoff, neuropathy, malaise, alcoholism

Poor concentration, confusion, confabulation

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TCA side effects

Cholinergic: dry mouth, constipation

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Panic disorder criteria

Recurrent unexpected panic attacks AND at least one attack followed by 1 month+ of persistent concern about additional attacks, worry about the implications of the attacks or its consequences, and/or significant change in behavior related to the attacks

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Toxicities causing cognitive dysfuncion

Lead

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Treat EPS (non-terdive dyskinesia)

Anticholinergics (Benztropine, Trihyxyphenidyl)

Anti-Histamine (Diphenhydramine)

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GAD criteria

More days than not, most of the day, 6+ months

Pick 3: Restlessness, easily fatigued, difficulty concentration, irritability, muscle tension, sleep disturbance

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Psychiatric Sx of SLE

Depression, mood disturbances

Psychosis!, delusions, hallucinations

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Hypomanic episode

Less severe than manic and only 4 days

So psychotic features, social/occupational impairment

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Major side effect associated with treating schizophrenia with Clozapine

Agranulocytosis

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Psychiatric sx of acute intermittent porphyria

acute depression, agitation, paranoia, visual hallucinations

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Anti-depressant side effects

Mania (in bipolar patients), anxiety, insomnia

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Major side effect of treating schizophrenmia with Ziprasidone

QTc Prolongation

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Treat Acute Psychosis (schizophrenia associated)

IM Haloperidol, Fluphenazine

Lorazepam

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Treat Tardive Dyskinesia

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Benztropine, Deuterabenazine

Cobalamin deficiency physical and psychiatric sx

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Pallor, dizziness, neuropathy, ataxia
Irritability, inattentiveness, psychosis, dementia
Treat anything below 400

Delusional Disorder

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Delusions for at least 1 month

Never met Criterion A for Schizophrenia

Diagnose Schizophrenia

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6 mos of 2+ of: Delusions, Hallucinations, Disorganized Speech, Disorganized/Catatonic behavior, negative sx
1 month of cluster A sx

Chron's disease pre-existing condition

Often panic disorder | UC is dependent personalities, maybe

Schizophreniform

Meets criteria A, D, and E for schizophrenia | At least 1 month, shorter than 6 months

MS psychiatric sx

Anxiety, euphoria, mania

What adverse effects are associated with treating schizophrenia with first generation anti-psychotics?

Extrapyramidal: Acute Dystonic Reactions, Drug-induced PD, Akathisia, Antipsychotic-induced catatonia, tardive dyskinesia Neuroleptic Malignant Syndrome

Treatments for Bipolar disorders

1: Mood stabilizers (lithium, valproic acid) | Also carbamazepine, 2nd gen anti-psychs, lamatrogine

Hyponatremia physical and psychiatric sx

Excessive thirst, polydipsia, stupor, coma, seizures | Confusion / delirium, lethargy, personality changes

Psychiatric sx of Hyperthyroidism

Nervousness, excitability, irritability, pressured speech, insomnia, psychosis, visual hallucination

Neurotransmitters of major depressive disorder

Lower b-adrenergics, abnormal NE function Decreased DA Decreased 5HT Decreased GABA

Criteria for a manic episode

At least 1 week, pick 3: Inflated self esteem/grandiosity, decreased need for sleep, more talkative, racing thoughts, distractibility, more goal-oriented behavior, excessive pleasure-seeking

Brief Psychotic Disorder

At least 2 of: Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior Episode at least 1 day, less than 1 month Eventual return to premorbid functioning

Criteria for Major depressive disorder

1+ major depressive episodes and absence of any manic, hypomanic, or mixed episodes

Persistent depressive disorder criteria

Depressed mood most of the day for at least 2 years Cant go more than 2 months without sx Not severe enough to qualify as major depressive episode

Toxicities causing Psychosis

Copper

Reduce suicide in schizophrenia patients

Clozapine

Psychiatric sx of Hypothyroidism

Lethargy, depression, personality change, paranoia

Psychiatric sx of frontal lobe tumor

Mood changes, irritability, facetiousness, impaired judgement, impaired memory, delirium, loss of speech, loss of smell

Physical and psychiatric sx of hepatic encephalopathy

Asterixis, hyperreflexia, spider angioma, palmar erythema, ecchymosis, liver enlargement/atrophy Euphoria, disinhibition, psychosis, depression

Cyclothymic disorder

Dysthmyic disorder with intermittent hypomanic periods 2 years of repeated hypomania, depressive episodes (no major depressive manic or mixed for 1st 2 years)

PTSD tx

SSRIs, Cognitive Processing Therapy (support groups and eye movement desensitization and reprocessing [EMDR])

Bipolar I vs II

I: At least 1 manic or mixed episode II: At least 1 major depressive and 1 hypomanic episode

Toxicities affecting peripheral nerve fxn

B6 and B12

Schizoaffective Disorder

Uninterrupted period of illness with either major depressive or manic episode w/ sx that meet criterion A for schizophrenia Same period of illness, delusions / hallucinations at least 2 weeks without prominent mood sx

Pancreatic cancer psychiatric sx

weight loss, abdominal pain, depression, lethargy, anhedonia, apathy, decreased energy

Criteria for major depressive episode

2 weeks Depressed mood and loss of interest/pleasure Pick 3 more: loss of energy, inability to concentrate, thoughts of death or suicide, psychomotor agitation, insomnia, weight loss or gain, feelings of worthlessness or guilt, etc

NT responses to stress

Increased Catecholamines Increased 5HT (+potentiating glucocorticoids) Corticotripin Releasing Factor triggers ACTH

Psychiatric side effects of glucocorticoids

Mania, psychosis

Avoid giving these to elderly with delirium

Benzos, Benadryl/diphenhydramine

Week 7 (Exam 3) Flashcards

(51 cards)