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253 Cards in this Set
- Front
- Back
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empiric Rx for brain abcess |
Antibiotics for primary infection |
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Rx for epidural and subdural hematoma
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evacuation of hematoma
(burr holes) |
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typical px for pseudotumor cerebri
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obese
female 20-30's |
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characteristics of grief that has become pathologic
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IF ANY OF THE FOLLOWING ARE PRESENT:
depression for two weeks after first 2 months hopeless, helpless, worthless, & guilt suicidal ideation distressing feelings persist for > 6 months inability to move on, trust others, and reengage in life by 6 months |
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neurotransmitter change in:
anxiety |
increased NE
decreased 5HT and GABA |
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neurotransmitter change in:
depression |
decreased NE, DA, 5HT
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neurotransmitter change in:
mania |
increased NE and 5HT
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neurotransmitter change in:
alzheimer |
decreased ACh
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neurotransmitter change in:
huntingtons |
decreased ACh and GABA
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neurotransmitter change in:
schizo |
increased DA
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neurotransmitter change in:
parkinson's |
decreased DA
increased ACh |
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what is mood? what is affect?
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mood=internal emotional state
affect=outward expression of that emotin |
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what is loose association
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jumping to new subject matter that is illogical
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what is tangentiality
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goes off on tangents (but you can see how the topic is related)
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what is word salad
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speaks words that together have no meaning
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conditions a/w depression
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hypothyroidism
hyperPTH parkinson's stroke CNS tumor pancreatic cancer |
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what Rx can cause depression
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sedative (alcohol, benzo, antihistamines)
stimulant withdrawal methyldopa 1st gen antipsychotics anti nausea (metoclopramide and prochlorperazine) glucocorticoids IFN-a |
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symptoms of atypical depression
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hypersomnia
psychomotor retardation hyperphagia/wt gain hypersensitivity to rejection |
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Rx for atypical depression
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MAOI's (work better than TCA's)
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Rx for seasonal affective disorder
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phototherapy (30 mins/day)
SSRI's bupropion |
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symptoms of major depression
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SIG E CAPS
sleep disturbance interest loss guilt energy loss concentration loss appetite changes psychomotor changes suicidal |
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major depressive disorder must have symptoms for how long
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> 2 weeks
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Dx and where is the lesion of px with hyperphagia, hyperorality, & hypersexuality
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dx = kluver bucy
lesion = b/l amygdala |
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What is the MCC of seizures in young adults (18-35 y/o)
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Trauma
EtOH withdrawal Brain tumors |
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Rx for cluster headaches
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100% O2 (hyperbaric)
triptans and dihydroergotamines |
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MOA/class of fluvoxamine
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SSRI
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MOA/class of fluoxetine
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SSRI
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MOA/class of sertraline
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SSRI
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MOA/class of paroxetine
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SSRI
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MOA/class of citalopram
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SSRI
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MOA/class of escitalopram
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SSRI
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MOA/class of nortriptyline
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TCA
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MOA/class of doxepin
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TCA
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MOA/class of imipramine
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TCA
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MOA/class of amitriptyline
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TCA
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MOA/class of desipramine
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TCA
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MOA/class of clomipramine
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TCA
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MOA/class of tranylcypromine
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MAOI
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MOA/class of phenelzine
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MAOI
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MOA/class of bupropion
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NDRI
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MOA/class of milnacipran
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SNRI
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MOA/class of venlafaxine
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SNRI
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MOA/class of duloxetine
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SNRI
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MOA/class of desvenlafaxine
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SNRI
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MOA/class of mirtazapine
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Tetracyclic
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MOA/class of trazodone
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atypical antidepressant
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MOA/class of nefazodone
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atypical antidepressant
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MOA/class of vilazadone
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atypical antidepressant
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what should not be taken with SSRI because of serotonin syndorme
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ANY DRUG THAT INCREASES SEROTONIN:
SSRI x 2 SNRI MAOI TCA St johns wart tryptophan levodopa triptans (5-HT receptor agonists) cocaine, amphetamines, ecstacy |
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features of serotonin syndorme
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MENTAL STATUS CHANGES:
anxiety agitation delirium restlessness disorientation AUTONOMIC EXCITATION diaphoresis tachycardia hyperthermia HTN NEUROMUSCULAR HYPERACTIVITY tremor muscle rigidity myoclonus hyperreflexia occular clonus b/l babinski sign bilaterally |
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compare/contrast etiology, onset, sx's, & tx of serotonin syndrome and neuroleptic malignant syndorme
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BOTH SYNDROMES:
autonomic instability hyperthermia muscle problems SEROTONIN SYNDROME: Etiology: excess serotonin Onset: rapid Sx's: hyperkinesia & clonus Tx: BZ's NEUROLEPTIC MALIGNANT SYNDROME: Etiology: SE of antipsychotic drugs Onset: gradual Sx's: bradykinesia & lead pipe rigidity Tx: Dantrolene |
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What is Serotonin Withdrawal Syndrome
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aka SSRI discontinuation syndrome
Onset: within days of abrupt discontinuation of SSRI Sx's: chills, fatigue, dizziness, irritability, anxiety, nausea & muscle aches Duration: dissipates over 1-2 weeks |
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which drugs are most known for causing serotonin w/draw syndorme
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paroxetine & venlafaxine
(b/c very short T1/2) |
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evaluation needed for px starting to take TCA
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SCREEN PT HX:
heart disease palpitations sycncope/near-syncope BASELINE EKG |
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symptoms of TCA toxicity
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cardiotoxicity
CNS toxicity ACh'c SE's (dry mouth, constipation, urinary retention, delirium, esp in the elderly) |
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in TCA overdose, what is used to correct QT prologation and seizures
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QT PROLONGATION (QRS > 100 msec's):
sodium bicarb SEIZURES: benzo's, barb's, & propofol (NOTE: phenytoin is INEFFECTIVE)) |
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antidepressant used to Rx comorbid neuropathic pain
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duloxetine
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what px is bupropion contraindicated
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seizure disorder
eating disorder coming off benzo or alcohol |
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antidepressant:
SE of priapism |
trazodone
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antidepressant:
lowers seizure threshold and can be used for smoking cessation |
bupropion
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antidepressant:
appetite stimulant that is likely to result in weight gain |
mirtazipine
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antidepressant:
works well with SSRI and increases REM sleep |
trazodone
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antidepressant:
can be used to Rx bedwetting |
imipramine (short-term only, e.g. vacations or sleep-overs)
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Name as many SSRI's as you can
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Fluvoxamine
Fluoxetine sertraline paroxetine citalopram escitalopram |
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Name as many SNRI's as you can
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milnacipran
venlafaxine duloxetine desvenlafaxine |
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Name as many NDRI's as you can
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bupropion
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Name as many MAOI's as you can
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phenelzine
tranylcypromine |
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Name as many TCA's as you can
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Mnemonic: CANDID
Clomipramine Amitriptyline Nortriptyline Imipramine Desipramine Doxepin |
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Name as many Tetracyclic's as you can
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Mirtazapine
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Name as many Atypical Antidepressants as you can
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Trazadone
Nefazadone Vilazadone |
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Dx and cause a crescent-shaped lesion on CT-Brain
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subdural hematoma
blunt head trauma --> rupture of bridging veins |
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initial study and later study of TIA/stroke px
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INITIAL STUDY: CT without contrast
FURTHER STUDIES: carotid doppler, echocardiogram, angiogram (i.e. CTA/MRA) |
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how to distinguish dysthymia from MDD
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DYSTHYMIA:
never meets MDD criteria no suicidal ideation sx's more than 1/2 the time lasting > 2 years no h/o major depressive episodes (o/w classified as recurrent depression) |
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Rx for bipolar disorder with mild depression
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lithium OR lamotrigine
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Rx for bipolar disorder with moderate depression
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lithium AND lamotrigine
or lithium PLUS atypical antipsychotic or lamotrigine PLUS atypical antipsychotic |
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Rx for bipolar disorder with severe depression
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ECT
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SE of lithium
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CNS EFFECTS:
depression tremor cognitive dulling THYROID ABNORMALITY RENAL ABNORMALITY: nephrogenic DI renal insuffIciency GI EFFECTS: n/v diarrhea metallic taste changes wt gain |
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Rx for DI caused by lithium
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HCTZ with amiloride (closes Na+ channels)
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how does lithium cause DI
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Opens Na+ channels in the collecting tubules
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symptoms of adjustment disorder with depressed mood
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psychosocial stressor (not bereavement)
Onset: w/in 3 months of identifiable stressor Resolution: by 6 months after stressor subsides |
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Rx for bipolar with renal failure
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valproate
carbamazepine |
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congenitaL malformation a/w lithium
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ebstein's anomoly
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difference between manic and hypomanic episode
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HYPOMANIC:
elation/irritability > 4 days but < 1 week no significant impairment of function MANIC: elation/irritability > 1 week significant impairment of function |
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sx's of mania
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"DIG FAST"
Distractability Insomnia Grandiosity Flight of Ideas Activity Incr'd (goal-directed) Speech (pressured) Taking risks (sexual, drugs, spending sprees) |
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Timeline for acute stress disorder vs PTSD
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ACUTE STRESS D/O:
within 30 days of traumatic event PTSD: lasting > 30 days after traumatic event |
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Timeline for Acute vs Chronic PTSD
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Acute PTSD: sx's present < 3 months
Chronic PTSD: sx's present > 3 months |
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Rx for PTSD
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SSRI (1st line)
TCA MAOI Atypical Antipsychotics (in refractory cases) mood stabalizers (improve impulsiveness, arousal, & flashbacks) a-blockers (improves nightmares & sleep disturbances) |
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Rx for OCD
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SSRI (1st line)
clomipramine (2nd line) |
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Rx for generalized anxiety disorder
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SSRI's
buspirone venlafaxine (SNRI) B-blockers |
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SE's of Benzo's
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Depression of CNS
Dependence Disinhibition Deficits in memory Dizziness Drug inhibition or interaction (additive with other CNS depressants) Dangerous when combined with other drugs (e.g. EtOH, opiates) |
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Antidote to Benzo toxicity; what is danger a/w administering the antidote
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Flumazenil (Benzo antagonist)
CAREFUL: can throw pt into benzo withdrawal --> SEIZURE |
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complication with performing LP on px with increased ICP
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herniation of brain stem (i.e. uncal herniation) ==> death
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symptoms of basilar artery stroke
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aka pontine ischemia
**CN defects **AMS/Coma (disruption of RAS) contralateral full body weakness & decr'd sensation (corticospinal tract) vertigo, lack of coordination, difficulty speaking, & visual changes |
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difference between bereavement and adjustment disorder
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ADJUSTMENT D/O:
impaired ability to function tied to stressor (other than death of loved one) BEREAVEMENT no impaired function to function related to death of a loved one |
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dx'c criteria for schizophrenia
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AT LEAST 2 SX'S (pos or neg) during a 1 month period
SOCIAL/OCCUPATIONAL DYSFUNCTION DURATION OF SX'S > 6 MONHTS |
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examples of positive symptoms of schizophrenia
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DELUSIONS (irrational belief that cannot be changed with logical argument)
HALLUCINATIONS (MC = auditory) DISORGANIZED SPEECH (e.g. frequent derailment or incoherence) GROSSLY DISORGANIZED OR CATATONIC BEHAVIOR |
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Rx's known to cause psychosis (i.e. positive sx's)
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HALLUCINOGENS: LSD/PCP
STIMULANTS: cocaine/amphetamines WITHDRAWAL: benzos, barbs, and alcohol OTHERS: glucocorticoids & anabolic steroids |
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examples of negative symptoms of schizophrenia
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flat affect
social isolation apathy (lack of emotional reactivity) anhedonia avolition social isolation |
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Rx for negative & positive sx's of schizophrenia
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POSITIVE SX'S: typical antipyschotics
NEGATIVE SX'S: atypical antipsychotics |
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how does delusional disorder differ from schizophrenia
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DELUSIONAL D/O:
realistic delusions (possible, but unlikely) normal functioning SCHIZOPHRENIA: unrealistic delusions (impossible) abnormal functioning |
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what might be seen in neuroimaging of px with schizophrenia
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enlargemed of ventricles (lateral and 3rd)
reduction in cortical volume (mass) |
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unique features & timeline of:
schizophrenia |
psychotic sx's >/= 6 months
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unique features & timeline of:
schizoaffective |
persistent psychosis (>/= 6 months) with or without mood disorder (mood d/o comes & goes)
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unique features & timeline of:
schizophreniform |
psychotic sx's > 1 month but < 6months
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unique features & timeline of:
brief psychotic disorder |
psychosis < 1 month
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unique features of:
schizoid |
voluntary social isolation
("schizoids avoid") |
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unique features of:
schizotypal |
odd thoughts, behavior, & appearance
("Schizotypals dress like a pickle") |
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What are the broad categories of antipsychotics
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TYPICAL antipsychotics (aka traditional neuroleptics)
low-potency high-potency ATYPICAL antipsychotics |
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Name as many LOW-potency TYPICAL antipsychotics as you can
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chlorpromazine
thioridazine |
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Name as many HIGH-potency TYPICAL antipsychotics as you can
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Haloperidol
Fluphenazine Loxapine Thiothixene Trifluoperazine |
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Name as many ATYPICAL antipsychotics as you can
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Olanzapine
Quetiapine Risperidone Clozapine Aripiprazole |
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What is the SE profile of antiphyschotics by category
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TYPICAL LOW-potency neuroleptics:
anticholinergic SE's fewer mvmt SE's TYPICAL HIGH-potency neuroleptics: fewer anticholinergic SE's mvmt SE's (EPS & TD) NMS ATYPICAL neuroleptics: fewer anticholinergic SE's fewer mvmt SE's wt gain --> DM's/DKA (esp Olanzapine) |
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What is the timing of the 2 types of "movement" disorders a/w antipsychotics
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Extrapyramidal sx's --> acute (days to months)
Tardive Dyskinesia --> delayed (months to years) |
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What neuroleptics are known for their EPS's
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high-potency neuroleptics (e.g. Haloperidol)
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ExtraPyramidal Sx's (EPS's) a/w antipsychotics
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EXTRAPYRAMIDAL SX'S (EPS'S):
Dystonia Parkinsonian sx's (akinesia) Akethesia |
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what is the Rx for acute dystonia
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benztropine or diphenhydramine
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Rx fo parkinson like SE
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d/c or reduce dosage of offending drug
ANTICHOLINERGICS: benztropine/diphenhydramine DOPAMINE AGONIST: amantadine |
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what time frame will you see parkinsonian like SE in px on antipsychotics
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4 days to 4 months
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features of tardive diskinesia
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choreoathetosis
(tongue, face, neck, trunk and/or limbs) often irreversible |
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Rx for tardive diskinesia
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d/c or lower dosage of offending drug
switch to antipsychotic with less EPS's (mvmt SE's) |
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features of neuroleptic malignant syndrome
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MENTAL STATUS CHANGES:
agitated delirium with confusion (rather than psychosis) MUSCLE RIGIDITY +/- tremor HYPERTHERMIA (> 38-40C) AUTONOMIC INSTABILITY tachypnea diaphoresis tachycardia labile or high BP RHABDOMYOLYSIS (appearing over 1-3 days) |
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Rx for neuroleptic malignant syndrome
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STOP THE OFFENDING AGENT!
RIGIDITY/HYPERPYREXIA: Dantrolene (inhibits Ca2+ release) FEVER: IVF's cooling blankets axillary ice packs Tylenol HTN: clonidine and/or nitroprusside (cutaneous vasodilation can facilitate cooling) Agitation: Benzo's (clonazepam, lorazepam) Others possible therapies: bromocriptine or amantidine DVT prevention: heparin |
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What antipsychotic class is olanzapine & what is a common SE
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Olanzapine = atypical antipsychotic
SE's = wt gain --> DM/DKA |
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which antipsychotic is known to cause agranulocytosis & what must be monitored when rx'd to a pt
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Clozapine
SE = agranulocytosis, therefore monitor CBC |
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Drug class:
olanzapine |
atypical antipsychotic
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Drug class:
quitiapine |
atypical antipsychotic
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Drug class:
risperidone |
atypical antipsychotic
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Drug class:
clozapine |
atypical antipsychotic
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Drug class:
aripiprazole |
atypical antipsychotic
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Drug class:
chlorpromazine |
LOW-potency typical antipsychotic
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Drug class:
thioridazine |
LOW-potency typical antipsychotic
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Drug class:
haloperidol |
HIGH-potency typical antipsychotic
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Drug class:
fluphenazine |
HIGH-potency typical antipsychotic
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Drug class:
loxapine |
HIGH-potency typical antipsychotic
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Drug class:
thiothixene |
HIGH-potency typical antipsychotic
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Drug class:
trifluoperazine |
HIGH-potency typical antipsychotic
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Defense mechanism:
calmly describes a murder they witnessed |
isolation of affect
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Defense mechanism:
subconsciously pushes memories out of consciousness |
repression
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Defense mechanism:
woman frustrated with child yells at her husband |
displacement
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personality disorder:
excessive need to be taken care of, submissive & clinging behavior, low self-confidence, fears of separation and losing support |
dependent
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personality disorder:
grandiosity, entitled, lack of empathy |
narcisistic
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personality disorder:
suicide attempts, unstable mood & behavior, sense of emptiness & loneliness, impulsive |
borderline
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personality disorder:
distrustful, suspicious, litigious |
paranoid
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personality disorder:
lifelong voluntary social withdrawal; no psychosis; socially inhibited (restricted range of affect) |
schizoid
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personality disorder:
feeling inadequate, hypersensitive to rejection/criticism, socially inhibited, shy |
avoidant
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personality disorder:
constant mood of unhappiness & pessimism |
depressive
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personality disorder:
odd appearance, thoughts, & behavior; no psychosis; social awkwardness |
schizotypal
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personality disorder:
controlling perfectionist, orderly, stubborn, indecisive |
obsessive compulsive
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personality disorder:
criminality, unable to conform to social norms, disregard for others' rights |
antisocial
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personality disorder:
excessively dramatic, emotional and extroverted; sexually provocative behavior; unable to maintain intimate relationships |
histrionic
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defense mechanism a/w:
paranoid |
projection
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defense mechanism a/w:
borderline |
splitting
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defense mechanism a/w:
histrionic |
repression
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defense mechanism a/w:
OC |
isolation
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difference between OCD & OCPD
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OCPD: do not recognize their behavior as problematic
OCD: recognize their behavior as problematic |
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compare/contrast conduct d/o vs antisocial d/o
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They are the same d/o with different age criteria:
CONDUCT D/O: < 18 y/o ANTISOCIAL D/O: > 18 y/o FEATURES OF BOTH: disregard others rights criminality cruelty to animals |
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most serious SE of clozapine
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agranulocytosis
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what is todds paralysis
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postictal hemiparesis, lasting 15-24 hrs
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Rx for acute otitis media
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1st line: amoxicillin x 10 days
2nd line: amoxicillin + clavulonate (i.e. augmentin) 3rd line: Cephalosporin |
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what treatments are effective in helping recovering alcoholics
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AA
disulfiram topiramate naltrexone acamprosate |
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components of CAGE criteria
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cut down
annoyance guilt eye-openner |
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which vitamins are alcoholics usually deficient in
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Vitamin A
Vitamin B1, B2, B6, B9, & B12 (i.e. thiamin, B2, B6, folate, & B12) Vitamin C |
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most successful Rx for alcoholics
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12-step group counseling (i.e. AA)
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symptoms a/w delirium tremens
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Tachycardia
HTN Diaphoresis Delerium/Hallucinations Seizures Agitation |
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drug of choice for alcohol withdraw
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LONG-ACTING BENZO'S:
diazepam lorazepam chlordiazepoxide |
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what vaccines are recommended for alcoholics
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pneumococcal
influenza Hep A & Hep B |
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drug causing:
post op constipation and or respiratory depression |
opioid intoxication
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drug causing:
severe depression, headache, fatigue, insomnia/hypersomnia, hunger |
amphetamine/cocaine w/draw
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drug causing:
pinpoint pupils, n/v, seizures |
opioid overdose
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drug causing:
belligerance, impulsiveness, nystagmus, homicidal, psychosis |
PCP intoxication
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drug causing:
headache, anxiety/depression, weight gain |
caffeine/nicotine w/draw
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drug causing:
anxiety/depression, delusions, hallucinations, flashbacks |
LSD intoxication
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drug causing:
euphoria, social withdraw, impaired judgment, hallucinations |
marijuana
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drug causing:
rebound anxiety, tremors, seizures, life-threatening |
alcohol, benzo, barb withdrawal
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drug causing:
anxiety, piloerection, yawning, fever, rhinorrhea, nausea, diarrhea |
opiate withdrawal
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what is the downside to adding bupropion to nicotine replacement in px trying to quit smoking
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incr'd risk of severe HTN
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cause of erythema of turbinates and nasal septum
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cocaine abuse
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Rx for px on PCP
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restraint in a dark, quiet room
IVF to prevent rhabdomyolysis Benzo's & antipsychotics for agitation |
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what drugs can be used in a patient with cocaine or amphetamine intoxication
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Benzo's
a-blockers (e.g. Phentolamine) |
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Compare/contrast LSD vs PCP intoxication
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BOTH LSD & PCP: visual hallucinations
LSD: flashbacks PCP: agitation, aggression, & violence + vertical & horizontal nystagmus |
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Rx for benign paroxysmal positional vertigo
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epley maneuver (repositions otoliths)
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Dx:
triad of cognitive impairment, urinary incontinence and abnormal gait |
normal pressure hydrocephalus
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Dx & Tx:
Px on lithium presents with copious amounts of dilute urine |
Dx: nephrogenic DI
Tx: HCTZ + amiloride |
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characteristics of refeeding syndrome
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seizures
rhabdomyolysis CV collapse hypophosphatemia |
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serum abnormalities in px with prolonged excessive vomiting/purging
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hypochloremic metabolic alkalosis (vomiting HCl)
incr'd amylase (salivary gland inflammation) |
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somatoform disorder:
unexplained pain |
pain disorder
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somatoform disorder:
px with normal anatomy is convinced a part of their body is abnormal |
Body Dysmorphic D/o
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somatoform disorder:
unexplained loss of sensory or motor function (normal PE/tests) |
conversion d/o
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somatoform disorder:
unwavering belief by the patient that she has a specific disease (despite medical reassurance) |
hypochondriasis
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somatoform disorder:
unexplained complaints in multiple organ systems |
somatization d/o
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somatoform disorder:
false belief of being pregnant |
pseudocyesis
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what eating disorder can be Rx with SSRI
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bulemia
(as long as they don't purge after taking meds) |
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What is Rx for pain syndrome
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SSRI's & TCA's may help
analgesics are NOT helpful |
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What is major difference b/w factitious/munchausen d/o & somatization/conversion d/o
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FACTITIOUS/MUNCHAUSEN D/O:
pt performs actions to cause sx's SOMATIZATION/CONVERSION D/O: sx's from no action by the pt |
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albuminocytologic dissociation indicates what
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GBS
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Dx
violent px with vertical or horizontal nystagmus |
PCP
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common causes of delirium
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UTI (MCC in elderly)
DRUGS: benzo's anticholinergic (esp in elderly) antihistamines corticosteroids |
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how does sundowning differ from delirium
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SUNDOWNING: deterioration of behavior during the evening hours in pt's WITH DEMENTIA
DELIRIUM: occurs in pt's WITHOUT H/O DEMENTIA & can be linked to a medical or substance-related cause |
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2 MCC of dementia
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Dx: CT or MRI
Alzheimer's (70%) --> cortical atrophy Vascular (15%) --> multiple infarcts |
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Dx
dementia a/w visual hallucinations and frequent falls |
lewy body dementia
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Dx
dementia a/w unpleasant behavior and personality changes |
picks disease (aka frontotemporal dementia)
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What is Rx in an elderly pt with delerium
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Antipsychotic (e.g. Haloperidol)
FYI: Benzo's would exacerbate the delirium |
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Compare/contrast delirium vs dementia
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DELIRIUM:
ALTERNATING levels of consciousness (rapid changes thru the day) attributable to an ACUTE process REVERSIBLE DEMENTIA: CONSISTENT level of consciousness thru the day rarely attributable to an acute process IRREVERSIBLE |
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what disease is a/w atrophy of the mamillary bodies
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Wernicke's Encephalopathy
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what is the MCC of conductive hearing loss
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otosclerosis
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what is the MCC of sensorineural hearing loss
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presbycussis
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comorbidities commonly a/w ADHD
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oppositional defiant d/o
conduct d/o bipolar d/o learning disability depression anxiety d/o |
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what can be used to Rx ADHD when stimulants and atomoxetine fail
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TCA's (imipramine, desipramine, nortriptyline)
bupropion a2-agonists (e.g. clonidine) limit dietary intake of caffeine & sugar |
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how is ADHD diagnosed
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6 symptoms of ADHD |
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childhood psychiatric disorder:
loss of previously acquired purposeful hand skills b/w 6 - 30 months |
rett d/o (females only) |
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childhood psychiatric disorder:
impaired social interaction, communications, & play; repetitive behaviors |
autism
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childhood psychiatric disorder:
impairment in social interactions, no language delay, & no cognitive delay |
asperger's syndrome
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childhood psychiatric disorder:
stereotyped hand movements |
rett d/o (females only)
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childhood psychiatric disorder:
hostility, annoyance, vindictiveness, disobedience, & resentfulness |
Oppositional Defiant D/o
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childhood psychiatric disorder:
multiple motor and vocal tics |
Tourette's syndrome
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childhood psychiatric disorder:
impulsive and inattentive |
ADHD
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childhood psychiatric disorder:
7 y/o that avoids going to school to stay home with parents |
separation anxiety d/o
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for what should a child suspected of having learning disorder be investigated
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hearing difficulty
vision impairment |
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How is Asperger's different from autism
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BOTH: |
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How is childhood disintegrative d/o (CDD) different than autism
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CDD has a period of normal development for at least 2 years before regressing (deterioration of language/social skills, loss of motor skills, & loss of bowel/bladder control)
AUTISM does NOT have a period of normal development with regression |
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What are therapeutic options for Tourette Syndrome
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SOCIAL ADJUSTMENT/COPING: psychotherapy |
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the responsibility to act in the patients best interest is termed what?
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beneficence
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5 keys to obtaining consent
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BRAINBenefit, Risk, Alternative, Indications, Nature (of intervention)
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what qualifies a minor as "legally emancipated"?
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married, in the armed forces, financially independent and have sought legal emancipation
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what is the term for a persons global and legal capacity to make decisions and be held accountable in a court of law?who assesses this and determines if a patient has it?
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Competencethe courts do
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what is the term referring to a persons ability to understand information, the situation, consequences of treating or not treating, etc? who assesses this and determines if a patient has it?
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decision making capacityphysicians do
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this advance directive is more flexible than the other bu should still coincide with the patients wishes
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durable power of attorney for health care
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this advance directive states the patients wishes if he or she is terminally ill or a vegetable
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living will
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in which states is physician-assissted suicide legal?
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Montana, Oregon, WashingtonMOW em' down doctor!!
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what did the Tarasoff decision decide?
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that physicians have the duty to warn (intended victim, police) of a patients intent to commit a violent crime
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what things should a doc break confidentiality for?
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WAIT a SECWounds (gun or knife)Automobile (impairment)Infectious diseasesTarasoff issuesSuicideElderly abuseChild abuse
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4 D's of malpractice
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DutyDerelictionDamageDirect cause |
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where do you go to find the scumbags?
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down to your local law firm
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what is the term that refers to the probability of finding a statistically significant association in a research study when one truly exists
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power
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what is an alpha error
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the null hypothesis is rejected even though it is true. Otherwise referred to as a false-positive. alpha dogs reject the truth |
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what is a beta error
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the null hypothesis is not rejected even though it is false (false-negative).
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what can adolescents receive treatment for without involving their parents?
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drugs, preggos, STDskids are DoPeS
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which study involves people throughout a population and is good for determining information about that population
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cross-sectional study |
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can employers request confidential medical information (such as genetic testing)>
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NO
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what is the word defined by this: a failure to maintain the duty that a doc owes to the patient, deviating from the "standard of care"
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what is breach of duty, alex?
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what is COBRA?
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consolidated omnibus budget reconciliation actlets workers keep health benefits when they are fired or cut back in work time so they can get a new job and maintain coverage during the interim |
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what is EMTALA
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emergency medical treatment and labor actmakes it so the hospital HAS to give care even if the patient cant pay or has no coveragebasically, allows any tom, dick or harry to come in the ER and demand treatment for his "back pain" even though hes a frequent flyer whos just seeking a bed, a meal and hopefully some pain meds |
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radiation below which nothing will happen in pregnancy?
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50mGy (5 rads) |
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True or false: Once a pt signs a statement giving concesnt, they must continue w/ the treatment.
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False. Exceptions include emergency situations and pts without decision making capacity |
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A 15 year old pregnant girl reuires hospitalization for pre-eclampsia. Is parental consent required?
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No. Parental consent is not necessary for the medical treatment of a minor if she is pregnant.
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A doctor refers a patient for an MRI at a facility he/she owns.
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Conflict of interest
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Involuntary psych hospitalization can be undertake for which 3 reasons
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Danger to self, danger to others, or unable to care for own basic needs |
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True or False: Withrawing a nonbeneficial treatment is ethically similar to withholding a nonindicated one.
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True
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When can a physician refuse to continue treating a pt on the grounds of futility?
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When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care.
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Conditions in which confidentiality must be overridden
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Real threat of harm to third party; SI; certain contagious diseases; elder and child abuse |
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Involuntary commitment or isolation for medical treatment may be undertaken for what reason
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When treatment noncompliance represents a serious danger to public health
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A 10 y.o. child presents in status epilepticus, but her parents refuse to treat on the grounds of their religious beliefs. What do you do?
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Treat, b/c diease represents an immediate threat to the childs life. Then seek a court order.
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A son asks that his mother not be told about her newly dx'd cancer. What do you do?
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A physician can withhold information from a pt only in rare cases of therapeutic privilege or if the pt reuests not to be tol. A pts family cannot require the physician to withold information to the pt |
