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38 Cards in this Set
- Front
- Back
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What are 8 classic signs and sx of Benzodiazepine withdrawal?
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-Autonomic hyperactivity
-Hand tremor -Insomnia -Nausea -Anxiety/agitation -Hallucinations -Seizures |
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What symptoms would point more toward opioid withdrawal?
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Runny nose/lacrimation
Nausea/vomiting/diarrhea Severe abdominal cramps |
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What symptoms would point more toward cocaine withdrawal?
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-Hypersleepiness/fatigue
-Depressed symptoms -Irritability/Anxiety |
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Which is life-threatening; BDZ, cocaine, or opioid withdrawal?
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Only BDZ withdrawal!
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In lite of the fact that BDZ withdrawal can be life threatening what is the best treatment for it?
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-Transfer to acute care facility
-Treat with a BDZ -Slowly taper the BDZ so withdrawal symptoms don't recur |
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What receptor do the Benzodiazpines primarily affect and how do they work?
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-GABA-A Cl- channel
-Alters Chloride influx |
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What other drugs affect the GABA receptor?
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Barbiturates
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What do the Barbiturates and BDZ's have in common?
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Withdrawal from both can be life-threatening
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What drug is a BDZ ANTAGOnist?
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Flumazenil
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What is Flumazenil used to treat?
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Benzodiazepine OVERDOSE (not withdrawal)
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What is the principal DANGER of Flumazenil?
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Its risk for PRECIPITATING severe withdrawal
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Why is BDZ withdrawal life-threatening?
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Because it can cause seizures
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What drug withdrawal would you suspect in a patient with hypersomnia and hyperphagia?
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Cocaine
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What drug withdrawal would you suspect in a patient with SLUD?
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Opioids
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What type of BDZs are most likely to cause the most severe discontinuation withdrawal syndrome?
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-Alprazolam
-Lorazepam |
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What type of diagnostic steps are taken when a patient's current adaptive functioning needs to be assessed?
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Individualized IQ testing
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What is the role of the Psychiatrist in helping manage the treatment of a child with mild mental retardation?
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Coordinating the right evaluations and referrals and monitoring for development of any psychiatric illnesses
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What are the 3 diagnostic criteria for Mental Retardation?
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-IQ below 70
-Deficits in Adaptive Functioning in at least 2 areas -Onset before age 18 |
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So what are the 2 types of tests needed for diagnosing mental retardation?
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-Adaptive functioning tests
-Intelligence tests |
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What exactly are Adaptive Functioning tests?
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Psychological assessments that measure social, communication, daily living, and community functioning skills
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What is required to answer the questions needed to complete the assessment in an Adaptive Functioning test?
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Collateral sources of info from people who know the patient well
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What is a test that is commonly used to assess Adaptive Functioning?
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Vineland Social Maturity Scale
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What exactly are Intelligence tests?
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Psychological tests that measure Intelligence Capacity
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What are the 2 most commonly used intelligence tests?
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-Wechsler scales
-Stanford-Binet scale |
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What is the most common cause of MODERATE TO SEVERE mental retardation?
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Down's syndrome/Trisomy 21
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What is the 2nd most common cause of mental retardation?
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Fragile X Syndrome
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What is Fragile X syndrome a result of?
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Mutation at the Xq27.3 locus
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What sex of patients are generally more severely affected by Fragile X syndrome?
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Males
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What % of the general population is affected by mental retardation and what sex in general is more?
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1% - males
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What fraction of mentally retarded patients have no identifiable cause?
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1/3
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And 3 common etiologies of mod to severe mental retardation are:
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-Trisomy 21
-Fragile X -Phenylketonuria |
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What should be considered in the differential diagnosis if what appears to be mental retardation is seen in a patient over 18 yrs old?
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Dementia
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What IQ levels are seen with Mild, Moderate, Severe, and Profound mental retardation?
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Mild - 50-55 to about 70
Mod - 35-40 to 50-55 Severe - 20-25 to 35-40 Profound - below 20-25 |
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What level of mental retardation generally can live and work independently with social support?
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Mild (IQ 50-70)
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What type of function is a patient with Moderate mental retardation capable of in general?
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Can work with lots of support and needs a high level of supervision
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At what level does mental retardation result in a patient being not independent, needing extensive supervision?
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Severe - IQ of 20-25 to 35-40
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What are the 4 main methods of PREVENTING mental retardation?
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-Abstain from drinking alcohol in pregn.
-Obtain appropriate immunizations -Take folic acid supplements -Proper nutrition/other vitamins |
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What is the most likely diagnosis in a 24 yo man who presents with new-onset blindness with no physiologic explanation and his mother died several months ago?
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Conversion disorder!
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