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45 Cards in this Set
- Front
- Back
Somatization Disorder
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Patient less than 30 has multiple complaints for 6MOS:
4 Pain 2 GI 1 Sexual 1 Neuro |
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Conversion Disorder
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ABRUBT loss of motor or sensory function
Motor: Shifting paralysis, globus hystericus, seizure Sensory: Parathesias, Vision problem Sx are not intentionally produced and can not be explained by a physical etiology. |
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Dissociative Amnesia
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While amnesia is part of all dissociative disorders, this diagnosis requires it is the ONLY dissociative symptom.
Inability to remember important personal information (usually surrounds stressful/traumatic event). Rx: Amobarbital or Ativan during interview |
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Dissociative fugue
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Sudden unexpected travel away from home or work plus inability to recall one's past.
Often seen as response to a stressor. Rx: Amobarbital or Ativan for interview |
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Dissociative Identity disorder
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At least two identities recurrently take control of the person's behavior.
Do not recall personal information or events associative with the non-current personality |
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Adjustment Disorder
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Developement of an emotional response to a stressor within three months of the stressor. The sx do not last longer than 6mos.
Common emotions are depression, anxiety and conduct disturbance TOC is therapy. |
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Postpartum Blues
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Mood lability and hypersensitivity that lasts 7-14 days after child is born.
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Substance Induced Mood Disorder
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Persistent disturbance in mood that occurs within one month of substance intoxication or withdrawl.
After one month (if sx persist), treat. |
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Acute Stress Disorder
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Meet criteria for PTSD and also have dissociative symptoms for
2 DAYS TO ONE MONTH Rx: Social Support |
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PTSD
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Avoidance, reliving of event and increased arousal GREATER THAN ONE MONTH after life threatening event
Rx: Group Psychotherapy |
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Drugs absolutely contraindicated in Pregnancy
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Lithium, Valproic acid and Haldol
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When to use SSRI
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Any depressive disorder
OCD Social anxiety Panic attacks Bulimia PTSD Premenstrual Dysphoric Disorder |
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Amphetamine Intoxication
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Euphoria, tachycardia, paranoia, hypervigelence, DILATED PUPIL
Rx: Benzos, Amantadine, Bromocriptine |
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Cannabis Intoxication
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Red eyes, impaired judgement, slowed reaction time
No Rx |
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Hallucinogen
LSD, Mushrooms, Mescaline |
Ideas of reference, depersonalization, hallucinations, illusions, anxiety and DILATED PUPIL
Rx: Antipsychotic or Benzo |
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Inhalant Intoxication
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They effect the cerebellum so you see belligerence, nystagmus, lethargy, uncoordination and crusting around the nose
No Rx |
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Opiate intoxication
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Pupillary constriction, constipation, drowsiness, slurred speech, respiratory depression.
Rx: Naloxone/Naltrexone Methadone for addicts Buprenorphine for detox |
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Benzo/Barb Intoxication
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Slurred speech, unsteady gait and uncoordination
Rx: Phenobarbitol challenge for Barbs and slow taper for benzo |
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Benzo Withdrawal
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Autonomic hyperactivity
Tremor Anxiety Hyperactivity Grand Mal Seizure** Rx: Slow taper of benzo |
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Alcohol withdrawal
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Autonomic hyperactivity
Hand tremor Insomnia Hallucinations Anxiety **Usually on day 3 without alcohol Rx: Benzos |
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Treatment for NMS
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Dantrolene
Bromocriptine Amantadine |
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Conduct Disorder
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Patient has ONE YEAR of demonstrating disregard for rules as well as the basic rights of others. Childhood onset type (before 10 at least one of the criteria). Adolescent-Onset type (zero criteria before age 10).
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ODD
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Patient has 6MOS of defiant, hostile, negativistic behavior. 4+ sx must be present for at least 6 months.
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ADHD
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For 6MOS before age 7 the child has demonstrated attention +/- hyperactivity problems in atleast two settings.
6 sx of inattention= ADHD ina. 6 sx of hyperactivity= ADHD HY 12 (6+6)= combined |
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How Asperger's is different from Autism and MR
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There is no clinically important language delay (words by age two, phrases by age four). No delay in cognitive development, self-help skills, adaptive behavior (separates from MR), and they have normal curiosity about the environment.
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What to do with a suicidal patient?
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Actively suicidal patient is put on one-to-one observation. A patient with an intent and a plan in place must be admitted to the hospital.
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Stages of Sexual Excitation
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Desire
Excitation Plateau Orgasm Resolution |
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Schizophrenia
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6MOS of sx with 1MOS active psychosis (2/5):
Delusions Hallucinations Disorganized speech Disorganized behavior Negative sx |
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Schizophreniform Disorder
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Patient has symptoms for 1-6MOS with 2/5 active symptoms for most of one month (or one constant/ 2 dialoging voices)
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Schizoaffective Disorder
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Meets criteria for either MDD or manic episode while simultaneously meeting criteria for Schizophrenia.
Has also has two weeks of delusions or hallucinations without any mood sx. |
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Common causes of delirium by age group
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Children: fever, infection
Young adults: drugs Middle aged: Alcohol withdrawl, injury Elderly:metabolic, CV and drugs |
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Naltrexone and Naloxone
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Naltrexone is a long lasting opioid antagonist that reduces cravings for alcohol in alcoholic patients. Naloxone is short acting and thus is the TOC for opiate overdose.
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Separation Anxiety Disorder
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4 WKS of sx must be present
Child must be <18 yrs old Usually associated with recent illness of a parent |
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Tourette's Disorder
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Tics almost daily for ONE YR
No tic free period for >3mos Has had motor and vocal tics <18 yrs old Rx: Dopamine antagonist like Haloperidol, Pimozide |
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TOC for Obsessive Compulsive Personality?
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Insight oriented psychotherapy
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Enuresis
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Voiding after age 5
Do not start drugs until age 7 Can use DDAVP (antidiuretic) or TCA |
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Delusional disorder
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Nonbizzare fixed delusions for atleast 1MOS.
Functioning is not significantly impaired. PR= .03% |
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Transient global amnesia
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Transient loss of memory where immediate recall and remote memory are preserved and nothing else.
No treatment. Resolves on its own and does not usually recur. |
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Signs and Sx of normal pressure hydrocephalus
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Ataxia, Dementia, Incontinence
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Nightmares
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Occur during REM sleep
Child reports "bad dream" the next day |
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Night terrors
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Occur during Delta wave sleep (Stage3/4). Child is inconsolable and does not remember the next day.
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Substance Use DO
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Substance Abuse one or more sx within a 12-month period. Failure to fulfill obligations, repeated use and social problems.
Substance Dependence: 3 or more sx for one year. (tolerance, withdrawal, impairment across multiple settings). |
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Bereavement
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• The patient’s symptoms are associated with the loss of a loved one that has occurred during
the past two months. • The patient may or may not meet the symptom criteria for Major Depression. |
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Major Depression
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5/9 sx for at least two weeks. One of the symptoms must be either item 1 or 2.
1. Depressed mood 3. Significant change in weight or appetite OR 4. Insomnia or hypersomnia 2. Loss of interest or pleasure 5. Psychomotor agitation or retardation 6. Fatigue or loss of energy 7. Feelings of worthlessness or guilt 8. Impaired concentration or ability to make decisions 9. Thoughts of suicide or self-harm |
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Brief Psychotic Dx
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More than 1 day and remits by 1 month
At least one of the following: delusions, hallucinations, disorganized speech or grossly disorganized catatonic behavior. |