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45 Cards in this Set

  • Front
  • Back
Somatization Disorder
Patient less than 30 has multiple complaints for 6MOS:
4 Pain
2 GI
1 Sexual
1 Neuro
Conversion Disorder
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.
Dissociative Amnesia
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
Dissociative fugue
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
Dissociative Identity disorder
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
Adjustment Disorder
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.
Postpartum Blues
Mood lability and hypersensitivity that lasts 7-14 days after child is born.
Substance Induced Mood Disorder
Persistent disturbance in mood that occurs within one month of substance intoxication or withdrawl.
After one month (if sx persist), treat.
Acute Stress Disorder
Meet criteria for PTSD and also have dissociative symptoms for
2 DAYS TO ONE MONTH
Rx: Social Support
PTSD
Avoidance, reliving of event and increased arousal GREATER THAN ONE MONTH after life threatening event
Rx: Group Psychotherapy
Drugs absolutely contraindicated in Pregnancy
Lithium, Valproic acid and Haldol
When to use SSRI
Any depressive disorder
OCD
Social anxiety
Panic attacks
Bulimia
PTSD
Premenstrual Dysphoric Disorder
Amphetamine Intoxication
Euphoria, tachycardia, paranoia, hypervigelence, DILATED PUPIL

Rx: Benzos, Amantadine, Bromocriptine
Cannabis Intoxication
Red eyes, impaired judgement, slowed reaction time

No Rx
Hallucinogen
LSD, Mushrooms, Mescaline
Ideas of reference, depersonalization, hallucinations, illusions, anxiety and DILATED PUPIL

Rx: Antipsychotic or Benzo
Inhalant Intoxication
They effect the cerebellum so you see belligerence, nystagmus, lethargy, uncoordination and crusting around the nose
No Rx
Opiate intoxication
Pupillary constriction, constipation, drowsiness, slurred speech, respiratory depression.
Rx: Naloxone/Naltrexone
Methadone for addicts
Buprenorphine for detox
Benzo/Barb Intoxication
Slurred speech, unsteady gait and uncoordination
Rx: Phenobarbitol challenge for Barbs and slow taper for benzo
Benzo Withdrawal
Autonomic hyperactivity
Tremor
Anxiety
Hyperactivity
Grand Mal Seizure**

Rx: Slow taper of benzo
Alcohol withdrawal
Autonomic hyperactivity
Hand tremor
Insomnia
Hallucinations
Anxiety

**Usually on day 3 without alcohol
Rx: Benzos
Treatment for NMS
Dantrolene
Bromocriptine
Amantadine
Conduct Disorder
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).
ODD
Patient has 6MOS of defiant, hostile, negativistic behavior. 4+ sx must be present for at least 6 months.
ADHD
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
How Asperger's is different from Autism and MR
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.
What to do with a suicidal patient?
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.
Stages of Sexual Excitation
Desire
Excitation
Plateau
Orgasm
Resolution
Schizophrenia
6MOS of sx with 1MOS active psychosis (2/5):
Delusions
Hallucinations
Disorganized speech
Disorganized behavior
Negative sx
Schizophreniform Disorder
Patient has symptoms for 1-6MOS with 2/5 active symptoms for most of one month (or one constant/ 2 dialoging voices)
Schizoaffective Disorder
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.
Common causes of delirium by age group
Children: fever, infection
Young adults: drugs
Middle aged: Alcohol withdrawl, injury
Elderly:metabolic, CV and drugs
Naltrexone and Naloxone
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.
Separation Anxiety Disorder
4 WKS of sx must be present
Child must be <18 yrs old
Usually associated with recent illness of a parent
Tourette's Disorder
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
TOC for Obsessive Compulsive Personality?
Insight oriented psychotherapy
Enuresis
Voiding after age 5
Do not start drugs until age 7
Can use DDAVP (antidiuretic) or TCA
Delusional disorder
Nonbizzare fixed delusions for atleast 1MOS.
Functioning is not significantly impaired.
PR= .03%
Transient global amnesia
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.
Signs and Sx of normal pressure hydrocephalus
Ataxia, Dementia, Incontinence
Nightmares
Occur during REM sleep
Child reports "bad dream" the next day
Night terrors
Occur during Delta wave sleep (Stage3/4). Child is inconsolable and does not remember the next day.
Substance Use DO
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).
Bereavement
• 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.
Major Depression
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
Brief Psychotic Dx
More than 1 day and remits by 1 month

At least one of the following: delusions, hallucinations, disorganized speech or grossly disorganized catatonic behavior.