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80 Cards in this Set
- Front
- Back
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NT in anxiety
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inc NE
dec GABA, serotonin |
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NT in depression
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dec NE, serotonin
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NT in Alzheimer's dementia
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dec ACh
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NT in Huntington's disease
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dec Ach, GABA
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NT in Schizophrenia
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inc Dop
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NT in Parkinson's
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dec Dop
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Define:
anosognosia autotopagnosia depersonalization |
unaware that one is ill
unable to locate one's own body parts body seems unreal or dissociated |
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Order of loss in orientation
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1 Time
2 Place 3 Person |
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Anterograde amnesia
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can't remember after CNS insult
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Retrograde amnesia
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can't remember before CNS insult
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Korsakoff's amnesia
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classic anterograde amnesia
thiamine deficiency --> bilal destruction of mammillary bodies seen in alcohols confabulation |
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which is worse: substance dependence or substance abuse
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dependence!
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7 signs of substance dependence (only 3 have to be met)
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Tolerance
Withdrawal Significant energy spent obtaining Substance in large amts/long time Persistent desire to cut back Important activities reduced Continued use despite dangers |
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4 signs of substance abuse (only 1 needed)
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Use so can't fulfill obligations at work, school, or home
Use in hazardous situations Legal problems Use despite persistent problems |
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Disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts. GGT noted.
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OH intox
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tremor, tachycardia, hypertension, malaise, nausea, seizures, DT, tremulousness, agitation, hallucinations
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OH withdrawal
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CNS depression, N/V, constipation, pupillary constriction, seizures
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opioid intox
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piloerection, anxiety, insomnia, dilated pupils
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opioid withdrawal
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psychomotor agitation, pupillary dilation, euphoria, cardiac arrhythmias, delusions, hallucinations
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amphetamines intox
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euphoria, psychomotor agiation, pupillary diation, tactile hallucinations, paranoid ideations, sudden cardiac death
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cocaine intox
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post use crash
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amphetamines and cocaine
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belligerence, vertical and horizontal nystagmus, psychosis
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PCP
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visual hallucinations, flashbacks
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LSD
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euphoria, paranoid delusions, social withdrawal, hallucinations
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marijuana
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recurrence of intox sxs due to reabsorption in GI tract; sudden onset of severe, random, homicidal violence
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withdrawal in PCP
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low safety margin, respiratory depression
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barbiturates
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anxiety, seizures, delirium, life-threatening CV collapse
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barb withdrawal
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greater safety margin. amnesia, ataxia, somnolence, minor resp depression, addictive with OH
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benzos
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rebound anxiety, seizures, tremor, insomnia
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benzo withdrawal
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restlessness, insomnia, increased diuresis, muscle twitching, cardiac arrhyth
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caffeine
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H/A, lethargy, depression, wt gain
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caffeine withdrawal
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restlessness, insomina, anxiety, arrthy
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nicotine
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irritability, H/A, anxiety, wt gain, craving
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nicotine withdrawal
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tx of alcoholism
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disulfiram, supportive tx, Alcoholics anonymous
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(-) effects of OH
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toxic effects in brain
forms adducts with proteins and nucleic acids acetate product leads to fatty liver increased NADH/NAD inhibits gluconeogenesis |
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delirium tremens
what is it sxs tx |
life-threatening OH withdrawal syndrome that peaks 2-5 days after last drink
sxs: autonomic system hyperactivity, psychosis, confusion tx: benzons |
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8 complications of alcoholism
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alocholic hep and cirrhosis
pancreatitis dilated CM peripheral neuropathy cerebellar degernation wk syndrome, testicular atrophy and hyperestrinism mallory-weiss syndrome |
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alcoholic cirrhosis
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micronodular cirrhosis;
sxs: jaundice, hypoalbuminemia, coagulation factor deficiencies, portal HTN (peripheral edema, ascites, encephalopathy, neurologic like asterixis and flapping tremor, esophageal varices) |
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sxs in WK syndrome
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Wernicke's: confusion, ophthalmopelgia, ataxia
Korsakoff's: confabulation, memory loss, personality change |
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Mallory-Weiss syndrom
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longitudinal lacerations at GE j(x) caused by excessive vomiting; painful
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track marks (needle sticks in veins)
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heroin addiction
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for heroin detox or long-term maintenance
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methadone
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waxing and waning level of consciousness; develops rapidly
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delirium (impaired consciousness)
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patient is alert, change in level of consciousness. Memory deficits. More oten gradual onset
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dementia
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aphasia, apraxia, agnosia, memory deficits, loss of abstract thought, beh changes, impaired judgment
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dementia
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depression (5 of these 9 criteria)
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sleep disturbance
loss of interest guilt loss of energy loss of concentration change in appetite psychomotor retardation suicidal ideations depressed mood |
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sleep patterns in depression
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dec slow-wave sleep
dec REM latency early-morning awakening s |
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risk factors for suicide completion
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sex
age depression *previous attempt ethanol loss of rational thinking sickness organized plan no spouse social support is lacking |
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manic episode (3 of 7)
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distractibility
irresponsibility grandiosity flight of ideas psychomotor agitation dec Sleep Talkativeness (pressured speech) |
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1 ___ defines bipolar disobrder
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manic or hypomanic episode
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consciously fakesto attain a specific gain
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malingering
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consciously creates sxs to asusme "sick role" but motivation is unconscious
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Factitious d/o
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chronic hx of multiple hospital admissions and willingness to receive invasive procedures
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Munchausen's syndrome
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illness production and motivation are unconscious drives
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somatoform d/o
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6 types of somatoform d/o
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conversion - motor or sensory sxs (paralysis, pseudoseizure)
somatoform pain d/o - prolonged pain hypochondriasis - preoccupation with having serious illness somatization d/o - variety of complaints in multiple organ systems body dysmorphic d/o - preoccupied with minor flaws pseudocysis - false belief of being pregnant (manesh) |
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Panic d/o (4 of 13)
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PANICS
Palpitations, paresthesias Abd distress Nausea Intense fear of dying or losing control, lIghtheadness Chest pain, chills, choking, disConnectedness Sweating, Shaking, shortness of breath |
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nightmares of flashbacks. Disturbance > 1 month. Follows acute stress d/o (2-4 wks)
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PTSD
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emotional sxs causing impairment follwing identifiable psychosocial stressor and lasting <6 mos
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adjustment d/o
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uncontrollable anxiety for at least 6 mos and unrelated to specific person, situation, or evcent
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generalized anxiety d/o
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severe communication problems and difficulty forming relationships
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Autistic d/o
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problems with social relationships and repetitive behvaior
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asperger d/o
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x-linked d/o seen ONLY in girls. loss of development and mental retardation, stereotyped hand-wringing
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rett d/o
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limited attention span and hyperactivity. emotionally labile, impulsive, prone to accidents
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adhd
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continued behavior violating social norms.
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conduct disorder (antisocial personality d/o if > 18yo)
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child is noncompliant in the absence of criminality
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oppositional defiant disorder
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motor/vocal tics and involuntary profanity
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tourette's syndrome
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fear of loss of attachment figure leading to factitious physical complaints to avoid going to school
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separation anxiety d/o
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binge eating followed by self-induced vomiting or use of laxatives
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bulimia nervosa
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differences between hallucinations, illusions, and delusions
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h - perceptions in absence of external stimuli
i - misinterpretations of actual external stimuli d - false beliefs not shared with other members of culture |
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differene btw delusions and loose association
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delusion - d/o in content of thought
loose assocation - d/o in form of thought |
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visual and auditory hall in
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schizophrenia
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tactile hall in
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cocaine intox or DT in OH withdrawal
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olfactory hall in
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aura of psychomotor epilepsy
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different btw central sleep apnea and obstructive sleep apnea
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central - no resp effort
obst - resp effort against airway obstruction |
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narcolepsy findings
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hypnagogic or hypnopompic hall, sleep episodes begins with REM sleep, cataplexy in some. Tx. stimulants like amphetamines
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Diagnosis of schizophrenia is 2 of the 5
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Delusions
Disorganized thoughts Disorganized or catatonic beh Hallucinations-auditory Negative sxs - flat affect, social withdrawal, lack of motivation, lack of speech or thought |
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5 subtypes of schizophrenia
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disorganized
catatonic paranoid undifferentiated residual |
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Cluster A personality d/o
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WEIRD
Paranoid - distrust, suspiciousness Schizoid - voluntary social withdrawal Schizotypal - odd beliefs or magical thinking |
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Cluster B personality d/o
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Wild.
Antisocial - criminality Bodrderline 0 unstable modd and interpersonal relationships Histrionic - attention seeking, sex provocative Narcissistic - gradniosity, sense of entitlement |
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Cluster C personality d/o
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Worried.
Avoidant - sensitive to rejection Obsessive-compulsive - preoccupied with perfection Dependent - submissive |
