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56 Cards in this Set
- Front
- Back
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Which neurotransmitter is commonly blamed for delirium?
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Acetylcholine
GABA, and DA are also blamed |
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Which neurotransmitter is commonly blamed for delirium?
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Acetylcholine
GABA, and DA are also blamed |
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What percentage of pts over 65 will experience delirium?
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10-15%
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Typical infections that can cause delirium?
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UTI
Meningitis Pneumonia Sepsis |
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Typical metabolic abnormalities that can lead to delirium?
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High Na
Hepatic encephalopathy Low O2 High CO2 High glucose Fluid imbalance Uremia High Ca |
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Four miscellaneous causes of delirium.
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Head trauma
Fat emboli Thiamine deficiency Anemia |
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Common drug intoxications that can lead to delirium
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EtOH
Hallucinogens Opioids Marijuana Stimulants Sedatives |
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Common drug withdrawal states that can lead to delirium
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EtOH
Benzos Barbiturates |
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Typical medication classes involved in delirium:
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Anesthetics
Anticholinergics Meperidine Antibiotics |
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Typical toxins that can lead to delirium:
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Carbon Monoxide
Organophosphates |
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Why can delirium be difficult to distinguish from dementia:
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Because dementia is a risk factor for delirium
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Three subtypes of delirium:
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Hyperactive
Hypoactive Mixed |
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What are the definitive tests for delirium?
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Trick question – There are none
This is why dx can be tricky |
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Ddx of delirium:
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Dementia
Psychotic or manic disorganization Status complex partial epilepsy |
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What is the number one most important thing to consider when treating delirium?
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Keeping the patient safe from harm
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What is the only approved medication for the treatment of delirium?
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Trick question – There are none!
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When is the only time you use benzos for treating delirium?
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When there is benzo or alcohol withdrawal.
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Is sundowning more frequent in delirium or dementia?
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Trick question – it's common to both
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Define personality
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Sum of individual's emotional cognitive and behavioral traits
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What is the relationship between personality traits and personality disorder:
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Traits themselves do not cause a disorder even if marked.
Only when traits become inflexible and maladaptive to cause functional impairment. |
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How to tell if Axis I vs Axis II disorder:
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Axis one are ego-dystonic (person does not wish to have symptoms)
Axis two is ego-syntonic (more disturbing to other people) |
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Which cluster of personality disorders is associated with Depressive disorders and substance abuse?
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Cluster B
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Which cluster of personality disorders is associated with Axis 1 anxiety disorders?
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Cluster C
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Patients with schizophrenia are more likely to have biological relatives with which cluster of personality disorder?
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Cluster A
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A person's defense mechanisms help define this:
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Personality
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At what age can you diagnose a personality disorder?
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Early adulthoood
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What is the only personality disorder that cannot be diagnosed before age 18?
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Antisocial personality disorder
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What is the criteria for diagnosing a personality disorder in a teenager?
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Must be present for at least 1 year.
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What is the quickest way to diagnose personality disorders?
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Look at interpersonal relations.
Also be on the look out when a person says, “it's not my fault” |
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What are some countertransferrence thoughts that might lead a physician to suspect a personality disorder?
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Doctor feels frustrated, irritated, or feels manipulated by patient. Preoccupied thinking about a patient
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Describe the defining features of Cluster A personality disorders:
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Odd and eccentric
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Describe the defining features of Cluster B personality disorders:
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Dramatic and emotional
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Describe the defining features of Cluster C personality disorders:
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Anxious and fearful
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Name the 3 Cluster A personality disorders:
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Paranoid
Schizoid Schizotypal |
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Name the 4 Cluster B personality disorders:
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Antisocial
Borderline Histrionic Narcissistic |
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Name the 3 Cluster C personality disorders:
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Avoidant
Dependent Obsessive compulsive |
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How to distinguish paranoid personality disorder from schizophrenia:
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People with personality disorder due not have abnormalities in thought processes.
No deterioration in hygeine. No hallucinations |
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How to distinguish paranoid personality disorder from schizotypal:
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Schizotypal has odd or unusual beliefs, odd perceptual experiences, and odd thinking.
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How to distinguish paranoid personality disorder from Axis 1 delusional disorder.
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Paranoid personality tends to be globally suspicious.
Delusional disorder has a fixed false single delusion |
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Precursor to Antisocial personality disorder:
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Conduct disorder
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Does an individual have to have a criminal record to be diagnosed with antisocial personality disorder?
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No
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Most common personality disorder:
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Borderline
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Name common defense mechanisms used in borderline personality disorder:
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Splitting, denial, projection, acting out, idealization, devaluation
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Which brain structure is associated with borderline?
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The amygdala (reduced in volume) becomes hyperactive
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Which personality disorder?
“You just can't trust anyone these days” |
Paranoid personality disorder
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Which personality disorder?
“I want to speak to the chief resident, not some medical student” |
Narcissistic personality disorder
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These two personality disorders both involve fears of abandonment:
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Borderline & Dependent
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What is the fundamental difference between avoidant personality disorder and schizoid personality disorder?
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Avoidant wants to have relationships, they just feel too afraid.
Schizoid doesn't even want relationships |
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Summarize OCPD in one word:
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Control
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Name some common defense mechanisms in OCPD:
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Intellectualization
Rationalization Isolation of affect Reaction formation Undoing |
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How does someone with OCPD feel about ethics and morals:
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Applies them rigidly
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Can a personality disorder “get better” without treatment.
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Yes!
As people age, they do learn some corrective traits. This is especially true with antisocial and borderline personalities |
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Which types of psychotherapies tend to help with personality disorders?
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Dialectical behavior therapy, supportive, and cognitive-behavioral psychoterapy.
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When should you consider using medicine to treat a personality disorder.
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When they can be used to target specific, identifiable symptoms.
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General pointers for treating personality disorders:
(there's lots of them) |
Clarify short term and long term goals
Provide structure Set limits Provide crisis intervention Hospitalize if necessary Identify and treat Axis 1 disorders Recognize transference and countertransference Symptom-targeted pharmacotherapy |
