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62 Cards in this Set

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IQ ranges
>130 = very superior
120-124 = superior
110-119= above average
90-109 = ave
80-89 = below ave
10-19 = borderling MR
50-70 = mild MR
35-49 = moderate MR
25-34 = severe MT
<24 = profound MR
IQ formula
mental age/chronological age
Clinical Dx of psychosis
1 - Perceptual disturbances
2 - Delusional Thinking
3 - Disordered Thought Processes
3 time ranges of psychotic d/o
brief psychotic d/o = Sx for <1 month
schizophreniform = Sx for 1-6 months
schizophrenia = Sx for >6 months
Schizophrenic - Sx
5 As=
Anhedonia
Affect flat
Alogia (poverty of speech)
Avolition (apathy)
Attention (poor)
Why do atypical antipsychotics cause less movement d/o?
-effect the DA in the limbic system, not the substantia nigra
-antagonize DA and 5HT receptors
__% of patients on antipsychotics show significant improvement
70
Good Px for schizophrenia
-onset = early 20s
-female
-precipitating factor
-FHx mood d/o
-good social support
-Sx = + and mood
-acute onet
-few relapses
-good function beforehand
Folie a deux
2 people in close relationship. 1 w/psychotic Sx --> other person develops Sx --> 20-40% recover when inducer removed
A person who who has been hospitalized for depression has a __% of committing suicide later in life
15
Depressive Sx
Sleep
Interest
Guilt/Worthlessness

Energy

Concentration
Appetite/Weight
Psychomotor Activity
Suicidal Ideation
Manic Sx
Distractibility
Insomnia (less *need* for sleep)
Grandiosity


Flight of Ideas
Activity/Agitation
Speech pressured
Thoughtlessness (risk taking/poor judgement)
Mania vs Hypomania
Mania Hypo
Lasts >/=7days >/=4 days
Impaired Severely Not markedly
(job/social)
Hospitalize? Maybe No
Psychotic Sx Maybe No
SAD (3 signs)
SAD = HIC
1 - Hypersomnia
2 - Irritability
3 - Carb craving
SAD = hibernation
ECT premedication
atropine
Rapid cycling is >/= __ episodes in ____
4, year
Bipolar II D/o = NO ____ episodes EVER
Manic
Dysthymic D/o (criteria)
CHASES
Concentration
Hopelessness
Appetite
Somnia
Energy
Self-Esteem

---DD = 2Ds:---
2 years depression, not asymp for 2 months
>/= 2 of above Sx

**NEVER HAS PSYCHOTIC SX**
**not episodic, all the time*
Panic Attack Sx
PANICS
Palpitations
Abd distress
Numbness/Nausea
Intense fear of death
Choking/Chills/Chest pain
Sweating/Shaking/SOB
Panic D/o
PA + anticipatory anxiety btwn PAs
MC mental d/o in USA
Phobias
___% of OCD patients have both obsessions and compulsions
75
OCD is ego-___ and OCPD is ego-___
dystonic
syntonic
Effectiveness of meds vs CBT in OCD
Equal
4 MC mental d/o
1 - phobias
2 - substance-induced
3 - MDD
4 - OCD
PTSD Meds
imipramine and doxepin
Meds for GAD
busiparone, SSRIs, BZDs (short term clonazepam or diazepam, taper off ASAP), SSRIs, extended-release venlafaxine (SNRI)
Dif btwn precipitating event for PTSD and Adjustment D/o
PTSD = event perceived as life-threatening/fatal to patient/someone neat
Adjustment = non-life-threatening
Timetable for Adjustment D/o Sx
Start w/in 3 months of event
End w/in 6 months of event ending
1st line Tx for Adjustment D/o
supportive psychotherapy
Personality D/o Sx (general)
Behavior pattern that manifests as (at least 2):
CAPRIcious
Cognition
Affect
Personal Relations
Impulse control
Personality D/o categories
A = MAD (as a hatter)
-paranoid
-schizoid
-schizotypal
B = BAD
-antisocial (in kids, conduct)
-borderline
-histrionic
-narcissistic
SAD
-dependent
-avoidant
-OCPD
NOS
-passive-aggressive
-depressive
-sadomasochistic
-sadistic
Borderline Personality D/o Sx
IMPULSIVE
Impulsive
Moody
Paranoid w/stress
Unstable Self Image
Labile (inappropriate anger)
Suicidal/Self harming
Intense relationships
Vulnerable to abandonment
Emptiness (poor sense of self)
MCly abused substance in USA
EtOH
% of Americans who abuse EtOH
7-10
CAGE ?s
(esp EtOH)
ever wanted to Cut down on substance?
felt Annoyed by criticism of substance use?
felt Guilty about substance use?
needed substance use as an Eye-opener?
Legal EtOH limit
80-100 mg EtOH/dL blood
Patient w/altered mental status in the ER
Give:
1 - thiamine
2 - glucose
3 - naloxone
Tx DTs
BZDs (like diazepam, , chlordiazepoxide, lorazepam, oxazepam)
__% of patients w/DTs die w/o Tx
15-20%
Korsakoff vs Wernike
-which is reversible and w/what?
Wernicke
Thiamine (vit B1)
Deadly cocaine intox Sx
respiratory depression, seizure, arrhythmia, MI, CVA
Tx cocaine intox
mild to mod = BZDs
severe agitation/psychosis = haloperidol

both = Sx support
Tx cocaine dependence
TCAs
psychotherapy
DA agonists (bromocriptine, amantadine)
Drug w/d can be fatal w/
BZDs
EtOH
Barbituates
Rotatory Nystagmus = pathonomonic for
PCP intox
Drug Urine Times
THC >/= 4 wks
PCP >1 week
Sedative-hypnotics
(BZD, Barbituates) 1 wk
Cocaine >/= 3d
Amphetamines 1-2d
Opiate 12-36h
Inhalants 4-10h
Barbituate OD Tx
Alkalinize pee w/Na+ Bicarb IV
BZD w/d
Flumazenil
Drowsy + GI probs + **constricted pupils**
Opiate intox
Opiate OD Sx and Tx
Sx = Rebels Admire Morphine
Respiratory depression
Altered mental status
Miosis
TX = IV naloxone or naltrexine
Tx opiate w/d
clonidine +/or buprenorphine
Things that don't require informed consent
1 - life-saving med emergency
2 - SI/HI prevention
3 - minors (parents consents, except w/OB care, STD Tx, substance abuse Tx --> confidential)
Emancipated Minor = if:
-married
-self-supporting
-military
-parent
Most important factor in risk of violence
Hx of violence
Malpractice
Dereliction of Duty lead Directly to Damages
Best SSRIs for eating d/o
paroxetine and mirtazepine

(party and mirth)
Meds to increase wt loss
1 - stimulants
-phentermine
-amphetamine
2 - orlistat (alli)
3 - sibutramine
Abreaction
strong rxn patients often get when retrieving traumatic memories
MCC of primary insomnia
primary insomnia
Tx of primary insomnia
hydroxyzine + zolpidem
Elder abuse occurs in __% of people >65 y/o
10