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68 Cards in this Set
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dissociation
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temporary drastic change in personality, etc
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displacement
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avoided ideas/feelings transferred to neutral party
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projection
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unacceptable internal impulse attributed to an external source
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reaction formation
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horny guy becomes a monk
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splitting
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belief that people are either all good or all bad at different times
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sublimation
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actress using bad memories of abuse to enhance acting
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infant deprivation effects
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weak, wordless, wanting, wary
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anaclitic depression
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separation from caregiver (ie hospitalization)
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ADHD
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before 7. decr frontal lobe volume.
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tx methylphenidate (ritalin), amphetamines (dexedrine), atomoxetine (nonstim SNRI)
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tourettes
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haloperidol
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childhood disintegrative disorder
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regression of language, social skills, bowel/bladder, motor skills between 3-4 yrs old. boys
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korsakoff's amnesia
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anterograde. thiamine def. bilat destruct of mammillary bodies. alcoholics. can also be retrograde.
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dissociative amnesia
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can't recall impt personal info
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delirium
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abnormal EEG
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visual hallucinations
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delirium
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auditory hallucinations
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schizophrenia
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tactile hallucinations
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DTs, cocaine
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schizophrenia
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more than 6 mos. decr dendritic branching. req 2 of: delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, flat affect/social wd/lack of motivation/lack of speech or thought
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subtypes: paranoid, disorganized, catatonic, undifferentiated, residual
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brief psychotic disorder, shizophreniform, schizoaffective
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BP: less than 1 month
SPiform: 1-6 mos SA: bipolar or depressive |
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mania
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at least 1 week. req 3:
Distractibility Irresponsibility (hedonism) Grandiosity Flight of ideas Activity/psychomotor Agitation decreased Sleep Talkativeness or pressured speech |
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bipolar
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only need mania to dx
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tx: lithium, valproic acid, carbamazepine, atypical antipsychotics
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cyclothymia
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dysthymia and hypomania lasting 2 yrs
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major depressive disorder
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selfplim, 6-12 mos. at least 5 for 2 wks (with depressed mood/anhedonia): SIGECAPS
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recurrent when 2 episodes with symptom free interval of 2 mos
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dysthymia
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2 years
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atypical depression
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most common subtype
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tx MAO inhibitors, SSRIs
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risk factors for suicide completion
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SAD PERSONS
Sex (male) Age (teen or elderly) Depression Previous attempt Ethanol/drugs loss of Rational Thinking Sickness Organized plan No spouse Social support lacking |
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panic disorder
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tx CBT, SSRI, TCA, benzo
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phobia
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tx with SSRI
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OCD
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tx with SSRI, clomipramine
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PTSD
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greater than 1 month. tx SSRI
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GAD
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at least 6 mos. tx: benzo, buspirone, SSRI
adjustment disorder if <6mos |
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munchausen syndrome
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chronic factitious disorder with physical s/sx. wants to receive invasive procedures
by proxy when by caregiver |
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somatization
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pain in multiple organ systems over years
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conversion
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sudden loss of sensory or motor fxn, pt indifferent
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Cluster A
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odd/eccentric
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paranoid
schizoid - social WD, limited emotion, likes social isolation schizotypal - eccentric appearance, odd beliefs, magical thinking, awkward |
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Cluster B
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dramatic, emotional, erratic
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antisocial
borderline - unstable mood/relationships, impulsive, sel-mutilate, splitting histrionic - emotional, excitable, attention, provocative, concerned with appearance Narcissistic |
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Cluster C
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anxious, fearful
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Avoidant - hypersensitive to rejection, timid, feels inadequate, wants relationships
OCD Dependent |
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Dependence
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at least 3 in a year: tolerance, withdrawl, do more than you want, can't quit, significant energy to use, QoL decr, continue despite probs
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abuse
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maladaptive pattern leading to distress:
failing to fulfill obligations use when hazardous causes legal probs use despite probs |
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GGT
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gamma glutamyltransferase is sensitive indicator of etoh use. tx: naltrexone
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WD: DTs (anxiety, tremor, seizure, insomnia). tx: benzo
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opioids
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abuse: N/V, constip, pup constrict, seizures. tx: naloxone, naltrexone
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WD: sweat, dilate pupil, piloerection, fever, rhinorrhea, nausea, cramps, diarrhea
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barbituates
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low safety margin
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WD: delirium, CV collapse
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benzo
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ataxia, resp depress, tx: flumazenil (comp GABA antag)
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amphetamines
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impair judg, pup dil, wakeful, attentive, delusion, hallusination, fever
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WD: cramps, hunger, sleepy
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cocaine
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impair judg, pup dil, hallucin, paranoid, angina, cardiac death
tx: benzo |
WD: suicide, sleepy, malaise, craving
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caffeine
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restless, diuresis, twitch
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nicotine
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restless
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WD: irritable, anxious, crave
tx: buproprion, varenicline |
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PCP
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vertical and horizontal nystagmus, tachy, psychosis, delirium
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WD: depression, anxious, irritable, restless, anergia, disturbed thought
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LSD
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pup dil
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depression with insomnia
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mirtazapine
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methylphenidate
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incr catecholamines at synaptic cleft, esp NE and dopamine
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ADHD, narcolepsy, appetite control
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antipsychotics
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blocks D2 receptors, incr cAMP
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tox: stored in fat. dry mouth, constipation (anticholinergic), hypotension (a), sedation (histamine)
Neuroleptic malignant syndrome: rigidity, myoglobinuria, autonomic instability, hyperpyrexia tx: danrtolene, bromocriptine |
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high potency antipsychotics
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haloperidol, trifluoperazine, fluphenazine
EPS |
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low potency antipsychotics
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thioridazine, chlorpromazine. anticholinergic, antihistamine, alpha block sfx
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chlorpromazine, thioridazine
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Corneal Deposits C
reTinal deposits T |
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atypical antipsychotics
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Olanzapine, Clozapine, Quetiapine, Risperidone, Aripiprazole, Ziprasidone
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Block 5HT2, Dopamine, alpha, and H1 receptors.
less EPS and anticholinergic sfx good for both pos and neg sx. |
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olanzapine
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OCD, anxiety, depression, mania, tourettes
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WG (also clozapine)
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clozapine
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WG, agranulocytosis
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lithium
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good for SIADH
LMNOP: Lithium: movement, nephrogenic DI, hypOthyroid, preg probs |
heart block. fetal: ebstein anomaly, malformation of great vessels. narrow therapeutic window.
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buspirone
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stims 5HT1A receptors. good for GAD. no interaction with alcohol or sedation/addiction/tolerance
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TCAs
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-pramines, -triptylines, doxepin, amoxapine
block reuptake of NE and serotonin tox: sedation, a block, anticholinergic sfx, tachy, urinary retention. amitryptyline has worse anticholinergic sfx. desipramine least sedating, lowest seizure threshold |
for bedwet (imipramine), OCD (clomipramine), fibromyalgia
Tri-Cs: Convulsions, coma, cardiotox, resp deres, fevers. confusion and hallucinations in elderly - use nortriptyline. tx CV tox with bicarb |
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SSRI
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tox: GI, anorgasmia, serotonin syndrome if give with MAOi - hyperthermia, muscle rigid, CV collapse, flush, diarrhea, seizures. tx: cyproheptadine (5HT r antag)
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SNRI
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venlafaxine (also GAD), duloxetine (also DM PN)
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tox incr BP, stim, sedation, nausea
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MAOi
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phenelzine, tranylcypromine, isocarboxazid, selegiline
incr amine NTs (NE, serotonin, dopamine) |
for atyp depr, anxiety, hypochondriac
tox: HTN crisis with tyramine and b agonists. CNS stim. not with SSRI or meperidine |
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buproprion
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smoke cess. incr NE and dopa
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tox: tachy, insomnia, HA, SEIZURE, no sex sfx
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mirtazapine
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a2 antag incr release of NE and serotonin. 5HT2 and 5HT3 receptor antag.
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tox: sedation, incr appetite, WG, dry mouth
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maprotiline
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blocks NE reuptake
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tox: sedation, ortho hypo
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trazodone
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inhibits serotonin reuptake
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for insomnia
tox: sedation, nausea, PRIAPISM, postural hypoten |
