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130 Cards in this Set
- Front
- Back
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ego-dystonic
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behavior is disturbing to self
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ego-syntonic
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behavior is not distrubing to self
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ego-syntonic
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is one’s set of stable, predictable emotional and behavioral traits.
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waxy flexibility
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when patients maintain postures into which they are placed seen with catatonic schizophrenia
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rett disorder
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normal development until 5-30 months and then lose hand skills and develop stereotyped movement, impaired lang developmend and gait, and decellerated head growth
only in girls |
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IQ calculated
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ratio of mental age to chronological age and multiplying by 100
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literal mindedness, where seen
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inability to form abstract concepts
concrete interpretation of proverbs in concrete thinking seen in patients with schizophrenia and organic brain disorders |
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hamilton test
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rating scale to assess symptoms and target behaviors of depression
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counter transferrance
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interviewer develops feelings and reaction to patient based on irrational and unconscious factors
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halstead-reitan
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5 tests that provide sophisticated info about organic impairment of mental functioning takes 4-6hr
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frotterism
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paraphilic interest in rubbing, usually one's pelvis or erect penis, against a non-consenting person for sexual gratification
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Pick's disease
gender more common? |
dementia that is clinically indistinguishable from AD that is associated with frontotemporal atrophy and ventricular dilation (5% of dementia) ( more common in women)
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partial complex seizures that occur in temporal lobe that are associated with personality change
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temporal lobe seizures
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prevention of sequelae and reoccurance of an acute illness
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tertiary prevention
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found in partial complex seizures
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smell taste kinesthetic hallucinations
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delusion
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firmly held belief that is untrue and contrary to persons upbringing
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dysomnia
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primary sleep disorders from trouble initiating and maintaining sleep
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parasomnia
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primary sleep disorders where an event disturbs or disrupts sleep
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primary gain
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"Expression of unacceptable feelings as physical symptoms
in order to avoid facing them" |
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secondary gain
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Use of symptoms to benefit the patient
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liliputions, where seen
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visual hallucinations of little people
seen in Lewy body dementia |
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aphasia
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trouble with words/grammer
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apraxia
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trouble with learned tasks
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agnosia
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trouble with percieving and recognize objects/people
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hypertensive crisis- delerium, hyperpexia, convulsions, rhabdomyolysis, renal failure
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seretonin syndrome
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hyperpyrexia, extrapyramidal rigidity, ANS dysfunction, lead pipe rigidity, death
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neuroleptic malignant syndrome
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mech of hyperprolactinemia
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decreased dopamine in the tubuloinfundibular tract causing decreased libido, galactorrhea, gynecomastia, impotence, amenorrhea, osteoporosis
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downward drift hypothesis
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which postulates that people suffering from schizophrenia are unable to function well in society and hence enter lower socioeconomic groups
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dopaminergic pathway thought to be responsible for neg sx of schizophrenia
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prefrontal cortex
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dopaminergic pathway thought to be responsible for pos sx of schizophrenia
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mesolimbic tract
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dopaminergic pathway blocked by neuroleptics and cause EPS
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nigrostriatal pathway
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Kaufman Assessment Battery for Children
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intelligence test for ages 2.5 to 12
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Weschler Intelligence Scale for Children–Revised (WISC-R)
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determines IQ for ages 6-16
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Stanford-Binet intelligence scale
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measures intelligence in young children
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mild retardation IQ, %MR and goal
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55-70, 85% of MR, goal is to function in society
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moderate retardation IQ, %MR and goal
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35-54, 10%- live in home
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severe retardation IQ, %MR and goal
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25-35, 3%- hospitalized
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coprolalia
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repetition of obscene words
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what impulse control disorder is commonly seen with bulemia
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kleptomania
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paranoid delusions, AH, affect not flat
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paranoid schizophrenic
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excessive purposeless movement or immobility, rigid posture, echolalia
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catatonic schizophrenic
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psychotic episodes with prominent mood sx, psychosis persists in absence of mood sx, mood sx present for substantial part of illness
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schizoaffective
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same as schizophrenia, no social withdrawal
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schizophreniform
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erotomaniac delusional d/o
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delusion someone is in love with them
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grandiose delusional d/o
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delusion of special abilities or is more important
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jealous
delusional d/o |
delusion that lover is not faithful
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persecutory
delusional d/o |
delusion that others are out to harm or conspire against them
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rx for atypical depression
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MAOI and buproprion
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hypersomnia, weight gain, irritability, anenergia, leaden paralysis
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atypical depression
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dysthymia
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mild chronic form of major depression, no episodes, no psychosis, no euthymia for more than 2 weeks sx have to last for 2 yr
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6 sx in three arenas:problems with social interaction (2), problems with language (1), repeated/stereotyped behaviors (1)
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autism
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normal development and then loss of skills in Lnguage/social/adaptive behavior/toileting/motor skills WITH impaired social skills/language/repetitive behaviors
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childhood disintegrative d/o
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impaired social interaction and repeated/restricted/stereotyped behaviors and activities
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aspergers
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negativistic, hostile and defiant behavior that is annoying, disruptive and difficult
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oppositional defiant d/o
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multiple motor and verbal tics that occur multiple times in a day and causes imparment
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tourette's
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rarest developmental d/o
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childhood disintegrative
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1/3 recover 2/3 schizophrenia or schizoaffective
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schizophreniform
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bipolar with greater suicide risk
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II
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assoc with fragile X, MR, tuberous sclerosis and seizures
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autism
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major cause of MR in girls,MeCP2 mutations on X chromosome, may be fatal in utero for boys
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rett's d/o
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pathophys of tourettes
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impaired dopamine regulation at caudate nucleus
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% conduct d/o progressions
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25-40% develop ASPD
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amnesia of identity and sudden unexplained travel, typically preceded by trauma and can result in est.new identity
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dissociative fugue
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dissociative d/o with no amnestic component
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Depersonalization
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common comorbidities with hypochondriasis
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80% MDD and anxiety d/o
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lying about signs or sx to obtain another gain (not just sick role) : avoiding police, money, room and board
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malingering
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major side effect of duloxetine
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hepatotoxicity
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anti depressants metabolized by cyp2d6
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fluoxetine, paroxetine, duloxetine
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SSRI with least sexual side effects
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setraline and escitalopram
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psych meds increasing QT
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citalopram, TCAs, quetiapine, ziprasadone
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side efffects of lithium
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GI, tremor, polyuria, nephrogenic DI, hypothyroidism, leukocytosis, psoriasis, preg-epstein's, toxicity\= seizures N/V, arrhythmia
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can cause stevens Johnson
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lamotrigine
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injectable antipsychotics
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haloperidol, respiradone
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5HT1A agonist D2/alpha adrenergic antagonist
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buspirone
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antidepressants w/o sexual side effects
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mirtazapine, buproprion
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good for MDD pts who are not eating
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mirtazapine
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% commit suicide of schizophrenia
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10%
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mood stabilizer that prevents suicide in Bipolar
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lithium
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lithium in pregnancy
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ok after 1st trimester 7.7% Epstein anomaly (tricuspid valve misplacement)
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more sever subtype of derpession
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melancholic
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flumazenil use
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anti-benzo
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fast acting benzo
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flurazepam, diazepam, triazolam
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potent benzodiazepines
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alprazolam, lorazepam (Ativan) or clonazepam (Klonopin)
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benzos not metabolized by liver
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lorazepam, temazepam and oxazepam
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moderate acting benzo
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temazepam, lorazepam, clonazepam, chlordiazepoxide, alprazolam
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long acting benzo
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oxazepam
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side effects of buspirone
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dizziness, nervousness, nausea typically gone after 1 week of use
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more effective for rapid cycling and mixed episodes
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depakote and lamictal
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medical differential of anxiety d/o
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hyperthyroidism
B12 def. hypoxia neurologic d/o- temporal lobe epilepsy anemia CVD pheo hypoglycemia |
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medical differential of psychosis
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Wilsons
epilepsy stroke infections porphyria cushings paraneoplastic calcium/Thyroid/encephalopathy |
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25% of kids with ADHD also have
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learning disorder
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childhood d/o more common in girls
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retts and mathematical learning d/o
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pseudodementia
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cognitive issues from severe depression
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substances that can cause psychosis
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PCP
etoh withdrawal amphetamines cocaine sedative-hypnotic withdrawal cortisol anticholinergic agents dopamine agonists MAOI withdrawal digitalis isoniazid heavy metals |
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EEG changes in dementia or delerium?
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delerium
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agorophobia without panic d/o...better or worse prognosis?
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worse
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post-partum psychosis is typically due to
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bipolar I
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MAOI drugs
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selegiline
isocarboxazide phenylzine tranylcypromine |
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provides the greatest relief of symptoms in children suffering from Tourette disorder.
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antipsycotics (D2 antagonism) but clonidine is 1st line
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mech of action of clonidine
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alpha2 agonist
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SSRI with short 1/2 life
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paroxetine
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drugs that work with BPD
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SSRIs and antipsychotic (fluoxetine and haloperidol)
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antidepressants that work for pain
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SNRI and TCA
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rx for akathesia
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propanolol
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rx for EPS (dystonia, dyskinesia, TD) from antipsychotics
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clozapine, anticholinergics
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rx for increased salivation from clozapine
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anti-cholinergic
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when does dystonia develop
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a few days after starting or increasing antipsychotic
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antipsychotics least likely to cause EPS
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apriprazole and ziprasadone
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rx of NMS
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remove antipsychotic, start dantrolene and bromocriptine
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is TD reversible
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sometimes- rx with clozapine!
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1st line for mania
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lithium, valproic acid (some say carbamazapine) and a antipsychotic
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time difference in hypomaia vs mania
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4 days to 7 days
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how long can manic episode last without rx
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up to 3 months
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antipsychotic that causes sinus tachycardia and rx
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clozapine rx with propanolol
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length of time to treat depression
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at least 6 months and usually on the scale of 8–12 months
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when do night terrors occur
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stage 3/4 of sleep (delta waves)- non REM
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when do dreams occur
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REM sleep, EEG is active here
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how do adolescents most commonly commit suicide? How do children?
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adolescents- firearms
children- substance injestion |
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rx for lead toxicity
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CaEDTA
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tic progression in tourettes
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start with blinking and eye rolling then grimacing/ licking movements and vocal tics such as throat clearing or grunting then later: body rocking or pelvic thrusting, and self-abusive tics, such as hitting,
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incidence of schizophrenia
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1%
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Cotard syndrome
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delusion that the person is dead, don't exist or that they have lost all blood and intestines
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Capgras syndrome
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belief people have been replaced by imposters
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rx of tylenol overdose
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acetylcysteine
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cortisol in MDD
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increased
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cancer that presents with depression
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pancreatic (others too)
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psychosis+abdominal pain=
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porphyria
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bilateral sixth nerve palsy and horizontal/vertical nystagmus
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wernickes encephalopathy
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hypokalemic, hypochloremic
alkalosis; high serum amylase; hypercholesterolemia, hypomagnesemia |
abnormalities in bulemia
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pupil constriction, drowsiness, impaired attention and memory, slowed respirations and slurred speech
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opiate intoxication
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