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80 Cards in this Set
- Front
- Back
Schizophreniform Disorder
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Criteria A for 1-6 months
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Schizophrenia
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Criteria A for greater than 6 months
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Criteria A
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2 of 5 psychotic symptoms or 1 of 5 if delusions are bizarre or hallucinations are severe
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Brief Psychotic Disorder
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1 or more psychotic symptoms for 1 month or less
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Psychotic Symptoms
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Delusions
Positive Symptoms (hallucinations) Disorganized Speech Disorganized or Catatonic Behavior Negative Symptoms |
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Negative Symptoms
Bleuler's 4A's and other A's |
Affect flat
Ambivalence (ahedonia, avolition) Autism (alogia) Associations loose |
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5 types of Schiozophrenia
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Paranoid (delusions or hallucinations)
Disorganized (speech & behavior; inappropriate affect) Catatonic (absent, excessive, or bizarre movement) Residual (Negative sx without prominent positive sx) Undifferentiated |
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Schizoaffective Disorder
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Meets Criteria A concurrently with MDD, Manic, or Mixed Episode
plus Has delusions or hallucinations for 2 weeks in the absence of mood disorders |
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Delusional Disorder
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Non-bizarre delusions for > 1 month
people following, being cheated on, patients in 40's |
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Akathisia
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Intense restlessness caused by antipsychotics
treated with procyclidine, an anticholinergic |
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Positive Symptoms are caused by...
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Excess dopamine in the mesolimbic pathway
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Extrapyramidal Side Effects
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Dopamine blockade in Nigrostriatal track
High-potency antipsychotics |
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examples and side-effects of Low-potency antipsychotics
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chlorpromazine
antihistaminergic: sedation anticholinergic: orthostatic hypotension |
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Prolactin Release is mediated by which dopaminergic tract
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Tuberoinfundibular
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Least-known dopaminergic tract name and possible function
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mesocortical; cognition, communication, social fn.
blockage causes akathisia |
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Aripiprazole (Abilify) differences and side effects
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partial Dopamine agonist
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Serotonin in psychotic disorders and antipsychotic treatment
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gen 2 antipsychotics: block 5ht2A
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Depressive symptoms
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Sleep
Interest Guilt Energy Mood Concentration Apetite Psychomotor agitation Suicidality |
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MDD criteria
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2 weeks of
Interest (anhedonia) Mood (depressed) plus 3 others |
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Dysthymic Disorder
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2 Sx, 2 years
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just 2 Depression types
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Melancholic
Atypical: increased appetite, increased sleep, rejection sensitivity. Tx: maoi |
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Bipolar Disorder Criteria
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1 week of
Elevated mood +3 Irritability +4 of: Distractable Insomniac Grandiose Flight of ideas Activity Speech pressured Thoughtless |
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mixed episode
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Mania plus major depressive episode for 1 week.
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hypomania
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mania for 4 days without impairment of function
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rapid cycling
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4+ mood episodes/year
treat with valproic acid |
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Lithium level
level for dialysis toxicities |
0.6-1.2
>2 w/ sx or >4 w/o hypothyroid nephrogenic diabetes insipidus tremors polyurea/polydipsia |
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Carbamazepine side-effect
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auto-induces itself via cyp3a4
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Lamotrigine side-effect
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Steven Johnson Syndrome
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other drugs approved for bipolar disorder
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atypical antipsychotics
when? |
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all antidepressants increase risk of mania in bipolar
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buproprion has lower incidences of inducing mania, venlafaxine & TCA's have higher incidences of inducing mania
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bipolar presentations in children and the elderly
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children present with irritability
elderly present with anhedonia |
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Panic Attack Treatment
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SSRI
CBT Short course of Benzodiazepines |
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Panic Disorder criteria
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Recurrent unexpected panic attacks
ONE MONTH of: 1. concern of additional attacks 2. worrying about consequences of attacks 3. change in behavior related to attacks Often presents as Agoraphobia |
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Specific Phobias
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Always cued by a stimulus
Animal Natural (heights) Blood/Injection/Injury Situational (bridges) Other (eg choking) Tx: behavioral therapy (systematic desensitization) |
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Social Phobias
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fear of being judged
General; tx: SSRI, benzos Performance types, tx: atenolol or propanolol (immediate and non-sedating) |
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Generalized Anxiety Disorder
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6 months of anxiety about multiple things for 6 months
plus 3/6 somatic symptoms: MRS ICE: muscle tension; restlessness; sleep; irritability; concentration; energy TX: SSRI/SNRI, buspirone (serotonin partial agonist); benzos Psychotherapy: CBT; supportive, insight-oriented therapy |
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OCD
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1. Fear of Contamination
2. Fear of Harm or Doubt, with Checking 3. Need for Symmetry, with Ordering or rituals 4. Difficulty Discarding with subsequent Hoarding TX: SSRI, Exposure Response Prevention, CBT Associated with Tourette's (motor and vocal) |
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PTSD
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1. Traumatic event
plus one month of: 2. Re-experiencing (dreams, flashbacks, intrusive thoughts) 3. Avoidance 4. Arousal (hypervigilance, insomnia, startling) that interfere with daily function |
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Acute Stress disorder
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less than 4 weeks
detachment or derealization are more common here than in PTSD. |
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SSRI with longest half-life
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Fluoxetine
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These antidepressants have shorter half-lives, and withdrawal symptoms
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Paroxetine and Venlafaxine
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Buproprion
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Dopamine and NE agonist
used for smoking cessation and ADHD |
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Renally excreted benzos for patients with hepatic impairment
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Oxazepam, Temazepam, Lorazepam
outside the liver |
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Lorazepam
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the only IM benzo
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Diazepam and Chlordiazepoxide
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long half-lives, used for withdrawal
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ODD
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angry, argues, annoys, defiant
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Conduct Disorder
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aggression to people/animals, stealing, destroying property, breaking laws.
Requirement of Antisocial personality disorder is diagnosis of conduct disorder by age 15. At age 18 this becomes antisocial personality disorder. |
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ADHD
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6 sx for 6 months by age 6
Attention Deficit or Hyperactivity or Both |
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Autistic Disorder
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Triad:
Social interaction problems Impaired communication Rigid or repetitive patterns of behaviors and interests |
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Asperger's Disorder
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Mild Autism
Social problems Repetitive Behavior NORMAL LANGUAGE |
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Rett's Syndrome
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Females only
Mutated MECP2 on x-chromosome |
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Childhood Disintegrative Disorder
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Loss of previously acquired skills spontaneously at age 2
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Mental Retardation
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Fragile x
Down Syndrome TORCH infections |
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Anorexia Nervosa
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Disturbed perception of weight
<85% of ideal weight Amenorrhea Psychotherapy |
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Bulemia Nervosa
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binging & purging (vomit or laxative)
normal weight Leads to hypochloremic, hypokalemic metabolic alkalosis Psychotherapy & SSRI (avoid buproprion) |
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Dementia
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Memory impairment
plus one of the following: Aphasia, Apraxia, Agnosia, ADLs? (decreased executive fn) Can have mood, lack of insight, psychotic symptoms |
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Pseudodementia
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Patients aware of memory problems
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Alzheimer's
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Dementia w/ gradual decline
70% of dementias, amyloids, B-pleated sheets, tau proteins |
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Vascular Dementia
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Dementia + neurological signs
Usually abrupt, step-wise decline |
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Lewy Body Dementia
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Dementia w/ visual hallucinations, fluctuating levels of cognition, Parkinsonian symptoms
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Pick's Disease
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Dementia + Disinhibition (personality changes preceding dementia), apathy, language disturbances)
AKA frontotemporal dementia |
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Creutzfeldt-Jakob
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Triad of:
Dementia, myoclonic movements, EEG abnormalities |
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Somatization Disorder
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Multiple physical complaints:
4 pain sites 2 gi sites 1 sexual site 1 neurological site due to emotional issues, not invented |
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Conversion Disorder
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Sensory (blindness or numbness) or muscle symptoms (paralysis, mutism), pseudoseizures
Acute=days to weeks (vs. somatization=chronic) |
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Factitious or Munchausen
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feigned symptoms to play sick role
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Malingering
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feigned symptoms to get benefit
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hypochondriasis
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preoccupation with having serious disease, not reassured by negative medical evaluation
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Body Dysmorphic Disorder
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Preoccupied with an imagined defect in appearance
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Dissociative Amnesia
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Unable to recall important personal information. Usually caused by traumatic or stressful event
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Dissociative Fugue
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Unexpected travel from home with the inability to recall one's past; assumes new identity
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Dissociative Identity Disorder
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(multiple personalities)
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believe that others' motives are malicious
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paranoid
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detachment from social relationships
lack of emotions |
schizoid
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magical thinking, odd beliefs and behaviors
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schizotypal
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Borderline
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core:
unstable relationships impulsivity identity disturbances depersonalization emptiness suicidality (cutting, suicidal gestures) emptiness affective instability or lability abandonment fears anger |
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Histrionic
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attention seeking
excessive emotions seductive shallow considers relationships more intimate than they are |
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Narcissistic
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grandiose: fantasies of unlimited success
need for admiration sense of entitlement problems with co-workers (thinks others are envious) problems with spouse (lack of empathy) present with depression when not given what they deserve |
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Antisocial
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Disregard for the rights of others with no remorse
Charming Signs by age 15 of conduct disorder |
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Dependent
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submissive and clinging behaviors
cant make decisions without someone else, fear of being alone |
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Obsessive-Compulsive
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controling, perfectionist, stubborn
Avoidant- social inhibition, feelings of inadequacy, hypersensitive to rejection |