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80 Cards in this Set

  • Front
  • Back
Schizophreniform Disorder
Criteria A for 1-6 months
Schizophrenia
Criteria A for greater than 6 months
Criteria A
2 of 5 psychotic symptoms or 1 of 5 if delusions are bizarre or hallucinations are severe
Brief Psychotic Disorder
1 or more psychotic symptoms for 1 month or less
Psychotic Symptoms
Delusions
Positive Symptoms (hallucinations)
Disorganized Speech
Disorganized or Catatonic Behavior
Negative Symptoms
Negative Symptoms

Bleuler's 4A's and other A's
Affect flat
Ambivalence (ahedonia, avolition)
Autism (alogia)
Associations loose
5 types of Schiozophrenia
Paranoid (delusions or hallucinations)
Disorganized (speech & behavior; inappropriate affect)
Catatonic (absent, excessive, or bizarre movement)
Residual (Negative sx without prominent positive sx)
Undifferentiated
Schizoaffective Disorder
Meets Criteria A concurrently with MDD, Manic, or Mixed Episode

plus

Has delusions or hallucinations for 2 weeks in the absence of mood disorders
Delusional Disorder
Non-bizarre delusions for > 1 month

people following, being cheated on, patients in 40's
Akathisia
Intense restlessness caused by antipsychotics

treated with procyclidine, an anticholinergic
Positive Symptoms are caused by...
Excess dopamine in the mesolimbic pathway
Extrapyramidal Side Effects
Dopamine blockade in Nigrostriatal track

High-potency antipsychotics
examples and side-effects of Low-potency antipsychotics
chlorpromazine

antihistaminergic: sedation
anticholinergic: orthostatic hypotension
Prolactin Release is mediated by which dopaminergic tract
Tuberoinfundibular
Least-known dopaminergic tract name and possible function
mesocortical; cognition, communication, social fn.

blockage causes akathisia
Aripiprazole (Abilify) differences and side effects
partial Dopamine agonist
Serotonin in psychotic disorders and antipsychotic treatment
gen 2 antipsychotics: block 5ht2A
Depressive symptoms
Sleep
Interest
Guilt
Energy
Mood
Concentration
Apetite
Psychomotor agitation
Suicidality
MDD criteria
2 weeks of
Interest (anhedonia)
Mood (depressed)

plus 3 others
Dysthymic Disorder
2 Sx, 2 years
just 2 Depression types
Melancholic

Atypical: increased appetite, increased sleep, rejection sensitivity. Tx: maoi
Bipolar Disorder Criteria
1 week of
Elevated mood +3
Irritability +4 of:

Distractable
Insomniac
Grandiose
Flight of ideas
Activity
Speech pressured
Thoughtless
mixed episode
Mania plus major depressive episode for 1 week.
hypomania
mania for 4 days without impairment of function
rapid cycling
4+ mood episodes/year

treat with valproic acid
Lithium level
level for dialysis
toxicities
0.6-1.2
>2 w/ sx or >4 w/o
hypothyroid
nephrogenic diabetes insipidus
tremors
polyurea/polydipsia
Carbamazepine side-effect
auto-induces itself via cyp3a4
Lamotrigine side-effect
Steven Johnson Syndrome
other drugs approved for bipolar disorder
atypical antipsychotics

when?
all antidepressants increase risk of mania in bipolar
buproprion has lower incidences of inducing mania, venlafaxine & TCA's have higher incidences of inducing mania
bipolar presentations in children and the elderly
children present with irritability

elderly present with anhedonia
Panic Attack Treatment
SSRI

CBT

Short course of Benzodiazepines
Panic Disorder criteria
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
Specific Phobias
Always cued by a stimulus

Animal
Natural (heights)
Blood/Injection/Injury
Situational (bridges)
Other (eg choking)

Tx: behavioral therapy (systematic desensitization)
Social Phobias
fear of being judged

General; tx: SSRI, benzos


Performance types, tx: atenolol or propanolol (immediate and non-sedating)
Generalized Anxiety Disorder
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
OCD
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)
PTSD
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
Acute Stress disorder
less than 4 weeks

detachment or derealization are more common here than in PTSD.
SSRI with longest half-life
Fluoxetine
These antidepressants have shorter half-lives, and withdrawal symptoms
Paroxetine and Venlafaxine
Buproprion
Dopamine and NE agonist

used for smoking cessation and ADHD
Renally excreted benzos for patients with hepatic impairment
Oxazepam, Temazepam, Lorazepam

outside the liver
Lorazepam
the only IM benzo
Diazepam and Chlordiazepoxide
long half-lives, used for withdrawal
ODD
angry, argues, annoys, defiant
Conduct Disorder
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.
ADHD
6 sx for 6 months by age 6

Attention Deficit or Hyperactivity or Both
Autistic Disorder
Triad:
Social interaction problems
Impaired communication
Rigid or repetitive patterns of behaviors and interests
Asperger's Disorder
Mild Autism
Social problems
Repetitive Behavior
NORMAL LANGUAGE
Rett's Syndrome
Females only

Mutated MECP2 on x-chromosome
Childhood Disintegrative Disorder
Loss of previously acquired skills spontaneously at age 2
Mental Retardation
Fragile x

Down Syndrome

TORCH infections
Anorexia Nervosa
Disturbed perception of weight
<85% of ideal weight
Amenorrhea

Psychotherapy
Bulemia Nervosa
binging & purging (vomit or laxative)

normal weight

Leads to hypochloremic, hypokalemic metabolic alkalosis

Psychotherapy & SSRI (avoid buproprion)
Dementia
Memory impairment
plus
one of the following:
Aphasia, Apraxia, Agnosia, ADLs? (decreased executive fn)

Can have mood, lack of insight, psychotic symptoms
Pseudodementia
Patients aware of memory problems
Alzheimer's
Dementia w/ gradual decline

70% of dementias, amyloids, B-pleated sheets, tau proteins
Vascular Dementia
Dementia + neurological signs

Usually abrupt, step-wise decline
Lewy Body Dementia
Dementia w/ visual hallucinations, fluctuating levels of cognition, Parkinsonian symptoms
Pick's Disease
Dementia + Disinhibition (personality changes preceding dementia), apathy, language disturbances)

AKA frontotemporal dementia
Creutzfeldt-Jakob
Triad of:
Dementia,
myoclonic movements,
EEG abnormalities
Somatization Disorder
Multiple physical complaints:
4 pain sites
2 gi sites
1 sexual site
1 neurological site

due to emotional issues, not invented
Conversion Disorder
Sensory (blindness or numbness) or muscle symptoms (paralysis, mutism), pseudoseizures

Acute=days to weeks (vs. somatization=chronic)
Factitious or Munchausen
feigned symptoms to play sick role
Malingering
feigned symptoms to get benefit
hypochondriasis
preoccupation with having serious disease, not reassured by negative medical evaluation
Body Dysmorphic Disorder
Preoccupied with an imagined defect in appearance
Dissociative Amnesia
Unable to recall important personal information. Usually caused by traumatic or stressful event
Dissociative Fugue
Unexpected travel from home with the inability to recall one's past; assumes new identity
Dissociative Identity Disorder
(multiple personalities)
believe that others' motives are malicious
paranoid
detachment from social relationships

lack of emotions
schizoid
magical thinking, odd beliefs and behaviors
schizotypal
Borderline
core:
unstable relationships
impulsivity
identity disturbances
depersonalization

emptiness
suicidality (cutting, suicidal gestures)
emptiness
affective instability or lability
abandonment fears
anger
Histrionic
attention seeking
excessive emotions
seductive
shallow
considers relationships more intimate than they are
Narcissistic
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
Antisocial
Disregard for the rights of others with no remorse
Charming
Signs by age 15 of conduct disorder
Dependent
submissive and clinging behaviors
cant make decisions without someone else, fear of being alone
Obsessive-Compulsive
controling, perfectionist, stubborn
Avoidant- social inhibition, feelings of inadequacy, hypersensitive to rejection