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60 Cards in this Set
- Front
- Back
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conditions associated to autism
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encephalitis
maternal rubella PKU tuberous sclerosis fragile X perinatal hypoxia |
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autism presentation
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lack of peer relationships
failure to use nonverbal social cues absent or bizarre speech repetitive activities purposeless rituals retardation in 75% higher incidence of abnormal EEG and seizures |
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autism treatment
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family counseling
special education antipsychotics for agitation |
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autism differential
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mental retardation
hearing impairment environmental deprivation selective mutism Rett Asperger |
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ADHD presentation
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short attention span
constant fidgeting inability to sit through cartoons or meals inability to wait in lines failure to stay quiet or still in class disobedience poor academic performance |
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conduct disorder definition
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persistent violations in:
aggression property destruction deceitfulness or theft rules |
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oppositional defiant disorder
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persistent pattern of negativistic, hostile and defiant behavior towards adults
arguments, temper outbursts, vindictiveness, deliberate annoyance |
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depression presentation
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depressed mood
anhedonia weight changes sleep disturbances psychomotor agitation or retardation fatigue or loss of energy feelings of wrothlessness or guilt poor concentration recurrent thoughts about death |
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bipolar I symptoms
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persistently elevated mood at least 1 week
increased self-esteem or grandiosity distractibility excessive involvement in activities more talkative than usual psychomotor agitation flight of ideas increased sexuality increased goal-oriented activity |
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dysthymic disorder
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depressed mood most of the time on most days at least 2 years
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cyclothymic disorder
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many periods of depressed mood and hypomanic mood for at least 2 years
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schizophrenia symptoms
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present > 6 months
hallucinations delusions disorganized speech or behavior catatonic behavior negative symptoms social/occupational dysfunction |
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types of schizophrenia
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paranoid
disorganized catatonic undifferentiated residual |
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brief psychotic disorder Vs. schizophreniform Vs. schizophrenia
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symtptoms < 30 days for brief psychotic
1 month to 6 months for schizophreniform > 6 months for schizo |
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schizoaffective disorder
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meets criteria for depressive episode, manic episode, mixed episode
symptoms of schizophrenia delusions or hallucinations |
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acute stress disorder Vs. PTSD
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PTSD is > 1 month
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somatization disorder presentation
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many physical symptoms affecting many organs
no medical explanation found long complicated medical histories |
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somatization disorder differential
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MS
myasthenia gravis SLE AIDS thyroid major depression GAS schizophrenia |
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hypochondriasis
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preocupation with diseases that persists despite physician reassurance
belief is not delusional affects individual level of functioning duration at least 6 months |
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pain disorder
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pain is present and causes distress to patient
psychologic factors are found symptoms not faked history of surgeries or medical care treatment --> SSRIs, biofeedback, hypnosis, nerve block |
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factitious disorder
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gridiron abdomen from multiple surgeries
demands treatment in the hospital if tests negative they accuse doctors and threaten litigation becomes angry when confronted |
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malingering
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conscious production of signs and symptoms
complain a lot and exagerate effects preocupied more with rewards than alleviation |
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somatoform disorders
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somatization disroder
conversion disorder hypochondriasis body dismorphic disorder pain disorder factitious disorder malingering |
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cognitive disorders
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delirium
dementia amnesia |
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childhood disorders
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mental retardation
learning disorder autistic disorder ADHD conduct disorder oppositional defiant disorder childhood enuresis childhood anxiety tourette |
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mood disorders
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major depression
bipolar disorder dysthimic disorder cyclothymic disorder seasonal affective disorder grief postpartum depression |
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psychotic disorders
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schizophrenia
brief psychotic disorder schizophreniform disorder schizoaffective disorder delusional disorder |
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anxiety disorders
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panic disorder
phobic disorder OCD PTSD GAS |
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dissociative disorders
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dissociative amnesia
dissociative fugue dissociative identity disorder depersonalization disorder derealization disorder |
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substance disroders
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substance intoxication
substance withdrawal substance dependance |
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impulse control disorders
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intermittent explosive disorder
kleptomania pyromania pathologic gambling trichotillomania |
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wating disorders
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anorexia nervosa
bulimia nervosa |
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personality disorders
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cluster A --> paranoid, schizoid, schitypal
cluster B --> histrionic, borderline, antisocial, narcissistic cluster C --> avoidant, dependant, obsessive compulsive |
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sleep disorders
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narcolepsy
sleep apnea insomnia parasominas --> nightmares, night terror, sleepwalking, sleeptalking |
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delirium
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disturbances in alertness with confusion caused by acute metabolic problems or substance intoxication
symptoms --> agitation, stupor, fear, emotional lability, hallucinations, delusions EEG --> generalized slowing of activity treatment --> underlying condition, protective physical restraints, antipsychotics |
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dementias
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Alzheimer
vascular Pick Creutzfeld-Jakob Huntington Parkinson HIV encephalopathy Wilson normal pressure hydrocephalus pseudodementia |
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general symptoms of dementia
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increasing disorientation
anxiety depression emotional lability personality disturbances hallucinations delusions |
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Alzheimer Vs. vascular dementia
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alzheimer --> women, older age of onset, chromosome 21, linear progressive deterioration, no focal deficits, supportive treatment
vascular --> men, younger than alzheimer, hypertension, stepwise/patchy deterioration, focal deficits, treat underlying condition |
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Wernicke Vs. Korsakoff syndrome
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wernicke --> acute, reversible, ataxia, nystagmus, opthalmoplegia, treat with thiamine
korsakoff --> chronic, irreversible, confusion, psychosis, amnesia, treat with thiamine |
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anorexia nervosa
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restricted caloric intake with or without purging
concern with appearance denial of emaciated conditions vomiting, laxatives, diuretics hypotension, bradycardia, lanugo, peripheral edema secondary amenorrhea |
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bulimia nervosa
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binge-eating followed by guilt and purging
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NREM characteristics
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slow EEG rhythms
high muscle tone absence of eye movements thoughtlike mental activity |
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stages of sleep
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1 --> dissapearance of alpha waves and appearance of theta wave
2 --> k complexes and sleep spindles 3 --> appearance of delta wave 4 --> continuation of delta wave REM --> bursts of sawtooth waves |
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REM characteristics
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aroused EEG
sexual arousal saccadic eye movements muscle atony dreams |
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narcolepsy
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sleep attacks
cataplexy hypnagogic and hypnopompic hallucinations sleep paralysis treatment --> forced naps, stimulants |
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sleep apnea
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cessation of airflow more than 30 episodes per night
snoring obesity daytime sleepiness and tiredness depression and mood changes hypoxemia, pulmonary hypertension treatment --> positive nasal airway pressure, weight loss, surgery |
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insomnia
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difficulty falling or staying asleep
affects patient's level of functioning frequent yawning and tiredness during day treatment --> sleep hygine |
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pure D2 antagonists
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typical antipsychotics
chlorpromazine thioridazine haloperidol |
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combineed D2/5HT2 antagonists
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atypical antipsychotics
risperidone clozapine olanzapine quetiapine ziprasidone aripiprazole |
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indications for antispychotics
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psychomotor agitation
schizophrenia psychotic disorders mood disorders sedation Huntington and Tourette |
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adverse effects of antispychotics
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antihistaminic --> sedation
alpha blockade --> hypotension anticholinergic --> dry mouth, blurred vision, urinary hesitancy, tachycardia D2 antagonism --> gynecomastia, galactorrhea, amenorrhea extrapyramidal movement disorders weight gain |
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movement disroders prduced by antipsychotics
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acute dystonia --> muscle spasms; treat with benztropine, diphenhydramine
parkinsonism --> bradykinesia, resting tremor, rigidity akathisia --> motor restlessness; treat with benzodiazepine and lower dose tardive dyskinesia --> choreoatetosis start in tongue or fingers |
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clozapine
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most effective for schizophrenia but 2nd line due to side effects
5% seizures 1% agranulocytosis close monitoring no incidence of movement disroders drooling, sedation, anticholinergic effects, weight gain |
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risperidone
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1st line for schizophrenia
minimal sedation small incidence of acute movement disroder |
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indications of ECT
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major depression non-respondant to antidepressives
risk of immediate suicide major depression in patients who responded well to ECT in the past |
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informed consent components
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information --> risks, benefits, alternatives
voluntariness --> noncoerced competency --> understanding and judgement |
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exceptions to infromed consent
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emergencies --> minutes to hours; if patient is unconscious or cognitively impaired
waiver by patient --> if patient is competent therapeutic priviledge --> information would be harmful to patient |
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involuntary treatment
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psychiatric hospitatlization --> suicidal, homicidal, gravely disabled
grave disability --> inability to provide food, clothing or shelter medication, seclusion, physical restraint --> psychiatric emergencies or court order |
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confidentiality
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implicit in clinician-patient relationship
special protection in HIV status or substance-abuse history inform patient when confidentiality has been breached |
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appropriate breaches of confidentiality
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essential information during emergency
patient request discussion among personnel judicial subpoena state-mandated reporting --> abuse |
