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88 Cards in this Set
- Front
- Back
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anorexia - diagnostic criteria |
*weight less than 85% expected |
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bulimia - diagnostic criteria |
*recurrent binge eating |
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anorexia-pathophysiology
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*genetic ties |
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anorexia - physical signs |
*emaciation |
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anorexia labs |
*GH elevated
*cortisol elevated *gonadotropins decreased *Thyroixine and TSH normal, T3 reduced *hypokalemic alkalosis, decreased CA *increased LFT, fatty deposition *increased cholesterol and carotenemia *parotid hypertrophy and elevated amylase *abnormal dexamethasone suppresssion and glucose tolerance *hypocholeremia *leukpenia |
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eating disorder treatments |
* in AN restore weight in BN restore electrolyte abnormalities
*starvation weight loss psychosis electorlyte abnormalities hypotension or hypothermia *cyproheptadine chlorpromazine, lorazepam, antidepressants decrease binging and purging |
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Epidemiology: most common disorders
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*NIMH catchment area study US - substance use disorder
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Freud and Erikson |
autonomy vs shame and doubt
ages 1-3 shame from elimination or self consciousness, holding and letting go |
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Freud and Erikson
Phallic-oedipal |
initiative vs guilt
age 3-5 guilt over aggressive goals mimicry of adults sibling rivalry, competition and aggression Oedipal conflict resolved with the creation of the superego (internalized parental values and standards but not a contoller of drives) |
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Freud and Erikson |
industry vs inferiority |
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Freud and Erikson
genital |
identity vs role diffusion
age 11-adolescense ego formation, preoccupation with appearance. formation of group identity morality and ethics watershed |
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Erikson
generativity vs stagnation |
age 40-65
not child dependent altrusim and creativity |
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Erikson
integrity vs despair |
over age 65
life has been productive and worthwile despair is fear of death integrity is your place in the life cycle |
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Freud and Erikson
oral |
trust vs mistrust
birth to 1 year |
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Erikson intimacy and isolation
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age 21 to 40
tasks are to love and work friendships and intimacy |
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structural model of the mind
*components |
ego id and superego
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the superego
*consicious or unconsious? *modulates drives? |
largely unconscious
*nope, that belongs to the ego |
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executive organ of the psyche? |
*ego
*spans consiousness *contains logical and abstract thinking (conscious and preconsious)and defenses *controls the reality and pleasure principle (not the id) |
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sublimation
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negative energies are put or diverted into personally and socially acceptable activities.
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denial vs repression |
denial - disavowing
repression - not available |
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Interpretation of Dreams
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expression of unconsious fantatsies or wishes
*latent dream content derives from the id |
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ego ideal
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not the same as the superego
an amalgam of internalized representations prescribes what you should do by making reference to the superego, connected with shame not guilt. |
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topographic theory
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unconsious preconsious and conscious
*presented in 1900 in Interpretation of Dreams *Ego and Id (1923) was the debut of the structual model *Anna Freud - first systematic study of defenses, agents athat act to keep conflcits out of consiousness, the birth of Ego psychology in 1936. |
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mature defenses
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altruism anticipation ascetism humor sublimation suppression
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head balanced
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16 weeks
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visual accomodation
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16 weeks
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sits steadily/leans
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28 weeks
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sits alone
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40 weeks
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creeps
pulls self to stand points |
40 weeks |
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walks with one hand
stand brifely |
52 weeks |
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responds to sounds
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4 weeks
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follows moving object
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16 weeks
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social smile
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16 weeks
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separation anxiety
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40 weeks
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peek a boo
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40 weeks
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feeds self
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40 weeks
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dresses self
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52 weeks
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draws cross
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4 years
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copies square
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5 years
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copies triangle
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6 years
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walks up stairs with one hand held
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18 months
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names self
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2 years
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put on shoes
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3 years
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object constancy
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2 to 5 years (mahler)
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babbles and sounds
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birth to 6 mo
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pat a cake and peek a boo
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7-11 months
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vocabulary at 12-18 months
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150 understood
uses 20 |
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speech intelligble, language to tell stories and ideas
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54 months on
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two words
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12 months
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phrases
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18 months
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one word
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40 weeks
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grasping and manipulation
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16 weeks
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creeping and poking
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40 weeks
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anal sphincter control
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3 years
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first smile, social smile
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1-2 weeks, social smile 4-8 weeks
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visual fixation
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2-4 weeks
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5 stages of grieving |
DABDA: denial anger bargainging depression acceptance
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normal auditory perception |
2 years
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Pick's Disease
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*dementia
*incidence peaks in late 50's most cases younger than 65 *rare with familial tendency *frontal and anterior prominence (spares parietal lobes) *Pick Bodies (silver staining) *early personality changes *frontal lobe syndrome, Kluver Bucy hyperorality speech preserved |
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psychosis |
neurosyphilis |
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visual disturbances |
PML |
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cognitive fluctuation without memory impairment
dementia Parkinsonism VH |
Dementia with Lewy Bodies
avoid EPS |
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chromosomes Apo e4 |
chromosome 19
chromosome 21 |
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early memory loss |
AD
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CJD EEG
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non specific sharp waves and spikes
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diarrhea |
Pellegra (niacin deficiency)
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dementia
necrosis of corpus callosum dysarhtria gait problems |
Marchiafava bignami
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amnestic syndromeof recent memory impairment
bitemporal hemianopia visual agnosisa alexia without agraphia |
bilateral PCA occlusion
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dementia
related to degeneration of dorsomedial thalamic nuclei polyneuropathy nystagmus ataxia confabulation and apathy |
Korsakoff dementia/amnestic syndrome (thiamine B1 deficiency)
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opthalmoplegia
ataxia confusional state |
Wernicke encpehalopathy
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gait apraxia
urinary incontinence dementia |
NPH
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Parkinson tremor
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4-6 hz
pill rolling greater at rest and stress starts unilateral and goes to generalized |
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kiddie epidemiology: child abuse |
neglect most common
15/1000 kids 2-3% |
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BZD without active metabolites
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LOT
lorazepam, oxazepam, temazepam. |
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treatment of hypertensive crisis |
phentolamine IV
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MAO and SSRI together symptoms |
serotonin syndrome (fever diaphoresis confusion myoclonus htn tremor and diarrhea)
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MAO stopping and starting |
wait 2 weeks before normal diet, or using TCA
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TCAs with plasma levels |
nortryptiline desiprmaine and imimpramine
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TCA and SSRI |
keep dose of TCA low
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TCA and MAOI |
start them together |
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Tertiary amines |
amytriptiline
imiparamine doxepin more prominent antilcholinergic side effects |
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cardiac complications of TCA |
long conduction
avoid in 1st degree of RBBB;anyone highter than first degree block should not get TCA |
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Lithium levels
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.9-1.4 for acute mania MEQ/L |
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Lithium kinetics
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no metabolites |
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Lithium side effects
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thirst or polyuria, tremor, diarrhea, weight gain, edema, hypothyroid, |
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Lithium toxicity and adverse events
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dehydration |
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LI contraindications |
renal dz |
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adolescent suicide
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3rd leading cause of death behind MVA and homocide |
