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25 Cards in this Set
- Front
- Back
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Describe the multiaxial classification scheme
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Axis I: All dx of mental illness except Axis II
Axis II: MR or personality disorders Axis III: medical conditions Axis IV: stressors Axis V: global assessment of function |
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What is the difference between "Ideas of Reference" and "Thought broadcasting"?
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I of R: messages being sent TO YOU
Thought broadcasting: Messages being sent FROM YOU |
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What are the types of hallucinations and when are they most often experienced?
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Auditory - mc in schizophrenia
Visual - mc in drug OD Olfactory - associated with epilepsy Tactile - mc in drug abuse or EtOH w/d |
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What pathways are believed to be affected in the pathophysiology of schizophrenia?
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Dopamine pathways
Prefrontal cortical: negative sx Mesolimbic - positive sx |
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What pathways are affected by anti-psychotic/neuroleptic medications and what adverse effects do they result in?
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Dopamine pathways
Tuberoinfundibular: cause hyperprolactinemia Nigrostriatal: extrapyramidal side effects |
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What other neurotransmitter abnormalities have been implicated in schizophrenia?
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Increased serotonin (atypicals antagonize 5Ht also)
Increased NE Decreased GABA (loss of GABAergic neurons may allow increased activity of DA pathways) |
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What do I expect to see on CT of patient with schizophrenia?
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enlargement ofventricles and diffuse cortical atrophy
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What is the difference between sschizophrenia and schizophreniform?
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Schizophrenia - > 6 months
Schizophreniform - 1-6 months |
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What is the prognosis for pt with schizophrenia? schizophreniform?
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Schizophrenia - 20-30% fxn in society with meds
Schizophreniform - 1/3 recover competely, 2/3 --> schizophrenia or schizoaffective |
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What is schizoaffective disorder?
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schizophrenia + mood disorder
- must have delusions or hallucinations for 2 weeks w/o mood sx to distinguish from mood disorder with psychotic sx |
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What is a brief psychotic disorder?
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Pt with schizophrenia symptoms for 1 day to 1 month
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What are the criteria for delusional disorder?
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- nonbizarre fixed delusion for at least 1 month
- does not meet criteria for schizophrenia - functioning not significantly impaired |
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What is the difference between a mood disorder and a mood episode?
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Episodes are distinct periods of time in which some abnormal mood is present
Disorders are defined by their paterns of mood episodes |
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What is the time criteria for diagnosis of major depressive episode?
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5 of SIGECAPS must be present for at least 2 weeks
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What are the differences between mania and hypomania?
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Hypo: lasts at least 4 days, no impairment in social fxn, no psychotic features
Mania: at least 7 days, impaired social fxn, psychotic features |
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What is a mixed episode?
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Lasts at least 1 week
Characteristics of mania and depression alternate and are present everyday |
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What drug should I pre-medicate with before treating pt with ECT?
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atropine, then general anesthesia, thena muscle relaxant
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What is the most common side effect of ECT?
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Retrograde amnesia (resolves in 6 months)
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Which antidepressant med is best to start patient on?
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All anti-depressants are equally effective - only difference is SE profile!
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What are the characteristics of serotonin syndrome? What is the cause?
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autonomic instability, hyperthermia, seizures --> coma, death
caused by using more than one SSRI or SSRI+MAOI |
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What is the difference between Bipolar I and Bipolar II?
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BPD I: Only 1 manic (or mixed) epsiode required for diagnosis
BPD II: one hypomanic episode + MDE |
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What is the difference between MDD and dysthymic disorder?
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MDD tends to be episodic while dysthymic disorder is generally persistent.
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What are the criteria for dysthmic disorder?
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chronic, mild depression, most of the time with no discrete episodes for 2 years, 2 of sigecaps, no break from sx for > 2 months
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What is cyclothymic disorder?
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Dysthymic disorder+hypomania
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What is double depression?
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Patients with MDD + dysthymic disorder during residual periods
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