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25 Cards in this Set

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  • Back
Describe the multiaxial classification scheme
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
What is the difference between "Ideas of Reference" and "Thought broadcasting"?
I of R: messages being sent TO YOU

Thought broadcasting: Messages being sent FROM YOU
What are the types of hallucinations and when are they most often experienced?
Auditory - mc in schizophrenia
Visual - mc in drug OD
Olfactory - associated with epilepsy
Tactile - mc in drug abuse or EtOH w/d
What pathways are believed to be affected in the pathophysiology of schizophrenia?
Dopamine pathways
Prefrontal cortical: negative sx

Mesolimbic - positive sx
What pathways are affected by anti-psychotic/neuroleptic medications and what adverse effects do they result in?
Dopamine pathways
Tuberoinfundibular: cause hyperprolactinemia

Nigrostriatal: extrapyramidal side effects
What other neurotransmitter abnormalities have been implicated in schizophrenia?
Increased serotonin (atypicals antagonize 5Ht also)
Increased NE
Decreased GABA (loss of GABAergic neurons may allow increased activity of DA pathways)
What do I expect to see on CT of patient with schizophrenia?
enlargement ofventricles and diffuse cortical atrophy
What is the difference between sschizophrenia and schizophreniform?
Schizophrenia - > 6 months

Schizophreniform - 1-6 months
What is the prognosis for pt with schizophrenia? schizophreniform?
Schizophrenia - 20-30% fxn in society with meds

Schizophreniform - 1/3 recover competely, 2/3 --> schizophrenia or schizoaffective
What is schizoaffective disorder?
schizophrenia + mood disorder
- must have delusions or hallucinations for 2 weeks w/o mood sx to distinguish from mood disorder with psychotic sx
What is a brief psychotic disorder?
Pt with schizophrenia symptoms for 1 day to 1 month
What are the criteria for delusional disorder?
- nonbizarre fixed delusion for at least 1 month
- does not meet criteria for schizophrenia
- functioning not significantly impaired
What is the difference between a mood disorder and a mood episode?
Episodes are distinct periods of time in which some abnormal mood is present

Disorders are defined by their paterns of mood episodes
What is the time criteria for diagnosis of major depressive episode?
5 of SIGECAPS must be present for at least 2 weeks
What are the differences between mania and hypomania?
Hypo: lasts at least 4 days, no impairment in social fxn, no psychotic features

Mania: at least 7 days, impaired social fxn, psychotic features
What is a mixed episode?
Lasts at least 1 week
Characteristics of mania and depression alternate and are present everyday
What drug should I pre-medicate with before treating pt with ECT?
atropine, then general anesthesia, thena muscle relaxant
What is the most common side effect of ECT?
Retrograde amnesia (resolves in 6 months)
Which antidepressant med is best to start patient on?
All anti-depressants are equally effective - only difference is SE profile!
What are the characteristics of serotonin syndrome? What is the cause?
autonomic instability, hyperthermia, seizures --> coma, death

caused by using more than one SSRI or SSRI+MAOI
What is the difference between Bipolar I and Bipolar II?
BPD I: Only 1 manic (or mixed) epsiode required for diagnosis

BPD II: one hypomanic episode + MDE
What is the difference between MDD and dysthymic disorder?
MDD tends to be episodic while dysthymic disorder is generally persistent.
What are the criteria for dysthmic disorder?
chronic, mild depression, most of the time with no discrete episodes for 2 years, 2 of sigecaps, no break from sx for > 2 months
What is cyclothymic disorder?
Dysthymic disorder+hypomania
What is double depression?
Patients with MDD + dysthymic disorder during residual periods