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32 Cards in this Set

  • Front
  • Back
What is necessary for a diagnosis of psychological factors affecting a medical condition?
A) General medical condition is present.

B) Psych or behavioral factors adversely affect the general medical condition.
Drug side effects of atypical antipsychotics : what chronic condition are they implicated in?
Cause glucose intolerance, hyperlipidemia, obesity. (diabetes)
Best established adverse effect of depression on cancer
poorer quality of life.
What is the relationship between depression and Coronary Artery Disease?
Depression is very common in CAD (20%)

Both are risk factors for each other, and depression is related to other CAD risk factors including smoking, sedentary lifestyle, diabetes, and obesity.
takotsubo cardiomyopathy : defn
acute stress cardiomyopathy.

Emotional stress precipitates acute ventricular dysfunction with apical ballooning.

Results in congestive heart failure associated with ECG changes suggestive of an anterior wall myocardial infarction.
What are psychoneuroendocrine effects on diabetes?
psychological stress leads to increased counterregulatory response (cortisol, epinephrine, etc) leading to relative insulin resistance.
T/F All antipsychotics cause weight gain
T
What is the relationship between thyroid function and depression?
Depression leads to increase T4, no change in T3 and rT3, and blunted TSH response to TRH.
What is the effect of lithium on thyroid function?
lithium causes hypothyroidism.
T/F Psychological distress is an independent risk factor for onset and recurrence of peptic ulcer disease
T
What is the mechanism of psychological distress increasing peptic ulcer disease incidence?
Risk behaviors: smoking, alcohol, sleep disorder, poor diet, overuse of NSAIDs

Pathophysiological effects: changes in blood flow and secretion, impairments in mucosal defenses and healing.
T/F Depression is an independent risk factor for stroke
T
What are Psychological Factors affecting Rheumatoid Arthritis?
Psych factors account for ½ the disability including more pain, poorer quality of life, less compliance, more joint surgery, etc.

Psychotherapy improves physical and psychological outcomes in RA.
process whereby a psychological phenomeno (distress, conflict, etc) is expressed as a physical symptom
somatization.
What disease:

Vague symptoms, dramatic and exaggerated. Concurrent interperson dysfunction present. Substance abuse, depression, anxiety, personality disorder common. Addicted to sick role.
Somatization disorder
what is the best management of somatization disorder patients?
A) Have one MD become main physician

B) Dont promise cure or scold patient

C) Regularly schedule brief outpatient visits

D) Partial physical exam directed towards symptoms

E) Avoid tests and procedures unless indicated by signs, not symptoms.
Somatic symptom or deficit, arising unconsciously out of psychological conflict, need, or trauma. Most often neurologic symptoms - paralysis, weakness, seizures, anesthesia, aphonia, etc. Often coexists with organic illness.
Conversion Disorder (CD)
la belle indifference: defn
blase approach to the symptom
What does the diagnosis of conversion disorder rest on?
neurological examination.

MUST demonstrate either internal inconsistency or incompatibiltiy with disease.
Hoover's sign: defn
hip extension weakness that returns to normal with contralateral hip flexion against resistance.

You will feel the patient extend the hip when the contralateral hip is flexed.
gratifying responses from the environment
secondary gain
At what age is hypochondriasis most common?
mid-later life.
intentional, devious production or feighning of medical illness
factitious disorder (aka munchausens)
How to differentiate somatization disorder from hypochondriasis
somatization d/o: many symptoms all over body; chronic,recurrent

hypochondriasis: obsessive fear of disease, transient to usually chronic.
In which somatoform disorders is the motivation conscious?
Factitious disorder

Malingering
Which somatoform disorder most likely manifests with neurological symptoms?
conversion disorder.
T/F Immigrants tend to have better health than native born population, even when lower in SES
T
Which group is most likely to receive substance abuse treatment?
low-income people. This is because of connection between substance abuse tx and public assistance services in many localities.
What %age of federally designated mental health professional shortage areas are rural?
85%
minority patients are more likely to be given (milder, more severe) mental health diagnoses.
more severe
acculturation: defn
socialization process by which minority groups gradually learn and adopt selective elements of the dominant culture.

It is the extent that one can "fit in."

Particularly useful in assessing adjustment of immigrant population to the mainstream culture.
assimilation: defn
integration of a person or group of people into a larger group so that the original differences are minimized or eliminated.