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172 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Autistic Disorder
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80% mentally retarded
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Rett's Disorder
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- onset from 5-48 months
- most commonly ~8 months |
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Charles Bonnet Syndrome
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- elderly
- visual hallucinations - does NOT bother pt |
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Capgras Delusion
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- more common in females
- belief that person closely related to them has been replaced by a double |
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Lewy Body Dementia
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- recurrent visual hallucinations
- Parkinsonism w/dementia |
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Dissociation
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PTSD
Tx: SSRI |
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Anorexia Nervosa
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65% are depressed
Tx: mirtazapine [Remeron] |
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Schizophrenic + chronic suicidal ideation
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Clozapine [Clozaril]
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Bipolar + chronic suicidal ideation
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Lithium [LithoBid]
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Serotonin Syndrome
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Caused by:
- SSRI + MAOI - carbamazepine [Tegretol] + MAOI - meperidine [Demerol] + MAOI |
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Serotonin Syndrome
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At first:
- lethargy - restlessness - confusion - flushing - diaphoresis - tremor - myoclonic jerks |
Progresses to:
- hyperthermia - hypertonicity - rhabdomyolysis - renal failure - convulsions - coma - death Tx: cyproheptadine |
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Catatonic
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First line Rx: benzos
Then: ECT |
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Clozapine [Clozaril]
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- most weight gain of antipsychotics
- hypersalivation - hypotension - seizures - agranulocytosis (get weekly blood draw) |
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Acute PTSD
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< 3 months
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Chronic PTSD
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> 3 months
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Depression Dx-tic criteria in children
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same as in adults
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Lithium SEs
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- flattened/inverted T-waves
- reversible hypothyroidism - hyperCa leading to hyperPT - irreversible decline in kidney function (after extended use) - benign leukocytosis (increase WBC) - decrease cardiac conduction |
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Topiramate [Topomax] SEs
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- kidney stones
- blurred vision - ocular pain - HAs |
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Normal bereavement lasts...
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- 2 months
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Major Depression lasts....
and includes.... |
- 2 weeks (no drugs or illnesses during those 2 wks)
- helpless - hopeless - suicidal |
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Assessment of suicidality includes...that are associated with LESS risk of actual suicide...
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- asking about previous suicide attempts
- stable relationships - no access to gun/weapons - futuristic comments - spiritual - employment - being "connected" - absence of command hallucinations |
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Mania lasts...
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- 7 days
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Hypomania lasts...
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- 4 days
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Leaden paralysis...
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- atypical depression
Rx: MAOIs |
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Lead pipe muscles...
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- Neuroleptic Malignant Syndrome seen as a SE of antipsychotics (esp. atypical)
- Rx: dantrolene / bromocriptine / amantadine |
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BP - Type 1
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Prevalence = 1%
Women = Men |
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BP - Type 2
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Prevalence = 0.5%
Women > Men |
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Acute Stress DIsorder
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- Sxs last < 1 month
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Dysthymia
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- depressed for at least 2 yrs
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Panic Attacks
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- last less than 1 hour
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Phobias
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- MC mental disorder
THEN: 2. substance-induced disorders 3. major depression 4. OCD |
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OCD
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Women = Men
Rx: clomipramine (TCA) fluvoxamine (SSRI) |
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GAD
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- at least 6 months
- excessive anxiety |
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Schizophrenia
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Prevalence = 1%
Women = Men |
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Conversion
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- NOT intentional
- Women > Men - usually preceded by a psychological stressor - pt is usually NOT worried by Sxs |
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Somatization Disorder
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- before age 30
- women > men - Sxs: 4 pain, 2 GI, 1 sexual, 1 pseudoneurological |
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Schizophrenia Diagnosis
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- greater than 6 months
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Brief Psychotic Disorder
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- at least 1 day
- less than 1 month |
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Schizophreniform
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- 1 month - 6 months
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Schizotypal Personality Disorder
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- magical belief
- NO hallucinations |
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Schizoid Personality Disorder
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- aloof
- cold - no friends, nor any desire to have any - men > women |
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Cluster A
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- paranoid
- schizoid - schizotypal |
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Cluster B
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- antisocial
- borderline - histrionic - narcissistic |
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Cluster C
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- OC
- dependent - avoidant |
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Social Phobia
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- Tx with SSRIs
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Specific Phobia
- performance phobia |
- Tx with Beta Blocker: eg. propranolol
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Ziprasidone [Geodon]
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- QT prolongation
*but Thioridazone [Mellaril] - a low potency typical antipsychotic - causes the longest QT prolongation |
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Thioridazone [Mellaril]
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- longest QT prolongation
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Aripiprazole [Abilify]
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- less weight gain
- less sedation therefore can give total dose in the AM |
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Hemodialysis
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- at lithium values > 2.0
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Akathisia
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- most common EPSE
- Tx with propranolol |
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Sleep Terror
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- men > women
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Body Dysmorphic Disorder
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- imagined defect in appearance
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Hair Loss (alopecia)
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- Depakote [Valproic Acid]
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Stranger Anxiety
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- at age 8 months
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Separation Anxiety
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- at age 18 months
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Buproprion
[WellButrin] [Zyban] |
- no sexual SEs
- do not give if having seizures or eating disorders (particularly bulimics) |
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Priapism
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Trazodone
- also causes orthostatic hypotension |
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SSRI
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SEs:
- anorgasmia - GI side-effects (MC = nausea) |
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Shared Psychotic Disorder
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- MC = couple relationships
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Acamprosate
[Campral] |
- metabolized in kidney
- decreases alcohol cravings - decreases glutamate |
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Naltrexone
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- metabolized in liver
- no opiates in past 7-10 days - used for EtOH/Opiate dependence |
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Early Stage Dementia
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- Dx with neuropsych testing
- r/o depression |
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Suicidal behavior
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SE of Interferon-alpha
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Amygdala
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- emotional coding
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Deconoate Switch
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- continue p.o. Rx for 3 months to reach steady state
- then give deconoate shot every 2-4 weeks |
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Increased diastolic BP
- HTN |
Venlafaxine [Effexor]
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Lamotrigine
[Lamictal] |
- Depakote (valproic acid) inhibits metabolism of lamotrigine therefore increasing levels of lamotrigine
- Lamotrigine increases metabolism of Depakote therefore decreasing levels of Depakote |
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Lamotrigine
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SE: SJR
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Cocaine-induced euphoria
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- caused by interaction at dopamine receptors
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Myocardial Infarction pts
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- give SSRI (Paxil / Celexa)
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Schizoaffective Disorder
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- hallucinations
- persistent delusion + mood Sxs |
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SIADH leading to Hyponatremia caused by...
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Carbamazepine [Tegretol]
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Thalamus
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- disrupted in OCD
- connecting cortex and striatum |
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Delirium
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- change in level of consciousness
- do NOT give benzos / Haldol |
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Kluver-Bucy Syndrome
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- bilateral temporal lobes
- sexual indiscretion - hypermetamorphosis (= irresistible impulse to notice and reactive to everything within sight) |
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Marchiafava-Bignami disorder
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- usually in alcoholic men
- impaired consciousness ataxia - dysarthria - demyelination of corpus callosum (middle 2/3rd's CC necrosis) |
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Ganser's Syndrome
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- seen mostly in prisoners
- approximate answers (eg. horse has 5 legs) |
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Couvade Syndrome
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- husband develops Sxs of pregnancy when wife is pregnant
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Cotard's Syndrome
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- usually in elderly
- depressed + nihilistic (= everything's bad) + hypochondriascal (= delusional belief that they and the world around them are dead) |
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ECT Death
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1:10,000
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ECT
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- do NOT give with benzos and lithium
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ECT
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- high risk with brain tumor and recent MI (wait 3 months after MI)
- check for papilledema |
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ECT
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- response improves with age
- less of a response if under age 30 |
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NMS
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- SE of antipsychotics
- Tx with: *dantrolene *bromocriptine *amantadine |
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Agranulocytosis
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- clozapine [Clozaril]
- carbamazepine [Tegretol] - (mirtazapine) |
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Hypothyroidism
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Lithium
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Somatoform Disorders
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- women > men
- before age 30 - worry about Sxs |
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Hypochondriasis
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- men = women
- worry about Dz - at least 6 months |
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Conversion
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- women > men
- lasts 1 month - NOT intentional |
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Malingering
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- men > women
- want something - intentional |
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Factitious
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- men > women
- primary gain - not monetary |
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Opiate w/d
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- dilated pupils
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Opiate Use
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- miosis
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Rx Narcotics
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- most abused
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Stimulants
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- increase BP / HR
- increase BS - increase dopamine/euphoria |
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MDMA [Ecstasy]
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- both stimulant + hallucinogenic
- reduces inhibitions - causes anxiety - increases empathy for others |
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Ma haung
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- Chinese variety of ephedra
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Cocaine intoxication
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- like amphetamine/stimulant intoxication
- mydriasis |
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Cross Tolerance
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- benzo
- barbituates - EtOH |
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Locus coeruleus
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- primary source of NE
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Parkinson's
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- if agitated give:
1. Clozaril (clozapine) 2. Seroquel (quetiapine) |
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Mitral valve prolapse
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- associated with panic disorder
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Alcohol
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- GABA agonist
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Prader-Willi Syndrome
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- Chromosome 15
- small stature - obesity - mental retardation |
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Cri-du-chat Syndrome
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- Chromosome 5
- mental retardation |
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PIck's
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- affects frontotemporal part of brain
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Myalgic encephalomyelitis
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- fatigue + cognitive decline
- endocrine + immune dysfunction |
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Gulf War Syndrome
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- depleted uranium
- organophosphates - pyridostigmine bromide - fatigue - loss of muscle control - HAs - immune dysfunction |
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Cholinesterase inhibitors
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- MC SE = nausea
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Mirtazepine
[Remeron] |
- low doses causes sedation
- increases appetite - decreases nausea |
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OCD medications
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- take 12 weeks
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Bipolar depression
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- Lamotrigine
- Lithium |
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Huntington's Dz
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- AD
- CAG repeat - Chromosome 4 |
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Visual hallucinations
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- delirium
- Lewy Body dementia - Charles Bonnet Syndrome |
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Premature ejaculation
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- MC sexual dysfunction
- Tx with paroxetine [Paxil] |
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PTSD
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- highest incidence after sexual assault
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Naloxone
[Narcan] |
- opiate overdose
- can precipiate w/d in opioid dependence |
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Flumazenil
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- for benzo overdose
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Olanzepine
[Zyprexa] |
SEs:
- sedation - weight gain (2nd most) - causes diabetes |
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Kleine-Levin Syndrome
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- in childhood
- excessive sleep - hallucinations |
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Narcolepsy
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- before age 30
- attacks of sleep during the day - sudden loss of muscle tone (cataplexy) |
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Catalepsy
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- in schizophrenia
- voluntarily immobile |
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Kleptomania
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- impulse control disorder
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Basal Ganglia
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- movement
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Temporal lobe
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- seizure
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Frontal lobe
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- judgement
- social behavior |
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Autistic Disorder
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- familial
- mental retardation in 80% |
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Antisocial Personality Disorder
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- 70% among monozygotic twins
- associated with cocaine abusers |
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Carbamazepine
[Tegretol] |
- lowers efficacy of oral contraceptives
- so does St. John's Wort and ginseng |
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Leukocytosis (increases WBC)
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- Lithium
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Leukopenia
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- Carbamazepine [Tegretol]
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Gingko biloba
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- do not give with blood thinners
- decreases efficacy of OCPs |
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Fregoli Delusion
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- identifies a familiar person in various other people
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Autoscopy
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- hallucination of oneself in a near death experience
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Lycanthropy
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- person transformed into an animal
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Ekbom's Syndrome
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- delusions of infestations, usually insects
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Hyperparathyroidism
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- caused by Lithium
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Catatonic mania
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- Tx with ECT
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Geriatric depression
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- Tx with ECT
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Pancreatitis (hemorrhagic)
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- caused by valproic acid [Depakote]
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ADHD
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- associated with prenatal nicotine exposure
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Subdural hematoma
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- confusion
- inattention - apathy - memory loss - HA |
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Adolescent suicide
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- depression
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Antisocial PD
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- cannot be diagnosed in children & adolescents
- must be 18 yo |
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Strongest suicide predictor
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- previous suicide attempts
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Things that decrease lithium levels...
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- NSAIDS
- Thiazides (by 50%) - ACEI - CCBs |
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Hand tremor
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- SE of Lithium
- Tx with propranolol |
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Ebstein's Anomaly
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- first trimester use of Lithium
- tricuspid valve defect |
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Causes hypercalcemia...
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- Lithium
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Depakote associated with...
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- fetal hepatotoxcitiy
- neural tube defects - do NOT give to children - do NOT use during pregnancy |
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Carbamazepine
[Tegretol] |
- do NOT give with MAOI
- cause can cause Serotonin Syndrome b/c of tricyclic component |
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ADHD
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- comorbid with prepubertal bipolar disorder
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Creutzfeldt-Jakob
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- rapidly progressive
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Nicotine
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- reduces auditory halucinations
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Tarasoff
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- duty to protect third party
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Bethanechol
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- used for urinary retention
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Akathisia
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- Tx with propranolol
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Narrow angle glaucoma
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- Tx with anticholinergics
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Mini Mental Status Exam
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- 25-30 = no impairment
- < 25 = mild impairment - < 20 = cognitive impairment |
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Wyatt vs Stickney
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- right to treatment
- not custodial care |
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Risperidone [Risperdal]
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- most TYPICAL of atypicals
- hyperprolactinemia |
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Neurosyphillis
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- personality change
- tremor - dysarthria - hyper-reflexia Rx with PCN G |
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Obsessions
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- intrusive thoughts
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Compulsions
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- ritualized activities
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acne and psoriasis
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Lithium
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alopecia
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Valproic acid
[Depakote] |
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Anticholingeric
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SEs:
- lethargy - blurry vision - mydriasis - urinary retention - tachy |
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Nortriptyline
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- safest of al TCA's
- least likely to cause orthostatic hypotension |
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Molindone [Moban]
- typical antipsychotic that is not used anymore |
- no weight gain
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Night terrors
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- NREM
- screams - flails |
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Epilepsy
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- increased risk of suicide especially if in temporal lobe
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