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299 Cards in this Set
- Front
- Back
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Mnemonic:
DYSTHYMIC DISORDER |
DYSTHYMIC DISORDER "CHASES"
▸poor Concentration or difficulty making decisions ▸feelings of Hopelessness ▸poor Appetite or overeating ▸inSomnia or hyperSomnia ▸low Energy or fatigue ▸low Self-esteem |
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Mnemonic:
DYSTHYMIC DISORDER (DD) |
DYSTHYMIC DISORDER (DD)
"2 Ds" |
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What Dopamine pathway is involved in hyperprolactinemia 2/2 antipsychotics?
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Hyperprolactinemia is cause by decreased Dopamine activity in the TUBEROINFUNDIBULAR PATHWAY.
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What Dopamine pathway is involved in movement disorders such as chorea and tics?
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Increased DA activity in the NIGROSTRIATAL PATHWAY, which extends from the substantia nigra to the basal ganglia, and is involved in the coordination of movement, is thought to be involved in movement disorders.
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What Dopamine pathway accounts for the euphoria accompanying drug use?
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The MESOLIMBIC PATHWAY extends from the ventral tegmental area to the limbic system.
—Increased DA activity in this pathway accounts for the euphoria, as well as delusions and hallucinations experienced by patients with schizophrenia. |
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What Dopamine pathway is involved in the extrapyramidal side effects associated with antipsychotic use, as well as the signs and symptoms of Parkinson's Disease?
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Decreased DA activity in the NIGROSTRIATAL PATHWAY causes extrapyramidal side effects.
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What Dopamine pathway accounts for the therapeutic effects of antipsychotics?
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Decreased DA activity in the MESOLIMBIC PATHWAY accounts for te therapeutic effects of antipsychotics.
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First-line drug in the treatment of Generalized Anxiety Disorder (GAD)
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Buspirone
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DSM Criteria:
Generalized Anxiety Disorder (GAD) |
GAD
★Excessive anxiety about multiple events ★3 or more: —impaired sleep —poor concentration —easy fatigability —irritability —muscle tension —restlessness |
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What type of drug is Dantrolene?
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DANTROLENE
—Direct Muscle Relaxant |
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Pharmacologic Therapy:
Neuroleptic Malignant Syndrome (NMS) |
NMS
—Dantrolene Sodium (Direct Muscle Relaxant) —Amantadine (NMDA Glutamate Receptor Antagonist) —Bromocriptine (DA Agonist) |
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Pharmacologic Therapy:
Antipsychotic-Induced Extrapyramidal Symptoms |
BENZTROPINE
—Anticholinergic |
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Pharmacologic Therapy:
Reverse toxic CNS effects caused by Anticholinergic Drugs |
Physostigmine
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DSM Criteria:
Major Depression |
MAJOR DEPRESSION
—Depressed Mood -or- Anhedonia —5 other SIG E CAPS Symptoms —Symptoms for majority of day, nearly every day, for at least 2 weeks |
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Onset of signs and symptoms of alcohol withdrawal after last drink?
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12-48 hours after last drink
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Onset of Delirium Tremens after last drink?
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2-4 days after last drink
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Diagnosis:
pupillary dilatation, rhinorrhea, muscle and joint aches, abdominal cramping, nausea, and diarrhea |
Heroin Withdrawal
—Symptoms are severe and out of proportion to physical findings |
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Best way to handle patients with Somatization Disorder
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SOMATIZATION D/O
Regularly scheduled appointments intended to reduce the underlying psychological distress. |
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Duration of Delusional Disorder for diagnosis?
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DELUSIONAL D/O
Requires the presence of non-bizarre delusions (involving situations that are logical possibilities) for at least 1 MONTH |
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When must symptoms develop for the diagnosis of Adjustment D/O?
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ADJUSTMENT D/O
—Emotional or behavioral symptoms develop within 3 months of exposure to an identifiable stressor. —Rarely last longer than 6 months after the stressor has ended. —Pt experiences marked distress in excess of what would be expected. |
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Treatment of Choice:
Adjustment D/O |
ADJUSTMENT D/O
—Psychodynamic Psychotherapy -or- —Brief Cognitive Psychotherapy |
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Anxiolytics:
Anxiety Symptoms |
ANXIOLYTICS
—Buspirone —Clonazepam |
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Pharmacologic Treatment:
Acute Dystonia |
ACUTE DYSTONIA
—Antihistamines (Diphenhydramine) —Anticholinergics (Benztropine, Trihexyphenidyl) |
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Pharmacologic Treatment:
Akithisia |
AKATHISIA
—Beta-Blocker (Propranolol) |
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Pharmacologic Treatment:
Parkinson's Disease |
PARKINSON'S DISEASE
—Levodopa |
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Pharmacologic Treatment:
Antipsychotic-Induced Parkinsonism |
ANTIPSYCHOTIC-INDUCED PARKINSONISM
—Benztropine |
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Diagnosis:
Cogwheel rigidity, bradykinesia, shuffling gait, and resting tremor. |
Parkinsonism
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Diagnosis:
Misinterpretation of bodily symptoms that results in intense anxiety about developing a fatal disease. |
Hypochondriasis
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Diagnosis:
Preoccupation with an imagined bodily defect that is so excessive it causes significant functional impairment. |
Body Dysmorphic Disorder
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Diagnosis:
Intentional production of false physical or psychological signs or symptoms in order to assume the sick role. |
FACTITIOUS DISORDER
—Unlike patients with malingering, those with factitious disorder receive no secondary gain. |
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Diagnosis:
Intentional production of false physical symptoms or grossly exaggerated physical or psychological complaints for the purpose of secondary gain. |
MALINGERING
Secondary Gain —financial compensation, avoidance of work, obtaining narcotics. |
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What may occur with abrupt cessation of Alprazolam?
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ALPRAZOLAM
—Short-acting Benzodiazepine —Commonly used for Panic D/O —Severe withdrawal symptoms including generalized tonic-clonic seizures and confusion |
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Panic Disorder is most common in which patient population?
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Women 20-40 yo
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Acute treatment of Panic Disorder?
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PANIC DISORDER
—Benzodiazepines (Alprazolam) for rapid relief of symptoms |
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Long-term treatment of Panic Disorder?
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PANIC DISORDER
—SSRI (Fluoxetine) —Once symptoms are controlled, Benzodiazepines should be tapered off due to risks of dependence. |
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Diagnosis:
Chronic mood disturbance involving repeated hypomanic and mild depressive episodes that do not meet the criteria for mania or major depression. |
CYCLOTHYMIA
—Lasts for at least 2 years |
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Diagnosis:
Chronically depressed mood that is present most of the time for a period of at least 2 years. |
DYSTHYMIC DISORDER
—Symptoms are milder than those of major depression. |
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Pharmacologic Treatment:
Nocturnal Enuresis |
NOCTURNAL ENURESIS
—Desmopressin (ADH Analogue) —Enuresis alarms should be tried first. —Imipramine is a 2nd-line agent |
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DSM Criteria:
Anorexia Nervosa |
ANOREXIA NERVOSA
1) Body weight <85% below normal 2) Amenorrhea for 3 months 3) Body distortion, viewing body as obese when thin 4) Fear of gaining weight or becoming fat despite being underweight |
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2 Subtypes of Anorexia Nervosa
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ANOREXIA NERVOSA
1) Restricting Subtype: fast and or exercise 2) Binge and Purge Subtype: binge eat followed by laxative usage or induced vomiting |
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Fine downy hair seen with Anorexia Nervosa
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Lanugo on the back and abdomen
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Diagnosis:
Pt who does not meet all criteria for Anorexia Nervosa (eg, has regular menses) |
Eating Disorder, NOS
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Diagnosis:
Episodes of binge eating followed by feelings of disgust or guilt, induced vomiting or laxative abuse, in a patient with a normal BMI. |
Bulimia Nervosa
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Diagnosis:
Childhood condition characterized by defiant and hostile behavior. |
OPPOSITIONAL DEFIANT DISORDER
—Symptoms are milder than those seen with conduct disorder. |
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Diagnosis:
Physical symptoms or complaints that have no organic basis. |
Somatization Disorder
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Difference between Anorexia Nervosa and Bulimia Nervosa?
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Anorexia Nervosa is always associated with amenorrhea and a body weight below normal.
Bulimia Nervosa is associated with normal menses and body weight. |
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Duration of maintenance therapy for a single episode of Major Depression following the patient's response.
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Antidepressant should be continued for a period of 6 MONTHS.
—If multiple episodes of depression have occurred, maintenance therapy will likely need to be continued for a longer period. |
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Most concerning side effect of Clozapine (Clozaril)?
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CLOZAPINE (CLOZARIL)
—Agranulocytosis |
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Significant adverse effect associated with Olanzapine (Zyprexa)?
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OLANZAPINE (ZYPREXA)
—Weight gain |
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Term:
Socially unacceptable behvior that prevents the individual from coping with reality. |
IMMATURE DEFENSE MECHANISM
—Commonly used by children or adolescents |
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Term:
Immature defense mechanism that substitutes a less disturbing view of the world in place of reality as a means of resolving conflict. |
FANTASY
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Term:
Refusal to accept a disturbing aspect of external reality because it is too threatening. |
DENIAL
—Immature Defense Mechanism |
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Term:
Mature defense mechanism that involves intentionally postponing the exploration of anxiety-provoking thoughts by substituting other thoughts. |
SUPPRESSION
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The offering of a rational, logical reason for an upsetting event rather than the real reason.
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RATIONALIZATION
—Neurotic Defense Mechanism |
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Pushing painful or anxiety-provoking thoughts out of awareness and into the unconscious.
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REPRESSION
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Blocking off disturbing thoughts or feelings from consciousness in an attempt to avoid emotional upset.
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DISSOCIATION
—Neurotic Defense Mechanism |
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Allows the individual to behave in a detached manner by separating emotional concerns from intellectual curiosity about an issue that causes anxiety.
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INTELLECTUALIZATION
—Neurotic Defense Mechanism |
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A man who had been sexually abused as a child and had no memory of it until a sibling reminded him years later of the trauma.
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Repression
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A patient who was rescued from a burning building and now denies any memory of the event.
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Dissociation
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A patient diagnosed with a terminal illness who refuses to accept that he will likely die soon.
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Denial
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A recently laid off woman who then starts researching the political causes of the country's recent economic downturn.
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Intellectualization
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Criteria for Diagnosis:
Selective Mutism |
SELECTIVE MUTISM
—Symptoms present for at least 1 month —Cause significant functional impairment —Not caused by another communication or learning disorder |
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Criteria for Diagnosis:
Separation Anxiety Disorder |
SEPARATION ANXIETY DISORDER
3 or more must be persistently present: —Excessive distress when separated from home —Excessive worry about losing major attachment figures —Refusal to go to school or other locations because of fear of separation —Nightmares about separation from attachment figure —Physical Complaints (headache, nausea, abdominal pain when separation from an attachment figure is anticipated) |
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Stranger Anxiety is a normal finding until what age?
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Age 3. After that, a persistent fear of strangers is generally attributable to other causes.
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Children who are verbal and talkative at home, but refuse to speak in select settings (eg, school, public events).
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Selective Mutism
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What is necessary to make the diagnosis of schizoaffective disorder vs. major depression with psychotic features?
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SCHIZOAFFECTIVE D/O
—At least 2 weeks when psychotic symptoms are present without any mood symptoms. |
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Sudden and unexpected travel, inability to remember the past and confusion about personal identity.
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Dissociateve Fugue
[fyoog] |
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The presence of two or more distinct identities that alternatively assume control of the person's behavior.
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Dissociative Identity Disorder
—formerly known as, Multiple Personality Disorder —Amnesia regarding important personal information about some of the identities is observed. |
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One or more episodes of inability to recall important personal information.
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DISSOCIATIVE AMNESIA
—usually related to a traumatic or stressful event and is too extensive to be considered ordinary forgetfulness. |
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Persistent or recurrent feelings of detachment from one's own physical or mental processes in the context of an intact sense of reality.
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Depersonalization Disorder
—feel they are observing their body and thoughts from afar, as if they are living in a dream —results in significant occupational or functional impairment |
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The state of experiencing familiar persons and surroundings as if they were strange or unreal.
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Derealization Disorder
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Individuals with this condition tend to be clingy and submissive, and crave the protection and care of others.
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Dependent Personality Disorder
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Inability to express emotion and social detachment. These patients do not enjoy close relationships and prefer to be aloof and isolated.
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Schizoid Personality Disorder
—Rarely indulge in any pleasurable activities and appear indifferent to praise or criticism from others. |
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Characterized by a pattern of odd and eccentric behavior and a reduced capacity for close relationships.
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Schizotypal Personality Disorder
—Usually exhibit "magical thinking" —May have bizarre fantasies or believe in telepathy, clairvoyance, or the concept of a sixth sense —Often have paranoid ideation and unusual perceptual experiences |
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Tend to have an exaggerated sense of self-importance, behaving arrogantly and craving constant admiration.
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Narcissistic Personality Disorder
—may be preoccupied with thoughts of unlimited power and success —lack of empathy and willingness to exploit others is commonly seen |
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Characterized by hypersensitivity to criticism, social inhibition, and feelings of inadequacy.
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Avoidant Personality Disorder
—although they want friendships, they avoid such intimate relationships because they fear ridicule —perceive themselves as inferior to others and are reluctant to engage in new activities or take risks for fear of being embarrassed —appear shy |
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Child fails to develop normal interactions with others and has impaired verbal and nonverbal communication.
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Autism
—presents early in childhood, becoming evident before age 3 —children often indulge in repetitive, stereotyped behavior and may babble and use strange words —they avoid eye contact and have restricted interests |
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Characterized by the presence of both motor and verbal tics.
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Tourette's Disorder
—tics frequently occur throughout the day, often in bouts —vocal tics my be obscene (coprolalia) |
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First-line therapy for Psychotic Disorders
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ATYPICAL ANTIPSYCHOTICS
—eg, Risperdone |
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Characterized by a period of normal development for at least 2 years, followed by a loss of previously acquired skills in at least 2 areas (expressive or receptive language; social skills; bowel or bladder control; play and motor skills)
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Childhood Disintegrative Disorder
—more common in males —prognosis is poor with most children severely disabled for life |
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Initial period of normal development until 6 months of age, followed by the loss of hand coordination and the development of peculiar stereotyped hand movements.
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Rett Syndrome
—rare pervasive developmental disorder occurring almost exclusively in girls —other common features: deceleration of head growth, poor coordination, seizures, ataxia, mental retardation, and diminished social interactions |
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Children with this disorder are disobedient, irritable, spiteful and argumentative and often blame others for their failings.
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Oppositional Defiant Disorder
—pattern of defiant, hostile behavior |
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ADHD presents before what age?
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ADHD
—presents before age 7 —characterized by inattention, impulsiveness, over-activity, forgetfulness, poor organization, and short attention span |
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Absolute contraindication for Buproprion (Wellbutrin)
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Epilepsy (h/o Seizures)
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Treatment for Benzodiazepine Intoxication
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BENZODIAZEPINE INTOXICATION
—Flumazenil |
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Therapy in which a patient is asked to identify specific behaviors that compromise one's function, then works with the therapist to alter certain target behaviors.
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Cognitive Behavioral Therapy (CBT)
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Antipsychotic for refractory illness (first-line treatments have not worked).
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Clozapine (Clozaril)
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What are the benefits and disadvantages of Atypical Antipsychotics compared to Typical Antipsychotics?
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ATYPICAL ANTIPSYCHOTICS
—Lower risk of EPS side effects —Increased risk of weight gain, hyperglycemia, dyslipidemia, diabetes, and hypertension |
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Time of Last Drink:
Mild Withdrawal |
MILD WITHDRAWAL
—6 hours after last drink —anxiety, tremulous, sweating, palpitations |
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Time of Last Drink:
Withdrawal Seizures |
WITHDRAWAL SEIZURES
—12-48 hours after last drink —single seizure or multiple in small period of time |
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Time of Last Drink:
Alcoholic Hallucinosis |
ALCOHOLIC HALLUCINOSIS
—12-24 hours after last drink —auditory, visual, tactile hallucinations with normal vital signs and intact sensorium |
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Time of Last Drink:
Delirium Tremens (DT) |
DELIRIUM TREMENS (DT)
—48-96 hours after last drink —fever, hypertension, tachycardia, diaphoresis, hallucinations, disorientation |
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What Alcohol Withdrawal Syndrome is characterized by disorientation vs. an intact sensorium?
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DELIRIUM TREMENS (DT)
—48-96 hours after last drink —fever, hypertension, tachycardia, diaphoresis, hallucinations, disorientation |
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Patient with intoxication presents with impulsiveness, marked agitation, impaired judgment, psychosis, paranoia hallucinations, or assaultive behavior.
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Phencyclidine (PCP) Intoxication
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Presence of hallucinations, delusions, disorganized speech, or grossly disorganized behavior for at least one day (but less than one month).
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Brief Psychotic Episode
—diagnosis should not be made if drug or alcohol abuse is likely responsible for bizarre behavior |
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Minimum time frame for diagnosis of PTSD?
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PTSD
—Symptoms last for a minimum of 1 month and may persist for many years —a/w recurrent intrusive thoughts, nightmares, and flashbacks about a traumatic event |
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DSM Criteria:
Panic Disorder |
PANIC DISORDER
1) At least 3 attacks in a 3 week period 2) No clear circumscribed stimulus 3) Abrupt onset of symptoms which peak within 10 minutes |
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4 Problems commonly a/w Panic Disorder
Most common? |
PANIC DISORDER A/W
—Depression (MC) —Agoraphobia —GAD —Substance Abuse |
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Though processes provide unnecessarily detailed answers that deviate from the topic of conversation but remain vaguely related.
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Circumstantial
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Loosely associated thoughts that rapidly move from topic to topic.
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Flight of Ideas
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Thought process in which there is an abrupt, permanent deviation from the current subject. This new thought process is minimally relevant at best and never returns to the original subject.
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Tangentiality
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Lack of logical connection between the thoughts or ideas of an individual.
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Loose Associations
—tends to be a more severe form of tangentiality in which one statement follows another but there is no clear association between the sentences. |
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Repetition of words or ideas during a conversation.
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Perseveration
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Non-bizarre (ie, can occur in real life) false beliefs in an otherwise high-functioning individual.
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Delusional Disorder
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False belief that a person of higher social status is in love with them, such as a movie star.
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Erotomanic Delusion
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False belief that someone is out to harm them or someone close to them.
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Persecutory Delusion
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False belief that their spouse is cheating when the evidence shows that they have remained faithful.
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Jealous Delusion
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Individuals with this disorder often show a pattern of instability in relationships and can be impulsive and/or reckless.
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Borderline Personality Disorder
—identity disturbance, recurrent suicidal or self-mutilating behavior,and feelings of emptiness. |
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Identity disturbance, recurrent suicidal or self-mutilating behavior,and feelings of emptiness.
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Borderline Personality Disorder
—pattern of instability in relationships and can be impulsive and/or reckless |
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Criteria for Diagnosis:
Conduct Disorder |
CONDUCT DISORDER
Requires at least 3 symptoms: —aggression towards people or animals —destruction of property —deceitfulness or theft —serious violation of rules |
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Demonstrate excessively labile emotions and attention-seeking behavior.
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Histrionic Personality Disorder
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Exaggerated sense of self-importance, demonstrate arrogant behavior, and lack empathy for others.
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Narcissistic Personality Disorder
—usually do not break the law and are not violent towards others |
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Patient aged 18 years or older who engage in illegal activities (eg, theft or assault) and disregard the rights of others.
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Antisocial Personality Disorder
—often display evidence of conduct disorder as minors |
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Significant side effect of Tricyclic Antidepressants in the elderly.
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Orthostatic Hypotension
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First-line therapy for patients with severe suicidality and psychosis.
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Electroconvulsive Therapy (ECT)
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Treatment for a bereaved patients who have at least 2 weeks of symptoms of depression 6-8 weeks after a major loss.
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Complicated Grief/Extended Bereavement Reactions
—Psychotherapy —Trial of Antidepressants |
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Side effects of antipsychotic-induced dopamine blockade.
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DOPAMINE BLOCKADE
—DA is a prolactin-inhibiting factor —Hyperprolactinemia, Gynecomastia, Galactorrhea, Menstrual Dysfunction, decreased Libido. |
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Bilateral tenderness and palpable lumps during the luteal phase of the menstrual cycle.
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Fibrocystic Disease of the Breast
—galactorrhea is NOT a common finding |
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How can hyperprolactinemia 2/2 antipsychotic medications be distinguished from a prolactinoma.
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Prolactinomas tend to produce very high levels of prolactin (>200ng/mL).
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Term:
Difficulty in recognizing objects. |
AGNOSIA
—Difficulty in recognizing objects. |
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Term:
Difficulty carrying out activities. |
APRAXIA
—Difficulty carrying out activities. |
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What is "executive functioning"?
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EXECUTIVE FUNCTIONING
—Organizing —Planning —Abstraction |
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Progressive cognitive decline that presents with memory impairment.
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ALZHEIMER'S DEMENTIA
Plus one or more of the following: —Apraxia —Aphasia —Agnosia —Disturbed Executive Functioning |
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How does Multi-Infarct Dementia present differently from Alzheimer's Dementia?
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Multi-Infarct Dementia tends to present acutely as a stepwise deterioration.
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Classic Triad:
—Incontinence —Dementia —Ataxia |
NORMAL PRESSURE HYDROCEPHALUS
—"Wet, Wacky, Wobbly" |
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Can present similar to Alzheimer's, but behavioral and personality changes are more common, with many patients becoming ether more apathetic or disinhibited.
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PICK'S DISEASE
—Atrophy of the frontal lobes and temporal lobes (Frontotemporal Dementia) |
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Atrophy of the frontal lobes and temporal lobes (Frontotemporal Dementia).
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PICK'S DISEASE
—Atrophy of the frontal lobes and temporal lobes (Frontotemporal Dementia) —Similar to Alzheimer's, but with behavioral and personality changes |
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Apparent memory loss seen in the depressed elderly.
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Pseudodementia
—memory loss a/w this condition reverses with treatment of the depression. |
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Elderly patient with gradually progressive memory loss and one or more of the following: apraxia, aphasia, agnosia, or disturbed executive functioning.
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Alzheimer's Disease
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2 Atypical Antipsychotics with greatest risk of weight gain
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—Clozapine (Clozaril)
—Olanzapine (Zyprexa) |
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Before starting Atypical Antipsychotics, the American Psychiatric Association recommends baseline assessment of ____.
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Baseline Assessment:
—Weight —Fasting Plasma Glucose —Blood Pressure —Fasting Lipid Profile Should be reassessed in 12 weeks |
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Labs required for patients started on Clozapine (Clozaril)
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Weekly complete blood counts (CBC) for the first 6 months of treatment due to risk of agranulocytosis.
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Labs required for patients started on Lithium
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—Baseline kidney function due to risk of nephrogenic diabetes insipidus
—Routine monitoring of thyroid function due to risk of hypothyroidism |
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Lab that should be performed for patients starting on the atypical antipsychotic Ziprasidone (Geodon)
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ECG due to its potential for causing QT prolongation
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What are the time limitations in the diagnosis of Dysthymic Disorder?
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DYSTHYMIC DISORDER
—Depressed mood occurring most days, lasting the majority of the day for at least 2 YEARS —During the 2 year period, (1 year for children/adolescents), the person has not been symptom free for more than 2 months at a time. |
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Time requirement for the diagnosis of Primary Insomnia
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PRIMARY INSOMNIA
—At least 1 month —isolated symptom of difficulty in falling or staying alseep —patients become worried about getting enough sleep, growing more and more frustrated |
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What does the DSM-IV criteria for many psychiatric conditions require in terms of severity of symptoms?
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The DSM-IV criteria for many psychiatric conditions require that symptoms be severe enough to cause significant functional impairment for a specified duration of time.
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Time requirement for the diagnosis of Hypochondriasis
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HYPOCHONDRIASIS
—At least 6 months —Concerns persist in spite of appropriate medical evaluations —Cause marked impairment |
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Fear of disease and preoccupation with the body that manifests itself through multiple somatic complaints.
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HYPOCHONDRIASIS
—Last at least 6 months —Concerns persist in spite of appropriate medical evaluations —Cause marked impairment |
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Development of unexplained serious neurological symptoms preceded by an obvious emotional trigger (eg, tragic event or argument)
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CONVERSION DISORDER
—symptoms are not artificially produced, are unexplained by any medical condition, and can be severe enough to cause social and functional impairment. |
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Low back pain, sciatica, saddle sensory disturbances, bladder and bowel dysfunction, and motor and sensory loss of the lower extremities.
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Cauda Equina Syndrome
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Patients with this disorder tend to be unable to make decisions without help and crave protection and guidance from others.
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DEPENDENT PERSONALITY DISORDER
—They are devastated by separation and loss and will go to great lengths to stay in a dependent relationship. |
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Preferred drug to treat Acute Mania
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ACUTE MANIA
—Antipsychotics such as Haloperidol |
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First-line Agents for Long-term Management of Bipolar Disorder
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BIPOLAR DISORDER
—Lithium —Lamotrigine (Lamictal) —Olanzapine (Zyprexa) —Quetiapine (Seroquel) |
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Time requirement for diagnosis of Hypomania
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HYPOMANIA
—symptoms for 4 days or less |
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Second-line Agents for Long-term Management of Bipolar Disorder
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BIPOLAR DISORDER
—Valproic Acid (Divalproex, Depakote) —Aripiprazole (Abilify) |
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What signs and symptoms are indications that psychiatric hospitalization is necessary?
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PSYCHIATRIC HOSPITALIZATION
—Homicidal Ideation (HI) —Suicidal Ideation (SI) —Grave Disability —Gross Disorganization —Agitated or Threatening Behavior —Severe symptoms of Substance Intoxication or Withdrawal |
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Changes in Brain CTs of Schizophrenic patients
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SCHIZOPHRENIA
—Enlarged Ventricles —Prominent Sulci —Decreased Cerebral & Hippocampal Mass |
|
|
Indications for Electroconvulsive Therapy (ECT)
|
ECT
1) Severe Refractory Depression 2) Depression in Pregnancy 3) Refractory Mania 4) Neuroleptic Malignant Syndrome 5) Catatonic Schizophrenia |
|
|
Side Effects of ECT
|
SIDE EFFECTS OF ECT
—Anterograde/Retrograde Amnesia —Prolonged Seizures —Delirium —Headache —Nausea —Skin Burns |
|
|
Immature defense mechanism in which an individual expresses his aggression toward another person with repeated, passive failures to meet the other person's needs.
|
Passive-Aggressive Behavior
|
|
|
The altered perception of disturbing aspects of external reality in an effort to make it more acceptable.
|
DISTORTION
The altered perception of disturbing aspects of external reality in an effort to make it more acceptable. |
|
|
An intravenous drug abuser who contracts hepatitis C and blames his condition on inadequate control of hepatitis C within the community.
|
DISTORTION
The altered perception of disturbing aspects of external reality in an effort to make it more acceptable. |
|
|
The shifting of emotions associated with an upsetting object or person to a safer alternate object or person that represents the original in some regard.
|
DISPLACEMENT
—Neurotic Defense Mechanism |
|
|
A woman who is angry with her husband and throws away his baseball card collection as retaliation.
|
DISPLACEMENT
—Neurotic Defense Mechanism |
|
|
Immature defense mechanism that involves directly expressing an unconscious wish or impulse to avoid addressing the accompanying emotion.
|
ACTING OUT
|
|
|
A child who throws a temper tantrum because he is disappointed that his mother won't take him to the park.
|
ACTING OUT
|
|
|
Immature defense mechanism involving the assimilation of another person's attitude into one's own perspective.
|
INTROJECTION
—Immature Defense Mechanism |
|
|
A battered woman who believes her husband is right when he says she is worthless.
|
INTROJECTION
—Immature Defense Mechanism |
|
|
Intentionally postponing the exploration of anxiety-provoking thoughts by substituting other thoughts.
|
SUPPRESSION
—This allows for the individual to cope with the present reality instead. |
|
|
A woman focuses on her children's needs instead of thinking about her father's diagnosis.
|
SUPPRESSION
—This allows for the individual to cope with the present reality instead. |
|
|
Failure to accept a disturbing aspect of external reality.
|
DENIAL
—Immature Defense Mechanism |
|
|
A patient diagnosed with a terminal illness who refuses to accept that he will likely die soon.
|
DENIAL
—Immature Defense Mechanism |
|
|
Completely blocking off disturbing thoughts or feelings from consciousness in an attempt to avoid emotional upset.
|
DISSOCIATION
—Neurotic Defense Mechanism |
|
|
A patient who was rescued from a burning building and now denies any memory of the event.
|
DISSOCIATION
—Neurotic Defense Mechanism |
|
|
Treatment Regimen for Social Phobia
|
SOCIAL PHOBIA
—Assertiveness Training (a component of CBT) —SSRI (Paroxetine) |
|
|
3 factors leading to a high index of suspicion for Physical/Sexual a
Abuse |
ABUSE
—Patient (especially female) presents with behavioral change —Family has an unstable economic background —Parents have a h/o drug/alcohol abuse |
|
|
DSM-IV Criteria for Manic Episode
|
MANIC EPISODE
—Abnormally and persistently elevated or expansive mood for at least 1 week —At least 3 DIG FAST symptoms |
|
|
Pharmacologic Therapy:
—Depression + Insomnia —Depression + Decreased Appetite |
MIRTAZAPINE (REMERON)
—Tetracyclic Antidepressant (TeCA) —Anxiolytic and Appetite Stimulating Properties |
|
|
How long does it take for Lithium Carbonate to take effect?
|
LITHIUM
—4 to 10 days to produce a beneficial effect |
|
|
Guidelines for Lithium therapy in Bipolar Patients
|
LITHIUM
—Single manic episodes require long-term maintenance for at least 1 year —3 or more relapses require lifelong maintenance therapy |
|
|
Name 4 Reversible Acetylcholinesterase Inhibitors (AChEIs) used in the treatment of Alzheimer's Disease
|
ALZHEIMER'S DISEASE
—Donepezil —Rivastigmine —Galantamine —Tacrine |
|
|
What type of neurons are lost in Alzheimer's Disease
|
Cholinergic Neurons are selectively lost
—Reversible Acetylcholinesterase Inhibitors appear to be effective in slowing the cognitive decline |
|
|
Drug for treating agitation and psychosis in Alzheimer's patients
|
Risperidone (Risperdal)
|
|
|
Drug with mild antiparkinsonian activity and used for temporary, short-term monotherapy early in the course of the disease.
|
AMANTAIDNE
—may improve akinesia, rigidity, and tremor |
|
|
Drug used in conjunction with Atropine for the treatment of Organophosphate Poisoning
|
ORGANOPHOSPHATE POISONING
—Pralidoxime + Atropine |
|
|
Presentation of Cannabis (Marijuana) Intoxication
|
CANNABIS (MARIJUANA) INTOXICATION
—Behavioral Changes (eg, social withdrawal, euphoria, anxiety) —2 or more: conjunctival injection, dry mouth, tachycardia, or increased appetite |
|
|
Triad of Opioid Overdose
|
OPIOID OVERDOSE
1) Respiratory Depression 2) Pinpoint Pupils 3) CNS Depression (leading to coma) —hypotension, hypothermia, tachycardia |
|
|
—Severe abdominal pain
—Peripheral vascular collapse —Renal failure |
Adrenal Crisis
|
|
|
—Poor coordination
—Unsteady gait —Slurred speech —Nystagmus |
Alcohol Intoxication
|
|
|
—Nausea or Vomiting
—Diarrhea —Muscle Spasms —Joint Pain —Abdominal Cramps —Rhinorrhea —Lacrimation —Sweating —Pupillary Dilatation —Autonomic Instability (eg, Hypertension) |
Opioid Withdrawal
|
|
|
Antidepressant + Smoking Cessation
|
Buproprion (Wellbutrin)
|
|
|
DRUG:
—Depression —Diabetic Neuropathy —Migraine Prophylaxis |
Amitriptyline (Elavil)
|
|
|
DRUG:
—Narcolepsy —Experimentally to improve motivation and energy in some patients with psychiatric illness. |
Modafinil (Provigil)
|
|
|
Mature Defense Mechanisms
|
"HI ASS MATURE"
—Humor —Introjection —Altruism —Sublimation —Suppression |
|
|
Neurotic Defense Mechamisms
|
"DDRRRs are NEUROTIC"
—Displacement —Dissociation —Rationalization —Reaction Formation —Repression |
|
|
Immature Defense Mechanisms
|
IMMATURE kid "SAID Pee"
—Somatization —Acting Out —Idealization —Denial —Projection |
|
|
Defense mechanism in which individuals dedicate themselves to helping others in order to deal with an emotional conflict, internal stressor, or external stressor.
|
ALTRUISM
—Unlike Reaction Formation, individuals do not overcompensate with the opposite reaction of how they actually feel. —Instead, they serve others in a positive manner in order to receive either direct or indirect gratification and reduce their own guilt. |
|
|
A behavior pattern in which a person does the complete opposite of what he/she really feels or desires.
|
REACTION FORMATION
—Usually a short-term neurotic response that eventually breaks down —Person uses excessive behavior to cover up how he/she really feels because the desire might be perceived as unacceptable by others in society. |
|
|
A married woman who is disturbed by her attraction to her husband's friend and treats the friend very rudely to hide her feelings.
|
Reaction Formation
|
|
|
Failure to accept a disturbing aspect of external reality.
|
Denial
|
|
|
Defense mechanism that allows unacceptable or negative impulses to be channeled into more acceptable or positive activities.
|
SUBLIMATION
—Individual does not feel guilty about his/her behavior, but finds a more socially acceptable way to channel it rather than change the actual behavior. |
|
|
A man with a fiery temper who channels his anger into athletic pursuits.
|
Sublimation
|
|
|
Voluntary withholding of unpleasant thoughts or feelings from one's mind and sometimes includes the substitution of other thoughts.
|
SUPPRESSION
—Allows the individual to cope with the present reality. |
|
|
Defense mechanism that involves minimizing internal fears by serving others in a positive manner.
|
Altruism
|
|
|
Definition:
Severe Malnutrition |
SEVERE MALNUTRITION
—Weight <75% of average body weight for age, sex, and height |
|
|
Compulsivity is characteristic of which subtype of Anorexia Nervosa?
|
Restricting Subtype of Anorexia Nervosa
—Compulsitivity |
|
|
Impulsivity is characteristic of which subtype of Anorexia Nervosa?
|
Binge and Purge Subtype of Anorexia Nervosa
—Impulsivity |
|
|
When is hospitalization highly recommended for patients with Anorexia Nervosa?
|
When there is evidence of:
—Medical Complications (eg, electrolyte disturbances, cardiac arrhythmias, physiologic instability) —Weight <75% of the average body weight for their age, sex, and height. |
|
|
Treatment:
Hypochondriasis |
HYPOCHONDRIASIS
—Symptoms usually develop during periods of stress, patients should be asked about their current emotional stressors —Brief Psychotherapy |
|
|
Sleep Pattern Changes in the Elderly
|
SLEEP (ELDERLY)
—Sleep less at night and nap during the day —Stage 4 sleep becomes shorter and eventually disappears —Awaken more often during all stages of sleep |
|
|
Substances not detectable by toxicology screening
|
—Household Inhalants
—Salvia —K2 (Spice) —Bath Salts |
|
|
Differential Diagnosis of Adolescent presenting with Behavioral Change
|
—Substance Use
—Partner Violence —Date Rape —Physical/Sexual Abuse —Pregnancy |
|
|
What type of disorder is Trichotillomania?
|
TRICHOTILLOMANIA
—Impulse-Control Disorder |
|
|
DSM-IV Criteria:
Trichotillomania |
TRICHOTILLOMANIA
1) Repeated episodes of pulling out one's hair resulting in hair loss that is noticeable 2) Experiencing anxiety right before the act of pulling out the hair or when trying to resist the temptation 3) A sense of relief after the hair has been pulled out 4) Behavior causes impairment or distress 5) Features inconsistent with any other medical or dermatological condition causing hair loss |
|
|
What other disorders is Trichotillomania associated with?
|
TRICHOTILLOMANIA
—OCD —Anxiety Disorders —Tourette's —Eating Disorders |
|
|
Difference between Alopecia Areata and Trichotillomania on exam
|
In Alopecia Areata, patches will be devoid of hair.
|
|
|
Side Effects of Methylphenidate (Ritalin, Concerta)
|
METHYLPHENIDATE
—Nervousness —Loss of Appetite —Nausea —Abdominal Pain —Insomnia —Tachycardia |
|
|
3 Monoamine Oxidase Inhibitors (MAOIs)
|
MAO INHIBITORS
1) Phenelzine (Nardil) 2) Tranylcypromine (Parnate) 3) Selegiline (Emsam) [patch] |
|
|
What must patients taking MAOIs avoid in their diet?
Why? |
MAOIs
—Avoid Tyramine (aged meats and cheeses) —Can result in Hypertensive Crisis |
|
|
Suitable alternative for Lithium in patients with impaired renal function
|
—Valproic Acid (Depakote)
—Carbamazepine (Tegretol) |
|
|
Defense mechanism in which emotional conflicts are transformed into physical (often neurological) symptoms
|
Conversion
|
|
|
Man being struck mute after getting fired from his job.
|
Conversion
|
|
|
Defense mechanism in which the individual displaces negative feelings a/w an unacceptable object or situation onto a "safer" object or situation.
|
Displacement
|
|
|
Immature defense mechanism in which individuals classify themselves and others as "all good" or "all bad".
|
Splitting
|
|
|
A woman suffering from Borderline Personality Disorder considers her current therapist to be ideal and her former therapist to be loathsome.
|
Splitting
|
|
|
Defense mechanism in which individuals provide a helpful, gratifying service to others as a means of quelling their own anxieties.
|
Altruism
|
|
|
A rape victim who establishes a rape crisis center in her community.
|
Altruism
|
|
|
Best tolerated atypical antipsychotic
|
Olanzapine (Zyprexa)
|
|
|
What long-acting injectable antipsychotics are available in depot form?
|
1) Haloperidol Decanoate (1-2/mo)
2) Fluphenazine Decanoate (2/mo) 3) Risperidone Depot (2/mo) 4) Paliperidone Depot (1/mo) |
|
|
Pharmacologic Treatment:
Daytime Somnolence 2/2 Narcolepsy |
PSYCHOSTIMULANTS
—Modafinil (Provigil) —Methylphenidate (Ritalin, Concerta) |
|
|
Pharmacologic Treatment:
Sleep Disorders |
Benzodiazepines
—Circadian Rhythm Sleep Disorder —Nightmare Disorder —Sleep Terror Disorder —Sleepwalking Disorder |
|
|
Pharmacologic Treatment:
Jet-Lag Subtype of Circadian Rhythm Sleep Disorder |
Melatonin
|
|
|
Diffuse muscle weakness leading to collapse.
|
Cataplexy
|
|
|
Rare disorder characterized by an inability to resist the impulse to steal objects that are either o low monetary value or are not needed for personal use.
|
KLEPTOMANIA
—Individuals periodically develop significant tension that is alleviated by stealing —More prevalent in females and occasionally a/w Bulimia Nervosa |
|
|
Pharmacologic Treatment:
Alcohol Withdrawal |
LONG-ACTING BENZODIAZEPINES
—Diazepam (Valium) —Lorazepam (Ativan) —Chlordiazepoxide (Librium) |
|
|
Drug used for long-term abstinence in alcoholic patients
|
Disulfiram (Antabuse)
|
|
|
Mechanism of action of Benzodiazepines
|
BENZODIAZEPINES
—Stimulate the GABA Receptor to cause Sedation |
|
|
Drug effective in Benzodiazepine-Refractory Alcohol Withdrawal
|
PHENOBARBITAL
—Anticonvulsant —Increases the duration of opening of the GABA chloride channel |
|
|
Pattern of odd and eccentric behavior and a reduced capacity for close relationships.
|
SCHIZOTYPAL PERSONALITY DISORDER
—Patients usually exhibit "magical thinking" —May have bizarre fantasies or believe in telepathy, clairvoyance, or the concept of sixth sense |
|
|
May have bizarre fantasies or believe in telepathy, clairvoyance, or the concept of sixth sense.
|
SCHIZOTYPAL PERSONALITY DISORDER
—Patients usually exhibit "magical thinking" —They have paranoid ideation and unusual perceptual experiences |
|
|
Hypersensitivity to criticism, social inhibition, and feelings of inadequacy.
|
AVOIDANT PERSONALITY DISORDER
—Although these individuals want friendships, they avoid such intimate relationships because they fear ridicule. |
|
|
Perceive themselves as inferior and are reluctant to engage in new activities or to take risks for fear of being embarrassed.
|
AVOIDANT PERSONALITY DISORDER
—Although these individuals want friendships, they avoid such intimate relationships because they fear ridicule. |
|
|
Indecisive and avoid taking the initiative because of feelings of inadequacy.
|
AVOIDANT PERSONALITY DISORDER
—Although these individuals want friendships, they avoid such intimate relationships because they fear ridicule. |
|
|
Have difficulty expressing disagreement with others for fear of losing support, and they dread being left alone to fend for themselves.
|
AVOIDANT PERSONALITY DISORDER
—Although these individuals want friendships, they avoid such intimate relationships because they fear ridicule. |
|
|
Social detachment and an inability to express emotion.
|
SCHIZOID PERSONALITY DISORDER
—Do not enjoy close relationships and prefer to be aloof and isolated —Rarely indulge in any pleasurable activities and appear indifferent to praise or criticism |
|
|
Pharmacologic Treatment:
—Seasonal Affective Disorder —Chronic Fatigue Syndrome —ADHD —Narcolepsy —Neuropathic Pain —Periodic Limb Movement Disorder |
Buproprion (Wellbutrin)
|
|
|
Conditions that predispose to seizures and would be contraindications to Buproprion
|
—Concurrent alcohol or benzodiazepine use
—Eating Disorders |
|
|
These patients do not enjoy close relationships with others and prefer to be aloof and isolated.
|
SCHIZOID PERSONALITY DISORDER
—Able to recognize reality and do not demonstrate bizarre cognition or psychosis |
|
|
Pharmacologic Treatment:
Tourette Syndrome |
TOURETTE SYNDROME
Typical Antipsychotics: —Haloperidol (Haldol) —Pimozide (Orap) |
|
|
The altered perception of disturbing aspects of external reality in an effort to make it more acceptable.
|
DISTORTION
|
|
|
An unfaithful husband who accuses his wife of infidelity.
|
PROJECTION
—Attributing of unacceptable internal thoughts or emotions to other individuals. |
|
|
Symptoms of Factitious Disorder that are predominantly physical in nature.
|
Munchausen's Syndrome
|
|
|
Patient presents to a healthcare setting with signs and symptoms that they have deliberately and consciously produced for no obvious reason other than to gain admission to a hospital and adopt the sick role.
|
Munchausen's Syndrome
(Factitious Disorder) —Usually very demanding and typically become highly upset when confronted. —Often leave AMA and go to another hospital |
|
|
Definition:
Unconcerned about the seriousness of the symptoms. |
La Belle Indifference
|
|
|
Antipsychotic with increased risk of developing jaundice.
|
Chlorpromazine (Thorazine)
|
|
|
Antipsychotic a/w Pigmentary Retinopathy
|
THIORIDAZINE (MELLARIL)
—Pigmentary Retinopathy |
|
|
Antipsychotic a/w Cataracts
|
QUETIAPINE (SEROQUEL)
—Cataracts |
|
|
2 Adverse Side Effects of Clozapine (Clozaril)
|
CLOZAPINE (CLOZARIL)
—Agranulocytosis (monitor WBC) —Lowers the Seizure Threshold |
|
|
2 Frequent Comorbid Conditions in Tourette Syndrome Patients
|
TOURETTE SYNDROME
—ADHD (60%) —OCD (27%): develops 3-6 years after the tics first appear |
|
|
Intoxication usually presents with distinct behavioral changes such as physical aggression, severe agitation, impulsivity, impaired judgement, psychosis, paranoia, or hallucinations.
|
PHENCYCLIDINE (PCP) INTOXICATION
—Nystagmus —Hypertension —Tachycardia —Ataxia —Dysarthria —Muscle Rigidity —Seizures —Coma |
|
|
Best approach when a psychotic patient asks if you share or believe in their delusions or hallucinations.
|
Non-committal and non-judgmental stance in which you acknowledge the patient's distress without endorsing specific delusions or hallucinations.
|
|
|
What complication is a fetus most at risk for with Lithium exposure in the first trimester.
|
LITHIUM EXPOSURE IN 1ST TRIMESTER
—Cardiac Malformations (Ebstein's Anomaly) |
|
|
What is Ebstein's Anomaly?
|
EBSTEIN'S ANOMALY
—Malformed and inferiorly attached tricuspid valve that causes atrialization of the right ventricle and a decrease in the size of the functional right ventricle. |
|
|
What psychotropic medication increases the risk of Ebstein's Anomaly twenty-fold with use during the first trimester of pregnancy.
|
LITHIUM EXPOSURE IN 1ST TRIMESTER
—Cardiac Malformations (Ebstein's Anomaly) |
|
|
Psychotropic medications known to cause craniofacial defects, neural tube defects, and genital anomalies in the unborn child.
|
Anticonvulsants (Mood Stabilizers)
—Carbamazepine (Tegretol) —Valproate (Depakote) —NOT Lithium! |
|
|
Lithium exposure in later trimesters is a/w?
|
LITHIUM EXPOSURE IN LATER TRIMESTERS
—Goiter —Transient Neonatal Neuromuscular Dysfunction |
|
|
Which psychiatric disorder has one of the strongest genetic components?
|
BIPOLAR DISORDER
—General Population (1%) —First-Degree Relative (5-10%) —Child with 2 bipolar parents (60%) —Monozygotic Twin (70%) |
|
|
Risk of developing Bipolar Disorder in a child with a first-degree relative who suffers from bipolar disorder (eg, parent, sibling, dizygotic twin)
|
BIPOLAR DISORDER
—General Population (1%) —First-Degree Relative (5-10%) —Child with 2 bipolar parents (60%) —Monozygotic Twin (70%) |
|
|
Pharmacologic Treatment:
Specific Phobia of Public Speaking |
BETA-BLOCKERS
—Propranolol |
|
|
Pharmacologic Treatment:
Performance-Related Anxiety |
BETA-BLOCKERS
—Propranolol |
|
|
Definition:
Frequent derailment or incoherence. |
Disorganized Speech
|
|
|
What medication should be tried first in a patient with OCD?
|
OCD
1st) SSRI (eg, Paroxetine) 2nd) Clomipramine (TCA) —CBT may also also be beneficial |
|
|
Recurrent and persistent aversion to and avoidance of genital sexual contact with a partner.
|
Sexual Aversion Disorder
|
|
|
An inability to attain or maintain the lubrication and swelling response associated with sexual arousal in a female.
|
Female Sexual Arousal Disorder
|
|
|
A persistent deficiency in both sexual fantasy and the desire for sexual activity.
|
Hypoactive Sexual Desire
|
|
|
A persistent delay in or absence of orgasm following a normal sexual excitement phase.
|
Female Orgasmic Disorder
|
|
|
Condition in which an individual with a male genotype has a female phenotype because of an in utero resistance to androgens.
|
Testicular Feminization
—These individuals have a vagina that is shorter than normal. |
|
|
An involuntary spasm of the perineal musculature that interferes with sexual intercourse.
|
Vaginismus
|
|
|
Pharmacologic Treatment:
Specific or Simple Phobias |
SPECIFIC or SIMPLE PHOBIAS
Benzodiazepines —Alprazolam (Xanax) |
|
|
A student who says he failed an exam because it was unfairly written, when the reality is he did not study enough.
|
RATIONALIZATION
—Offering of a rational, logical reason for an upsetting event rather than the true reason. |
|
|
A bank teller who is calm and collected while foiling a robbery attempt.
|
ISOLATION
—Mature Defense Mechanism |
|
|
A woman who unconsciously realizes that her husband is a criminal but resists conscious assembly of the available evidence.
|
RESISTANCE
—The intense opposition to bringing unpleasant thoughts to conscious awareness. |
|
|
Mnemonic for Breaking Bad News
|
"SPIKES"
—Set the Stage: Introduce yourself and your role in the patient's care —Perception: Determine the patient's level of knowledge and vocabulary —Inform: Review the chronology of events with appropriate language to the patient's cultural and educational level —Knowledge: Allow the patient to react and ask questions —Empathy: Show concern for the patient —Summary and Strategy: Make yourself available and review the subsequent plan of care |
|
|
What are the therapeutic effects of Lithium attributed to?
|
Ability to inhibit inositol-1-phosphatase in neurons.
|
|
|
Potential adverse effects associated with Lithium usage.
|
LITHIUM
—Gastrointestinal Distress (nausea, vomiting, diarrhea, abdominal pain) —Nephrotoxicity (resulting in polyuria and polydipsia, ultimately leading to nephrogenic diabetes insipidus) Hypothyroidism —Leukocytosis —Tremors —Acne —Psoriasis Flares —Hair Loss —Edema —Ebstein's Anomaly |
|
|
In which disorders are symptoms INTENTIONALLY produced or feigned?
|
—Factitious Disorder
—Malingering |
|
|
At what age must Somatization Disorder be evident for diagnosis?
|
Before the Age of 30
|
|
|
Common Findings in Anorexic Patients
|
ANOREXIC PATIENTS
1) Osteoporosis 2) Elevated cholesterol and carotene levels 3) Cardiac arrhythmias (prolonged QT interval) 4) Sick Euthyroid Syndrome 5) Hypothalamic-Pituitary Axis dysfunction resulting in anovulation, amenorrhea, estrogen deficiency 6) Hyponatremia 2/2 excess water drinking is often the only electrolyte abnormality, but the presence of other electrolyte abnormalities indicates purging behavior |
|
|
Concern for Anorexic Mothers after delivery
|
Postpartum Depression
—NOT Psychosis |
|
|
Risk for pregnant women with a current or previous diagnosis of anorexia nervosa.
|
ANOREXIA NERVOSA
—Miscarriage —Intrauterine growth retardation —Hyperemesis gravidarum —Premature birth —Cesarean Delivery —Postpartum Depression |
|
|
Intentional firesetting on more than one occasion with no obvious motive.
|
PYROMANIA
—Deliberately start fires to reduce tension —Afterward they feel gratification —Impulse Control Disorder |
|
|
Elevated blood pressure is associated with what psychiatric medication?
|
SNRIs (eg, Venlafaxine)
|
|
|
Orthostatic hypertension is associated with what psychatric medication?
|
TCAs (eg, Amitriptyline)
|
|
|
Seizure is a potential side effect of what antidepressant?
|
Buproprion
|
|
|
What neurotransmitter is altered in OCD?
|
OCD results from altered levels of Serotonin, a neurotransmitter that regulates mood, aggression, and impulsivity.
—Treatment of choice: SSRIs |
|
|
Major Depressive Episode super-imposed on Dysthymia.
|
Double Depression
|
|
|
Often desire relationships, but lack awareness of social conventions, including the use of nonverbal communication.
|
Asperger's Disorder
—Impairments in reciprocal social interactions —Restricted interests |
|
|
These patients lead solitary lives, have no interest in socialization, and have few supports except for family.
|
Schizoid Personality Disorder
—Lifelong pattern of detachment from social relationships and a restricted range of emotions. |
|
|
Most likely Atypical Antipsychotic to cause Parkinsonian EPS
|
Risperidone (Risperdal)
—Treated with Anticholinergic medication like Benztropine |
|
|
Intentional firesetting on more than one occasion with no obvious motive.
|
PYROMANIA
—Deliberately start fires to reduce tension —Afterward they feel gratification —Impulse Control Disorder |
|
|
Elevated blood pressure is associated with what psychiatric medication?
|
SNRIs (eg, Venlafaxine)
|
|
|
Orthostatic hypertension is associated with what psychatric medication?
|
TCAs (eg, Amitriptyline)
|
|
|
Seizure is a potential side effect of what antidepressant?
|
Buproprion
|
|
|
What neurotransmitter is altered in OCD?
|
OCD results from altered levels of Serotonin, a neurotransmitter that regulates mood, aggression, and impulsivity.
—Treatment of choice: SSRIs |
|
|
Major Depressive Episode super-imposed on Dysthymia.
|
Double Depression
|
|
|
Often desire relationships, but lack awareness of social conventions, including the use of nonverbal communication.
|
Asperger's Disorder
—Impairments in reciprocal social interactions —Restricted interests |
|
|
These patients lead solitary lives, have no interest in socialization, and have few supports except for family.
|
Schizoid Personality Disorder
—Lifelong pattern of detachment from social relationships and a restricted range of emotions. |
|
|
Most likely Atypical Antipsychotic to cause Parkinsonian EPS
|
Risperidone (Risperdal)
—Treated with Anticholinergic medication like Benztropine |
