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62 Cards in this Set
- Front
- Back
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IQ ranges
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>130 = very superior
120-124 = superior 110-119= above average 90-109 = ave 80-89 = below ave 10-19 = borderling MR 50-70 = mild MR 35-49 = moderate MR 25-34 = severe MT <24 = profound MR |
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IQ formula
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mental age/chronological age
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Clinical Dx of psychosis
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1 - Perceptual disturbances
2 - Delusional Thinking 3 - Disordered Thought Processes |
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3 time ranges of psychotic d/o
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brief psychotic d/o = Sx for <1 month
schizophreniform = Sx for 1-6 months schizophrenia = Sx for >6 months |
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Schizophrenic - Sx
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5 As=
Anhedonia Affect flat Alogia (poverty of speech) Avolition (apathy) Attention (poor) |
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Why do atypical antipsychotics cause less movement d/o?
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-effect the DA in the limbic system, not the substantia nigra
-antagonize DA and 5HT receptors |
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__% of patients on antipsychotics show significant improvement
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70
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Good Px for schizophrenia
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-onset = early 20s
-female -precipitating factor -FHx mood d/o -good social support -Sx = + and mood -acute onet -few relapses -good function beforehand |
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Folie a deux
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2 people in close relationship. 1 w/psychotic Sx --> other person develops Sx --> 20-40% recover when inducer removed
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A person who who has been hospitalized for depression has a __% of committing suicide later in life
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15
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Depressive Sx
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Sleep
Interest Guilt/Worthlessness Energy Concentration Appetite/Weight Psychomotor Activity Suicidal Ideation |
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Manic Sx
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Distractibility
Insomnia (less *need* for sleep) Grandiosity Flight of Ideas Activity/Agitation Speech pressured Thoughtlessness (risk taking/poor judgement) |
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Mania vs Hypomania
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Mania Hypo
Lasts >/=7days >/=4 days Impaired Severely Not markedly (job/social) Hospitalize? Maybe No Psychotic Sx Maybe No |
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SAD (3 signs)
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SAD = HIC
1 - Hypersomnia 2 - Irritability 3 - Carb craving SAD = hibernation |
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ECT premedication
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atropine
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Rapid cycling is >/= __ episodes in ____
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4, year
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Bipolar II D/o = NO ____ episodes EVER
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Manic
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Dysthymic D/o (criteria)
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CHASES
Concentration Hopelessness Appetite Somnia Energy Self-Esteem ---DD = 2Ds:--- 2 years depression, not asymp for 2 months >/= 2 of above Sx **NEVER HAS PSYCHOTIC SX** **not episodic, all the time* |
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Panic Attack Sx
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PANICS
Palpitations Abd distress Numbness/Nausea Intense fear of death Choking/Chills/Chest pain Sweating/Shaking/SOB |
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Panic D/o
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PA + anticipatory anxiety btwn PAs
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MC mental d/o in USA
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Phobias
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___% of OCD patients have both obsessions and compulsions
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75
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OCD is ego-___ and OCPD is ego-___
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dystonic
syntonic |
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Effectiveness of meds vs CBT in OCD
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Equal
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4 MC mental d/o
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1 - phobias
2 - substance-induced 3 - MDD 4 - OCD |
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PTSD Meds
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imipramine and doxepin
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Meds for GAD
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busiparone, SSRIs, BZDs (short term clonazepam or diazepam, taper off ASAP), SSRIs, extended-release venlafaxine (SNRI)
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Dif btwn precipitating event for PTSD and Adjustment D/o
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PTSD = event perceived as life-threatening/fatal to patient/someone neat
Adjustment = non-life-threatening |
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Timetable for Adjustment D/o Sx
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Start w/in 3 months of event
End w/in 6 months of event ending |
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1st line Tx for Adjustment D/o
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supportive psychotherapy
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Personality D/o Sx (general)
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Behavior pattern that manifests as (at least 2):
CAPRIcious Cognition Affect Personal Relations Impulse control |
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Personality D/o categories
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A = MAD (as a hatter)
-paranoid -schizoid -schizotypal B = BAD -antisocial (in kids, conduct) -borderline -histrionic -narcissistic SAD -dependent -avoidant -OCPD NOS -passive-aggressive -depressive -sadomasochistic -sadistic |
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Borderline Personality D/o Sx
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IMPULSIVE
Impulsive Moody Paranoid w/stress Unstable Self Image Labile (inappropriate anger) Suicidal/Self harming Intense relationships Vulnerable to abandonment Emptiness (poor sense of self) |
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MCly abused substance in USA
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EtOH
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% of Americans who abuse EtOH
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7-10
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CAGE ?s
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(esp EtOH)
ever wanted to Cut down on substance? felt Annoyed by criticism of substance use? felt Guilty about substance use? needed substance use as an Eye-opener? |
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Legal EtOH limit
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80-100 mg EtOH/dL blood
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Patient w/altered mental status in the ER
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Give:
1 - thiamine 2 - glucose 3 - naloxone |
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Tx DTs
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BZDs (like diazepam, , chlordiazepoxide, lorazepam, oxazepam)
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__% of patients w/DTs die w/o Tx
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15-20%
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Korsakoff vs Wernike
-which is reversible and w/what? |
Wernicke
Thiamine (vit B1) |
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Deadly cocaine intox Sx
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respiratory depression, seizure, arrhythmia, MI, CVA
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Tx cocaine intox
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mild to mod = BZDs
severe agitation/psychosis = haloperidol both = Sx support |
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Tx cocaine dependence
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TCAs
psychotherapy DA agonists (bromocriptine, amantadine) |
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Drug w/d can be fatal w/
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BZDs
EtOH Barbituates |
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Rotatory Nystagmus = pathonomonic for
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PCP intox
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Drug Urine Times
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THC >/= 4 wks
PCP >1 week Sedative-hypnotics (BZD, Barbituates) 1 wk Cocaine >/= 3d Amphetamines 1-2d Opiate 12-36h Inhalants 4-10h |
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Barbituate OD Tx
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Alkalinize pee w/Na+ Bicarb IV
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BZD w/d
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Flumazenil
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Drowsy + GI probs + **constricted pupils**
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Opiate intox
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Opiate OD Sx and Tx
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Sx = Rebels Admire Morphine
Respiratory depression Altered mental status Miosis TX = IV naloxone or naltrexine |
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Tx opiate w/d
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clonidine +/or buprenorphine
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Things that don't require informed consent
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1 - life-saving med emergency
2 - SI/HI prevention 3 - minors (parents consents, except w/OB care, STD Tx, substance abuse Tx --> confidential) |
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Emancipated Minor = if:
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-married
-self-supporting -military -parent |
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Most important factor in risk of violence
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Hx of violence
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Malpractice
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Dereliction of Duty lead Directly to Damages
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Best SSRIs for eating d/o
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paroxetine and mirtazepine
(party and mirth) |
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Meds to increase wt loss
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1 - stimulants
-phentermine -amphetamine 2 - orlistat (alli) 3 - sibutramine |
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Abreaction
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strong rxn patients often get when retrieving traumatic memories
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MCC of primary insomnia
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primary insomnia
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Tx of primary insomnia
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hydroxyzine + zolpidem
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Elder abuse occurs in __% of people >65 y/o
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10
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