First Aid - Psychiatry (Part 1)

arold001's version from 2015-12-31 07:00

Section 1

Question Answer
Unacceptable feelings/thoughts are expressed through actionacting out
Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stressdissociation
avoidance of awareness of some painful realitydenial
avoided ideas/feelings are transferred to some neutral person or objectdisplacement
partially REMAINING at a more childish levels of developmentfixation = men fixating on sports games
modeling behavior after another person who is more powerful or who meant alot to youidentification
separation of feelings from ideas and eventsisolation of affect
unacceptable internal impulse is attributed to an external sourceprojection = a man who wants another woman thinks his wife is cheating
providing logical reasons for actions actually performed for other reasons, usually to avoid self-blamerationalization
INVOLUNTARY withholding of an idea/feelings from conscious awarenessrepression
not remembering a traumatic experience/pressing bad thoughts into unconsioussrepression
guilty feelings alleviated by generosity toward othersaltruism
process whereby one replaces an unacceptable wish with an action that is similar to the wish but does NOT conflict with ones value systemsublimation
VOLUNTARY withholding an idea/feelings from conscious awarenesssuppression

Section 2

Question Answer
another name for infant withdrawn/unresponsiveanaclitic depression
failure to provide a child with adequate food, shelter, supervision, education, affectionchild neglect
whats the age of onset for ADHD?BEFORE age 7
name 3 characteristics of ADHD?characterized by hyperactivity, impulsivity and inattention in MULTIPLE settings (school, home, church)
ADHD is a/w what brain changes?decrease FRONTAL lobe volumes
repetitve and pervasive behavior violating basic rights of others (physical aggression, destruction of properties, theft) before age 18conduct disorder
enduring pattern of hostile, defiant behavior toward authority figures in absence of serious violations of social normsoppositional defiant disorder
how long must multiple motor tics and 1 vocal tic be present for diagnosis of tourettes syndrome>1 year!
separation anxiety disorder is seen in which age group?7-9 years old
whats the drug of choice to tx separation anxiety disorder?SSRI
what are pervasive developmental disorders?characterized by difficulties with language and failure to acquire or early loss of social skills
what are the 4 main pervasive developmental disordersautism, aspergers disorder, retts disorder, childhood disintegrative disorder
whats the difference btw autism vs. aspergers?autism: below-normal intelligence + language deficits.
aspergers: normal intelligence + NO verbal or language deficits
marked regression in multiple areas of functioning after at least 2 years of apparent NORMAL development (and before age of 10)childhood disintegrative disorder
what 3 changes in NT are a/w anxiety? (NE, GABA, 5-HT)increase NE, decreased GABA, decreased 5-HT
what 3 NT changes are a/w depression? (NE, DA, 5-HT)decreased NE, DA, 5-HT
what 3 NT changes are a/w huntingtons disease?decreased ACh and GABA, increased DA
what 3 NT changes are a/w Parkinsons disease (DA, 5-HT, ACh)decrease DA, increased serotonin and ACh

Section 3

Question Answer
whats the order of loss for orientation?time --> place --> person (last to be lost)
inability to recall important PERSONAL information, usually due to severe trauma or stressdissociative amnesia
what are the 4 components of cognition?memory, attention, language, judgement
distorted perception of realitypsychosis
what are the 4 signs of psychosisdelusions, hallucinations, disorganized speech, disorganized behavior
perceptions in the absence of external stimuli = seeing a light thats NOT actually therehallucination
false beliefs about oneself or others that persists despite the factsdelusion
words and ideas are strung together based on sounds, puns or loose associationsdisorganized speech
name 2 instances a/w tactile hallucinations?alcohol withdrawal or cocaine abuse
sensation of bugs crawling on skinformication

Section 4

Question Answer
how do you diagnosis schizophrenia? (how many sxs do you need?)diagnosis requires 2 or more of the following: delusions, hallucination, disorganized speech, disorganized or catatonic behavior, negative sxs (flat affect, social withdrawal, lack of motivation, lack of speech or though)

2 exceptions = 2 command AH talking to one another or BIZARRE delusion
time line for brief psychotic disorder vs. schizophreniform vs. schizophrenia vs. schizoaffectiveBrief psychotic disorder: <1 month, usually STRESS related
Schizophreniform: 1-6 months
Schizophrenia: >6 months
Schizoaffective disorder: at least 2 WEEKS of stable mood with psychotic symptoms plus a major depressive, manic or mixed episodes
what is schizoaffective disorder?
how long does psychotic features need to last for?
at least 2 WEEKS of stable mood with psychotic symptoms, plus a major depressive, manic or mixed episode
schizophrenia + bipolar or depressive episodeschizoaffective
what are the 5 subtypes of schizophrenia?paranoia (delusions), disorganized, catatonic, undifferentiated, residual
age of onset of schizophrenia in men vs. womenmen: teens to early 20s
women: 20-30s
what is delusion disorder?fixed, persistent, NONBIZZARE belief system lasting >1 MONTH
how long must delusions be present to be diagnosed as delusional disorder>1 MONTH
another name for multiple personality disorderdissociative identity disorder
presence of 2 or more distinct identities or personality statesdissociative identity disorder
dissociative identity disorder (multiple personality disorder) is a/w what history?history of SEXUAL ABUSE
what is a mood disorder?characterized by an abnormal range of moods and loss of control over them --> severity of moods cause distress and impairment in social and work functioning
what are the 4 main mood disorders?1) majore depressive disorder
2) bipolar disorder
3) dysthymic disorder (chronic depression)
4) cyclothymic disorder
how long must a MANIC episode last for?>1 WEEK
how do you diagnose manic episode?diagnosis requires HOSPITALIZATION or at least 3 DIGFAST for >1 week
what does DIGFAST stand for in manic episode?Distractibility, Irresponsibility (seek pleasure without regard to consequence), Grandiosity, Flight of ideas, increase goal-directed Acitivities/agitation, decrease need for Sleep, Talkative
whats the difference btw mania vs. hypomania?hypomania: not severe enough to cause marked impairment in social and/or work functioning or to neccessitate hospitalization
dysthymia and hypomania lasting for 2 yearscyclothymia

Section 5

Question Answer
how long must major depressive episodes last for?major depressive episodes lasting 6-12 MONTHS..episodes characterized by at least 5/9 sxs for 2 or MORE WEEKS
in order to diagnose major depressive disorder, either which 2 sxs have to be reported?either depressed mood or anhedonia
milder form of depression lasting for at least 2 YEARSdysthymia
milder form of bipolar disorder lasting at least 2 yearscyclothymia = hypomania + mild depression
being able to experience improved mood in response to positive eventatypical depression
whats the most common subtype of depressionatypical depression = mood reactivity, hypersomnia, weight gain, leaden paralysis, interpersonal rejection sensitivity
whats the tx for atypical depressionMAOI and SSRI
onset and duration for postpartum blues vs. postpartum depressionPostpartum blues: starts 2-3 days after delivery and resolves within 10-14 days.
Postpartum depression: starts within 4 WEEKS after delivery and lasts 2 weeks-1 year.
how long does postpartum psychosis last for?lasts days - 6 weeks
name the 5 anxiety disorders1) GAD
2) panic disorder
3) phobia
4) OCD
how do you diagnose panic disorder? (how many sxs?)presence of recurrent periods of intense fear and discomfort peaking in 10 minutes with at least 4 sxs: PANICS (palpitations, paresthesias, abd distress, nausea, intense fear of dying or losing control, lightheadedness, chest pain, chills, choking, disconnectedness, sweating, shaking, SOB
whats therapy is used for panic disorder?CBT
name 3 tx for panic disordersSSRI, venlafaxine, benzos
which SNRI can be used to tx panic disorders?venlafaxine
another name for social phobia?social anxiety disorder
whats the tx for social phobia?SSRI

Section 6

Question Answer
recurrent intrusive thoughts, feelings or sensations that cause distressobsessions
what are the 2 tx options for OCD?SSRI or clomipramine
which TCA is used to tx OCD?Clomipramine used to tx oCd
whats the difference btw acute stress disorder vs. PTSD?Acute stress disorder: <1 month
PTSD: >1 month
how long must uncontrollable anxiety last for in GAD?at least 6 MONTHS!
whats the tx for PTSD?psychotherapy and SSRI
whats the tx for GAD?SSRI or SNRI
how long does adjustment disorder last for?< 6 months
whats the difference btw adjustment disorder vs. GAD?Adjustment disorder: < 6 months
chronic factituous disorderMunchausen's syndrome
chronic factitious disorder with predominantly physical signs and sxs characterized by multiple hospitalizations and willingness to receive invasive proceduresMunchausen's syndrome
munchasusens syndrome by proxywhen illness in a child or elderly pt is caused by caregiver. motivation is to assume sick role by proxy
name the 5 different somatoform disorders?1) somatization disorder
2) conversion disorder
3) hypochondriasis
4) body dysmorphic disorder
5) pain disorder
what are somatoform disorders?disorders characterized by physicals sxs with NO identifiable physical cause. both illness production and motivation are UNCONSICOUS drives. Symptoms are NOT intentionally produced or faked.
4 pain, 2 GI, 1 sexual 1, pseudoneuro over a period of YEARS, developing before age 30somatization disorder
what is conversion disorder?sudden loss of sensory or motor function (paralysis, blindness, mutism) often following an ACUTE STRESSOR; pt is aware but sometimes indifferent toward sxs (la belle indifference)
what outlook is a/w conversion disorder?la belle indifference = pt is aware but indifferent toward sxs
preoccupation with and fear of having a serious illness despite medical evaluation and reassurancehypochrondriasis
prolonged pain with NO physical findings; PAIN is predominant focus of clinical presentationpain disorder
what characterizes a personality disorder?personality disorder = inflexible, maladaptive, rigidly pervasive pattern of behvaior causing subjective distress and/or impaired functioning. person is usually NOT aware of the problem

Section 7

Question Answer
schizophrenic psychotic sxs + bipolar or depressive mood disorderschizoaffective
what mood disorder is a/w anorexia nervosa?depression
whats russells sign?dorsal hand calluses from induced vomiting in bulimia
whats gender identity disorder?strong persistent cross-gender identification characterized by persistent discomfort with one's sex, causing distress and/or impaired functioning
desire to live as opposite sex, thru surgery or hormone therapytranssexualism
paraphilia of wearing clothes of opposite sextransvestism (wear a vest)
need more of the drug to achieve the same effect?tolerance
what are the 6 stages of change in overcoming substance addiction1) precontemplation
2) contemplation
3) preparation/determination
4) action/willpower
5) maintenance
6) relapse
what type of drug is morphine?opiod
what type of drug is methadone?opiod
whats a sensitive lab value for alcohol intoxication?serum GGT (y-glutamyltransferase)
whats a sensitive indicator for alcohol use?serum GGT
whats the tx of deliruim tremens?benzos
whats the 2 drugs for opiod overdose?naloxone and naltrexone
what are signs of opiod intoxication?euphoria, respiratory and CNS depression, decreased gag reflex, PINPOINT pupils, seziures (overdose)
what are signs of opiod withdrawal?sweating, dilated pupils, piloerection (cold turkey), fever, rhinorrhea, YAWNING, diarrhea, FLU-LIKE symptoms

Section 8

Question Answer
Whats the tx for benzodiazepine overdose?flumazenil = competitive benzodiazepine antagonist
What are signs of amphetamine withdrawals?anhedonia, INCREASED appetite, hypersomnolence, existential crisis
what are signs of amphetamine intoxication?euphoria, dilated pupils, prolonged wakefulness and attention, FEVER, HTN, tachycardia, anorexia, paranoia
what are signs of cocaine intoxication?dilated pupils, HALLUCINATIONS (including cocaine crawlies), paranoia, angina, sudden cardiac death
whats the tx for cocaine intoxication?benzos
whats the signs of cocaine withdrawal?hypersomnolence, malaise, severe psychological craving, DEPRESSION/SUICIDALITY
whats the sign of nicotine intoxicationrestlessness
what are 2 drugs used to tx nicotine WITHDRAWALbupropion or varenicline
what are the 3 hallucinogens?PCP, LSD, marijuana
which hallucinogen: visual or auditory distortions, depersonalization, anxiety, paranoia, psychosisLSD
which hallucinogen: euphoria, anxiety, paranoid delusions, perception of slowed time, increase appetite, DRY MOUTH, hallucinationsmarijuana
what is dronabinol?prescription marijuana = antiemetic for chem and appetite stimulant for AIDS pts
what are signs of marijuana withdrawal?irritability, depression, insomnia, nausea, anorexia...sxs peak in 48 hours and last for 5-7 days
how long is marijuana detectable in urine?4-10 days
what is methadone? what is it used for?long-acting ORAL opiate; used for heroin detox or long term maintenance
name the 2 tx options for heroin addiction1) methadone
2) naloxone + buprenorphine = partial opiod agonist
whats the tx for wernickes korsakoff?IV vitamin B1 (thiamine)
when do delirum tremens peak?peaks 2-4 days after last drink
whats the tx of delirum tremens?benzodiazepines

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