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Psych FA

Psychiatry Section of First Aid

QuestionAnswer
NT changes with anxiety increase NE, decrease GABA, decrease 5-HT
high NE, low GABA, low serotonin anxiety
NT changes with depression low NE, low serotonin, low dopamine
low NE, low serotonin, low dopamine depression
NT changes with Alzheimer's low ACh
low ACh Alzheimer's
NT changes with Huntington's low Ach, low GABA
low ACh, low GABA Huntington's
NT changes with Schizophrenia high dopamine
high dopamine schizophrenia
low dopamine, high ACh Parkinson's
NT changes in Parkinson's low dopamine, high ACh
Rett's disorder Girls (males die in utero), normal development til age 4 then decline in development, verbal skills; mental retardation; ataxia; stereotyped hand-wringing
Childhood Disintegrative disorder BOYS. Marked regression in multiple areas of functioning after AT LEAST 2 years of apparently normal development. SIGNIF loss of expressive/receptive language skills, social skills, or adaptive behavior; bowel /bladder control; play or motor skills
Boys. Marked regression in multiple areas of functioning after AT LEAST 2 years of apparently normal development. SIGNIF loss of expressive/receptive language skills, social skills, or adaptive behavior; bowel /bladder control; play or motor skills Childhood Disintegrative disorder
Girls, normal development til age 4 then decline in development, verbal skills; mental retardation; ataxia; stereotyped hand-wringing Rett's disorder
common causes of loss of orientation alcohol, drugs, fluid/electrolyte imbalance, head trauma, hypoglycemia, nutritional deficiencies
classic anterograde amnesia Korsakoff's. caused by thiamine deficiency (esp in alcoholics). bilateral destruction of mamillary bodies. can have some retrograde amnesia. Associated with confabulation
Korsakoff's amnesia. classic anterograde amnesia. Korsakoff's. caused by thiamine deficiency (esp in alcoholics). bilateral destruction of mamillary bodies. can have some retrograde amnesia. Associated with confabulation
Delirium: Acute vs Chronic? Consciousness? Other changes? EEG? reversible? waxing & waning consciousness with ACUTE onset. RAPID decrease in attn span, level of arousal. Abnorm EEG. ACUTE changes in mental status, disorganized thinking, halluc (visual), misperception, disturbed sleep-wake cycle, cognitive dysfxn. reversible.
waxing and waning level of consciousness with acute onset. rapid decrease in attn span, level of arousal. Abnorm EEG. acute changes in mental status, disorganized thinking, halluc (visual), misperception, disturbed sleep-wake cycle, cognitive dysfxn. Delirium
Dementia: Acute vs Chronic? Consciousness? Other changes? Reversible? EEG? GRADUAL decline in cognition with NO CHANGE in level of consciousness. MEMORY DEFICITS (irreversible), aphasia, apraxia, agnosia, loss of abstract thought, behav/personality changes, impaired judgement. PT is ALERT. NORMAL EEG.
GRADUAL decline in cognition with NO CHANGE in level of consciousness. MEMORY DEFICITS (irreversible), aphasia, apraxia, agnosia, loss of abstract thought, behav/personality changes, impaired judgement. PT is ALERT. NORMAL EEG. Dementia
Causes of dementia Alzheimer's, vasc thrombosis, hemorrhage (may have acute/subacute onset), HIV, Pick's disease, substance abuse, CJD
cause: Alzheimer's dementia
cause vasc thrombosis / hemorrhage dementia
cause: HIV dementia
cause: substance abuse dementia
cause: CJD dementia
cause: Pick's disease dementia
cause: drugs with anticholinergic effects delirium
visual hallucination common in ___ delirium
auditory hallucination common in ___ schizophrenia
olfactory hallucination common in ___ aura of psychomotor epilepsy
tactile hallucination common in ___ alcohol withdrawal or cocaine abusers (ants crawling on one's skin)
hypnagogic hallucination common in ___ hynaGOgic: while GOing to sleep
going to sleep hallucinations hypnogogic
hypnopompic hallucination common in ___ hypnaPOMPic: occurs while waking from sleep (POMPous upon waking)
waking FROM sleep hallucinations hypnapompic
Intox: disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts. High serum GGT. alcohol. Treatment: naltrexone, disulfiram. GGT is sensitive of alcohol use.
withdrawal: tremor, tachycardia, hypertension, malaise, seizures, delirium tremens, tremulousness, agitation, hallucinations (including tactile) alcohol. Treatment for DT's: benzodiazepines.
treatment for alcohol intox naltrexone, disulfiram
treatment for DTs benzodiazepines
intox: CNS depression, n/v, constipation, pupillary constriction (pinpoint pupils), seizures (life threatening OD) opioids (e.g. morphine, heroin, methadone). treatment: naltrexone, naloxone
treatment for opioid intox: naltrexone, naloxone
withdrawal: anxiety, insomnia, dilated pupils, piloerection ("cold turkey"), "flulike" symptoms (fever, rhinorrhea, nausea, stomach cramps, diarrhea), yawning opioids. tx: symptomatic, nalone + buprenorphine, methadone
tx for opioid withdrawal symptomatic, nalone + buprenorphine, methadone
intox: low safety margin, respiratory depression. barbiturates. tx: symptomatic (assist respiration, increase BP)
tx for barbiturate OD tx: symptomatic (assist respiration, increase BP)
withdrawal: anxiety, seizures, delirium, life-threatening cardiovascular collapse barbiturates
intox: greater safety margin. amnesia, ataxia, somnolence, minor resp depression. additive effects with alcohol. benzodiazepine. tx: flumazenil (competitive GABA antagonist)
tx for benzo intox tx: flumazenil (competitive GABA antagonist)
withdrawal: rebound anxiety, seizures, tremor, insomnia benzo.
intox: psychomotor agitation, impaired judgement, pupillary dilation, hypertension, tachycardia, euphoria, prolonged wakefulness and attn, cardiac arrhythmias, delusions, hallucinations, fever amphetamines
withdrawal: post use "crash" including depression, lethargy, headache, stomach cramp, hunger, hypersomnolence amphetamines
intox: euphoria, psychomotor agitation, impaired judgement, tachycardia, pupillary dilation, htn, hallucinations (tactile), paranoid ideations, angina, sudden cardiac death cocaine. tx: benzos.
tx for cocaine OD? benzos
withdrawal: post-use "crash" including severe depression and suicidality, hypersomnolence, severe psychological craving, and malaise cocaine
restlessness, insomnia, increased diuresis, muscle twitching, cardiac arrhythmias caffeine
withdrawal: headache, weight gain, lethargy, depression caffeine.
withdrawal: irritability, headache, anxiety, weight gain, craving. nicotine. tx: bupropion/varenicline
tx for nicotine withdrawal? bupropion/varenicline
intox: belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis, delirium pcp
withdrawal: depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep pcp
intox; marked anxiety or depression, delusions, visual hallucinations, flashbacks, pupillary dilation LSD
heroin addiction: users at risk for...? signs...? treatment...? hepatitis, abscess, hemorrhoids, AIDS, right-sided endocarditis. signs of opioid intoxication: pinpoint pupils, respiratory depression, coma. treatment: naloxone, naltrexone (competitively inhibit opioids, use with OD)
what is suboxone? how does it compare to other drugs that are used to treat the same thing? naloxone + buprenorphine (partial agonist). long acting with fewer withdrawal symptoms than methadone. Naloxone is not active when takien orally, so withdrawal symptoms only occur if INJECTED (lower abuse potential)
what drug is a partial agonist of the opioid receptor? what is this used for? what are advantages / disadvantages? suboxone = naloxone + buprenorphine (partial agonist). long acting with fewer withdrawal symptoms than methadone. Naloxone is not active when takien orally, so withdrawal symptoms only occur if INJECTED (lower abuse potential)
complications of alcoholism alcoholic cirrhosis, hepatitis, pancreatitis, peripheral neuropathy, testicular atrophy, wernicke-korsakoff syndrome, mallory-weiss syndrome
wernicke's encephalopathy triad confusion, ophthalmoplegia, ataxia. due to thiamine deficiency.
confusion, ophthalmoplegia, ataxia wernicke's encephalopathy triad - thiamine deficiency.
korsakoff's psychosis signs/symptoms and associations. reversible or not? can progress from wernicke's encephalopathy. irreversible memory loss, confabulation, personality changes. assoc with periventricular hemorrhage/necrosis of mamillary bodies. Tx: IV thiamine.
delirium tremens - signs in order of appearance ANS hyperactivity (tachycardia, tremors, anxiety, seizures), psychotic symptoms (hallucinations, delusions), confusion. can be life-threatening. peaks 2-5 days after last drink.
patient presents with: ANS hyperactivity and then psychotic symptoms and then confusion. what do they have? delirium tremens
what are the autonomic hyperactivity symptoms with DTs? tremor, tachycardia, anxiety, seizures.
what are the psychotic sx assoc with DT's? hallucinations, delusions
treatment of DTs? benzodiazepines.
Created by: pecanpie792