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Psych FA
Psychiatry Section of First Aid
| Question | Answer |
|---|---|
| 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
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