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HY Psych

Pathology

QuestionAnswer
increased NE, decreased GABA, decreased 5HT anxiety
decreased NE, decreased 5HT, decreased dopamine depression
decreased ACh Alzheimer's
decreased GABA and decreased ACh Huntington's
increased dopamine Schizophrenia
decreased dopamine, increased 5HT, increased ACh Parkinson's
increased NE, increased 5HT, increased dopamine mania
waxing and waning consciousness with acute onset, hallucinations, sleep disturbances, and disorganized thinking; may be precipitated by anticholinergic drugs or UTIs delirium
gradual decrease in cognition with no change in level of consciousness, loss of abstract though, and impaired judgment; no psychotic symptoms dementia
delusions, hallucinations (usually auditory), disorganized speech (loose associations), disorganized/catatonic behavior, and negative symptoms for longer than 6 months and associated with a decline in functioning schizophrenia
psychotic symptoms (e.g., hallucinations, delusions, flat affect) lasting for less than one month and usually precipitated by stress brief psychotic disorder
psychotic symptoms lasting between 1 and 6 months schizophreniform disorder
at least 2 weeks of stable mood with psychotic symptoms, plus a major depressive, manic, or mixed episode; may be bipolar or depressive subtype shizoaffective disorder
fixed, persistent non-bizarre belief system lasting more than 1 month; functioning is not impaired delusional disorder (shared with another person= folie a deux)
What disorder has SIG E CAPS? What does it mean? Depression: Sleep disturbance, Interest loss, Guilt/feelings of worthlessness, Energy loss, Concentration loss, Appetite/weight changes, Psychomotor retardation or agitation, and Suicidal ideation
What is the diagnostic criteria for a major depressive episode? 5 SIG E CAPS symptoms with patient reported depressed mood or anhedonia for at least 2 weeks
What disorder has DIGFAST? What does it mean? Manic episode: Distractibility, Irresponsibility, Grandiosity, Flight of ideas, increase in goal directed Activity/psychomotor Agitation, decreased need for Sleep, and Talkativeness or pressured speech
Milder form of depression lasting at least 2 years Dysthymia
Mild form of bipolar disorder lasting at least 2 years Cyclothymic disorder (dysthymia and hypomania)
What is the diagnostic criteria for bipolar I? at least 1 manic episode (3 DIGFAST x 1 week) with depressive symptoms; manic episodes must last at least 1 week
What is the diagnostic criteria for bipolar II? at least 1 hypomanic (like manic, but no impairment in social/occupational f'n and no psychosis) epidsode with depressive symptoms
Hypersomnia, hyperphagia, and extreme sensitivity to rejection atypical depression
what is the treatment of choice for atypical depression? MAO inhibitors and SSRIs
What is the most important question to ask when trying to assess a repeated suicide attempt risk? "What did you do after you attempted to kill yourself?" If they just waited to die (vs calling for help), then they are at a high risk for a repeated attempt.
conscious faking of a medical disorder for intentional gain (monetary or otherwise); complaints cease after gain malingering
consciously faking a disorder to fulfill a subconscious motivation to assume the sick role factitious disorder (chronic= Munchausen's and chronic in a child at the hands of a caregiver= Munchausen's by proxy)
Patient comes in complaining of pain in at least 4 locations. Three months later, they have loss of sensation in their extremities and dyspareunia. You recall that one year ago, she complained of abdominal discomfort and dysphagia. Somatization disorder
Patient develops blindness in one eye after his parent's divorce, but does not seem at all concerned. Conversion disorder (more common in teens; think V for voltage=neuro problems) with la belle indifference (aware of sx, but doesn't really care)
Patient is afraid that his sinus headaches are being caused by brain cancer, even after a thorough workup that showed no evidence of malignancy. Hypochondriasis
Young woman with BMI of 19.5 is concerned that her hips are too large and that she is very overweight. She is also disturbed by the bump on her nose. Body dysmorphic disorder
Patient has unexplained pain lasting for 2 years. Pain disorder.
weird, accusatory, aloof, awkward personality disorder cluster Cluster A
Cluster A personalities paranoid, schizoid, schizotypal
wild and bad to the bone personality disorder cluster Cluster B
Cluster B personalities antisocial, borderline, histrionic, narcissistic
worried, cowardly, compulsive, and clingy personality disorder cluster Cluster C
Cluster C personalities avoidant, obsessive compulsive, dependent
patient cuts themselves after breaking up with their latest on-again/off-again boyfriend; believes all men are evil and all women are victims borderline (splitting is major defense mechanism) [B]
quiet, withdrawn man prefers to live on the outskirts of town where he doesn't have to interact with other people schizoid [A]
young woman is afraid to approach her classmates because she is afraid that they will reject her because she is not good enough avoidant [C]
young woman prefers to date older men because they tend to take care of her and serve as a father figure that she can be submissive to; she has very low self esteem dependent [C]
19 yo male with a long and violent criminal record antisocial [B]
aspiring actress wears provocative clothing to her doctor appointments and flirts excessively with her doctor as well as the other patients in the waiting room histrionic [B]
a young man likes to dress up as an elf and believes that he can communicate with trees using a long-lost magical language; finds it difficult to interact with his co-workers Schizotypal [A]
Woman has difficulty getting along with her co-workers because of her unrealistically high expectations, perfectionism, and controlling behavior. She cannot see anything wrong with her behavior and believes that her co-workers are just incompetent. Obsessive-compulsive [C]
A young man on a date demands that he be seated at the best table in the restaurant, and consistently antagonizes the wait staff. When his date points out his poor manners, he becomes enraged and storms out of the restaurant. Narcissistic [B]
Security guard becomes very suspicious of his doctor when it is suggested that he begin colon cancer screening. He accuses the doctor of conspiring with the insurance companies to take all of his money. Paranoid [A]
A 50 yo woman is generally gloomy and unhappy and always expects the worst outcome. Depressive personality disorder [no assoc'd cluster]
emotional lability, slurred speech, ataxia, coma, blackouts, elevated GGT alcohol intoxication
what is the treatment for alcohol intoxication? naltrexone or time w/fluids
What is the ratio of AST to ALT in alcohol intoxication? 2:1
Delirium tremens severe alcohol withdrawal; life threatening
What is the treatment for delirium tremens? Benzos
CNS depression, nausea, vomiting, constipation, pinpoint pupils, seizures Opioid intoxication
Differential diagnosis for pinpoint pupils? Opioid intoxication and organophosphate (or other cholinergic) poisoning
What symptoms of opioid intoxication can you NOT develop tolerance to? Constipation and pinpoint pupils (miosis).
Sweating, dilated pupils, piloerection (cold turkey), diarrhea, and flu-like symptoms Opioid withdrawal
Is opioid withdrawal life-threatening? What is the treatment? No. Tx is symptomatic. For babies, give tincture of opium.
Is opioid overdose life-threatening? Yes. It can cause respiratory depression and seizures.
What is the treatment for opioid overdose? Naloxone or naltrexone
Marked respiratory depression with a low safety margin Barbiturates intoxication
What is the treatment for barbiturate overdose? symptom management by assisting respiration and increasing BP
delirium, life-threatening CV collapse barbiturate withdrawal
Ataxia, minor respiratory depression, greater safety margin benzo intoxication
What is the treatment for benzodiazepine intoxication? Flumazenil, a competitive GABA antagonist
impaired judgment, pupillary dilation, prolonged wakefulness and attention, delusions, hallucinations, and fever amphetamine intoxication
stomach cramps, hunger, hypersomnolence amphetamine withdrawal
impaired judgment, pupillary dilation, hallucinations (including tactile), paranoid ideations, angina, sudden cardiac death (PACs or PVCs) cocaine intoxication
suicidality, hypersomnolence, malaise, severe psychologic craving lindsay lohanism (cocaine withdrawal)
What is the treatment for cocaine intoxication? Benzos
restlessness, increased diuresis, muscle twitching caffeine intoxication
restlessness nicotine intoxication
irritability, anxiety, craving nicotine withdrawal
What are the treatment options for nicotine withdrawal? Nicotine patch, gum, or lozenges; buproprion/varenicline
belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, homicidality, psychosis, delirium PCP intoxication
depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep PCP withdrawal
What is the treatment for PCP intoxication? Benzos and haloperidol (calm those suckers down!)
marked anxiety or depression, delusions, visual hallucinations, flashbacks, pupillary dilation LSD intoxication
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social withdrawal, increased appetite, dry mouth, hallucinations marijuana intoxication
irritability, depression, insomnia, nausea, anorexia marijuana withdrawal
What is the differential diagnosis for pupillary dilation? Amphetamines, cocaine, LSD, atropine poisoning
What is the CAGE screening test used for? What do the letters stand for? Alcohol dependence screening. C= Have you ever tried to Cut back? A= Are you Annoyed by others questioning your drinking? G= Do you feel Guilty about drinking? E= Do you ever need an Eye opener?
What is the diagnosis for a major depressive disorder (not episode)? 2 or more major depressive episodes with a symptom free interval of 2 months
Created by: sarah3148