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34 Cards in this Set
- Front
- Back
what are the RF for suicide?
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SAD PERSONS
Sex (male) Age (older) Depression Previous attempt Ethanol/substance abuse Rational thought Sickness (chronic illness) Organized plan No spouse Social support lacking |
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management of a patient who is trying to commit suicide?
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A patient who endorses suicidality requires emergent inpatient hospitalization
even against his will. |
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when is suicide an increase risk?
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Suicide risk ↑ after antidepressant therapy
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who attempts to commit suicide more male or female? who is more likely to succeed?
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Women are more likely to attempt
suicide, whereas men are more likely to succeed by virtue of their ↑ use of more lethal methods. |
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what is Pain disorder and what is it associated with?
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Intensity or profile of pain symptoms is inconsistent with physiologic processes. More common in females. May be associated with depression
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Bulimia Nervosa is more common in what gender? and what is it associated with?
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More common among women; associated with low self-esteem and OCD.
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signs and symptoms of a patient with bulimia nervosa?
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bingeeating and compensatory behaviors that include purging or fasting.
■ Patients are ashamed and conceal their behaviors. ■ Signs include dental enamel erosion, enlarged parotid glands, and scars on the dorsal hand surfaces (from inducing vomiting). |
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Tx. for bulimia nervosa?
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Psychotherapy and Antidepressants
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Tx for anorexia nervosa
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Rx:
■ Initially, monitor caloric intake to stabilize weight; then focus on weight gain. ■ Hospitalize if necessary to restore nutritional status and correct electrolyte imbalances. ■ Once the patient is medically stable, initiate individual, family, and group psychotherapy. Treat comorbid depression and anxiety. |
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criteria for Substance abuse
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requires ≥ 1 of the following in one year:
■ Failure to fulfill responsibilities. ■ Use in physically hazardous situations. ■ Legal problems during the time of substance use |
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Substance dependence require what of the following?
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requires ≥ 1 of the following in one year:
■ Tolerance and using progressively larger amounts to obtain the same desired effect. ■ Withdrawal symptoms when not taking the substance. ■ Failed attempts to abstain from the substance. ■ Significant time spent obtaining the substance. ■ Isolation from life activities. |
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tourette's syndrome: more common in what gender, associated with what?
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More common in males; shows a genetic predisposition. Associated with
ADHD, learning disorders, and OCD |
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signs and symptoms of tourett's
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multiple motor (e.g.,
blinking, grimacing) and vocal (e.g., grunting, coprolalia) tics occurring many times per day, recurrently, for > 1 year. |
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tx for tourett's
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haloperidol, pimozide, or clonidine
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tx. for learning disabilities
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Rx: Interventions include remedial classes or individualized learning
strategies. |
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treatment for autism spectrum disorders
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Intensive special education, behavioral management, and symptomtargeted
medications. ■ Family support and counseling are crucial. |
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how is ADD diagnosed?
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Diagnosis requires ≥ 6 symptoms from each category for ≥ 6 months in at
least two settings → significant social and academic impairment. Some symptoms must be present in patients before age seven |
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Tx for ADD
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Methylphenidate, Antidepressants (e.g., SSRIs, nortriptyline, bupropion) and α2-agonists
(e.g., clonidine). |
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Evolution of EPS:
4 hours: 4 days: 4 weeks: 4 months: |
4 hours: Acute dystonia
4 days: Akinesia 4 weeks: Akathisia 4 months: Tardive dyskinesia |
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tx for personality disorders
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TREATMENT
■ Psychotherapy is the mainstay of therapy. ■ Pharmacotherapy is reserved for cases of comorbid mood, anxiety, or psychotic disorders. |
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Tardive dyskinesia tx
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Discontinue or ↓ dose of neuroleptic,
Giving anticholinergics or decreasing neuroleptic may initially worsen tardive dyskinesia. |
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Dyskinesia tx
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Give an anticholinergic (benztropine) or
rigidity). dopamine agonist (amantadine). Decrease dose of neuroleptic or discontinue (if tolerated). |
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Akathisia
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↓ neuroleptic and try β-blockers
(propranolol). Benzodiazepines or anticholinergics may help. |
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TCA toxicity—Tri-C’s:
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Convulsions
Coma Cardiac arrhythmias |
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Symptoms of mania
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DIG FAST
Distractibility Insomnia (↓ need for sleep) Grandiosity (↑ selfesteem)/ more Goal directed Flight of ideas (or racing thoughts) Activities/psychomotor Agitation Sexual indiscretions Talkativeness |
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what is atypical depression
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Weight gain, hypersomnia, rejection sensitivity.
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management of delirium
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■ Treat underlying causes (delirium is often reversible).
■ Normalize fluids and electrolytes. ■ Optimize the sensory environment. ■ Use low-dose antipsychotics (e.g., haloperidol) for agitation and psychotic symptoms. ■ Use physical restraints if necessary |
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most common cause of delirium in the elderly?
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occult UTI is common in the elderly; check UA
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management of phobias
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■ Desensitization through incremental exposure to the feared object or
situation. |
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tx for performance anxiety for social phobia
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SSRIs, low-dose benzodiazepines, or β-blockers
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what is panic disorder associated with?
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depression, agoraphobia, generalized anxiety, substance abuse
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tx. for OCD
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Rx: Pharmacotherapy (clomipramine or SSRIs
cognitive-behavioral therapy (CBT) |
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GAD tx
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Rx: Lifestyle changes, psychotherapy, medication. SSRIs, venlafaxine, and
buspirone are most often used |
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tx. of GAD acute symptoms
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Benzodiazepines may be
used for immediate symptom relief. |