Term
Causes of psychoses (broad differential) |
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Definition
1. General medical condition - head trauma, dementia, delerium, metabolic
2. Affective - depression + psychosis, mania + psychosis
3. Substance use
4. Psychotic - a. schizophrenia, b. schizophreniform, c. brief psychotic episode, d. schizoaffective, e. delusional
5. Personality disorder - a. schizotypal, b. schizoid, c. BPD, d. paranoid, e. OCD
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Term
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Definition
A. >1 for more than 1 month of (only need 1 if bizarre)
delusion
hallucination
speech changes (derailed, incoherent)
grossly disorganized/ catatonic
negative sx: flattened, alogia, avolition
B. Social fxn decreased in >1 area
C. Prodrome for >6months
D. Exclude schizoaffective or mood
E. Exclude GMC
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Term
"A" criteria for schizophrenia |
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Definition
≥2 of for most of ≥1 month
- delusions
- hallucinations
- disordered thought
- disordered speech
- -ve symptoms - alogia, avolition, flattened affect
Unless bizarre then only 1 needed (voices...) |
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Term
"B" criteria for schizophrenia |
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Definition
Social/ occupational disfunction impairment below level of function prior to onset of symptoms
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Term
| A (1) symptoms panic disorder |
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Definition
>3 of, peak at 10 minutes
S - sweating
T - trembling
U – unsteady/ dizzy
D – depersonalization/ derealization
E – excessive heart beats
N – nausea/ stomach upset
T – tingling/ paresthesias
S - SOB
Fear – death/ going crazy
3Cs – Chills/ CP/ Choking |
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Term
| A (2) symptoms of panic disorder |
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Definition
>1 months of >1 of
- concern over having an attack
- worry over consequences of attack
- worry is changing behaviour |
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Term
| B symptoms of panic disorder |
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Definition
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Term
| C symptoms of panic disorder |
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Definition
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Term
| D symptoms of panic disorder |
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Definition
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Term
| Epidemiology for panic disorder |
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Definition
| 1.5-5% population, onset >20 |
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Term
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Definition
SSRI – fluoxetine: 5-10mg
Paroxetine: 10 mg,
Sertraline: 25-50mg
Start low (1/3-1/2 usual antidepressant dose), go slow, advise of SE
SNRI - venlafaxine
Benzo: long acting, no prn, regular dosing – clonazepam 2-4mg/d BID dosing |
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Term
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Definition
| Anxiety about having a panic attack where you can’t leave or get help – avoid situation |
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Term
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Definition
| Excessive anxiety/worry, occurring more days than not for at least 6 months |
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Term
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Definition
| Find it difficult to control the worry |
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Term
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Definition
Anxiety and worry assd with ≥3 of
B – blank mind
E – easily fatigued
S – sleep disturbance
K – keyed up
I – irritability
M – muscle tension |
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Term
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Definition
1. ↓caffeine/ EtOH
2. psycho – ed
3. benzos (short, long acting, no prn), buspirone (TID)or SSRI/SNRI, TCA, ß blocker
NO Buproprion (stim)
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Term
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Definition
| Non benzo anxiolytic – non sedating, no tolerance, no interactions with benzos or with EtOH, but takes 2-3 weeks, and TID dosing needed |
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Term
Definition substance abuse
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Definition
≥1 of within 12 months
O - fail to fulfill major role/ obligation
H - use in hazardous situation
L - Legal problems
F - function
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Term
| Definition of substance dependence |
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Definition
≥ 3 of in 12 months
- tolerance
- withdrawal drink
- more for longer than intended
- desire/fail to cut down
- time to buy/use/recover
- give up important activities
- continue over everything |
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Term
| Define substance intoxication |
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Definition
| Reversible physiological and behavioural changesd/t recent exposure to substance |
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Term
| Define substance withdrawal |
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Definition
| Substance specific syndrome that develps following cessation of or reduction in dosage of regularly used substance |
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Term
| Define stages of alcohol withdrawal |
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Definition
1. 6-12h – tremor, sweat, agitation, anorexia, cramps, diarrhea, sleep disturbance
2. 1-7d – hallucinations
3. 12-72h, up to 7d – seizures
4. 3-5d – DT, confusion, delusions, hallucinations, agitations, tremor, autonomic hyperactivity |
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Term
| Management EtOH withdrawal |
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Definition
CIWA-A
Diazepam 20 mg po q1-2h prn
If Hx of seizures, q1h x 3
Thiamine 100mg IM then 100mg po od 3d
Supportive – hydration/ nutrition |
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Term
| What is wernicke- korsakoff |
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Definition
| EtOH induced amnesic disorder d/t thiamine deficiency, necrotic lesions in brain |
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Term
| Schizophreniform disorder |
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Definition
A, D, E of schizophrenia, symptoms 1-6months duration
Good prognosis, abrupt beginning and end |
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Term
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Definition
| Acute, 1 criteria, 1 day to 1 month with eventual return to premorbid functioning |
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Term
| Schizoaffective disorder - A criteria |
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Definition
| uninterrupted period of illness during which there is either a major depressive episode, manic episode or mixed episode concurrent with A symptoms of schizophrenia |
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Term
| Schizoaffective - B symptoms |
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Definition
| in the same period, delusions or hallucinations in the absence of prominent mood symptoms for 2 weeks |
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Term
| Schizoaffective - C symptoms |
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Definition
| mood symptoms present for substantial portion of total duration of active and residual periods of illness |
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