Schizophrenia
Symptoms that occur between 1 month to 1 year prior to the first psychotic break
Prodromal symptoms
The four common theories of major depressive disorder (MDD) are...
BONUS (+100pts) if you can describe ONE of the theories
biologic, psychodynamic, cognitive, learned helplessness
Holly, a 24 year old woman, presents to an appointment with her PCP disheveled, describing being "very productive" over the past week, and has been able to deep clean and re-paint her entire home. She is talkative throughout the exam and jumps from topic to topic. She reports feeling "the best I have ever been" despite only sleeping approximately 2 hours each night.
What type of episode do you presume Holly is experiencing?
Mania
Intense activation of _____ leads to normal activities being neglected
Reward syste/pathways
An individual with disregard for & violation of rights of others by not following social norms, deceitfulness, and reckless disregard for safety likely has...
BONUS (+100pts): what cluster is this from?
Cluster B
Name the POSITIVE symptoms of Schizophrenia
BONUS (+100PTS): are these MORE or LESS responsive to medications?
Hallucinations, delusions, thought disorder, bizarre behavior
MORE responsive
In ____, self esteem is preserved, whereas in ___ worthlessness and self-loathing are common
Grief, MDD
Defining characteristics of Bipolar ___ are when an individual experiences hypomania with profound depression
II
The 4 symptoms of alcohol use
Craving
Loss of Control
Physical Dependence
Tolerance
A major defense mechanism seen in this disorder is splitting and self mutilation (ex: superficial cutting) is common
Borderline Personality Disorder
Name 4 anticholinergic symptoms
Dry mouth, urinary retention, constipation, blurred vision, photosensitivity, dry eyes, ejaculatory inhibition
MRI magnetic pulses stimulate areas of the brain
Transcranial Magnetic Stimulation (TMS)
The strongest and most consistent risk factor for bipolar disorder
Genetic heritability
What elapsed time period is evaluated when determining if an individual meets DSM-5 criteria for Alcohol Use Disorder?
12 months
Limits should be ___, ____ and _____
Clear, consistent and enforceable
An emergency that is caused by sudden reduction in dopamine activity-- results in severe muscle rigidity, fever, HTN, tachycardia, diaphoresis, tachypnea, confusion
Neuroleptic Malignant Syndrome (NMS)
Tyramine containing foods should be avoided with this class of antidepressants
MAOI's
The 1st choice for treatment individuals with Bipolar I disorder in the acute and maintenance phase
BONUS (100pts) if you can correctly identify the therapeutic range for this medication
Lithium
Therapeutic between 0.4-1.3mEq/L
Toxic beyond 1.5mEq/L
The three nutritional/dietary supplements used in an alcohol withdrawal protocol
Thiamine (prevents encephalopathy)
Magnesium sulfate (reduces seizures)
Folic acid/ multivitamins (correct nutritional deficiencies)
The threat of separation or abandonment increases symptoms in this disorder
Borderline Personality Disorder
BONUS (+100pts): name the specifiers required for the diagnostic criteria
Schizoaffective disorder
Specifier: bipolar OR depressed type
A patient with a medication history including fluoxetine (discontinued without taper) and paroxetine presents with increased anxiety, insomnia, constant shaking, tachycardia, and extreme fatigue.
What do you suspect the cause of these symptoms is?
BONUS (+100pts) if you can describe treatment of this
Serotonin syndrome
Treatment: discontinue serotonergic agents!!!! Can use benzodiazepines for psychomotor agitation.
What dietary teaching should be provided to a patient taking Lithium? Why?
Monitor hydration and salt intake
Lithium is reabsorbed in the proximal tubule and competes with sodium (if sodium decreases, lithium increases), loss of sodium (ex: excessive sweating) can result in lithium toxicity
____ works by blocking opiate receptors, reducing alcohol and opiate preference
Naltrexone (Revia)
Name the four characteristics of personality disorders
Inflexible or maladaptive responses to stress
Disability to work or love
Ability to evoke interpersonal conflict
Capacity to "get under the skin"