Psychiatry UWORLD

Alzheimer disease

-Neurofibrillary tangles with Tau protein -Amyloid plaques -Ch. 21 APP gene -Apolipoprotein E4

Frontotemporal dementia

-Tau protein inclusion (neurofibrillary tangles, Pick bodies) -aggregation of phosphorylated Tau protein -TDP-43 protein inclusions

Countertransference

-You suck as a physician -Put him down!

Alcohol withdrawal

1. Downregulates GABA A r 2. Upregulates NMDA receptor

Brief psychotic disorder

> 1 days & <2 month, sudden onset, full return to function

Schizophreniform disorder

>1 month <6 months, same symptoms as SZ, funtional decline not needed

Delirium

Acute Impaired consciousness Fluctuating Reversible Global impair

Mindy is a medical student who has anxiety and trouble centrating. She went to rotation witnessing a child who had been badly burnt pulled out of the fire 3 weeks ago. Mindy sweats, shake and has trouble breathing. She almost quit medical school. What is the diagnosis?

Acute stress disorder >3 days <1 month

Panic disorder develops

Agorophobia (not wanting to go to medical school, church)

Projection- divorced child "i'm fine"

Attributing one's one feelings to others

Dementia

Cognitive decline Interferes with activities with daily living

Mild Cognitive Impairment

Cognitive decline normal functioning (cook clean) <26/30

Tricyclic SE

Confusion Constipation Urinary retention** Hypotension Caution in elderly patients

Van Goh has Schizophrenia

Delusions, Hallucination, Disorganized speech,Negative symptoms >6 months

Facial dysmorphism (short palpebral fissures, thin upper lip, smooth philtrum, growth retardation, neuro abnormalities, and behavioral difficulties)

Fetal Alcohol Syndrome

Benzo

GABAA increase frequencyof chloride channel opening

3 yoa Madison

GM: Walks up/down stairs with alternating feet, Rides tricycle FM: copies a circle, uses utensils Language: 3 word sentences, speech 75% intelligible Cog: Knows age/gender, imaginative play

Dementia

Gradual onset Irrversib Denies fluctuations in consciousness

Lithium * can cause hypothyroidism (wt gain)

Lithium

Patient has cancer (nonsomatic depressive symptoms)

Low of interest in family

Fluphenazine

More Muscular ridigity

Buproprion

NE-DA reuptake inhibitor first line tx for MDD Does not cause Sexual dysfunction

Bup-Ren orphine

Partial opioid Agonist High affinity; low intrinsic can displace other opioids and precipitae withdrawal symptoms (come back to haunt you)

Rex normal development of age 10 months regresses (loss of babbling and motor control) handwringing, loss of motor and language skills, sterotypic hand movements. Deceleration of head growth.

Rett syndrome

Somatic symptom disorder - I hurt

Schedule regular visits with same provider

Second generation antipsychotics

Serotonin 2A receptor antagonism metabolic syndrome, weight gain, EPS Low risk of EPS

Mature defense mech

Sublimation- fighting kick boxing Suppression- putting unwanted feelings aside to cope with reality; conscious choice not to dwell on a particular though or feeling Altruism Humor

MAO mito enzymes (normally)

breakdown monoamines

Sheldon= ASD

deficits in social communciation reciprocal social interactions restricted interests (science) Behavioral rigidity (sitting in his favorite spot)

Schizoaffective disorder

delusion or hallucination for >2 weeks in the abscenc of major depressive or manic episodes

Negative symptoms of SZ

flat affect (lack of facial expression, monotone voice) poverty of speech social withdrawal

Methadone- Meth pinapple

full mu-opioid receptor Agonist long half life suppress cravings and withdrawal

ADHD

pattern of inattention hyperactive/impulsive

Wilson disease

transaminase