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
