Summative behavioral health concise review

SIGECAPS of Depression

Sleep disturbances

Interests are ↓

Guilt

Energy is ↓

Concentration is ↓

Appetite is ↓

Psychomotor Agitation

Suicidal thoughts

5 or more x2 weeks = MDE

euphoria, increased energy, increased talking, rapid thoughts, no sleep, don't feel tired

manic episode→lasts at least 7 days

hypomanic at least 4 days

>1 MDE + NO mania/hypomania hx

MDD

first line tx for MDD

SSRI/SNRI

contraindicated in seizure disorders/anorexia

bupropion (wellbutrin)

mania vs. hypomania

Hypomania = 4 days, no impairment of social/work functioning, no psychotic features

Mania = 7 days, impairment, might have psychotic features - needs hospitalization

DIGFAST for bipolar disorder

Distractibility

Indiscretion

Grandiosity

Flight of ideas

Activity increase

Sleep deficit

Talking increase

DIGFAST for hypomania (idk why its different)

Distractibility

Insomnia

Grandiosity

Flight of ideas

Activty increase

Pressured Speech

Thoughtlessness

abnormally elevated or irritable mood lasting 1 week, 3/7 DIGFAST

bipolar 1

>1 MDE + >1 hypomanic episode, no manic episodes

bipolar II

gold standard for bipolar

lithium

medication induced depressive disorder

accutane

narcolepsy 1st line tx

modafinil

cluster A personality disorders

paranoid, schizoid, schizotypal

odd, withdrawn, sus, eccentric

emotionally cold, restricted affect, avoids close relationships, little sexual interest, social isolation

schizoid personality disorder

odd, eccentric/peculiar behavior or appearance of speech, lack of close friends, weird behaviors

schizotypal

long term pattern of unstable emotions, behaviors, beliefs, F>M, unstable interpersonal relationships, fear of abandonment, emptiness, impulsive

borderline personality disorder

I DESPAIRR

5/9 = borderline personality disorder:

Identity disturbance

Disordered affect

Emptiness

Suicidality

Paranoia

Abandonment fear

Impulsivity

Rage

Unstable relationships

cluster B disorders

antisocial, borderline, histrionic, narcissistic

dramatic, attention seeking, impulsive, erratic

sense of self-importance, extreme preoccupation with themselves, lack of empathy

narcissistic personality disorder

provocative for attention, shifting emotional states that seems fake, change opinions based on what others think, seductive behavior, influenced by others

histrionic personality disorder

cannot and will not conform to societal norms, commit unlawful acts, lack of remorse, harms animals

antisocial personality disorder → behavior before age 15

cluster C personality disorders

avoidant, dependent, obsessive-compulsive

low self esteem, worries about being criticized, feels inadequate, avoids jobs with interpersonal contact, fear of embarrassment

avoidant personality disorder

preoccupied with rules, orderliness, and control, perfectionist, controlling, workaholic, obsessions/compulsions are rare

OCPD

has others assume responsibility for major areas of their lives, discomfort when alone, indecisive

dependent personality disorder→avoid benzos

intrusive symptoms, avoidance symptoms, negative mood, arousal/reactive symptoms

PTSD →SSRIs

PTSD symptoms that occur for less than one month

acute stress disorder

recurrent and persistent thoughts, urges, or images along with repetitive behaviors or mental acts/rituals

OCD

MC hallucination

auditory

depakote causes _________ tox

liver

lithium causes ____________ tox

renal

renal impairment + risperidone =?

decrease dose by 50%

drugs that prolong QT

zofran

geodon

clarithromycin

hallucinations, delusions, disorganized speech, disorganized behavior, negative symptoms

2/5 for 6 months = schizophrenia

schizoaffective disorder

Psychotic disorder featuring symptoms of both schizophrenia and major mood disorder.

russell's sign

calluses on hands that are physical signs of bulimia

1st line pharm tx for bulimia

prozac

FDA approved for tx of BED

vyvanse

when do alcohol withdrawal seizures occur?

within first 6-48 hrs of last drink

most severe form of withdrawal syndrome

delirium tremens

z-bars

xanax

angel dust

PCP

increased energy, feeling of pleasure, enhanced tactile experiences

MDMA (ectasty, molly) intoxication

MDMA cause of death

hyperthermia and dehydration

benzo reversal agent

flumazenil

tachycardia, hyperthermia, HTN, seizures, diaphoresis, mydriasis

cocaine intoxication

FGA vs. SGA

first gen: more extrapyramidal sx d/t D2 blockade

Second gen: more metabolic side effects

personality disorder with greatest suicide risk

borderline

MC population for suicide

M >65 y/o

can't recall from a period of time

localized amnesia →MC

remember some but not all events during a period of time

selective amnesia

unreality, detachment, watching yourself outside your body, no sense of control over actions

depersonalization

foggy, dream like, behind a veil, unreality or detachment with respect to surroundings

derealization

2 or more distinct personalities whose identities differ

DID

abdominal/general pain, diarrhea/constipation, heartburn, preoccupied with health

somatic symptoms disorder →high levels of anxiety and worry about body

extreme out of proportion anxiety about health, no somatic symptoms

illness anxiety disorder →doc hopping, repeated testing

falsify sx and illness to obtain external rewards (money, no work, avoid duties)

malingering

tourette's treatment

tetrabenazine

aggression to people and animals, destruction of property, deceitful/theft, no remorse, violation of rules/law, onset before 18 y/o

conduct disorder →inc. risk of antisocial PD

1st line for MDD in peds

fluoxetine

kids with depression often present as ___________ rather than depressed

irritable

arousal from causing psych/physical suffering of another

sadism