Psychiatry Lecture Review

Comprehensive vocabulary flashcards covering the Mental Status Exam, ego defense mechanisms, psychotic disorders, mood disorders, pharmacology, personality disorders, and pediatric psychiatry based on the lecture transcript.

Mental Status Exam (MSE) - Affect

The examiner's observation of the patient's mood, including fluctuation (labile), range (flat, full, constricted), and specific description (sad, euphoric).

Ego

The 'mediator' in Freudian theory that acts as a rational decision-maker between the primitive demands of the ID and the moral rules of the SUPEREGO.

Sublimation

A mature ego defense mechanism where a person redirects unacceptable impulses, such as anger, into productive activities like athletics.

Reaction Formation

An immature ego defense mechanism where an individual performs the exact opposite of their true thoughts, such as a father who never wanted children becoming a 'super dad.'

Splitting

An immature defense mechanism associated with Borderline Personality Disorder where the patient views people or situations as all good or all bad.

Brief Psychotic Disorder

Symptoms of schizophrenia that are typically stress-related and last for less than 1 month, involving at least one positive symptom.

Schizoaffective Disorder

A condition characterized by schizophrenia symptoms (psychosis) occurring alongside a mood disorder (affect), where hallucinations or delusions persist for at least 2 weeks in the absence of mood symptoms.

Positive Symptoms (Schizophrenia)

The presence of additional behaviors such as delusions, hallucinations (most commonly auditory), disorganized speech, and disorganized behavior.

Negative Symptoms (Schizophrenia)

The loss of prior function, often remembered as the '4 As': Affect (flat), Anhedonia, Alogia (poverty of speech), and Asociality.

Acute Dystonia

An extrapyramidal symptom occurring within 4 hours to 4 days of treatment characterized by muscle spasms or stiffness; treated with Benztropine or Diphenhydramine.

Tardive Dyskinesia

Abnormal facial movements such as lip-smacking that occur after months to years of typical antipsychotic use; managed by switching to Clozapine or adding a VMAT-inhibitor.

Neuroleptic Malignant Syndrome (NMS)

A complication of antipsychotics characterized by 'lead-pipe' rigidity, rhabdomyolysis (high CK), myoglobinuria, fever, and encephalopathy.

Clozapine

An atypical antipsychotic used for refractory schizophrenia that requires close monitoring for agranulocytosis and has side effects including myocarditis and metabolic syndrome.

Mesolimbic Pathway

The dopamine pathway where increased activity is responsible for the positive symptoms of schizophrenia; blocked by antipsychotics to reduce symptoms.

Nigrostriatal Pathway

The dopamine pathway responsible for motor control; blockade by antipsychotics leads to extrapyramidal symptoms (ADAPT).

Major Depressive Disorder (MDD)

A mood disorder requiring anhedonia or depressed mood plus 4 'SIG E CAPS' symptoms lasting for at least 2 weeks.

Dysthymia

Also called Persistent Depressive Disorder; characterized by a depressed mood with at least 2 symptoms for at least 2 years without lapses longer than 2 months.

Postpartum Blues

Tearfulness and fatigue starting 2-3 days after delivery due to hormone withdrawal, typically resolving within 2 weeks.

SAD PERSONS

A mnemonic for suicide risk factors: Sex (Male), Age (Teen/Elderly), Depression, Prior attempt, Ethanol/drug use, Rational thinking impaired, Sickness, Organized plan, No social support, and Stated future intent.

Tyramine-Induced Hypertensive Emergency

A severe reaction occurring when patients taking Monoamine Oxidase Inhibitors (MAO-Is) consume tyramine-containing foods; treated with phentolamine.

Tricyclic Antidepressant (TCA) Overdose

Characterized by the '3 Cs': Cardiotoxicity, Coma, and Convulsions; treated with sodium bicarbonate.

Bipolar I Disorder

A diagnosis defined by the occurrence of at least one manic episode, which can also involve psychotic features.

Bipolar II Disorder

A diagnosis requiring at least one hypomanic episode and one major depressive episode.

Lithium

A first-line mood stabilizer for bipolar disorder with a narrow therapeutic index of $0.8 - 1.2\,mEq/L$ and side effects including hypothyroidism and EBstein anomaly.

Cluster A Personality Disorders

The 'Wacky/Weird' cluster with genetic associations to schizophrenia, including Schizotypal, Schizoid, and Paranoid types.

Panic Disorder

A disorder characterized by one unexpected panic attack followed by at least 1 month of preoccupation with having another attack.

Post-Traumatic Stress Disorder (PTSD)

Disturbances lasting over 1 month following a traumatic event, involving re-experiencing dreams, avoiding stimuli, and sympathetic arousal.

Generalized Anxiety Disorder (GAD)

A condition involving excessive worry and 3 out of 6 symptoms (fatigue, irritability, restlessness, etc.) lasting more than 6 months.

Agoraphobia

Marked fear and anxiety regarding 2 or more situations where escape is difficult, lasting more than 6 months.

Malingering

Intentionally feigning or causing illness for secondary gain, such as avoiding prison or obtaining prescribed drugs, with conscious motivation.

Conversion Disorder

The development of neurologic symptoms like numbness or paralysis following a stressful event, where the patient may appear notably un-distressed.

Narcolepsy

A chronic sleep disorder due to a deficiency of hypocretin, presenting with excessive daytime sleepiness and hypnagogic or hypnopompic hallucinations.

Anorexia Nervosa

An eating disorder characterized by a BMI $< 18.5$, preoccupation with low body weight, and long-term consequences like osteoporosis and myocardial atrophy.

Re-feeding Syndrome

A complication of nutritional rehabilitation in eating disorders involving hypertension, instability, or seizures caused by hyperinsulinemia and electrolyte shifts.

Conduct Disorder

Repetitive behaviors that violate social norms, such as harming animals or stealing, in children under 18 years old; known as Antisocial Personality Disorder if over 18.

Tourette's Syndrome

The presence of both motor and vocal tics for more than 1 year, often comorbid with ADHD and OCD.

Phencyclidine (PCP) Intoxication

Characterized by psychomotor agitation, nystagmus, aggression, and autonomic stimulation lasting more than 1 hour.

Wernicke-Korsakoff Syndrome Prevention

The administration of thiamine before glucose in patients with alcohol use disorder to prevent neurologic complications.

Delirium Tremens

A severe form of alcohol withdrawal occurring 2-4 days after the last drink, presenting with autonomic instability, seizures, and tachycardia.

Alzheimer's Disease

Gradual cognitive decline caused by $\beta$-amyloid plaques and hyperphosphorylated Tau tangles, often treated with Acetylcholinesterase inhibitors.