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41 Cards in this Set

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Anorexia nervosa
characterized by thinking she needs to lose more weight despite being very thin; amenorrhea; lanugo hair; and bradycardia
characterized by tachycardia, postural tremor, exophthalmos, heat intolerance, weight loss despite normal appetite, low TSH and elevated T3 and T4.
is a chronic serious condition characterized by emotional blunting, first rank symptoms, formal thought disorder and, early in the illness, hallucinations and delusions.
Narcissistic personality disorder
disorder is characterized by a multi-year history of overvaluing one’s abilities, being preoccupied with fantasies of success, becoming enraged when one doesn’t receive special treatment, feeling entitled to and having excessive desire for praise and attention, lacking empathy, being interpersonally exploitative and being haughty or arrogant.
Bulimia nervosa
is characterized by recurrent episodes of binge eating, compensatory behavior to prevent weight gain (e.g., misusing laxatives, enemas or diuretics, vomiting, fasting and exercising excessively); and excessive attention to body shape and weight.
anorexia management and prognosis
She is at risk for electrolyte abnormalities, arrhythmias and pneumonia. Ten to 20% of persons with anorexia nervosa die from it. She should be treated initially in a specialized inpatient eating disorders treatment unit. Her suicide risk is much higher than that of other 16-year-olds in the general population
Obsessive compulsive disorder
characterized by recurrent, intrusive, unwelcome thoughts that, early in the illness, the patient knows are absurd. In anorexia nervosa, the patient thinks her views about her weight and appearance are correct, not absurd.
tuberculosis with calchexia
, the patient has severe weight loss with weakness, fever with night sweats and, often, symptoms and signs (e.g., hemoptysis, enlarged cervical nodes) related to the site of the infection.
Pulmonary carcinoma with brain metastasis
metastasis is usually associated with cough or hemoptysis, weight loss, and symptoms and signs related to the site of the metastasis in the brain and extent of increased intracranial pressure, such as seizures, nausea, vomiting, headache, delirium, paralysis, numbness, hemianopia, ataxia and dyspraxias
anorexia nervosa treatment
Treatment by an experienced multidisciplinary team. Management by a single physician, be it a generalist or psychiatrist, is likely to be inadequate. SSRIs may be helpful but not sufficient to effect cure. Neuroleptics are not usually helpful. Cognitive and behavioral therapy can be very helpful when they are part of a specialized program run by an experienced multi-disciplinary team.
the feeling that one’s body is strange or foreign, as if one were a spectator of one’s own body, is associated with severe anxiety and psychosensory seizures.
objects appear to change size and shape.
a sensation in one modality appears to trigger a sensation in another modality, such as a smell triggering a sound.
Panic disorder
which anxiety attacks (panic attacks) occur without a known precipitant
eventually answer the examiner’s questions, but give far more details than is necessary.
panic attacks occur when patients anticipate or experience a situation where they fear losing control of themselves (e.g., fainting, vomiting, becoming incontinent, dying) and nobody could help them. These situations may include shopping malls (agoraphobia is Greek for fear of the marketplace), bridges, tunnels, elevators, crowds, open spaces and being away from one’s house or neighborhood. ) Induction of an anxiety attack with intravenous lactate characterizes panic disorder or agoraphobia
Obsessive compulsive disorder
characterized by repeated unwanted intrusive thoughts perceived (early in the illness) as absurd, that lead to actions (compulsions) designed to alleviate the worry.
specific phobia
fear of an object, animal (e.g., snakes, insects, dogs), or situation (e.g., thunderstorms, heights, blood and injury) that most persons don’t fear.
Generalized anxiety disorder
characterized by chronic worry, tension and tiredness but in which panic attacks are infrequent or non-existent.
Reduced frontal blood flow and metabolism
occurs in schizophrenia, schizoaffective disorder, major depressive episodes with melancholic features, manic episodes, and attention deficit hyperactivity disorder.
Increased caudate blood flow and metabolism
obsessive compulsive disorder
Mild diffuse cortical and cerebellar vermis atrophy
schizophrenia, schizoaffective disorder, major depressive episodes with melancholic features, manic episodes and anorexia nervosa
Six per second EEG spikes
some epileptic seizures
Mitral valve prolapse
panic disorder
Panic disorder
is associated with spontaneous anxiety (panic) attacks unrelated to any known stressor.
post-traumatic stress disorder
months or years after an event in which one’s life or body integrity was threatened, one re-experiences the event with nightmares, daydreams, obsessions or “flashbacks”; experiences “numbing” in which one avoids others or situations that resemble the original event, has mildly reduced emotional expressivity or a feeling that life will be foreshortened, or is comfortable only among others who experienced a similar event; and has sympathetic over-activity in which one awakens suddenly from nightmares, startles easily or is hypervigilant.
secondary anxiety disorder
due to a general medical or neurologic condition that causes anxiety, including cardiopulmonary emergencies, hypoglycemia, thyrotoxicosis, Cushing’s disease, epilepsy, stroke, head injury, caffeinism, amphetamine toxicity, alcohol, barbiturate or benzodiazepine withdrawal; or pheochromocytoma.
Social phobia
anxiety or panic during or in anticipation of situations in which one thinks that others will notice, and ridicule, one being anxious. These situations include public speaking, using a public restroom, eating in restaurants, conversing with others, or being in a group. The phobic person doesn’t realize that most other people don’t really care whether he or she is anxious. Most of them care only about whether he or she is caring and competent.
Acute stress disorder
characterized by history of a fatal event during which the patient was intensely anxious and, for three weeks afterwards, felt depersonalized, re-experienced the event and had trouble sleeping, functioned notably less well than before the event, and recovered within one month.
conversion disorder
following a conflict or other stressor, the patient experiences one or more symptoms suggesting a neurologic or general medical disorder but where the findings do not support a diagnosis of neurologic or general medical disorder. For example, the patient might have paralysis without Babinski sign, clonus, hyperreflexia, hyporeflexia, atrophy or fasciculations.
dissociative fugue
the patient travels away from home or work, cannot recall his or her past, and is not fully aware of his or her own identity.
factitious disorder
the patient deliberately produces signs of illness to enter the sick role.
somatization disorder
, the patient has four or more medically unexplained pain symptoms, two or more medically unexplained gastrointestinal symptoms besides pain, one or more medically unexplained sexual symptoms, and one or more pseudoneurologic (conversion) symptom.
obsessive compulsive disorder
, the patient has recurrent intrusive unwelcome thoughts that he or she perceives, early in the illness, as absurd. This patient has recurrent intrusive unwelcome thoughts based on an actual experience.
schizotypal personality disorder
, the patient has a multi-year history of being a loner; having odd ideas like clairvoyance or telepathy, or ideas of reference that are not delusions; odd speech, odd behavior or appearance; unusual perceptual experiences like illusions, mildly blunted affect; and suspiciousness
dissociative identity disorder
, the patient has two or more identities or personality states, at least two of which predominate at various times, and the patient forgets more personal information than could be explained by ordinary forgetfulness.
post-traumatic stress disorder
have at least one additional psychiatric disorder, including major depressive disorder, substance abuse, panic disorder, obsessive compulsive disorder and antisocial personality disorder. PTSD tends to be chronic without full recovery, does not respond to ECT, is preceded by and associated with a traumatic event, and is associated only rarely with dementia.
reduced hippocampal volume
Increased caudate blood flow and metabolism
obsessive compulsive disorder
Immune marker β-lymphocyte antigen identified by monoclonal antibody D8/27
Punctate hemorrhages in the periventricular gray matter and thalamus
Wernicke’s encephalopathy, experienced by malnourished or starved persons (alcoholics, anorexics or prison camp inmates) with genetically-related thiamine metabolism inadequacy.