PEDIATRICS

PSYCHIATRY
1. Axis Determination I = clinical psych disorders II personality disorders, III Coexisting medical conditions IV psychosocial stressors, V global assessment of functioning

2. Schizophrenia Positive Sx: delusions, hallucinations, bizarre behavior; Negative Sx: alteration of affect, ambivalence, apathy, loosening of associations; males=females; industrial nations have incr. prevalence; Misalignment of cells in cortex; incr. ventricle size; decr. activity in frontal cortex on PET scan.
3. Disorganized: insidious, incoherent, inappropriate affect, social impaired
4. Catatonic: rigidity, posturing or excitement, negativism
5. Paranoid: highest functioning type, grandiose, jealous, persecution
6. Undifferentiated: not defined by other subtypes
7. Melerill = Retrograde ejaculation, Tx: Respiradol (Best side effect profile), Clozaril (agranulocytosis w/ weekly CBC) prescribed weekly,
8. Neurolyptic Malignant Syndrome = incr. temp, incr. CPK, rigidity

9. Schizophrenifrom same sx as schizophrenia but have lasted for less than 6 months

10. Schizoaffective mood disorder and separate psychotic sx. Must experience 2 weeks of psychotic sx w/o mood impairment for dx to be made; Antidepressants are 1st line tx

11. Major Depression loss of interest in activities, sleep, wt, concentration, hopelessness, suicidal ideation, nihilism; Seasonal affective, Vegetative (non functioning can be terminal) Dysthymia(chronic low level); Reactive related to environment w/o severity id sx; Masked 1o depression denied or hidden by other sx
12. Depression & anxiety can occur together & can be treated w/ an antidepressent; Left anterior or rt posterior stroke => incr. possibility of depression; Tx: 1st Tricyclic (Imiprimine); SSRI = side effects; Trazadone=priapism Asendin (Amoxipine) = Extrapyramidal Symptoms

13. BiPolar Bimodal peak 20's & 30'sCycling mood= highs w/ euphoria, hyperactive, pressured speech, flight of ideas, decr need for sleep, delusions, inflated self esteem, risks, poor judgement; Lows are major depressive episodes tx: lithium

14. Panic Attacks Sudden, unprovoked onset of fear, impending doom, palpitations, SOB, chest pain, smothering, dizziness. May be associated w/ agoraphobia Tx: with SSRI's

15. Phobias Persistent and irrational fear of a specific object or activity or situation. Tx like a phobia

16. Obsessive Compulsive Persistent, unwanted thoughts, impulses or images
17. repetitive, purposeful intentional behaviors meant to decrease tension caused by the obsessive thoughts; genetic Tx: Anafranil (Tricyclic) Prozac & Luvox (SSRI)

18. PTSD intrusive recollections, daydreams, nightmares, poor concentration, psychic numbing; Tx: don't treat w/ meds unless compulsion component
19. Studies: Buffalo Creek Disaster, Beverly Hills Nightclub

20. Dissociative Disorder Amnesia = loss of memory, Fugue = assoc w/ physical flight, Identity Disorder = multiple ego states; Depersonalization = feelings of self estrangement or unreality

21. Whirndingo Fear of becoming a cannibal

22. Amok sudden unprovoked outburst of wild rage usually ending in homicide

23. Coprolalia Feces & filth

24. Koro penis is shrinking and may disappear

25. Latah imitate words or actions to which they are exposed

26. Piblotko Run around in snow naked

27. White Out Syndrome lack of diverse stimuli in snow clad environment

28. Narcolepsy REM sleep, sudden onset of daytime sleep and cataplexy; REM sleep is inappropriately present at beginning

29. Personality Disorders Cluster A = Bizarre = Paranoid, Schizoid (no close relationships, restricted emotions) Schizotypical (schizoid + odd or distorted behavior or cognition)
30. Cluster B = Over emotional = Antisocial (Disregard for social norms) Borderline, Histrionic, Narcissistic (self centered)
31. Cluster C = Anxiety & Fear = avoidant, dependent, Obsessive compulsive