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SIGNS AND SYMPTOMS IN PSYCHIATRY 1
PSYCHIATRY
CONTENTS
SIGNS AND SYMPTOMS IN PSYCHIATRY ....................................................................................................................... 5
GENERAL FEATURES OF PSYCHIATRIC SYMPTOMS ................................................................................................... 5
DELUSION .................................................................................................................................................................. 7
ILLUSION ................................................................................................................................................................... 7
HALLUCINATION........................................................................................................................................................ 8
TESTS IN PSYCHIATRY ................................................................................................................................................ 8
SUBSTANCE RELATED DISORDERS ................................................................................................................................ 9
GENERAL FEATURES OF SUBSTANCE RELATED DISORDERS ...................................................................................... 9
AMPHETAMINE ......................................................................................................................................................... 9
COCAINE .................................................................................................................................................................... 9
CANNABIS ............................................................................................................................................................... 10
LSD .......................................................................................................................................................................... 11
ALCOHOL ................................................................................................................................................................. 11
DELIRIUM TREMENS................................................................................................................................................ 13
FETAL ALCOHOL SYNDROME .................................................................................................................................. 13
OPIOID RECEPTORS ................................................................................................................................................. 13
OPIOID DRUGS ........................................................................................................................................................ 14
OPIOID POISONING ................................................................................................................................................. 16
TREATMENT OF OPIOID POISONING....................................................................................................................... 16
NICOTINE................................................................................................................................................................. 17
CAFFEINE ................................................................................................................................................................. 17
COGNITIVE DISORDERS ............................................................................................................................................... 17
FEATURES OF COGNITIVE DISORDERS .................................................................................................................... 17
ORGANIC BRAIN SYNDROME .................................................................................................................................. 18
DELIRIUM ................................................................................................................................................................ 18
AMNESTIC DISORDERS ............................................................................................................................................ 19
DEMENTIA ............................................................................................................................................................... 19
ALZHEIMER’S DISEASE ............................................................................................................................................. 20
SCHIZOPHRENIA .......................................................................................................................................................... 21
RISK OF SCHIZOPHRENIA ......................................................................................................................................... 21
FEATURES OF SCHIZOPHRENIA ............................................................................................................................... 22
TYPES OF SCHIZOPHRENIA ...................................................................................................................................... 23
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SIGNS AND SYMPTOMS IN PSYCHIATRY 2
PSYCHIATRY
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SIGNS AND SYMPTOMS IN PSYCHIATRY 3
PSYCHIATRY
IMPOTENCE ............................................................................................................................................................. 40
ERECTILE DYSFUNCTION ......................................................................................................................................... 40
PREMATURE EJACULATION ..................................................................................................................................... 40
EATING DISORDERS ..................................................................................................................................................... 40
SLEEP DISORDERS........................................................................................................................................................ 41
GENERAL FEATURES OF SLEEP DISORDERS ............................................................................................................. 41
EEG .......................................................................................................................................................................... 42
REM SLEEP .............................................................................................................................................................. 43
NREM SLEEP ............................................................................................................................................................ 43
NARCOLEPSY ........................................................................................................................................................... 43
IMPULSIVE DISORDERS ............................................................................................................................................... 43
PEDIATRIC PSYCHIATRY ............................................................................................................................................... 44
GENERAL FEATURES OF PEDIATRIC PSYCHIATRY .................................................................................................... 44
ATTENTION DEFICIT HYPERACTIVE DISORDER ........................................................................................................ 44
AUTISM ................................................................................................................................................................... 45
MENTAL RETARDATION .......................................................................................................................................... 45
CONDUCT DISORDER AND SPECIFIC LEARNING DISORDER .................................................................................... 46
MANCHAUSEN SYNDROME ........................................................................................................................................ 46
TREATMENT IN PSYCHIATRY ....................................................................................................................................... 46
ANTIPSYCHOTICS ..................................................................................................................................................... 46
NEUROLEPTIC MALIGNANT SYNDROME ................................................................................................................. 49
ANTIDEPRESSANT DRUGS ....................................................................................................................................... 49
MAO INHIBITORS .................................................................................................................................................... 51
SERATONIN SYNDROME .......................................................................................................................................... 51
ANTIANXIETY DRUGS .............................................................................................................................................. 51
BENZODIAZEPINE ANTAGONIST .............................................................................................................................. 52
DRUGS ACTING ON GABA ....................................................................................................................................... 53
ELECTROCONVULSIVE THERAPY ............................................................................................................................. 53
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SIGNS AND SYMPTOMS IN PSYCHIATRY 4
PSYCHIATRY
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SIGNS AND SYMPTOMS IN PSYCHIATRY 5
PSYCHIATRY
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SIGNS AND SYMPTOMS IN PSYCHIATRY 6
PSYCHIATRY
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SIGNS AND SYMPTOMS IN PSYCHIATRY 7
PSYCHIATRY
DELUSION
ILLUSION
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SIGNS AND SYMPTOMS IN PSYCHIATRY 8
PSYCHIATRY
HALLUCINATION
TESTS IN PSYCHIATRY
MC screening test for Organic brain Disorder Bender Visual Motor Gestalt test
Signs of organic brain damage evident on Bender Gestalt test
NOT a projective test Bender Gestalt test
Rorscach test measures Personality
Rorscach inkblot test is Projective
A projective test in which pictures are Thematic appreciation test
shown to help the patient to discuss his
fantasies and fear
Test using projection Rorschach test
Halstead Reitan battery Finger oscillation, rhythm, thematic appreciation test
Halstead Reitan battery does NOT involve Constructional apraxia
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SUBSTANCE RELATED DISORDERS 9
PSYCHIATRY
AMPHETAMINE
COCAINE
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SUBSTANCE RELATED DISORDERS 10
PSYCHIATRY
CANNABIS
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SUBSTANCE RELATED DISORDERS 11
PSYCHIATRY
LSD
Flashback LSD
Flashback phenomenon is also associated Cannabis, Psilocybin
with
Crossover of sensory perception, sounds can be seen, LSD
colors can be heard
Morning glory is associated with LSD (clear consciousness)
Treatment is NOT required for withdrawal of LSD
Treatment for LSD abuse Talking down
ALCOHOL
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SUBSTANCE RELATED DISORDERS 12
PSYCHIATRY
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SUBSTANCE RELATED DISORDERS 13
PSYCHIATRY
DELIRIUM TREMENS
OPIOID RECEPTORS
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SUBSTANCE RELATED DISORDERS 14
PSYCHIATRY
OPIOID DRUGS
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SUBSTANCE RELATED DISORDERS 15
PSYCHIATRY
in causing
Drug contraindicated in renal failure Pethidine
Opioid that should NOT be used with MAO inhibitors Pethidine
Least addictive potential Codeine
NOT an opioid agonist Ketamine
Opioid agonist-antagonist compounds Buprenorphine, Nalbuphine, Pentazocine, Nalmefene
Pentazocine Decreased vomiting and constipation compared to
morphine, risk of addiction is less than that of
morphine, agonist antagonist
Minimum Respiratory depression Pentazocine
Contraindicated in Porphyria, Minimal Medullary Pentazocine
Depression
Tramadol Opioid analgesic
Buprenorphine Partial agonist at mu agonist
Buprenorphine 25 times more potent than morphine
Bell Shaped Dose Response Curve, Most Potent Buprenorphine
Morphine
Ceiling effect Buprenorphine
Alternate to methadone for treatment of opioid Buprenorphine
dependence
Butarphonol Opioid agonist antagonist
Alvimopen Peripheral mu antagonist
Fedotozine Kappa receptor antagonist
100 times more potent than morphine Fentanyl
MC used Lipophilic drug for Spinal ANALGESIA Fentanyl
Muscle Spasm Fentanyl
Remifentanyl Short half life, More potent than alfentanyl
Remifentanil Useful for short painful procedures, Metabolized by
plasma esterases, Equipotent as fentanyl
Constant Context Sensitive Half Time Remifentanil
Shortest acting intravenous analgesic Remifentanil
Shortest elimination half life Remifentanil
Opioid NOT given intrathecally Remifentanil
Best induction agent for outpatient anaesthesia Alfentanyl
Does NOT cause Respiratory Depression Alfentanyl
Maximum Late Medullary Paralysis Alfentanyl, Buprenorphine
Common side effect seen with alfentanyl Chest wall rigidity
More potent opioid Sulfentanyl
Highly protein bound Sulfentanyl
Opioid having maximum plasma protein binding Sulfentanil
capacity
Opioid with long t 1/2 and high oral parenteral activity Methadone
ratio
NOT true about methadone Its main indication is pain
Long term maintenance in opioid addiction Methadone
Least sedative narcotic Papaverine
Opioid drug given by transdermal route Fentanyl
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SUBSTANCE RELATED DISORDERS 16
PSYCHIATRY
OPIOID POISONING
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COGNITIVE DISORDERS 17
PSYCHIATRY
NICOTINE
CAFFEINE
Caffeine Trimethylxanthine
Caffeinism occurs if ingestion of caffeine is 500 mg/day
above
Caffeine withdrawal is associated with Headache, depression, anxiety
NOT a feature of caffeine withdrawal Mania
COGNITIVE DISORDERS
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COGNITIVE DISORDERS 18
PSYCHIATRY
DELIRIUM
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COGNITIVE DISORDERS 19
PSYCHIATRY
AMNESTIC DISORDERS
DEMENTIA
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COGNITIVE DISORDERS 20
PSYCHIATRY
ALZHEIMER’S DISEASE
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SCHIZOPHRENIA 21
PSYCHIATRY
SCHIZOPHRENIA
RISK OF SCHIZOPHRENIA
General Population 1%
Nephew/Niece 2.5%
Half siblings 3.5%
Non twin sibling of Schizophrenic 8%
Dizygotic twin of Schizophrenic 12%
Child with One parent Schizophrenic 12%
Sibling of Schizophrenic with one parent 15%
Schizophrenic
Child with Both parents Schizophrenic 40%
Monozygotic twin of Schizophrenic 47%
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SCHIZOPHRENIA 22
PSYCHIATRY
FEATURES OF SCHIZOPHRENIA
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SCHIZOPHRENIA 23
PSYCHIATRY
TYPES OF SCHIZOPHRENIA
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MOOD DISORDERS 24
PSYCHIATRY
MANAGEMENT OF SCHIZOPHRENIA
MOOD DISORDERS
DEPRESSION
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MOOD DISORDERS 25
PSYCHIATRY
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MOOD DISORDERS 26
PSYCHIATRY
MANIA
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MOOD DISORDERS 27
PSYCHIATRY
BIPOLAR DISORDERS
SUICIDE
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MOOD DISORDERS 28
PSYCHIATRY
LITHIUM
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MOOD DISORDERS 29
PSYCHIATRY
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ANXIETY DISORDERS 30
PSYCHIATRY
ANXIETY DISORDERS
ANXIETY NEUROSIS
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ANXIETY DISORDERS 31
PSYCHIATRY
PHOBIA
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ANXIETY DISORDERS 32
PSYCHIATRY
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PSYCHOANALYSIS, EGO AND EGO DEFENCE MECHANISMS 33
PSYCHIATRY
ADJUSTMENT DISORDER
PSYCHOANALYSIS
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PSYCHOANALYSIS, EGO AND EGO DEFENCE MECHANISMS 34
PSYCHIATRY
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PSYCHOANALYSIS, EGO AND EGO DEFENCE MECHANISMS 35
PSYCHIATRY
RESEARCHERS IN PSYCHIATRY
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PERSONALITY DISORDERS 36
PSYCHIATRY
Many of our bad activities in day to day life can be Negative conditioning
removed by
Psychodynamic theory of mental illness is based on Unconscious internal conflict
Counter transference Doctor’s feeling towards patient
NOT a method of learning in psychiatry Catharsis
Behavior therapy is useful in Phobia, OCD, Personality disorder, Panic attack, Anxiety
Cognitive behavior therapy deals with Maladaptive assumptions, Emotional consciousness of
automatic thoughts
NOT a part of cognitive behavior therapy Consolidation
NOT done in behavior therapy to increase a behavior Punishment
Patient of contamination phobia was asked by the Modelling
therapist to touch everything he touches
Systemic desensitization therapy used for Phobia
Treatment of obsessive compulsive disorder Exposure and response prevention
Reviving and bringing a psychiatric patient to normal Abreaction
consciousness
Features of seasonal affective disorder More common in women, anergy, fatigue,
weight gain, hypersomnia, episodic
carbohydrate craving, disease prevalence
increases with distance from equator,
improvement may occur by altering
exposure to light
Treatment of Choice for Seasonal Affective Disorder Phototherapy
Stimulation of nerve leading to elevated mood Vagus > Olfactory
PERSONALITY DISORDERS
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SOMATOFORM DISORDER 37
PSYCHIATRY
SOMATOFORM DISORDER
SOMATISATION DISORDER
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SOMATOFORM DISORDER 38
PSYCHIATRY
FIBROMYALGIA
HYSTERIA
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GENDER IDENTITY AND SEXUAL DISORDERS 39
PSYCHIATRY
HYPOCHONDRIASIS
DISSOCIATIVE DISORDERS
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EATING DISORDERS 40
PSYCHIATRY
IMPOTENCE
ERECTILE DYSFUNCTION
PREMATURE EJACULATION
EATING DISORDERS
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SLEEP DISORDERS 41
PSYCHIATRY
SLEEP DISORDERS
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SLEEP DISORDERS 42
PSYCHIATRY
EEG
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IMPULSIVE DISORDERS 43
PSYCHIATRY
REM SLEEP
NREM SLEEP
Slow wave sleep predominant in first one NREM stage III and IV
third of night sleep is a phase of
Nocturnal enuresis Stage IV of REM sleep
Treatment of choice for night terror Clonazepam
NARCOLEPSY
IMPULSIVE DISORDERS
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PEDIATRIC PSYCHIATRY 44
PSYCHIATRY
PEDIATRIC PSYCHIATRY
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PEDIATRIC PSYCHIATRY 45
PSYCHIATRY
(Ritalin)
10 year child always restless, inattentive to study, want Behavioral therapy
to play outside. Next
AUTISM
MENTAL RETARDATION
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MANCHAUSEN SYNDROME 46
PSYCHIATRY
Conduct disorder of child manifests with Disregard for right of others, doesn’t care for authority,
backward in study, steal things
14 year boy, difficulty in expressing himself in writing Specific learning disorder
frequent spelling mistakes. but mathematical ability and
social adjustment appropriate for age
Best therapy suited to teach life skill to a mentally Contingency
challenged child
Poor scholastic performance is NOT associated with PICA
MANCHAUSEN SYNDROME
TREATMENT IN PSYCHIATRY
ANTIPSYCHOTICS
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TREATMENT IN PSYCHIATRY 47
PSYCHIATRY
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TREATMENT IN PSYCHIATRY 48
PSYCHIATRY
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TREATMENT IN PSYCHIATRY 49
PSYCHIATRY
ANTIDEPRESSANT DRUGS
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TREATMENT IN PSYCHIATRY 50
PSYCHIATRY
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TREATMENT IN PSYCHIATRY 51
PSYCHIATRY
MAO INHIBITORS
SERATONIN SYNDROME
ANTIANXIETY DRUGS
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TREATMENT IN PSYCHIATRY 52
PSYCHIATRY
BENZODIAZEPINE ANTAGONIST
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TREATMENT IN PSYCHIATRY 53
PSYCHIATRY
ELECTROCONVULSIVE THERAPY
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