Psychiatry amnesia

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					Chanesd Srisukho
Common sense is
 the collection of prejudices
 acquired by age eighteen.
         Albert Einstein (1879 - 1955)



          Psychiatry - Chanesd Srisukho
 DEFINITION
 Normal / Abnormal
 Causes
 Treatments




                Psychiatry - Chanesd Srisukho
Please open your book:

      First aid for the
      USMLE STEP 1


            Psychiatry - Chanesd Srisukho
Psychiatry - Chanesd Srisukho
   Level of mind
     Conscious
     Preconscious
     Unconscious


   Thinking process
     Secondary process – reality principle
     Primary process – pleasure principle



                      Psychiatry - Chanesd Srisukho
   Structure of mind
     Id
      ○ Libidinal drive (think “libido”)
      ○ Aggressive drive
     Ego - buffer
     Superego
      ○ Conscience
      ○ Ideal person (Idol)




                          Psychiatry - Chanesd Srisukho
   Defensive mechanism
     Repression – common
     Denial
     Projection – (think “projector points”)
     Displacement
     Reaction formation
     Rationalization
     Isolation
     Regression
      ○ Regression in children
                        Psychiatry - Chanesd Srisukho
   Defensive mechanism (continued)
     Identification
     Acting out


   Mature defensive mechanism
     Sublimination
     Humor
     Altruism
     Suppression

                       Psychiatry - Chanesd Srisukho
Psychiatry - Chanesd Srisukho
 Oedipus complex – Boy
 Electra complex – Girl
 Basic trust
 Stranger recognition
 Temperament – basic temper of child
     Easy temperament
     Difficult temperament
     Slow-to-warm-up temperament
   Self-esteem
                     Psychiatry - Chanesd Srisukho
Psychiatry - Chanesd Srisukho
   Consciousness abnormality
     Disorientation
     Delirium – syndrome
   Emotions abnormality
     Anxiety
     Panic attack
     Ambivalent
     Apathy



                       Psychiatry - Chanesd Srisukho
   Thought abnormality
     Stream and form of thought
      ○ Blocking
      ○ Incoherence
      ○ Flight of idea
      ○ Neologisms
     Content of thought
      ○ Delusion – fixed false believe
           Grandiose
           Persecutary
           Bizarre
           Jealous

                          Psychiatry - Chanesd Srisukho
   Perception abnormality
     Illusion
     Hallucination
      ○ Auditory hallucination
      ○ Visual hallucination
      ○ Tactile hallucination




                        Psychiatry - Chanesd Srisukho
   Memory abnormality
     Amnesia
     Paraamnesia
      ○ confabulation
      ○ Déjà vu
      ○ Jamais vu

   Intelligence abnormality
     Dementia
     Pseudodementia


                        Psychiatry - Chanesd Srisukho
Psychiatry - Chanesd Srisukho
Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV)
   Schizophrenia
   Mood disorders
     Depressive disorders
     Bipolar disorders
      ○ Maniac
      ○ Depressive
   Anxiety disorders
     Panic disorders and agoraphobia
     Specific and social phobia
     Obsessive-Compulsive Disorder (OCD)
     Posttraumatic Stress Disorder and Acute Stress
      Disorder
     Separation anxiety disorder
                        Psychiatry - Chanesd Srisukho
Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV)
   Somatoform disorder
     hypochondriasis
 Factitious disorder
 Malingering
 Paraphilias
     Exhibitionism
     Frotteurism
     Voyeurism
     Fetishism

                        Psychiatry - Chanesd Srisukho
Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV)
   Paraphilias (continued)
     Pedophilia
     Sadism
     Masochism
     Homosexualism
     Necrophilia
     Zoophilia




                      Psychiatry - Chanesd Srisukho
Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV)
   Impulse control disorder – want so much
    that cannot stop his heart
     Pyromania
     Kleptomania
     Pathological gambling
     Trichotillomania
   Adjustment disorder



                         Psychiatry - Chanesd Srisukho
Diagnostic and Statistical Manual
of Mental Disorders (DSM-IV)
   Personality Disorder
     ≠ Personal trait
     Clusters
      ○ Cluster A : paranoid, schizoid
      ○ Cluster B : antisocial, borderline, histrionic,
        narcissistic
      ○ Cluster C : Avoidant, dependent, obsessive-
        compulsive




                         Psychiatry - Chanesd Srisukho
Psychiatry - Chanesd Srisukho
Others
   Gain
     1˚ gain
     2˚ gain
     3˚ gain
 Tic
 Attention-deficit hyperactivity disorder
  (ADHD)
 Mental Retardation (MR)
 Learning disorder (LD)


                   Psychiatry - Chanesd Srisukho
Others
   Autistic disorder
     Autism – only me on this planet
 Orientation
 Amnesia
     Anterograde amnesia – no new memory
     Retrograde amnesia
     Korsakoff’s amnesia – Ber1Ber1, mamillary
     bodies



                        Psychiatry - Chanesd Srisukho
Others
   Phobia
     Gamophobia
     Algophobia
     Acrophobia
     Agoraphobia
   Eating disorders
     Anorexia nervosa
     Bulimia Nervosa
   Substance abuse and antidote

                        Psychiatry - Chanesd Srisukho
Others
 Intelligent Quotient
 Classical conditioning – natural
  response
     Elicited by stimulus (conditioned or learned)
     Pavlov’s DOGs
   Operant conditioning – rewards
     Reinforcement – continuing
      ○ Positive reinforcement
      ○ Negative reinforcement
     Punishment – stop

                       Psychiatry - Chanesd Srisukho
Others
   Stress effects
     ↑FFA
     ↑corticosteroids
     ↑lipids
     ↑cholesterol
     ↑catecholamines
     Affects water absorption, muscular tonicity,
      gastrocolic reflex, mucosal circulation
   Elimination disorder

                         Psychiatry - Chanesd Srisukho
Psychiatry - Chanesd Srisukho
DRUGS
   Antipsychotics
     Haloperidol, chlorpromazine
      ○ Block D2 receptor
      ○ Use in schizophrenia, psychosis, acute mania
      ○ EPS side effects
         Dystonia
         Akinesia – Parkinsonian symptoms
         Akathisia
         Tardive dyskinesia




                          Psychiatry - Chanesd Srisukho
DRUGS
   Lithium
     Mood stabilizer for bipolar disorder
     ADH antagonist
     Side effects : polyuria, DI
   Antidepressants
     Serotonin-specific reuptake inhibitors (SSRI)
      ○ Prozac (fluoxetine)
      ○ Side effects : SD, GI distress
        “Serotonin syndrome” – hyperthermia, muscle
        rigidity, CVS collapse
      ○ Take 2-3 wks to have an effect

                       Psychiatry - Chanesd Srisukho
DRUGS
   Tricyclic antidepressants
     Imipramine, amitryptyline, clomipramine
     Block reuptake of Ach, histamine, serotonin
      and NE
     Use in Major depression, bedwetting, OCD
     SE: sedation, atropine-like side effects
     Toxicity : Tri C’s : Convulsion, Coma ,
      Cardiotoxicity



                      Psychiatry - Chanesd Srisukho
Quiz
Psychiatry   : Questions




              Psychiatry - Chanesd Srisukho
ANY QUESTION?


    Psychiatry - Chanesd Srisukho
           From error to error
one discovers the entire truth.
                                           -Sigmund Freud



           Psychiatry - Chanesd Srisukho

				
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