Psych

Psychiatry

FA 2014, p.500-520

In general, psych is SDAM. However, there are some major things that you must focus on when studying this content

Errata2013:None2014: Pg. 512 Eating disorders In the entry for anorexia nervosa, change the lower limit of normal :BMI from 17 to 18.5 kg/m2

Path Pointers:Know all of thetiming cutoffsanddiagnostic criteriathat are mentioned in FA!! This ishuge. The question will often hinge on whether or not a patient's symptoms fall within the correct diagnostic time period or not! (E.g. does this patient have dysthymia or MDD?)

Learning the Drugs Know the unique uses of specific drugs in each class or the specific drug that is useful in a specific patient.Examples: buproprion for depression + smoking cessation buproprion as an option in a patient who is struggling with a typical SSRI (2/2 sexual side effects)mirtazapine in a pt who is depressed + anorexicDefinitely know all of the special circumstances for psych meds like these.

Classical vs. Operant conditioningKnow the differenceClassical:Learning, which elicits Classic/Involuntary responsesCondition classic response with stimuli

OperantLearning which elicits Voluntary responsePositive, Negative, Punishment, Extinction

Transference and CountertransferenceSDAMTransference: patients projectionCounter Transference: doctors projection

Ego defenses & Infant DeprivationEgo DefenseSDAMNot worth reviewing in class;these are tested so do encourage their review upon self study.

Infant Deprivation Reactive Attachment Disorder -DITfairly straightforward, reviewContinued separation from caregiver/ failure to provide nurturing bondCauses: Decreased development of language, feeding, muscle tone, trust, withdrawnCan remember via 4 Ws Reversible >6 months= IrreversibleE.g.: orphanage in Russia

Child Abusechild abuse is usually tested in a vignette with a pediatric patient being examined after some sort of incidentThere may be fractures on exam, found on imaging studies, etcRetinal Hemorrhage/ Detachment Shaken baby syndrome clue, esp. if bilateral!!Subdural Hematoma Different phases of healing on XrayMust report to CPSthe vignette will neither rule in/rule out child abuse and the question will basically be should you just trust the parent's story or not with the answer being some variation on no.

Childhood and early-onset disordersADHD: know that the onset isbefore 12 years old (DSM V) different from DSM IV 2013characterized by hyperactivity/impulsivity/inattention inmultiple settings. Know thetreatments! Methylphenidate Ritalin, most common amphetamine athomexetine behavioralPimp side who is bitchingPimozide For Tourette's syndromeConduct dd: Symptoms ofantisocial personality in someone who is