2.

7
September 2013
…CuaveroNOtEs…
“Let’s survive Psychiatry I together… GoD BLESS 2D!”  PSYCH Supplements

This trans is designed for review: It contain list of some topics that (if  Serotonin & Dopamine = ↓ = depression; ↑ = mania
I‟m not mistaken) were included in our 1st shifting exam, and also the  Inhibitory: GABA (major); Glycine
highlighted topics in 2nd shifting.  Excitatory: Glutamate
Hope this could aid you in studying. Happy Study 2D.  Substance P = Pain mediation
 Neuropeptide Y = +appetite; obesity
First shifting Highlights  Cholecystokinin = anxiety, panic attack
1.1 Trans  Melatonin = sleep
 Functional Perspectives of NORMALITY: HEALTH, UTOPIA,
AVERAGE, PROCESS 1.6 Trans
 Life cycle theories (EPIGENETIC PRINCIPLE)
o Freud’s Psychosexual development  DEATH AND DYING:
o Erikson’s Psychosocial development o Criteria of Brain Death
o Piaget’s Theory of cognition o Stages of death and dying (Elizabeth Kubler-Ross)
o Kohlberg’s Morality development o Grief, Mourning, Bereavement (meaning)
 STAGES OF DEVELOPMENT: o Normal vs. Abnormal Grief
1. PRENATAL o Grief vs. Depression
2. INFANCY (Reflex; Object permanence, Symbolization)  AGGRESSION
3. TODDLER (Firmly established object permanence, Sphincter control) o Aggression that do not involve physical injury: Verbal
4. PRE-SCHOOL YEARS aggression, Coercion, Intimidation, Manegerial style,
(Pre-operational stage, Egocentric thinking, Premeditated social ostracism of others
Phenomenalistic causality, Animalistic thinking, Birth Order) o Commonly cited predictors of violence/aggression (Nasa table,
5. MIDDLE CHILDHOOD if odd one out tas isa sa choices ung “transient anger”, siya
(Concrete operational stage, Syllogistic reasoning, na yung NOT/ LEAST common predictor)
conservation, reversibility, Chum/body-coined by Sullivan) o Psychological Factors:
6. ADOLESCENCE o Instinctive Behavior (Freud=Thanatos and Eros, Konrad
a. Early Lorenz=Fighting instinct that humans share with other
b. Middle (Superficial dates; Sexual experimentation) organisms, hunger games)
c. Late (Development of Morals, Career decisions) o Learned Behavior (Bandura = BOBO DOLL EXP, Social
learning)
1.2 Trans o Frustration-aggression hypothesis
7. ADULTHOOD o Media violence: Observational learning, Disinhibition,
a. EARLY ADULTHOOD Desensitization
(peaking biological development; *third individuation=to o Serotonin, NE, GABA = (-) Agression
develop young adult sense of self; transition) o Dopamine = facilitates aggression
b. MIDDLE ADULTHOOD o Chromosomal: 47 Chromosome XYY Syndrome
(Golden age; Climacterium, Empty-nest syndrome; Midlife o Catharsis
crisis- sense of urgency)  ACCIDENTS
*Levinson – LIFE STRUCTURE=pattern of individual’s life o Definition
at any particular time o PSYCHOPHYSIOLOGICAL CONSIDERATIONS
*Butler – STOCK TAKING=what to do with the rest of  FATIGUE
one’s life  INTAKE OF SUCH TOXIC SUBSTANCES (barbiturates,
c. LATE ADULTHOOD antihistamines, marijuana, alcohol)
(Aging Syndrome, Ageism)  Persons With Diabetes, Epilepsy, Cardiovascular
*Bernice Neugarten – time of reconciliation with others  Disease, And Mental Disorders are involved in more
 than twice as many accidents
1.3 Trans  AGE-RELATED IMPAIRMENTS: (both motor and
 ATTACHMENT AND LEARNING THEORIES: know the proponents  cerebral function deficits)
and also where each term BELONGS (Classical, Operant, Social o MOTIVATIONS
learning, Cognitive, Motivational)  underlying self-destructive tendency
 unconscious sense of guilt and a need to atone or to be
1.4 Trans punished for such guilt feelings
 PERSONALITY THEORIES: focus on Freud and Erikson’s stages  unconscious wish to escape or to avoid something is often
and terms. Others, parang Maslow (Hierarchy of needs/Self apparent.
actualization) lang.
 DEFENSE MECHANISMS (terms and meaning) 2nd Shifting Highlights
 2.2 and 2.3 Transes FOCUS HERE: MSE AND SSX
1.5 Trans o Sa SSx, more of application so know the definition
 BRAIN AND BEHAVIOR: o Sa MSE, categorization (ex. Delusion = sa Thought Content;
o Dominant Hemisphere vs. Non dominant Hallucination = sa Perception)
o Since mahaba si SSx, choose wisely on what to prioritize. Feeling ko
o Basal ganglia and its Lesions (Hemiballismus, Parkinson’s,
pinakaimportant yung andun din sa MSE.
Huntington’s)
 2.4 Trans = PE and Lab, sabi lang ni doc:
o Basal Ganglia= (-); RAS (Reticular activating system))= (+)
o Important ang MEDICAL screening sa psych dahil may mga
o 3 level processing of language: Phonological (Inferior gyrus of
medical conditions na nag-mamanifest din ng psychiatric SSx
frontal lobe); Lexical (left temporal lobe); Semantic (middle &
o Study: LITHIUM ASSAYS, SUBSTANCE OF ABUSE TESTING
superior gyri of left temporal lobe)
in urine (clearance time)
o AMYGDALA=FEAR
o There is no official psychiatric laboratory test for
o MEMORY: (Working, long-term, procedural)
diagnosis. Main tool sa Psych: Hx and MSE
o Prefrontal lesion = loss of social responsibility, capacity for
o Know the Baseline values ng T3, T4 at FBS
concentration and abstraction)
 2.5 Trans = pinaka important:
o Frontal lobe injury = impair executive fx (Motivation,
o Models Of Interaction; Specific Techniques In
Attention, Sequencing of actions)
Interviewing; Character And Quality Of Physician
o Frontal lobe syndrome: Slowed thinking, Poor judgment,
 2.6 Trans = sa axis, know what condition is in each axis. Sa mga
decreased curiosity, social withdrawal, irritability)
scales, alamin daw ang function of the “other scales”
o Study NTs/hormone/endogenous opiod and their fx:

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 PSYCH Supplements

Additional Notes for 2nd Shifting Scale for schizophrenia and psychosis:
OTHER RATING SCALES SCORING & FX  Brief Psychiatric Rating Scale
GAF (Global  30-21 = Serious impairment  Scale for the Assessment of Negative Symptoms (SANS)
Assessment Function ) With (Delusion & Hallucination  Mga scale na may “Thought, Language, Communication” at
Scale  “0” = NO DATA (Applicable in most scales) “Quality of Life”(PICS= Patterns of Individual Change Scale)

 Areas/ Categories: Scale for Mood disorders = Scales na may “Depression” at “Mania”
 Problem solving  Montgomery-Asberg Scale
 Organization
 Emotional Climate Scale for Anxiety Disorders
 hypothetical continuum:  Brief Outpatient Psychopathology Scale
o competent,  Physicians Questionnaire
o optimal relational  Impact of Events Scale
o functioning  Mga scale na may “Obsessional”, “Avoidance and Distress”,
o disrupted, “Panic”, “Phobia” at “Fear”
o dysfunctional relationship
GARF (Global  5 range scale: Screening test for Medical Illness (Req. in Psych accdg. To 9 th
Assessment  0 –INADEQUATE DATA ed Kaplan)
RELATIONAL  1-20 - too dysfunctional to retain  CBC w/ defferential count
Function) Scale continuity of contact and attachment  Complete blood chemistries including measurement of
 21-40 - obviously and seriously ELECTROLYTES, GLUCOSE, CALCIUM, MAGNESIUM, and
dysfunctional HEPATIC and RENAL FUNCTION TESTS
 41-60 - unsatisfying relationships tend  Thyroid function tests
to predominate  Rapid Plasma Reagent (RPR) or VDRL test
 61-80 - somewhat unsatisfactory. Many  Urinalysis
but not all difficulties are resolved  Urine toxicology screen
without complaints.  ECG
 81-100 - functioning satisfactorily from  Chest Roentgenography (for patients >35 y/o)
self-report of participants and from  Plasma levels of any drug being taken if appropriate
perspectives of observers
Toxic and Lethal levels of some drugs (Marami pa „to sa book,
SOFAS  50 – Serious Impairment (no friends, unable kumuha lang ako ng ilang parang important, para kasing may
(Social and to jeep a job) nabanggit si doc about toxicology)
OCCUPATIONAL  20 – Cannot maintain minimal personal DRUG TOXIC BLOOD LEVELS LETHAL
Functioning Scale) hygiene Acetaminophen 15.0 mg 150.0mg
Salycilate >39.0 mg 50 mg
 High adaptive level (Sublimation, Humor, Carbamazapine >1.5 mg -
Anticipation, Supression, Altruism) Ethanol 100 mg (legal intox.) 350.0 mg
 Mental Inhibitions (Compromise Lithium 1.39 mg (2.0 mEq/L) >3.47 mg (>4.0
formation) level (Displacement, mEq/L)
Repression, Intellectualization, Undoing) Methamphetamine 0.06 – 0.5 mg 1.4 – 2.0 mg
 Minor image-distorting level (Devaluation, Coccaine 90.0 μg 0.1-2.0mg
idealization, omnipotence) Amphetamine 50.0 μg 200.0 μg
 Disvowa level (denial, projection,
Defensive
rationalization)
Functioning Scale PRACTICE TEST
 Major image-distorting level (autistic
I. TOPIC: Signs and Symptoms CHOICES
fantasy, projective identification, Splitting of
self-image or image of others) D: What is your name? ; P: Jess a. Verbigeration
 Action level (Acting out, Apathetic 1 D: How old are you? ; P: Jess b. Echolalia
withdrawal, Help-rejecting complaining, D: Where do you live? ; P: Jess c. Perseveration
Passive aggression) D: What is your name? a. Tangentiality
 Level of defensive dysregulation 2 P: I have a very long name and I b. Derailment
(delusionsl, psychotic) c. Circumstantiality
want to change it.
Scoring: 0 to 6 D: She is your mother.
a. Othello Syndrome
 0 – not present P: No, she’s not my mother, she’s
3 b. Capgras Syndrome
 1 – VERY mild fake. My real mother was c. Magical Thinking
Brief Psychotic  2 – mild abducted.
Rating Scale  3 – moderate a. Word Salad
 4 – moderately severe Time measure for clock, hand
4 b. Word approximation
 5 – severe shoes for gloves. c. Neologism
 6 – extremely severe The patient's replies to questions a. Poverty of Speech
 0 = none 5 are restricted in amount tend to be b. Poverty of CONTENT OF SPEECH
HAM – A  1 = mild c. Blocking
(Hamilton Anxiety  2 moderate
brief, concrete, and unelaborated.
Rating Scale)  3 = sewveere Patient's replies are adequate in
a. Poverty of Speech
 4 = severly grossly disabling amount but tend to be vague,
6 b. Poverty of CONTENT OF SPEECH
overconcrete, or and convey little c. Blocking
HAM – D  HAM – A = for anxiety information
(Hamilton  HAM – D = for Depression The patient show a decrease in a. Anhedonia
Depression Rating  Walang nakalagay sa book but accdg. to 7 sexual interest and activity, or b. Melancholia
Scale) upper batch trans: Total score of above 9
enjoyment when active. c. Alexithymia
is considered BORDERLINE OF PATHOLOGY
 0 none a. Auditory Delusion
SANS The patient reports voices, noises
 1 Questionable 8 b. Auditory Illusion
(Scale for & sounds that no one else hears. c. Auditory Hallucination
 2 mild
Assessment of a. Delusion of Jealousy
 3 moderate Patient believes he [she] is being
Negative 9 b. Delusion of Persecution
 4 marked conspired against in some way
Symptoms) c. Delusion of Reference
 5 severe

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 PSYCH Supplements

a. Othello syndrome a. Coprolalia

Patient believes his [her] spouse is Compulsive utterance of obscene
10 b. Obsession 34 b. Echolalia
having an affair with someone. c. Capgras Syndrome word c. Amimia
Patient believes that he [she] has a. Delusion of Guilt Unconscious filling of gaps in a. Amnesia
11 committed some terrible sin or b. Delusion of infidelity 35 b. Confabulation
memory c. Hyperphagia
done something unforgivable. c. Delusion of Reference
a. Adiadochokinesia
Patient believes that he [she] is a. Delusion of Jealousy Inability to perform rapid
36 b. Dyskenesia
12 being talk about in the television b. Delusion of Persecution alternating movements c. Bradykinesia
or radio c. Delusion of Reference a. Agitating
Grinding or gnashing of teeth
Patient believes that others could 37 b. Bruxism
a. Thought Control typical occurring in sleeping
see and hear his [her] thoughts c. Dypervigilance
13 b. Though Broadcasting
because it was exposed to a. True Insight
c. Thought Withdrawal Understanding reality with
everyone. 38 b. Intellectual Insight
motivation to change c. Critical judgment
A pattern of speech which is very a. Tangentiality a. Nihilistic delusion
14 indirect and delayed in reaching its b. Clanging Thought that you or part of you
39 b. Depersonalization
goal idea c. Circumstantiality are non existent c. Derealization
A pattern of speech in which a. Tangentiality Pathological need to act on an a. Obsession
15 sounds rather than meaningful b. Clanging 40 impulse that if resisted, produce b. Compulsion
relationships govern word choice. c. Circumstantiality anxiety c. Impulse control
Patient tends to be physically II. TOPIC: MSE CHOICES
a. Anergia
inert. He [she] may sit for hours 1 Monotonous voice a. Appearance
16 b. Apathy
and does not initiate spontaneous c. Ambivalence
2 Cooperative b. Overt behavior
activity. 3 Blunted c. Attitude
Hallucination d. Speech
Several birds are flying in the sky, a. Hallucination 4
Complete denial of sickness e. Form of thought
17 but the patient said “several bats b. Illusion 5
f. Content of thought
are flying in the sky”. c. Delusion 6 Capability to decide
g. Mood
a. Hypnagogic 7 Rigid
Hallucination that occur when a h. Affect
18 b. Hypnopompic 8 Abstract thinking=ability to deal w/ concept i. Perception
person is waking up. c. Anosognosia 9 Capgras syndrome j. Sensorium
a. Déjà vu 10 Jamais vu k. Insight
A false feeling that one can’t
19 b. Jamais vu 11 Depersonalization l. Judgement
recognize a familiar situation. c. Deja entendu 12 Formication
a. Twilight state Irritable
Belief that one is so madly in love 13
20 b. Erotomania Hyperactive
with him/her c. Egomania
14
15 Punning
a. Folie A Deux
16 Perplexed
21 Shared delusion. b. Selective inattention
d. Clouding
17 Phobia
a. Disinhibition 18 Obsessions
Drink alcohol then lose control and 19 Circumstantiality
22 b. Trance
perform an aggressive act. c. Hyperphagia 20 Gait
a. Euthymic III. Additional Questions inspired from our one and only QUIZ
23 Normal range of mood. b. Euphoric
1. Student mistaken as a witch.
c. Dysphoric
2. False belief that is also incongruent with the truth and a person’s
a. Anhedonia
24 Inability in describing or cultural background
b. Melancholia
awareness of emotions or mood.
.
c. Alexithymia
3. Thought that my professor was so truly madly deeply in love with me
4. When to take urine test in a person who took amphetamine, in order to
Patient has signs and symtoms of a. Pseudocyesis have negative result?
25 pregnancy, but not pregnant (w/ b. Amenorrhea 5. If the doctor give several options to the patient and allow the patient to
complete cessation of menses) c. Pseudopregnensis decide in what he/she wanted.
a. Pica 6. In What Axis? (Diabetes mellitus)
26 Eating Clay and plastic b. Bulimia 7. In What Axis? (Patient become depressed because he FAILED his test)
c. Corporagia 8. In What Axis? (Schizophrenia)
a. Pica 9. If the doctor tries to convince the patient to quit smoking, and lose
27 Binge-eating b. Bulimia weight.
c. Corporagia 10. Sense of shared decision making is established.
a. Pica
 SSX ANSWER KEYS:
28 Eating Filth or feces b. Bulimia 1. C 6. B 11. A 16. A 21.A 26. A 31. A 36. A
c. Corporagia 2. A 7. A 12. C 17. B 22.A 27. B 32. C 37. B
a. Mimicry 3. B 8. C 13. B 18. B 23.A 28. C 33. A 38. A
Patholodical imitation of
29 b. Echopraxia 4. B 9. B 14. C 19. B 24.C 29. B 34. A 39. A
movement c. Automatism 5. A 10. A 15. B 20. B 25.A 30. A 35. B 40. B
a. Mimicry  MSE ANSWER KEYS:
Simple imitative motor activity of 1. D 4. I 7. B 10. I 13. G 16. A 19. A
30 b. Echopraxia
childhood that is voluntary c. Automatism 2. C 5. K 8. J 11. I 14. B 17. B 20. B
3. H 6. L 9. F 12. I 15. E 18. B
a. Trichotollomania
 Identification KEYS:
31 Compulsion to pull out hair b. Dypsomania 1.Illusion 5. Informative model 9. Deliberative model
c. Nymphomania 2.Delusion 6. Axis III 10. Interpretative model
a. Elevated Mood 3. Erotomania 7. Axis IV
Intense elation with feelings of
32 b. Eutyhmia 4. AFTER 48 hours 8. Axis I
grandeur. c. Euphoria
a. Somnambulism …PSYCH TRANSERS Signing off…
 GOD BLESS! 
33 Sleep walking b. Sundowning
c. Coma vigil

Transcribers: Noe, Gisela, Jess  Page3 of 3