Sunday, 1 March 2015

Psychiatry syndromes

🔺Wernickes encephalopathy
An acute reaction to severe thiamine deficiency mostly d/t chronic alcohol use.
C/b ocular signs (nystagmus & external ophthalmoplagia)
Higher mental function disturbance(disorientation, confusion, recent memory disturbances)
Apathy & ataxia.
Peripheral neuropathy & malnutrition may be co-existent.

🔺Korsakoffs psychosis
Also d/t severe thiamine deficiency d/t chronic alcohol use.
C/b amnestic syndrome with gross memory disturbances
Insight often impaired.

🔺Marchiafava-Bignami syndrome
A rare disorder most probably d/t alcohol-related nutritional deficiency.
C/b disorientation, personality & intellectual deterioration, hallucinations, epilepsy, dysarthria, ataxia & spastic limb paralysis.

🔺Holiday Heart
Atrial or ventricular arrhythmias, especially paroxysmal tachycardia, after drinking a binge of alcohol in individuals showing no other evidence of heart disease.

🔺Hemp insanity (cannabis psychosis)
Asso with cannabis.
Acute schizophreniform disorder with disorientation & confusion
Good prognosis.

🔺Amotivational syndrome
Lethargy, apathy, loss of interest, anergia, reduced drive & lack of ambition d/t chronic cannabis use.

🔺Van Gogh syndrome
Dramatic self-mutilation occurring in schizophrenia.

🔺Pfropf schizophrenia
A syndrome of schizophrenia occurring in presence of mental retardation.

🔺Oneiroid schizophrenia
A subtype of schizophrenia with acute onset, clouding of consciousness, disorientation, dream-like states & perceptual disturbances with rapid shifting.

🔺Alice in Wonderland syndrome
Perceptual distortion of shape, size, colour& reciprocal position of objects. seen with schizophrenia, migraine

🔺PAD syndrome
Phobic-Anxiety-Depersonalization syndrome.
Commoner in women 20-40 years.
C/b diffuse anxiety, multiple phobias, panic attacks, depersonalization, derealization & depressive features.

🔺Othello syndrome (conjugal paranoia)
A psychosis in which the content of delusions is predominantly jealousy (infidelity) involving spouse.

🔺Clerambaults syndrome (erotomania)
A psychosis in which the content of delusions is erotic.
Most often in women with erotic conviction that a person with higher status is in love with the patient.

🔺Kadinsky-Clerambaults syndrome
A syndrome of mental automatism

🔺Folie a deux
Induced delusional disorder c/b sharing of delusions b/w 2 persons.
So is folie a trios, folie a quatre, folie a famille…

🔺Capgras syndrome (delusion of doubles)
C/b delusional conviction that other persons in environment are not their real selves but are their own doubles.
There are 4 types
1. Typical Capgras syndrome(illusion des sosies)- pt sees a familiar person as a stranger who is imposing as the familiar person.
2. Illusion de Fregoli pt falsely identifies strangers as familiar persons.
3. Syndrome of subjective doubles pts own self is perceived as being replaced by a double.
4. Intermetamorphosis pts misidentification is complete including both external appearance & personality.

🔺Fregolis phenomenon
Delusion that a persecutor is taking on a variety of faces like an actor.

🔺Cotards syndrome
Delusion that one has lost everything- possessions, strength & even bodily organs such as heart.
Seen in severe depression where pt has extreme nihilistic delusion (e.g. may think that his bowels are rotting and he will never pass stools again)

🔺Gansers syndrome (hysterical pseudodementia)
Commonly found in prison inmates.
C/b vorbeireden- approximate answers- person understands nature of questions but answers wrong.

Lack of concern towards symptoms despite apparent severity of disability produces.
Seen in pts with conversion & dissociation disorder(hysteria).

🔺Briquets syndrome (Somatisation disorder)
A chronic or recurrent illness with either a dramatic or complicated medical history.
A pt with at least 25 unexplained medical symptoms for a diagnosis or with 20-25 unexplained symptoms for a probable diagnosis.

🔺Munchausen syndrome (Factitious disorder, Polysurgis, Professional patients, Hospital hoboes, Hospital addiction)
Pt repeatedly simulates or fakes diseases for sole purpose of obtaining medical attention.

🔺Munchausen syndrome by proxy
Pt intentionally produces physical signs & symptoms in another person who is under ptâ€s care.

🔺Ekbom syndrome (Restless Legs syndrome)
Pt experiences extremely uncomfortable feeling in leg muscles during walking.
Asso with insomnia.

🔺Gelineus syndrome
Asso with hypersomnia.

🔺Pickwickian syndrome
Sleep apnea commoner in elderly & obese persons, asso with hypersomnia.

🔺Kleine-Levin syndrome
C/b hypersomnia

🔺Clumsy Child syndrome (Motor dyspraxia, Motor skills disorder, Developmental coordination disorder)
C/b poor coordination in daily activities of life.

🔺Idiot Savant syndrome
Pervasive impairment of functions but certain islets of precocity or splinter functions may remain.

🔺Hellers syndrome (Disintegrative psychosis)
A type of childhood psychosis with age of onset 3-5 years.
C/b rapid downhill course leading to deterioration & development of neurological deficits.

🔺Aspergers syndrome
Predominantly in boys.
Less severe form of pervasive developmental disorder
Autism without significant delay in language & cognitive development.
schizoid personality
pedantic speech
preoccupation with obscure facts

🔺Retts syndrome
Occurs in girls.
After an apparently normal early development & normal head circumference at birth, there is deceleration of head growth b/w age of 5-30 months.
Loss of purposive hand movements & acquired fine motor manipulative skills with subsequent development of stereotyped hand movements.

🔺Strauss syndrome
Attention deficit hyperkinetic disorder, Minimal brain dysfunction, Organic drivenness.

🔺Gilles de la Tourettes syndrome
C/b multiple motor tics
Multiple vocal tics
Duration of >1 year

🔺Kanner syndrome
Failure to develop attachment with a parenter al figure & pre-occupation with inanimate objects.

Wechsler's classification
IQ Range ("Deviation IQ") Intelligence Classification
130 and over Gifted
120-129 High
110-119 High Average
90-109 Average
80-89 Low Average
70-79 Borderline
Below 69 Extremely Low

✏Psychiatry one liners......

neurobiology of ocd, most important area involved is..... answer :: orbitofrontal cortex  
First drug shown to have antidepressant efficacy historically ::  isoniazid

first historical book on psychotherapy in india... answer :: d bhagvada gita  

(last dnb q)... drug very effective in intermittent explosive disorder or drug used to manage anger outbursts in conduct disorder answer is..::: carbamazepine...

  (one liner series for dnb)" Empty nest syndrome" is related to which psychiatric disorder::: answer is depression..

learned helplessness model of seligman is related to which psychiatric disorder::: answer is depression...

most prevalent psychiatric disorder anxiety disorder(total) > mood disorder(total) > major depressive episode > any other subtype of anxiety disorder.

  "low csf levels of 5 HIAA, have been linked to increased aggressive behaviour"... (important for may exams & nimhans.)
[6:23pm, 24/08/2014] manvigupta78: Syndromes associated with dementia
Alzheimers disease
Picks disease
Parkinsons disease
Shy-Drager syndrome (Multisystem degeneration)
Huntingtons chorea
Steel-Richardson syndrome (progressive Supranuclear palsy)
Binswangers disease (subcortical arteriosclerotic encephalopathy)
Wilsons disease
Leighs disease
Creutzfeldt-Jacob disease
Gerstmann-Straussler-Scheinker disease
ALS-Parkinsons-Dementia complex of Gaum

👹Syndromes associated with mental retardation

Downs syndrome
Turners syndrome
Kleinfelters syndrome
Cri du chat syndrome
Fragile X syndrome
Hartnups disease
Tay-Sachs disease
Gauchers disease
Niemann-Pick disease
Lesch Nyhan syndrome
Hurlers disease
Hunters disease
Sanfillipos disease
Renpennings syndrome
Sturge-Weber syndrome
Crouzons syndrome
Aperts syndrome
De Lange syndrome (Amsterdam dwarfism)

Some Culture-Bound Syndromes are as follows

Dhat syndrome
A culture-bound syndrome prevalent in Indian subcontinent.
C/b complaint of passage of   dhat in urine.
Multiple somatic symptoms.
May be anxiety, depression or sexual dysfunction associated.

Prevalent in Asia including India.Affected male pt believes that his penis is shrinking & may disappear into his abdominal wall & he may die.
Females affected infrequently, believing that their breasts & vulva are shrinking.

Prevalent in South-East Asia.
C/b sudden, unprovoked ep

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