Forensic Medicine

Tuesday, September 1, 2015

Psychiatry Facts from Previous Papers

·         Anxiety––↑i NE, ↓d GABA, ↓d serotonin (5-HT).
·         Depression––↓d NE and ↓d serotonin (5-HT).
·         Alzheimer’s dementia––↓d ACh.
·         Huntington’s disease––↓d GABA, ↓d  ACh.
·         Schizophrenia––↑i dopamine.
·         Parkinson’s disease––↓d dopamine.

·         Hallucinations are perceptions in the absence of external stimuli.
·         Illusions are misinterpretations of actual external stimuli.
·         Delusions are false beliefs not shared with other members of culture/subculture that are firmly maintained in spite of obvious proof to the contrary.
·         Loose associations are disorders in the form of thought (the way ideas are tied together).


·         1° gain––what the symptom does for the patient’s internal psychic economy.
·         2° gain––what the symptom gets the patient (sympathy, attention).
·         3° gain––what the caretaker gets (like an MD on an interesting case).

·         Selected Important Court Cases
ii.       Karen Ann Quinlan: Substituted Judgment Standard
iii.      Brother Fox(Eichner vs Dillon):Best Interest Standard
iv.     Infant Doe: Foregoing Lifesaving Surgery, Parents Withholding Treatment
v.       Roe vs Wade(1973):The Patient Decides
vi.     Tarasoff Decision: Duty to Warn and Duty to Protect

·         Autoscopic psychosis – Visual hallucination of a transparent phantom of one’s own body
Lycanthopy – Delusion that the person is a werewolf/other animal
·         Many antidepressants including SSRIs, TCAs & MAOIs suppress REM sleep & can be useful in Tt of cataplexy.
·         In amphetamine abuse these two do not occur together
- Formication (tactile hallucination) is seen in ®  Chronic abuse.
- Paranoid ideation (delusion of persecution) occurs in ®  Acute intoxication.
 On the other hand both delusion of persecution and formication are seen together in chronic cocaine abuse.
·         Dd
·          




1)      "AKATHISIA---restlessness/irresitible urge to move about & increased motor activity,Rx-amantadine,benzhexol,propranolol,"----------((2))

2) "ALZHEMER'S DISORDER---Ach.-biochemical cause ,predisposing factors--down's synd.,head trauma,low edu.group,"---------((2))

3) "ANTIPSYCHOTICS---
longacting -Fluphenazin,"----------((2))

4) "BEHAVIOUR---
TYPE A---time urgency ,impatiency,hard driving ,career orientation,ambitiousness, COINED BY friedman & rosenman ,"---------((2))

5) "
BEHAVIOR THERAPY---indicated for Phobia,cardinal elements--Systemic desensitization & Flooding,"----------((2))

6) "BUSPIRONE---anti-anxiolytic,newer NONSEDATIVE ,non hypnotic axiolytic,"---------(2)

7) "
CLOZAPINE---assosiated with agranulocytosis , causes sialorrhyroea,"-----------(( 2))

8) "EEG---alpha waves--> awake & eyes closed ( stage I sleep) ( ATKD'S-MNEMONIC-B,,,,A1,T1K2,D34(NREM),,,B-REMS)"-----------((2))

9) "FEAR---due to abnormal experiences of childhood , over consciousness & excess perception of danger , least common in depressive psychosis ,"-----------((2))

10) "
FLUOXETINE---mech. of action--inhibition of serotonin uptake , side-effect--Anxiety,loose stools,Nause is troublesome"-----------((2))

11) "
GPI(GENERAL PARESIS OF INSANE) ---fes. Confabulation, Grandiose, Delusions, Mental deterioration, "-----------((2))

12) "
HALLUCINOGENS---Cocaine, Mescaline, LSD, Phencyclidine, "----------((2))

13) "
HALOPERIDOL----acute drug dystonia after> 1day, causes Akathesia , used in BALLISMUS aswell,"---------((2))

14) "HYPOCHONDRIASIS---
Preoccupation with body diseases, Over conscious about some illness, "----------((2))

15) "IMPOTENCE---it is also seen in D.M., diff. Between psy.Impotence & Organic I.--is diagnosed by monitoring of Penile TUMESCENCE during sleep ,"-----------((2))

16) "INTELLIGENCE QUOTIENT---I.Q.= (mental age X 100)/ chronological age (%),
I.Q. Test = Binet Stanfort Test"------------((2))

17) "NEUROLEPTICS---blood levels checked for toxicity , commonest side-effect--Sedation , "---------((2))

18) "
OEDIPUS COMPLEX---coined by sigmund Freud, seen in boys 3-5yrs of age,"------------((2))

19) "PHENOTHIAZINEs---involuntary perioral movement , used in Rx of depression , tardive dyskinesia is the side-effect,"------------((2))

20) POST-TRAUMATIC STRESS DISORDER---most common after major life threatening event/ e.g. any CAR accident,rape,earthquake,.. etc.-----------((2))

21) "PREMATURE EJACULATION --- Rx-SQUEEZE Technique, "------------((2))

22) "PSYCHONEUROSIS---diagnosis by VERBAL ACCOUNTS.,"------------((2))

23) "PSYCHOSOMATIC DISORDERS---e.g.--HTN,Peptic Ulcer disease, Bronchial Asthama, Hyperventilation"------------((2))

24) "THOUGHT---DISORDERS--loosening of Association,
THOUGHT INSERTION---this is SCHEIDNER'S FIRST RANK SYMP."--------------((2))

25) "WITHDRAWAL SYMP.---PHYSICAL--absent-in Cannabis, Present in Pethidine,Opium,Haloperidol,Alcohol, Rx required in for withdrawal symp.--Cannabis, Cocaine,Alcohol,"------------((2))


1) ABREACTION---used in Rx of phobia,-----------((1))

2) "
AFFECT---disorders of affect , disturbances of affect--panic , apathy , phobia,"---------((1))

3) "AFFECTIVE DISORDERS---depression ,reaction form'n ,adjustment reaction ,"-------((1))

4) "AGGRESSION ---PASSIVE AGG.--spills half,"-------((1))

5) "
AGORAPHOBIA---fear of open spaces , DOC.--alprazolam,"-------((1))

6) "ALEXITHYMIA---inability to recognize & describe feelings,"--------((1))

7) "AMBIVALENCE---coined by EUGEN BLEULER,"---------(1))

8) "AMNESIA---anterograde amnesia--caused by giving ECT.,good prognostic indicator of head injury.,"---------((1))

9) "AMOTIVATIONAL SYNDROME---seen in cannabis,"------((1))

10) "AMOXAPINE---antidepressant with side effects like -tardive dyskinesia & neuroleptic malignant synd.,"-------((1))

11) AMPHETAMINES--- ,-----((1))

12) "ATTENTION DEFICIT DISORDER---seen with phenobarbitone ,"--------((1))

13) "AUTISTIC DISORDER---lesion is in Temporal lobe ,"-------((1))

14) "BALLISMUS---Rx haloperidol ,"-------((1))

15) "CHLORPROMAZINE---?rigidity,mask like face,tremors,(uses/side effects),"------(1))

16) "
CLAUSTROPHBIA---fear of CLOSED spaces ,"-------((1))

17) "COGNITVE BEHAVIORAL THERAPY---is the Rx for Depression ,"-------((1))

18) "
COPROLALIA---seen in TOURETTE'S SYND.,"-------((1))

19) CYCLOSERINE---anti -TB.-shows NeuroPsychiatric manifestation,--------((1))

20) "
DÉJÀ VU---seen in normal persion ,temporal lobe epilepsy,psychosis,"--------((1))

21) DISORIENTATION---seen in Organic brain synd.,------------((1))

22) Diethyl Propion---1st. Choice in wt. reduction prog.,---------((1))

23) "DRUG DEPENDENCE---is due to withdrawal symptoms ,"---------((1))

24) "EXHIBITIONISM---shameless exposure of genitals ,"-------((1))

25) "FETISHISM---obtaining Sexual excitement with inanimate objects , "--------((1))

26) FREE ASSOCIATION---coined by FREUD.,------((1))

27) "GANSER'S SYND.---inappropriate answer...... , "--------------((1))

28) HASHISH---active substance—TetraHydroCannabinol,----------((1))

29) "HEROIN---withdrawal fes.--Yawing, muscle cramps, Hypersomnia, HTN.,"---------((1))

30) "HICCOUGH---Intractable--DOC-chlorpromazine/Largactil , "--------((1))

31) ILLUSIONS---,------((1))

32) "IMIPRAMINE---antidepressant ,DOC--in nocturnal enuresis , "--------((1))

33) INSOMNIA---
Familial Fatal Insomnia--seen in PRION disease,-------((1))

34)
KLEPTOMANIA---Irresistible ure to STEAL things of LITTLE value,---------((1))

35) "
La Belle Indifference---seen in Dissociative disorders ,"--------((1))

36) LUCID INTERVAL---seen in INSANITY,------------((1))

37) least addictive---DihyroxyPropoxyphene,-----------((1))

38) MAOIS---induced hypertensive crisis-Rx-->reversed with Phentolamine,----------((1))

39) "MANDRAX---is combination of HYPNOTIC + ANTI-HISTAMINE,"----------((1))

40) "MASOCHISM---sexual partner are aroused & gratified by whipping ,"------------((1))

41) "MEMORY---RECENT--CENTRE--HIPPOCAMPUS ,"-------------((1))

42) "METHADONE---used in maintainance of Rx of opium dependence/ ?Withdrawal ,"-------------((1))

43) "MORPHINE---addiction , Withdrawal is done with Clonidine ,"---------------((1))

44) MYXEDEMA---ass. with depression ,-----------((1))

45) "MUNCHAUSEN SYND.---factitious disorder ,"---------((1))

46) "NARCOLEPSY---symp.--Cataplexy , Sleep acttacks, Sleep paralysis, "-----------((1))

47) "
NIGHT TERRORS-seen in NREM sleep--TOC.-clonazepam,"-------------((1))

48) "NYMPHOMANIA---not a compulsive & habit forming disorder , "---------((1))

49) ORGANIC AMNESTIC SYND.---most common cause—Concussion,----------((1))

50)
OTHELLO SYND.---Delusion of Infidelity on part of Sexual partner,-----------((1))

51) PARANOID DISORDER---Pseudocommunity,---------((1))

52) PERSONALITY DISORDERS---BORDERLINE-sucidal tendencies,--------((1))

53) PHENCYCLIDINE---ass. With DEPERSONALISATION,-----------((1))

54) "
PICASSO SYND.---painter obsession developed into artistic painting, "--------((1))

55) PROJECTION---mature defense mech.,------------((1))

56) "PSYCHIATRIC MANIFESTATION---seen in Hypothyroidism, Hyperthyroidism, Acute Intermittent Porphyria, Inability for Erection, Inability to take deep breath , Pain,"--------((1))

57) "PSYCHOTHERAPY---PSYCHOANALYTICAL---Insight therapy, Behavioral therapy & SUPPORTIVE therapy, "--------------((1))

58)
PUNISHMENT---inflicting pain to get rid of a bad habit ,--------------((1))

59) "PUNCH DRUNKENNESS ---is ass. With BOXING.,"--------------((1))

60)
BRIEF REACTIVE PSYCHOSIS---after loss of loved-one's,--------------((1))

61) REINFORCEMENT---+ve R.-? Conditioned learning,----------------((1))

62) "SLEEP DEPRIVATION---leads to decreased mental altertness,"----------((1))

63) SLEEP-WALKING-somnabulism--seen in NREM STAGE 3/4 Sleep,-------(1))

64) "STUPOR---DEPRESSIVE--loss of power in all 4 limbs, Waxy Flexibility of muscle tone in limbs,"-------------((1))

65) "SUPERSTITION---a False belief unexplained by reality ( Shared by a number of persons/people ) ,"---------((1))

66) SUPER-EGO---coined by Sigmund Freund,--------((1))

67) "TARDIVE DYSKINESIA---due to Reserpine,HALOPERIDOL,"--------((1))

68) "THINKING---ABSTRACT--similarity between chair & table->both has 4 legs,"-------((1))

69) "THIORIDAZINE---side-effect--Pigmentary Retinopathy,"--------((1))

70) "THERMATIC PERCEPTION TEST---by Wechslers , "---------((1))

71) WERNICKE'S ENCEPHALOPATHY----Rx-Thiamine supplement,---------((1))

72) EIGHT STAGE CLASSIFICATION OF HUMAN LIFE---BY ERIKSON ,-----------((1))

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