Iran Specialty Board Psychiatry flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Mesolimbic pathway

Dopamine pathway from ventral tegmental area to nucleus accumbens and limbic structures; mediates reward and positive psychotic symptoms; hyperactivity is linked to delusions and hallucinations.

Nigrostriatal pathway

Dopamine pathway from substantia nigra to striatum; blockade causes extrapyramidal symptoms, and degeneration causes Parkinson disease.

Tuberoinfundibular pathway

Dopamine pathway from hypothalamus to anterior pituitary; dopamine inhibits prolactin release, so blockade raises prolactin and causes galactorrhea and amenorrhea.

First-rank symptoms

Schneiderian symptoms including thought insertion, withdrawal, or broadcast, made feelings or acts, third-person commenting voices, and delusional perception; historically suggestive of schizophrenia.

Thought blocking

Abrupt interruption of speech with a subjective sense that thoughts have been removed; classically associated with schizophrenia.

Flight of ideas

Rapid, pressured speech with frequent topic shifts linked by understandable associations; characteristic of mania.

Schizophreniform disorder

Schizophrenia-like symptoms lasting at least 1 month but less than 6 months, with full return to premorbid functioning expected.

Brief psychotic disorder

Sudden onset of delusions, hallucinations, or disorganized behavior lasting at least 1 day but less than 1 month, with full return to baseline.

Clozapine agranulocytosis

Severe neutropenia caused by clozapine; requires regular absolute neutrophil count monitoring and immediate discontinuation if ANC falls below 1000/µL.

Bipolar I disorder

Diagnosis requiring at least one manic episode lasting 1 week or necessitating hospitalization; depressive episodes are common but not required.

Rapid cycling

Presence of at least four mood episodes within 12 months; more common in women and associated with antidepressant exposure and thyroid dysfunction.

Mixed features specifier

At least three manic/hypomanic symptoms during a depressive episode, or depressive symptoms during mania; associated with high suicide risk.

Panic attack

Abrupt surge of intense fear peaking within minutes with at least four autonomic or cognitive symptoms such as palpitations, dyspnea, and fear of dying.

PTSD symptom clusters

Intrusion, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity lasting more than 1 month after trauma exposure.

Acute stress disorder

Trauma-related symptoms lasting from 3 days to 1 month after exposure; PTSD is diagnosed only after 1 month.

Delirium tremens

Severe alcohol withdrawal with confusion, hallucinations, autonomic instability, and seizures, typically occurring 48-96 hours after the last drink; treat with benzodiazepines.

Wernicke encephalopathy

Thiamine deficiency causing confusion, ataxia, and ophthalmoplegia; give thiamine before glucose to prevent precipitation or worsening.

Buprenorphine

Partial opioid agonist used for opioid use disorder; has a ceiling effect on respiratory depression and can precipitate withdrawal if given too early.

Hypoactive delirium

Subtype of delirium with reduced motor activity, lethargy, and inattention; frequently missed and associated with poor outcomes.

Lewy body dementia

Dementia with fluctuating cognition, visual hallucinations, parkinsonism, and REM sleep behavior disorder; severe neuroleptic sensitivity is common.

ADHD diagnostic threshold

At least six inattentive or hyperactive-impulsive symptoms before age 12 in two or more settings; five symptoms suffice for older adolescents and adults.

Autism spectrum disorder

Neurodevelopmental disorder with deficits in social communication and restricted, repetitive behaviors, with onset in the early developmental period.

Borderline personality disorder

Pattern of instability in affect, identity, and relationships with impulsivity; dialectical behavior therapy is first-line treatment.

Conversion disorder

Functional neurological symptoms such as weakness or sensory loss incompatible with recognized disease; diagnosis requires medical rule-out.

ECT indications

Severe depression with psychosis or catatonia, treatment-resistant depression, mania, and catatonia; typically 6-12 sessions.

Lithium therapeutic range

Serum level of 0.6-1.2 mEq/L drawn 12 hours after the last dose; monitor renal, thyroid, and calcium levels.

Tarasoff duty

Duty to protect identifiable third parties from a patient's serious threat of violence, which may include warning the potential victim or notifying authorities.

Involuntary admission criteria

Mental disorder plus danger to self or others or grave disability, with use of the least restrictive alternative and due process protections.

Assertive community treatment

Multidisciplinary team with low caseloads and 24/7 availability providing community-based care for people with severe mental illness.

Positive predictive value

Proportion of positive test results that are true positives; depends on disease prevalence and rises as prevalence increases.

Number needed to treat

Number of patients who must be treated for one additional favorable outcome; calculated as 1 divided by the absolute risk reduction.

Serotonin syndrome

Toxic serotonergic state with clonus, hyperreflexia, agitation, and hyperthermia; stop serotonergic agents and give cyproheptadine in severe cases.