Emergency Medicine study guide

thanatology
the study of death and dying
-crisis management, team approach, prepare the family

rape
not a sexual act, this is an act of violence
-sexual dysfunction often occurs with this

paradoxical rationalization
act of self blame in the event of trauma
ex. a lot of rape victims will blame themselves for the act of the rape (many think if they blame themselves they can prevent it from ever happening in the future)

suicide
fatal: 50% firearms are male bias
non-fatal: female bias (highest attempt rate)
highest fatal= elderly men

anorexia nervosa
distortion of the body image, obsession with eating and weight control, irrational fear of weight gain
-obsession with food but they don’t actually eat it
-compulsive exercise
-hair changes
-lanugo
-menses abnormalities
-greater diagnosis in females than males
-increased risk with high up females

hyperventilation ventilation syndrome
minute ventilation rate exceeds metabolic demands
-increase in O2, not enough CO2
-paresthesias, perioral, chest, hands, carpopedospasm, respiratory alkalosis causes ionized Ca++
-dizziness < pco2 causes cerebral vasoconstriction (before you diagnose this you need to rule out all medical first that can cause hyperventilation - pulmonary emboli, pneumothorax, coronary artery syndrome)

dystonic reaction
abnormal muscle tone produced as a side effect of certain medications especially antipsychotics
-dopamine receptor imbalance
-torticollis, oculogyric crises, opisthotonos (arched back), trismus (jaw tightening)
-associated meds that cause this : 1st gen antipsychotics, antiemetic, antidepressants

treatment of dystonic reaction
treats this abnormal muscle tone reaction
Cogentin (benzotropin)
Benadryl (diphenhydramine)

la bella indifference
a naïve, inappropriate lack of emotion or concern for the perceptions by others of one’s disability, usually seen in persons with conversion disorder (significant)

tarditive dyskinethia
an involuntary and repetive movement disorder associated with high potency or long term use of some antipsychotic medications
ex. lip smacking, tongue darting, grimacing, lateral jaw movements
treatment- early recognition, discontinue med that causes it.

catatonic reaction
waxy flexibility
-acute schizophrenia