1. Panic disorder: 
-recurrent panic attack with no trigger plus >1 month worrying about having another panic attack
-associated with major depression > substance use > phobias > OCD.
-paroxetine and sertraline first line
-with agoraphobia: fear/avoidance of places where it would be bad to have a panic attack (crowded, no escape, no help) sometimes so bad that people wont leave their house
2. Paxil is FDA approved for social anxiety disorder
3. There is a genetic concordance between tourettes' and OCD
4. Four most common mental illnesses: phobias > substance abuse > major depression > OCD.
5. GAD: lifetime prevalence 45%
-excessive worry for 6 mos, plus 3 of the following
-Restlessness
-Fatigue
-Difficulty concentration
-Difficulty sleeping
-Irritability
-Muscle tension
6. Substances
-abuse: using it >1 year + any negative consequences (job, legal, relationships).
-dependence: using it > 1 year + tolerance/withdrawal + multiple negative consequences
7. Alcohol: 
-management of acute alcohol intoxication: thiamine, D50, nalxone
-wernicke: ataxia, altered mental status, nystagmus/gaze palsies
-korsakoff: anterograde and retrograde amnesia, confabulation
8. Differential for delirium:
-Alcohol
-Electrolytes
-Iatrogenic (all analgesics, benzos, anticholinergics, antiepileptics, steroids, BP meds, H2 blockers, antibiotics, parkinsons drugs)
-Oxygen - hypoxia
-Uremia/Ammonia
-Trauma
-Infection
-Poison
-Seizure (postictal)
9. Dementia vs delirium: 
-Dementia patients just have bad memories/cognition-- they are not altered mentally, they know what's happening, they are often A&O. It's slow onset, gradual fall, lose both recent and distant memory.
-Delirium patients have altered mental status, hallucinate, are not A&O, have no idea what's going on. Their course is rapid onset, waxing and waning, lose recent memory but retain distant memory.
10. Alzheimer's disease & vascular dementia
-Same DSM criteria: Memory slowing plus one of the following:
-Aphasia (loss of language-- incl speech and understanding)
-Apraxia (loss of ability to make purposeful movement)
-Agnosia (cannot interpret senses-- i.e. visual- can't recognize an object)
-Loss of executive function
It can also be accompanied by personality changes-- depression, anxiety, paranoia, agitation.
Vascular dementia is faster onset, stepwise progression, focal neurological findings, less loss of personality