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AprilBehavioral Flashcards

1
Q

Most prevelant DSM problems

A

Anxiety/depression, chemical dependency, somatization, personality disorders

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2
Q

disorders in DSM - IV

A

297

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3
Q

Axis II Disorders - Clusters A,B,C

A

Weird, Wild, Worried

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4
Q

Folstein Mental Exam Score of 15 indicates cognition that is, A) Normal B)Mildly Impaired C)Moderate D) Severe

A

C) Moderate

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5
Q

Folstein Mental Exam Score of 24 indicates cognition that is, A) Normal B)Mildly Impaired C)Moderate D) Severe

A

B)Mild

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6
Q

4 Depression Screening Tools

A

Hamilton Rating Scale (Ham-D), Patient Health Questionaire (PHQ-9), Geriatric Depression Scale (GDS), Beck Depression Inventory

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7
Q

2 Anxiety Screening Tools

A

Hamilton Rating Scale (Ham-A), Patient Health Questionaire (GAD-7)

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8
Q

3 ADHD Screening Tools

A

SNAP-IV (90), Vanderbilt Teacher (47), Vanderbilt Parent (35)

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9
Q

Truthfullness, Degree of Accuracy of Predictive Statements, Does it test what it says it does

A

Validity

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10
Q

Consistency of predictive statements, can be reproduced

A

Reliability

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11
Q

Intelligence Tests

A

Binet, Stanford-Binet

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12
Q

IQ equation

A

MA/CA X 100 = IQ

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13
Q

Average IQ range

A

90-109

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14
Q

Assess ability to recall and draw complicated picture

A

Rey Complex Figure

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15
Q

MMPI

A

find psychopathological patterns that may not be apparent

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16
Q

Personality Assessment Inventory

A

334 items, 4 point likert scale

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17
Q

Mental Retardation associated with

A

Rubella, low SES, Cytomegalic Inclusion Body Disease, Syphilis, Toxoplasmosis, etc.

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18
Q

2 major cause of mental retardation

A

FAS and Down Syndrome

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19
Q

Fetal Alcohol Syndrome signs

A

Small, small eyes, smooth philthrum, small chin, poor coordination, hyperactive, LD, MR, sleep disturbances

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20
Q

Downs signs

A

Flat head, little tone, flat face, slanty eyes, short nose, wide space fingers - toes, single palmar crease

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21
Q

3 Types of Downs Syndrome

A

1) Full Trisomy 21 2) Mosaicism 3)Translocation 21 and 15

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22
Q

Prenatal Test for Downs

A

Aminocentesis - look for HCG

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23
Q

Secondary Problems of MR

A

low self esteem, neg. self image, psychiatric disorders

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24
Q

Autism prevelance

A

11/1000

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25
Q

Characterstics of Autism

A

1)lack of relatedness 2)no social smile 3)babbling, clickin 4)expressive not receptive 5)exploratory play absent 6)rigid play pattern 7) insomnia

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26
Q

Asperbergers

A

1)solitary 2)impaired social interaction 3)impaired non-verbal communication 4)odd speech

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27
Q

Which is not aspect of Asperberger’s speech A) stilted and repetitive B)obsessive with patterns, weather etc. C)Lack common sense D)Clicking E)Lucid speech

A

D)Clicking

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28
Q

Rare disorder only affects females with normal development to 6-18 months then regression

A

Rett Syndrome

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29
Q

Rare form of Autism, onset 3-4 years, loss of motor, language, social skills

A

Childhood Disintegrative Disorder

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30
Q

4 Types of child abuse

A

Physical, Sexual, Emotional, Neglect

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31
Q

Suspected child abuse requires verbal and written report within this time frame.

A

72 hours

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32
Q

Predictors of Perpetration a)victimized B)observed mother brutalized C)male D)adverse childhood experiences

A

A, B, D

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33
Q

3 types of symptoms of ADHD

A

Inattention, Hyperactivity, Impulsivity

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34
Q

NT in ADHD, #, firing rate, receptor #

A

Less, Low rate firing, fewer receptors

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35
Q

Arousal too high, can’t detect between salient and stimuli

A

Hyperarousal

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36
Q

ADHD remission time

A

12-20 years

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37
Q

Ist line treatment for ADHD

A

stimulants, ritalin, adderal, amphetamines

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38
Q

2nd line treatment for ADHD

A

Strattera and Bupropion

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39
Q

Block Dopamine Uptake

A

Ritalin,concerat, focalin

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40
Q

Increase Dopamine in synapse

A

Adderal, Dexadrine, Vyvanse

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41
Q

Inhibit NET, DAT, SERT

A

Strattera and bupropion

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42
Q

Stimlant adjunct for ADHD

A

Catapres/Clonidine or Tenex/Guanfacine

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43
Q

Narcolepsy med, can be used for ADHD

A

Modanfil/Provigil

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44
Q

Procrastionation, low frustration tolerance, sense of flair and low self esteem all Sx of what?

A

Adult ADHD

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45
Q

Identity status based on presence or absence of these 2 factors

A

Crisis and Commitment

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46
Q

SCOFF

A

Sick because full, lost Control, lost One stone, believe to be Fat, Food dominates

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47
Q

Predisposition toward disorder

A

Diathesis

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48
Q

Diasthesis-Stress Model

A

Predisposition + stress - protective factors/resilience = disease expression

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49
Q

Is anorexia or bulimia more common?

A

Bulimics outnumber anorexics 2:1

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50
Q

Eating disorder common to single white college students

A

Bulimia

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51
Q

Common complication of Bulimia

A

Dental erosion, esophagus rupture, aspiration pneumontis, arrythmias

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52
Q

Important screen for suspected bulimia

A

Low potassium

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53
Q

Pharmacological treatment for Bulimia

A

Antidepressants- TCA, MAO, Prozac

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54
Q

Physical Symptom unique to Anorexia

A

Amenorrhea

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55
Q

Immature, Need to be in control, Perfectionism, Neg. self view all common to what disorder?

A

Anorexia Nervosa

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56
Q

Clinical signs of Anorexia Nervosa

A

Hypothermia, cyanosis, bradycardia, hypotension, low WBC, prolonged QT

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57
Q

Common anorexia complications

A

Refeeding syndrome, lanugo, hair loss, infertility, pancytopenia

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58
Q

Treament for Anorexia includes A) Antidepressants B) Assess suicide risk C) Inv., family and cognitive therapy D) Correct Deficiencies

A

B,C,D

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59
Q

Mental Disorders most likely to have addiction disorders A. Bipolar I B. Anxiety C.Schizophrenia D. Antisocial Personality Disorder

A

D. Antisocial personality disorder

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60
Q

Drugs that mimic mental illness

A

Cocaine/Meth, Stimulants, LAS, Alcohol, PCP

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61
Q

Diagnose Substance Abuse Disorders if A) Symptoms where there before B) Symptoms persist during abstinence C) Close relative has SUD D)Symptoms began when SUD began

A

A, B

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62
Q

Why is treating a mental disorder important for a person with SUD?

A

It increases the chances of overcoming SUD

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63
Q

Pharmacotherapy for SUD

A

Methadone + Sertraline or benodiazepines

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64
Q

Dysfunction of Scizophrenia

A

Reward dysfunction (DA)

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65
Q

Danger of treating Schizophrenic for SUD.

A

Could tip them into a full blown episode

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66
Q

5 axes of DSM IV

A

1-diagnosis2-permanent psychological problems3-medical conditions4-stressors5-global assessment of functioning

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67
Q

disruptive mood dysregulation disorder

A

a new diagnosis of temper outbursts in children

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68
Q

attenuated psychosis syndrome

A

a new prodrome of psychoses

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69
Q

use disorder

A

new term for addiction

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70
Q

neurocognitive disorder

A

new term for dementia

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71
Q

paraphilias

A

group of psychosexual disorders

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72
Q

4 memory tests

A

rey figure
rey auditory (15 words)
CA verbal learning test
wechsler IX memory scale

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73
Q

2 neuropsychological tests

A

halstead-reitanluria-nebraska

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74
Q

rorschach test

A

personality test with 10 inkblots

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75
Q

thematic apperception test (murray)

A

personalitypicture-what happened?

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76
Q

MMPI test

A

most comprehensive and best personality.

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77
Q

szondi test

A

bullshit personality which picture do you relate to?

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78
Q

Scores of MMSE/Folstein

A

30 points possible23 points is cutoff

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79
Q

scores of wechsler intelligence scale

A

normed to 100 70 = 2 sds from 100= mental retardation

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80
Q

3 Intelligence tests used with kids

A

mccarthy scale BEST PRESCHOOL
wechsler preschool/primary
Bayley for infants

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81
Q

cultural-familial retardation

A

no organic brain damage

Normal distribution of IQ<70

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82
Q

amniocentesis (4) for down’s

A

alpha fetoprotein (low)HCGestriol (low)inhibin A

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83
Q

advanced language in autism

A

expressive language

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84
Q

gene with autistic assoc

A

HOXA1

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85
Q

onset of childhood schizophrenia

A

AFTER 5 years

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86
Q

childhood disintegrative disorder, CDDtype of disease2 symptoms

A

severe, later-onset autismloss of language, bowel, bladder

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87
Q

identity and intimacy development of males, females

A

males identity first, then intimacy

females develop at the same time<

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88
Q

2 high yield questions to screen eating disorders

A

are you satisfied with your eating patterns?do you ever eat in secret?

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89
Q

anorexiafemale-male ratiomean year onset

A

10:117 years

90
Q

2 types bulimia

A

<p>purging typenonpurging type</p>

91
Q

bulimia female-male ratio

weight

A

8:1

average weight

92
Q

russell’s sign

A

callouses on dorsum of hand from self-induced vomiting.

93
Q

bulimia prognosis NOT affected by (2)

A

age of onset

duration of symptoms

94
Q

two types anorexia

A

restricting

binge eating/purging

95
Q

refeeding syndrome

A

<p>low electrolytes in response to anorexia. life threatening</p>

96
Q

pancytopenia

A

low RBC’s, WBC’s in response to anorexia

97
Q

female athlete’s triad (3)

A

disordered eating
amenorrhea
osteoporosis

98
Q

2 disorders in ADHD

A

executive functionself-regulation

99
Q

3 parts of PF cortex with ADHD associations

A

dorsolateral - attention
PF motor - motor activity
orbital - impulsivity

100
Q

orbital PF cortex to ganglia and back (name of circuit)

A

impulsivity circuit

101
Q

function dorsal anterior cingulate, ACC

A

motivation

102
Q

tx for hyperarousal (2)(more common with adults Include MOA

A

amoxetine - NE inhibitor

guanfancin - alpha 2A adrenergic receptor agonist

103
Q

2 types stimulants for ADHD

A

methylphenidate

amphetamine

104
Q

3 brand names methylphenidate

A

ritalin
concerta
focalin

105
Q

mechanism methylphenidate (stimulant)

A

DA reuptake inhibitor

106
Q

3 brand names amphetamine

A

Adderall
Dexedrine
Vyvanse

107
Q

MOA of amphetamine

A

increases presynaptic release of DA

108
Q

brand name atomoxetine

109
Q

MOA and benefit atomoxetine

A

NE reuptake inhibitor first then DA, then 5HT

takes time but low abuse potential

110
Q

MOA of Buproprion

111
Q

3rd line for ADHD

A

TCA antidepressants

112
Q

4th line tx ADHD (2)

A

Clonidine Guanfacine

113
Q

MOA Clonidine, Guanfacine

A

alpha 2A adrenergic receptor agonist
Guanfacine has fewer side effects
Clonidine decreases BP

114
Q

CV contraindications for stimulants (3)

A

congentical heart defects
arrhythmias
syncope

115
Q

if you have substance use patient, the odds that they have a psychiatric disorder

116
Q

patient with depression

how many have SUD?unipolar?bipolar?

A

unipolar 30%

odds bipolar 60%

117
Q

schizophrenia & borderline antisocial personality disorder% SUD

118
Q

PCP and ketamine abuse cause what type of symptoms

A

antisocial behaviors

119
Q

therapy type which is particularly useful for bipolar

A

group therapy

120
Q

SCID

A

assessment tool for personality disorders

structured clinical interview

121
Q

“W” words describing cluster A-C personality disorders

A

weird
wild
worried

122
Q

3 descriptors for cluster A

A

accusatory
aloof
awkward

123
Q

2 descriptors for cluster B

A

big emotions

bad to the bone

124
Q

3 descriptors for cluster C

A

cowardly
compulsive
clingy

125
Q

3 cluster A disorders

A

paranoid
schizoid
schizotypal

126
Q

2 treatments for cluster A disorders

A

social skills training

Haloperidol

127
Q

summary of schizoid PD

A

distant (negative symptoms)

128
Q

summary of schizotypal PD

A

magical thinking(positive symptoms)

129
Q

4 cluster B disorders

A

antisocial
borderline
histrionic
narcissistic

130
Q

2 characteristics borderline

A

unstable

suicidality

131
Q

2 characteristics histrionic

A

attention seeking

sexually seductive

132
Q

3 cluster C disorders

A

avoidant
dependent
obsessive-compulsive PD

133
Q

2 tx for avoidant personality

A

social skills training

Sertraline

134
Q

3 strong beliefs of OCD personality disorder

A

order
perfectionism
control

135
Q

4 stages sexual cycle

A

desire
arousal
excitement
orgasm/resolution

136
Q

dyspareunia

A

genital pain during sex

137
Q

2 sexual desire disorders

A

hypoactive sexual desire

sexual aversion

138
Q

female sexual arousal disorder a reduction of (2)

A

lubrication

swelling

139
Q

vaginisumus

A

involuntary muscle spasm of vaginal control

140
Q

4 steps of PLISSIT model of sex therapy

A

permission
limited information
specific suggestions
intensive therapy

141
Q

difference
viagra
levitra
cialis

A

4 hour duration
12 hour duration
2+ day duration

142
Q

Alprostadil

A

used for penile injections, transurethral

143
Q

Bremelanotide

A

malanocortin agonist not yet on market

aphrodisiac

144
Q

3 treatments for SRI induced sexual problems

besides dose reduction and switching agents

A

augment with Buproprion cyproheptadine (antihistamine)

weekend drug holiday (but not Fluoxetine)

145
Q

2 interventions to reduce alcohol demand for adolescents

A

life skills training

motivational interviewing

146
Q

4 types schizophrenia

A

paranoid
disorganized
catatonic
undifferentiated

147
Q

3 perinatal infections ++schizohrenia

A

toxoplasmosis
influenza
borrelia

148
Q

2 birth months of ++schizo

149
Q

expressed emotion theory

A

increased shouting, etc in families- ++schizo

150
Q

3 NTs (and amts) implicated in schizophrenia

A

+DA
+5HT
-glutamate

151
Q

anosognosia

A

poor insight found in schizophrenics(lack of awareness of disability)

152
Q

schizophreniform disorder

153
Q

schizoaffective disorder

A

w/mono or bipolar depression

154
Q

gold standard of schizo drugsand negative component

A

Clozapine

agranulocytosis

155
Q

unique components of Risperidone

A

part typical, part atypical

156
Q

two atypicals with less weight gain

A

ziprasidone

ariprazole

157
Q

hysteriabriquet’s syndrome aka

A

somatization disorder

158
Q

somatization prevalence (incl gender)onset

A

2% women 0.2% men
adolescent onset.
duration = year

159
Q

5 diagnostic criteria somatization

A 
onset <
30 years
4 different sites pain
2 GI1 
sexual pseudo-neuro
160
Q

conversion disorder

age of onset

A

kids to 35

161
Q

couvade

A

male pregnancy, a conversion disorder

162
Q

comptocormia

A

flexion of spine, a conversion disorder

163
Q

body dysmorphic disorder

A

preoccupation with a real or imagine defect of body

164
Q

hypochondriasis
prevalence
gender

A

4-9% of population

males=females

165
Q

difference between malingering and factitious

A 
malingering = external motivations
factitious = for medical tx
166
Q

disorder associates with factitious

A

borderline

167
Q

peregrinating factitious disorder

A

munchausen

168
Q

profile of munchausen patient

A

single male

40’santisocial

169
Q

treatment model for conduct disorder

include unacceptable treatment

A

multisystemic family therapy

NOT GROUP THERAPY

170
Q

2 comorbidities of conduct disorder

171
Q

2 treatments ODD

A

positive parenting program

problem-solving communication training

172
Q

3 internalizing disorders (adolescent)

A

anxiety/depression
OCD
phobias

173
Q

3 externalizing disorders (adolescent)

A

conduct disorder
ODD
ADHD

174
Q

CRAFFT questions for adolescents SUD

A 
car?
relax?
alone?
family friends?
forget?
trouble?
175
Q

3 depression screenings for kids

A

PHQ-9
beck depression inventory
children’s depression inventory

176
Q

tx for adolescent depression

include unacceptable

A

SSRIs

TCAs are contraindicated - toxic + prolongs QT interval

177
Q

5 pediatric antidepressants with FDA approval
4 SSRI
1 exceptional TCA

A

fluoxetine, sertraline, fluvoxamine, escitalopram

clomipramine

178
Q

black box warning for pediatric antidepressants

Include follow up schedule

A

suicide risk

follow up:weekly-1 month,biweekly - 1 month,then quarterly

179
Q

length of time for adolescent antidepressant treatment

A

6-9 months

180
Q

prevalence suicide

A

12/100,000

181
Q

3 uniqe risk factors for adolescents and suicide

A

exposure
triggers
past attempts

182
Q

% of suicides with a diagnosis

include most common

A

90%

mood disorders

183
Q

4 high yield suicide screening questions

A

do you have suicidal thoughts?plan?means?past attempt?

184
Q

double depression

A

major depression and dysthymia

185
Q

treatment course for depression

A

9 months - 1 year

186
Q

neurotransmitters reduced in depression (3)include increased receptor

A

LOW levels of 5HT, NE, DA+5HT2 binding sites

187
Q

frequency of episodes for SAD

A

2 years, 2 episodes

188
Q

prevalence SAD

189
Q

2 tx SAD

A

10,000 lux for 30 minutes/day

SSRIs

190
Q

MOA Venlafaxine

191
Q

MOA Buproprion

192
Q

1st line tx for depression (3 but 1 is a class)

A

SSRIs
Venlafaxine
Buproprion

193
Q

2nd line tx depression

A

Duloxetine

194
Q

MOA Duloxetine

195
Q

3rd line tx depression (2)

A

TCA

Mirtazapine

196
Q

4th line tx. depression

A

MAO inhibitor

197
Q

prevalence of bipolar disorder

A

<p><1% (.6%)</p>

198
Q

bipolar 1 vs. bipolar 2

A

bipolar 1 - 1 week manic + 3 symptoms

bipolar 2 - hypomanic (perceived as positive)

199
Q

genetics of bipolar

A

weak correlation;
1st degree relatives 10% assoc.
2nd degree relatives 5% assoc

200
Q

occam’s razor

A

use as few dx as possible to explain all symptoms

201
Q

personality disorders often confused with bipolar

202
Q

only 2 agents proven to have anti-suicidal effects

A

Clozapinelithium

203
Q

activation syndrome

A

a manic-like syndrome caused by anti-depressants.NOT MANIA!

204
Q

tx for impulsivity and emotional liability in bipolar disorder

A

Olanzapine (zyprexa)or other anti-psychotics

205
Q

proposed phenotype system of DSM V for bipolar (4 levels)

A

narrow phenotype
phenotype 1
phenotype 2
broad phenotype

206
Q

% of SUD patients that have a mental disorder

207
Q

2 substances that can cause antisocial behaviors

A

ketamine

PCP

208
Q

therapy better than meds? for bipolar

A

group therapy

209
Q

pharm therapies for anxiety disorders

210
Q

two decent SSRIs for anxiety and SUD

A

Paroxetine

Sertraline (PTSD)

211
Q

<p>1st line treatment for GAD (with or without SUD)
</p>

212
Q

yerkes-dodson curve

A

performance v anxiety

213
Q

base rate

A

rate found depends where you found it (psych wards, etc)

214
Q

female/male ratio of panic disorder AND agoraphobia

215
Q

2 qualities for diagnosis OCD

A

impairment

patient recognizes unreasonableness

216
Q

3 requirements for PTSD diagnosis

A

re-experience
avoidance
hyper-vigilance

217
Q

2 components of behavioral model of anxiety

2 factor learning theory

A

neutral stimulus avoidance behavior

positively reinforced

218
Q

3 regions of brain overactive in panic disorder

A

amygdala
temporal cortex
hippocampus

219
Q

2 regions of brain overactive in OCD

A

caudate

orbital gyrus

220
Q

best treatment for OCD

A

behavioral therapy

221
Q

Buspirone MOA

A

partial 5HT agonist

222
Q

diagnosing SUD in adolescents
2 or more of (4)
(4 things that cause probs)

A 
SOLS (save our leaky ship)
obligations
hazardous
legal
social

Social Behavioral Mindi (3 decks)

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