Behavioral (not pharm) - Unit 3 Flashcards by Jenny Schreiber

which mental health disorder consumes 90% of public health funding for psychological issues?

schizophrenia

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Impairment of reality testing, loss of contact with reality

psychosis/ hallucination/ delusion/ Illusion/ ideas of reference

psychosis

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Sensory perception not generated by an external stimulus is

psychosis/ hallucination/ delusion/ Illusion/ ideas of reference

hallucination

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Abnormalities in thought content, false beliefs not correctable by logic or reason is
(psychosis/ hallucination/ delusion/ Illusion/ ideas of reference)

delusion

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Misperception of a real external stimulus is

psychosis/ hallucination/ delusion/ Illusion/ ideas of reference

illusion

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False conviction that you are the subject of attention by other people e.g. crowds, TV, radio, conversations (psychosis/ hallucination/ delusion/ Illusion/ ideas of reference)

ideas of reference

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Lack of informative content in speech is called

Alogia/ Echolalia/ Thought blocking/ Neologism/ Circumstantiality/ tangentiality

Alogia

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Repeating statements of others and associating words by their sounds is
(Alogia/ Echolalia/ Thought blocking/ Neologism/ Circumstantiality/ tangentiality)

Echolalia

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Presenting unnecessary and voluminous details before answering a question is
(Alogia/ Echolalia/ Thought blocking/ Neologism/ Circumstantiality/ tangentiality/ delirium)

circumstantiality

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inventing new words is

Alogia/ Echolalia/ Thought blocking/ Neologism/ Circumstantiality/ tangentiality/ delirium

neologism

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Abrupt halt in the train of thinking, often due to hallucinations is
(Alogia/ Echolalia/ Thought blocking/ Neologism/ Circumstantiality/ tangentiality/ delirium)

thought blocking

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Beginning in a logical fashion but getting further and further from the point, failing to answer the question
(Alogia/ Echolalia/ Thought blocking/ Neologism/ Circumstantiality/ tangentiality/ delirium)

tangentiality

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How many months of signs of schizophrenia must persist before a clinical diagnosis of schizophrenia can be given?

6 months

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What is the triad of Psychosis?

hallucination, alteration in sensory perception
delusion, abnormal thought content
thought disorder, abnormal processing/organization

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A disturbed state of mind characterized by restlessness, illusion and incoherence of thought induced by fever, intoxication or another disorder is
(Alogia/ Echolalia/ Thought blocking/ Neologism/ Circumstantiality/ tangentiality/ delirium)

delirium

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Stupor or extreme agitation, incoherent speech, blank facial expression and bizarre posturing are characteristics of being (paranoid/ catatonic/ dissorganized)

catatonic

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In schizophrenia, the (prefrontal cortex/ mesolimbic tract) is hyperactive

mesolimbic tract

amygdala, scary faces

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In schizophrenia, the (prefrontal cortex/ mesolimbic tract) is hypoactive

prefrontal cortex

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In schizophrenia the mesolimbic tract is overstimulated by (norepinephrin/ serotonin/ dopamine)

dopamine

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Patients with schizophrenia will have elevated levels of the dopamine metabolite _______ _____ as a result of excess dopamine metabolism

homovanillic acid

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LSD can cause hallucination by increasing _______ levels in the brain

serotonin, 5HT

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To reduce Schizophrenia you would like to block D2 receptors in the (mesolimbic/ mesocortical) pathway

mesolimbic

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For ADHD, is a norepinephrine re-uptake inhibitor

clonidine/ guanfacine/ atomoxetine

atomoxetine

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For ADHD, agonize or stimulate the alpha-2 Norepinephrine receptor
(clonidine/ guanfacine/ atomoxetine)

clonidine and guanfacine

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What does SIGECAPS stand for?

``` sleep dissorder interest/pleasure reduction guilt, worthless feeling energy loss concentration impairment appetitechange psychomotor change suicidal ideation ```

Diurnal depression is worse in the (AM/PM)

worse in AM, better in afternoon w/ sun; melancholic type has this plus 100% loss of enjoyment

In depression the amygdala is (hyperactive/hypoactive)

hyperactive

These two sedating anti-depressants block the 5HT2 receptors which is counter intuitive

1. Trazodone | 2. Mirtazapine

A lack of 'joint attention' in a child may indicate _______

autism

A restricted repertoire of interest and repetitive behaviors such as rewinding and re-watching TV can indicate ________

autism

Prevalence of autism is greater in (boys/girls)

boys, 4 times higher

Intellectual disability is an IQ below ____ AND ______

IQ below 70, AND deficits in behavior

blood plasma analysis of a 45 y.o. male has elevated homovanillic acid. he likely has (bulemia/ parkinson's/ depression/ schizophrenia)

schizophrenia

An anxious patient sits in the ED. At this time, the GABA activity in the brain is likely (increased/ decreased/ unchanged)

decreased

The major neurotransmitter implicated in alzheimers is (5HT/ NE/ DA/ ACh)

ACh

______ uses minute doses of a substance that causes symptoms to stimulate the body's self-healing response.

homeopathy

_______ uses non-invasive treatments to help your body do its own healing, uses massage, acupuncture, herbals, exercise and life counseling

naturopathy

If the _______ gene is defective, you cannot convert folate into L-methylfolate, which is needed to make neurotransmitters in the brain

MTHFR

List 5 key genes of the many genes associated with schizophrenia

1. COMT =Catechol-O-methyltransferase 2. BDNF = brain derived neurotrophic 3. TH = tyrosine hydroxylase 4. D2 = DRD2 5. D3 = DRD3

List 2 key genes of the many genes associated with ADHD

1. DRD4 = D4 | 2. DRD5 = D5

MDD has fMRI signals hot in the (award + addiction center/ frontal cortex)

frontal cortex

AHDH has fMRI signals hot in the (award + addiction center/ frontal cortex)

award and addiction center

List 3 key genes of the many genes associated with MDD

1. DAT = dopamine transporter 2. DRD4 = D4 3. COMT

5HT is made in the ______ ______ of the brain

Raphe nucleus

the somatic pain associated with deprression may be due to low levels of (DA/ NE/ 5HT) in the brain

Hyperfunction of the limbic pathway causes (panic/ worry/ ADHD/ depression)

panic and worry

Hypofunction in the frontocortico pathways causes (panic/ worry/ ADHD/ depression)

ADHD, depression

The increased negative effects in MDD such as more guilt, more anxiety, more loneliness is more attributed to low (5HT/ DA)

5HT

The decrease in positive effects in MDD such as less happiness, less alertness, less confidence is more attributed to low (5HT/ DA)

Women are more likely to have excess COMT function and low neurotransmitters due to ________

random X-inactivation, COMT on X chrom.

Low neurotransmitter degradation -> increased NE in limbic areas -> anxiety (COMT Met/ COMT Val)

COMT Met

High neurotransmitter degradation -> low NE in cortex -> depression (COMT Met/ COMT Val)

COMT Val

PD: Paranoid, Schizoid, Schizotypal are part of cluster (A/ B/ C)

Cluster A

PD: Antisocial, Histrionic, Narcissistic are part of cluster (A/ B/ C)

Cluster B

PD: Avoidant, Dependent, Obsessive compulsive are part of cluster (A/ B/ C)

Cluster C

PD: which cluster is psychotic-like but not psychotic? (A/ B/ C)

Cluster A

Detachment from social relationships and restricted range of emotions (Paranoid/ Schizoid/ Schizotypal)

Schizoid

Pattern of interpersonal deficits with perceptional distortions such as ideas about ESP or aliens (Paranoid/ Schizoid/ Schizotypal)

Schizotypal

Which cluster of PD are most psychotic? (A/ B/ C)

cluster A

Which cluster of PD are behavioral disorders? (A/ B/ C)

cluster B

Which is a pattern of excessive emotionality and attention seeking, sexual seduction and self-dramatization (Antisocial/ Histrionic/ Narcissistic/ Borderline)

Histrionic

Which is a disregard for and a violation of the rights of others, associated with conduct disorder? (Antisocial/ Histrionic/ Narcissistic/ Borderline)

Antisocial

Which is a pervasive pattern of grandiosity, need for admiration, lack of empathy and sense of entitlement (Antisocial/ Histrionic/ Narcissistic/ Borderline)

Narcissistic

In whatever manner he acts, he feels justified (Antisocial/ Histrionic/ Narcissistic/ Borderline)

Narcissistic

Which PD cluster is associated with being anxious but is not an anxiety disorder? (A/ B/ C)

cluster C

Which has a pervasive pattern of instability, with an unstable self image, impulsivity and mood lability (Antisocial/ Histrionic/ Narcissistic/ Borderline)

Borderline

Which is associated with perfectionism, preoccupation with details, rules, lists and schedules (Avoidant/ Obsessive-compulsive/ Dependent)

Obsessive-compulsive

Which has a hypersensitivity to to criticism and rejection and is socially inhibited due to feeling inadequate? (Avoidant/ Obsessive-compulsive/ Dependent)

Avoidant

Excessive need to be taken care of beginning in early adulthood, submissive and clingy (Avoidant/ Obsessive-compulsive/ Dependent)

Dependent

Personality disorders with impulsion and aggression have been associated with low maternal (DA/ 5-HT/ NE/ Vit D)

5-HT, specifically the 5-HIAA metabolite

Which PD cluster might be treated with mood stabilizers? (A/ B/ C)

cluster B, | Antisocial, Histrionic, Narcissistic, Boarderline

What are the 3 personality disorders that are a part of cluster A?

1. Paranoid 2. Schizoid 3. Schizotypal

What are the 4 personality disorders that are a part of cluster B?

1. Antisocial 2. Histrionic 3. Narcissistic 4. Boarderline

What are the 3 personality disorders that are a part of cluster C?

1. Avoidant 2. Dependent 3. Obsessive compulsive

To be diagnosed with mania, you must have at lease __# symptoms for __# days

3 symptoms for 7 days

What does DTRHIGH stand for in diagnosing mania?

``` Distractible Talkative Racing thought Hyperactive Impulsive Grandiose Hyposomnic ```

Hypomania can be diagnosed after only __# days

In psychology, an extremely happy mood is _________ a normal positive mood is ________ and a depressed mood is ______

Hyperthymia: Extremely happy Euthymia: Normal Dysthymia: Depressed

You only need to see the manic phase to diagnose bipolar type (I/II)

type I

Which has more depression and hypomanic phases: bipolar type (I/II)

type II

drug for bi-polar: provides membrane stability and promotes neuronal health

Lithium

mood swings, with periods of hypomanic symptoms alternating with periods of mild symptoms of depression is called ________. How long does it need to occur for

cyclothymia; 2 years

Anti-manic agent that increases GABA tone, also anti-epileptic

Valproate= valproic acid

What are the 4 types of Anxiety Disorders?

1. GAD generalized 2. SAD social 3. OCD 4. PTSD

For adults, a diagnosis of General Anxiety Disorder, GAD requires symptoms for greater than _____ in more than ___ setting

greater than 6 months | more than 1 event/activity

Anxiety more frequently affects (women/men)

women

What neurotransmitters are increased or decreased in anxiety? ( 5HT, GABA, NE, Glutamate)

increased NE and Glutamate | decreased 5HT and GABA

Diagnosis of GAD requires 3 or more of of what symptoms?

1. Restlessness 2. Easily Fatigued 3. Difficulty concentrating 4. Irritability 5. Muscle tension 6. Sleep disturbance

Pt has persistent GAD, along with the CBT and SSRI, try _______

Buspirone

What are the front line therapies for Generalized Anxiety Disorder, GAD?

1. CBT: cognitive behavioral therapy | 2. SSRIs and SNRIs

Dx: performance anxiety Rx: ?

Beta-blocker, propranolol

Unexpected abrupt surges of intense fear or discomfort that peak in minutes are called a ______ _____

Panic disorder

At least 4 characteristics are required to make a Dx of panic disorder. List at least 4

1. Palpitations 2. Sweating 3. Shaking/trembling 4. S.O.B. 5. chest pain 6. Nausea 7. Chills or heat 8. Derealization 9. Fear of dying

anxiety disorder where the sufferer perceives the environment to be dangerous, uncomfortable, or unsafe is called ________

agorophobia

A diagnosis of a panic disorder requires fear or anxiety out of proportion to the actual danger for more than ___ months

6 months

What is the first line treatment for a phobia?

1. flooding 2. systemic desensitization both are exposures to the thing that incites fear

Recurrent and persistent thought, urges or images that are intrusive and unwanted are called an ________

obsession

Trying to ignore, suppress or neutralize an obsession is called ________

an undoing ego defense mechanism

A repetitive behavior that a patient performs that has a set of rules that are strictly adhered to is called a ______

compulsion

What is the first line therapy for OCD? | The drug treatments?

Therapy: CBT, cognitive behavioral therapy Drugs: 1. SSRI 2. clomipramine

Which have insight into their behavior? which generally don't? (OCD/OCPD)

OCD: have insight into behavior OCPD: don't

1. vocal ticks, 2. motor ticks and 3. OCD are all common in _____ ______

tourette's disorder

a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups is called a ______

tic

What is the most common thing to cause PTSD?

death of a loved one

What is the most likely thing to cause PTSD?

assault, done by another human

the reliving of events, memories, dreams o nightmares related to an event are the ________ symptoms of PTSD

intrusive

What are the 5 criteria that must be present for PTSD?

1. re-experiencing the event, dreams, flashback 2. Avoidance, of thoughts, people, places 3. dissociative symptoms, amnesia, time slowin 4. negative mood 5. changes in arousal, hyper-aroused, hyper-vigilance

PTSD symptoms for less than 1 month is called ______

Acute Stress Disorder, ASD | symptoms for 3 days to 1 month, greater than 1 month is PTSD

What are the first line therapies for PTSD? | Drugs?

therapy: Cognitive behavioral, for all anxiety disorders Drugs: 1. SSRI for all anxiety disorders, 2. TCAs

To be a mild TBI, Loss of consciousness must not exceed ___ minutes and the glasgow coma score must be between ___ and ___

30 | glassgow coma score between 13-15

The most mild form of TBI is ________

concussion

The majority cause of TBI is (blunt trauma/ MVCs/ falls)

most common: falls, blunt trauma, MVCs least common

a region of injured tissue or skin in which blood capillaries have been ruptured is called a ______

contusion

If a neuron is stretched in a TBI, the rate of conductance is _______

slowed

How many days does it take for energy homeostasis to be achieved after a concussion?

7-10 days

Glasgow coma scale: Severe ___ to ____ Moderate ____ to ___ Mild ____ to ____

Severe: 3-8 Moderate: 9-12 Mild: 13-15

a state of agitation, distress, and restlessness, side-effect of antipsychotic and antidepressant drugs, coma recovery

akesthsia

Frontal cortex: social comportment/behavior (dorsolateral prefrontal/ lateral orbitofrontal)

lateral orbitofrontal

Frontal cortex: executive function (dorsolateral prefrontal/ lateral orbitofrontal)

dorsolateral prefrontal

The non-SSRI 5HT1a partial agonist for GAD is _______

Buspirone

Insomnia is a (dyssomnia/ parasomnia) since it is dissatisfaction with the quantity or quality of sleep

dyssomnia

sleep disorder characterized by problems in timing, quality or amount of sleep (dyssomnia/ parasomnia)

dyssomnia

sleep disorder with abnormalities in physiology or behavior associated with sleep (dyssomnia/ parasomnia)

parasomnia

insomnia requires disturbances in sleep for ____ nights/week for ___ months

3 nights/week for | 3 months

What are the 4 excitatory transmitters that can keep you up at night?

1. Norepinephrine in locus ceruleus 2. Serotonin in raphe nucleus 3. Dopamine in Ventral tegmental area 4. Histamine in tuberomammilary nucleus

A deficiency in which 3 inhibitory neurotransmitters can cause insomnia?

1. GABA 2. melatonin 3. adenosine

habits and practices conducive to sleeping well on a regular basis are called _____ _____

sleep hygiene

To promote a more accurate circadian clock, antagonize (5HT2a/ 5HT1d/ 5HT7)

5HT1d + 5HT7

To create a deeper sleep pattern, antagonize (5HT2a/ 5HT1d/ 5HT7)

5HT2a

↓ NE, ↓ 5HT, ↓ DA | Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

depression

↑DA, ↑5HT, glutamate ↑ or ↓ | Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

schizophrenia

↑DA, ↓ GABA | Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

Mania

↓ GABA, ↓ 5-HT ↑NE, | Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

anxiety

↓ ACh, ↑ glutamate | (Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers)

Alzheimers

Obesity therapy, lipase inhibitor (Amphetamines/ Orlistat/ Topiramate and zonisamide)

orlistat

Obesity therapy, decrease appetite (Amphetamines/ Orlistat/ Topiramate and zonisamide)

Amphetamines

Obesity therapy, anticonvulsants (Amphetamines/ Orlistat/ Topiramate and zonisamide)

Topiramate and zonisamide

Anorexia is a BMI less than ___

mild: 17 moderate: 16-16.9 severe 15-15.9

More ridged personality (anorexia/ bulimia)

anorexia

noradrenergic and specific serotonergic antidepressant (NaSSA), used as an appetite stimulant in anorexia

mirtazapine

recurrent binge eating with compensatory behaviors is called ______

bulimia, may be purging or non-purging

often from dysfunctional family, more conflicted, less ridged (anorexia/ bulimia)

bulimia

Russell's sign is seen in (anorexia/ bulimia)

bulimia, abraided knuckles

Which has a better course of recovery? (anorexia/ bulimia)

bulemia

what drugs are used for bulemia?

SSRI's | imipramine, desipramine, trazodone and MAOis

to be diagnosed with bulimia, you must bing __x/week for ____ months

1x/week for 3 months

mild bulimia is called ______

binge eating dissorder

subclinical anorexia is called ______

avoidant/restrictive food intake disorder

A delusion where the patient feels that someone has been replaced by an imposter is called _______

Capgras delusion

Patient hold a delusional belief that different people are in fact a single person who changes appearance or is in disguise is called ________

Fregoli delusion

Delusion that one is a werewolf is called _____

Lycanthropy

syndrome where symptoms of a delusion are transmitted from one person to another is called ______

Folie a Deux

inability to accept one's own reflection as one's own body, feeling a disconnection from one's own body is called _______

Cotard's delusion

morphine derivative with heroin like effects, but causes flesh to rot is called _______

krokodil = desomorphine

somatic delusion where the patient feels that they are infested with a parasite, they can see it and feel it, is called ______

Morgellons or delusional parasitosis

Delusion where the affected person feels that someone of high status or famous person is in love with him or her is called

Erotomanic delusion

delusions may be caused by too much dopamine in the _______ pathway

mesolimbic, similar to schizophrenia

what type of therapy is used for delusional disorders?

psychotherapy

dementia progession goes from: normal aging -> _______ -> dementia

MCI, mild cognitive impairment

inability to perform particular purposive actions, as a result of brain damage is called ________

apraxia

inability to interpret sensations and recognize things, typically as a result of brain damage is called _______

agnosia

gamma secretase is regulated by presenilin 1 on chr (1/ 14/ 19/ 21) and presenilin 2 on chr (1/ 14/ 19/ 21)

presenilin 1: chromosome 14 | presenilin 2: chromosome 1

the amyloid precursor protein APP is found on chr (1/ 14/ 19/ 21)

21, which is triplicated in downs

Apo E4 is found on chromosome (1/ 14/ 19/ 21)

What are the top 4 most common types of dementia?

1. AD, alzheimer's Dz 2. VD: Vascular Dementia 3. DLB: Dememtia with Lewy Bodies 4. FTLD: Frontotemporal lobe dementia

senile plaques are made of _______

Aβ amyloid

Neurofibrillary Tangles are made of ______

hyperphosphorylated tau

which combo of secretase cleavage of APP is bad for AD? (alpha/ beta/ gamma) secretase

beta + gamma combo cleavage of APP

the catalytic subunit of gamma secretase is ______

presenilin

Alzheimers in the age range of 20-30s is usually caused by _______

APP, downs syndrome, trisomy 21

Alzheimers in the age range of 40-50s is usually caused by _______

presenilin 1 or 2 mutation

Alzheimers in the age range of 60-90s is usually caused by _______

Apo E4 | Apo E2 is protective

Alzheimers in the age range of 50-60s is usually caused by _______

APP on Chr 21 is altered

intracellular aggregates of actin and actin-associated proteins observed in neurons are called ______ bodies

Hirano

early onset alzheimers occurs before the age of ____

changes in social and personal behavior, apathy, blunting of emotions, deficits in language, memory loss late in course (AD/ VD/ DLB/ FTLD/ PD)

FTLD: Frontotemporal lobe dementia

Treat FTLD, Frontotemporal lobe dementia | cholinesterase inhibitor/ Valproic acid/ SSRI

valproic acid for behavioral control | SSRI for irritability, depression or impulsive behavior

Which type of FTLD is associated with ALS? (FTLD-tau/ FTLD-TDP43/ FTLD-FUS)

TDP43 and FUS

Which type of FTLD is also called Pick's Dz? (FTLD-tau/ FTLD-TDP43/ FTLD-FUS)

tau

Which is a glutamate NMDA receptor blocker for AD? ( Donepezil/ Rivastigmine/ Galantamine/ Memantine)

Memantine | others are AChE inhibitors

which has a 'step-wise' progression of deterioration with emotional lability? (AD/ VD/ DLB/ FTLD/ PD)

VD,vascular dementia, abrupt steps after each CVA

Lewy bodies are clumps of _______ in neurons

alpha-synuclein and ubiquitin protein

If the alpha-synuclein and ubiquitin protein lumps affect the CORTEX first, it is called ______

Dementia with lewy bodies

If the alpha-synuclein and ubiquitin protein lumps affect the SUBSTANTIA NIGRA first, it is called ______

Parkinson's disease

A dark core surrounded by a pale corona is a (plaque/ tangle/ lewy body)

lewy body

flame shaped (plaque/ tangle/ lewy body)

tangle of tau

dementia with fluctuation in symptoms, visual hallucinations and delusions is (AD/ VD/ DLB/ FTLD/ PD)

DLB, Dementia with lewy bodies

what are normal, mild, mod and severe on the Mini mental status exam MMSE

normal: 27-30 mild: 20-30 moderate: 10-20 severe: 0-10

freud's life force was named _____

libido

reversion to an earlier phase while under stress is called ____

regression

extra investment of libido in one phase is called _______

fixation

name the age range of each phase: 1. oral 2. anal 3. oedipal/electra 4. Latency

1. oral: 0- 1+1/2 2. anal: 1+1/2 - 3 3. oedipal/electra: 3- 6 4. latency: 6- adolescents

"the CIA is out to get me!" (delusional projection/ psychotic denial/ distortion)

delusional projection

"I am not Eric, I am jesus christ!" (delusional projection/ psychotic denial/ distortion)

psychotic denial,denial of external reality

"You are the psych resident? I am the great psychologist Kaufmann!" (delusional projection/ psychotic denial/ distortion)

distortion

What are the 3 psychotic defense mechanisms?

1. delusional projection 2. psychotic denial 3. distortion

What are 4 immature defense mechanisms?

1. Projection 2. Somatization 3. Acting Out 4. Splitting

What are the Neurotic defenses?

1. Denial 2. Displacement 3. Dissociation 4. identification 5. intellectualization 6. Isolation 7. Rationalization 8. Reaction formation 9. Regression 10. Undoing

What are the Mature defenses?

1. Altruism 2. Sublimation 3. Anticipation 4. Suppression 5. Humor

redirection of emotions to a substitute that were originally felt in childhood is called ________

transference

redirection of a psychotherapist's feelings toward a client is called ________

countertransference

Acute pain is less than 1 ____

week

Chronic pain is longer than _______

6 months

Opioid are more frequently given to patients with a (higher/lower) level of education

lower

Which is better for neuropathic pain (opioid/NSAID)

opioid

Which is better for inflammatory pain (opioid/NSAID)

NSAID

Redirecting feelings towards a less cared for object rather than the thing that is causing the arousal is called ________

displacement, neurotic

feelings are acknowledged, modified and directed towards a significant person or goal so that modest satisfaction results

sublimation, mature

the conscious decision to postpone paying attention to a impulse or conflict is called ________

suppression, mature

unable to accept facts about reality is called _______

denial, neurotic

providing superficially reasonable accounts to explain away negative feelings is called _______

rationalization, neurotic

realistic planning for future discomfort is called _______

anticipation, mature

protecting against past negative events by 'corrective' behaviors such as superstitious rituals is called _______

undoing

what are 2 antidepressant SNRIs for chronic pain?

1. duloxetine 2. milnacipran may have 5HT or NE side effects

A TCA for pain is ________

Amitriptyline

What is SBIRT?

Screening, brief motivational intervention, referral, treatment. For people with substance disorders

What are the 6 common types of psychotherapy?

1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral

improvement of results when receiving attention is known as the _________ effect

Hawthorne

good for depression, anxiety or personality disorders (1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral)

Psychoanalytic/psychodynamic

relieves symptoms by unlearning maladaptive behaviors (1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral)

behavioral

good for role disputes, role transitions, loss and grief (1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral)

interpersonal

based on the idea that problematic relations early in life predisposes you to develop current disorder (1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral)

interpersonal

token economy is a form of: (1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral)

behavioral

Replaces presumed distorted appraisals with more adaptive appraisals (1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral)

cognitive | alters pts schema

behavior change can be effected through cognitive change (1. Psychoanalytic/psychodynamic 2. Interpersonal 3. Family 4. Behavioral 5. Cognitive 6. Cognitive Behavioral)

CBT

sudden dramatic loss of one or more voluntary motor and/or sensory function suggesting a neurological etiology is a _______ ________

Conversion disorder

Hypochondriasis is similar to which anxiety disorder?

GAD

protracted pain longer than is expected severe enough to seek medical attention is called _______

pain disorder

Formerly known as munchausens, now called _______

Factitious disorder

being sick for gains such as to be cared for or be an expert are components of ______ ______

Factitious disorder

When a parent feigns or induces illness in their child it is called _______

Factitious disorder by proxy

Conscious simulation or exaggeration of an illness to achieve secondary gain is called _________

malingering, may be a crime

disturbance in the level of consciousness, cognition, perception, judgement, affect or behavior due to a drug is called ________

intoxication

dependance is due to _______ or drug receptors

down regulation

alcohol potentiates the ______ receptor

GABAa

A reversal agent for Benzo OD is _______

flumazenil

dopamine is made in the _______

Ventral tegmental area

What part of the brain is the "wranglers" that control the DA circuit of VTA -> NAc -> Limbic ->VTA?

OFC, orbitofrontal cortex VMPFC, ventromedial prefrontal cortex DLPFC, dorsolateral prefrontal cortex

with a stimulant, pupils (myosis/ mydriasis) | with an opioid, pupils (myosis/ mydriasis)

stimulant: mydriasis opioid: myosis

You can die of withdrawal from (cocaine/ alcohol/ heroin)

alcohol only

what is the nicotine receptor partial agonist used to help quit smoking?

Verenicline

The best treatment to quit smoking is a combination of ______ and ______

Verenicline and nicotine replacement

Name the Kubler Ross stages of dying

Denial, anger, bargaining, depression, acceptance (DABDA)

In which neurodevelopmental disorder is pruning delayed? (decrease in number of synapses in PFC)

ADHD

What is the number one comorbid condition in ADHD?

Anxiety

For ADHD, how do atomexetine, guanfacine, and clonidine work?

ato: NRI | guan and clon: alpha-2 agonists (these help the neurons fire more synchronously)

What is the first pharmacotherapy you should try on children with ADHD? What next?

slow release MPH, then slow release amphetamine, then immediate release stimulants, then atomoxetine, clonidine ER, and guanfacine ER

What is the first pharmacotherapy you should try on adults with ADHD? What next?

try atomoxetine, modafinil, guanfacine ER, and clonidine ER first; then slow release amphetamine, slow release MPH and then immediate release stimulants

ADHD patients have hyper/hypoactive anterior cingulate cortexes

hypo (PTSD pts have hyperactive)

How many settings do ADHD symptoms need to be in to get diagnosis of ADHD? What is the threshold age?

2+; 6-17

What developmental disorder do we use multidimensional tx foster care (MTFC) for?

Conduct disorder

How many criteria are needed for ADHD, ODD, and CD (over what period of time)?

ADHD: 6 for 6 mo; ODD: 4 for 6 mo; CD: 3 for 12 mo

What are the three symptoms to look for in suicidal patients?

Ideation, intention, and plan (the more the risk triad is filled out the higher the risk of an event in the near future)

5-HTT gene polymorphism: which allele causes less resiliency and greater depressions/suicide attempts, and which seems to be protective

short ‘s’ alleles promote less resiliency and greater depressions and suicide attempts in response to stressful situations The LL long allele seems protective

In which type of amnesia is orientation to person the worst (dementia/neurocognitive disorder, dissociation, or substance induced)

dissociative amnesia (also see travel- fugue)

The etiologic triad of overwhelming stress (trauma), insufficient nurturing/protection, and dissociative capacity can lead to this disorder

Dissociative identity disorder

What drugs should be avoided in dissociation because it may increase the risk? Should also be avoided in cluster B PDs.

benzos

What is: feelings of unreality or detachment from one’s self or of being an outside observer

depersonalization (can feel like you are floating outside your body and watching yourself)

What is: experiences of unreality or detachment from surroundings

derealization (things appear microscopic, sounds sound muffled, visual distortions)

All dissociative disorders are F more than M, except this one where they are equal

depersonalization/derealization disorder

To get a diagnosis of intellectual disability, you need to meet these 3 criteria: IQ equal to or less than ___; deficits in adaptive functioning (___ or more); and onset before age ___.

70; 2; 18

For autism, what type of therapy is most effective method of acquiring new behavior and which is the most effective for decreasing problematic behavior?

new behaviors: discrete trial instruction (aka applied behavioral analysis) decreasing problematic: reinforcement based tx's

Folate supplementation can be used to augment ___ therapy

SSRI (folate can enhance serotonin function by slowing destruction of brain tryptophan)

When we empathize(feel) something emotional we activate the ____ part of the brain a lot

medial prefrontal cortex(MPFC)

What drugs can help pain secondary to somatization?

SSRIs/TCAs (even without anxiety/depression comorbidity)

What is the F:M ratio (just which one is higher) in bipolar I and bipolar II?

I: W=M II: W>M

What disorder causes lab changes – low PO4, low Mg, high amylase, salivary enlargement, and esophagitis/tears

bulimia (and russell's sign = abraided knuckles

What disorder causes with hypothermia, edema, bradycardia, hypotension, syncope, amenorrhea, low K+ → widens QT interval, metabolic acidosis, and osteoporosis

anorexia (and lanugo hair)

Name two genetic receptor mutations related to obesity

melanocortin 4 and leptin

Blocking ___ receptors, make you insensitive to leptin. Name the drug that agonizes the receptor.

5HT2C (SSRIs can cause down regulation of the receptors; lorcaserin

How does naltrexone/buprorion work against obesity? Topirimate/phentermine?

Naltrex antagonizes opioid receptors, lowering appetitive reward and bup is an antidepressant that increase NE tone via NRI likely curbing appetite and increasing energy An epilepsy medication that appears to have anti diabetic properties (Improves insulin sensitivity) and a low level stimulant that curbs appetite

Name the 3 major classes of CBT

coping skills therapies (more emphasis on behavior), cognitive restructuring (more emphasis on cognition), problem solving therapies (both)

What is the most common cluster of personality disorders?

C is most common, followed by A, then B; however B is most common in medical setting

What does SWAG stand for, and for what disorder, and how long do you need to have symptoms

Suicidality, weight loss, anhedonia (inability to find pleasure from pleasurable activities), guilt; adjustment disorder; development of symptoms after a stressor within 3 months, and goes away within 6 mo after stressor solved (tx with psychotherapy)

____ hyperactivity predicts SSRI response for depression

R insula

What drug can be used for nightmares in PTSD?

prazosin (alpha 1 inhibitor)