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Pharm 2018-2019 > Behavioral (not pharm) - Unit 3 > Flashcards

Behavioral (not pharm) - Unit 3 Flashcards

1
Q

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

A

schizophrenia

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2
Q

Impairment of reality testing, loss of contact with reality

psychosis/ hallucination/ delusion/ Illusion/ ideas of reference

A

psychosis

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3
Q

Sensory perception not generated by an external stimulus is

psychosis/ hallucination/ delusion/ Illusion/ ideas of reference

A

hallucination

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4
Q

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

A

delusion

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5
Q

Misperception of a real external stimulus is

psychosis/ hallucination/ delusion/ Illusion/ ideas of reference

A

illusion

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6
Q

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)

A

ideas of reference

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7
Q

Lack of informative content in speech is called

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

A

Alogia

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8
Q

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

A

Echolalia

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9
Q

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

A

circumstantiality

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10
Q

inventing new words is

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

A

neologism

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11
Q

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

A

thought blocking

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12
Q

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)

A

tangentiality

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13
Q

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

A

6 months

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14
Q

What is the triad of Psychosis?

A
  1. hallucination, alteration in sensory perception
  2. delusion, abnormal thought content
  3. thought disorder, abnormal processing/organization
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15
Q

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)

A

delirium

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16
Q

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

A

catatonic

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17
Q

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

A

mesolimbic tract

amygdala, scary faces

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18
Q

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

A

prefrontal cortex

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19
Q

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

A

dopamine

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20
Q

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

A

homovanillic acid

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21
Q

LSD can cause hallucination by increasing _______ levels in the brain

A

serotonin, 5HT

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22
Q

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

A

mesolimbic

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23
Q

For ADHD, is a norepinephrine re-uptake inhibitor

clonidine/ guanfacine/ atomoxetine

A

atomoxetine

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24
Q

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

A

clonidine and guanfacine

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25
Q

What does SIGECAPS stand for?

A 
sleep dissorder
interest/pleasure reduction
guilt, worthless feeling
energy loss
concentration impairment
appetitechange
psychomotor change
suicidal ideation
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26
Q

Diurnal depression is worse in the (AM/PM)

A

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

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27
Q

In depression the amygdala is (hyperactive/hypoactive)

A

hyperactive

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28
Q

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

A
  1. Trazodone

2. Mirtazapine

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29
Q

A lack of ‘joint attention’ in a child may indicate _______

A

autism

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30
Q

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

A

autism

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31
Q

Prevalence of autism is greater in (boys/girls)

A

boys, 4 times higher

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32
Q

Intellectual disability is an IQ below ____ AND ______

A

IQ below 70, AND deficits in behavior

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33
Q

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

A

schizophrenia

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34
Q

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

A

decreased

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35
Q

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

A

ACh

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36
Q

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

A

homeopathy

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37
Q

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

A

naturopathy

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38
Q

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

A

MTHFR

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39
Q

List 5 key genes of the many genes associated with schizophrenia

A
  1. COMT =Catechol-O-methyltransferase
  2. BDNF = brain derived neurotrophic
  3. TH = tyrosine hydroxylase
  4. D2 = DRD2
  5. D3 = DRD3
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40
Q

List 2 key genes of the many genes associated with ADHD

A
  1. DRD4 = D4

2. DRD5 = D5

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41
Q

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

A

frontal cortex

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42
Q

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

A

award and addiction center

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43
Q

List 3 key genes of the many genes associated with MDD

A
  1. DAT = dopamine transporter
  2. DRD4 = D4
  3. COMT
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44
Q

5HT is made in the ______ ______ of the brain

A

Raphe nucleus

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45
Q

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

A

NE

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46
Q

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

A

panic and worry

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47
Q

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

A

ADHD, depression

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48
Q

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

A

5HT

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49
Q

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

A

DA

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50
Q

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

A

random X-inactivation, COMT on X chrom.

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51
Q

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

A

COMT Met

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52
Q

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

A

COMT Val

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53
Q

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

A

Cluster A

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54
Q

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

A

Cluster B

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55
Q

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

A

Cluster C

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56
Q

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

A

Cluster A

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57
Q

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

A

Schizoid

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58
Q

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

A

Schizotypal

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59
Q

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

A

cluster A

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60
Q

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

A

cluster B

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61
Q

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

A

Histrionic

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62
Q

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

A

Antisocial

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63
Q

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

A

Narcissistic

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64
Q

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

A

Narcissistic

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65
Q

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

A

cluster C

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66
Q

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

A

Borderline

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67
Q

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

A

Obsessive-compulsive

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68
Q

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

A

Avoidant

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69
Q

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

A

Dependent

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70
Q

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

A

5-HT, specifically the 5-HIAA metabolite

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71
Q

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

A

cluster B,

Antisocial, Histrionic, Narcissistic, Boarderline

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72
Q

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

A
  1. Paranoid
  2. Schizoid
  3. Schizotypal
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73
Q

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

A
  1. Antisocial
  2. Histrionic
  3. Narcissistic
  4. Boarderline
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74
Q

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

A
  1. Avoidant
  2. Dependent
  3. Obsessive compulsive
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75
Q

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

A

3 symptoms for 7 days

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76
Q

What does DTRHIGH stand for in diagnosing mania?

A 
Distractible
Talkative
Racing thought
Hyperactive
Impulsive
Grandiose
Hyposomnic
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77
Q

Hypomania can be diagnosed after only __# days

A

4

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78
Q

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

A

Hyperthymia: Extremely happy
Euthymia: Normal
Dysthymia: Depressed

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79
Q

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

A

type I

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80
Q

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

A

type II

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81
Q

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

A

Lithium

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82
Q

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

A

cyclothymia; 2 years

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83
Q

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

A

Valproate= valproic acid

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84
Q

What are the 4 types of Anxiety Disorders?

A
  1. GAD generalized
  2. SAD social
  3. OCD
  4. PTSD
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85
Q

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

A

greater than 6 months

more than 1 event/activity

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86
Q

Anxiety more frequently affects (women/men)

A

women

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87
Q

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

A

increased NE and Glutamate

decreased 5HT and GABA

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88
Q

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

A
  1. Restlessness
  2. Easily Fatigued
  3. Difficulty concentrating
  4. Irritability
  5. Muscle tension
  6. Sleep disturbance
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89
Q

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

A

Buspirone

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90
Q

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

A
  1. CBT: cognitive behavioral therapy

2. SSRIs and SNRIs

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91
Q

Dx: performance anxiety
Rx: ?

A

Beta-blocker, propranolol

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92
Q

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

A

Panic disorder

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93
Q

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

A
  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
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94
Q

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

A

agorophobia

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95
Q

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

A

6 months

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96
Q

What is the first line treatment for a phobia?

A
  1. flooding
  2. systemic desensitization
    both are exposures to the thing that incites fear
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97
Q

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

A

obsession

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98
Q

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

A

an undoing ego defense mechanism

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99
Q

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

A

compulsion

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100
Q

What is the first line therapy for OCD?

The drug treatments?

A

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

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101
Q

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

A

OCD: have insight into behavior
OCPD: don’t

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102
Q
  1. vocal ticks, 2. motor ticks and 3. OCD are all common in _____ ______
A

tourette’s disorder

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103
Q

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

A

tic

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104
Q

What is the most common thing to cause PTSD?

A

death of a loved one

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105
Q

What is the most likely thing to cause PTSD?

A

assault, done by another human

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2
3
4
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106
Q

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

A

intrusive

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107
Q

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

A
  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
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108
Q

PTSD symptoms for less than 1 month is called ______

A

Acute Stress Disorder, ASD

symptoms for 3 days to 1 month, greater than 1 month is PTSD

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109
Q

What are the first line therapies for PTSD?

Drugs?

A

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

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110
Q

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

A

30

glassgow coma score between 13-15

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111
Q

The most mild form of TBI is ________

A

concussion

112
Q

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

A

most common: falls, blunt trauma, MVCs least common

113
Q

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

A

contusion

114
Q

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

A

slowed

115
Q

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

A

7-10 days

116
Q

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

A

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

117
Q

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

A

akesthsia

118
Q

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

A

lateral orbitofrontal

119
Q

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

A

dorsolateral prefrontal

120
Q

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

A

Buspirone

121
Q

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

A

dyssomnia

122
Q

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

A

dyssomnia

123
Q

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

A

parasomnia

124
Q

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

A

3 nights/week for

3 months

125
Q

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

A
  1. Norepinephrine in locus ceruleus
  2. Serotonin in raphe nucleus
  3. Dopamine in Ventral tegmental area
  4. Histamine in tuberomammilary nucleus
126
Q

A deficiency in which 3 inhibitory neurotransmitters can cause insomnia?

A
  1. GABA
  2. melatonin
  3. adenosine
127
Q

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

A

sleep hygiene

128
Q

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

A

5HT1d + 5HT7

129
Q

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

A

5HT2a

130
Q

↓ NE, ↓ 5HT, ↓ DA

Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

A

depression

131
Q

↑DA, ↑5HT, glutamate ↑ or ↓

Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

A

schizophrenia

132
Q

↑DA, ↓ GABA

Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

A

Mania

133
Q

↓ GABA, ↓ 5-HT ↑NE,

Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers

A

anxiety

134
Q

↓ ACh, ↑ glutamate

(Depression/ mania/ schizophrenia/ Anxiety/ Alzheimers)

A

Alzheimers

135
Q

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

A

orlistat

136
Q

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

A

Amphetamines

137
Q

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

A

Topiramate and zonisamide

138
Q

Anorexia is a BMI less than ___

A

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

139
Q

More ridged personality (anorexia/ bulimia)

A

anorexia

140
Q

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

A

mirtazapine

141
Q

recurrent binge eating with compensatory behaviors is called ______

A

bulimia, may be purging or non-purging

142
Q

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

A

bulimia

143
Q

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

A

bulimia, abraided knuckles

144
Q

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

A

bulemia

145
Q

what drugs are used for bulemia?

A

SSRI’s

imipramine, desipramine, trazodone and MAOis

146
Q

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

A

1x/week for 3 months

147
Q

mild bulimia is called ______

A

binge eating dissorder

148
Q

subclinical anorexia is called ______

A

avoidant/restrictive food intake disorder

149
Q

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

A

Capgras delusion

150
Q

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

A

Fregoli delusion

151
Q

Delusion that one is a werewolf is called _____

A

Lycanthropy

152
Q

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

A

Folie a Deux

153
Q

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

A

Cotard’s delusion

154
Q

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

A

krokodil = desomorphine

155
Q

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

A

Morgellons or delusional parasitosis

156
Q

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

A

Erotomanic delusion

157
Q

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

A

mesolimbic, similar to schizophrenia

158
Q

what type of therapy is used for delusional disorders?

A

psychotherapy

159
Q

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

A

MCI, mild cognitive impairment

160
Q

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

A

apraxia

161
Q

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

A

agnosia

162
Q

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

A

presenilin 1: chromosome 14

presenilin 2: chromosome 1

163
Q

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

A

21, which is triplicated in downs

164
Q

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

A

19

165
Q

What are the top 4 most common types of dementia?

A
  1. AD, alzheimer’s Dz
  2. VD: Vascular Dementia
  3. DLB: Dememtia with Lewy Bodies
  4. FTLD: Frontotemporal lobe dementia
166
Q

senile plaques are made of _______

A

Aβ amyloid

167
Q

Neurofibrillary Tangles are made of ______

A

hyperphosphorylated tau

168
Q

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

A

beta + gamma combo cleavage of APP

169
Q

the catalytic subunit of gamma secretase is ______

A

presenilin

170
Q

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

A

APP, downs syndrome, trisomy 21

171
Q

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

A

presenilin 1 or 2 mutation

172
Q

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

A

Apo E4

Apo E2 is protective

173
Q

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

A

APP on Chr 21 is altered

174
Q

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

A

Hirano

175
Q

early onset alzheimers occurs before the age of ____

A

60

176
Q

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

A

FTLD: Frontotemporal lobe dementia

177
Q

Treat FTLD, Frontotemporal lobe dementia

cholinesterase inhibitor/ Valproic acid/ SSRI

A

valproic acid for behavioral control

SSRI for irritability, depression or impulsive behavior

178
Q

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

A

TDP43 and FUS

179
Q

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

A

tau

180
Q

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

A

Memantine

others are AChE inhibitors

181
Q

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

A

VD,vascular dementia, abrupt steps after each CVA

182
Q

Lewy bodies are clumps of _______ in neurons

A

alpha-synuclein and ubiquitin protein

183
Q

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

A

Dementia with lewy bodies

184
Q

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

A

Parkinson’s disease

185
Q

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

A

lewy body

186
Q

flame shaped (plaque/ tangle/ lewy body)

A

tangle of tau

187
Q

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

A

DLB, Dementia with lewy bodies

188
Q

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

A

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

189
Q

freud’s life force was named _____

A

libido

190
Q

reversion to an earlier phase while under stress is called ____

A

regression

191
Q

extra investment of libido in one phase is called _______

A

fixation

192
Q

name the age range of each phase:

  1. oral
  2. anal
  3. oedipal/electra
  4. Latency
A
  1. oral: 0- 1+1/2
  2. anal: 1+1/2 - 3
  3. oedipal/electra: 3- 6
  4. latency: 6- adolescents
193
Q

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

A

delusional projection

194
Q

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

A

psychotic denial,denial of external reality

195
Q

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

A

distortion

196
Q

What are the 3 psychotic defense mechanisms?

A
  1. delusional projection
  2. psychotic denial
  3. distortion
197
Q

What are 4 immature defense mechanisms?

A
  1. Projection
  2. Somatization
  3. Acting Out
  4. Splitting
198
Q

What are the Neurotic defenses?

A
  1. Denial
  2. Displacement
  3. Dissociation
  4. identification
  5. intellectualization
  6. Isolation
  7. Rationalization
  8. Reaction formation
  9. Regression
  10. Undoing
199
Q

What are the Mature defenses?

A
  1. Altruism
  2. Sublimation
  3. Anticipation
  4. Suppression
  5. Humor
200
Q

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

A

transference

201
Q

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

A

countertransference

202
Q

Acute pain is less than 1 ____

A

week

203
Q

Chronic pain is longer than _______

A

6 months

204
Q

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

A

lower

205
Q

Which is better for neuropathic pain (opioid/NSAID)

A

opioid

206
Q

Which is better for inflammatory pain (opioid/NSAID)

A

NSAID

207
Q

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

A

displacement, neurotic

208
Q

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

A

sublimation, mature

209
Q

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

A

suppression, mature

210
Q

unable to accept facts about reality is called _______

A

denial, neurotic

211
Q

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

A

rationalization, neurotic

212
Q

realistic planning for future discomfort is called _______

A

anticipation, mature

213
Q

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

A

undoing

214
Q

what are 2 antidepressant SNRIs for chronic pain?

A
  1. duloxetine
  2. milnacipran
    may have 5HT or NE side effects
215
Q

A TCA for pain is ________

A

Amitriptyline

216
Q

What is SBIRT?

A

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

217
Q

What are the 6 common types of psychotherapy?

A
  1. Psychoanalytic/psychodynamic
  2. Interpersonal
  3. Family
  4. Behavioral
  5. Cognitive
  6. Cognitive Behavioral
218
Q

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

A

Hawthorne

219
Q

good for depression, anxiety or personality disorders

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

A

Psychoanalytic/psychodynamic

220
Q

relieves symptoms by unlearning maladaptive behaviors

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

A

behavioral

221
Q

good for role disputes, role transitions, loss and grief

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

A

interpersonal

222
Q

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)

A

interpersonal

223
Q

token economy is a form of:

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

A

behavioral

224
Q

Replaces presumed distorted appraisals with more adaptive appraisals

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

A

cognitive

alters pts schema

225
Q

behavior change can be effected through cognitive change

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

A

CBT

226
Q

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

A

Conversion disorder

227
Q

Hypochondriasis is similar to which anxiety disorder?

A

GAD

228
Q

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

A

pain disorder

229
Q

Formerly known as munchausens, now called _______

A

Factitious disorder

230
Q

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

A

Factitious disorder

231
Q

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

A

Factitious disorder by proxy

232
Q

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

A

malingering, may be a crime

233
Q

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

A

intoxication

234
Q

dependance is due to _______ or drug receptors

A

down regulation

235
Q

alcohol potentiates the ______ receptor

A

GABAa

236
Q

A reversal agent for Benzo OD is _______

A

flumazenil

237
Q

dopamine is made in the _______

A

Ventral tegmental area

238
Q

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

A

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

239
Q

with a stimulant, pupils (myosis/ mydriasis)

with an opioid, pupils (myosis/ mydriasis)

A

stimulant: mydriasis
opioid: myosis

240
Q

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

A

alcohol only

241
Q

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

A

Verenicline

242
Q

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

A

Verenicline and nicotine replacement

243
Q

Name the Kubler Ross stages of dying

A

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

244
Q

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

A

ADHD

245
Q

What is the number one comorbid condition in ADHD?

A

Anxiety

246
Q

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

A

ato: NRI

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

247
Q

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

A

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

248
Q

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

A

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

249
Q

ADHD patients have hyper/hypoactive anterior cingulate cortexes

A

hypo (PTSD pts have hyperactive)

250
Q

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

A

2+; 6-17

251
Q

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

A

Conduct disorder

252
Q

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

A

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

253
Q

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

A

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

254
Q

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

A

short ‘s’ alleles promote less resiliency and greater depressions and suicide attempts in response to stressful situations

The LL long allele seems protective

255
Q

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

A

dissociative amnesia (also see travel- fugue)

256
Q

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

A

Dissociative identity disorder

257
Q

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

A

benzos

258
Q

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

A

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

259
Q

What is: experiences of unreality or detachment from surroundings

A

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

260
Q

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

A

depersonalization/derealization disorder

261
Q

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 ___.

A

70; 2; 18

262
Q

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

A

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

263
Q

Folate supplementation can be used to augment ___ therapy

A

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

264
Q

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

A

medial prefrontal cortex(MPFC)

265
Q

What drugs can help pain secondary to somatization?

A

SSRIs/TCAs (even without anxiety/depression comorbidity)

266
Q

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

A

I: W=M
II: W>M

267
Q

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

A

bulimia (and russell’s sign = abraided knuckles

268
Q

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

A

anorexia (and lanugo hair)

269
Q

Name two genetic receptor mutations related to obesity

A

melanocortin 4 and leptin

270
Q

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

A

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

271
Q

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

A

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

272
Q

Name the 3 major classes of CBT

A

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

273
Q

What is the most common cluster of personality disorders?

A

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

274
Q

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

A

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)

275
Q

____ hyperactivity predicts SSRI response for depression

A

R insula

276
Q

What drug can be used for nightmares in PTSD?

A

prazosin (alpha 1 inhibitor)

Pharm 2018-2019 (7 decks)

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