Epidemiology and Biostatistics Flashcards
The usual, expected rate of disease over time; when the disease is maintained without much variation within a region is called ……
Endemic
The occurrence of disease in excess of the expected rate (an outbreak) is called ……
Epidemic
An worldwide epidemic is called …..
Pandemic
The actual measured rate for a whole population is the ….. rate
crude
The actual measured rate for a subgroup of population is the ….. rate
specific
The rate that is adjusted to make groups equal on one factor (an “as if” statistic for comparing groups, thus removing any difference between the population is the ….. rate, also called ….. rate
standardized/ adjusted
When analysing prevention, it’s helpful to think about disease state. Thus, Primary prevetion promotes ……, there’s no ……; it decrease disease ……. Secondary prevention is …… detection of …… or mild disease; one example are ….. tests; it effect on prevalence is ….., depending on the intervention. Tertiaty prevention prevent ….. and slow ……
health/ disease/ incidence/ early/ asymptomatic/ screening/ variable/ recurrence/ progression
Sensitivity is the test ability to identify ….. patient. A sensitive test negative result rule …… disease. 1 - sensitivity = …… rate. Specificity is the test ability to identify ….. patient. A specific test positive result …… disease. 1 - specificity = …… rate. A screening test should have high …….
sick/ out/ false negative/ healthy/ false positive/ sensitivity
High prevalence of a disease increase the ……., while low prevalence of a disease increase the ……. Prevalence has no effect on …… or ……. of a test. And increasing Incidence has no effect on ….. or ……
Positive predictive value/ Negative predictive value/ Sensitivity/ Specificity/ sensitivity/ positive predictive value
The point of optimum sensitivity equals the point of optimal ……. predictive value, while the point of optimum specificity equals the point of optimal ……. predictive value
negative/ positive
Bias in research is a deviation from the truth. The reliability of a test is th ability to ……. the test, either across testing situations (……. reliability), within a test (…….. reliability), or across judges (……. reliability). Validity is the …… of a test, the degree to which a test measures what was intended.
reproduce/ test-retest/ split-half/ inter-rater/ accuracy
In a study, when sample is not representative to population, it’s called …… bias. If this bias is due to sample be collected in a hospital trying to estimate the population prevalence it’s called ….. bias. When people who are included on a survey are different from people not included, it’s called ……. bias. A solution is …… and ….. data
selection/ Berkson/ nonrespondent/ randomising/ weight
In a study, when the process of gathering the information distorts it, it’s called …… bias. It can be due to ….. questions or because subjects behaviour is altered because they are being study (……. effect). A solution is to have a …..
measurement/ leading/ Hawthorne/ control group
In a study, when there’s …….. (…….. effect), experimenters’ expectations are inadvertently communicated to subjects, who then produce a desired effect. A solution is to do a ….. study.
experimenter expectancy/ pygmalion/ double-blind
In a study, the …… bias give a false estimate of survival rates. The early detection of a disease is confused with increased survival. A solution is to use …… to assess the benefit of screening.
lead-time/ life expectancy
In a study, the ….. bias is always present in retrospective studies, due to subject fail to accurately recall events. A solution is to use …..
recall/ confirmation
In a study, the ….. bias means severe disease individuals are less likely to be uncovered in a survey because they dye first. A solution a to …… by ……
late look/stratify/ disease severity
In a study, the ……. bias is present when the factor being examined is related to other factors of less interest (hidden factors affect results. A solution is to use …..
confounding/ meta-analysis
In a study, when there’s a …… bias, parts of the study do not fit together, the most common issue is a non-comparable control group. A solution is to do an ……. of groups.
design/ random assignment
Case control study is composed by a group of people with a ……, compared to a group without ……..; it’s almost always a …… study. It cannot access ….. or …… of disease, but can help determining …… relationships. Very useful for study conditions with very low incidence. Uses ……
disease/ disease/ retrospective/ incidence/ prevalence/ causal/ odds ratio
Cohort study is composed of a group who have been exposed to ……, compared to a group not exposed to …….. Outcome is disease …… in each group. It’s a …… study. It can determine …… and …… relationships. Uses ……. risk and ….. risk.
risk factor/ risk factor/ incidence/ prospective/ incidence/ causal/ relative/ attributable
Cohort study analyse the data comparing results using ……. risk (how much more likely is something to happen in one group compared to the other), and ….. risk (how many more cases in one group; or how many of the cases are really due to the risk factor). If RR > 1, exposure is ….. to disease; If RR <1, exposure is …… to disease.
relative/ attributable/ risk factor/ protective
Odds ratio estimate the ……. of a ……. Likelihood of someone with the disease had been exposed to risk factor.
strength/ risk factor
The phases of a clinical trials are, Phase 1: testing …… in …….. volunteers; Phase 2: testing protocol and dose in a …… group of ……. volunteers; and Phase 3: testing …… and occurrence of ……. in a …… group of ……. volunteers.Post-FDA approval, marketing surveys will collect reports of drug …….
safety/ healthy/ small/ patient/ efficacy/ side effect/ large/ patients/ side effects
Not all curves are normal; sometimes curves are skewed positively or negatively. A positive skew has the tail to the right, and the …… greater than ….. A negative skew has the tail to the left, and the …… greater than …..
For skewed distributions, the …… is a better representation of central tendency than is the …….
mean/ median/ median/ mean/ median/ mean
In any normal distribution curve, a constant proportion fall within 1, 2, 3 SDs of the mean: within 1SD ….., 2SD ….. and 3 SD …..
68/ 95/ 99,7
Confidence Interval is calculated using the equation: CI=……………
When comparing 2 groups, any overlap of confidence intervals means the groups …….. significantly different. If the given confidence intervals contain 1, then ……. statistically significant effect on exposure.
mean +- Z x (SD/√n)/ are not/ there’s no
Type I error (alpha error): is when we …… the null hypothesis when it is really ……. The chance of type I error is given by the …….
Type II error (beta error): is when we …… the null hypothesis when it is really …….
reject/ true/ p value/ fail to reject/ false
If the null hypothesis is rejected, there’s no chance of ……. error. If the null hypothesis is not rejected, there’s no chance of ……. error.
type II/ type I
When comparing 2 nominal data, the statistical test used is ….. When comparing 2 interval data, the statistical test used is ….. When comparing 1 nominal and 1 interval data, the statistical test used is …..
chi-squase/ Pearson correlation/ t- test
The addiction pathway in the brain is the …… pathway. The primarily gratifying stimulus arrive in the cerebral cortex and activate the ……., that release …… (increase desire for stimulus) and ……. (gives the body the impression of satisfaction so craving are reduced), and stimulate the ……, which increase the desire for the stimulus (positive feedback)
mesolimbic/ ventral tegmental area/ dopamine/ serotonin/ nucleus accumbens/
Drinking between weeks 6 to 9 is most likely to lead to facial abnormalities associated with fetal alcohol syndrome. It can cause ….. problems, ….. or …… problems, and abnormal …….
growth/ behavioral/ mental/ facial features
Most substance users do not believe they have a problem. The….. questionnaire is a screening test for problem drinking and potential alcoholism. The questions are If the person ever tried to …… alcohol intake, If they have ever been …. about criticism concerning drinking, If they ever felt ….. about drinking, and if drinking was ever used as en ….. in the morning. The common stages by which people tend to change their drinking behaviour are: precontemplation, ……., …….., …….., …….. and relapse. The cycle may repeat until sobriety is stablished.
CAGE/ cut down/ annoyed/ guilty/ eye opener/ contemplation/ preparation/ action/ mantainance
If there’s concern about liver impairment, then use benzodiazepines that are metabolised outside the liver: ……, …….. and ……..
oxazempam/ temezepam (shot t1/2)/ lorazepam
Paraphilic disorders necessarily involve …… (erotic focus) and ………. Pedophilia is the most common. Exhibitionism is the desire to …….. Voyeurism is the sexual pleasure derived from ……. Sadism is the sexual pleasure derived from ……. Masochism is the sexual pleasure derived from ……. Fetishism is the sexual focus on …… Frotteurism is the sexual pleasure derived from …….
paraphilia/ impairment/ expose genitals/ watching others who are naked/ other’s pain/ being abused or dominated/ objects/ rubbing of genitals
Genito-pelvic pain/ penetration disorders involve involuntary …… of the other third of the vagina which prevent penile insertion, and recurrent and persistent …… before, during and after intercourse. It is diagnosed only in women. Not diagnosed If caused by a medical condition. Treatment is ….. or hear ……
muscle contraction/ pain/ relaxation/ hegar dilator
Defense mechanisms are the primary tools of the ego used to manage the internal conflicts between ….. and ……. All defences are unconscious, with one exception: …….. Defenses are adaptive as well as maladaptive
ID/ superego/ supression
A mechanism of defence that attributes his own wishes, desires, thoughts, or projections to someone else. Internal states are perceived as a part of someone else, it’s called ……. This is the main defence mechanism seen in …… personality disorder
projection/ paranoid
A defence mechanism that doesn’t allow reality to penetrate to avoid acknowledgement of a painful aspect of reality, it’s called …….
denial
A defence mechanism that people and things in the world are idealised (all good or all bad). The world is pictured in extreme terms, it’s called ……. This is the main defence mechanism seen in …… personality disorder. …… and behavioural stereotype are also a result of ……
splitting/ boderline/ prejudice/ splitting
A defence mechanism that cause a temporary, or transient block in thinking or inability to remember. It often happens in embarrassing moments, it’s called …….
blocking
A defence mechanism that cause returning to an earlier stage of development you have already completed (unconscious childish behavioural in adult), it’s called …….
regression
A defence mechanism in which psychological conflict is converted into bodily symptoms, it’s called ……. It is the main defence mechanism of ….. symptom disorders.
somatization/ somatic
A defence mechanism that acquire characteristics of others as our own, an unconscious form of imitation, is called …….
introjection
A defence mechanism when the target of an emotion or drive changes to a substitute target, is called ……. This is the defence mechanism seen in ……
displacement/ phobias
A defence mechanism when an idea is initially accepted and then this idea or feeling is withheld from consciousness, is called ……., also called unconscious forgetting.
repression
A defence mechanism when there’s a separation of an idea or event from the emotion (affect) that accompany it, is called ……. It is an important defence mechanism for self preservation.
isolation of affect
A defence mechanism when facts and logic are used to avoid confronting emotions, is called …….
intellectualization
A defence mechanism when an emotion or behavioural outburst masks underlying feelings or ideas (distraction), is called ……. This is the defence mechanism seen in …… and ……. personality disorders.
acting out/ borderline/ antisocial
A defence mechanism when rational explanations are used to justify attitudes, beliefs, or behaviours that are unacceptable, is called ……. This is the defence mechanism seen in …… disorder.
rationalization/ suabstance use
A defence mechanism when an unacceptable impulse is transformed into its opposite, is called ……. (excessive overreaction can be a sign of reaction formation). This is the defence mechanism seen in …… disorder
reaction formation/ obsessive compulsive
A defence mechanism when performing an act to undo previous unacceptable act or thought, is called ……. This is the defence mechanism seen in …… disorder
undoing/ obsessive compulsive
A defence mechanism when hostility is expressed covertly, is called ……. The feelings of hostility are unconscious, and the person using the defence is generally unaware of them. This is the defence mechanism seen in …… personality and young children.
passive-agressive/ borderline
A defence mechanism that separates the self from one’s experience to avoid emotional distress (altered sense of reality), is called ……. This is the defence mechanism seen in …… disorders
dissociation/ dissociative
A defence mechanism that uses laugh to cover pain and anxiety, permitting expression of feelings and thoughts without personal discomfort, is called …….
humor
A defence mechanism when the impulse gratification is achieved by channelling the unacceptable impulse into a social acceptable direction, is called …….
sublimation
A defence mechanism when there’s a conscious decision to forget or ignore something, is called ……. It is the ONLY CONSCIOUS defence mechanism
supression
Intelligence quotient (IQ) is a general estimate of the functional capacity of a person. Intellectual disability is an IQ < ……. The mean IQ is …… and SD is ……
70/ 100/ 15
Smiling as a reflex is present at ……, social smile starts at …. weeks and preferential social smile starts at …… weeks.
birth/ 8 weeks/ 12 weeks
Stranger anxiety is distress in the presence of unfamiliar people, it peaks at age ….. and can last until age …….. Separation anxiety is distress following separation from a caretaker, it starts at age …… and can last until age ……
8 months/ 12 months/ 8 moths/ 2 years
Patients in end-of-life may cycle through the Kluber-Ross stages of adjustment. These stages not necessarily occurs in order, and not everyone necessarily pass through all stages. The stages are …… (shock), ……., ……., ……. and …….
denial/ anger/ bargain/ depression/ acceptance
Personality is how a person interact with the world and other people. The test to evaluate personality can be …… or ……. tests. The ….. tests utilise simple stimuli, restricted range of possible responses, scored mechanistically and require no clinical experience. The ……. -referenced test, compare the results to a present standard, while ….. -referenced test, compare the results to a normative group. In the other hand, the ….. test utilise ambiguous stimuli and have a wide range of possible responses and is scored by experienced clinicians.
objective/ projective/ objective/ criterion/ norm/ projective
Awake stage show ….. waves on EEG, drowsy shows …. waves. Stage 1 shows …… waves (….. voltage), Stage 2 shows sleep ….. (…. voltage and ….. frenquency) and …. complexes; Stage 3 (delta) shows ….. voltage and ….. frequency waves. REM sleep shows …. waves (…. voltage and …. frequency)
beta/ alpha/ theta/ moderate/ spindles/ high/ high/ k/ high/ low/ beta/ low/ high
The longest stage of sleep is stage ……, while the deepest stage of sleep (restorative sleep) is stage …… Sleep latency usually last for …… and REM latency is ……. There’s a greater amount of REM in the …… half of night, and memories are consolidated in the hippocampus during this sleep.
2/ 3/ 5 to 15 minutes/ 90 minutes/ second
Serotonin helps to ……. sleep and is REM-…… Acetylcholine is higher during …… sleep (associated with erection in men). NE is lower during ….. sleep. Dopamine produce arousal and …… Dopamine levels …… upon waking. Orexin (hypocretin) regulates arousal, appetite and …… Melatonin is converted from ….. in the pineal gland, under directions from the body internal circadian clock, it’s production is inhibited by activation of …….. cells in the retina. Thus, bright environmental light, capable of suppressing human melatonin, reverses winter depressive symptoms of patients with seasonal affective disorder (SAD).
initiate/ OFF/ REM/ REM/ rise/ wakefulness/ serotonin/ photoreceptors
Dopamine increases wakefulness, thus dopamine blockers (antipsychotics) increase ….. Benzodiazepines cause limited decrease in …. and stage 4 sleep, if chronically used then stop, sleep ….. will increase (no REM rebound). Moderate alcohol consumption leads to ….. sleep onset and increase …… during the second half of the night. Alcohol intoxication decreases ….. and cause …… rebound (nightmares) with withdrawal. Barbiturates decrease ….. and cause ……. in withdrawal. Major depression …… REM, …… REM latency, …… stages 3 and 4 sleep. It also leads to early morning waking and multiple awakenings during the night.
sleep/ REM/ latency/ early/ wakefulness/ REM/ REM/ REM/ REM rebound/ increase/ decrease/ decrease
Narcolepsy is a disorder of REM sleep. There’s a decreased ability to control the sleep-awake cycle. Patients typically enter ….. within 10 minutes. It’s linked to deficiency in …… Narcolepsy patients experience 4 main symptoms: 1- excessive daytime …… (most common), 2- ……. (sudden loss of consciousness - pathognomonic), 3- hallucinations when waking up (…….) or going to sleep (…..), and 3- sleep …… (inability to move or speak while falling asleep or waking up. Treatment is ….. and psycostimulants to treat sleepless, and antidepressant to treat …..
REM/ hypocretin (orexin)/ sleepiness/ cataplexy/ hypnopompic/ hypnogogic/ paralysis/ modafinil/ cataplexy
Sleep apnea is characterised by restlessness and loud ….., and is common in ….., middle-age men. The …. or upper airway sleep apnea is when the airway collapse during sleep. ….. sleep apnea is when the area of the brain that controls breathing does not send the correct signals to the breathing muscle, associated with medical problems. It can also be a mixed apnea. To diagnose we use a …….. Treatment may be limited to ….. and ….. cessation (mild cases), or ……. in moderate to severe cases, and surgery in obstructive reasons.
snore/ obese/ obstructive/ central/ nocturnal polysomnography/ diet/ smoke/ CPAP
Insomnia is characterised by difficulty initiating and maintaining sleep. It may be primary or secondary (most common). Treatment varies within sleep ….., behavioural modification (stimulus control), pharmacotherapy (……. - work on sleep receptors and ……. - melatonin receptor agonist).
hygiene/ zolpidem/ ramelteon
Night terror usually occurs during sleep stage ……, its common in young boys that wake up in the middle of the night and scream, has a familial character and the patient usually has no memory, treatment is ….. Nightmares usually occurs during sleep stage ……, its common in stressful times (may remember), treatment is ……
3/ benzodiazepines/ 2/ antidepressants
Informed consent is a complete discussion of proper information related to a treatment or procedure. Full informed consent requires 5 components of information: …… of procedure, ……. of procedure, ……., ……. and ……. It may be written or oral and can be withdrawn at any time
nature/ purpose/ risks/ benefits/ alternatives
There are 4 situations in which a physician does not need to obtain informed consent: ……. situations, …… is provided by the patient, patient is ……, and therapeutic ……
emergency/ waiver/ incompetent (unconscious, attempted suicide, grossly psychotic, intoxicated, physical or mental state that prevents simple comunication)/ privilege
Decision making standards capacity is determined by ……, competence is determined by …… and sanity is a verdict and is determined by ……
physician/ judge/ jury
Remove from patient contact health care professionals who pose risk to patients. Types of risk include: …… disease, ……. related disorders, …… (or other psychological issues) and …….
infectious/ substance/ depression/ incompetence
Medical order during a medical visit is history, ….. examination, ….. results, …… and ……
physical/ laboratory/ diagnosis/ treatment
Most common known cause of intellectual disability is …….., while the most common genetic causes are …… and ……. syndromes
fetal alcohol syndrome/ down/ fragile-X
The hallmark of autism spectrum disorder is an inability to ….. with others. It is usually diagnosed age
connect/ 3/ communication/ repetitive/ IQ/ Rett/ shaping/ antipsychotics
Tourette syndrome is characterised by multiple …… and ….. tics. Mean age of onset is …. It’s associated with increased levels of ……, associated with ….. and …….
vocal/ motor/ 7/ dopamine/ ADHD/ OCD
Attention Deficit Hyperactivity Disorder is marked by ……, ……, and/ or ……. that leads to problems functioning at home, school or work. It’s more common in ….. (male x female). Associated with decreased …… (impulsivity) and decreased ……. (inattention). Treatment is ……, …….. (1st line stimulates), or ……. (NE reuptake inhibitor - doesn’t work on dopamine, so it’s not addictive)
inattention/ impulsivity/ hyperactivity/ male/ dopamine/ noradrenaline/ methylphenidate/ mextroamphetamine/ atomoxetine
Schizophrenia is seen in 1% of population, and happens equally in men and women. They can positive symptoms (…… and ……), due to increased …… in the ……., or negative symptoms (anhedonia, blunt affect, avolition, alogia), due to decreased ….. in ……. pathway. If these symptoms (mainly positive) occurs for less than 6 months, it’s called ……. disorder, and If it’s for less than 1 month, it’s called …….. disorder.
hallucinations/ delusions/ dopamine/ mesolimbic/ dopamine/ mesocortical/ squizophreniform/ brief psychotic disorder
Major depressive disorder symptoms need to last for more than ……. and affect level of functioning (must include …… mood or …….) Look for SIGECAPS symptoms (decreased ……, decreased ……, increased ……, decreased ……, decreased ……, decreased ……, …… retardation, and ……). It’s associated with low levels of ….., ……. and …… Treatment is …… The major depressive disorder with seasonal pattern is associated with abnormalities in ….. Treatment is …… therapy
2 weeks/ depressive/ anhedonia/ SIGECAPS/ sleep/ interest/ guilt/ energy/ cincentration/ appetite/ psychomotor/ suicidal/ dopamine/ serotonin/ NE/ antidepressants/ melatonin/ bright light
Persistent depressive disorder is …… severe then major depressive disorder. Symptoms must last for more than ……, with depressive symptoms experienced most days. Hospitalization is usually not needed. Functionally is not significantly impaired.
less/ 2 years
Bipolar disorder is the most genetic of all psychiatric disorders. Symptoms of mania (elevated mood for more than ….. or hospitalization) is diagnostic of bipolar type ……. (mania and depression), while bipolar type …… involves ….. and depression.
1 week/ 1/ 2/ hypomania
Cyclothymic disorder is a diagnosis of exclusion. Symptoms need to last for at least ……., and is characterised by mood ….. (periods of ….. alternating with periods of milder ……), but neither meets criteria for mania or major depressive disorder. Treatment is primarily ……. and mood stabilisers
2 years/ swings/ hypomania/ depression/ psychotherapy
Anorexia nervosa is characterised by restriction of food intake that leads to …… of body weight, BMI …… It’s difficult to treat. The person has body image ….. and fear of gaining weight. There are medical complication due to …… and increased risk of …… 50% will ….. and …… Treatment involves hospitalisation, behavioural modifications, SSRI and family therapy.
loss/ <17/ disturbance/ malnutrition/ suicide/ binge/ purge
Bulimia nervosa is characterised by …… eating followed by …….. Weight is …… The person has body image ….. Treatment involves behavioural modification and ….. (low baseline serotonin).
binge/ purging/ normal/ disturbance/ SSRI
Binge eating disorder is a ……. without the compensatory behaviour seen in bulimia nervosa. Weight is …… Treatment is stimulants.
binge eating/ above normal
Anxiety disorders are linked to abnormalities in serotonin, NE and GABA. Panic disorder is defined by presence of …… for more than ……., and involves worrying about having more attacks and significant maladaptive behavioural changes related to the attack. Panic attacks are …..-lived and out of blue, with increased ……. activity. Treatment is ….. (for panic attacks) or …… (for panic disorders).
panic attack/ 1 month/ short/ sympathetic/ benzodiazepines/ SSRI
Anxiety disorders are linked to abnormalities in serotonin, NE and GABA. Generalized anxiety disorder is a constant sense of …… of more than ….. about things that should not have to worry about. The anxiety interferes with daily life. Leading to FRISCM: ……, ……., …… disturbance, ……. difficult and …… tension. Treatment is ….. and …… (5-HT partial agonist).
worrying/ 2 weeks/ fatigue/ restlessness/ insomnia/ sleep/ concentration/ muscle/ SSRI/ buspirone
Anxiety disorders are linked to abnormalities in serotonin, NE and GABA. Phobias are irrational ….. of things or situations and the need to avoid them. Treatment is behavioural modification technique such as systematic …… or flooding.
fears/ desensitisation
Anxiety disorders are linked to abnormalities in serotonin, NE and GABA. Social anxiety is fear of being embarrassed or humiliated in social situations. If it is …… anxiety is only related to performance in public. Treatment are …… and ….. (for stage fright, given before the event). May accompany …… personality disorder.
performance/ SSRI/ b blockers/ avoidant
Obsessive-Compulsive disorder is characterised by obsessions: thoughts are intrusive, senseless and time consuming, and compulsions: acts that are repetitive and time consuming. The defence mechanisms used are ….. and ……. Treatment is ….. (high doses) and behavioural modification (exposure and response prevention).
reaction formation/ undoing/ SSRI
Body dysmorphic disorder is belief that some part of one’s body is abnormal, defective or misshapen. It’s associated with the neurotransmitter …… Treatment is psychotherapy and …..
serotonin/ SSRI
Hoarding disorder is difficulty parting with the possessions regardless their value. There’s distress when thinking of ….. of things. Treatment is psychotherapy and …..
getting rid/ SSRI
Trichotillomania is an ….. to pull out one’s own hair, followed by a sense of ….. when doing it.
irresistible urge/ relief
Post traumatic Stress disorder and Acute Stress disorder result from exposure to actual or threaten death, serious injury, serious injury, or sexual violation, as a direct or witness experience. Exposure may lead to ……. of symptoms in form of nightmares or flashbacks. Patients have ….. disturbances (due to anxiety and nightmares), phobic avoidance, hyper….., ….. instability. Treatment is exposure therapy and SSRIs. The post trauma stress disorder onset occurs at …… and duration is ……., while Acute Stress disorder onset occurs at …… and duration is …….
re-experiencing/ sleep/ vigilance/ mood/ anytime/ more than a month/ 3 days/ less than a month
Adjustment disorder is a diagnosis of exclusion, it’s due to a maladaptive response to identifiable …… causing distress in functioning. Symptoms must occur within …… of stressor and cannot last more than ……. in duration. Treatment is supportive psychotherapy.
stressor/ 3 month/ 6 months
Somatic symptom disorder is the ….. production of symptoms. There are excessive thoughts, feelings and behaviour related to somatic symptoms. Duration > ……. Treatment is psychotherapy.
unconscious/ 6 months
Illness anxiety disorder, used to be called ……., is characterised by the belief that one has an underlying ……, despite constant reassurance. Duration ……., somatic symptoms are …… and treatment is psychotherapy.
hypochondriasis/ disease/ more than 6 moths/ not present (If present, are mild)
Factitious disorder there’s a …… production of symptoms with an …… motivation. No obvious external gains. Treatment is psychotherapy.
Malingering is ……. a mental illness, it is the ….. productions of symptoms with …… motivation. Patient has obvious external gains.
conscious/ unconscious/ not/ conscious/ known
In dissociative disorders, the defence mechanism used is …… It involves the splitting of brain and consciousness, typically caused by traumatic events. Amnesia is the inability to ….. important personal informations. It is seen in …… identity disorder (multiple personality).
dissociation/ remember/ dissociative
In dissociative disorders, the defence mechanism used is …… It involves the splitting of brain and consciousness, typically caused by traumatic events. …… disorder is characterised by recurrent experiences of being outside from the body.
dissociation/ Depersonalization
In dissociative disorders, the defence mechanism used is …… It involves the splitting of brain and consciousness, typically caused by traumatic events. Fugue may appear with all subtypes (…… or ……. disorder) and involves sudden unexpected travel, and inability to recall the past, or confusion of identity.
dissociation/ Amnesia/ dispersonalization
Personality disorders are maladaptive patterns of behaviour. They are ego-….. and lifelong. Cluster A involves the odd and eccentric types. Paranoid personalities are long-standing ….. or mistrust of others; frequently preoccupied with issues of trust, reads hidden …… into comments or events, carries grudges. Schizoid personality causes social …… (they like it that way), seen by others as eccentric, isolated and withdrawn; restricted ….. expression. Squizotypal are very …., strange, weird people, with ….. thinking, odd speech and incongruous affect. May have short-lived …… episodes.
syntonic/ suspiciousness/ meaning/ withdrawal/ emotional/ odd/ magical/ psychotic
Personality disorders are maladaptive patterns of behaviour. They are ego-….. and lifelong. Cluster B involves the dramatic and emotional personalities. Histrionic is a colourful, dramatic and extroverted person that is always seeking for ….., have a very …… behaviour and desires spotlight. Narcissistic has a grandiose sense of self-……., preoccupied with fantasies of unlimited wealth, power and love; demands constant ……, has a ….. self-esteem, and meets criticism with indifference or rage. Borderline personality is marked by very ….., fast and intense relationships; the person is in a constant crisis and chaos, there’s a self-detrimental impulsivity and defence mechanisms used are ….. and ……
syntonic/ attention/ seductive/ importance/ attention/ fragile/ chaotic/ splitting/ passive agression
Personality disorders are maladaptive patterns of behaviour. They are ego-….. and lifelong. Cluster B involves the dramatic and emotional personalities. Antisocial personalities are unable to conform to rules of society. They have ….. acts, theft, reckless, and aggressive. They show lack of …… Treatment is ………
syntonic/ criminal/ remorse/ insight oriented therapy
Personality disorders are maladaptive patterns of behaviour. They are ego-….. and lifelong. Cluster C involves the anxious and fearful personalities. Avoidant personality is extremely sensitive to ……., sees self as socially ….; it’s excessively ….. and socially isolated but has an intense internal desire for affection and acceptance. Obsessive compulsive personality disorder is characterised by ……, inflexibility, loves rules, orders and want to keep routine. The dependent personality gets others to assume ……., they subordinates own needs to others, are unable to express ….. and may be linked to abusive spouse.
syntonic/ inept/ shy/ rejection/ perfectionism/ responsibility/ disagreement
In psychopharmacology, common side effects involves the histamine block (…… and ……), muscarine block (anticholinergic - ….. mouth, ….. vision, ….., confusion, etc), and alpha 1 block (….. and dizziness).
weight gain/ sedation/ dry/ blurred/ constipation/ hypotension
The antipsychotic medications are used to treat 4 types of conditions: ….. and other psychosis, ……., ……. syndrome and ….. disorder. The mechanism of action is …… blockage in the ……synaptic receptors
schizophrenia/ hiccups/ Tourette/ bipolar/ dopamine/ post
Antipsychotics side effects can be …… reaction, that is the first side effect to occur (within hours to days), ……. (within 3 weeks), treated with anticholinergic, ……. (within 6 weeks), treated with anticholinergic, ……. (within 10 weeks), …….. (within 3 to 6 months), treat switching to atypicals. The most rare and sever side effect is …… syndrome, that can happen at any time, may be lethal, and is treated with ……
dystonic/ rigidity/ tremors/ Akathisia/ tardive dyskinesia/ neuroleptic malignant/ dantrolene
Tardive dyskinesia is a side effect caused by ………, it causes involuntary movements of ….., …… and blinking. It persists after medication is ……. and is caused by up regulation of …… receptors. Treatment can be made with ……
antipsychotics/ jaw/ mouth/ terminated/ dopamine/ valbenazine
Dopamine tracts include: …… and …….: drugs reduce psychotic symptoms; ………: increases movement disorder (extrapyramidal reactions - ……, ….. and rhythmic); and ………: increases prolactin.
mesolimbic/ mesocortical/ nigrostriatal/ choreiform/ athetoid/ tuberoinfundicular
Typical antipsychotics block …… receptors, treats mostly …. symptoms and have ….. side effects. Atypical antipsychotics block …… and …… receptors, treats …… and …. symptoms and have ….. side effects
D2/ positive/ more/ D2/ 5-HT2A/ positive/ negative/ less
Typical antipsychotic medication with high anticholinergic effect and low extrapyramidal effect is ……
Typical antipsychotic medication with low anticholinergic effect and high extrapyramidal effect is …… The typical antipsychotic with additional risk for retinitis pigments and retrograde ejaculation is …….
chlorpromazine/ haloperidol/ thioridazine
The atypical antipsychotics are divided in PINES (block …… and also cause …… and somnolence), DONES (block ……, causing orthostatic hypotension and tachycardia) and 2 PIPS and 1 RIP ( ……..). Among the atypicals, the last choice is ……, due to risk of agranulocytosis and need to weekly check of CDC. The atypical that has the lowest risk of movement side effect is …….
histamine/ weight/ alpha/ D2 partial agonist/ clozapine/ quetiapine
Antidepressant medications are used to treat ……, ….. and …. disorders. Mechanism of action is on ……, ……., and ….. receptors. The tricyclic antidepressants block reuptake of ….. and ……, alpha-1 adrenergic receptors and muscarinic receptors. They cause many side effects and are …. in overdose. They also block cardiac Na channels, causing …..
depression/ anxiety/ pain/ serotonin/ NE/ dopamine/ NE/ serotonin/ lethal/ arrhythmias
Monoamine oxidase inhibitors inhibit the metabolism of ….., ….., ….. and …….. MAOI plus tyramine can cause ……, signs include occipital headache, stiff neck, nausea, dilated pupil, nose bleed. The treatment for this side effect is to stop medication, give …….. (alpha 1 blockage) or …… (antipsychotic with hypotensive effects).
dopamine/ serotonin/ NE/ tyramine/ hypertensive crisis/ phentolamine/ chlorpromazine
Selective serotonin reuptake inhibitors are the most commonly used antidepressants. The mechanism of action is inhibition of reuptake of ……. They are also used to treat ….. and …… disorders. Side effects include ……. gain, …… problems (anorgasmia and delayed orgasm), ….. and ….. complaints. Serotonin syndrome is associated with high doses, ……/SSRI combo and ……/ synthetic narcotic combination, causing restlessness, sweating, insomnia, diarrheas, cramps delirium. Treatment of serotonin syndrome is removal of causative agent and administer …… (1st generation antihistamine).
serotonin/ anxiety/ sexual/ weight/ sexual/ headache/ GI complains/ MAOI/ MAOI/ cyproheptadine
Serotonin Norepinephrine reuptake inhibitors are used to treat depression, …. and ….. disorders. The drug ….. can be used to treat neuropathic pain. Side effects include increased …… and ……. vision.
anxiety/ pain/ duloxetine/ blood pressure/ blurry
Other antidepressants used are ……, that is an antagonist to 5-HT receptor and an alpha 1 blocker, it is very sedating, may lead to ….. and sometimes is used to treat ….. dysfunction. The antidepressant …….. is an alpha 2 antagonist, that stimulate …… and …… release, and block …… (decrease nausea). It’s side effects are …. and ….. due to block of histamine receptor. The antidepressant …… (aproved for depression and smoking cessation), it is a relatively weak inhibitor of …. and …… reuptake, don’t inhibit reuptake of …… It’s not associated with weight gain and ….. side effects. Side effects are increased risk of ……, and is not used in patients with seizure or eating disorders.
Trazodone/ priapism/ erectile/ mirtazapine/ NE/ serotonin/ 5-HT3/ weight gain/ sedation/ bupropion/ NE/ dopamine/ serotonin/ sexual/ seizures
Lithium is the drug of choice for bipolar disorder. It’s therapeutic window is …… Good ….. function and adequate …… are essential with lithium, as 95% is excreted in urine. If the blood levels >2,5, consider …… as the treatment of choice. Side effects include hypo……, ……toxicity, teratogenicity (Ebstein’s abnormality affecting the …….), and diabetes …….
narrow/ renal/ hydration/ dialysis/ thyroidism/ nephro/ tricuspid valve/ insipidus
Valproic acid is used to treat bipolar disorder and rapid cycling bipolar disorders. The mechanism of action involves augmentation of ……. in CNS. Side effects are ….gain, sedation, ……., GI distress and teratogenicity (……. defects). It’s necessary to monitor blood levels, as it can cause ………
GABA/ weight/ alopecia/ neural tube/ hepatotoxicity
Carbamazepine is also used to treat bipolar disorder, the mechanism of action is blocking …… in neurons with action potential; it alters central …… receptor and is teratogenic. Side effects include GI distress, ……, mild leukocytosis, ……., and ……. anaemia. It is a p450 inducer and is necessary to monitor blood levels and signs of ……
Na/ GABA/ rash/ agranulocytosis/ aplastic/ rash
Lamotrigine is used for ……. of mania, not used to treat …… mania. It is the least teratogenic. It is associated with ……. syndrome.
profilaxis/ acute/ Steven-Johnson
Benzodiazepines are used to treat …… disorders, ……. disroders, …… withdrawal and seizures. The mechanism of action is depression of the CNS, by binding to …….. receptors, facilitating the action of GABA (increase frequency of Cl opening). All of them go under hepatic oxidation, except for ….., ……. and ……… The side effects are sedation, insomnia, addiction and risk of …… in elderly
anxiety/ sleep/ alcohol/ GABA-Cl/ Oxazepam/ Temazepam/ Lorazepam (Outside The Liver)/ falls (due to confusion and disorientation)
Buspirone is used to treat anxiety disorders when possible ……. of benzodiazepines is a concern. It has no …… effect and is not potentiated by …….. The mechanism of action works on ……. Full effect is seen > 7 days, some ….. is seen and there’s a low abuse potential.
abuse/ withdrawal/ alcohol/ serotonin/ sedation
The left hemisphere is dominant in …… and ……-type problem solving. It is the dominant hemisphere in 97% of population (40-60% in ….-handed persons). Stroke damage to left hemisphere is likely to cause ……. Right hemisphere is dominant in perception, artistic and visual-spatial tasks. Stroke damage to right hemisphere is more likely to cause …… and indifference
language/ calculation/ left/ depression/ apathy
The frontal lobe is responsible for personality and ……., intelligence, attention/ …….., body ……, problem-solving and speech (….. area). Injury in this part of the brain causes loss of ….., mood ….., changes in ….. behaviour, unable to focus, difficulty with language (Aphasia).
emotions/ concentration/ movement/ broca/ movement/ swings/ social
Parietal lobe is responsible for the sense of ……, …… and ……. It’s responsible for ….. and …… perception. Injury to this part of the brain causes lack of awareness or neglect of certain body parts, difficulty distinguishing …. from …..
touch/ pain/ temperature/ visual/ spacial/ left/ right
Occipital lobe is responsible for ……, injury to this part of the brain will lead to defect in ….. or …… spots. Visual …… and ………
vision/ vision/ blind/ illusions/ hallucinations
Temporal lobe is responsible for ……. (understanding - …… area), memory, and …… Injury to this part of the brain causes difficult …… language and speaking (aphasia), and difficult recognising faces.
speech/ wernicke/ hearing/ understanding
Cerebellum is responsible for …., ……. and …… Injury to this part of the brain causes difficult ….. fine movements, difficulty walking and tremors
posture/ balance/ coordination of movement/ coordinating
Brainstem is responsible for …., …… rate and …….. Injury to this part of the brain causes changes in ……, and problems with balance and movement
consciousness/ heart/ breathing/ breathing
Acetylcholine is a neurotransmitter that has an unclear role in the brain. It plays a significant role in …… disease. Cholinergic neurons are concentrated in ….. system and basal …… In the corpus striatum, Ach circuits in equilibrium with ….. neurons
Alzheimer/ reticular activating/ forebrain/ dopamine
Norepinephrine (NE) in the brain is implicated in altering ……. (ADHD), perception and …… (mania). Depletion of NE leads to ….. and excess of NE leads to …… Activation of alpha 1 receptor leads to ….., alpha 2 receptors is located on cell bodies of ……. neurons, …… NE release, Beta 1 is excitatory to …., …. and ….., and B2 causes vasodilation and bronchodilator
attention/ mood/ depression/ mania/ vasoconstriction/ presynaptic/ inhibit/ brain/ heart/ lungs
The most important dopamine receptor is ….. (blocked by all antipsychotics). There are 4 pathways of known psychiatric importance: ……… pathway (blockage leads to tremors, muscle rigity and bradykinesia), …… pathway (blockage reduces positive psychotic symptoms), ……… pathway (blockage increases negative symptoms), and ……. system (blockage leads to increases in prolactin).
D2/ nigrostriatal/ mesolimbic/ mesocortical/ tuberoinfundibular
Serotonin has a role in regulation of mood, sleep, sexual activity, aggression, anxiety, motor activity, cognitive function and etc. It has an inhibitory influence and is liked to ….. control. Low serotonin, low ….. control.
impulse/ impulse
Glutamic acid is a neurotransmitter that stimulates neuron …… It is the principal excitatory neurotransmitter in the brain, connecting the cerebral cortex and …….. There is evidence that it is the principle neurotransmitter of …. pathway. It may have a role in producing …… symptoms (PCP symptoms - NMDA antagonist).
fire/ corpus striatum/ visual/ schizophrenic
Substance P is a peptide containing 11 amino acids and is the major neurotransmitter of ……. neurons that convey …… sensation from periphery. Opiates relieve pain in part by …….. the release of substance P
sensory/ pain/ blocking
Gamma Aminobutyric Acid (GABA) is a neurotransmitter almost exclusively in the brain, ……. the firing of neurons, and is the brain’s principle ……. neurotransmitter.
reduces/ inhibitory
An acute onset of impaired cognitive functioning that is fluctuating, brief and reversible is called ……, it is usually due to ….., ….. or …… abnormalities. The loss of cognitive abilities, progressive or static, and rarely reversible is called ……. disorder.
delirium/ infection/ medication/ electrolyte/ neurocognitive
Neurocognitive disorder due to Alzheimer disease represents 60% of those with neurocognitive disorder. Risk factors include female, …… history, head ……, and ….. syndrome. Neuroanatomic findings include cortical ……., flattened ….. and enlarged …… Histopathology shows senile ……. (…… deposits), neurofibrillary …… (…. protein), neuronal loss and granulovacuolar degeneration of neurons. Associated with chromosome …… (gene for the amyloid protein). There’s decreased …… and …… Deterioration is gradual. Treatment is long-acting cholinesterase inhibitor such as ……, ……., …….. (slow down progression), or NMDA antagonist, ……, to treat moderate to severe cases
family history/ trauma/ down/ atrophy/ sulci/ ventricles/ plaques/ amyloid/ tangles/ tau/ 21/ Ach/ NE/ donepezil/ rivastigmine/ galantanime/ memantine
Vascular neurocognitive disorder risk factors are male, ……. or other cardiovascular disorder that affects ….. and …..-sized vessels. Deterioration may be ….wise, and there may be ….. neurologic symptoms. Treatment is directed to the ….. cause.
hypertension/ small/ medium/ step/ focal/ underlying
Frontotemporal neurocognitive disorder (….. Disease) is characterised by atrophy of ….. and …… lobes. Histopathology shows ….. bodies (intraneuronal inclusions) and ….. cells (swollen neurons) in affected brain areas. It’s most common in men with family history of ….. disease. It’s difficult to distinguish from …… disease. May see features of Kluver-Bucy syndrome (hyper sexuality, hyperplasia and passivity).
Pick/ frontal/ temporal/ Pick/ Pick/ Pick/ Alzheimer
Neurocognitive disorder due to prion disease is a rare spongiform encephalopathy that presents with neurocognitive disorder, myoclonus and ….. abnormalities. Symptoms progress over months, and findings include ….. and …… abnormalities, choreoathetosis, and other abnormal movements. It’s fatal within ….
EEG/ visual/ gait2 years
Neurocognitive disorder due to Huntington disease is a rare, progressive neurodegenerative disease that involves loss of …… neurons of the basal ganglia. It manifest as choreoathetosis, …… and ….. disorder. It’s caused by defect in a autosomal dominant gene in chromosome …. Atrophy of ….. nucleus, with ….. enlargement is common.
GABAergic/psychosis/ neurocognitive/ 4/ caudate/ ventricular
Neurocognitive disorder due to Parkinson disease is a common, progressive neurodegenerative disease that involves loss of …… neurons in …… Motor symptoms include …… tremor, ……, …… and …… disturbances. Treatment involves use of dopamine precursors (….. or ……), dopamine agonists (…..), anticholinergic medication (…….) and ……. (selective MAO-B inhibitor).
dopaminergic/ substantia nigra/ resting/ rigidity/ bradykinesia/ gait/ levodopa/ carbidopa/ bromocriptine/ benztropine/ selegiline
Neurocognitive disorder due to Lewy bodies cause ……, …… features and extrapyramidal signs. Antipsychotic medication may …… behaviour.
hallucinations/ parkinson/ worsen
Neurocognitive disorder due to HIV happens because HIV …… and progressively destroys …… It’s clinically apparent in 30% of those with AIDs. Can manifest as ….. disturbance.
directly/ brain parenchyma/ mood
Wilson Disease causes neurocognitive disorder and is due to ……. deficiency. The eyes may have ……. and ….. may be present.
ceruloplasmin/ kayser-fleischer ring/ Asterix
Normal pressure hydrocephalus is one of the few dementia that is reversible. It present with enlarged ……, due to increased CSF, with normal pressure. It’s characterised by …….. incontinence, …… disorder and ….. apraxia. Treatment is shunt placement.
ventricles/ urinary/ neurocognitive/ gait (WET, WACKY, WOBBLY)
Pseudodementia is typically seen in …… with …… disorder who appear to have symptoms of neurocognitive disorder. Improvement should be seen after treatment with …… Onset of symptoms can usually be dated
elderly/ depressive/ antidepressants
Private insurance can be ………., which make fixed payment for number of patients in their care, thus incentive …… care but there’s a risk of ……. Or it can be ……….., in which the provider makes money on volume, thus efficiency is rewarded and there’s a risk of …..; it is based on ……. (what patient pays before insurance), ……. (flat fee for each service) and ……. (remainder bill is divided).
Health Maintenance Organization (HMO)/ preventive/ under treatment/ Preferred Provider Organization (PPO)/ over treatment/ deductible/ copayment/ coinsurance
The government insurance can be Medicare, supported by the …… government; this program pays the health care costs of ….., …… and dependents of ….., the part A is free and include …… care, part B pays for ….. services and deductibles and copayments are applicable. The Medicaid is supported by the …… government, and covers ….. care for the poor, with no deductible and copayments.
federal/ age >65/ disabled/ disabled/ hospital/ physician/ federal and state/ all
