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Human Behavior > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is the single biggest cause of morbidity, mortality, and years lost globally?

A

Major Depressive Disorder

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2
Q

What is the DSM V criteria for MDD (# of symptoms for how long)?

A

5 or more symptoms for at least 2 weeks

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3
Q

What are the DSM V symptoms for MDD?

A

Depressed mood, Loss of interest or pleasure in activities, weight loss or gain, insomnia or hypersomnia, psychomotor agitation or retardation, loss of energy, decreased concentration, inappropriate guilt or worthlessness, recurrent thoughts of death or suicide

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4
Q

What pathway do most antidepressants work on?

A

The monoamine systems

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5
Q

What is the Suprachiasmatic Nucleus?

A

Region of the brain in the hypothalamus that is responsible for controlling circadian rhythms

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6
Q

What are 6 danger signs of Suicide?

A

Talking about it; statements of hopelessness, helplessness, worthlessness; preoccupation with death; making arrangements; giving things away; anxiety

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7
Q

T/F–> MDD is more common in men

A

False

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8
Q

When is it appropriate to use ECT?

A

Severely depressed patients who do not repond to drugs

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9
Q

What is the essential feature of Persistent Depressive Disorder?

A

Depressed Mood + at least 2 depressive symptoms

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10
Q

How long must symptoms persist to be considered Persistent Depressive Disorders?

A

At least 2 years (1 for kids)

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11
Q

What is the essential feature of Disruptive Mood Dysregulation Disorder? and how often do outbursts occur?

A

Severe temper outbursts w/ underlying persistent angry or irritable mood; 3 or more times a week

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12
Q

What are 4 of the most common symptoms of Premenstrual Dysphoric Disorder?

A

Affective lability, irritability, depressed mood, anxiety/tension

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13
Q

What is the definition of mania?

A

Persistent, elevated, expansive, or irritable mood w/ increased activity or energy lasting for at least 1 week

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14
Q

To diagnose mania you need 3 or more of the following:

A

Grandiosity, decreased need for sleep, pressured talk, flight of ideas/racing thoughts, distractibility, increased activity/psychomotor agitation, excessive involvement in consequential behavior

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15
Q

T/F–> Bereavement can precipitate MDD

A

True

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16
Q

Grief or MDD –> Self-Esteem preserved

A

Grief

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17
Q

Grief or MDD –> Limited capacity to experience happening or pleasure

A

MDD

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18
Q

What are the 3 key tips to use in interviewing patients with behavioral disorders?

A

Normalization, Continuation, Redirection

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19
Q

What are the 4 Ps in a psychiatric interview?

A

Predisposing Factors, Precipitating Factors, Perpetuating Factors, Protective Factors

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20
Q

What are the 5 components of the Psychiatric interview in a medical chart?

A

Psych hx, Family hx, Social Developmental hx, PE, ROS

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21
Q

T/F–> you should always ask about suicide ideations even if patient makes no mention of it.

A

True

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22
Q

What aspect of the biopsychosocial model is described here: Learning/memory, emotions, coping skills, trauma, personality, behaviors, attitudes/beliefs

A

Psychology

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23
Q

Mental Health Illness or Disorder? –> A conditions that affects a person’s thinking, feeling or mood

A

Mental Illness

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24
Q

Mental Health Illness or Disorder? –> Syndrome characterized by clinically significant disturbance in cognition, emotion regulation or behavior

A

Mental Disorder

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25
Q

What is the Diathesis-Stress Model?

A

Etiological theory that examines the interaction of non-biological or genetic traits and environmental influences to produce disorders

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26
Q

T/F–> Autism, ADHD, Asperger’s Childhood disintegrative Disorder and Pervasive developmental disorder are all under one diagnosis of Autism spectrum disorder

A

FALSE (ADHD is not included here)

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27
Q

What pathways are involved in the dopamine hypothesis of schizophrenia?

A

Mesocortical, Nigrostriatal, Tuberoinfundibular, Mesolimbic

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28
Q

T/F–> To diagnose Schizophrenia there must be at least 3 positive symptoms

A

False–> only need 1 positive symptom

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29
Q

How many symptoms of Catatonia must be present and what are they?

A

3; Motor immobility, excessive motor activity, extreme negativism, peculiarities of voluntary movement, stereotyped movements

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30
Q

What makes for a worse prognosis for schizophrenia?

A

Early age of onset, male, more negative symptoms, brain abnormalities, lower level of function prior to onset, substance use, disorganized subtype

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31
Q

T/F–> The new generation antipsychotics have shown greater efficacy in treating schizophrenia

A

False; The only major difference is the SE profile

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32
Q

What is the require time course of symptom presentation in: Schizophrenia, Schizophreniform, and Brief Psychotic disorder?

A

Schizophrenia: signs of disturbance for at least 6 months
Schizophreniform: 1 month to 6 months
Brief Psychotic d/o: 1 day to 1 month with return to normal functioning

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33
Q

T/F–> Schizoaffective disorder is a thought disorder.

A

False; It is a Mood disorder with both schizophrenia ad mood components

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34
Q

What are the 6 types of delusions?

A

Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed

35
Q

What is negative reinforcement in Substance Use Disorders?

A

the noxious experience that occurs when the reward is not obtained

36
Q

Where do “uppers” hit in the brain vs. “downers”

A

“Uppers” hit the Nucleus Accumbens vs. “Downers” hit the VTA

37
Q

What does CAGE stand for? How many does the patient have to say “yes” to determine the diagnosis?

A 
C: Cut Down 
A: do people Annoy you by criticizing behavior? 
G: Guilt about drinking?
E: Eye Opener 
2 yes
38
Q

How did the DSM 5 change the terminology around illnesses of addiction?

A

Substance abuse or dependence changed to Substance Use Disorders characterized as Mild, Moderate, Severe

39
Q

What are the 3 criteria clusters in Substance Use Disorders?

A

Loss of Control, Adverse consequences, Physiological Dependence

40
Q

What is considered “severe” substance abuse?

A

use exceeds daily or near daily limits with >6 sx

41
Q

What is the most effective treatment of nicotine addiction?

A

Combination of Replacement and pharmacological treatments

42
Q

What is the most commonly used treatment of alcohol and sedative withdrawal?

A

Diazepam (lorazepam, alprazolam, clonazapam also used)

43
Q

T/F–> Drugs with shorter half lives are more likely to be addictive

A

True

44
Q

What is the Wernicke Triad of Substance Use Disorders?

A

Confusion, Ataxia, Nystagmus

45
Q

What are 3 parts of Korsakoff Psychosis?

A

Amnesia, Confabulation, Hallucinations

46
Q

What is the treatment of opioid overdose vs. use disorder?

A

overdose: Naloxone (Narcan)

Use Disorder: Methadone, Buprenorphine, Clonidine, Naltrexone

47
Q

What is the physiological mechanism of stimulants?

A

Cocaine inhibits DA reuptake at presynaptic neuron and amphetamines cause increased DA release

48
Q

What is the MOA of PCP?

A

NMDA antagonist

49
Q

T/F–> Hallucinogens are not considered addictive

A

True

50
Q

What is the treatment of choice for Ecstasy?

A

Cognitive Behavioral Therapy for Use Disorder

51
Q

What are the 3 underlying structures for anxiety disorders?

A

Cognitive, Physiological, Behavioral

52
Q

What are the 3 chemical systems involved in the Physiological response in anxiety disorders and the associated substance

A

Stress Response–> Cortisol
Monoamines–> Norepi and Serotonin
Central NTs–> GABA. Glutamate

53
Q

What are the 5 steps to the Anxiety Circle?

A
  1. Threats
  2. Anticipation, negative prediction, cognitive distortions
  3. Arousal
  4. Avoidance
  5. Risk Factors
54
Q

What is the key to treating Anxiety Disorders?

A

Break the cycle

55
Q

What are the types of Cognitive Behavioral Therapy used in treating Anxiety Disorders?

A

Exposure Therapy
Systematic Desensitization
Flooding

56
Q

What pharmacological treatments are used for anxiety disorders?

A

benzodiazepines, SSRIs/SNRIs/TCAs, Buspirone, Anticonvulsants, Atypical Antipsychotics

57
Q

What is the purpose of the Mental Status Exam?

A

Evaluate, quantitatively and qualitatively, a range of mental functions and behaviors

58
Q

What is clanging?

A

Thoughts that are associated by the sound of words rather than by their meaning

59
Q

What is pressured speech?

A

Fast and difficult to interrupt/understand; Seen in bipolar and mania

60
Q

What is perseveration?

A

Persistent repetition of specific words or concepts despite the absence or cessation of a stimulus; seen in cognitive disorders and schizophrenia

61
Q

Define Obsessions

A

Intrusive and unwanted ideas which intrude into consciousness despite efforts to suppress them

62
Q

What are Delusions? What are types of delusions

A

Delusions: false fixed personal beliefs that are not shared by others
Grandiose, Religious, Persecution
Erotomatic, Jealousy, Nihilistic
Thought broadcasting, thought insertion, thought withdrawal
Ideas of reference, ideas of influence

63
Q

Define Hallucinations

A

Abnormal perceptions in which patient hears, sees, tastes, smells, or feels something others cannot

64
Q

How is visuospatial ability tested on the mental exam?

A

Draw a clock indicating a certain time

65
Q

How do you test a patient’s insight and judgement?

A

Ask questions such as “How do you plan to follow up with your medical care?” and “What would you do with a stamped, addressed letter you found on the street?”

66
Q

How do you test attention and concentration on the mental status exam?

A

Attention: spell World backwards
Concentration: calculations, test ability to read and write

67
Q

How do you test registration/recall?

A

Can patient learn something new (give them 3 words) and repeat it back to you almost immediately

68
Q

What are the 4 components to “Orientation”

A

Time, Place, Person, Situation

69
Q

What is Echopraxia?

A

the involuntary repetition or imitation of another persons actions; especially seen in tourettes or autism

70
Q

What is Catalepsy?

A

Condition in which a person can be molded into a position and they maintain position for prolonged period of time; seen in catatonic schizophrenia

71
Q

What is the minimum # of symptoms and the time period in which they must present for a diagnosis of Major Depressive Episode?

A

5 symptoms that must be present during the same 2-week period and must represent a change from previous functioning; 1 of the symptoms must be either depressed mood or loss of interest or pleasure

72
Q

What are the 9 characteristic symptoms of major depression?

A

“Depression Is Worth Studiously Memorizing Extremely Grueling Criteria. Sorry.”

Depressed mood, Interest, Weight, Sleep, Motor activity, Energy, Guilt, Concentration, Suicide

73
Q

One ore more of the following symptoms must be present in Premenstrual Dysphoric Disorder:

A
  1. Marked Affect Lability (mood swings, sensitivity, sudden sadness or tearfulness)
  2. Marked Irritability or anger or increased interpersonal conflicts
  3. Marked Depressed Mood, feelings of hopelessness, self-deprecating thoughts
  4. Marked anxiety, tension, and/or feelings of being keyed up or on edge
74
Q

Diagnostic Criteria for Delusional disorder: Presence of one (or more) delusions with a duration of _____________ or longer.

A

1 month

75
Q

What are the 3 typical stages of Schizophrenia

A
  1. Prodromal Phase: insidious onset occurring over months or years; subtle behavioral changes
  2. Active Phase: Psychotic symptoms develop, including hallucinations, delusions, disorganized speech and behavior
  3. Residual Phase: Active-phase symptoms are absent or no longer prominent; often role impairment
76
Q

What is Derailment (loos association) speech?

A

Breakdown in both the logical connection between ideas and the overall sense of goal-directedness; Words make sentences but the sentences don’t make sense

77
Q

What are the 7 symptoms of Mania?

A

Euphoric mood, increase in activity, racing thoughts/flight of ideas, inflated self-esteem, decreased need for sleep, distractibility, poor judgement

78
Q

What are Negative Symptoms–> 5 A’s (found primarily in schizophrenia)

A

Alogia, Affectie Flattening or Blunting, Avolition-Apathy, Anhedonia-Asociality, Attention

79
Q

What are the Risk Factors associated with Suicide?

A

SAD PERSONS–> Sex (male>female), Age (older for men, middle aged women), Depression, Previous Attempt, Ethanol abuse, Rational thinking loss, Social support lacking, organized plan, No spouse, Sickness

80
Q

What is the most prevalent mental illness in adults?

A

Anxiety Disorders

81
Q

_________% of those who die by suicide have an underlying mental illness

A

90%

82
Q

Suicide among those with _____________ is 50x greater than the general population.

A

Schizophrenia

83
Q

What race has the highest prevalence of adult mental illness?

A

American Indians/Alaskan Natives

Human Behavior (1 decks)

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