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Human Behavior > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are examples of immature defenses?

A 
Acting Out Externalization
Fantasy
Idealization
Omnipotent Control Passive Aggressive Projection
Projective Identification Somatization
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2
Q

What are examples of neurotic defenses?

A

Displacement Dissociation Hypochondriasis Intellectualization Isolation Rationalization Reaction Formation Regression Repression/Blocking Undoing

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3
Q

What are examples of mature/high order defenses?

A

Altruism Anticipation Humor Identification Introjection Sublimation Suppresion

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4
Q

Define displacement

A

discharging pent up feelings usually of hostility on object less dangerous than the one that initially aroused the emotion

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5
Q

Define rationalization

A

justifying ones failures with socially acceptable reasons instead of the real reasons

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6
Q

Define reaction formation

A

transforming anxiety producing thoughts into their opposites in consciousness

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7
Q

Define regression

A

returnign to more primitive levels of behavior

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8
Q

Define denial

A

refusing to admit that something unpleasant is happening or that a taboo emotion is being experienced

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9
Q

Define personality

A

Combination of stable, habitual patterns of behavior that are characteristic of a person and that develop over the first two decades of life and then change little

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10
Q

What is a personality trait vs. personality state?

A

Personality patterns are considered traits because they
are longstanding and consistent while personality state behavior refers to behaviors that come and go, such as a mood state

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11
Q

What is temperament?

A

Infants and children manifest patterns of behavioral style (e.g., shy, fussy, calm, easy, etc.) that form the core of adolescent and adult personality.

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12
Q

What is the path to personality and temperament?

A

genes, environment and stessors

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13
Q

When does non-shared environment play less of a role and neural development is substantially complete?

A

once past age 20-25

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14
Q

What are defense mechanisms of depression?

A

introjection

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15
Q

What are defense mechanisms of psychosis/paranoia?

A

projection

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16
Q

What are defense mechanisms of obsessive-compulsive?

A

undoing

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17
Q

What are defense mechanisms of antisocial PD?

A

omnipotent control

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18
Q

What are defense mechanisms of borderline personality d/o?

A

splitting and projective identification, acting out, dissociation

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19
Q

What are defense mechanisms of shizotypal PD?

A

fantasy

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20
Q

What are defense mechanisms of histronic PD?

A

hypochondriasis, somatization, regression

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21
Q

What are defense mechanisms of narcissistic PD?

A

omnipotent control, denial, externalization

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22
Q

What are defense mechanisms of dependent PD?

A

idealization

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23
Q

What is the 6th most disabling illness?

A

BPD

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24
Q

What percentage of mood disorders does BPD account for?

A

25%

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25
Q

What is the most expensive behavioral health care diagnosis?

A

BPD

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26
Q

What is average age of onset of first episode for BPD?

A

18 yo (most 1st episodes are <25 yo)

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27
Q

What is typically the first BPD episode in females?

A

depressive

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28
Q

What is typically the first BPD episode in males?

A

manic

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29
Q

What is suicide risk for BPD patients?

A

15x general pop

accounts for 25% all completed suicides

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30
Q

What is risk of divorce in BPD patients?

A

2-3x general pop

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31
Q

What is the etiology of BPD?

A

exact cause unk, benetic, biochem, socio environmental factors

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32
Q

What biochemical process plays a role in BPD?

A

neuroendocrine-hypothalamus-Pituitary adrenal axis and excess cortical secretion

hypothyroidism

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33
Q

define bipolar I

A

episodes of full blown mania and major depression (may also have hypomania)

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34
Q

define bipolar II

A

episodes of hypomania and major depression but not full blown mania

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35
Q

define paranoid personality disorder

A

pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent

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36
Q

define schizoid personality disorder

A

pattern of detachment from social relationships and a restricted range of emotional expression

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37
Q

define schizotypal personality disorder

A

pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior

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38
Q

Define antisocial personality disorder

A

pattern of disregard for, and violation of, the rights of others

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39
Q

Define borderline personality disorder

A

pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity

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40
Q

define histrionic personality

A

pattern of excessive emotionality and attention seeking

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41
Q

define narcissistic personality disorder

A

pattern of grandiosity, need for admiration, and lack of empathy

42
Q

define avoidant personality disorder

A

pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

43
Q

define dependent personality disorder

A

pattern of submissive and clinging behavior related to an excessive need to be taken care of

44
Q

What are common causes for substance or medication induced BPD?

A

cocaine
corticosteroids
stimulants

45
Q

What is BPD often misdiagnosed as?

A

MDD because pts underreport elevated mood (and its also less common than depressed mood)

46
Q

What is the ratio of depressed mood:elevated?

A

3: 1 in BP I
37: 1 BP II

47
Q

Ddx for BPD

A 
unipolar MDD
schizoaffective d/o
schizophrenia
ADHD
Borderline PD
substance abuse
48
Q

What are comorbitidies of BPD?

A

substance use d.o, anxiety d/o, personality d/o, ADHD

49
Q

What is rapid cycling?

A

4 or more episodes in a year

50
Q

What is precontemplation stage?

A

no intention of changing within the next 6 mo (uneducated on risks, tried and failed)

51
Q

What is contemplation stage?

A

intent to take action within 6 mo (know pros and cons, can last long time)

52
Q

What is preparation stage?

A

ready to take action in the next month

53
Q

What is the action stage?

A

has made the change

54
Q

What is the maintenance stage?

A

behavior is changed

55
Q

What is the termination stage?

A

may reach a point where

\there is no change of relapse for some behaviors (not true for all)

56
Q

What are the 5 Rs for “don’t want to quit”?

A 
relevance- encourage pt to quit
risks- ID potential negative consequences
rewards- benefits of stopping
roadblocks- barriers in quitting
repetition- repeat every visit
57
Q

What are the 5 A’s for “want to quit”?

A

Ask- if they use
Advise- to quit
Assess- willingness to quit (within 30 d)
Assist- (STAR) set quit date, tell fam, anticipate challenges, remove products
Arrange-

58
Q

What are normal BMI values?

A

18.5-24.9

59
Q

What are sx of delirium?

A

reduced awareness, drowsy, lethargic, distractable, new memory impairment, hallucinations, delusions, sleep-wake reversal, sx wax and wane through the day

60
Q

What neuro exam should you do for delirium?

A

sterngth testing, sensory testing, cranial nerve testing, visual fields, nuchal rigidity

61
Q

What is the MC etiology of meningitis in elderly?

A

listeria

62
Q

How long can a pt be involuntary held for if suicide risk and refuse?

A

72 hrs

63
Q

What is a contract for safety?

A

make agreement that they’ll contact the office if they feel suicidal

64
Q

What is the Tarasoff ruling?

A

health professional have a duty to protect intended victim by warning (not duty only to pt)

65
Q

Define psychosis

A

disturbance in perception of reality, evidenced by hallucinations, delusions or thought disorganization

66
Q

What are psychotic pts at high risk for?

A

agitation, agression, suicide, homicide

67
Q

What pts are highest risk for violence in psychosis?

A

M>F
substance abusers x 30
antisocial PD x100

68
Q

How often does a patient in restraints need to be checked on

A

every 15 min

69
Q

When can an alcohol intoxicated pt go home?

A

when they know ehere they are and can walk safely or caly BAC

70
Q

How quickly can alcoholics clear BAC?

A

25 mg/dl/hr

71
Q

Why do pts have muscle aches, back pain and nausea and noth other sx?

A

pain fibers are unequally distributed (not on organs like spleen, kidney etc) but pain fibers are on muscles and joints

72
Q

What is the significance of diffuse/poorly localized sx?

A

in CNS things far apart int he body lie close together-

generalized regulatory process “central sensitization”

73
Q

Describe the somatosensory pain pathways

A

direct and relayed, bidirectional and shaped by experience

74
Q

What is the pathway of sensory and somatosensory information?

A

info reaches amygdala and triggers rapid response via HPA while at the same time info is relayed via thalamus to cingulate cortex and prefrontal cortex which will apply memory and interpretation and then back regulates the thalamus

75
Q

How do hormones affect somatic distress?

A

testosterone affects pain sensitivity and other emotional states
female reproductive organs may produce sx (endometriosis)
E2/P regulares monoamine neurotrans activity

76
Q

What pain do males with somatic system disorder typically present with?

A

low back pain

77
Q

What is malingering?

A

feigning illness for obvious gain
common in soldiers, prisoners, people involved in legal proceedings
associated with antisocial PD

78
Q

What us somatic system d/o?

A

Physical distress that preoccupies person, care seeking dramatic self report

79
Q

What is illness anxiety disorder?

A

Preoccupation with having or acquiring a serious illness

80
Q

What is a factitious disorder?

A

Production of sx to receive medical attention

Can be induced by parents

81
Q

What is Pseudocyesis?

A

false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy

82
Q

What is Trichotillomania?

A

hair pulling disorder

83
Q

What is excoriation?

A

skin picking disorder

84
Q

What is YBOCS?

A

yale-brown obsessive compulsive scale

used to follow tx and assess progress, well validated

85
Q

What is the pathophys oc OCD?

A

“hyperfrontality” corticothalamic striatal learning

86
Q

What are subtypes of major and minor neurocog dz?

A 
Alzheimer’s dz (MC)
vascular disease
Lewy bodies
TBI
HIV infection
Prion disease
Parkinson’s disease
Huntington’s disease
Substance/medication-induced
Frontotemporal neurocognitive disorder
another medical condition
87
Q

What is the idea of the puberty light switch?

A

psychosocial effects of puberty play a role in hormones and genetic risk for eating disorder to develop

88
Q

What are physiological findings associated with AN?

A

delayed gastric emptying

brain vol reduction in frontal, insular, cingulate and parietal cortices

89
Q

What genes play a role in AN?

A

5HT transporter s and l

90
Q

What are inhibitory signals for satiety?

A

leptin feedback/adipose signal

insulin FB

91
Q

What are excitatory signals to stimulate eating?

A

Ghrelin-stomach

92
Q

What is released as reward from eating?

A

dopamine, endogenous opioids, endocannabinoid

93
Q

What are good prognostic factors of ED?

A 
young age
first episode
short duration before treatment
somewhat preserved body weight
intact family
absence of co-morbidity
94
Q

What are poor prognostic factors of ED?

A

purging anorexia
chronicity >12 y
alcohol and drug use
psych comorbidities

95
Q

What biological changes should you assess for in ED?

A 
wt/ht
↓pulse/↓ BP
↓ temp
EKG (arrhythmias)
CBC
CMP (met alkalosis, hypokalemia)
Thyroid (nrml TSH ↓T3)
UA
Bone scan (↓density)
96
Q

What are renal complications of ED?

A

↑BUN and ↑ CR due to dehydration and ↓ GFR

97
Q

What are cardio complications of ED?

A

bradycardia, hypotension, QT prolongation

98
Q

What are neuro complications of ED?

A

↑CSF, ↓grey and white matter, structural brain abnormalities

99
Q

What is criteria for hospitalization of children and adolescents with ED?

A 
<75% BMI
acute weight loss
severe bradycardia
hypotension <90/45
orthostatic ↑in pulse or ↓ BP
EKG abnor
Hypothermia
Electrolyte disturb
Exercise >2d
Uncontrolable binging/purging
Acute food refusal
100
Q

What is refeeding syndrome?

A

fluid and electrolyte imbalances as result of reintroducing nutrition

highest risk is 1st week (peak day 4)

101
Q

What are signs of refeeding syndrome?

A 
hyophosphatemia
hypokalemia
hypomagnesemia
abnormal glucose metabolism
vitamin deficiencies
102
Q

What is bereavement?

A

experience after loss of loved one to death

Human Behavior (5 decks)

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