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Behavioral Sciences > Pathology > Flashcards

Pathology Flashcards

1
Q

Pt. presents with mild subjective deficits, diminished capacity to process new information, detailed memory has declined, multi-tasking has become more difficult

A

Normal age related changes in cognitive function

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2
Q

Pt. presents with an acute onset of mental impairment (overstated), sleep disturbances, executive functioning impaired, and reduced interest and effort

A

Depression

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3
Q

What is the differences between vascular dementia and Alzheimers

A

1) VD has a Hx. of risk factors
2) VD has more visual memory impairment
3) VD has greater executive function impairment
4) VD pt. have a greater awareness of deficits
5) VD has less cognitive memory loss

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4
Q

How do you differentiate between Picks disease and Alzheimers?

A

1) Picks is located within only the frontal and temporal lobes
2) Picks occurs before 65, AD after 65
3) Severe behavioral problems are observed in Picks
4) Picks has the absence of amyloid plaques

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5
Q

Pt. suffering with tremors, agitation, anxiety, delirium, and psychosis due to withdrawal; may also have seizures, tachycardia, and palpitations

A

Alcohol withdrawal (Delirium Tremens)

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6
Q

Pt. suffering with tremors, anxiety, perceptual disturbances, psychosis, and insomnia due to withdrawal

A

Benzodizaepine withdrawal

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7
Q

Pt. suffering with nausea, vomiting, abdominal cramping, and muscle aches due to withdrawal; may also have dilated pupils, yawning, lacrimation

A

Heroin (opioid) withdrawal

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8
Q

Pt. suffering with increased appetite, hypersomnia, intense psychomotor retardation, severe depression due to withdrawal

A

Cocaine-meth amphetamine withdrawal

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9
Q

Pt. suffering with dysphoria, irritability, anxiety, and increased appetite due to withdrawal

A

Nicotine withdrawal

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10
Q

Damage to the temporal lobe that results in hyperorality, hyperphagia, hypersexuality, and placidity

A

Kluver-Bucy syndrome

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11
Q

What are Argyll Robertson pupils? What do they indicate?

A

1) Pupils that constrict to accommodation, but not light

2) Neurosyphilis or diabetes

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12
Q

What chromosomes are involved with Alzheimers?

A

1) Chromsome 1 encodes Presenilin 2
2) Chromsome 14 encodes Presenilin 1
3) Chromsome 21 encodes APP
4) Chromsome 19 encodes APOE 2,3, and 4

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13
Q

What is better APOE 2 or 4?

A

APOE 2- decreased risk of Alzheimers

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14
Q

What neurotransmitters are low in Alzheimer?

A

1) Acetylcholine
2) Norepinephrine
3) Glutamate

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15
Q

Terminology

1) Lack of speech
2) Lack of drive/motivation
3) Inability to experience pleasure

A

Negative symptoms

1) Alogia
2) Avolition
3) Anhedonia

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16
Q

Where do dopamine receptors occur?

A

1) Extrapyramidal tract
2) Mesolimbic tract
3) Tubero-infundibular (controls prolactin release)
4) Brainstem

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17
Q

What are the criteria for diagnosis of Schizophrenia?

A

1) 2 or more symptoms that are active for a month
2) Significant portion of time with at least one major area of dysfunction
3) Continuous signs of distrubance persisting for at least 6 months

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18
Q

What must be ruled out before diagnosing a psychosis?

A

1) Medical conditions

2) Drug use

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19
Q

Sensory Perceptions in the absence of external stimuli

A

Hallucinations

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20
Q

False beliefs about oneself or others that persist despite the facts

A

Delusions

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21
Q

Words and ideas are strung together based on sounds, puns, or loose assocaitions

A

Disorganized speech

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22
Q

Hallucination commonly associated with medical illness

A

Visual hallucination

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23
Q

Hallucination commonly associated with psychiatric illness

A

Auditory hallucination

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24
Q

Hallucination that occurs as an aura of psychomotor epilepsy

A

Olfactory hallucination

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25
Q

What are the different subtypes of schizophrenia?

A

1) Paranoid
2) Disorganized
3) Catatonic
4) Undifferentiated
5) Residual

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26
Q

Schizophrenia subtype characterized by a preoccupation with one or more delusions or frequent auditory hallucinations

A

Paranoid Schizophrenia

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27
Q

Schizophrenia subtype characterized by two automatisms

A

Catatonic

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28
Q

automatism consisting of motoric immobility

A

Catatoinic stupor

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29
Q

Automatism consisting of excessive motor activity that is purposeless

A

Catatonic excitement

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30
Q

Automatism consisting of negative sympotms

A

Extreme negativism

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31
Q

Automatism consisting of peculiarities of voluntary movements

A

Catatonic posturing

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32
Q

Automatism consisting of repetition of vocalizations made by another person

A

Echolalia

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33
Q

Schizophrenia that lasts 1-6 months

A

Schizophreniform disorder

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34
Q

An uninterrupted period of illness during which a major depressive, manic, or mixed episode occurs; at least 2 week duration

A

Schizoafffective disorder

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35
Q

Presence of hallucinations, delusions, disorganized behavior or speech for one month

A

Brief psychotic disorder

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36
Q

Development of delusions in a person who is in a close relationship with another person with delusional disorders; resolves with separation from individual with delusional disorder

A

Shared Pyschotic Disoder (Folie a deux)

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37
Q

Fixed, persistent, nonbizarre belief system lasting >1 month; functioning not impaired

A

Delusional disorder

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38
Q

Schizophrenia symptoms

1) Hallucinations
2) Delusions
3) Disturbed thinking
4) Bizarre behavior

A

Positive symptoms of schizophrenia

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39
Q

Schizophrenia symptoms

1) Lack of emotions
2) Impaired spontaneity
3) Passive/apathy
4) Social withdrawal
5) Lack of pleasure (anhedonia)

A

Negative symptoms of schizophrenia

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40
Q

What causes a worse prognosis of schizophrenia?

A

Presence of several negative symptoms

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41
Q

What causes a worse prognosis of schizophrenia?

A

Presence of several negative symptoms

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42
Q

What are the vulnerability genes found in schizophrnenia?

A

1) Neuregulin 1
2) Dysbindin
3) COMT
4) DISC
5) BDNF

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43
Q

What are the core symptoms for major depressive disorder?

A

Think: SIGECAPs

1) Sleep pattern changes
2) Interest changes
3) Guilt and worry
4) Energy changes
5) Concentration changes
6) Appetite changes
7) Psychomotor disturbances
8) Suicidal ideation

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44
Q

One or more major depressive episode with 5 out of 9 core symptoms that lasts a minimum of 2 weeks; absence of manic, mixed, or hypomanic episodes

A

Major depressive disorder

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45
Q

Risk factors for Suicide?

A

Think SAD PERSONS

1) Sex (male)
2) Age (teenagers and elderly)
3) Depression
4) Previous attempt
5) Ethanol
6) loss Rational
7) Sickness
8) Organized plan
9) No spouse
10) Social support is lacking

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46
Q

What are the three major neurotransmitters involved depression

A

1) Serotonin
2) Norepinephrine
3) Dopamine

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47
Q

What drugs can induce depression?

A

1) Reserpine
2) Propranolol
3) Methyldopa and clonidine
4) Ampehtamine withdrawal
5) Oral contraceptives

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48
Q

milder form of depression lasting at least 2 years

A

Dysthymia

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49
Q

Symptoms associated with winter season; improves in response to full-spectrum bright-light exposure

A

Seasonal affective disorder

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50
Q

Presence of abnormally elevated, expansive, or irritable moods for at least 1 week along with 3 out of 7 symptoms

A

Manic Episode

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51
Q

What are the core symptoms of a manic episode?

A

think: DIG FAST
1) Distractibility
2) Irresponsibility
3) Grandiosity (inflated self-esteem)
4) Flight of ideas
5) Activity directed by goals increased
6) Sleep not needed
7) Talkativeness

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52
Q

Manic like episode that is less severe; does not require hospitalization; no psychotic features

A

Hypomanic episode

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53
Q

Disorder lasting greater than 2 years that consists of a swing between dysthymia and hypomania; milder form of bipolar disorder

A

Cyclothymic disorder

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54
Q

History of one manic episode with associated symptoms (3 out of 7)

A

Bipolar I

55
Q

History of one hypomanic episode

A

Bipolar II

56
Q

What must you be sure of before you give a pt. an antidepressant?

A

1) Make sure they are not bipolar and in a depressive episode
2) Antidepressant can activate mania

57
Q

Transplanting one’s unacceptable impulses onto another person

A

Projection

58
Q

Expressing unacceptable thoughts or impulses through actions; Example tantrum

A

Acting out

59
Q

Redirecton of an unacceptable impulse into the opposite

A

reaction formation

60
Q

Reverting to a less mature way of coping with difficulties

A

Regression

61
Q

Modeling one’s behavior after someone who is perceived to be more powerful

A

Identification

62
Q

Unconscious belief that people are either wholly good or wholly bad

A

Splitting

63
Q

Mood symptoms with concurrent symptoms of schizophrenia; Dx must have proof of psychotic symptoms in the absence of prominent mood symptoms for at least two weeks

A

Schizoaffective

64
Q

Schizophrenic like symptoms that last 1-6 months

A

Schizophreniform disorder

65
Q

Suicidal conditions with potential to progress rapidly to suicidal behavior

A

Heightened risk

66
Q

Suicidal behavior may occur within hours

A

Near term risk

67
Q

Pairing a sexually arousing paraphilic stimulus with an unpleasant odor

A

Aversion therapy

68
Q

What is satiation?

A

Where you reward the good and then place them in a bad environment and they cannot please themselves any longer

69
Q

Enduring patterns of behavior and inner experiences that deviates markedly from the cultures expectation

A

Abnormal personality disorder

70
Q

Pervasive distrust and suspiciousness of others

A

Paranoid personality disorder

71
Q

What is the cause of Paranoid personality?

A

1) Early shame inducing experiences/mistrust

2) Experiences of mistreatment

72
Q

What are the defense mechanisms of a paranoid personality disorder?

A

1) Splitting

2) Projection

73
Q

Pervasive detachment from relationships

A

Schizoid personality disorder

74
Q

What are the different clusters of personality disorders?

A

Think: Weird, Wild, and Wimpy

1) Odd and Eccentric Personality disorders
2) Dramatic, Emotional, and Erratic Disorders
3) Anxious and Fearful

75
Q

Pervasive pattern of excessive need to be taken care of by others

A

Dependent personality disorder

76
Q

Pervasive pattern or preoccupation with details at the expense of efficiency

A

Obsessive compulsive

77
Q

Pervasive pattern of feelings of inadequacy, hypersensitivity to any form of critisicsm

A

Avoidant

78
Q

Pervasive pattern of exploiting others, disregard for the rights of others and society

A

Antisocial

79
Q

Pervasive pattern of extreme emotionality and attention seeking

A

Histrionic

80
Q

Pervasive pattern of grandiosity, superiority, lack of emphathy for others

A

Narcissistic

81
Q

What are the group A: Odd and Eccentric Personality disorders?

A

1) Paranoid
2) Schizoid
3) Schizotypal

82
Q

What are the group B: Dramatic, Emotional, and Erratic disorders?

A

1) Borderline
2) Narcissistic
3) Histrionic
4) Antisocial

83
Q

What are the group C: Anxious and Fearful disorders?

A

1) Avoidant
2) Dependent
3) Obsessive compulsive

84
Q

What is the criteria for the Confusion Assessment Method (CAM)?

A

Requires criteria 1, 2, and 3/4

1) Acute change in mental status and fluctuating course
2) Inattention
3) Disorganized thinking
4) Altered level of consciousness

85
Q

What is the criteria for mental retardation diagnosis?

A

1) IQ <70
2) Diagnosis before 18
3) Deficits in more than one area of daily living skills

86
Q

What are the criteria that must be met for the diagnosis of autism?

A

1) Communication problems
2) Social impairments
3) Behaviors that are restricted or repetitive

87
Q

Inability to achieve in reading, writing or math at a level consistent with one’s IQ

A

Learning disorder

88
Q

What are good prongosis factors for autism?

A

1) High IQ

2) Better language or social skils

89
Q

Severe disabling level of anxiety where the child is fearful to be away from parent. What is the disorder? What is necessary for diagnosis?

A

1) Separation Anxiety disorder

2) At least 3 of 8 symptoms must be present for at least four weeks

90
Q

Presence of both motor and vocal tics that has occured over a year

A

Tourette’s disorder

91
Q

Children have defiant quallities but not as bad as conduct disordered behavior; commonly called “spoiled”

A

Oppositional defiant disorder

92
Q

Pattern of behavior that violates the rights of others; increased risk of having an Antisocial Personality disorder

A

Conduct disorder

93
Q

Treatment for delirium without underlying causes

A

Antipsychotics (HALDOL!)

94
Q

Recurrent, spontaneous, primary attacks with 4 out of 13 panic symptoms followed by 1 month of either persistent concern of another attack, worries about implications of attack, or behavioral changes due to attack.

A

Panic Disorder

95
Q

Diagnosis of panic disorder?

A

Episodic panic (4 out of 13 symptoms) with 1 month of:

1) fear of another attack
2) Implications of attack
3) Behavioral changes due to attack

96
Q

Fear and anxiety due to situations where escape might be difficult; public transportation, crowds, and elevators elicit fear

A

Agoraphobia

97
Q

Exposure to a traumatic event that involved threat to life and was filled with a response of intense fear, helplessness, and horror that lasts for a minimum of two days and no longer than four weeks. What does this become if greater than two weeks?

A

1) Acute Stress Disorder

2) Post Traumatic Stress Disorder

98
Q

Repetitive behavior that a person feels driven to perform

A

Compulsion

99
Q

What are the mature defenses?

A

1) Altruism
2) Humor
3) Sublimation
4) Suppression

100
Q

Unselfishly assisting others to avoid negative feelings

A

Altruism

101
Q

Rerouting an unacceptable drive in a socially acceptable way

A

Sublimation

102
Q

Temporary, drastic change in personality, memory, consciousness or motor behavior to avoid emotional stress

A

Dissociation

103
Q

Disorder by which an individual consciously or unconsciously uses the body or bodily symptoms for psychological purposes

A

Somatization disorder

104
Q

What is required for diagnosis of somatization disorder?

A

1) Four pain symptoms
2) Two GI symptoms
3) One sexual symptom
4) One pseduoneurological symptom

105
Q

Monosymptom with symbolic relationship between conflict and physical symptoms: unconscious

A

Conversion disorder

106
Q

Preoccupation with fear of having a serious disease

A

Hypochondriasis

107
Q

Pattern of cognition invoking the emotional memory of the trauma; lasting >6 months

A

Post Traumatic Stress Disorder

108
Q

Uncontrollable worry with no specific trigger for at least 6 months

A

Generalized Anxiety Disorder

109
Q

What is the first line treatment for anxiety disorders?

A

SSRIs

  • Sertraline
  • Paroxetine
  • Citalopram
  • Escitalopram
  • Fluoxetine
  • Fluvoxamine
110
Q

What are clinical features of a pt. with Anorexia nervosa?

A

1) Fatigue
2) Headache
3) Abdominal bloating
4) Constipation
5) Hair loss
6) Cold intolerance
7) Fractures with minimal trauma
8) Anxiety, depression, or stress
9) Excessive exercise

111
Q

What physical exam findings might indicate Anorexia nervosa?

A

1) Brittle hair and nails
2) Hair loss
3) Bradycardia
4) Low body temperature
5) Low BP
6) Acrocyanosis
7) Dry skin

112
Q

What physical exam findings might indicate Bulimia nervosa?

A

1) Parotid or salivary gland enlargement
2) Russel sign - callusses and abrasions on the skin of hand
3) Dental enamel errosions

113
Q

What is the equation for BMI?

A

BMI = (Weight (lbs))/((Height in inces)^2 (703))

114
Q

What drives the circadian rhythm?

A

1) Suprachiasmatic nucleus of the hypothalamus

2) Inhibits melatonin synthesis in the pineal gland

115
Q

What are the stages of NREM sleep?

A

1) Stage N1 (Pre-sleep)
2) Stage N2
3) Stage N3 (Slow wave sleep)

116
Q

What is the most restorative stage of sleep?

A

N3 (slow wave sleep)

117
Q

What stage of sleep is at increased risk for parasomnias?

A

N3 (slow wave sleep)

118
Q

Transient reduction, but not complete cessation of breathing for 10 seconds or longer

A

Hypopnea

119
Q

Presence of Sleep spindles/K complexes indicates what stage of sleep?

A

Stage N2

120
Q

What is the strongest stimulus of the circadian rhythm?

A

1) Light

2) Controls suprachiasmatic nucleus

121
Q

What hormone is dependent upon delta sleep (stage N3)

A

Growth hormone

123
Q

what is the clasisc tetrad for narcolepsy

A

1) Excessive daytime sleepiness
2) Catplexy (pathognmonic)
3) Hypnagogic hallucinations
4) Sleep paralysis

124
Q

Maladaptive pattern of substance use defined as 3 or more of the following over a year:

1) Tolerance
2) Withdrawal
3) Predominance of thoughts on drugs or inability to quit
4) Substance taken in larger amounts over longer time than desired
5) Important social, occupational, or recreational activity reduction
6) Use in spite of knowing it to be a problem

A

Substance dependance

125
Q

Maladaptive substance use patern consisting of 1 of the following over a year:

1) Recurrent use resulting in failure to fulfill major obligations
2) Recurrent use in physically hazardous situations
3) Recurrent substance related legal problems
4) Continued use in spite of persistent problems

A

Substance abuse

126
Q

X linked disorder seen exclusively in Girls; occurs around 1-4 yrs old; Loss of development, loss of verbal abilities, mental retardation, and stereotyped handwriting

A

Rett syndrome

127
Q

Marked regression in multiple areas of mental functioning after 2 years of normal development; common in boys

A

Childhood disintegrative disorder

128
Q

Marked regression in multiple areas of mental functioning after 2 years of normal development; common in boys

A

Childhood disintegrative disorder

129
Q

Complete cessation of breathing lasting 10 or more seconds while asleep

A

Apnea

130
Q

Cessation of breathing with no respiratory effort during occurence

A

Central apnea

131
Q

What is the purpose of the Epworth sleepiness score?

A

To determine objectively pt. sleepiness

132
Q

What is the Mallampati classification?

A

Classification of airway obstruction

133
Q

What Mallapmpati classification indicates complete block of viewing anything in the mouth

A

Class IV

134
Q

When does melatonin peak?

A

2-4 am

Behavioral Sciences (3 decks)

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