Pre-Test 1 Flashcards by Robby Skinner

What is flight of ideas

Patient expresses thoughts very rapidly, with constant shifting from one idea to another, though the ideas are often connected

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Loose association vs flight of idease

Both have lost goal directness, button LA the patient never gets back to the point and there is no clear connection between the sentences

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What is perservation

Response that persists even after a new stimulus has been introduced

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What is tangentiality

Pattern of thought in which the patient answers a question with something that is related to the question, but does not answer it directly

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How do you test abstract reasoning in MSE

Ask patient to interpret a proverb

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Cutoff between schizophreniform and schizophrenia

6 months

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Age range for increased risk of violence

15-24

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ER sedating meds? what does the second drug do

IM haloperidol and lorazepam

Lorazepam decreases the dose of antipsychotic needed and protects against dystonic reactions

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What is projective identification

Defense mech when a person projects his own unconscious feelings on another, and the other person identifies with the projected emotion and begins to behave in the manner dictated by the projected emotion

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circumstantiality vs tangentiality

Circumstantiality is a disturbance in which the patient digresses into unnecessary details before communicating the central idea
Tangentiality is present when the patient wanders and digresses to unnecessary details and the substance of the idea is never communicated

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What is it called when a patient thinks his thoughts are being stolen

Thought broadcasting

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CD criteria and timing

Criteria: Aggression to people or animals, destruction of property, deceitfulness or theft, serious violation of rules
Three criteria met in the past 12 months with at least one present in the last year

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Malingering gain primary or secondary?

Secondary

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ODD features

Defiance issues: losing temper, arguing with adults, defying rules, annoying people, blaming others

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When can thyroid storm present

When a thyrotoxic patient is recovering from acute illness or stress

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EEG for hepatic encephalopathy

Triphasic waves

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Diffuse encephalopathy EEG

Diffuse slowing of background rhythms

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Caffeine withdrawal EEG

Increase in amplitude or voltage of theta activity

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Erikson stage of children 1-3

Autonomy vs Shame and Self Doubt

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Erikson stage of children under 1

Basic trust vs Mistrust

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Erikson stage for children 3-5

Initiative vs Guilt

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Erikson stage 21-40 years

Intimacy vs isolation

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Erikson stage 40-65

Generativity vs stagnation

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What is a transitional object for a young kid

Toy or blanket substitute for primary care-giver

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Erikson stage over 65

Integrity vs Despair

Id, Ego, and superego

Id: instinctual drives Ego: Find equilibrium b/w gratification of instinctual drives and rules of society Superego: determines societal rules and tells the ego what is not to be done

When is an unacceptable unconscious impulse transformed into its opposite

Reaction formation

What is sublimation

Satisfaction of an objectionable implies is obtained by using socially acceptable means *writing a book to live out character fantasies*

What is undoing

Compulsive act that is performed in an attempt to negate or avoid the consequences of a fantasized action that is the result of an obsessional impulse

What is the protest phase of separation

Around 16 months old, after 3 days of separation a kid will push away mom when she comes back

Primary metabolite of dopamine

Homovanillic acid

What is cataplexy

Sudden loss of muscle tone triggered by strong emotions which takes place during full wakefulness

What is ideational apraxia? typical finding in what disease?

Inability to put sequence of skilled acts together in a row | Typical finding in those with cortical degeneration from Alzheimer's

TLE personality? what is the opposite called?

Hyposexuality, emotional intensity, and viscosity | Opposite would be Kluver-Buscy

Triptans work on

5-HT (1D) serotonin receptor

Atypical receptor (besides dopa)

5-HT (t6)

Receptor responsible for EPS in antipsychotics

D2 receptors

Complete inability to perceive color

Central achromatopsia

Inability to ingrate a visual scene a perceive it as whole

Simultanagnosia

What is inability to identify and draw items using visual cues

Apperceptive visual agnosia

Inability to direct gaze rapidly

Oculomotor apraxia

How does MDD affect sleep

Decreased latency of REM sleep

Cocaine inhibits uptake of

NorEpi and Dopa

Hereditary alzhemiers mutation

Presenlin 1

Low level of what in CSF may predict suicide risk

Seratonin

OCD neurotransmitter issue

Dysfunction of serotoninergic pathways

Neurotransmitter involved in anxiety

Most common AE of anti-parkinson medications

Hallucinations

Protein that clears out memories that aren't being used

Protein phosphatase 1

Atrophy of what in huntingtons

Caudate nucleus

Injury to right pre-frontal area could cause? | Injury to left pre-frontal area?

Right: laughter, euphoria, and tendency to make jokes and puns Left: abolishes normal mood-elevating influences of the right area and produces depression and uncontrollable crying

Dysfunction of orbitofrontal area causes?

Disinhibition, irritability, lability, euphoria, and lack of remorse

Lesion to dorsolateral area can cause

Deficiencies in planning, monitoring, flexibility, and motivation

Vit A excess

Yellowing of skin and eyes

Vit D excess

Calcification of bone and soft tissue, formation of kidney stones

What vitamin excess can lead to clotting issues

Vitamine E | *often taken in excess by those who believe it prevents against heart attacks*

Serotonin receptors in where may cause initial increase in anxiety when starting medicine

Limbic system

90% of bodies serotonin receptors are where

In gut

MRI of chronic neurosyphillis

Enhancement of meninges at the base of the brain | *seen with many chronic infections*

Dementia and gait disorder think

Normal pressure hydrocephalus | *don't forget to look for peeing on self*

Triphasic waves on EEG seen with

Hepatic encephalopathy

What is disintegrative disorder

Now part of ASD, development normal through at least 2 years of life and falls apart before the age of 10

Most common reason for psychiatrist to see adolescents in ER setting

Suicidal behavior

Treatment of vocal tics

Neuroleptics and A2 agonists (clonidine, guanfacine)

When is separation anxiety disorder no longer considered normal

After 3 years of age

Reactive attachment disorder is the product of?

A severely dysfunctional relationship between the principal caregiver and the child

Best initial tx for sleep terrors

Make sure the kid is safe

Psychotic symptoms present in what % of kids w/ MDD? what else is unusual

1/3 | Also tend to be aggressive and irritable rather than sad

Typical alzheimers symptoms

Progressive memory loss Aphasia Anomia Apraxia (inability to perform voluntary motor activity) Agnosia (inability to process and understand sensory stimuli)

What kind of head trauma can cause dementia

Chronic subdural hemoatomas - headaches, confusion, inattention, apathy, memory loss, drowsiness, and coma

Frontal lobe tumors mainly present as

Personality changes

Drug for delirium

Haloperidol

Brain stuff of alzheimers

Neurofibrillary tangles, neuritic plaques, and loss of Ach neurons in basal ganglia

Most cases of CJD

Iatrogenic, following transplant of infected corneas

First line treatment for panic attack

Breath into a paper bag

Temporal lobe epilepsy personality

Hypo sexuality, emotional intensity, and perserverative approach to interactions (termed viscosity)

Most common neuro issue with HIV

Dementia

Somatic symptom disorder features

Recurrent physical complaints that are not explained by physical factors and that cause significant impairment and medical seeking (can be w/ predominate pain)

Garlic odor on breath from what poisoning

Arsenic

What should always be considered in depressed middle aged patients

Pancreatic carcinoma

Cholinesterase inhibitors for alzhemiers

Donepezil (first line) Rivastigmine (GI side effects) Galantine (GI side effects) Tacrine

Occipital lobe tumors present with

Headache, pappilledema, and homonymous hemianopsia | *visual problems (hallucinations) and seizures common*

Test to discern b/w epileptic and non-epileptic seizures

Prolactin level (will not change in non-epileptic seizures)

Most common cause of new onset hallucinations in recently hospitalized patient

What kind of dementia does multiple head traumas cause

Chronic traumatic encephalopathy