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Psy Guy Flashcards

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1
Q

{{BLANK}} is the only phobia w/ a paradoxical response of bradycardia, hypotension, and fainting

A

Blood-inj. phobia

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1
Q

SANS activation during blood injury. phobia creates a {{BLANK}} response/fainting

A

vasovagal

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2
Q

A social phobia is more likely to develop after?

A

Stressful or humiliating

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3
Q

Panic Dx must be present as a panic attack along w/ {{BLANK}} to be diagnosed

A

> 1 month of concern/effects from the attack

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4
Q

{{BLANK}} is the main cause of the S/Sx of panic disorder

A

Hypocapnia

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5
Q

A person w/ agoraphobia is scared to…

A

Be in public places (10% remission w/o Tx)

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6
Q

1 reason people use marijuana is

A

anxiety

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7
Q

1 reason people D/C marijuana is

A

anxiety

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8
Q

DOC for specific phobias

A

CBT (incl. exposure)

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9
Q

Flooding Tx is dangerous in phobia Tx why?

A

Can either work or make worse

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10
Q

EtOH works similarly to {{BLANK}} in the treatment (self) for SAD

A

BZDs

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11
Q

T/F: Current treatments are over 50% effective in the treatment of SAD (e.g., SSRI, SNRI, BZD, etc.)

A

True

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12
Q

T/F: SSRIs have not been shown to be more efficacious than placebo in the Tx of panic dx

A

False

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13
Q

T/F: CBT & antidepressants (e.g., SSRI) have been shown to be equally effective in the tx of panic dx

A

True

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14
Q

What is true about the Tx of GAD (i.e., C&C meds)

A

SSRI/SNRI all have same degree of efficacy (just pick one)

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15
Q

T/F: CBT has been shown to be more efficacious in the tx of GAD

A

False

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16
Q

{{BLANK}} is 2nd amongst all diseases/injuries leading to disability

A

MDD

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17
Q

What is the main goal of treating MDD (initially)?

A

If untreated, try to Tx & make episode short –> remission more likely

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18
Q

What is true about MDD recurrence?

A

High rate (esp. if long 1st episode & untreated)

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19
Q

{{BLANK}} is 2-3 x higher in primary care and PCPs tend to be the sole provider for many (> 50%) pts w/ mental illness

A

MDD

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20
Q

Expalin the Dx criteria for MDD (superficial explanation)

A

SIG E CAPS
* Sleep
* Interests
* Guilt
* Energy
* Concentration
* Appetite
* Psychomotor agitation/retardation
* Suicidal ideation

NOTE: must also have depressed mood

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21
Q

Is MDD heritable? Why or why not?

A
  • Yes (40%)
  • 1st degree FMH = 2-4x risk
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22
Q

Depression is a Dx sign for {{BLANK}} cancer before the patient even knows about their cancer

A

Pancreatic cancer

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23
Q

What is important about the Tx of adjustment disorder?

A

identify the stressor & refer to therapist

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24
Q

What adjustment disorders are more common in children?

A

Conduct & Conduct w/ emotions

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25
Q

When initiating pharmacotherapy for a mental illness you should keep in mind to?

A

Lowest dose, shortest duration

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26
Q

In depression, remission occurs more often if you {{BLANK}}

A

initiate pharmacotherapy

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27
Q

The most important characteristics of therapy for tx of depression is?

A

Relationship between therapist & Pt

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28
Q

{{BLANK}} is an effective treatment for depression but requires general anesthesia and is reserved for refractory cases

A

ECT

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29
Q

{{BLANK}} blocks ECT facilitated muscle movements

A

Succinylcholine (effects only seen on EEG)

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30
Q

What are notable SE/ADR from ECT?

A
  • Acute confusion
  • Anterograde amnesia
  • Retrograde amnesia
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31
Q

{{BLANK}} is more effective than any other tx for MDD

A

ECT (70-90%)

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32
Q

What does rapid cycling mean in BP?

A

≥ 4 mood episodes within 12 months

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33
Q

T/F: A BP pt is less likely to have another manic episode after the first

A

False, 90% have recurrent mood episodes

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34
Q

A manic episode in a BP pt typically precedes

A

Depressive episode

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35
Q

In BP pts, they have a high-risk of dying by?

A

Suicide

15x higher than normal; 25% completed suicides are due to BP

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36
Q

What is true when you compare suicides between BP I & BP II?

A

In BP II, suicides are more lethal

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37
Q

What is the mnemonic used in BP Dx?

A

DIG FAST
* Distractable
* Insomnia
* Grandiosity
* Flight of ideas
* Activity (increased)
* Social (increased)
* Traumatic experiences

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38
Q

If a pt is hospitalized due to their manic episode, what do they have?

A

BP I

BP II = hypomania = no hospital

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39
Q

To Dx BP II, the pt must exhibit both?

A
  • Hypomania
  • Depression
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40
Q

Seasonal affective disorder is most common?

A
  • winter
  • northern latitudes (E.g., NY)
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41
Q

What is the Tx for seasonal affective disorder?

A

10,000 lux light x 30 mins per day

Must hit pupil but don’t look straight into it the entire time

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42
Q

Why should someone w/ BP be maintained on a mood stabilizer even after S/Sx resolution?

A
  • Relapse is 85% x 5 years
  • Tx reduces suicidality & violent behavior
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43
Q

{{BLANK}} must be maintained at a level of 0.8-1.2 x 5 days to know if it is working but has shown to reduce the risk of suicide in PB patients

A

Lithium

Caution: hydration should be maintained (increase/decrease – affects tx

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44
Q

You will know if valproate has reached target levels of 50-125 within {{BLANK}} days

A

3 days

lithium x 5 days

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45
Q

{{BLANK}} is a mood stabilizer that carries the risk of SJS/TENS that can be fatal

A

Lamotrigine

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46
Q

What is the main diff between sensory dilirium & dementia?

A
  • Delirium: resolves
  • Dementia: progressive
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47
Q

How common is delirium?

A

End of life > ICU > nursing home/acute care facility > old age

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48
Q

Most Dx’d w/ AZD are?

A
  • 75-84: 53%
  • ≥ 85: 40%

AZD is repsonsible for 60-90% of dementias

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49
Q

What is the avg. survival time after Dx of AZD?

A

10 years

up to 20 years in some cases

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50
Q

What do AZD pts typically die from?

A

Aspiration

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51
Q

What are common characteristics of the late-stage AZD pt?

A
  • Mutism
  • Bed-bound
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52
Q

What is the avg survival time after Dx of Frontotemporal neurocognitive Dx?

A

3-4 yrs after Dx

6-11 yrs after initial Sx appearance

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53
Q

What are risk factors of frontotemporal neurocognitive disorder?

A
  • 40% have FMH of early-onset NCD
  • 10% autosomal dominant pattern
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54
Q

A person with lewy body dementia (NCD) given a regular dose of antipsychotics can display what reaction?

A

Increased SE/ADR
* They are more sensitive
* This reaction can help lead to Dx

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55
Q

What is the avg. survival time for NCD – lewy body dementia?

A

5-7 yrs after clinical presentation

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56
Q

{{BLANK}} is typically present for at least 1-year prior to the onset of motor sx in lewy body dementia

A

cognitive decline –> motor decline

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57
Q

What are risk factors for vascular NCD?

A
  • HTN
  • DM
  • Smoking
  • Obesity
  • High Chol
  • High homocysteine
  • A-fib
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58
Q

TBIs can lead to {{BLANK}} and {{BLANK}}

Sequela

A

depression; aggression

59
Q

In alcohol abuse, most NCDs are maintained within the first {{BLANK}} months unless the person did not reach abstinence until after 50 yo

A

30-40% within first 2 months

60
Q

{{BLANK}} infection can lead to NCD

A

HIV; 30-50% display NCD

Rapid progression; infants & children may display delay

61
Q

In HD, {{BLANK}} abnormalities can predate motor abnormalities by ~15 yrs

A

psych/congitive –> motor

62
Q

How do obsessions & compulsions interact w/ one another?

A
  • Obsession: they try to suppress
  • Compulsion: attempt to neutralize w/ action
63
Q

Commonly, a {{BLANK}} disorder is seen in OCD patients

A

Tic

64
Q

Similar to BP, {{BLANK}} is a common component in OCD

A

suicidality

25% attempt; 50% think about it

65
Q

1st line for OCD?

A

CBT

66
Q

What is true regarding pharmacotherapy in OCD?

A

Pts need higher dose SSRI or clomipramine

67
Q

If a patient has a comorbid eating disorder along w/ body dysmorphia, what is treated first?

A

Eating disorder (more deadly)

68
Q

When is body dysmorphia typically Dx’d?

A

before 18 yo (2/3 of pts)

69
Q

Hoarding is typically seen in {{BLANK}} adults

A

older

70
Q

{{BLANK}} is when someone finds pleasure in the pulling of hairs (e.g., scalp, eyelashes, etc.)

A

Trichotillomania

71
Q

{{BLANK}} is when someone is constantly picking their skin leaving lesions and even eating the skin

A

Excoriation

72
Q

Excoriation typically begins w/ a {{BLANK}} condition

A

Dermatologic (acne)

73
Q

In what domains is someone abnormal regarding general personality disorder?

A
  • Cognition
  • Affectivity
  • Interpersonal functioning
  • Impulse control
74
Q

How common are personality disorders in the U.S.?

A

15% of U.S. population

75
Q

C&C paranoid personality disorder versus delusion.

A
  • Paranoid = lot of people
  • Delusion = subset or individual
76
Q

How do people with paranoid personality disorder acquire confirmation?

A

They are “combative” in conversation & receive hostility from others that confirms their expectations

They expect/suspect people/world is out to get them

77
Q

Why do you not commonly see individuals for schizoid personality dx?

A
  • Lack of social skills
  • Lack of desire for social life
  • Prefer isolation
  • Longers

They don’t usually present because they are okay

78
Q

C&C schizotypal versus schizoid.

A
  • Schizotypal = magical
  • Schizoid = loner
79
Q

When do you typically run into a person w/ schizotypal dx? (clincally setting)

A
  • 30-50% have MDD
  • You see them for that
80
Q

Psycopaths & sociopaths are typical of {{BLANK}} disorder

A

Antisocial personality disorder

81
Q

What is the only Dx where a person must of had S/Sx/Dx of another illness?

A
  • Antisocial personality disorder
  • Dx/Hx of Conduct disorder (< 15 yo)
82
Q

Where is the highest prevalence of antisocial personality disorder patients?

A
  • Prisons, jails, SUD clinics, etc.
  • Think, Wolf of Wallstreat, Bernie Madoff
83
Q

People w/ {{BLANK}} disorder present a superficial charm, grandiosity, and expertise to ordinary people

A

Antisocial personality disorder

They are really callous, cynical, self-inflated, expoitative

84
Q

A person w/ antisocial personality disorder can become more stable after?

A

reaching 4th decade of life

85
Q

Someone w/ {{BLANK}} disorder is more likely to die from violent/traumatic means

A

Antisocial personality disorder

86
Q

What is a classic case of borderline personality disorder?

A
  • Relationship w/ ups/downs
  • They or partner creates (e.g., I’m going to leave)
  • They threaten suicide or attempt to get partner back
  • Cycle continues
87
Q

Relationships of someone w/ borderline personality disorder will improve after?

A
  • 30-40 yo
  • Better functioning w/o major cyclic pattern
  • Also, 10-yrs outpatient Tx, 50% no longer qualify for Dx
88
Q

1st line for borderline personality disorder?

A

DBT

89
Q

{{BLANK}} are hypersexual and get depressed if not the center of attention

A

Histrionic personality disorder

90
Q

C&C narcissistic versus borderline

A
  • Narcissistic: what they present
  • Borderline: internal (what they can get)
91
Q

The true issue of narcissistic personality disorder is?

A
  • vulnerable self-esteem
  • Very sensitive to criticism

Criticism can haunt them and leave them enraged

92
Q

What happens as a person w/ narcissistic personality disorder ages?

A

They are bothered by new onset of physical limitations

93
Q

T/F: narcissistic adolescent children will grow up to have worse S/Sx

A

False, it typically goes away

94
Q

Individuals w/ {{BLANK}} disorder want love and companionship but are afraid of rejection

A

Avoidant personality disorder

95
Q

How do people w/ avoidant personality dx get confirmation?

A
  • Act fearful/intense
  • Elicit ridicule/derision from others
  • Confirms their worries
96
Q

Individuals w/ {{BLANK}} disorder have a major self-doubt & want to solely rely on someone for their life

A

Dependent personality disorder

97
Q

Who are characteristic OCPD patients?

A
  • High achievers (e.g., med students)
98
Q

Why does a person w/ OPCD have trouble w/ relationships?

A

They are more logical than emotional

99
Q

Why do people w/ OPCD have trouble getting tasks completed?

A

Difficulty in prioritization

100
Q

{{BLANK}} is the 1st line Tx for personality disorders

A

Psychotherapy

101
Q

{{BLANK}} is most effective psychotherapy for BPD

A

DBT
* Decrease suicidality
* Decrease hospitalizations

102
Q

C&C illness anxiety dx versus somatic dx

A
  • Somatic: they complain about Sx only not dx
  • Illness: say they have dx
103
Q

A child walks in on their parents having sex, they then report they are blind. What dx do they have?

A

Conversion dx

remember, they display la belle indifference

104
Q

C&C Malingering versus factitious disorder

A
  • Factitious: they don’t want an external reward just looked at like a hero or “babied”
  • Malingering: want an external reward (e.g., money)
105
Q

Someone w/ rumination disorder is likely to suffer from {{BLANK}}

A

Intellectual disability

106
Q

The #1 prerequisite to have anorexia nervosa is to display {{BLANK}}

A

Underweight (low BMI)

107
Q

T/F: Someone w/ anorexia is typically always thinking about food

A

True

108
Q

An overweight “model” presents to you w/ eroded enamel, calluses along their phalagneal dorsum (right hand) and enlarged parotid glands. What do you suspect?

A

Bulima nervosa

109
Q

Weight Tx may initiate {{BLANK}} disorder

A

Bine-eating

Eat more after dieting/cheat meals

110
Q

If you surroundings appear “dream-like” while in war you may have?

A

Derealization

111
Q

If you feel like you are “outside your body” you may be experiencing?

A

Depersonalization

112
Q

Roughly {{BLANK}}% of people w/ experience at least one episode of depersonalization/derealization in their lifetime

A

50%

113
Q

What is the epidemiology behind PTSD?

A
  • Veterans
  • Females
114
Q

C&C ASD versus PTSD

A
  • ASD: Dx within 1 month
  • PTSD: Dx 1-6 months
115
Q

T/F: If adopted, a child will escape the increased risk of SUD (EtOH) assoc. w/ their FMH

A

False, FMH risk is inherited for EtOH abuse (3-4x more likely)

116
Q

When does alcohol abuse typically present?

HINT: Traveling

A

Air travel (must D/C to travel on plane)
* Pt experiences agitation, anxiety, HA, diaphoresis
* May have seizures, hallucinations, delirium tremens

117
Q

Cannabis-related Dx is more common in?

A

Native Americans & Alaska natives

118
Q

Auditory hallucinations are most assoc. w/ {{BLANK}}

A

Schizophrenia

119
Q

Visual hallucinations are most assoc. w/ {{BLANK}}

A

Substance use

120
Q

Vertical nystagmus and strength are assoc. w/ {{BLANK}}

A

PCP

121
Q

Why would someone experience a resurgence of lysergic acid after D/C of the drug?

A

Goes into adipose tissue & can get back into system to elicit effects

122
Q

Pupillary dilation is seen w/ {{BLANK}}

A

Cocaine & Stimulants

123
Q

Pupillary constriction is seen w/ {{BLANK}}

A

Opioids

124
Q

What BZD is preferred to tx EtOH withdrawal in someone w/ liver dysfunction?

A

Lorazepam

Probably oxazepam & temazepam too

125
Q

What BZD is preferred to Tx EtOH withdrawal if there is no increase in LFTs?

A

Chlordiazepoxide

126
Q

C&C Bizarre versus non-bizarre delusions

A
  • Bizarre: possible
  • Non-bizarre: impossible (e.g., cat in anus watching me at night)
127
Q

C&C Delusion vs hallucinations

A
  • Delusions: belief
  • Hallucinations: experience (w/o stimuli)
128
Q

C&C Delusional vs schizophreniform vs schizphrenic disorders

A
  • Delusional: 1 day to 1 month
  • Schizophreniform: 1 month to 6 months
  • Schizophrenia: > 6 months
129
Q

{{BLANK}} delusion is the belief someone you watch on TV is in love w/ you

A

Erotomanic

130
Q

{{BLANK}} delusions are the thought you are special to the human race (e.g., Jesus Christ 2.0)

A

Grandiose

131
Q

{{BLANK}} delusions are the belief you have an unfaithful partner (w/o evidence)

A

Jealous

132
Q

The most common delusion is?

A

Persecutory

133
Q

In {{BLANK}} delusions, the person believes that someone/something is out to get them and may repeatedly sue them or resort to violence

A

Persecutory

134
Q

In {{BLANK}} delusions the person believes a fould odor is coming from them (or infestation, parasite, etc.)

A

Somatic

135
Q

What is the risk factors of schizophrenia?

A
  • Late winter/early spring
  • Urban environment
  • Perinatal hypoxia
  • Greater partneral age
136
Q

What is true regarding suicide risk of schizophrenic patients?

A

Risk is higher after recent episode or hospitalization

MONITOR after

137
Q

Why is life expectancy reduced in schizophrenic patients?

A

Metabolic effects

138
Q

Why do majority of schizophrenic patients ingest tobacco/nicotine?

A

Works as an antipsychotic on nicotinic receptors

139
Q

Risk of suicide w/ schizoaffective dx is increased when?

A

having depressive symptoms

140
Q

Stimulant use can cause {{BLANK}} hallucinations making the person think bugs are crawling on them

A

Tactile

141
Q

What should you do when someone is admitted for psychosis?

A
  • Drug screen (7-25% of episodes are due to SUD)
  • PMH
  • Hx
142
Q

{{BLANK}} reduce/eliminate S/Sx of schizophrenia in about 70% of patients

A

Antipsychotics

143
Q

{{BLANK}} is the most effective anti-schizophrenic but has an increased risk of agranulocytosis

A

Clozapine

144
Q

{{BLANK}} is a 2nd gen antipsychotic w/ an increased risk of gynecomastia

A

Risperidone

145
Q

How do you initiate a LAI antipsychotic?

A
  • Give inj.
  • Give PO med x 2-4 wks
  • Gives time for LAI to get into system
146
Q

What is the Tx for catatonia?

Catatonia: mutism, posturing, grimacing; mind going to fast to talk

A
  • BZD or ECT
  • Slows mind down enough for them to display activity (e.g., talk)

Psych (4 decks)

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