Psych 11 Flashcards
Describe id, ego, and superego
Id = instinctual drives
Ego = finds equilibrium between gratification of instinctual drives and the rules of society
Superego = contains internalized parental and societal rules and dictates to the ego what is not to be done
Describe “undoing” defense mechanism
- Attempting to reverse a situation by adopting a new behavior
- E.g. Man who has had a brief fantasy of killing his wife by sabotaging her car takes the car in for a complete checkup
What is Ritalin
Methylphenidate - for ADHD
What is Adderall
Dextroamphetamine
Describe presentation of frontotemporal lobe dementia
Early personality changes
Late dementia
Describe partial complex seizure
Altered state of consciousness, usually manifested by staring, is accompanied by hallucinations (olfactory are common), automatisms (buttoning and unbuttoning, masticatory movements, speech automatisms), perceptual alterations (objects changing shape or size), complex verbalizations
Cushing syndrome (from exogenous corticosteroids), often manifests in which psychiatric disorders?
Depression and mixed anxiety and depressive state
What can be used to treat psychotic symptoms of a delirious patient
Haloperidol
Want to avoid benzos or antipsychotics with anticholinergic effects
Transmission of Creutzfeldt-Jakob disease
Most cases are iatrogenic, following transplant of infected corneas or use of contaminated neurosurgical instruments
What is the point of breathing into a paper bag when you are hyperventilating?
To avoid hypercapnia, which is what end up leading to all the downstream effects
Presentation of temporal lobe epilepsy
- Bizarre behavior, often without classic grand mal shaking movements
- Characterized by hypo-sexuality, emotional intensity and a perseverative approach to interactions, termed viscosity
Presentation of Wernicke vs. Korsakoff syndrome
♣ Due to Thiamine deficiency
Wernicke = ataxia, confusion, ocular abnormalities (nystagmus, gaze palsies)
Korsakoff = anterograde and retrograde amnesia, compensatory confabulation
Tx of somatic sx disorder
Have the patient see a primary care physician at regular intervals
What is the most common cause of delirium in the eldery
Multiple medications
Which anti-cholinesterase is first line for cognitive dysfuncition in Alzheimers?
Donepezil = most well tolerated
Tumors of which brain lobe are associated with homonymous hemianopia
Occipital lobe
Tumors of which brain lobe are associated with olfactory and other unusual hallucinations, derealization episodes, mood lability, irritability, anger, and behavioral dyscontrol
Temporal lobe
What lab test can be helpful in diagnosing non-epileptic seizures
Prolactin
Epileptic seizures cause and increase in prolactin and nonepileptic seizures do not
Displacement vs. Projection
Projection = Attributing unacceptable internal impulses to an external source
Displacement = Transferring avoided feeling or ideas to a neutral person
What are effective family interventions for schizophrenic patients
Teaching family members about schizophrenia, emphasizing the importance of keeping interpersonal communication at a low emotional quotient, and helping the family learn more adaptive ways to cope with stress
What does extinction refer to?
The progressive disappearance of a behavior or a symptom when the expected consequence does not happen
What do you do if a patient on Clozapine experiences mild leukopenia?
Monitor closely - twice weekly CBC test. Continue clozapine
What do you do if a patient on Clozapine experiences severe leukopenia
Stop Clozapine. Daily CBC. Clozapine may be reinstated after the WBCs normalize
Uses of St. Johns wort
Antidepressant, sedative, anxiolytic
Uses of ginseng
Stimulant, for fatigue, elevation of mood, immune enhancement
Side effects of Zolpidem and Zaleplon
Dissociative-like state: sleep-walking, binge-eating, aggressive outbursts, and night driving all which the patient does not remember
Drug treatment of akithisia
Beta blockers (Propranolol) are most effective
Benzos and anticholinergics may be somewhat effective
Tx of shift work sleep disorder
Modafinil is the only approved medication
Preferred drug to treat psychotic sx in patients with Parkinsons
Quetiapine - due to sedative quality and lack of EPS
What is the half-life of Lithium / how long does it take to reach steady state
Half life = 20 hours
Takes 5 half-lives to reach steady state. 5 x 20 = 100 hours = about 8 days
Drugs used to treat neuroleptic malignant syndrome
Bromocriptine, Amantidine, Dantrolene
What is clang association
Thoughts that come out in a rhyming pattern, whether or not the verbalized sentence means anything logical
Time frame and number of symptoms needed for GAD
At least 3 symptoms for at least 6 months
Next step with a violent and struggling patient in restraints in the emergency room
IM Haloperidol + IM Lorazepam
IV is too hard too start in struggling patient. Antipsychotic + Benzo means you can use less of each
What is projective identification
A person projects his or her unconscious feeling onto another and then that person begins to identify with the projected emotion and behave acccordingly (eg. patient acts as if therapist is super angry and then eventually therapist begins to get super angry)
Depersonalization vs. Derealization
Depersonalization = feeling detached from oneself or disconnected from your body; floating above it
Derealization = sense that the environment is strange or unreal
What is Nihilism
Belief that oneself, other, or the world are either nonexistant or are coming to an end
What is echopraxia
Mimicking of examiners body posture and movements
What is the primary metabolite of dopamine
Homovanillic acid
What is cataplexy
Brief loss of muscle tone precipitated by strong emotion (e.g. laughter excitement)
Chronic stress increases levels of what chemical in the body?
Glucocorticoids
What disorder presents as: hypo-sexuality, emotional intensity and a perseverative approach to interactions, termed viscosity
Temporal lobe epilepsy
In what stage of sleep does dreaming occur
REM
Damage to what brain lobe leads to personality changes, disinhibited behavior, and poor judgment
Frontal lobe
MOA and use of Buspirone
5HT1A and 5HT2 agonist
Treats anxiety
Most common gene mutation in Alzheimers
Presenilin 1 (70-80%)
Presenilin 2 (20-30%) APP (2-3%)
What neurotransmitter is associated with addiction?
Dopamine
What part of the sleep cycle to night terrors occur
Non-REM
Night terrors are characterized by partial awakening accompanied by screaming, thrashing, and autonomic arousal
What neurotransmitter is disrupted in OCD
Serotonin
What neurotransmitter is disrupted in ALzheimers dementia
Acetylcholine
Where in the brain is damaged in Korsakoff?
Mammilary bodies
Where in the brain is damaged in Huntington
Caudate
Dysfunction of what part of the brain leads to disinhibition, irritability, lability, euphoria, and lack of remorse
Orbitofrontal area of the frontal lobe
