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5th Time I've made a new class > PSYCH > Flashcards

PSYCH Flashcards

1
Q

What is a false belief or wrong judgement held with conviction despite incovertible evidence to the contrary

A

delusion

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2
Q

what is an unconscious separation of a group of mental processes from the rest of the conscious awareness

A

dissociation

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3
Q

disturbance in amount, quality or timing of sleep

A

dysomnia

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4
Q

higher levels of cognitive/mental functioning including planning, abstraction, inductive reasoning and organizing

A

executive functioning

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5
Q

subjective perception of an object or an event when no such stimulus or situation exsists

A

hallucination

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6
Q

a misinterpretation or false perception of a real sensory stimulus

A

illusion

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7
Q

absence of interest in or pleasure from performance of acts that would ordinarily be enjoyable

A

anhedonia

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8
Q

medication used to treat anxiety

A

anxiolytic

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9
Q

syndrome of psychomotor retardation characterized by periods of physical rigidity and lack of response to outside stimuli

A

catatonia

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10
Q

state in which the individual interprets and regards everything in relation to himself and not to others

A

narcissism

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11
Q

mental or behavioral disorder causing gross distortion or disorganization of a persons mental capacity; a defective response and capacity to recognize reality, communicate and relate to others to the degree of interfering with a persons capacity to cope with ordinary demands of everyday life

A

psychosis

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12
Q

what are some causes of PTSD

A

sexual
trauma to someone in close interpersonal network
interpersonal violence
organized violence
other violent events (MVA or natural disaster)

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13
Q

what areas of the brain has MRI studies shown a decreased volume in?

A

left amygdala (fear center)
hippocampus (memories)
anterior cingulate cortex

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14
Q

what might be the cause of someone who has affective dysregulation, cognitive impairment, behavioral responses to regular stimuli such as flashbacks, severe anxiety, fleeing, or combative behavior?

A

PTSD

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15
Q

how long must symptoms of PTSD be present for following trauma for psychiatry to make a diagnosis

A

at least 4 weeks (one month)

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16
Q

what is the treatment for PTSD

A

psychotherapy:
- exposure therapy
- CBT
- EMDR (eye movement desensitization and reprocessing)
Medications:
- Antidepressants (SSRI - Setraline)
- Prazosin for nightmares
- beta blockers for tremors/ sympathetic resp.
- antipsychotics for comorbid psychosis
AVOID BENZODIAZEPINES DUE TO SAFETY &DEPENDENCY

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17
Q

What are some differentials to consider when evaluation of a patient with weight loss

A

hyperthyroidism
malignancy
GI diseases
Chronic infectious disease
affective disorders (depression)

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18
Q

what is the diagnosis criteria for someone who may have anorexia

A
  • restriction of energy intake that leads to low body weight
  • intense fear of gaining weight or becoming fat or persistent behavior that prevents weight gain, depite being underweight
  • distorted perception of body weight and shape, undue influence of weiht and shape on self worth
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19
Q

what could be found on examination of someone suspected to have anorexia

A

low bmi (< 17.5)
emaciation
hypothermia
bradycardia
hypotension
hypoactive bowel sounds
xerosis (dry scaly skin)
brittle hair and hair loss
lanugo body hair
abd distention

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20
Q

what is recurrent episodes of binging and purging and inappropriate compensatory behavior to prevent weight gain

A

bulimia nervosa

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21
Q

what are some clinical findings of someone with bulimia nervosa

A

dehydration
menstral irregularities
mallory-weiss
pharyngitis
erosion of dental enamel
ECG changes may occur

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22
Q

what is it called when someone eats nonfood substances and is often associated with iron deficiency anemia

A

PICA

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23
Q

what is repeated regurgitation of food that is not due to GERD, pyloric stenosis, or another medical condition

A

rumination disorder

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24
Q

what is substance abuse

A

psychological dependence or craving
physiologic dependence
tolerance

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25
Q

what is the third leading preventable cause of death in the united states

A

alcohol use disorder

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26
Q

men under 65, how many drinks can they have in a week to be considered at risk for alcohol use disorder

A

more than 14 standard drinks per week
- standard drink = 5oz wine or 12 oz beer

more than 4 drinks on any day

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27
Q

women under 65, how many drinks per week puts them at risk for alcohol use disorder

A

more than 7 standard drinks per week

more than 3 drinks on any day

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28
Q

when evaluating for alcohol use disorder what questions will you ask

A

CAGE
- CUT DOWN on drinking?
- have people ANNOYED you by criticizing your drinking
- have you felt bad or GUILTY
- drink in the morning EYE OPENER

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29
Q

What is a complication of alcohol use disorder

A

wernicke korsakoff syndrome

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30
Q

what is wernicke korsakoff syndrom caused by

A

due to a deficiency of thiamine (Vitamin B)

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31
Q

what is the most common symptom of wernicke encephalopathy acute syndrome

A

confusion and nystagmus

Others: gait ataxia, wide based gait, slow short steps,

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32
Q

what is the wernicke encephalopathy acute syndrome triad

A

encephalopathy
disorientation/inattentiveness
oculomotor dysfunction
nystagmus

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33
Q

what is a consequence of wernicke encephalopathy which causes anterograde and retrograde amnesia

A

korsakoff

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34
Q

what are the physical signs of alcohol withdrawl

A

tachycardia
hypertension
tremor

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35
Q

mild symptoms of alcohol withdrawl typically resolve in how many days

A

one to two

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36
Q

in severe cases of alcohol withdrawal hallucination’s or seizures can occur what is the time frame for each

A

hallucinations: within 12-24 hrs resolves in 1-2 days
seizures: typically tonic clonic within 6 to 48 hours of last drink

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37
Q

what is the kindling effect

A

risk of seizures increases with repeated withdrawals

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38
Q

what begins within 72-96 hours after last drink and presents with fluctuating disturbances in attention and cognition, may include hallucinations and severe forms may include agitation, fever, tachycardia, htn, or drenching sweats

A

delirium due to alcohol withdrawl

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39
Q

how would delirium due to alcohol withdrawl be treated

A

benzos and support
(diazepam)

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40
Q

what is the leading cause of mortality worldwide

A

tobacco use

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41
Q

nicotine withdrawal is perhaps the greatest barrier of quiting, when does this occur

A

peaks in the first 3 days and slowly subsides over a course of one month
- associated with increased appetite, weight gain, depression, insomnia, irritability, anxiety and restlessness

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42
Q

what is the treatment for nicotine withdrawal

A

nicotine replacement therapy
- long acting: patch
- short acting: gum

Buproprion (wellbutrin)
- inhibits reuptake of norepinephrine and dopamine as well as acts as nicotinic receptor antagonist

Varenicline (chantix)
- stimulates dopamine activity but to a much smaller degree than nicotine
- reduces cravings and withdrawal sx

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43
Q

when do the effects of cannabis occur

A

occurs in 10-20 minutes and last 23 hour

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44
Q

what is the source of marijuana

A

cannabis sativa

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45
Q

when is marijuana detected in most urine tests

A

4-6 days for short term users
20-50 days in long term users

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46
Q

what is the treatment of choice for acute opiod intoxication

A

naloxone

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47
Q

what are the findings of someone who may have acute opioid toxicity

A

v/s: HR decrease or increase, decreased BP/RR/Temp
GI: decreased b/s
Neuro: sedation
Miosis

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48
Q

what mimics acute opioid toxicity and is not uncommon and is easily correctable

A

hypoglycemia

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49
Q

how does acute stimulant intoxication present

A

sweating
tachycardia
elevated b/p
mydriasis
hyperactive
confusion
disorientation

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50
Q

what could alert the clinician to cocaine use

A

unexplained nasal bleeding
headaches
fatigue
insomnia
anxiety
depression
chronic hoarseness

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51
Q

what are the three different mood states with bipolar

A

mania
hypomania
major depression

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52
Q

which mood state of bipolar is a distinct period of abnormally or persistently elevated, expansive or irritable mood and persistently increased activity or energy, lasting at least one week and presents most of the day nearly every day

A

mania

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53
Q

what is the acronym used to remember the symptoms of mania

A

DIGFAST
Distractibilty
indiscretions
grandiosty
flight of ideas
activity increase
sleeplessness
talkative

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54
Q

which phase of bipolar is less severe, thought form is more organized - quick and creative thinking is common. Easier to engage in conversation, less risky behavior, no hallucinations, no psychotic sx

A

hypomania

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55
Q

how many symptoms must be present in a TWO week period for major depression phase of bipolar

A

five
- depressed mood
- diminished interest
- weight loss/gain
- insomnia/hypersomnia
- psychomotor
- decreased energy
- guit/feeling worthless
- impaired concentration
- thoughts of suicide

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56
Q

if a patient is suspected to have bipolar disorder and is agitated what can the IDC do prior to medevac

A

try to talk them down
Haloperidol

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57
Q

what is the maintenance therapy that is usually employed by psychiatrist for BPD

A

mood stabilizer or antipsychotic
- lithium
- valproic acid
- lamotrigine (lamictal)
- Quetiapine (Seroquel)

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58
Q

what is the most common psychiatric disorder in the general population

A

depression

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59
Q

what are some risk factors associated with depression

A

family history
female gender
childbirth
childhood trauma
stressfull life events
poor social support
serious medical illness
substance abuse

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60
Q

what is an example of a depression screening tool

A

PHQ-9

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61
Q

what somatic symptoms are associated with depression

A

headache
abdominal pain
pelvic pain
back pain

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62
Q

what pneumonic is used by PCM’s to quickly screen for depression

A

SIGECAPS
- sleep changes (increased during the day, decreased at night)
- interest loss ( that used to interest them)
- guilt - worthlessness ( devalue self)
- energy - lack ( fatigue)
- concentration (reduced concentration)
- appetite ( decline or increase)
- psychomotor agitation ( anxious/lethargic)
- suicide/death preoccupation

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63
Q

what is the most important complication of depression

A

suicide

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64
Q

when inquiring about suicidal behavior what questions are you asking

A

specific nature of ideation
intent, plan, ability to carry out that plan
personal history of suicide attempts
family history of suicide attempts or suicide

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65
Q

for new onset depression, what labs will be ordered

A

cbc
chem
ua
thyroid function
hcg

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66
Q

what is the mainstay of treatment for depression

A

psychotherapy
pharmacotherapy
or both (best results)

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67
Q

what are the two classes of medication that are typically used in the treatment of depression

A

SSRI - fluoxetine, paroxetine, escitalopram, citalopram

SNRI - venlafaxine, duloxetine

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68
Q

what are some common side effects of antidepressants

A

sexual dysfunction
drowsiness
weight gain
insomnia
anxiety
dizziness
headache
dry mouth
blurred vision
nausea
rash
tremor
constipation
abd pain/stomach upset

69
Q

what are the two important mood disorders that are commonly encountered

A

adjustment disorder
postpartum depression

70
Q

what is commonly seen in the navy and occurs in the context of a recent stressor but does not meet the criteria of major depressive disorder

A

adjustment disorder

71
Q

how long before symptoms of adjustment disorder resolve after life stressor is removed

A

resolves within six months when stressor is removed

72
Q

when does post partum depression usually occur

A

usually occurs within 12 months after delivery

73
Q

what is the diagnostic criteria for post partum depression

A

the same as major depressive disorder
- at least 5 symptoms for at least 2 weeks

74
Q

what is the treatment for post partum depression

A

mild-mod: psychotherapy such as CBT as the initial treatment especially if breastfeeding

CBT unsuccessful or more severe: SSRI/Bupropion/mirtazapine (remeron)

SSRI: paroxetine (paxil) or sertraline (zoloft) appears to have least effect on infants

75
Q

what is characterized by excessive and persitent worry that is hard to control, causes significant distress and occurs more days than not for at least 6 months

A

generalized anxiety disorder (GAD)

76
Q

what other psychiatric conditions are common with generalized anxiety

A

depression
specific phobias
medically unexplained chronic pain

77
Q

what is the clinical manifestation of generalized anxiety

A

hypoarousal and muscle tension is common
poor sleep
fatigue
difficulty relaxing
headaches
pain in neck, shoulder and back

78
Q

what screening form is used for generalized anxiety

A

GAD 7

79
Q

what is the treatment for generalized anxiety

A

CBT, medication or both
- SSRI and SNRI are typical medication classes used as a first line

80
Q

what is panic disorder

A

people who experience multiple panic attacks

81
Q

what is a spontaneous, discrete episode of intense fear that begins abruptly and lasts for several minutes to an hour

A

panic attack

82
Q

what is the dsm-5 diagnostic criteria for panic disorder

A

an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of the following 13 symptoms occur
- palpitations
- sweating
- trembling/shaking
- SOB
- chest pain/discomfort
- nausea
- dizzy
- chills or heat sensation
- fear of going crazy
- fear of dying

83
Q

what is agoraphobia

A

fear and anxiety lead to avoidance of situations that may lead to panic

84
Q

what is the treatment for panic attacks

A

anxiolytics
- benzodiazepines: clonazepam/lorezepam/diazepam/alprazolam (but should be avoided due to addiction risk)

  • SSRI: reduce the frequency of panic attacks/severity of anxiety/ degree of phobic
85
Q

what are two broad categories of delusions

A

bizarre- belief family member have been replaced by body-doubles

non-bizarre: belief spouse is cheating despite overwhelming evidence of the contrary

86
Q

what is a wakeful sensory experience of content that is not actually present

A

hallucination

87
Q

what is misinterpretations of sensory experience

A

illusion

88
Q

what is the most common hallucination manifestation

A

auditory - hearing voices

89
Q

what are some medical conditions associated with psychosis

A

delirium
endocrine disorder- thyroid/adrenal
hepatic or renal
infections - HIV/syphilis/LYME
demyelinating - MS or lupus
Neuro- TBI/Tumor/seizure
vitamin deficiency - B12

90
Q

what is involuntary contractions of muscles associated with psychosis

A

dystonia

91
Q

what is the treatment for dystonia

A

benadryl

92
Q

what occurs after greater than 6 months of treatment of an antipsychotic and is involuntary movements of the face, sucking or smacking lips, movements of tongue, facial grimace, or odd movements of extremities

A

tardive dyskinesia

93
Q

what is the treatment for sleep disorder

A

sleep hygiene is first line
medications are best for acute - used when sleep hygiene is inaffective
antihistamines are beneficial and produce no dependency - hydroxyzine or diphenhydramine
trazodone- long term

94
Q

personality disorder is clustered how

A

A, B, C

95
Q

what are two personality types in cluster B

A

borderline personality disorder(BPD)
antisocial personality disorder (ASPD)

96
Q

what is the disorder that is instability of interpersonal relationships, self-imagine and emotions. Tend to view others as all good or all bad, and suicidal threats, gestures and attempts are more common

A

Boarderline

97
Q

What might present as someone who has a disregard for and violation of rights of others, unstable work history, history of arrests, financial depends on others, alcohol abuse, marital problems, wildness in childhood, poor military performance, pathological lying or suicide attempts

A

antisocial

98
Q

what is the treatment for personality disorders

A

social - hospitals/halfway house/self help
behavioral - reinforcement with praise or reward
psychological - group therapy
medical - hospitalization

99
Q

marked pattern of inattention and/or hyperactivity-impulsivity must interfere with functioning in at least how many settings

A

2
work, school, home

100
Q

in order to be diagnosed with ADHD symptoms must be present before what age

A

7 years old

adults must have childhood onset by age 12, persistent and current symptoms to be diagnosed

101
Q

what is the treatment for ADHD

A

medications are the mainstay of treatment
- methylphenidate (ritalin/concerta/metadate)
- amphetamines (adderall, vyvanse)

102
Q

what aspect of the brain is most susceptible to damage due to being near the sphenoid ridge

A

hipocampus

frontal lobe is also susceptible to countercoup injury

103
Q

how are head injuries rated

A

using the glascow coma scale

104
Q

what is loss of recall immediately before the event

A

retrograde amnesia

105
Q

what is loss of recall immediately after the head trauma

A

anterograde amnesia

106
Q

symptoms attributed to post concussion syndrome are greatest when

A

first 7 to 10 days

107
Q

what is the treatment for gender dysmorphia

A

psychotherapy - support a a social gender transition and the initiation of biomedical tx

Medical - horomone therapy

108
Q

what are some causes of erectile dysfunction

A

increased age
depression
smoking
diabetes
htn
nervous tissue disorder
social anxiety
PTSD

109
Q

treatment for erectile dysfunction

A

psychological and organic
- phosphodiesterase type 5 inhibitors
stendra
viagra
cialis
levitra

110
Q

treatment of female orgasmic disorder

A

often related to depression and cognitive - behavioral therapy involving changing negative thoughts and attitudes toward sex

111
Q

treatment for female arousal disorder

A

sex therapy and cognitive intervention
bupropion has been reported to increase various indices of sexual responsiveness in women with low sexual desire

112
Q

genito-pelvic pain and penetration disorder includes four common comorbid symptoms

A

difficulty having intercourse
genito-pelvic pain
fear of pain from vaginal penetration
tension of pelvic floor muscles

113
Q

treatment for genito-pelvic pain

A

psychotherapy treatment involving acknowledging the pain and cognitive behavioral management

114
Q

what is an absence of desire for sexual activity and persistently or recurrently deficient (or absent) sexual/erotic thoughts or fantasies for at least 6 months

A

male hypoactive sexual desire disorder

115
Q

what might be the cause of male hypoactive sexual desire disorder

A

hypogonadism
transient stress or interpersonal conflict
mood disorder
schizophrenia
substance abuse
medications
normal age related decline in sexual desire

116
Q

what is the treatment for male hypoactive sexual desire disorder

A

CBT combined with sex therapy with the main goal being to educate patient how to communicate his sexual prefrences to the partner

117
Q

what is a recurrent pattern of ejaculation occuring during partnered sexual activity within approx. 1 minutes following vaginal penetration and before individual wished and is present for at least 6 months

A

premature ejaculation

118
Q

what is the most important complication in mental health

A

suicide

119
Q

patients with what illness have a suicide rate over 30 times that of the general population

A

AIDS

120
Q

what should be included in suicide prevention training

A

warning signs
supervisors getting to know their personnel
watching for changes in: behavior, attitude, or performance

121
Q

what can be used as a guide for asking questions and answers will help identify whether someone is at risk for suicide

A

columbia-suicide severity rating scale (C-SSRS)

122
Q

what is available for structured intervention for rescuers and survivors involved in incidents likely to produce traumatic stress

A

SPRINT
special psychiatric rapid intervention team

123
Q

what are the components of a mental status exam

A

physical appearance and behavior
state of consciousness
cognitive abilities
speech and language skills

124
Q

What is tested by asking the patient to listen and repeat a sentence or series of numbers

A

Immediate recall

125
Q

What is tested by giving the patient a short time to view four or five objects, saying you will ask them in a few minutes. Ten minutes later you ask the patient to list the objects

A

Recent memory

126
Q

What is tested by asking the patient about verifiable past events

A

Remote memory

127
Q

What is tested by asking the patient to spell the word WORLD forward and backward or their ability to perform arithmetic calculations?

A

Attention span

128
Q

What is a standardized brief screening tool to assess cognitive function and to detect changes over time. It consists of 11 items measuring orientation, registration, attention, and calculation, recall and language

A

Mini mental state exam or Folstein test

129
Q

By asking a patient to provide a solution to a hypothetical situation, what is this testing?

A

Judgment

130
Q

In terms of coherence, what is it called when a patient repeats a word, phrase or gesture

A

Preservation

131
Q

In terms of coherence, what is t called when a patient uses word substitution to avoid revealing a word that was forgotten

A

Circumlocution

132
Q

In terms of coherence, what is it called when the patient has disordered words or sentences

A

Flight of ideas or loose association

133
Q

In terms of coherence, what is it called when the patient uses words that only have meaning to the patient

A

Neologism

134
Q

In terms of coherence, what is it called when the patients word choice is based on sound so that the words rhyme in a nonsensical way

A

Clang association

135
Q

In terms of coherence, what is it called when the patient demonstrates repetition or uses another persons words

A

Echoalia

136
Q

What is a speech disorder that can be repetitive or expressive, include hesitations nd other speech rhythm disturbances

A

Aphasia

137
Q

When diagnosing bulimia nervosa, behaviors must occur how often

A

Occurring on average at least once per week for three months

138
Q

What is the timeline requirements for the mania phase of bipolar?

A

A distinct period of abnormally or persistently elevated, expansive or irritable mood and persistently increased energy lasting at least ONE WEEK and presents most of the day, nearly every day

139
Q

What is the time line that 5 or more symptoms of major depression must be present

A

5 or more in the same TWO week period

140
Q

What medications are used to treat bipolar disorder long term

A

Antipsychotics
Lithium
Valproic acid
Lamotrigine (lamictal)
Quetiapine (Seroquel)

141
Q

What ranks 2nd among all injuries and illnesses as cause of disability in the United States

A

Major depression

142
Q

Adjustment disorder typically resolves when

A

Within 6 months when the stressor is removed

143
Q

Excessive and persistent worrying that is hard to control and causes significant distress (i.e. anxiety) must occur for how long in order to be diagnosed with generalized anxiety disorder?

A

Occurs more days than not for at least SIX MONTHS

144
Q

What is the treatment for generalized anxiety disorder

A

CBT, medications or both
SSRI’s and SNRI’s are typical medications used as first line

145
Q

What is spontaneous, discrete episode of intense fear that begins abruptly and lasts for several minutes to an hour

A

Panic attack

Panic disorder is when multiple recurrent episodes occur

146
Q

How are panic attacks treated

A

Benzodiazepines - clonazepam, lorazepam, diazepam, alprazolam

Antihistamines - hydroxyzine

SSRI’s - reduce the frequency of attacks but will not break an active attack

147
Q

What is belief that one is being harassed or followed by an outside entity

A

Persecutory delusions

148
Q

What is belief that one is a billionaire

A

Grandiose delusion

149
Q

What is belief that a famous person is in love with them

A

Erotomatic delusion

150
Q

What is the belief that ones sinuses has been infested with worms

A

Somatic delusion

151
Q

What is belief that a dialog on TV is talking directly to you

A

Delusion of reference

152
Q

What is believing ones thoughts and movements are being controlled by a powerful outside force

A

Delusion of control

153
Q

What is used as a screening tool to help determine if someone is suffering from an eating disorder

A

SCOFF
Do you make yourself SICK because you feel uncomfortably full
Do you worry you have lost CONTROL over how much you eat
Have you lost more than ONE stone (14 IBS) in a 3 month period
Would you say FOOD DOMINATES your life

154
Q

What stage of tobacco cessation is when the person has achieved smoking cessation

A

Maintenance

155
Q

What stage of tobacco cessation is when the are actively involved in a quit attempt

A

Action

156
Q

What stage of tobacco cessation is when they are considering a quit attempt

A

Contemplation

157
Q

What stage of tobacco cessation is when they are not ready to quit

A

Pre-contemplation

158
Q

What is the greatest barrier to tobacco cessation

A

Nicotine withdrawal

159
Q

What labs should be ordered for new onset depression

A

CBC
Chemistry
UA
Thyroid function test
Urine HCG

160
Q

What vitamin deficiency can cause psychosis

A

B12

161
Q

What type of infections can cause psychosis

A

HIV
Syphilis
Herpes encephalitis
Lyme disease

162
Q

What demylenating conditions can cause psychosis

A

Multiple sclerosis and lupus

163
Q

What neurological diseases can cause psychosis

A

Tbi
Tumor
Seizure
Stroke

164
Q

What is a common cause of sleep disturbance

A

Depression

165
Q

Insomnia can be a sign of what psychological disorder

A

Bipolar - mania phase

166
Q

What is a DDX of ADHD

A

Oppositional defiant disorder/conduct disorder: characterized by pattern of negativistic, hostile, and defiant behavior
- Can co-occur with ADHD in 30-50% of cases

Bipolar or depression

Cognitive performance and learning disabilities

167
Q

What is a significant factor in many suicide attempts

A

Alcohol

168
Q

What age range does non-suicidal self injury occur in and why

A

Ages 12 to 14

  • engaging in NSSI include to regulate emotion and elicit attention
169
Q

What are the components of a mental health examination

A

Physical appearance and behavior
State of consciousness
Cognitive abilities
Speech and language skills

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