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Psych Flashcards

1
Q

Dissociation

A

-Drastic change in personality to avoid emotional stress

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2
Q

Displacement

A
  • Avoided feelings transferred to neutral party.

- Mom yells at kid because angry at husband

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3
Q

Fixation

A
  • Overly engrossed in minmally important activity

- Spend all time playing video games/watching sports

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4
Q

Identification

A
  • Modelling behavior after powerful figure.

- Abused child thinks he is a child abuser

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5
Q

Isolation

A
  • Separate feelings from events

- Talk about a murder in a non schalant sort of way

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6
Q

Projection

A
  • Internal impulse attributed to external source.

- Man looking at other women accuses wife of cheating

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7
Q

Rationalization

A
  • Rationalizine poor outcome

- After being fired saying, that job wasn’t good anyways

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8
Q

Reaction Formation

A
  • Replace bad feelings with opposite.

- Adulterous man joins a monastery

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9
Q

Regression

A
  • Turning back maturity clock

- Kid begins wetting bed at birth of new sibling

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10
Q

Repression/blocking

A

-Involuntarily supressing memories

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11
Q

Splitting

A

-All good or all bad

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12
Q

Altruism

A

-Mob boss gives large donation to charity

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13
Q

Humor

A

-Nervous student laughs at test

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14
Q

Sublimation

A
  • Turning painful emotions into positive outcome

- Anger at abusive father spurs kid to perform well in sports

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15
Q

Supression

A

Voluntarily witholding thoughts. Don’t think about test until it is here.

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16
Q

ADHD

A

-Childhood, diagnosed by seven. Inability to sit and learn. Normal intelligence but learning difficulties. Decreased volume in frontal lobe.
-Tx: methylphenidate: DA and NE uptake inhbibitor in the frontal lobe
Tx: atomoxetine: selective NE uptake inhibitor

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17
Q

Concduct Disorder

A
  • Disregard for others and rules. Theft, assault etc. Seen in childhood
  • Can lead to antisocial personality disorder in adult
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18
Q

Oppositional Defiant Disoreder

A
  • Disrgard for authority without seriously breaking social norms.
  • Weak form of conduct disorder. Diagnosis cannot exist together
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19
Q

Tourrettes Syndrom

A
  • Spontaneous involuntary tics that last for greater than 1 yr.
  • Diagnosed before age 18
  • Commonly seen in pts with OCD
  • Inherited with variable penetrance
  • Give antipsychoitcs (dopamine antagonists)
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20
Q

Separation Anxiety

A
  • 7-9 profound response outside of normal

- Tx: SSRI and behavioral therapy

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21
Q

Autism

A
  • Impaired language and interaction skills. Focus more on objects than on people.
  • Repeated sterotypic behavior.
  • Is always present from birth.
  • More common in boys 5:1
  • Usually below normal intelligence, but not always
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22
Q

Aspergers

A
  • Mild form of autism with all consuming obsessions.

- Repetitive behavior and problems with social interactions

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23
Q

Rett’s Syndrome

A
  • x linked, seen only in girls. Boys die in utero
  • Normal until 1-4 yrs of age when total loss of abilities ensues.
  • Loss of language, bladder control. Wringing movements of hands. Mental Retardation
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24
Q

Childhood Disintegrative disorder

A
  • Normal until 3-4 yrs then has loss of learned skills including language and bladder control.
  • More commonly seen in males
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25
Q

Neurotransmitter changes in diseased states

A
  • Anxiety: Elevated NE decreased 5HT and GABA
  • Depression: Decrease in all (NE, DA, 5HT)
  • Alzhiemers: loss Ach (Nucleus meynert)
  • Huntingtons: Loss GABA and Ach. Increase in DA
  • Schizophrenia: Increase in DA
  • Parkinson’s: Loss DA, Increase in Ach and 5HT
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26
Q

Amnesia

A
  • Retrograde: can’t remember before insult
  • Anterograde: can’t form new memories since insult
  • Korsakoff’s: alcholoic antergrade amnesia with confabulations
  • Dissociative: Involuntary loss of memories. Usually associated with trauma or stress.
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27
Q

Delerium

A
  • Rapid onset, Waxing and waning changes in conciousness, perception, hallucinations.
  • Usually due to secondary illness and seen on inpatients.
  • Shows abnormal EEG
  • May be caused by anticolinergic drugs
  • Treat with haloperidol
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28
Q

Dementia

A
  • Gradual loss of memory and cognition.
  • Will have normal EEG.
  • Normal aging does not interfere with activities of daily living where dementia does.
  • Pseudodementia is onset of dementia like symptoms tht are caused by depression. Usually patient is in 50’s-70’s but not always.
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29
Q

Psychosis

A

-Caracterized by hallucinations, dillusions, and diorganized speaking and thinking

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30
Q

Hallucinations

A
  • Perceptions in the absence of stimuli.
  • Visual: Usually seen in medical illness not psychiatric
  • Auditory: See in psychiatric more than medical
  • Olfactory: usually part of aura prior to siezure. Tumor or epilepsy (olfactory in temporal lobe)
  • Tactile: Usually seen in acoholics, delerium tremens
  • Termed hypnogogic if occurs when falling asleep and hypnopompic if occurs when waking up
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31
Q

Schizophrenia

A
  • Psychosis that occurs for longer than 6 months.
  • Must have 2 out of 4 positive symptoms (hallucinations, dillusions, disorganized speech, disorganized catatonic behavior)
  • Negative symptoms: Flat affect, withdrawl, and lack of motivation
  • Subtypes: Paranoid(dellusions), Disorganized, Catatonic, undifferentiated (parts of all)
  • Increased risk with marijuanna smoking
  • Increased risk of suicide
  • Underlying pathology is elevated dopamine, treat with antipsychotics that block dopamine (Haloperidole)
  • Large genetic component
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32
Q

Brief Psychotic Disorder

A

-Psychosis lasting less than 1 month, usually stress related

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33
Q

Schizophreniform

A

-Psychosis lasting 1-6 months

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34
Q

Schizoaffective

A
  • Psychosis in the presence of affective disorder.

- Bipolar or depressive

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35
Q

Schizophrnia gradient

A

-Brief Psychotic, Schizophrniform, shcizophrenic, sphizoaffective

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36
Q

Delusional Disorder

A

-Fixed dellusional thoughts for greater than 1 month that do not interfere with daily life.

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37
Q

Dissociative Disorder

A

-Multiple personalities, continuation of defense mechanism

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38
Q

Dissociative Fugue

A

-Rare, pt will have major change in geographical location and will not know how it occured.

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39
Q

Manic Episode

A
  • Lasts greater than 3 weeks. DIGFAST
  • Distractability, Irresponsibility, Grandiosity, Flight of ideas, Activity and Agitation, Sleep decreased, Talkative speech
  • Causes interference with daily life. Difference between hypomanic
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40
Q

Hypomanic

A

-Manic symptoms that don’t interefere with daily life.

41
Q

Bipolar

A
  • Experiencing symptoms of mania with symptoms of depression.
  • When treating always give mood stabilizer (Lithium, Valproate, Carbemazapine) or else you will induce mania with an increased risk of suicide.
42
Q

Cyclothymia

A
  • Experiencing depression and hypomania for greater than 2 years.
  • Longer and more watered down version of bipolar
43
Q

Major Depressive Disorder

A
  • SIGMECAPS, usually lasts 6-12 months, but must last more than 2 weeks. Must experience 5/9 and must include a depressed mood
  • Occurs in women 10-25% and men 5-12%
  • Sleep changes
  • Interest loss
  • Guilt and worthlessness
  • Mood, required.
  • Energy loss
  • Concentration loss
  • Appetite changes
  • Psychomotor retardation
  • Suicidal ideation
44
Q

Dysthymia

A
  • Long term depression with lesser symptoms than major depressive disorder.
  • Must occur for greater than 2 years
45
Q

Seasonal Effective Disorder

A

-Mild depression that occurs in winter with loss of light. Improves with increased light

46
Q

Atypical Depression

A
  • More common than major depressive.
  • Have similiar symptoms that are more mild. (increased appetite, psychomotor retardation, increased sleep)
  • Improves with positive experiences.
47
Q

Post Partum Blues

A
  • Common, 50-85%.
  • Depressed mood, tearfullness, fatigue.
  • Resolves in 2 weeks. No treatment indicated
48
Q

Post Partum Depression

A
  • 10-15%
  • Depressed mood, anxiety, poor concentratoin.
  • Lasts longer than 14 days. Major distinguishing factor from blues
  • Treat with psychotherapy and antideperssants
49
Q

Post Partum Psychosis

A
  • 0.1-0.2%
  • Hallucinations, dellusions, Confusion
  • Suidicadal/homicidal ideation
  • Serious problem
  • 4-6 weeks post partum
  • Tx with antipsychotics, antidepressants, and maybe inpatient to prevent from harming baby or others.
50
Q

Electroconvulsive Therapy

A
  • Shocks that cause a painless siezure. Used in extreme situations and in pregnancy.
  • May cause memory problems
51
Q

Anxiety

A

-30% women and 19% of men. Mainstay of treatment in all disorders is SSRI

52
Q

Panic Disorder

A
  • Extreme but brief physical symptoms

- SSRI, Benzo’s, Venlafaxine

53
Q

Specific Phobia

A
  • Pt is aware of irrationality, not usually treated or treated with desensitization
  • Social phobia is sometimes treated with SSRIs
54
Q

OCD

A

-SSRI or Clomipramine

55
Q

PTSD

A

Flashbacks and increased arousal that occur for greater than 1 month

56
Q

Acute Distress Disorder

A

-PTSD symptoms that last less than 1 month. Tx is usually supportive

57
Q

Malingering

A

-Faking an illness for secondary gain

58
Q

Factious Disorder

A
  • Causing oneself to be sick/injured
  • Munchausen syndrome: OK with having many invasive tests run
  • Munchausen by Proxy: Use kid as sick/injured role
59
Q

Somatization

A

-Multiple varried complaints. More common in women

60
Q

Hypochondriasis

A

-Obsession with having serious illness

61
Q

Body Dismorphic Disorder

A

-Obseission with minor or imagined physical flaws

62
Q

Pain Disorder

A

-All complaints revolve around pain

63
Q

Paranoid Personality

A

-Excessive suspision, Projection is main defense mechanism

64
Q

Schozoid

A

-Voluntarily excessively withdrawn, minimal social interaction

65
Q

Schizotypal

A

-Wild and magic beliefs. Creates social awkardness

66
Q

Antisocial

A
  • Often from conduct disorder

- Disregard for law or others well-being

67
Q

Borderline

A

-Unstable mood and relationships. Often self mutilation. Feelings of emptiness. Females more likely than males

68
Q

Histrionic

A

-Need for attention and obsession with appearance. Sexually provacative

69
Q

Naracistic

A

-Grandiose sense of self and entitlement. Meets criticism with rage.

70
Q

Avoidant

A

-Excessive fear of rejection. Often has few or poor relationships. Desires relationships, but can’t have them as opposed to schizoid.

71
Q

Obsessive Compulsive

A
  • Not OCD. Actions occur in accordance with beliefs

- Obsession with order and perfection.

72
Q

Dependent

A

-Submissive, clingy, low self confidence

73
Q

Anorexia

A
  • Obsession with false self image
  • Weight less than 85% of ideal. Difference between bulliumia
  • Physical signs: Anemia, osteoporosis, amenorrhea, etc.
74
Q

Bullemia

A
  • Binge and purge.
  • Normal Body Weight. Different from anorexia
  • Phsyical Signs: Erosion of enamel, scars on back of hands, parotitis.
75
Q

Transgender

A

-Extreme desire to be opposite sex, seek surgery or hormonal fix

76
Q

Transvestite

A
  • Paraphilia

- Desire to be opposite sex in dress only.

77
Q

Substance Dependence

A
  • 3 or more of the following signs in a year
  • Use in larger quantities and for longer time
  • Causes impairment in life responsibilies
  • Requires excessive time/effort to acquire
  • Failed attempt at quitting
  • Tolerance
  • Withdrawl
  • Use in spite of awareness of problem
78
Q

Substance Abuse

A
  • Causes impairment in social and occupational responsibility
  • Physical Harm
  • Legal Harm
  • Persistant use in spite of these
79
Q

Stages of change

A
  • Precontemplation
  • Contemplation
  • Preparation
  • Action
  • Maintenance
  • Relapse
80
Q

Alcohol Intoxication and Withdraw

A
  • Intoxication: Stupor, respiratory depression, coma, elevated GGT and AST>ALT.
  • Withdrawl: Brief causes hangover (acetylaldehyde). 1-2 days may cause hallucinations. 2-5 days is delerium tremens(tachycardia, Hypertension, siezures, hallucinations). Tx Benzos.
81
Q

Disulfiram like drugs

A
  • Cause accumulation of acetyladehyd

- Metronidazole, griseofulvin, sulfonylureas, cephalosporins

82
Q

Opiods

A
  • Intoxication: Pinpoint pupils, respiratory depression, coma, constipation. Treat with naloxone. Do not give oxygen as drive to breath is oxygen mediated
  • Withdrawl: Overwhelming sympathetics. Sweating, piloerection, dilated pupils, naseau, cramps
83
Q

Oipiod addiction

A
  • Methadone is a long acting mu agonist that has decreased abuse potentional and will limit withdrawl
  • Buprenorphine is a partial mu agonist that when given with naltrexone (minimize cravings) can aid in withdrawl and cravings.
84
Q

Barbituates

A
  • Intoxication: respiratory depression. Tx with respiratory support
  • Withdawl: Delerium and CV collapse
85
Q

Benzodiasepines

A 
-Intoxiacation: Minimal respiratory depression, ataxia. Flumezanil is a benzodiazepine binding site antagonist.
Ultra short (midazolam) and short (triazolam, oxazolam)

-Witdrawl: sleep disturbance and anxiety

86
Q

Amphetamines

A
  • Block reuptake of NE and Dopamine and others in synaptic cleft
  • Intoxication: SANS symptoms: dilated pupil, agitation, grandiosity, tachycardia, anorexia, cardiac arrest and siezure
  • Withdrawl: Depression, anhedonia, hypersomnolence
87
Q

Cocaine

A
  • Block NT reuptake similair to amphetamines
  • Intoxication: Dilated pupils, grandiosity, hallucinations, paranoia, cardiac arrest, angina.
  • Withdrawl:Solmnolence, malaise, suicidal ideation
88
Q

Nicotine Withdrawl

A

Irritability and cravings

-Tx: Buprpion and varenicline

89
Q

PCP

A
  • Analog of ketamine, antagonist of NMDA-R. Also binds Nm which leads to superhuma strength and possible rhabdomyolysis.
  • Intoxication: Agression, nystagmus, homocidality, analgesia, psychosis, delerium. Tx: rapid acting benzos (midazolam)
90
Q

LSD

A
  • Perceptual distortions, psychosis, possible flashbacks

- Minimal withdrawl

91
Q

Marijuana

A

-Binds canabanoid R, and antimuscarininc
Intoxication: Paranoia, delusions, inreased appetite. Dry mouth and conjunctival injection from antimuscarinic and alpha blockade.
-Used medicinally for antiemesis and increase appetite (AIDS and Chemo)
-Linked to higher rates of schizophrenia
-Withdrawl: Irritability, depression insomnia. Peaks in 48hrs and lasts 5-7 days. Lipophilic and stays in system for 10 days.

92
Q

Awake EEG

A

low amplitude high frequency. When eyes close amplitude increases slightly. alpha and beta waves

93
Q

NREM1

A

-Light sleep with high frequency low amplitude theta waves

94
Q

NREM2

A

-Theta waves waves with interposed K complexes and sleep splindles that are higher amplitude

95
Q

NREM3

A

-High ampliude delta wave sleep

96
Q

REM

A

-High frequency low amplitude waves. Like being awake, but complete paralysis. ACh is main NT. NE will decrease REM sleep.

97
Q

Depression

A

-Increase REM sleep with repeated awakenings

98
Q

Narcolepsy

A
  • Repeated intrusion of sleep pre-empted by an auora/hallucination
  • Tx Modafanil/amphetamines during day
  • Sodium oxybate at night
  • Associated with psyhosis and mutations in orexin
99
Q

Nightmares and Terrors

A

Terrors are in NREM sleep

-Mares in REM sleep

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