Psych

Question 1

positive reinforcement

Answer 1

• positive stimulus increases a behavior

Question 2

negative reinforcement

Answer 2

• removal of a negative stimulus increases a behavior

Question 3

punishment

Answer 3

• averse stimulus stops a behavior

Question 4

extinction

Answer 4

• removal of a positive stimulus stops a behavior

Question 5

transference

Answer 5

• patient projects feelings about others onto physician (psychiatrist is seen as parent)

Question 6

countertransference

Answer 6

• doctor projects feelings about important people onto patient (pt reminds them of a younger sibling)

Question 7

acting out

Answer 7

immature defense, expressing unacceptable feelings and thoughts through actions
- ex: tantrums

Question 8

dissociation

Answer 8

immature defense, temporary, drastic change in personality, memory, consciousness or motor behavior to avoid emotional stress
- extreme forms can result in dissociative identity disorder

Question 9

denial

Answer 9

immature defense, avoid the awareness of some painful reality
- a common reaction in newly diagnosed AIDS/cancer patients

Question 10

displacement

Answer 10

immature defense, transferring avoided ideas and feelings to some neutral person/object
- mother yells at child because her husband yelled at her, husband punches a wall because he is mad at wife

Question 11

projection

Answer 11

immature defense, attributing an unacceptable internal impulse (or ones own feelings) to an external source (or others)
- man who wants another woman thinks his wife is cheating on him, kid whose parents are getting divorced thinks they are mad at him

Question 12

fixation

Answer 12

• immature defense, partially remaining at a more childish level of development
• men fixating on sports games

Question 13

regression

Answer 13

immature defense, turning back the maturational clock and going back to earlier modes of dealing with the world
- seen in children under stress such as illness, punishment, or birth of new sibling (previously toilet trained starts bed wetting)

Question 14

identification

Answer 14

immature defense, modeling behavior after another who is more powerful (although not always admired)
- abused child identifies with abuser

Question 15

isolation of affect

Answer 15

immature defense, separating feelings from ideas and events

- describing murder in graphic detail with no emotional response

Question 16

fantasy

Answer 16

subtituting imaginary scenarios for reality

Question 17

rationalization

Answer 17

immature defense, proclaiming logical reasons for action actually performed for other reasons, usually to avoid self blame
- after getting fired, saying the job wasnt important anyways

Question 18

repression

Answer 18

immature defense, involuntary withholding an idea or feeling from conscious awareness
- not remembering a conflictual or traumatic experience, pressing bad thoughts into the unconscious

Question 19

suppression

Answer 19

mature defense, intentional witholding of an idea or feeling from conscious awareness
- choosing not to worry about the big game until its time to play, choosing not to worry about your step 1 grade

Question 20

altruism

Answer 20

mature defense, alleviating guilty feelings by unsolicited generosity towards others (avoiding negative feelings by helping others)
- mafia boss makes a large charitable donation, alcoholic stops drinking and volunteers

Question 21

humor

Answer 21

mature defense, appreciating the amusing nature of an anxiety provoking or adverse situation
- ex: nervous medical student makes jokes about a test

Question 22

sublimation

Answer 22

mature defense, replacing an unacceptable wish with a course of action that is similar to the wish but does not conflict with one’s value system

Question 23

conduct disorder

Answer 23

• repetitive and pervasive d/o of violating basic human rights (physical aggression, vandalism)
• may go on to antisocial personality disorder

Question 24

ODD

Answer 24

• enduring pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social norms

Question 25

tourettes

Answer 25

need to have symptoms x 1 year, frequently coexists with OCD/ADHD

Question 26

Rett disorder

Answer 26

X linked disorder seen almost exclusively in girls - symptoms apparent age 1-4, including regression characterized by loss of development, loss of verbal abilities, intellectual disability, ataxia, and stereotyped hand wringing

Question 27

delusional d/o

Answer 27

- fixed, persistent, untrue belief system lasting > 1 month | - functioning not otherwise impaired

Question 28

keeping "schizo" straight

Answer 28

- < 1 month - brief psychotic d/p - 1-6 months - schizophreniform - > 6 months - schizophrenia - + 2 weeks of mood symptoms (must have 2 weeks with solo psychosis) - schizoaffective

Question 29

mania

Answer 29

DIG FAST x 1 week - distractability, irresponsibility, grandiosity, flight of ideas, increased goal-directed activity/psychomotor agitation, sleep req decreased, talkative/pressured speech

Question 30

Bipolar d/o

Answer 30

Type I - 1 manic episode with or without a hypomanic or depressive episode Type II - hypomanic and depressive episode

Question 31

dysthymia

Answer 31

2 symptoms of depression x 2 years

Question 32

post partum blues

Answer 32

depressed affect, tearfulness, and fatigue staring 2-3 days after delivery - usually resolves within 10 days

Question 33

post partum depression

Answer 33

- 10-15% incidence rate | - depression that starts within 4 weeks of delivery, lasts 2 weeks to a year or more

Question 34

pathologic grief

Answer 34

- prolonged greif lasting > 6-12 months or grief that is delayed, inhibited or denied - may experience depression, delusions or hallucinations

Question 35

generalized anxiety disorder

Answer 35

uncontrollable anxiety for > 6 months unrelated to a specific person, situation or event - associated with sleep disturbance, fatigue, GI disturbance of difficulty concentrating

Question 36

adjustment d/o

Answer 36

emotional symptoms (anxiety, depression) causing impairment following an identifiable stressor for < 6 months

Question 37

PTSD vs. acute stress disorder

Answer 37

acute stress is 3 days - 1 month, PTSD is more than 1 month

Question 38

narcolepsy

Answer 38

- disordered regualtion of sleep wake cycles - decreased orexin production in the lateral hypothalamus (hypocretin-1/orexin-A deficiency in the CSF) - hyponogogic and hyponopompic hallucinations - sleep starts with REM sleep (REM latency < 15 minutes) - cataplexy or spontaneous facial movements without emotional triggers - treat with daytime stimulants (amphetamines, modafinil) and nighttime sodium oxybate (GHB)

Question 39

opioid intox and withdrawal

Answer 39

- intox: euphoria, CNS depression, decreased gag, pupillary constriction and seizures - w/d: sweating, dilated pupils, piloerection, fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea

Question 40

barbituates intox and withdrawal

Answer 40

- intox: resp depression | - w/d: delerium, life-threatening CV collapse

Question 41

benzo intox and withdrawal

Answer 41

- intox: ataxia, minor resp depression | - w/d: sleep disturbance, depression, rebound anxiety, seizure, tremors, perceptual disturbances

Question 42

amphetamine intox and withdrawal

Answer 42

- intox: euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, HTN, tachycardia, anorexia, paranoia, fever - w/d: anhedonia, increased appetite, hypersomnolence, existential crisis/severe depression

Question 43

cocaine

Answer 43

- intox: impaired judgement, pupillary dilation, hallucinations, paranoid ideations, angina, sudden cardiac death - w/d: hypersomnolence, malaise, severe psychological craving, depression/suicidality

Question 44

nicotine

Answer 44

- intox: restlessness - w/d: irritability, anxiety, craving - treat withdrawal with buproprion/varenicline (competitive partial agonist of nicotinic Ach receptor that decreases symptoms of withdrawal and increase efficacy of nicotine)