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USMLE Step 1-2015 > psych > Flashcards

psych Flashcards

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USMLE® Step 1 flashcards
1
Q

Autisim is associated with what diseases

A

mental retardation (intellectual disability), tuberous sclerosis, fragile x

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2
Q

Alzheimer disease NT changes

A

decrease ACh increase glutamate

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3
Q

Anxiety NT changes

A

increase NE, decrease GABA, decrease 5-HT

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4
Q

depression NT changes

A

decrease NE, decrease 5-HT, decrease dopamine

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5
Q

huntington disease NT changes

A

decrease GABA, decrease Ach, increase dopamine

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6
Q

parkinson disease NT changes

A

decrease dopamine increase Ach

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7
Q

schizophrenia NT changes

A

increase dopamine

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8
Q

Order of loss in terms of orientation

A

1st: time 2nd: place 3rd: person

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9
Q

What is dissociative fugue?

A

aburupt ravel or wandering during a period of dissociative amnesia, associated with traumatic circumstances

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10
Q

In elderly ppl what can present like dementia and what should you screen for?

A

Depression and hypothyroidism (pseudodementia)–>measure TSH, b12 levels

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11
Q

Time period schizophrenia

A

> 6 months

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12
Q

time period brief psychotic disorder

A
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13
Q

time period schizophreniform disorder

A

lasting 1-6 months

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14
Q

time period schizoaffective disorder

A

lasting >2 weeks (schizophrenia with episodic superimposed major depression or mania (or both))

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15
Q

time period delusional disorder

A

> 1 month

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16
Q

time period of manic episode

A

lasts at least 1 week

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17
Q

time period for hypomanic episode

A

lasts at least 4 consecutive days

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18
Q

Difference btwn hypomanic and manic

A

manic has severe mood disturbance with persistently elevated, expansive, or irritable mood while mood disturbance not severe enough in hypomanic

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19
Q

Treatment of bipolar and what can make it worse?

A

Treatment is mood stabilizer (lithium, carbamazepine, valproic acid), atypical antipsychotics. Antidepressants can percipitate mania

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20
Q

how long does cyclothymic disorder last for diagnosis?

A

at least 2 years

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21
Q

What does electroconvulsive therapy do?

A

produces grand mal seizure in an anesthetized patient

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22
Q

Access of patients to what item increases risk of suicide?

A

firearms

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23
Q

Infant deprivation effects (4 W’s)

A

Wanting (infant withdrawn/unresponsive)
Wary (lack of basic trust)
Weak (failure to thrive)
Wordless (lack of socialization skills)

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24
Q

3 parts to psychosis

A

Delusions, Hallucinations (usually auditory), Disorganized speech

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25
Q

Often occur as an aura of psychomotor epilepsy and in brain tumors

A

Olfactory

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26
Q

Common in alcohol withdrawal and also seein in cocain abusers as bugs crawling on one’s skin

A

Tactile

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27
Q

Occurs while goign to sleep sometimes seen in narcolepsy hallucination

A

Hypnogogic

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28
Q

Occurs while waking from sleep sometimes seen in narcolepsy

A

Hypnopompic

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29
Q

Hyperactive pathway in schizophrenia

A

mesolibic-mesocortical pathway

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30
Q

Persistent feelings of detachment or estrangement from one’s own body, thosughts, perceptions, and actions (__) or ones environment (_____)

A

Depersonalization

Derealization

31
Q

Characteristics of MANIC episode

A

Distractibility, Irresponsibility (seeks pleasure w/o regard to consequences), Grandiosity (inflated self esteem), Flight of Ideas, Increase in goal directed Activity/psychomotor Agitation, decrease need for Sleep, Talkativeness or pressured speech

32
Q

How long does major depressive episodes last?

A

6-12 months

33
Q

Criteria for depression

A

SIG E CAPS

1) Sleep disturbance
2) Loss of interest
3) Guilt or feelings of worthlessness
4) Energy loss and fatigue
5) Concentration problems
6) Appetite/weight changes (usually decreased)
7) Psychomotor retardation or agitation
8) Suicidal ideations

34
Q

Main difference btwn atypical depression and major depression

A

Improved mood with positive events

35
Q

Depression vs anxiety sleep stages?

A

Think of norepinephrine (decreased in depression so incrreased REM sleep; increased in anxiety so decreased rem sleep)

36
Q

Length of pathologic grief

A

> 6 months

37
Q

Risk factors for suicide

A 
Sex (male)
Age (teenager or elderly)
Depression
Previous attempt
Ethanol or drug use
loss or Rational thinking
Sickness (medical illness, 3 or more prescription)
Organized plan
No spouse
Social support lacking
38
Q

What is not considered pathologic grief

A

Hallucinations (eg hearing voice of deceased love one) in the absence of other psychotic symptoms are not pathologic

39
Q

Panic disorder criteria

A 
PANICS
Palpitations
Paresthesias
Abdominal distress
Nausea
Intense fear of dying or losing
lIght headedness
Chest pain/Chills/Choking/disConnectedness
Sweating
Shaking 
Shortness of breath
40
Q

Diagnosis of panic disorder

A

Attack + 1 month (or more ) of following

  • Persistent concern of additional attacks
  • Worrying about consequences of attack
  • Behavioral change related to attacks
41
Q

Length of generalized anxiety disorder vs adjustment disorder

A

> 6 months,

42
Q

PTSD vs Acute stress disorder time period

A

> 1month, 3 days to one month

43
Q

enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and onself

A

Personality trait

44
Q

Inflexible, maladaptive and rigidly pervasive behavior causing distress + impaired functioning

A

Personality disorder

45
Q

Pervasive distrust and suspiciousness; projection is major defense mechanism

A

Paranoid

46
Q

Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

A

Schizotypal

47
Q

Unstable mood and interpersonal relationships, impulsivity, self-mutiliation, boredom, snese of emptiness; splitting major defencse

A

Borderline

48
Q

Excessive emotionality and excitability, attention seeking, sexually provocative, overlly concerned with appearance

A

Historinic

49
Q

Submissive and clingy, excessive need to be taken care of, low self-confidence

A

dependent

50
Q

Preoccupation with order, perfectionism, and control and behavior is consistent with ones own beliefs or values

A

OCPD

51
Q

Transsexualism vs Transvestism?

A

Transsexualism-desire to live as opposite sex through surgery and hormone therapy
Tresvestism-paraphilia, not gender dysphoria. Wearig clothes of opposite sex

52
Q

Stages of change in overcoming substance addiction

A

1) Precontemplation
2) contemplation
3) preparation/determination
4) action/willpower
5) maintenance
6) relapse

53
Q

1st symptom of alcohol withdrawal

A

tremouslousness (5-10 hr after) w/ gi distress, anxiety, agitation, autonomic disturbance (increase HR, respiration, body temp)

54
Q

2nd major symptom of alcohol withdrawal

A

DT (48-72 hours after)

55
Q

Treatment of opioid intoxication

A

naloxone, naltrexone

56
Q

Treatment of opioid withdrawal

A

methadone, buprenorphine

57
Q

How does opioid withdrawal present?

A

“Flu-like symptoms”–> sweating, dilated pupils, piloerection (“cold turkey”), fever, rhinorrhea, yawning, nausea, stoach cramps, diarrhea

58
Q

ADHD treatment

A

Stimulants (e.g. methylphenidate)

59
Q

Alcohol withdrawal treatment

A

Long acting benzodiazepines (eg chlordiazepoxide loarazepam, diazepam)

60
Q

Bipolar disorder treatment

A

Lithium, valproate (mood stabilitzing), atypical antipsychotics

61
Q

Bulimia treatment

A

SSRI

62
Q

Depression treatment

A

SSRI

63
Q

GAD treatment

A

SNRI SSRI

64
Q

OCD treatment

A

SSRI, clomipramine

65
Q

PAnic disorder treatment

A

SSRI, venlafaxine, benzodiazepine

66
Q

PTSD treatment

A

SSRI, venlafaxine

67
Q

Schizophrnia tratment

A

Atypical antipsychotics

68
Q

Social phobia treatment

A

SSRI, B blocker

69
Q

Tourette syndrome treatmen

A

Antipsychotics (e.g. fluphenazine, pimozide, tetrabenazine, clonidine)

70
Q

PCP acts at what receptor and what does it do?

A

Acts as a NMDA receptor antagonist leading to excess release of excitatory neurotransmitters

71
Q

LSD acts at what receptor and what does it do?

A

Acts on the 5-HT serotonin receptor

72
Q

Heroin addiction treatment?

A

Methadone-long term oral opiate with good oral bioavailability for heroin detoxification or long-term maintenance

Naloxone+buprenorphine-antagonist +partal agonist. Naloxone not orally bioavailable, withdrawal if injected

Naltrexone-long-acting opioid antagonist used for relapse prevention once detoxified

73
Q

Untreated Wernicke encephalopathy can lead to what?

A

Irreversible memory loss in korsakoff syndrome

74
Q

Triad of wernicke encephalopathy

A

Ataxia, confusion NOT confabulations , ophthalmoplegia

USMLE Step 1-2015 (18 decks)

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