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USMLE Step 1-2015 > psych > Flashcards

psych 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
Often occur as an aura of psychomotor epilepsy and in brain tumors
Olfactory
26
Common in alcohol withdrawal and also seein in cocain abusers as bugs crawling on one's skin
Tactile
27
Occurs while goign to sleep sometimes seen in narcolepsy hallucination
Hypnogogic
28
Occurs while waking from sleep sometimes seen in narcolepsy
Hypnopompic
29
Hyperactive pathway in schizophrenia
mesolibic-mesocortical pathway
30
Persistent feelings of detachment or estrangement from one's own body, thosughts, perceptions, and actions (__) or ones environment (_____)
Depersonalization Derealization
31
Characteristics of MANIC episode
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
How long does major depressive episodes last?
6-12 months
33
Criteria for depression
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
Main difference btwn atypical depression and major depression
Improved mood with positive events
35
Depression vs anxiety sleep stages?
Think of norepinephrine (decreased in depression so incrreased REM sleep; increased in anxiety so decreased rem sleep)
36
Length of pathologic grief
> 6 months
37
Risk factors for suicide
``` 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
What is not considered pathologic grief
Hallucinations (eg hearing voice of deceased love one) in the absence of other psychotic symptoms are not pathologic
39
Panic disorder criteria
``` 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
Diagnosis of panic disorder
Attack + 1 month (or more ) of following - Persistent concern of additional attacks - Worrying about consequences of attack - Behavioral change related to attacks
41
Length of generalized anxiety disorder vs adjustment disorder
> 6 months,
42
PTSD vs Acute stress disorder time period
> 1month, 3 days to one month
43
enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and onself
Personality trait
44
Inflexible, maladaptive and rigidly pervasive behavior causing distress + impaired functioning
Personality disorder
45
Pervasive distrust and suspiciousness; projection is major defense mechanism
Paranoid
46
Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness
Schizotypal
47
Unstable mood and interpersonal relationships, impulsivity, self-mutiliation, boredom, snese of emptiness; splitting major defencse
Borderline
48
Excessive emotionality and excitability, attention seeking, sexually provocative, overlly concerned with appearance
Historinic
49
Submissive and clingy, excessive need to be taken care of, low self-confidence
dependent
50
Preoccupation with order, perfectionism, and control and behavior is consistent with ones own beliefs or values
OCPD
51
Transsexualism vs Transvestism?
Transsexualism-desire to live as opposite sex through surgery and hormone therapy Tresvestism-paraphilia, not gender dysphoria. Wearig clothes of opposite sex
52
Stages of change in overcoming substance addiction
1) Precontemplation 2) contemplation 3) preparation/determination 4) action/willpower 5) maintenance 6) relapse
53
1st symptom of alcohol withdrawal
tremouslousness (5-10 hr after) w/ gi distress, anxiety, agitation, autonomic disturbance (increase HR, respiration, body temp)
54
2nd major symptom of alcohol withdrawal
DT (48-72 hours after)
55
Treatment of opioid intoxication
naloxone, naltrexone
56
Treatment of opioid withdrawal
methadone, buprenorphine
57
How does opioid withdrawal present?
"Flu-like symptoms"--> sweating, dilated pupils, piloerection ("cold turkey"), fever, rhinorrhea, yawning, nausea, stoach cramps, diarrhea
58
ADHD treatment
Stimulants (e.g. methylphenidate)
59
Alcohol withdrawal treatment
Long acting benzodiazepines (eg chlordiazepoxide loarazepam, diazepam)
60
Bipolar disorder treatment
Lithium, valproate (mood stabilitzing), atypical antipsychotics
61
Bulimia treatment
SSRI
62
Depression treatment
SSRI
63
GAD treatment
SNRI SSRI
64
OCD treatment
SSRI, clomipramine
65
PAnic disorder treatment
SSRI, venlafaxine, benzodiazepine
66
PTSD treatment
SSRI, venlafaxine
67
Schizophrnia tratment
Atypical antipsychotics
68
Social phobia treatment
SSRI, B blocker
69
Tourette syndrome treatmen
Antipsychotics (e.g. fluphenazine, pimozide, tetrabenazine, clonidine)
70
PCP acts at what receptor and what does it do?
Acts as a NMDA receptor antagonist leading to excess release of excitatory neurotransmitters
71
LSD acts at what receptor and what does it do?
Acts on the 5-HT serotonin receptor
72
Heroin addiction treatment?
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
Untreated Wernicke encephalopathy can lead to what?
Irreversible memory loss in korsakoff syndrome
74
Triad of wernicke encephalopathy
Ataxia, confusion NOT confabulations , ophthalmoplegia

USMLE Step 1-2015 (18 decks)

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