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STEP 1 RECALL > Psych > Flashcards

Psych Flashcards

1
Q

Defense mechanism: Splitting

A

Seeing the world in black & white (people or groups are either wholly good or wholly bad)– common in patients with borderline personality disorder

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2
Q

Defense mechanism: Projection

A

Transplanting your own unacceptable impulses on to another person (a pt who has sexual desires for her doc accusing him of having desires for her)

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3
Q

Defense mechanism: Reaction formation

A

The redirection of an unacceptable impulse into the opposite (a former smoker who avidly enforces a no smoking rule)

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4
Q

Defense mechanism : Sublimation

A

One of the mature defense mechanisms, involves channeling an unacceptable behavior into an acceptable form (a pt with sexually explicit thoughts becoming a sex therapist)

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5
Q

Defense mechanism : Acting out

A

Expressing unacceptable thoughts via actions (throwing a tantrum)

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6
Q

Defense mechanism : Intellectualization

A

Suppressing one’s feelings by thinking about the problem

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7
Q

pt with chronic fatigue, unhappiness, low energy, anhedonia (not caring) for 4 years, no suicidal thoughts, no changes in eating or sleeping, no concentration changes…

A

Dysthymic disorder —-> depressed mood most days for at least 2 years*, a low intensity mood disorder that responds well to antidepressants

(not MDD – have to have 5 or more of the “SIGECAPS” criteria for 2 weeks or more)

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8
Q

What are the mature defense mechanisms?

A

“SASH”

Sublimation
Altruism
Suppression
Humor

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9
Q

Defense mech: Dissociation

A

Temporary drastic change in personality or behavior to avoid emotional stress (classic w/ child or sex abuse victims)

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10
Q

Defense mech: Displacement

A

fellings or ideas are transferred to some neutral person (ie: parent blames child for something spouse did)

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11
Q

Defense mech: Fixation

A

partially remaining at a more childish level of development

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12
Q

Defense mech: Identification

A

modeling behavior after a more powerful person (though not necessarily admired)

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13
Q

Defense mech: Isolation of affect

A

separating feelings from events (ie: witness describing a murder without showing emotion)

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14
Q

Defense mech: Rationalization

A

proclaiming logical reasons for actions actually done for a different reason (ie: get fired – say you didn’t like the job anyway)

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15
Q

Defense mech: Regression

A

going back to earlier modes of dealing with the world (ie: child who reverts back to bedwetting even after he has been potty trained)

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16
Q

Defense mech: Repression

A

INVOLUNTARY withholding of an idea or feeling

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17
Q

Defense mech: Altruism

A

alleviating your guilty feelings by doing nice things for others

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18
Q

Defense mech: Suppression

A

VOLUNTARILY withholding an idea or feeling from awareness ( the more ‘mature’ form) 00 ie: choosing not to worry about Step 1 until the day before

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19
Q

Child w/ poor muscle tone, language skills, lack of trust, weight loss, illnesses…

A

Long term deprivation of affection to the child

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20
Q

Most common form of child mistreatment, poor hygiene, malnutrition, social withdrawl, failure to thrive

A

neglect (failure to provide food, shelter, supervision, education, affection) –> REPORTABLE JUST LIKE ABUSE

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21
Q

boy who destroys property, steals, violates social norms repeatedly, under age 18

A

Conduct disorder

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22
Q

defiant toward authority figures, but generally stays within social norms in other areas

A

Oppositional defiant disorder

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23
Q

to be diagnosed w/ Tourette’s , you must have ‘tics’ for more than ___________

A

1 year

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24
Q

language impairment in a young boy, below normal intelligence, focuses on objects not people

A

Autism

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25
Q

milder than Autism, normal intelligence but problems socially

A

Asperger’s

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26
Q

X-linked mutation in MECP-2 gene, only effects girls, loss of development, regression around age 1-4 , classic “hand-wringing” behavior

A

Rett’s syndrome

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27
Q

similar to Rett’s, but more common in boys and onset is age 3-4

A

Child disintegrative disorder (“Hellers”)

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28
Q

anterograde amnesia caused by Thiamine (B1) deficiency, destruction of the mamillary bodies

A

Korsakoff’s amnesia – seen in alcoholics

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29
Q

waxing & waning level of consciousness with acute onset, often reversible, often w/ visual hallucinations, can be secondary to infection, trauma, substance abuse, will have an abnormal EEG if you did one…

A

Delirium (very common in hospitalized patients)

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30
Q

gradual decline in cognition with no changes in LOC, memory loss, aphasia, personality changes, impaired judgment, can be caused by Alzhiemers, HIV, Picks dz, Stroke… would have a normal EEG

A

Dementia (usually irreversible)

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31
Q

Auditory hallucinations are common in what dz?

A

Schizophrenia

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32
Q

Olfactory hallucinations assoc with ____

A

epilepsy or brain tumor

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33
Q

Tactile halucinations are assoc w/ _____

A

alcohol withdrawal or cocaine abuse (bugs crawling on skin)

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34
Q

chronic mental disorder w/ periods of psychosis, disturbed behavior and thought, decline in functioning for GREATER THAN 6 MONTHS – has + and - symptoms

A

Schizophrenia

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35
Q

Positive symptoms of Schizophrenia

A

delusions, hallucinations, disorganized speech, disorganized / catatonic behavior

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36
Q

Negative symptoms of schizophrenia

A

flat affect, social withdrawal, no motivation, lack of speech or thought

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37
Q

Schizophrenia symptoms that last btw 1-6 months (but not more than 6 mos)

A

Schizophreniform disorder

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38
Q

Schizophrenia symptoms for at least 2 weeks, PLUS a mood disorder (mania or depression or both)

A

Schizoaffective disorder

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39
Q

an untrue belief that is persistant > 1 month but is not totally bizzare

A

Delusional disorder

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40
Q

an untrue belief that is persistant > 1 month but is not totally bizzare

A

Delusional disorder

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41
Q

What are the mature defense mechanisms?

A

“SASH”

Sublimation
Altruism
Suppression
Humor

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42
Q

anterograde amnesia caused by Thiamine (B1) deficiency, destruction of the mamillary bodies

A

Korsakoff’s amnesia – seen in alcoholics

How well did you know this?
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43
Q

waxing & waning level of consciousness with acute onset, often reversible, often w/ visual hallucinations, can be secondary to infection, trauma, substance abuse, will have an abnormal EEG if you did one…

A

Delirium (very common in hospitalized patients)

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44
Q

gradual decline in cognition with no changes in LOC, memory loss, aphasia, personality changes, impaired judgment, can be caused by Alzhiemers, HIV, Picks dz, Stroke… would have a normal EEG

A

Dementia (usually irreversible)

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45
Q

Auditory hallucinations are common in what dz?

A

Schizophrenia

46
Q

Olfactory hallucinations assoc with ____

A

epilepsy or brain tumor

47
Q

Tactile halucinations are assoc w/ _____

A

alcohol withdrawal or cocaine abuse (bugs crawling on skin)

48
Q

chronic mental disorder w/ periods of psychosis, disturbed behavior and thought, decline in functioning for GREATER THAN 6 MONTHS – has + and - symptoms

A

Schizophrenia

49
Q

Positive symptoms of Schizophrenia

A

delusions, hallucinations, disorganized speech, disorganized / catatonic behavior

50
Q

Negative symptoms of schizophrenia

A

flat affect, social withdrawal, no motivation, lack of speech or thought

51
Q

Schizophrenia symptoms that last btw 1-6 months (but not more than 6 mos)

A

Schizophreniform disorder

52
Q

Schizophrenia symptoms for at least 2 weeks, PLUS a mood disorder (mania or depression or both)

A

Schizoaffective disorder

53
Q

an untrue belief that is persistant > 1 month but is not totally bizzare

A

Delusional disorder

54
Q

Presence of 2 or more distinct identities or personality states , common in women with a history of sexual abuse

A

Dissociative identity disorder

55
Q

An abrupt change in location, inability to recall past, confusion, assumption of a new identity, and the patient doesn’t remember this state after its over—- associated with trauma, natural disasters …

A

Dissociative fugue state

56
Q

Distinct period of abnormally elevated, expansive or irritable mood lasting at least 1 week, must have 3 or more of the traits

A

Manic episode

Must have 3 of these:

Distractibility 
Irresponsibility
Grandiosity 
Flight of ideas/ racing thoughts
Agitation, increased activity 
Decreased need for sleep
Talkativeness or pressured speech
57
Q

Like a manic episode, still lasts longer than 1 week but doesn’t affect the persons life enough to warrant hospitalization

A

Hypomanic episode

58
Q

Only need one manic or hypomanic episode for diagnosis

A

Bipolar disorder

59
Q

Depressive symptoms for longer than 2 weeks with episodes that usually last 6-12 months (must include patient reported depression or anhedonia plus 4 of the SIGECAPS)

A

Major depressive disorder

60
Q

SIGECAPS for depression

A 
Sleep disturbance 
Interest loss (anhedonia)
Guilt 
Energy loss
Concentration loss
Appetite/ weight changes 
Psychomotor retardation 
Suicidal ideations
61
Q

Milder form of depression, lasts 2 years or more

A

Dysthymia

62
Q

Most common form of depression, characterized by hypersomnia, overeating, mood reactivity, but can experience improved mood in response to positive events

A

Atypical depression

63
Q

Treatment for atypical depression

A

MAOIs, or SSRIs

64
Q

Hypervigilance, avoidance, distress, and re-experiencing event for > 1 month

A

PTSD

65
Q

PTSD symptoms for <1 month

A

Acute stress disorder

66
Q

Anxiety that isn’t related to any specific person or thing, lasts longer than 6 months , includes sleep disturbances, fatigue, GI distress….

A

Generalized anxiety disorder

67
Q

Pt consciously fakes a disorder in order to obtain a secondary gain (drugs, getting out of work)

A

Malingering

68
Q

Pt consciously fakes symptoms in order to obtain a primary gain (attention for being sick)

A

Factitious disorder

69
Q

Munchausens and Munchausens by proxy are categories of ____________________ disorder

A

Factitious disorder ( they want attention for being sick or for their child being sick)

70
Q

Cluster A personality disorders

A

“Weird”

1- paranoid – distrustful, accusatory, projection is common
2- schizoid – voluntary social withdrawal, content being alone, limited emotional expression
3- schizotypal – odd beliefs, magical thinking, awkward

71
Q

Cluster B personality disorders

A

“Wild”

1- antisocial – sociopaths, criminals, > 18 years old
2- borderline – splitting is common, females, unstable mood, impulsive
3- histrionic – attention seekers, theatric
4- narcissistic – requires excessive admiration, sense of entitlement

72
Q

Cluster C personality disorders

A

“Worried”

1- avoidant – socially inhibited, timid, but desires to be social**, sensitive to rejection
2- obsessive- compulsive – needs order, control, perfection
3- dependent – submissive, clingy, low self confidence

73
Q

Personality type that is socially inhibited, timid, feels inadequate BUT desires to have relationships ((compared to Schizoid which do not want relationships))

A

Avoidant personality

74
Q

body weight < 85% of ideal for height, decreased bone density, excessive dieting / + or - purging, amenorrhea for > 3 months, anemia…

A

Anorexia nervosa

75
Q

binge eating / purging, body weight often maintained around a ‘normal’ range, assoc with parotitis, enamel erosion, metabolic alkalosis

A

Bulimia nervosa

76
Q

Lab AST is twice the value of ALT and serum gamma-glutamyltransferase is elevated

A

signs of Alcohol intoxication

77
Q

treatment fot Delirium tremens (DT’s)

A

benzodiazepines

78
Q

Intoxication w/ these drugs cause pupillary constriction (miosis) – “pinpoint pupils”

A

Opioids ( morphine, heroin, methadone)

79
Q

Treatment for Opioid intoxication (Heroin, Morphine…)

A

Naloxone, Naltrexone

80
Q

Sweating, dilated pupils, N/V, fever, runny nose – all signs of _____ withdrawal

A

Opiod withdrawal (tx = symptomatic)

81
Q

these drugs can cause marked respiratory depression

A

Barbiturates

82
Q

have a smaller risk of respiratory depression and treatment for intoxication is Flumazenil

A

Benzodiazepines

83
Q

Intoxication with _____, ______ & ________ can cause pupillary dilation (mydriasis)

A

Amphetamines, LSD & Cocaine

84
Q

this drug can cause angina, premature labor, pupillary dilation, hallucinations and sudden cardiac death

A

Cocaine

85
Q

this drug can cause belligerence, aggression, agitation, nystagmus, tachycardia, homicidality

A

PCP

86
Q

this drug can cause flashbacks, pupillary dilation, visual hallucinations

A

LSD

87
Q

Heroin users are at risk for ______

A

hepatitis, abscesses, overdose, AIDS, right sided endoarditis

88
Q

Methadone use

A

for Heroin detox, long term maintenance

89
Q

confusion, ophthalmoplegia & ataxia

A

Wernicke’s encephalopathy

90
Q

how Disulfiram works

A

causes Acetaldehyde to build up by blocking Acetaldehyde DH –> makes pt feel very sick if they consume any alcohol

91
Q

life threatening alcohol withdrawal syndrome, peaks 2-5 days after last drink, tactile hallucinations

A

Delirium tremens (treat with Benzos)

92
Q

SSRI’s —> used to treat a huge variety of psych disorders EXCEPT ____ & ______

A

bipolar or schizophrenia (use mood stabilizers and antipsychotics for these)

93
Q

What are the “mood stabilizers” used to treat bipolar?

A

Lithium, Valproic acid, Carbamazepine

94
Q

CNS stimulates (amphetamines) act by ________________________

A

increasing NE & dopamine at the synaptic cleft

Used for ADHD, narcolepsy & appetite control

95
Q

What are the TYPICAL antipsychotics?

A

Haloperidol, and anything that ends in
“-azine”

  • they all block Dopamine (D2) receptors, increasing cAMP
  • treat the + schizo symptoms, psychosis, mania, & Tourette’s
96
Q

What are the main side effects of the Typical Antipsychotics? (haloperidol + “-azines”)

A

Extrapyramidal side effects (dystonia, akinesia (like parkinson’s) , restlessness, tardive dyskinesia)

and also SE’s from blocking muscarinic, alpha and histamine receptors (dry mouth, constipation, hypotension, sedation)

and hyperprolactinemia and galactorrhea

97
Q

What are the ATYPICAL antipsychotics?

A

Olanzapine, Clozapine, Quetipine, Risperidone, Aripiprazole, Ziprasidone

“It’s Atypical for OLd CLosets to QUietly RIsper from A to Z”

-can treat both the + and - effects of Schizo

–have less severe side effects so these are preferred!

98
Q

Mechanism of Atypical antipsychotics?

A

not totally understood (effect various receptors)

99
Q

the atypical antipsychotic __________________ can cause granulocytosis so you must monitor WBC count

A

Clozapine

“Clozapine traps granulocytes in the closet”

100
Q

Lithium mechanism & side effects

A

mechanism = inhibits IP3 cascade

Side effects = “LMNOP”

Lithium causes
Movement (tremors)
Nephrogenic DI
hypOthyroidism 
Pregnancy probs (Epstein's anomaly)
101
Q

Buspirone mechanism and use

A

stimulates 5HT 1A receptors – used for generalized anxiety disorder

102
Q

Amitriptyline, Nortriptyline, Imipramine, Desipramine, Clomipramine, Doxepin, Amoxapine

A

Tri- cyclic Antidepressants

end in “-iptyline” or “-ipramine” mostly

103
Q

Mechanism of TCA’s

A

block the reuptake of NE and Serotonin

-used for MDD, bedwetting (Imipramine) , OCD (clomipramine) & fibromyalgia

104
Q

SSRI mechanism & side effects

A

block the reuptake of Serotonin only

SE’s = sexual dysfunction, Serotonin syndrome ((hyperthermia, flushing, diarrhea, siezures))

105
Q

Name the SSRI’s

A

Fluoxetine
Paroxetine
Sertraline
Citalopram

106
Q

Pt starts taking an antidepressant and comes to you 2 weeks later complaining that they are not working…. what do you advise them?

A

Antidepressants usually take 4-8 weeks to have an effect!

107
Q

SNRI mechanism and SE’s (Venlafaxine, Duloxetine)

A

block Serotonin and NE reuptake

SE’s – less than SSRI’s, may have incr in BP

  • used for depression ((*Duloxetine can also be used for diabetic peripheral neuropathy))
108
Q

MAOI’s mechanism

A

increase the levels of NE, Dopamine and Serotonin (**do not eat Tyramine containing foods when on b/c will cause HTN crisis)

109
Q

What are the MAOI’s

A

Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline

“MAO Takes Pride In Shanghai”

110
Q

What are the atypical antidepressants?

A

Bupropion – incrs NE & Dopamine
Mirtazapine – alpha 2 blocker
Maprotiline –blocks NE reuptake
Trazodone – blocks Serotonin reuptake

STEP 1 RECALL (12 decks)

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