Psych II

Question 1

Orientation

Answer 1

order of loss
time
place
person

Question 2

korsakoff syndrome

Answer 2

anterograde amnesia

B1 deficient

destruction mammillary bodies - alcoholics

Question 3

dissociative amnesia

Answer 3

cannot recall personal info

severe trauma/stress

fugue - travel or wandering

Question 4

delirium

Answer 4

wax and wane consciousness

disorganized thinking
hallucination
illusion
misperception

disturbed sleep cycle

secondary other issue

abnormal EEG

benzo - alcohol withdrawal

Question 5

dementia

Answer 5

decreased intellectual function

no affect LOC

memory loss, apraxia, aphasia, impaired judgement

Question 6

AD

Answer 6

increased risk of delirium

Question 7

reversible dementia

Answer 7

hypothyroid
depression
vit B12 deicient
normal pressure hydrocephalus

Question 8

irreversible dementia

Answer 8

AD
lewy body
HD
pick disease
cerebral infarct
prion disease
chronic substance abuse

Question 9

psychosis

Answer 9

distorted perception of reality

delusion, hallucination, disorganized thinking

Question 10

hallucination

Answer 10

pereption absence of external stimuli

visual
auditory
olfactory
gustatory
tactile
hypnagogic - while going to sleep
hypnopompic - occur waking from sleep

Question 11

delusion

Answer 11

unique false belief about oneself or others that persist despite the facts

Question 12

schizophrenia

Answer 12

last longer than 6 months

mental disorder, period psychosis

high DA activity

diagnosis - 2 or more symptoms
-positive - delusion
hallucination
disorganized speech
catatonic
-negative sx - flat affect, social withdrawal, lack motivation, lack of speech or thought

increased risk of suicide

Question 13

brief psychotic disorder

Answer 13

less than 1 month

often stress related

Question 14

schizophreniform

Answer 14

1-6 months

Question 15

schizoaffective

Answer 15

longer than 2 weeks

psychotic sx with episodic superimposed major depression or mania

psychosis is present with and without mood disorder

mood disorder - only present with psychosis

Question 16

tx schizophrenia

Answer 16

risperidone

atypicals are first line

Question 17

frequent marijuana in teen

Answer 17

psychosis/schizophrenia

Question 18

delusional disorder

Answer 18

fixed persistent false belieft

longer than 1 month

women believes married to celebrity when she isn’t

Question 19

dissociative identity disorder

Answer 19

2 or more identities

MC in women

hx sex abuse, PTSD, depression, substance abuse

Question 20

depersonalization disorder

Answer 20

detach from ones own body or environment

Question 21

mood disorder

Answer 21

abnormal range of mood

loss control over mood

Question 22

manic episode

Answer 22

period of abnormal persistent elevated, expansive, irritable mood

abnormal and persistent high activity or energy

diagnosis - require hospitalization

distractable, grandiose, flight of idea, less need for sleep

Question 23

hypomanic episode

Answer 23

like manic - but no hospitalization

Question 24

bipolar disorder

Answer 24

bipolar I - 1 manic episode with or without low episode

bipolar II - presence of hypomanic and depressive episode

antidepressant tx - can precipitate mania
high risk suicide

Question 25

tx bipolar

Answer 25

lithium, valproic acid, carbamazepine

Question 26

cyclothymic disorder

Answer 26

dysthymia and hypomania

milder form of bipolar disorder lasting at least 2 years

Question 27

major depressive disorder

Answer 27

6-12 months

5 of 9 sx for 2 or more weeks

SIGECAPS
sleep problem
interest loss
guilt
energy loss
concentration problem
appetite change
psychomotor retardation
suicide

Question 28

sleep changes with depression

Answer 28

less slow wave
less REM latency
more REM early in sleep cycle
more total REM

nighttime awakening
early morning awakening

Question 29

persistent depressive disorder

Answer 29

dysthymia

depression, mild - at least 2 years

Question 30

tx depression

Answer 30

CBT SSRIs - first line

SNRIs, mirtazapine, bupropion
ECT

Question 31

atypical depression

Answer 31

mood reactivity
reversed vegetative sx
leaden paralysis - heavy arms/legs

MC subtype

tx - CBT and SSRI

also MAOI

Question 32

maternal blues

Answer 32

within 4 weeks of delivery

depression, tearfulnes, fatigue, resolve 10 days

tx supportve

Question 33

postpartum depression

Answer 33

depression, anxiety, poor concentration

tx - SSRI, CBT

Question 34

postpartum psychosis

Answer 34

delusion, hallucination

thought of harming baby or self

risk fx - hx bipolar or psychosis
-first pregnancy, fam bx

tx - hospitalization

Question 35

pathologic grief

Answer 35

shock, denial, guilt, somatoc sx

longer than 6 months
satisfies major depression

hallucinations - voice of deceased loved one - not psychotic

Question 36

ECT

Answer 36

tx refractory depression with psychosis and acutely suicidal patient

Question 37

risk fx suicide completion

Answer 37

male
teen or elderly
depression
previous attempt
ethanol drug abuse
loss rational thinking
sickness
organized plan
no spouse
social supprt lacking

women try more, men succeed more

Question 38

anxiety disorder

Answer 38

inappropriate fear/worry

interfere with daily functioning

tx - CBT, SSRI, SNRI

Question 39

panic disorder

Answer 39

recurrent panic attacks
-peak in 10 minutes

palpitation, paresthesia, GI distress, nausea, fear of dying, light headed, chest pain, chill

diagnosis - attack followed by 1 month of:

• persistent concern more attacks
• worry about consequence of attack
• behavioral change due to attacks