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Psych Part 2 Flashcards

1
Q

2 most important psychiatric classifications are

A

DSM V
ICD 10

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2
Q

The DSM-5 lists _______ major categories of mental disorders, composing more than _______ discrete illnesses.

A

22; 150

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3
Q

is one of the first terms used to describe this disorder. It emphasizes the change
in cognition and early onset of the disorder

A

dementia precox

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4
Q

dementia precox was coined by _____

EUGENE BLUELER
Emil Kraepelin
Karen Honey
Melanie Klein

A

Emil Kraepelin

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5
Q

schizophrenia was coined by

A

EUGENE BLUELER

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6
Q

schizo symptoms are caused by too much _______ in the hypothalamus

A

pruning

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7
Q

Posits that schizophrenia results from too much _______ activity

A

dopaminergic

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8
Q

Excessive dopamine release in the ________ tract in patients with Schizophrenia has been
linked to the severity of positive psychotic symptoms

hypothalamic
frontal cortex
mesolimbic
thalamic

A

mesolimbic

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9
Q

Excessive serotonin also causes both positive and negative symptoms.

true false

A

true

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10
Q

The loss of dopaminergic neurons could lead to the hyperactivity of GABAergic neurons.

true false

A

false

The loss of GABAergic neurons could lead to the hyperactivity of dopaminergic neurons.

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11
Q

Schizophrenia is a result of intrapsychic conflicts arising from the early fixation and the ego defect.

true false

A

true

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12
Q

5 Schizo types

p
d
c
u
r

A

paranoid disorganized catatonic undifferentiated residual

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13
Q

paranoid disorganized catatonic undifferentiated residual

marked disturbance in motor function

A

catatonic

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14
Q

paranoid disorganized catatonic undifferentiated residual

preoccupation with one or more delusions (i.e. delusion of grandeur and
persecution) or frequent auditory hallucinations; typically tense, suspicious, guarded, reserved and
sometimes hostile or aggressive

A

paranoid

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15
Q

paranoid disorganized catatonic undifferentiated residual

cannot fit into one type or another

A

undiffrerentiated

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16
Q

paranoid disorganized catatonic undifferentiated residual

marked regression to primitive, disinhibited, and unorganized behavior and by
the absence of symptoms that meet the catatonic type; usually active but in an aimless, non-constructive
manner

A

disorganized

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17
Q

continuing evidence of the schizophrenic disturbance in the absence of a
complete set of active symptoms or of sufficient symptoms to the diagnosis

paranoid disorganized catatonic undifferentiated residual

A

residual

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18
Q

schiz

AT LEAST 1 MONTH
BUT LESS THAN 6
MONTHS

A

SCHIZOPHRENIFORM

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19
Q

schiz

2 or more weeks
of psychotic
symptoms alone
with the eventual
development of a
major mood
episode (fulfills
criteria for
MDD/Bipolar)

A

SCHIZOAFFECTIVE
DISORDER

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20
Q

schiz

AT LEAST 1 DAY BUT
LESS THAN 1 MONTH

A

BRIEF PSYCHOTIC
DISORDER

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21
Q

At least 6
months

A

schiz

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22
Q

____ or more of the following present
for a specific time frame. At least
_____ of these must be (1), (2), or (3) symptoms

schiz

A

2; 1

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23
Q

Classical Signs and Symptoms (schiz)

  3. Disorganized ____________
  4. Grossly __________
  5. ______ symptoms
A
  1. Delusions
  2. Hallucinations
  3. Disorganized speech
    (e.g. frequent
    derailment or
    incoherence)
  4. Grossly disorganized
    or catatonic behavior
  5. Negative symptoms
    (i.e. diminished
    emotional expression
    or avolition
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24
Q

Brief psychotic Disorder signs and symp

Not usually associated with
___________.

● Usually, but not always, an isolated
episode associated with a _________

A

● Not usually associated with
negative symptoms.
● Usually, but not always, an isolated
episode associated with a stressor
(include as specifier).

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25
Q

SCHIZOAFFECTIVE
DISORDER

● An uninterrupted period of illness
during which there is a ________ concurrent with the
symptoms of Schizophrenia
indicated above.

● Symptoms that meet criteria for
a ________ are
present for the majority of the
total duration of the active and
residual portions of
the illness.

A

major mood episode

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26
Q

psychosis which has delusions ONLY as its primary symptom, usually non-bizarre delusions

delusional disorder
substance induced psychosis
psychosis secondary to another med condxn

A

delusional

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27
Q

delusional disorder
substance induced psychosis
psychosis secondary to another med condxn

arise from epilepsy, systemic lupus erythematosus, and
thyroid pathology

A

pyschosis secondary to another med

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28
Q

delusional disorder
substance induced psychosis
psychosis secondary to another med condxn

psychosis after intoxication or withdrawal from methamphetamine,
alcohol, cannabis, and steroids

A

substance induced psychosis

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29
Q

Treatment schiz except:

Dopamine
receptor
antagonist (DRA)
or TYPICAL
antipsychotics

Monoamine Oxidase (MAO)
inhibitors

Serotonin and
dopamine
antipsychotics

NOTA

A

Monoamine Oxidase (MAO)
inhibitors

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30
Q

● ISOCARBOXAZID
● HALOPERIDOL
● ESCITALOPRAM
● FLUPENTHIXOL
●QUETIAPINE
● CLOZAPINE

which of the ff are used for schiz treatment

A

HALOPERIDOL
● FLUPENTHIXOL
●QUETIAPINE
● CLOZAPINE

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31
Q

15% to 20% have good outcomes; >50% of patients have poor outcomes

true false

A

false

10% to 20% have good outcomes; >50% of patients have poor outcomes

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32
Q

No remissions in 3 years

good or poor prognosis for schiz

A

poor

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33
Q

good or poor prognosis for schiz

mood disorders symptoms

A

good

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34
Q

positive symptoms

good or poor prognosis for schiz

A

good

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35
Q

young onset

good or poor prognosis for schiz

A

poor

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36
Q

good or poor prognosis for schiz

no precipitating factors

A

poor

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37
Q

MOOD DISORDERS
A. Pathophysiology
- A result of dysregulation of monoamine neurotransmitters such as __________, ____________,
___________ and histamine.

A

norepinephrine, serotonin,
DOPAMINE and histamine.

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38
Q

Hypo-functioning of ________ has become the biogenic amine neurotransmitter most commonly
associated with depression

A

serotonin

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39
Q

Dopamine activity may be reduced in depression and increased in mania

true false

A

true

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40
Q

Mania is viewed as a defensive reaction against underlying depression

true false

A

true

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41
Q

mood disorder types

At least 2
weeks

A

Major
Depressive
Disorder

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42
Q

mood disorder types

Manic episode:
AT LEAST 1
WEEK

Major
depressive:
AT LEAST 2
WEEKS

A

Bipolar 1
disorder

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43
Q

MD type

Hypomanic:
AT LEAST _____
CONSECUTIVE
DAYS

Major
depressive:
AT LEAST 2
WEEKS

A

Bipolar 2
disorder

4 days

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44
Q

Major
Depressive
Disorder

At least _______ of the ______ succeeding
symptoms, at least ______ is a core
symptom:

A

5,9,1

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45
Q

MDD

2 core symptoms:
___________
___________
● 3 psychological symptoms:
- ___________
- Feelings of
_____________
- Difficulty in _________
● 4 somatic symptoms:
- Disturbances in __________
- _______ or hyper_______
- Psychomotor ________
- Fatigue

A

2 core symptoms:
- Depressed mood
- Anhedonia
● 3 psychological symptoms:
- Suicidality
- Feelings of
worthlessness or
inappropriate guilt
- Difficulty in concentration
● 4 somatic symptoms:
- Disturbances in appetite
or weight
- Insomnia or hypersomnia
- Psychomotor retardation
or agitation
- Fatigue

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46
Q

BP 1

A patient has a _________ manic episode
(abnormal and persistent elevated,
expansive, or irritable mood);
At least _______ of the following symptoms:

A

single ; 3

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47
Q

BP 1

  1. Inflated __________
  2. Decreased need for __________
  3. More _________ than usual
  4. _________ or racing
    ___________
  5. Distractibility
  6. Increase in ___________
  7. Excessive involvement _________
A
  1. Inflated self-esteem or
    grandiosity
  2. Decreased need for sleep
  3. More talkative than usual
    or pressure to keep
    talking
  4. Flight of ideas or racing
    thoughts
  5. Distractibility
  6. Increase in goal-directed
    activity or psychomotor
    agitation
  7. Excessive involvement in
    activities that have a high
    potential for painful
    consequences
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48
Q

A depressive episode preceding the
manic episode is common, but is NOT
necessary for diagnosis in bp1

true false

A

true

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49
Q

MDD treatment except:

● FLUOXETINE
● ESCITALOPRAM
● IMIPRAMINE
● Alprazolam
● AMITRIPTYLINE
● ISOCARBOXAZID

A

● Alprazolam

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50
Q

GI disturbances, headaches, restlessness side effects of

A

ssri

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51
Q

Prolongation of the QT interval in the ECQ,
leading to arrhythmias side effects of

A

TCA

52
Q

● FLUOXETINE
● ESCITALOPRAM are

A

SSRI

53
Q

ISOCARBOXAZID is under

A

MOA Monoamine Oxidase

54
Q

MOOD STABILIZER

Valproic Acid
Lithium Carbonate

A

Lithium Carbonate

55
Q

Valproic Acid
Lithium Carbonate

Antiepileptic drug that prevents
overfiring of monoamine neurons
by stabilizing the membrane

A

VALPROIC

56
Q

(Depakene) IS

Valproic Acid
Lithium Carbonate

A

VAL

57
Q

GI disturbance
● Tremors, delirium
● Acne
● Weight gain
● Ddiabetes insipidus

SIDE EFFECTS OF

SSRI
MOA
VALPROIC
LITHIUM CARBONATE

A

LITHIUM

58
Q

Indicated only for acute mania
● Has wider therapeutic range than
lithium
● Nausea and vomiting
● Sedation
● Ataxia
● Rash
● Hyponatremia
● Weight gain or weight loss,
● Osteoporosis
● Teratogenesis

SIDE EFFECTS OF

A

VALPROIC ACID

59
Q

MDD

In about 50% of patient, the depressive episodes usually occur before age ______ years.

A

40

60
Q

Untreated depressive episode lasts________ months; most treated least about _____ months

A

6 to 13; 3

61
Q

It often starts with depression and is a recurring disorder.

A

BP1

62
Q

Only _______% of BP1 patients experience only manic episodes.

A

10% to 20%

63
Q

An untreated manic episode lasts about _____ months

A

3

64
Q

Generally ______ prognosis than those with MDD.

A

poorer

65
Q

Advanced age of onset

GOOD OR POOR PROGNOSIS

A

GOOD

66
Q

Bipolar 2 disorder:
- The diagnosis is unstable because there is a high likelihood that patients will have the same diagnosis up
to 5 years later.

true false

A

false

Bipolar 2 disorder:
- The diagnosis is stable because there is a high likelihood that patients will have the same diagnosis up
to 5 years later.

67
Q

is a response to a known, external, definite, or nonconflictual threat.

A

fear

“ANXIETY” is a response to a threat that is unknown, internal, vague, or conflictual

68
Q

The autonomic nervous system of some patients with anxiety disorder exhibit _______ sympathetic tone

A

increased

69
Q

The autonomic nervous system of some patients with anxiety disorder exhibit adapt properly to repeated stimuli

true false

A

false

adapt slowly

70
Q

The autonomic nervous system of some patients with anxiety disorder respond excessively to moderate stimuli.

true false

A

true

71
Q

Different types of acute stress result in increased 5-HT or SEROTONIN receptors in the except

prefrontalcortex
nucleus accumbens
thalamus
amygdala
lateral hypothalamus
aota
nota

A

thalamus

72
Q

Hypothalamic levels of ______ - RELEASING HORMONE are increased by stress, resulting in the
activation of the HPA axis.

co______**

A

CORTICOTROPIN

73
Q

Anxiety serves as a signal of the presence of danger in the subconscious.

true false

A

false

Anxiety serves as a signal of the presence of danger in the unconscious.

74
Q

Anxiety D types

1 MONTH OR
MORE

A

panic disorder

75
Q

Anxiety D types

6 mos (4)

A

agoraphobia, specific phobia, GAD, SAD

76
Q

A panic attack is an abrupt surge of intense
fear or intense discomfort that reaches a
peak within minutes, and during which time
________ (or more) of the following symptoms occur

A

4

77
Q

Recurrent unexpected panic attacks.
A panic attack is an abrupt surge of intense
fear or intense discomfort that reaches a
peak within minutes, and during which time
4
(or more) of the following symptoms occur;
1. Palpitations
2.______________
3. Trembling or _________
4. Sensations of __________
5. Feelings of ____________
6. Chest ___________
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady,
light-headed, or faint
9. ___________ or heat sensations
10. Paresthesia
11. ____________ (feelings of unreality)
or ___________ (being
detached from oneself)
12. Fear of _________
13. Fear of __________

At least one of the attacks has been followed by
1 month (or more) of one or both of
the following:

  1. Persistent __________
  2. A significant ______________ related to
    the attacks
A

Recurrent unexpected panic attacks.
A panic attack is an abrupt surge of intense
fear or intense discomfort that reaches a
peak within minutes, and during which time
4
(or more) of the following symptoms occur;
1. Palpitations
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady,
light-headed, or faint
9. Chills or heat sensations
10. Paresthesia
11. Derealization (feelings of unreality)
or depersonalization (being
detached from oneself)
12. Fear of losing control
13. Fear of dying

At least one of the attacks has been followed by
1 month (or more) of one or both of
the following:
1. Persistent concern or worry
about additional panic attacks
or their consequences
2. A significant maladaptive
change in behavior related to
the attacks

78
Q

Agoraphobia

Marked fear or anxiety about ______ (or more) of the
following 5 situations:
1. Using _______
2. Being in ______
3. Being in __________
4. Standing _______
5. Being ___________ alone

A

2

  1. Using public transportation (e.g.,
    automobiles, buses, trains, ships,
    planes)
  2. Being in open spaces (e.g., parking
    lots, marketplaces, bridges)
  3. Being in enclosed places
    (e.g., shops,
  4. Standing in line or being in a crowd
  5. Being outside of the home alone
79
Q

agora

the individual fears or avoids these situations
because of thoughts that ________

A

escape might be
difficult.

80
Q

The anxiety and worry are associated with 3
(or more) of the following 6 symptoms:
1. Restlessness or feeling keyed up or
on edge
2. Being easily fatigued
3. Difficulty concentrating or mind
going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance
*Only one item is required in children

A

GAD

81
Q

Treatment for Anxiety disorders

A

SSRI, BEnzodiazepines, Tricyclic drugs, MAO

82
Q

Alprazolam (Xanax) is a medication to treat AD under what mech

A

benzodiazepine

83
Q

Paroxetine (Paxil) is an _____ for _____

A

ssri for anxiety

84
Q

Most cases of agoraphobia are thought to be caused by panic disorder. When the panic disorder is
treated, the agoraphobia often improves with time.

true false

A

true

85
Q

Usual onset of panic disorder is in ______ or
________

A

late adolescence or early adulthood.

86
Q
  • Specific phobia exhibits a bimodal age of onset. ________ peak for animal phobia, natural environment
    phobia and blood-injection-injury phobia. Early adulthood peak for other phobias (e.g. situational
    phobia).
A

Childhood

87
Q

Social anxiety has its onset in ____ or ______

A

late childhood or early adolescence.

88
Q

Symptoms are observed beginning early adulthood and present in a variety of contexts. It is thereby NOT
diagnosed in children.

A

personality disorder

89
Q

Dopaminergic and serotonergic systems indicate _______ functions in persons with personality
disorders.

A

arousal-activating

90
Q

Personality traits are related to a fixation at one psychosexual stage of development which caused personality disorder

true false

A

true

91
Q

Cluster A odd and eccentric personality disorder

A

paranoid, schizoid, schizotypal

92
Q

cluster B: EMOTIONAL
AND ERRATIC personality d

A

borderline, histrionic, antisocial, narcissistic

93
Q

cluster C: FEARFUL AND
ANXIOUS personality d

A

OC, dependent, avoidant

94
Q

Grandiose sense of self-importance; seeks and expect
special treatment; sense of entitlement; handles
criticisms poorly and very susceptible to depression

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

A

narcissistic

95
Q

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

Disturbed thinking and communicating; distorted and
magical thinking; distinctive or peculiar speech

A

schizotypal

96
Q

Passive-dependent personality; clingy and submissive; lacks
self- confidence, get others to assume responsibility for
major areas of their lives; feels extreme discomfort when
alone for more than a brief period

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

A

dependent

97
Q

Disregard for laws and rights of others; with evidence of
conduct disorder before 15 years of age

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

A

antisocial

98
Q

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

Cold and aloof; detached and unemotional; quiet, distant,
seclusive and unsociable

A

schizoid

99
Q

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

Extreme sensitivity to rejection and may lead socially
withdrawn life; shy but not asocial as they show great desire
for companionship; inferiority complex

A

avoidant

100
Q

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

Emotional constriction, orderliness, perseverance,
stubbornness and indecisiveness; shows pervasive pattern
or perfectionism and inflexibility

A

oc

101
Q

Attention-seeking; excitable and emotional and behave in a
colorful, dramatic, extroverted fashion; inability to
maintain deep, long-lasting attachments

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

A

histrionic

102
Q

unstable sense of self and relationship, tends to be
impulsive and associated with multiple suicidal attempts

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

A

borderline

103
Q

paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant

Excessive suspiciousness and distrust of others

A

paranoid

104
Q

Personalities in Cluster B have tendencies towards developing

A

mood disorders.

105
Q

Personalities in Cluster C have tendencies towards developing

A

anxiety disorders.

106
Q
  • They are often lifelong and are strong predisposing factors for other
A

psychiatric conditions.

107
Q

Acute decline in both the level of consciousness
and cognition with particular impairment in
attention

A

ddelirium

108
Q

delirium Hallmark symptom:

A

IMPAIRMENT OF CONSCIOUSNESS

109
Q

A progressive cognitive impairment in clear
consciousness. It is marked by severe impairment
in memory, judgment, orientation and cognition.
The cognitive deficits represent a decline from a
previous level of functioning.

A

dementia

110
Q

delirium

% of elderly (55 y/o or older)
% of elderly (85 y/o or older)
Common in ______ cases

A

1; 13; postoperative

111
Q

● % in 65 years of age and older
● % in 85 years of age and older
● % in outpatient general medical practices
● % in chronic care facilities

A

● 5% in 65 years of age and older
● 20-40% in 85 years of age and older
● 15-20% in outpatient general medical practices
● 50% in chronic care facilities

112
Q

● Higher prevalence in _________
● Most common: ______ DISEASE
(50-60%) - increases in prevalence

A

female; ALZHEIMER’S

113
Q

delirium diagnostic

A: A disturbance in _______ and ________ (reduced orientation
to the environment).
B: The disturbance develops over a short period
of time (usually hours to a few days), represents
a change from baseline attention and
awareness, and tends to __________ in severity
during the course of a day.
C: An additional disturbance in cognition.
D: The disturbances are not better explained
by another preexisting, established, or evolving
neurocognitive disorder and do not occur in
the context of a severely reduced level of
arousal, such as coma.
E: There is evidence from the history, physical
examination, or laboratory findings that the
disturbance is a direct physiological
consequence of another medical condition,
substance intoxication or
withdrawal, or exposure to a toxin, or is due to
multiple etiologies.

A

attention and awareness

fluctuation

114
Q

dementia is progressive

true false

A

true

115
Q

delirium primary goal:

A

TREAT THE UNDERLYING CAUSE

116
Q

dementia first step:

A

VERIFICATION OF DISEASE

117
Q

Sudden onset

dementia delirium

A

delirium

118
Q

● Can occur with prodromal
symptoms (e.g. restlessness and
fearfulness)

A

delirium

119
Q

Onset: 50s or 60s with gradual deterioration

A

dementia

120
Q

Age of onset and rapidity of deterioration vary
● Survival: ~8 years (AD) with a range of 1-20
years

A

dementia

121
Q

Can persist as long as the causative
factors are prese

A

delirium

122
Q

Symptom regression for reversible cases

A

dementia

123
Q

Slowed progress; recede

A

dementia

124
Q

Symptoms usually recede

A

delirium

125
Q

Once it is over, it is characteristically spotty

A

delirium

126
Q

Psychosocial Determinants delirium

A
  • Person’s premorbid intelligence
  • Coping mechanism
  • Defense mechanisms

OT Sem 2 (9 decks)

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