Psych Part 2 Flashcards
1
Q
2 most important psychiatric classifications are
A
DSM V
ICD 10
2
Q
The DSM-5 lists _______ major categories of mental disorders, composing more than _______ discrete illnesses.
A
22; 150
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
4
Q
dementia precox was coined by _____
EUGENE BLUELER
Emil Kraepelin
Karen Honey
Melanie Klein
A
Emil Kraepelin
5
Q
schizophrenia was coined by
A
EUGENE BLUELER
6
Q
schizo symptoms are caused by too much _______ in the hypothalamus
A
pruning
7
Q
Posits that schizophrenia results from too much _______ activity
A
dopaminergic
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
9
Q
Excessive serotonin also causes both positive and negative symptoms.
true false
A
true
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.
11
Q
Schizophrenia is a result of intrapsychic conflicts arising from the early fixation and the ego defect.
true false
A
true
12
Q
5 Schizo types
p
d
c
u
r
A
paranoid disorganized catatonic undifferentiated residual
13
Q
paranoid disorganized catatonic undifferentiated residual
marked disturbance in motor function
A
catatonic
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
15
Q
paranoid disorganized catatonic undifferentiated residual
cannot fit into one type or another
A
undiffrerentiated
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
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
18
Q
schiz
AT LEAST 1 MONTH
BUT LESS THAN 6
MONTHS
A
SCHIZOPHRENIFORM
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
20
Q
schiz
AT LEAST 1 DAY BUT
LESS THAN 1 MONTH
A
BRIEF PSYCHOTIC
DISORDER
21
Q
At least 6
months
A
schiz
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
23
Q
Classical Signs and Symptoms (schiz)
- Disorganized ____________
- Grossly __________
- ______ symptoms
A
- Delusions
- Hallucinations
- Disorganized speech
(e.g. frequent
derailment or
incoherence) - Grossly disorganized
or catatonic behavior - Negative symptoms
(i.e. diminished
emotional expression
or avolition
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).
25
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.
major mood episode
26
psychosis which has delusions ONLY as its primary symptom, usually non-bizarre delusions
delusional disorder
substance induced psychosis
psychosis secondary to another med condxn
delusional
27
delusional disorder
substance induced psychosis
psychosis secondary to another med condxn
arise from epilepsy, systemic lupus erythematosus, and
thyroid pathology
pyschosis secondary to another med
28
delusional disorder
substance induced psychosis
psychosis secondary to another med condxn
psychosis after intoxication or withdrawal from methamphetamine,
alcohol, cannabis, and steroids
substance induced psychosis
29
Treatment schiz except:
Dopamine
receptor
antagonist (DRA)
or TYPICAL
antipsychotics
Monoamine Oxidase (MAO)
inhibitors
Serotonin and
dopamine
antipsychotics
NOTA
Monoamine Oxidase (MAO)
inhibitors
30
● ISOCARBOXAZID
● HALOPERIDOL
● ESCITALOPRAM
● FLUPENTHIXOL
●QUETIAPINE
● CLOZAPINE
which of the ff are used for schiz treatment
HALOPERIDOL
● FLUPENTHIXOL
●QUETIAPINE
● CLOZAPINE
31
15% to 20% have good outcomes; >50% of patients have poor outcomes
true false
false
10% to 20% have good outcomes; >50% of patients have poor outcomes
32
No remissions in 3 years
good or poor prognosis for schiz
poor
33
good or poor prognosis for schiz
mood disorders symptoms
good
34
positive symptoms
good or poor prognosis for schiz
good
35
young onset
good or poor prognosis for schiz
poor
36
good or poor prognosis for schiz
no precipitating factors
poor
37
MOOD DISORDERS
A. Pathophysiology
- A result of dysregulation of monoamine neurotransmitters such as __________, ____________,
___________ and histamine.
norepinephrine, serotonin,
DOPAMINE and histamine.
38
Hypo-functioning of ________ has become the biogenic amine neurotransmitter most commonly
associated with depression
serotonin
39
Dopamine activity may be reduced in depression and increased in mania
true false
true
40
Mania is viewed as a defensive reaction against underlying depression
true false
true
41
mood disorder types
At least 2
weeks
Major
Depressive
Disorder
42
mood disorder types
Manic episode:
AT LEAST 1
WEEK
Major
depressive:
AT LEAST 2
WEEKS
Bipolar 1
disorder
43
MD type
Hypomanic:
AT LEAST _____
CONSECUTIVE
DAYS
Major
depressive:
AT LEAST 2
WEEKS
Bipolar 2
disorder
4 days
44
Major
Depressive
Disorder
At least _______ of the ______ succeeding
symptoms, at least ______ is a core
symptom:
5,9,1
45
MDD
2 core symptoms:
___________
___________
● 3 psychological symptoms:
- ___________
- Feelings of
_____________
- Difficulty in _________
● 4 somatic symptoms:
- Disturbances in __________
- _______ or hyper_______
- Psychomotor ________
- Fatigue
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
46
BP 1
A patient has a _________ manic episode
(abnormal and persistent elevated,
expansive, or irritable mood);
At least _______ of the following symptoms:
single ; 3
47
BP 1
1. Inflated __________
2. Decreased need for __________
3. More _________ than usual
4. _________ or racing
___________
5. Distractibility
6. Increase in ___________
7. Excessive involvement _________
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
48
A depressive episode preceding the
manic episode is common, but is NOT
necessary for diagnosis in bp1
true false
true
49
MDD treatment except:
● FLUOXETINE
● ESCITALOPRAM
● IMIPRAMINE
● Alprazolam
● AMITRIPTYLINE
● ISOCARBOXAZID
● Alprazolam
50
GI disturbances, headaches, restlessness side effects of
ssri
51
Prolongation of the QT interval in the ECQ,
leading to arrhythmias side effects of
TCA
52
● FLUOXETINE
● ESCITALOPRAM are
SSRI
53
ISOCARBOXAZID is under
MOA Monoamine Oxidase
54
MOOD STABILIZER
Valproic Acid
Lithium Carbonate
Lithium Carbonate
55
Valproic Acid
Lithium Carbonate
Antiepileptic drug that prevents
overfiring of monoamine neurons
by stabilizing the membrane
VALPROIC
56
(Depakene) IS
Valproic Acid
Lithium Carbonate
VAL
57
GI disturbance
● Tremors, delirium
● Acne
● Weight gain
● Ddiabetes insipidus
SIDE EFFECTS OF
SSRI
MOA
VALPROIC
LITHIUM CARBONATE
LITHIUM
58
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
VALPROIC ACID
59
MDD
In about 50% of patient, the depressive episodes usually occur before age ______ years.
40
60
Untreated depressive episode lasts________ months; most treated least about _____ months
6 to 13; 3
61
It often starts with depression and is a recurring disorder.
BP1
62
Only _______% of BP1 patients experience only manic episodes.
10% to 20%
63
An untreated manic episode lasts about _____ months
3
64
Generally ______ prognosis than those with MDD.
poorer
65
Advanced age of onset
GOOD OR POOR PROGNOSIS
GOOD
66
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
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
is a response to a known, external, definite, or nonconflictual threat.
fear
“ANXIETY” is a response to a threat that is unknown, internal, vague, or conflictual
68
The autonomic nervous system of some patients with anxiety disorder exhibit _______ sympathetic tone
increased
69
The autonomic nervous system of some patients with anxiety disorder exhibit adapt properly to repeated stimuli
true false
false
adapt slowly
70
The autonomic nervous system of some patients with anxiety disorder respond excessively to moderate stimuli.
true false
true
71
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
thalamus
72
Hypothalamic levels of ______ - RELEASING HORMONE are increased by stress, resulting in the
activation of the HPA axis.
co______**
CORTICOTROPIN
73
Anxiety serves as a signal of the presence of danger in the subconscious.
true false
false
Anxiety serves as a signal of the presence of danger in the unconscious.
74
Anxiety D types
1 MONTH OR
MORE
panic disorder
75
Anxiety D types
6 mos (4)
agoraphobia, specific phobia, GAD, SAD
76
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
4
77
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
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
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
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
agora
the individual fears or avoids these situations
because of thoughts that ________
escape might be
difficult.
80
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
GAD
81
Treatment for Anxiety disorders
SSRI, BEnzodiazepines, Tricyclic drugs, MAO
82
Alprazolam (Xanax) is a medication to treat AD under what mech
benzodiazepine
83
Paroxetine (Paxil) is an _____ for _____
ssri for anxiety
84
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
true
85
Usual onset of panic disorder is in ______ or
________
late adolescence or early adulthood.
86
- 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).
Childhood
87
Social anxiety has its onset in ____ or ______
late childhood or early adolescence.
88
Symptoms are observed beginning early adulthood and present in a variety of contexts. It is thereby NOT
diagnosed in children.
personality disorder
89
Dopaminergic and serotonergic systems indicate _______ functions in persons with personality
disorders.
arousal-activating
90
Personality traits are related to a fixation at one psychosexual stage of development which caused personality disorder
true false
true
91
Cluster A odd and eccentric personality disorder
paranoid, schizoid, schizotypal
92
cluster B: EMOTIONAL
AND ERRATIC personality d
borderline, histrionic, antisocial, narcissistic
93
cluster C: FEARFUL AND
ANXIOUS personality d
OC, dependent, avoidant
94
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
narcissistic
95
paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant
Disturbed thinking and communicating; distorted and
magical thinking; distinctive or peculiar speech
schizotypal
96
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
dependent
97
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
antisocial
98
paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant
Cold and aloof; detached and unemotional; quiet, distant,
seclusive and unsociable
schizoid
99
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
avoidant
100
paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant
Emotional constriction, orderliness, perseverance,
stubbornness and indecisiveness; shows pervasive pattern
or perfectionism and inflexibility
oc
101
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
histrionic
102
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
borderline
103
paranoid, schizoid, schizotypal, borderline, histrionic, antisocial, narcissistic, OC, dependent, avoidant
Excessive suspiciousness and distrust of others
paranoid
104
Personalities in Cluster B have tendencies towards developing
mood disorders.
105
Personalities in Cluster C have tendencies towards developing
anxiety disorders.
106
- They are often lifelong and are strong predisposing factors for other
psychiatric conditions.
107
Acute decline in both the level of consciousness
and cognition with particular impairment in
attention
ddelirium
108
delirium Hallmark symptom:
IMPAIRMENT OF CONSCIOUSNESS
109
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.
dementia
110
delirium
% of elderly (55 y/o or older)
% of elderly (85 y/o or older)
Common in ______ cases
1; 13; postoperative
111
● % in 65 years of age and older
● % in 85 years of age and older
● % in outpatient general medical practices
● % in chronic care facilities
● 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
● Higher prevalence in _________
● Most common: ______ DISEASE
(50-60%) - increases in prevalence
female; ALZHEIMER’S
113
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.
attention and awareness
fluctuation
114
dementia is progressive
true false
true
115
delirium primary goal:
TREAT THE UNDERLYING CAUSE
116
dementia first step:
VERIFICATION OF DISEASE
117
Sudden onset
dementia delirium
delirium
118
● Can occur with prodromal
symptoms (e.g. restlessness and
fearfulness)
delirium
119
Onset: 50s or 60s with gradual deterioration
dementia
120
Age of onset and rapidity of deterioration vary
● Survival: ~8 years (AD) with a range of 1-20
years
dementia
121
Can persist as long as the causative
factors are prese
delirium
122
Symptom regression for reversible cases
dementia
123
Slowed progress; recede
dementia
124
Symptoms usually recede
delirium
125
Once it is over, it is characteristically spotty
delirium
126
Psychosocial Determinants delirium
- Person's premorbid intelligence
- Coping mechanism
- Defense mechanisms
