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USMLE > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Acting Out

A

Unacceptable feelings are expressed through actions (tantrums)

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2
Q

Dissociation

A

Temporary drastic change in personality to avoid emotional stress-> Extreme form = multiple personality disorder

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3
Q

Denial

A

Avoid awarness of something painful (common in HIV diagnosis patients)

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4
Q

Displacement

A

Transfer of bad feelings to a neutral person/object

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5
Q

Fixation

A

Remaining in some childish level of development

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6
Q

Identification

A

Modeling behavior towards someone more powerful

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7
Q

Isolation

A

Separate feelings from ideas/event

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8
Q

Projection

A

Transfer of internal impulse to external source (wants another women, but blame wife is cheating)

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9
Q

Rationalization

A

Logical reasoning for something that happened to avoid self-blame

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10
Q

Reaction formation

A

Ward-off idea by replacing with emphasis of opposite action (unconcious)

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11
Q

Regression

A

Turning back maturation clock (child under stress -> wets himself)

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12
Q

Repression

A

Involuntarily withhold an idea from awareness

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13
Q

Splitting

A

Things are either all good or all bad (seen with borderline personality)

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14
Q

Altruism

A

Guilty feeling alleviated by generosity towards others

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15
Q

Humor

A

Appreciating amusing nature of anxiety-provoking/adverse situation

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16
Q

Sublimation

A

Replaces an unaccetable wish to action that is similar but does not conflict with one’s value system (actress uses experience of abuse to enhance acting)

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17
Q

Suppression

A

Voluntary withold idea from conscious awareness

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18
Q

Infant deprivation effects

A

“Infants go Wah Wah Wah Wah”

Weak (decreased muscle tone)

Wordless (poor language/social skills)

Wanting

Wary (weight loss/physical illlness/anaclitic depression)

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19
Q

Child abuse evidence

A

Physical: Healed fracture, cigarette burns, subdural hematomas, multiple bruises, retinal hemorrhage/detachment

Sexual: Genital/anal truama, STD, UTI’s

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20
Q

Child neglect evidence

A

Poor hygiene, malnutrition, withdrawal, impaired social/emotional development, failure to thrive

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21
Q

Conduct disorder (childhood)

A

Repetitive behavior violating social norm (aggression, destruction of property, theft) - antisocial after age 18

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22
Q

ADHD

A

Difficulties in school, poor imuplse control. limted attention span

Tx: Methylphenidate (ritaline), amphetamines, atomoxetine

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23
Q

Oppositional defiant disorder

A

Hostile, defiant behavior to authority figures (no serious violation of social norm)

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24
Q

Tourette’s

A

Sudden, rapid, reucurrent motor movement or vocalization

Association: OCD

Tx: Antipsychotics - Fluphenazine, pimozide, tetrabenazine

25
Separation anxiety disorder
Fear of separation (common onset 7-9 yrs old) May lead to factitious complaints to avoid school
26
Autistic Disorder
Severe language impairment and poor social interactions. Greater focus on objects than people. Usually with below normal intelligence Tx: Behavior and supportive therapy
27
Asperger's
All absorbing interest, repetitive behavior and problems with social interaction. Usually normal intelligence, no language impairment
28
Rett's disorder
X-linked in girls (boys die in utero) Normal until age 1-4: _Regression_ -\> Loss of development, mental retardation, loss of verbal abilities, **sterotyped hand-wringing**
29
Childhood disintegrative disorder
_Regression in multiple areas_ after at least 2 yrs -\> language, **social, bowel, bladder skills** More common in boys
30
Causes of loss in orientation (time/place/person)
Alcohol, drugs, electrolyte imbalance, head truama, hypoglycemia, nutritional deficiency
31
Delirium
Waxing and waning of conciousness with acute onset Acute changes in mental status, disorganized thinking, hallucinations (visual), misinterpretation, disturbances in sleep-wake cycle, cognitive disfunction Abnormal EEG Check drugs with anti-cholinergic effects Common cause: Drugs, UTI
32
Dementia
Gradual decrease in cognition with no change in conciousness. Characterized by memory deficit, aphasia, apraxia, agnosia, loss of abstract thought, behavior changes, impaired judgements. **Patient alert**. Causes: Alzheimers, vascular thrombissi, hemorrage (multiple infracts), HIV, pick's dz, CJD Elderly patients -\> depression may look like dementia
33
Hallucinations
Percentions in absence of external stimuli
34
Illusions
Misperception of actual external stimuli
35
Delusions
False belief not shared with others (CIA is spying on you)
36
Loose association
Disorder in form of thought (way they are tied together)
37
Paranoid
Pervasive distrust and suspiciousness Projection is a major defense mechanism
38
Schizoid
"Schizoid, avoid" Content with social isolation
39
Schizotypal
"Schizotypal dresses like a pickle" eccentic appearance, odd/magical thinking, interpersonal awkwardness
40
Antisocial
Criminal - disregard for and violation of rights of others (conduct disorder \<18)
41
Borderline
Unstable mood, self-mutilation, boredom, sense of emptiness Splitting is a defense mechanism
42
Histrionic
Excessive emotionality, attention seeking, sexually provocative
43
Narcissitic
Sesne of entitlement, demands best, respond to criticism with rage
44
Avoidant
Hypersensitive to rejection socially timid, **wants relationships**
45
Obsessive-compulsive
Wants order, perfection Disorder - don't like what they are doing Trait - not aware they are doing it
46
Dependent
Submissive/clingy, low self-confidence
47
Schizoid vs schizotypal vs schizophrenic vs schizoaffective
Schzoid - avoids people Schzotypal - schzoid + odd thinking Schizophrenic - greater odd thinking than schzotypal Schizoaffective - schzophrenic + biopolar/depressive disorder
48
Anorexia nervosa
Excessive dieting +/- purging, body image distortion Severe weight loss, metatarsal stress fractures, amenorrhea, anemia, electrolyte disturbances Commonly coexist with depression
49
Bulimia nervosa
Binge eating +/- purging Body weight within normal range. Parotitis, enamel erosion, electrolyte distubrances, alkalossi, dorsa calluses Tx: SSRI
50
Signs of alcohol abuse
Intoxication: emotional lability, slurred speech, ataxia GGT, AST \> 2ALT Tx: Time Withdrawal: similar to other depressants - lifethreatening tremors, ezisures Tx: Benzodiazepines
51
signs of depressant abuse
Intoxication: Mood elevation, decrease anxiety, respiratory depression Withdrawal: Anxiety, tremor, sezisure, insomnia
52
Signs of Opioids abuse
Intoxication: CNS depression, nausea, vomiting, pinpoint pupils, seizsures Tx: Naloxone, nalterxone Withdrawal: Sweating, dilated pupils, piloerection, diarrhea Tx: symptomatic
53
Signs of Barbituates abuse
Intoxication: Marked respiratory depression Tx: Symptom management (assist respiration, increase BP) Withdrawal: Delirium, lifethreatening cardiovascular collapse
54
Signs of benzodiazepine abuse
Intoxication: Large safety margin - Ataxia, minor respiratory depression Tx: Flumazenil (compettive GABA antagonist)
55
Signs of Stimulant abuse
Mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias Withdrawal: post-use crash - depression, lethargy, weight gain, headaache
56
Signs of amphetamine abuse
Intoxication: Impaired judgement, pupillary dilation, prolonged wakefulness and attention, delucions, hallucinations, fever Withdrawal: Stomach cramps, hunger
57
Signs of cocaine abuse
Impaired judgement, pupillary dilation, angina, sudden cardiac death Tx: Benzodiazepine/haloperadol Withdrawal: Suicidal, hypersomnolence, malaise, severe psychological craving
58
Signs of caffeine abuse
Intoxication: Restlessnes, diuresis, muscle twitching, premature atrial/ventricular contractions
59
Signs of nicotine abuse
Intoxication: Restlessness Withdrawal: Irritability, anxiety, craving Tx: nicotine patch; bupropion/varenicline

USMLE (8 decks)

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