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USMLE > Psychiatry > Flashcards

Psychiatry Flashcards

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USMLE® Step 1 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
Q

Separation anxiety disorder

A

Fear of separation (common onset 7-9 yrs old)

May lead to factitious complaints to avoid school

26
Q

Autistic Disorder

A

Severe language impairment and poor social interactions. Greater focus on objects than people. Usually with below normal intelligence

Tx: Behavior and supportive therapy

27
Q

Asperger’s

A

All absorbing interest, repetitive behavior and problems with social interaction. Usually normal intelligence, no language impairment

28
Q

Rett’s disorder

A

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
Q

Childhood disintegrative disorder

A

Regression in multiple areas after at least 2 yrs -> language, social, bowel, bladder skills

More common in boys

30
Q

Causes of loss in orientation (time/place/person)

A

Alcohol, drugs, electrolyte imbalance, head truama, hypoglycemia, nutritional deficiency

31
Q

Delirium

A

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
Q

Dementia

A

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
Q

Hallucinations

A

Percentions in absence of external stimuli

34
Q

Illusions

A

Misperception of actual external stimuli

35
Q

Delusions

A

False belief not shared with others (CIA is spying on you)

36
Q

Loose association

A

Disorder in form of thought (way they are tied together)

37
Q

Paranoid

A

Pervasive distrust and suspiciousness

Projection is a major defense mechanism

38
Q

Schizoid

A

“Schizoid, avoid”

Content with social isolation

39
Q

Schizotypal

A

“Schizotypal dresses like a pickle”

eccentic appearance, odd/magical thinking, interpersonal awkwardness

40
Q

Antisocial

A

Criminal - disregard for and violation of rights of others (conduct disorder <18)

41
Q

Borderline

A

Unstable mood, self-mutilation, boredom, sense of emptiness

Splitting is a defense mechanism

42
Q

Histrionic

A

Excessive emotionality, attention seeking, sexually provocative

43
Q

Narcissitic

A

Sesne of entitlement, demands best, respond to criticism with rage

44
Q

Avoidant

A

Hypersensitive to rejection socially timid, wants relationships

45
Q

Obsessive-compulsive

A

Wants order, perfection

Disorder - don’t like what they are doing

Trait - not aware they are doing it

46
Q

Dependent

A

Submissive/clingy, low self-confidence

47
Q

Schizoid vs schizotypal vs schizophrenic vs schizoaffective

A

Schzoid - avoids people

Schzotypal - schzoid + odd thinking

Schizophrenic - greater odd thinking than schzotypal

Schizoaffective - schzophrenic + biopolar/depressive disorder

48
Q

Anorexia nervosa

A

Excessive dieting +/- purging, body image distortion

Severe weight loss, metatarsal stress fractures, amenorrhea, anemia, electrolyte disturbances

Commonly coexist with depression

49
Q

Bulimia nervosa

A

Binge eating +/- purging

Body weight within normal range. Parotitis, enamel erosion, electrolyte distubrances, alkalossi, dorsa calluses

Tx: SSRI

50
Q

Signs of alcohol abuse

A

Intoxication: emotional lability, slurred speech, ataxia
GGT, AST > 2ALT
Tx: Time

Withdrawal: similar to other depressants - lifethreatening tremors, ezisures
Tx: Benzodiazepines

51
Q

signs of depressant abuse

A

Intoxication: Mood elevation, decrease anxiety, respiratory depression

Withdrawal: Anxiety, tremor, sezisure, insomnia

52
Q

Signs of Opioids abuse

A

Intoxication: CNS depression, nausea, vomiting, pinpoint pupils, seizsures
Tx: Naloxone, nalterxone

Withdrawal: Sweating, dilated pupils, piloerection, diarrhea
Tx: symptomatic

53
Q

Signs of Barbituates abuse

A

Intoxication: Marked respiratory depression
Tx: Symptom management (assist respiration, increase BP)

Withdrawal: Delirium, lifethreatening cardiovascular collapse

54
Q

Signs of benzodiazepine abuse

A

Intoxication: Large safety margin - Ataxia, minor respiratory depression
Tx: Flumazenil (compettive GABA antagonist)

55
Q

Signs of Stimulant abuse

A

Mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias

Withdrawal: post-use crash - depression, lethargy, weight gain, headaache

56
Q

Signs of amphetamine abuse

A

Intoxication: Impaired judgement, pupillary dilation, prolonged wakefulness and attention, delucions, hallucinations, fever

Withdrawal: Stomach cramps, hunger

57
Q

Signs of cocaine abuse

A

Impaired judgement, pupillary dilation, angina, sudden cardiac death
Tx: Benzodiazepine/haloperadol

Withdrawal: Suicidal, hypersomnolence, malaise, severe psychological craving

58
Q

Signs of caffeine abuse

A

Intoxication: Restlessnes, diuresis, muscle twitching, premature atrial/ventricular contractions

59
Q

Signs of nicotine abuse

A

Intoxication: Restlessness

Withdrawal: Irritability, anxiety, craving
Tx: nicotine patch; bupropion/varenicline

USMLE (8 decks)

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