Psychiatry Flashcards
Positive vs negativ reinforcement vs punishment?
Positive = Reward produces action (press button get food) Negative= Target behavior removes averse stimulus (press button Loud noise off) punishment= Repeated averse stimulus to stop unwanted behavior
Transferance vs countertransferance?
Transferance= Patient projects someone onto Doctor Countertransferance= Doctor projects onto pts **Counter = doCtor
Avoided feelings and ideas are transferred to neutral person or object?
Displacement
Mother yells @ child cause husband yelled at her
Partially remaining at more childish level of development?
Fixation
Men fixating on sports
Unacceptable impulse is attributed to external source?
Projection
I want to cheat so i think my wife is cheating
Unwanted feelings or thoughts are replaced by the opposite ?
Reaction formation
Pt mad at the doctor for making her wait complements his shoes.
Going back to earlier modes of dealing with the world?
Regression
“under stress, illness, or punishment a previously toilet trained kid wets the bed”
Involuntary withholding of ideas or feelings from conscious awareness?
Repression
“Not remembering traumatic event”
Replacing unacceptable wishes with a course of action similar to the wish that does NOT conflict with values?
Sublimation
“i mad @ father so i play hard sport”
Voluntary withholding of ideas or feelings from conscious awareness?
Suppression
“Choosing to not think about USMLE step 1”
Conduct disorder vs Oppositional defiant disorder?
Conduct = violating rights of other & breaking rules
ODD= hostile, defiant toward authority but NOT violating social rules/ or others rights
**White boys vs Kurds
What is the treatment for a recurrent nonrhythmic stereotyped motor and vocal tic persistent for >1yr?
Tourettes = Haloperidol (antipsychotics)
child with poor social interactions, language difficulties, and repetitive behavior?
Autistic
**Asperger= Normal intellect and language
X-linked disorder that causes girls from 1-4 yo to regress and lose all developed abilities (language, mental retardation, ataxia) stereotype hand wringing?
Rhett syndrome (males die in utero) **Child disintegrative disorder= Male version
Neurotransmitter changes associated with: Anxiety Depression Alzheimers Huntingtons Schizophrenia Parkinsons
Anxiety = Inc NE + Dec GABA/5HT Depression= dec NE/ DA / 5HT Alzh = Dec ACh Hunt = dec GABA/ ACh + inc DA Schizo = inc DA PD = dec DA + dec ACh/ 5HT
Dementia vs Delirium vs pseudodementia?
Delirium= Acute, abnormal consciousness, altered mental status, abnormal EEG, Reversible Dementia= Gradual, normal consciousness, memory loss, Irreversible, EEG normal Pseudodementia= Depression in elderly presenting as dementia
Defining characteristics of: Brief psychotic do Schizophreniform Schizophrenia Schizoaffective
Brief = Stress induced, 6mo, +/- symptoms, Inc DA/ dec dendrites Schizoaffective= psychotic + unstable mood (@ least 2wks of stable mood)
5 subtypes of schizophrenia: Paranoid Disorganized Catatonic Undifferentiated Residual
Paranoid= delusions Disorganized = weird behavior/speech/hygiene Catatonic= Automatisms Undifferentiated = ALL of them Residual = negative symptoms
Dissociative disorders:
Identity
depersonalization
fugue
identity = Multiple personality depersonalization = detachment from body (out looking in) fugue = Abrupt change in geography, inability to recall past/ has new identity
Manic disorder characteristics?
> 1 wk Talkative Racing thoughts and ideas NO need for sleep Buy shit Inflated self-esteem (smartest women in the world)
Bipolar disorders ? 1 & 2
Bipolar 1 = @ least 1 manic episode
Bipolar 2= hypomania + depression
*Anti-depressant meds can bring out Mania
Pt with 3 yr history mild depression and mild mania?
Cyclothymic = >2yrs (dysthymia + hypomania)
Characteristics of major depressive disorder?
6-12 months
SIG E CAPS
What are characteristics of Atypical depression? Rx?
Mood reactivity = improve with + events Hypersomnia Wght gain Leaden paralysis (heavy arms/ legs) Rejection sensitivity Rx: MAOi + (normal SSRIs)
Electroconvulsive therapy is the treatment of choice for depression in what scenarios?
MDD that is refractory to other treatments
Pregnant women with MDD
Immediate action for MDD in suicidal pt
What are risk factors for going through suicide?
Sex= male Age = teenagers/ elderly Depression Previous attempt Ethanol Sickness (medical condition) No spouse Organized plan No social support
Panic disorder characteristic and treatment?
Intense fear/ discomfort peaking @ 10min
Associated w/ Agoraphobia
Rx: SSRIs, venlafaxine
What is the treatment for exaggerated fear of embarrassment in social situations?
Social phobia
Rx: Beta blocker or SSRIs
pt with recurring intrusive thoughts that must be acted upon to relieve. Intrusive thoughts are not controlled and are Inconsistent with pts beliefs. What is the treatment for this condition?
OCD ==> Not “OC personality disorder”
Rx: SSRIs, Clomipramine (TCA)
Difference btwn PTSD and acute stress disorder?
Acute stress disorder = 2days - 1 mo
PTSD= >1 month in duration
What is the treatment of choice of generalized anxiety disorder?
GAD > 6months => ass w. sleep disturbance, fatigue, GI
Adjustment do=> <6months
Rx: SSRIs or SNRIs
Pt that consciously fakes disorders/ complaints to get out of work or obtain drugs and then does not follow instruction nor take meds?
Malingering
Pt consciously creates symptoms to assume sick role in order to gain attention?
Factitious disorder
- Munchausen= severe/ long hx of hopitalizations
- by proxy = do it to child/ elderly
21 yo female with many symptoms in many organs that Do not seem to have physical cause and are not intentionally created?
Somatization
Conversion disorder is?
Sudden loss loss of sensory or motor function after acute stressful event
Schizoid vs Schizotypal?
Schizoid= distant, not social, no desire for others Schizotypal = Magical thinking, awkward, with no psychosis
Pt with very unstable mood, impulsive, self-mutailation, and all or nothing attitude?
Borderline
Pt that is very sensitive to rejection and but desires relationships?
Avoidant
Stages of overcoming substance abuse?
Pre-conteplation Contemplation Preparation/ determination Action Maintenance Relapse
Sign and symptoms of Opioid withdrawal?
Pilo-erection fever rhinorhea diarrhea Rx: Methadone, Buprenorphine
What are symptoms of Bezo withdrawal?
Depression
Rebound anxiety
SEIZURES
What are SS of cocaine intoxication? Rx?
Mydriasis Hallucinations (tactile) paranoid Angina=> sudden cardiac death Rx: Benzos
SS of PCP intoxication and withdrawal?
Intoxication= belligerent, Vertical/horizontal nystagmus, Homicidality
Rx: Benzo, Haloperidol
Withdrawal= Depression, anergia, restless
Alcoholic 2-5 days after his last alcoholic drink will experience?
DT= Rx with BENZO
ANS instability
Psychotic
Confusion
