Psychiatry Flashcards by Azad Karim

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

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Transferance vs countertransferance?

Transferance= Patient projects someone onto Doctor 
Countertransferance= Doctor projects onto pts
**Counter = doCtor

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Avoided feelings and ideas are transferred to neutral person or object?

Displacement

Mother yells @ child cause husband yelled at her

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Partially remaining at more childish level of development?

Fixation

Men fixating on sports

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Unacceptable impulse is attributed to external source?

Projection

I want to cheat so i think my wife is cheating

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Unwanted feelings or thoughts are replaced by the opposite ?

Reaction formation

Pt mad at the doctor for making her wait complements his shoes.

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Going back to earlier modes of dealing with the world?

Regression

“under stress, illness, or punishment a previously toilet trained kid wets the bed”

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Involuntary withholding of ideas or feelings from conscious awareness?

Repression

“Not remembering traumatic event”

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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”

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Voluntary withholding of ideas or feelings from conscious awareness?

Suppression

“Choosing to not think about USMLE step 1”

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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

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What is the treatment for a recurrent nonrhythmic stereotyped motor and vocal tic persistent for >1yr?

Tourettes = Haloperidol (antipsychotics)

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child with poor social interactions, language difficulties, and repetitive behavior?

Autistic

**Asperger= Normal intellect and language

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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

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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

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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

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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)

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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