Psychiatry

Question 1

What type of defense is throwing a tantrum?

Answer 1

Acting out

Expressing unacceptable feelings and thoughts through actions

Question 2

What type of defense is temporary, drastic changes in personality, memory, consciousness, or motor behavior?

Answer 2

Dissociation

Question 3

What age is associated with ADHD

Answer 3

onset before age 12

Question 4

What is coprolalia?

Answer 4

Involuntary obscene speech- assoc with Tourettes

Question 5

What is the treatment for tourettes?

Answer 5

antipsychotics, behavioral therapy

Question 6

When is separation anxiety commonly seen? What is the treatement?

Answer 6

7-9 y; SSRIs

Question 7

What presents as loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing? Commonly presents in girls

Answer 7

Rett syndrome

X-linked (males die in utero)

Question 8

What neurotransmitter changes are associated with depression?

Answer 8

decr norepinephrine
decr 5-HT
decr dopamine

Question 9

What neurotransmitter changes are associated with anxiety?

Answer 9

incr norepinephrine
decr GABA
decr 5-HT

Question 10

What neurotransmitter changes are associated with schizophrenia?

Answer 10

Incr dopamine

Question 11

What is korsakoff amnesia?

Answer 11

anterograde amnesia, assoc with thiamine deficiency, damage to mamillary bodies; seen in alcoholics

Question 12

What are hypnagogic and hypnopompic hallucinations?

Answer 12

Hypnogogic- occur when going to sleep

Hypnopopmic- occur when waking form sleep

Question 13

What are EEG findings for delirium vs dementia?

Answer 13

delirium- EEG abnormal

dementia- EEG normal

Question 14

What is a distorted perception of reality characterized by delusions, hallucinations and/or disorganized thinking?

Answer 14

Psychosis

Question 15

What are the causes of visual, auditory, oflactor, and tactile hallucinations?

Answer 15

Visual- medical illness
Auditory- psychiatric illness
Olfactory- psychomotor epilepsy, brain tumor
Tactile- alcohol withdrawal, cocaine

Question 16

How is delusional disorder characterized?

Answer 16

fixed, persistent, untrue belief system, lasting >1mo

Question 17

Compare schizphrenia, brief psychotic disorder, schizophreniform disorder, schizoaffective disorder?

Answer 17

schizophrenia: >6mo, 2 of (delusion, hallucination, disorganized speech, disorganized behavior, neg sx)
breif psychotic: <1mo
schizophreniform: 1-6 mo
schizoaffective: at least 2 weeks; psychotic sx with major depressive/manic

Question 18

Compare bipolar I vs bipolar II

Answer 18

bipolar I: at least 1 manic episode with or without hypomanic or depressive episode
bipolar II: presence of a hypomanic and depressive episode

Question 19

Treatment of bipolar disorder

Answer 19

mood stabilizers

atypical antipychotics

Question 20

cylcothymic disorder

Answer 20

dysthymia and hypomania

milder form of bipolar disorder lasting at least 2 years

Question 21

Characterized by mood reactivity, reversed vegetative symptoms, leaden paralysis, long-standing interpersonal rejection sensitivity

Answer 21

atypical depression

Question 22

what sleep changes are associated with depression?

Answer 22

decr slow wave sleep
dcr REM latency
incr total REM
repeated/early morning awakenings

Question 23

What is the treatment of social anxiety disorder?

Answer 23

SSRI

Question 24

What are the treatments for OCD?

Answer 24

SSRI, clomipramine

Question 25

Compare post-traumatic stress disorder vs acute stress disorder?

Answer 25

PTSD: >1mo | acute stress disorder: 3 days- 1mo

Question 26

Describe Munchausen syndrome

Answer 26

chronic factitious disorder; hx of multiple hospital admissions, willingness to receive invasive procedures

Question 27

Compare malingering vs factitious disorder

Answer 27

Malingering- faking or exaggerating for secondary gain (eg avoid work, compensation); complaints often cease after gain Factitious- consciously creats sx for attention (primary gain)

Question 28

schizoid vs schizotypal vs paranoid personality disorder

Answer 28

schizoid- voluntary social withdrawal, limited emotional expression paranoid- pervasive distrust and suspiciousness; projection common schizotypal: eccentric appearance, magical thinking, interpersonal awkwardness

Question 29

Cluster of personality disorders associated with odd or eccentric; inability to develop meaningful social relationships, no psychosis

Answer 29

Cluster A

Question 30

Cluster of personality disorders assocaited with dramatic, emotional, or erratic behaviors

Answer 30

Cluster B

Question 31

Cluster of personality disorder associated with anxiousness or fearfullness

Answer 31

Cluster C

Question 32

Personality disorder: | excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance

Answer 32

Histrionic personality disorder

Question 33

Personality disorder: | grandiosity, sense of entitlement, lack of empathy, reacts to criticism with rage

Answer 33

narcissistic

Question 34

Personality disorder: | unstable mood and interpersonal relationships, impulsiveness, self-mutilation, boredom, sense of emptiness

Answer 34

borderline

Question 35

Compare sleep terror disorder vs nightmares?

Answer 35

sleep terror: occurs during slow-wave sleep | nightmare: during REM

Question 36

What is the pathophysiology and treatment of narcolepsy?

Answer 36

pathophysiology: decr orexin production in lateral hypothalamus Treat: daytime stimulants (amphetamines, modafinil); nighttime sodium oxybate

Question 37

Intoxication associated with low safety margin and marked respiratory depression

Answer 37

barbiturates

Question 38

Withdrawal: delirium, life-threatening cardiovascular collapse

Answer 38

barbiturates

Question 39

Intoxication: ataxia, minor resp depression

Answer 39

benzodiazepines

Question 40

What serum test and LFTs indicate alcohol use?

Answer 40

GGT- sensitive indicator of alcohol use | AST 2x ALT

Question 41

Intoxication: euphoria, respiratory and CNS depression, decr gag reflex, pupillary constriction, seizures

Answer 41

opioids

Question 42

Intoxication: euphoria, grandiosity, pupil dilation, hypertension, anorexia, paranoia, fever

Answer 42

amphetamines

Question 43

intoxication: impaired judgement, pupillary dilation, halluciantion, angina, paranoid ideations

Answer 43

cocaine

Question 44

intoxication: restlessness, diuresis, muscle twitching

Answer 44

caffeine

Question 45

intoxication: belligerence, impulsiveness, fever, psychomotor agitation, analgesia, vertical and horizontal nystagmus, psychosis, homicidality

Answer 45

PCP

Question 46

intoxication: perceptual distortion, depersonalization, psychosis, paranoia

Answer 46

LSD

Question 47

intoxication: euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, dry mouth

Answer 47

marijuana

Question 48

Dronabinol

Answer 48

prescription form of marijuana

Question 49

Methadone

Answer 49

long-acting oral opiate; used for long-term maintenance

Question 50

naloxone + buprenorphine

Answer 50

partial agonist; long acting with fewer sx of withdrawal

Question 51

naltrexone

Answer 51

long acting antagonist; prevent relapse once detoxified

Question 52

What are the treatments for alcoholism?

Answer 52

disulfram (neg effects when take) | naltrexone

Question 53

What is the treatment for DTs?

Answer 53

benzodiazepines