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Boards DF > psychiatry > Flashcards

psychiatry Flashcards

1
Q

learning in which a particular action is elicited bc it produces a punishment or reward

usually deals with VOLUNTARY responses

A

operant conditioning

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2
Q

discontinuation of reinforcement (positive or negative) eventually elimantes behavior. can occur in operant or classical conditioning

A

extinction

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3
Q

doctor projects feelings about formative or other important persons onto pt

A

countertransference

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4
Q

pt projects feelings about formative or other important persons onto physician

A

transference

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5
Q

expressing unacceptable feelings and thoughts through actions

tantrums

A

acting out

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6
Q

mother yells at her child bc her husband yelled at her

A

displacement

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7
Q

temporary drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress

A

dissociation

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8
Q

partially remaining at a more childish level of development (vs regression)

A

fixation

adults fixating on video games

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9
Q

expressing extremely positive thoughts of self and others while ignoring negative thoughts

A

idealization

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10
Q

modeling behavior after another person who is more powerful

abused child later becomes a child abuser

A

identification

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11
Q

describing murder in graphic detail with no emotional response

A

isolation of affect

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12
Q

disgruntled employee is repeatedly late to work

A

passive aggression

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13
Q

a man who wants to cheat on his wife accuses his wife of being unfaithful

A

projection

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14
Q

proclaiming logical resaons for actions actually performed for other reasons, usually to avoid self blame

after getting fired: guy says job wan’t importnant anyways

A

rationalization

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15
Q

a pt says that all nurses are cold but doctors are warm and friendly

A

splitting

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16
Q

mafia boss makes large donation to charity to make himself feel better about negative feelings

A

altruism

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17
Q

choosing to not worry about the big game until it is time to play

A

suppression

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18
Q

mature forms of defense

A

SASH

suppression, altruism, sublimation, humor

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19
Q

infant deprivation effects

A

weak, wordless, wanting (socially), and wary

deprivation for >6 months can lead to irreversible changes

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20
Q

vulnerable child syndrome

A

parents perceive child as especially susceptible to illness or injury
usually follows serious illness or life threatening event

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21
Q

ADHD

A

onset before age 12, multiple settings

continues into adulthood for 50% individuals

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22
Q

autism spectrum disorder associated with

A

increased head and brain size

must be in childhood

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23
Q

x linked dominant disorder in girls
symptoms at age 1-4
regression with loss of development, verbal abilities, intellectual disability, ataxia, stereotyped hand wringing

A

rett syndrome

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24
Q

conduct disorder

A

like antisocial personality but less than 18

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25
Q

enduring pattern of hostile, defiant behavior toward authroity figures in absence of serious violations of social norms

A

oppositional defiant disorder

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26
Q

common onset is 7-9
fear of separation from home or loss of attachment figure
factitious physical complaints to avoid going to or staying at school

treatment?

A

separation anxiety disorder

treat: CBT, play, therapy, family therapy

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27
Q

tourette syndrome

A

before 18, sudden tics that persists for over 1 YEAR

treat with psychoeducation, behavioral therapy

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28
Q

NTs alzheimers

A

increased glutamate

decreased Ach

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29
Q

NTs anxiety

A

increased norep

decreased, gaba and serotonin

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30
Q

depression NTs

A

decreased norep, serotonin, dopamine

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31
Q

huntingtons NTs

A

decreased GABA and ach

increased dopamine

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32
Q

parkinsons NTs

A

decreased dopamine

increased Ach

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33
Q

schizophrenia NTs

A

increased dopamine

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34
Q

orientation loss order

A

time, place, person

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35
Q

korsakoff syndrome

A

amnesia (anterograde over retro) caused by B1 deficiency

destruction mamillary bodies

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36
Q

inability to recall important info, usually subsequent to severe trauma or stress

A

dissociative amnesia

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37
Q

abrupt travel or wandering during period of disociative amnesia with traumatic circumstance

A

dissociative fugue

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38
Q

mutliple personalitiy disodered

A

dissociative identify disorder

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39
Q

delerium

eeg
drug to use
caused by

A

wax and wane level of consciousness
disorganized thinking, hallucinations
illusions, misperceptions, disturbance in sleep wake cycle
secondary to other illness often

diffuse slowing EEG

haloperidol as needed
can be caused by anticholinergics in elderly
reversible

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40
Q

dementia is or isn’t reversible

A

is not

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41
Q

hypnaGOgic hallucination

A

Occurs while GOing to sleep

Sometimes seen in narcolepsy

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42
Q

Hypnopompic hallucination

A

Occurs while waking from sleep
Pompous upon awakening
Sometimes seen in narcolepsy

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43
Q

Reversible causes of dementia

A

Hypothyroidism, depression, vitamin B12 deficiency, normal pressure hydrocephalus, neurosyphilis

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44
Q

In elderly people ____ and ____ may present like dementia (pseudodementia)
Screen for what

A

Depression and hypothyroidism

TSH and B12 levels

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45
Q

What would you see on brain image of schizophrenic

A

Venticulomegaly

46
Q

How long do symptoms have to be going on for it to be schizophrenia

Brief psychotic disorder?
Schizophreniform

A

6 months
Less than 1 month
1-6 months

47
Q

What is schizoaffective disorder (SAD)

A

Over 2 weeks of hallucinationts or delusions without major mood episode + periods of concurrent major mood episode with schizo symptoms

Both schizo without mani and shizo with mania

48
Q

Delusional disorder last for

A

Has to be false belief for 1 month or more

49
Q

Manic episode must last how long

A

At least 1 week

50
Q

Hypomanic episode

A

Like manic episode except mood disturbance is not sevrere enough to cause marked impairment in social and or occupational functioning or to necessitate hospitalization

No psychotic features

Last 4 consecutive days

51
Q

Bipolar 1

A

At least 1 mani episode +/- a hypomanic or depressive episode
Ian shameless

52
Q

Bipolar II

A

Presence of hypomanic and depressive episode

BP 2 HD

53
Q

Milder form of bipolar disorder lasting AT LEAST 2 years

Fluctuating btwn mild depression and hypomanic symptoms

A

Cyclothymic disoerder

I lived in CT for 2 years and was a little depressed and hypomanic

54
Q

Major depressive disorder

A

Episodes last 6-12 months
5 of 9 SIGECAPS for 2 weeks
Must have depressed mood or anhedonia

55
Q

Pts with depression typically have the following changes in sleep stages

A

Decreased slow wave sleep and REM latency

Increased REM early in sleep cycle and increased in total REM

Repeated nighttime awakenings
Early morning wakenings

56
Q

Depression with atypical features

A

Differs from classical forms of depression
Characterized by mood reactivity (being able to experience improved mood in response to positive events, albeit briefly)
Reversed vegetative symptoms (hypersomnia, hyperphagia)
Leaden parlysis (heavy arms and legs)

57
Q

Maternal postpartum blues occurs ____ days after delivary and resolves when

Treatment?

A

2-3 days after birth, 10 days resolves

Treat = supportive

58
Q

Postpartum depression

Treat?

A

10-15% incidencee rate
Depressed affect, anxiety, poor concentration

CBT and SSRI

59
Q

Characterized by mood congruent delusions, hallucinagtions, and thoughts of harming the baby or self. Risk factor is history of bipolar, or psychotic disorder, first preg, fam histroy, recent stop of psych meds

Treatment?

A

Pospartum psychosis

Treat with hospitalization and atypical antipsychotic then ECT if needed

60
Q

How long does grief usually last

A

Under 6 months

61
Q

What is ECT used for

Produces what

AE

A

Treatment refractory depression, depresssion with psychotic symptoms, and acutely suicidal pts

Produces grand mal seizure in anesthetized pt

Ae = diorientation, HA, anterograde/retrograde amnesia usually resolving in 6 months

Safe in pregnancy

62
Q

Risk factors for suicide completion

A

SAD PERSONS

Sex (male), age (young adult or elderly), depression, previous attempt, ethanol or drug use, rational thinking loss, sickness, organixed plan, no spouse or social support, stated future intent

63
Q

Suicide: ___ try more often _____ succeed more

What object

A

Women try more, men succeed more often

Guns

64
Q

Treatment panic disorder

A

CBT, SSRI and venlafaxine first line

Benzo in acute setting

65
Q

Exaggerated fear of open or enclosed places, using public tranit, being in line or crowds, or leaving home alone

Treat?

A

Agoraphobia

CBT, SSRI, MAO inhibitor

66
Q

Treatment of social anxiety disorder

A

CBT SSRI, venlafaxine

67
Q

Generalized anxiety disorder lasts how long

A

Anxiety lasting over 6 months

Restless, irritable, sleep disturbance, fatigue

68
Q

Treatment of GAD

A

CBT, SSRI, SNRI, buspirone, TCAs

Benzos are second line

69
Q

Adjustment disorder

A

Emotional symptoms causing impairment following an identifiable psychosocial stressor and lasting less than 6 MONTHS, over 6 months with chronic stressor

70
Q

Treatment for obsessive compulsive disorder

A

CBT, SSRI, clomipramine are first line

71
Q

Treatment for body dysmorphic disorder

A

CBT

72
Q

How long does disturbance of post traumatic stress disorder have to last

Treatment?

A

1 month

CBT, SSRI

73
Q

Acute stress disorder

Treatment

A

Lasts between 3 days and 1 month

CBT

74
Q

Pt consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain an external gain (avoiding work, obtaining compensation)
Complaints cease after gains

A

Malingering

75
Q

Pt consciously creates physical and or psychological symptoms in order to assume sick role and to get medical attention (internal gain)

A

Factitious disorders

76
Q

Chronic factitiious disorder with predominantly physical signs and symptoms characterized by history of multiple hospital admissions and willingness to undergo invaasive proceudres

A

Factitious disorder imposed on self (munchausen syndrome)

77
Q

Illness in a child or elderly pt is caused or fabricated by caregiver. Motivation is to assume sick role by another. Form of child/elder abuse

A

Factitious disorder imposed on antoerh

Munchausen syndrome by proxy

78
Q

Variety of bodily complaints like pain and fatigue lasting for months to years. Associated with excessive, persistent thoughts and anxiety about symptoms

A

Somatic symptom disorder

79
Q

Loss of sensory or motor function (paralysis, blindness, mutism) often following an acute stressor. Pt is aware of but sometimes indifferent toward symptoms, more common in females, adolescents and young adults

A

Conversion disorder (functional neurologic symptom disorder)

80
Q

Excessive preoccupation with acquiring or having a seroius illness, often despite medical evaluation and reassurance. Minimal somatic symptoms

A

Illness anxiety disorder

81
Q

False, nondelusional belief of being pregnant. May have signs and symptoms of pregnancy but is not pregnant

A

Pseudocyesis

82
Q

Cluster A personality disorders

A

Paranoid, schizoid, schizotypal

83
Q

Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

A

Schizotypal

84
Q

Voluntary social withdrawal, limited emotional expression, content with social isolation

A

Schizoid

85
Q

Pervassive distrust and suspiciousness, projection is the major defense mechanism

A

Paranoid

86
Q

Type B personality disorders

A

Antisocial, borderline, histrionic, narcissistic

87
Q

Unstable mood and interpersonal relationshiops, impulsivity, self-mutilation, suicidality, sense of emptiness, females > males

Treatment

A

Borderline

Dialectical behavorior therapy

88
Q

Excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance

A

Histrionic

89
Q

Cluster C personality disorders

A

Avoidant
Obsessive compulsive
Dependent

90
Q

Submissive and clingy, excessive need to be taken care of, low self confidence

A

Dependent

Pts in abusive relationships

91
Q

BMI and associations with with anorexia

Treatment and problem with treatment

A

BMI under 18.5
Decreased bone density, severe weight loss, metatarsal stress fractures, amenorrhea (due to loss of pulsatile GnRH) lanugo anemia, electrolyte disturbances

Treat: pyschotherapy nutritional rehab are first line 
Refeeding syndrome (increase insulin--> hypophosphatemia-->cardiac complications) with really malnourished pts
92
Q

Bulemia is binging and purging for how long

A

Weekly for at least 3 months
BMI may be normal
Russel sign which is dorsal hand calluses from induced vomiting

93
Q

Binge eating disorder increases risk for what

First line treatment

A

Diabetes

Psychotherapy like CBT
SSRI

94
Q

Desire to live as the opposite sex, often through surgery or hormone treatment

A

Transexualism

95
Q

Paraphilia, not gender dysphoria, wearing clothes of opposite sex

A

Transvestism

96
Q

Sleep terror disorder occurs what stage of sleep

A

N3 (no memory of arousal)

nightmares are in REM sleep

97
Q

Narcolepsy

Sleep wake cycle
Physiology
Associated with what symptoms

A

Disordered regulation of sleep-wake cycles
Excessive daytime sleepiness
Caused by hypocretin (orexin) production in lateral hypothalamus
Associated with: hypnagogic (just before sleep) or hypnopompic (just before awakening) hallucinations
Nocturnal and narcoleptic sleep eipsodes
Cataplexy (loss of all muscle tone following strong emotional stimulus like laughter)
Strong genetic component

98
Q

Treatment for narcolepsy

A

Daytime stimulants (amphetamines, modafinil) and nighttime sodium oxybate (GHB)

99
Q

Stage of change in overcoming substance addiction

A

PC PAMR

Precontemplation, Contemplation, Prep/determination, Action/willpower, Maintenance, Relapse

100
Q

Withdrawal: sweating, dilated pupils, piloerection, fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea

Treatment

A

Opioids

Methadone, buprenorphine

101
Q

Withdrawal: delirium, life threatening cardiovascular collapse

A

Barbs

102
Q

When does delirium tremens usually occur

A

2-4 days after last drink during alcohol withdrawal

Treatm with benzos

103
Q

High potency antipsychotics and side effects

A

Try to fly high
Trifluoperazine, fluphenazine, haloperidol

AE: (EPS)

104
Q

Low potency antipsychotics first gen and AE

A

Chlorpromazine, thioridazine
Anticholinergic, antihistamine, a1 blockade

C hlorpromazine = Corneal deposits
T hioridazine = reTinal deposits

105
Q

Onset of EPS with antipsychotics

A

ADAPT

Hours to days: Acute dystonia (muscle spasm, stiffness, ouclogyric crisis)

Days to months: akathisia (restlessness) and parkinsonism

Months to years = tardive dyskinesia (orofacial chorea)

106
Q

Side effects of lithium

A

LMNOP

Lithium side effects
Movement (tremor)
Nephrogenic DI
HypOthyroidism
Pregnancy problems

Ebstein anomaly in newborn
Thiazide use in lithium toxicity in bipolar pts

107
Q

Buspirone MOA

A

Stimulates 5 HT1A (buspir ONE)
Sarah on the anxiety bus

Takes 1-2 weeks to work
Does not interact with alcohol

108
Q

What is epstein anomaly. Found in what and what is it

A

Lithium use while pregnant

Tricuspid leaflets displace inferior
RV hypoplasia
Tricuspid regurgitation or stensosis
Patent foramen ovale

109
Q

Most common and fastest AE with lithium

A

Tremor

110
Q

First line treatment drug for anorexia

A

Fluoxetine

111
Q

First line treat binge eating disorder

A

Lis dexamphetamine

112
Q

Treatment for bulemia nervosa drug

A

Fluoxitine

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