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Kaplan Shelf prep > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Cluster A personality disorders include :

A

Paranoid
Schizoid
Schizotypal

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2
Q

Cluster B personality disorders include:

A

Histronic
Borderline
Narcissistic
Antisocial

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3
Q

Cluster C personality disorders include:

A

Avoidant
Obsessive-compulsive
Dependent

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4
Q

What substances can produce psychosis

A

Cocaine, heroin, marijuana, LSD, K2

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5
Q

What if the patient is only psychotic when he is sad?

A

Major depression with psychotic features

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6
Q

Excessive anxiety and worry about most things, most days for more than 6 months accompanied by restlessness and concentration difficulties. Diagnosis

A

Generalized anxiety disorder

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7
Q

Excessive anxiety and worry about most things, most days for more than 6 months accompanied by restlessness and concentration difficulties. Treatment?

A

Psychotherapy
SSRIs
Venlafaxine and buspirone

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8
Q

GAD + severe and explosive anxiety. Treatment?

A

Lorazepam

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9
Q

4 Autonomic hyperactivity symptoms seen in panic attack

A 
Shortness of breath
Trembling 
Dissociative symptoms
Paresthesias
Diaphoresis 
Palpitations
Chills
Nausea
Dizziness 
Fear of dying
Chest pain
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10
Q

Three attacks in 3 week period and worry about more. Diagnosis?

A

Panic disorder

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11
Q

Can induce panic attack by ____, ______, ______, ____, and _____

A 
Hyperventilation
Carbon dioxide
Yohimbine
Sodium lactate
Epinephrine
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12
Q

Acute treatment for panic attack

A

Benzodiazepines: Alprazolam, lorazepam, clonazepam and diazepam

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13
Q

Maintenance treatment for the prevention of the next panic attack…..

A

SSRI

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14
Q

Duration to keep on medication in panic disorder

A

6-12months

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15
Q

Treatment for performance anxiety and when should it be administered

A

Betablocker- atenolol or propranolol

30-60 mins before performance

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16
Q

Intrusive thoughts that increases anxiety+ time consuming ritual that reduces anxiety. Diagnosis

A

Obsessive-Compulsive disorder.

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17
Q

Intrusive thoughts that increases anxiety+ time consuming ritual that reduces anxiety. Managements

A

SSRI
Supportive therapy
Exposure
Motivational interviewing

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18
Q

Persistent difficulties with parting with one’s possessions regardless of their value. Diagnosis?

A

Hoarding disorder

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19
Q

Persistent difficulties with parting with one’s possessions regardless of their value. Treatment?

A

SSRI

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20
Q

Believes body part is abnormal, misshapen or defective when it is normal in appearance. Diagnosis?

A

Body dysmorphic disorder

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21
Q

After traumatic exposure, symptoms last for >2days - <1 month. Diagnosis?

A

Acute stress disorder

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22
Q

After traumatic exposure, symptoms last for > 1 month

A

Post traumatic stress disorder

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23
Q

What hormones are increased in ASD/PTSD?

A

Norepinephrine and Epinephrine

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24
Q

What hormones are decreased in ASD/PTSD?

A

Cortisol

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25
Q

First line treatment of ASD/PTSD

A

Paroxetine and sertraline

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26
Q

__________ is used to reduce the incidence of nightmares

A

Prazosin

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27
Q

Identifiable stressor and symptoms must occur within 3 months of onset lasting < 6 months after end of stressor

A

Adjustment disorder

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28
Q

Person attributes his or her own wishes, desires, thoughts or emotions to someone else. Defense mechanism?

A

Projection

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29
Q

Not allowing reality to penetrate. Asserting that so e clear features of external reality just isn’t true. Defense mechanism?

A

Denial

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30
Q

People and things in the world are perceived as all bad or all good. Defense mechanism?
Seen in what personality disorder

A

Splitting

Borderline

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31
Q

Temporary or transient block in thinking or an inability to remember. Defense mechanism?

A

Blocking

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32
Q

Returning to an earlier stage of development. Defense mechanism?

A

Regression

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33
Q

Psychic derivatives are converted into bodily symptoms. Feelings are manifest as physical symptoms rather than psychological distress. Defense mechanism?

A

Somatization

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34
Q

A resident dresses and acts like the attending physician. Defense mechanism?

A

Introjection/ identification

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35
Q

An attending physician scolds a resident who later expresses his anger by yelling at a medical student. Defense mechanism?

A

Displacement

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36
Q

An idea or feeling is eliminated from consciousness. You forget, and then forget that you forgot. Defense mechanism?

A

Repression

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37
Q

Reality is accepted, but without the expected human emotional response to that reality. Facts without feelings. Defense mechanism?

A

Isolation of affect

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38
Q

Affect us stripped away and replaced by an excessive use of intellectual processes. Cognition replaces affect. Defense mechanism?

A

Intellectualization

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39
Q

Temper tantrum is thrown by an abandoned child to cover the depression he really feels.
Massive emotional or behavioral outburst to cover up underlying feeling or idea.
Defense mechanism?

A

Acting out

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40
Q

Rational explanation are used to justify attitudes, beliefs, or behaviors that are unacceptable. Defense mechanism?

A

Rationalization

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41
Q

An unacceptable impulse is transformed into its opposite. Defense mechanism?

A

Reaction formation

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42
Q

Acting out the reverse of unacceptable behavior. Repairs or fixed the impulse. Defense mechanism?

A

Undoing

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43
Q

Non-performance or poor performance after setting up the expectation of performance. Defense mechanism?

A

Passive-aggressive

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44
Q

Separates self from one’s experience.
The facts of the events are accepted, but the self is protected from the full impact of the experience.
Defense mechanism?

A

Dissociation

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45
Q

Permits the overt expression of feelings and thoughts without personal discomfort.
Laughter covers the pain and anxiety.
Defense mechanism?

A

Humor

46
Q

Impulse- gratification is achieved by channeling the unacceptable or unattainable impulse into a socially acceptable direction.

Defense mechanism?

A

Sublimation

47
Q

Conscious decision to postpone attention to an impulse or conflict.
Forget, but remember that you forgot.

Defense mechanism?

A

Suppression

48
Q

The patient unconsciously transfers thoughts and feelings about a parent or significant other person onto his physician.
Diagnosis?

A

Transference

49
Q

The physician unconsciously transfers thoughts and feelings about a parent or significant other person onto his patient.

A

Counter transference

50
Q

Problems in social interaction, poor eye contact, stereotyped or repetitive movements seen in a child less than 3 years. Diagnosis?

A

Autism spectrum disorder

51
Q

Autism spectrum disorders is linked to chromosome ___ and _____

A

Chromosome 15&11

52
Q

Risk factors of autism spectrum disorder

A

Prenatal or perinatal injury eg, rubella in first trimester

Mother has allergies, asthma or psoriasis during pregnancy

53
Q

Treatment of Autism

A

Applied behavioral analysis

Behavioral techniques

Risperidone and aripiprazole

54
Q

Inattention, short attention span or hyperactivity for more than 6 months in a child less than 7 years

A

Attention deficit hyperactivity disorder

55
Q

First line treatment of ADHD

A

Methylphenidate and dextroamphetamine

56
Q

Second line treatment of ADHD and class of medication?

A

Atomoxetine ( norepinephrine reuptake inhibitor)

57
Q

What can be used to enhance cognition and attention in the prefrontal cortex and reduce distractibility?

A

Clonidine and guanfacine

58
Q

Psychotic symptoms > 1 day and < 30 days.

Diagnosis?

A

Brief psychotic disorder

59
Q

Psychotic symptoms > 1 month to < 6 months.

Diagnosis?

A

Schizophreniform

60
Q

Psychotic symptoms >6 months.

Diagnosis?

A

Schizophrenia

61
Q

Diagnostic criteria symptoms for schizophrenia and the like

A 
Delusions 
Hallucinations 
Disorganized speech 
Abnormal psychomotor activity 
Negative symptoms
62
Q

Negativism, echopraxia, automatic obedience. Rigidity of posture.
Diagnosis?

A

Catatonia

63
Q

Predictors for Good prognosis of schizophrenia

A
  • paranoid symptoms
  • quick onset
  • late onset (female)
  • positive symptoms
  • no family history of schizophrenia
  • family history of mood disorder
  • absence of structural brain abnormalities
64
Q

Brain structural and anatomic abnormalities seen in schizophrenia

A
  • Large ventricular size and ventricular brain ratio
  • cortical atrophy
  • smaller frontal lobes
  • atrophy of temporal lobe
65
Q

Which antipsychotic is safer for use in pregnant patients and for bipolar depression?

A

Lurasidone

66
Q

Most effective antipsychotic?

A

Clozapine

67
Q

High risk of agranulocytosis; monitor CBC on regular basis?

A

Clozapine

68
Q

Increased risk of prolongation of QT interval; avoid in conduction defects?

A

Ziprasidone

69
Q

Antipsychotic that is more sedating, orthostasis, cataract surgery? Less EPS

A

Quetiepine

70
Q

Hours to days after antipsychotic:

  • muscle spasms
  • torticollis
  • laryngeal spasm
  • oculogyric crisis

Diagnosis?

A

Acute dystonic reaction

71
Q

Hours to days after antipsychotic:

  • muscle spasms
  • torticollis
  • laryngeal spasm
  • oculogyric crisis

Treatment?

A

Benztropine
Trihexyphenidyl
Diphenhydramine

72
Q

Generalized restlessness
Pacing
Rocking
Inability to relax after a few weeks after antipsychotic use

Diagnosis?

A

Akathisia

73
Q

Generalized restlessness
Pacing
Rocking
Inability to relax after a few weeks after antipsychotic use

Treatment?

A

Reduce dose
Beta blockers
Switch to atypical

74
Q

Abnormal involuntary movements of head, limb, trunk, perioral, most common

Diagnosis?

A

Tardive dyskinesia

75
Q

Abnormal involuntary movements of head, limb, trunk, perioral, most common

Treatment?

A

Valbenazine, deutetrabenazine

Clozapine has least risk

76
Q

Muscular rigidity, fever, autonomic changes, agitation on antipsychotics?

Diagnosis ?

A

Neuroleptic malignant syndrome

77
Q

Muscular rigidity, fever, autonomic changes, agitation on antipsychotics?

Treatment?

A

Dantrolene or bromocriptine

78
Q

Mood disorder present with at least a 2 wk course of symptoms include a change from the previous level of functioning.

A

Major depressive disorder

79
Q

SIGECAPS symptoms ?

A 
Sleep
Interest
Guilt
Energy 
Concentration 
Appetite 
Psychomotor retardation/agitation 
Suicidal ideation
80
Q

What is the single most effective treatment for depression?

A

Electroconvulsive therapy

81
Q

Depressed mood on most days for greater than 2 years. Functional but at a suboptimal level.

Diagnosis and treatment?

A

Persistent depressive disorder

SSRI/SNRI

82
Q

Depression with seasonal pattern.

Diagnosis?

Treatment?

A

Seasonal affective disorder

Bright light therapy

83
Q

After death of loved one + SIGECAP symptoms

Treatment?

A

SSRI / SNRI

84
Q

History of Symptoms of major depression + symptoms of mania / symptoms of hypomania

A

Bipolar disorder

85
Q

DIGFAST of manic symptoms

A 
Distractibility
Insomnia / impulsive behavior 
Grandiosity 
Flight of ideas/thoughts
Agitation 
Speech (pressured)
Thoughtlessness ( risk taking behavior)
86
Q

What is the treatment for an acute manic episode seen in the emergency room?

A

Lithium
Valproic acid
Olanzapine

87
Q

First line maintenance therapy for bipolar disorder?

A

Lithium

88
Q

What should be monitored with the use of lithium?

A

Kidney function

Thyroid function

89
Q

Therapy for bipolar depression

A

Lamotrigine, Lurasidone

90
Q

Presence of hypomania and mild depression for more than 2 years.

Diagnosis?

A

Cyclothymia

91
Q

Compulsive, rapid ingestion of food followed by compensatory behavior such as self-induced vomiting, use of laxatives or exercise.

Diagnosis?

A

Bulimia nervosa

92
Q

Compulsive, rapid ingestion of food followed by compensatory behavior such as self-induced vomiting, use of laxatives or exercise.

Treatment?

A

SSRIs
Insight
Group therapy

93
Q

Hypotension, bradycardia, lanugo hair, underweight and edema seen in a teenage girl with fear of being fat.

Diagnosis?

A

Anorexia nervosa

94
Q

Hypotension, bradycardia, lanugo hair, underweight and edema seen in a teenage girl with fear of being fat.

Most common cause of death?

A

Arrhythmia

95
Q

______ are the most likely method by which either men or women commit suicide

A

Firearms

96
Q

What is the most commonly abused substance in the US?

A

Alcohol

97
Q

Seizures in alcohol withdrawal is generally seen when

A

24-48 hours

98
Q

Altered mental status, hallucinations (tactile at times), autonomic instability 48-72 after last drink.

Diagnosis?

A

Delirium tremens

99
Q

Most successful alcohol treatment?

A

Alcoholic Anonymous

100
Q

Pinpoint pupils, sedation, constipation, bradycardia, respiratory depression.

Substance intoxication?

A

Opioids

101
Q

Pinpoint pupils, sedation, constipation, bradycardia, respiratory depression.

Intoxication treatment?

A

Naloxone

102
Q

Medications for opiate use disorder?

A

Methadone- mu agonist

Naltrexone- opiate antagonist

Buprenorphine- partial mu agonist

103
Q

Pupillary dilation, restlessness, anxiety, confusion with risk of arrhythmia, seizures, coma

Substance intoxication

A

Stimulants

104
Q

Treatment of withdrawal from tobacco

A

Bupropion

Varenicline

Replacement- gum, patch

105
Q

Psychosis, illusions, hyperacusis, sensitivity of touch, taste/smell altered

Substance intoxication?

A

MDMA ( XTC or Ecstacy)

106
Q

Insomnia, irritability, anxiety, poor appetite, depression, physical discomfort.

Substance withdrawal?

A

Cannabis

107
Q

Severe agitation, dissociative symptoms, paranoid delusions, hallucinations, violent with decreased awareness of pain; ataxia, dysarthria, vertical and horizontal nystagmus.

Substance Intoxication ?

A

Phencyclidine - Angel dust

108
Q

Severe agitation, dissociative symptoms, paranoid delusions, hallucinations, violent with decreased awareness of pain; ataxia, dysarthria, vertical and horizontal nystagmus.

Treatment?

A

Antipsychotics for agitation or benzodiazepines

Low stimulation environment

109
Q

A patient with bipolar disorder presents to the ER with slurred speech, tremors and ataxia.

A

Lithium toxicity

110
Q

Therapeutic level of lithium?

A

0.5-1.5

111
Q

Treatment or TCA intoxication

A

Stop TCA

Sodium bicarbonate, activated charcoal

Kaplan Shelf prep (11 decks)

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