psychiatry (F.A.)

Question 1

Schitzophrenia vs Schitzoaffective vs Bipolar Disorder Type I

Answer 1

• schitzophrenia= mania but NO MOOD disorder (ex: “mood is terrific”
• schitzoaffective= mania AND MOOD disorder (but has the be one instance he had MANIA without MOOD disorder)
• bipolar disorder type I- mania and mood must ALWAYS go together

Question 2

Ego defense: fixation

Answer 2

partially remaining at a more childish level

Question 3

Ego Defense: Idealization

Answer 3

thinking of yourself and everyone extremely positively.

while ignoring any flaws

Question 4

Ego Defense: splitting

Answer 4

people are either “all good” or “all bad” at times

Question 5

Ego Defense: sublimation VS reaction formation

Answer 5

sublimation- mature; replacing unacceptable wish with action that does not conflict with wish (ex:channel agression into sports)
reaction formation- immature; doing the opposite of how you feel

Question 6

Ego defense: suppression vs repression

Answer 6

suppression- mature; temporary; intentional

repression- immature, unintentional witholding of an idea from conscious

Question 7

ego defense: isolation

Answer 7

removing your affect/feelings from idea/events

-like retelling a murder with no affect

Question 8

Rett Syndrome

Answer 8

X-linked dominant, only seen in girls, mutation of MECP2, causes regression around 1-4 yo and characterized by hand wringing

Question 9

Oppositional Defiant Disorder

Answer 9

defiant behavior against authority

Question 10

disruptive mood dysregulation disorder

Answer 10

onset before age 10, severe/recurrent tantrums, with constant irritability in between

Question 11

Learning Disorder

Answer 11

difficulty in ONE subject with success in others

Question 12

depersonalization/derealization disorder vs dissociative amnesia

Answer 12

detachment from one’s body and environment.

vs forgetting key features of your identity and other personal information

Question 13

schitzophrenia vs schitzophreniform vs bried psychotic

Answer 13

brief psychotic lasts less than a month (but v rare so always check for substance abuse)
shizophreniform lasts 1-6 mo

Question 14

Delusional disorder

Answer 14

delusional symptoms (false belief) for greater than 1 month without any other functioning problems.

Question 15

Manic symptoms

Answer 15

DIG FAST 
Disorganized speech 
Irresponsibility 
Grandiosity 
Flight of thoughts 
increased Activity/Agitation 
Sleep decreased 
Talkative

Question 16

Cyclothymic Disorder

Answer 16

milder Bipolar Disorder lasting atleast 2 years

Question 17

postpartum blues vs post partum depression

Answer 17

blues is less than 10 days
depression is greater than 2 weeks
blues just need followup
depression can warrant SSRIs and CBT

Question 18

Dysthmic Disorder

Answer 18

milder depression for 2+ years

Question 19

PTSD vs Acute Stress Disorder

Answer 19

PTSD is greater than 1 month of symptoms (treat with CBT or SSRIs or venlafaxine)
Acute Stress Disorder lasts between 3 days and 1 month (pharmacotherapy not indicated but CBT maybe)

Question 20

Cluster A disorders

Answer 20

“weird”
paranoid
schitzoid- “aloof” but likes it that way
schitzotypal- magical thinking, weird clothing

Question 21

Cluster B disorders

Answer 21

“wild”
antisocial - (under 18= conduct disorder), violent/criminal
borderline- splitting, suicide, unstable
histrionic- attention seeking, appearance obsessed
narcissistic- grandiosity

Question 22

Cluster C disorders

Answer 22

“Worried”
avoidant- want interpersonal relationship but fear of rejection
Obsessive compulsive personality- perfection and order
dependent- clingy and submissive

Question 23

malingering vs facitious disorders

Answer 23

both consciously FAKE an illness, but the motive differs
malingering is for external gain
facititous is for internal gain- to assume sick role

Question 24

somatic symptom disorder

Answer 24

not consciously faking illness
constant illness/pain
do consistent out patient follow up

Question 25

conversion disorder

Answer 25

stressor causes loss unrelated of sensory/motor function

- mutism

Question 26

illness anxiety

Answer 26

preoccupation with having SERIOUS illness

Question 27

anorexia vs bulemia nervosa vs binge

Answer 27

anorexia: BMI<18.5
BN: BMI> 18.5
bulemia and anorexia may show binge/purge pattern
Binge eating has no purge pattern (remember, purge is any compensatory behavior)

Question 28

refeeding syndrome

Answer 28

occurs with anorexia

causes spike in insulin, leading to hypophosphatemia with cardiac consequences

Question 29

electrolyte abnormalities of bulemia nervosa

Answer 29

hypokalemia

hypoCHLORemia

Question 30

sleep terror disorder vs nightmare

Answer 30

sleep terror- deep sleep of Nonrem 3, screaming and no memory in the morning
nightmare- REM, with memory

Question 31

alcohol withdrawal

Answer 31

3 hr+ = tremulousness
6hr+= withdrawal seizures
12 hr+= visual hallucinations
48 hr+= delirius tremens (autonomic hyperactivity- tachy/anxiety)

Question 32

alcohol intoxication markers

Answer 32

increased serum GGT (gamma glutamyltransferase)

AST> 2ALT

Question 33

opioid intoxication

Answer 33

pinpt pupils, respiratory/cns depression with lost gag reflex, euphoria

Question 34

opioid withdrawal

Answer 34

diarrhea, sweating, yawning, sweating, dilated pupils, goosebumps

Question 35

amphetamine intoxication

Answer 35

pupillary dilatation, htt and tachycardia, grandiosity and euphoria

Question 36

cocaine intoxication

Answer 36

pupillar dilatation, hallucinations, angina/SCD

Question 37

Phencyclidine intoxication (PCP)

Answer 37

violene, analgesia, nystagmus, tachy/htt

Question 38

LSD (lysergic acid diethylamide) intoxication

Answer 38

perceptual distortion, depersonalization

Question 39

MDMA (ecstacy)

Answer 39

hallucinations, teeth clenching, serotonin syndrome

Question 40

what class of drugs in PIMOZIDE

Answer 40

1st gen antipsychotic

Question 41

what are the suffixes for type 2 antipsychotics? an exception?

Answer 41

-“apine”, -“idone” exception: aripiprazole

Question 42

Buspirone
clinical use?
features?

Answer 42

5HT1a agonist
GAD (2nd line)
non addictive, non sedative, no tolerance, acts within 1-2 weeks

Question 43

-milnaciprans are what class of drugs?

Answer 43

SNRI (such as venlafaxine and duloxetine)

Question 44

Varencicline

clinical use?

Answer 44

• partial nicotinic receptor ACh agonist

- smoking cessation

Question 45

Vilazodone

clinical use?

Answer 45

5HT reuptake inhibitor, 5HT1a partial agonist,

GAD, MDD

Question 46

Vortioxetine

clinical use?

Answer 46

inhibits 5HT reuptake, 5HT1 agonist, 5HT3 receptor antagonist
MDD