Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Boards and Wards Complete > Psychiatry (p348-373) > Flashcards

Psychiatry (p348-373) Flashcards

1
Q

In evaluating a psych pt, what must first always be ruled out?

A

drug abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What should be the approach to treatment of psych disorders?

A

Combination tx with psychotherapy and pharmacologic tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some criteria to hospitalization?

A

Danger to self
danger to others
Unable to care for self

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Syndrome of repeated major depressive episodes

A

Major depressive disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the criteria for major depressive disorder?

A

2 depressive episodes to continue for greater than 2 weeks each seperated by atleast 2 months or greater.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is psychodynamic therapy?

A

understanding self and inner conflicts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is cognitive behavioral therapy?

A

recognizing negative thought or behavior and altering thinking/behavior accordingly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is interpersonal therapy?

A

Examines relation of sx to negative/absent relationships with others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the indication for Electroconvulsive treatment?

A

refractory cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the side effects of TCAs

A

orthostatic hypotension

prolonged QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When does seritonin syndrome occur?

A

MAOI interaction with SSRIs, meperidine or pseudoephedrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When might hypertensive crisis occur in a pt on MAOi’s?

A

If they eat tyramine rich foods (wine and cheese)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What side effect is mirtazapine associated with?

A

agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Major depressive symotoms that continue for a duration of minimum 2 years.. .diagnosis?

A

Dysthymic disorder

Tx as you would MDD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Older adult whose partner just died, sx less than 2 months…diagnosis?
More than 2 months? Dx?

A

2 mos = MDD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pt with increased energy, decreased need to sleep, pressured speech, hypersexuality, impulsivity, spending large amounts of money, outrageous activity. Dx?

A

Bipolar disorder (manic depression) – seen more in young people. whereas MDD is for people in 40s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long must episodes last to be classified as bipolar?

A

> 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the difference between bipolar I and II?

A

I = manic episode with or without depressive episodes

II = depressive episodes with hypomanic episodes but by definition the absence of manic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is rapid cycling and what can it be precipitated by?

A

4 episodeds in 12 months, can be precipitated by anti depressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the 1st and 2nd line for bipolar disorder?

A

Valproate is 1st line

Lithium 2nd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why must lithium levels be frequently checked?

A

Toxicity can cause tremor and polyuria from nephrogenic diabetes inspidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Side effect of valproate and carbamazepine

A

Blood dyscrasias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 2 biggest culprits of drug induced mania?
Dx?
Rx?

A

Cocaine and amphetimenes
Dx with Urine or serum tox screen
Tx: Ca channel blockers for acute autonomic sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

False sensory perception not based on a real stimulus

A

Hallucination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

False interpretation of external reality

A

Delusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When is hospitalization indicated for hallucinations or delusions?

A

When voice telling pt to hurt themselves or others or if condition is disabling enough to the point where pt cannot care for themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the time frame differences between schizophrenia, schizophreniform and brief psychotic disorder?

A

schizophrenia >6 months continuously
schizophreniform 1-6months
brief psychotic disorder 1 day to 1 month with full recovery to baseline functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Schizoaffective definition

A

mood disorder + schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What kind of delusions do people with delusional disorder have?

A

non bizarre delusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Pts acutely not oriented to person, time or places. Severity waxes and wanes

A

Delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Paranoid delusions + feeling of bugs crawling on skin (formication) is a sign of..

A

cocaine and amphetamine use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What drug was used if pt has visual, taste touch or olfactory hallucinations?

A

LSD and PCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What class of drugs are chlorpromazine and haldoperidol?

A

Typical antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What class of drugs are clzapine, respiridone and olanzapine

A

Atypical antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Younger pt less than 25 yrs with MI like sx, escalate for 10 mins, last about 30 mins.Dx? Tx?

A

Panic disorder, dx made by exclusion
SSRI, SnRI, if you need asap, Benzos
Cognitive behavioral training, respiratory relaxation training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Sustained muscle spasm anywhere in the body, but often in the neck jaw or back, lasting 4hrs to 4 days. Dx? Tx?

A

Acute dystonia

Tx: IV diphenhydramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Cog wheel rigidity, shuffling gait, resting tremor lasting 4 days to 4 mos. Dx? Tx?

A

Parkinsonism

Tx: Benztropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Involuntary irregular movements of head, tough, lips, limbs and trunk. Lasts 4 mos - 4 years

A

Tardive dyskinesia

Tx: change meds or decrease doses immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Subjective sense of discomfort, restlessness, pacing, sitting down and getting up. Dx? tx?

A

Akathisia

Tx: lower medication doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Life threatening muscle rigidity –> fever, increased BP/HR, rhabdomyolysis over 1-3 days. Can easily be misdiagnosed as a psycotic sx. Labs can show increased WBC, CK, transaminases, plasma myoglobin. Dx? Tx?

A

Malignant Neuroleptic syndrome

Tx: immediately stop drug, give Dantrolene (stops Ca release into cells), Cool patient to prevent hyperpyrexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Fear of being in situations where escaping would be very difficult should a panic attack arise. Dx? Tx?

A

Agoraphobia
Tx: Exposure desensitization = exposure to noxious stimulus in crements while undergoing concurrent relazation tx. Also, B-blocker for prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Recurrent thoughts

A

Obsessions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Recurrent act

A

Compulsions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Obsessive thought creates anxiety and compulsion relieves that anxiety. Commonly includes cleanliness/contamination. Pt recognizes the absurdity of the obsessions. Dx? Tx?

A

Obsessive Compulsive disorder
SSRI (1st line) or Clomipramine
CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Obsessive thought creates anxiety and compulsion relieves that anxiety. Commonly includes cleanliness/contamination. Pt sees nothing wrong with obsessions. Dx?

A

Obsessive compulsive personality disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Pt s/p traumatic violent event and relives the moment through conscious thoughts and dreams. Avoids public places and activities. Depression, moodiness, difficulty concentrating. Dx?

What is acute form of this

A

Post traumatic stress disorder

Acute form = acute stress disorder (seen in victims of sexual assault)

Tx: SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What drug should you be cautious of giving PTSD pt?

A

Careful of giving benzodiazepines bc high association between substance abuse and PTSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the 2 approaches of psychotherapy?

A

Prolonged exposure treatment: relieving the experience

Cognitive processing therapy: attacking the source vs. controlling the sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Worry for most days for atleast 6 months, irritability and inability to concentrate. Insomnia, fatigue, restlessness. SOCIAL DYSFUNCTION (affecting school, job, marital strain). Dx? Tx?

A

Generalized anxiety disorder
Tx: psychotherapy bc chronicity of probleml, biofeedback and relaxation techniques are good
Pharm: B blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Paranoid, schizoid and schizotypal personalities thought of as weird or eccentric. Cluster ___

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Borderline, antisocial, histrionic, narcissistic personalities thought of as wild, dramatic and agressive. Cluster ___

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Avoidant, dependent, obsessive compulsive thought of as shy and nervous. Cluster ___

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Transforming unacceptable feeling into actions, often loud ones (tantrums). What ego defense?

A

Acting out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Contstructivev service to others that brings pleaseure and personal staisfaction. What ego defense?

A

Altruism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Refusal to accept external reality because it’s too life threatening. What ego defense?

A

Denial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Redirection of some emotion from a real source to substitute person or object. What ego defense?

A

Displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Overt expression of ideas and feelings (especially those that are unpleasant to focus on or too terrible to talk about) that gives pleasure to others ie jokes about someone close to you just dying. What ego defense?

A

Humor

58
Q

Patterning behavior after someone elses. What ego defense?

A

Identification

59
Q

Explaining away the unreasonable in form of logic. What ego defense?

A

Intellectualization

60
Q

Identifying with some idea or object so deeply that it becomes part of that person. What ego defense?

A

Introjection

61
Q

Attributing unacceptable thoughts, feelings, behaviors and motives to others. What ego defense?

A

Projection

62
Q

Personality disorder where pt negatively misinterprets actions of other. Projection is often ego defense. No fixed delusions or hallucinations. Dx?

A

Paranoid disorder cluster A

63
Q

Personality disorder where pt is socially withdrawn, no close emotional ties, but can still recognize reality. Dx?

A

Schizoid cluster A

64
Q

Personality disorder where pt believes in concepts not considered real by the rest of society (magic, clairvoyance) Often related to schizophrenics. Ego defense is fantasy. Dx?

A

Schizotypal cluster A

65
Q

Personality disorder where pt violates the rights of others, break the law, seductive. Must have exhibited behevaiors while young (15) but actual dx can only be made as adult 18 yrs. Dx?

What would this dx be if child?

A

Antisocial. cluster B

Conduct disorder

66
Q

Personality disorder where pt is volatile, swing wildly between idealizing and devaluing. Ego defense is splitting (people are very good or very bad). Have the ability to disassociate. Self destructive behavior. Dx?

A

Borderline personality disorder cluster B

67
Q

Personality disorder where pt requires attention of everyone, uses sexuality and physical appearance to get it. Use disassociateion and repression. Dx?

A

Histrionic cluster B

68
Q

Personality disorder where pt feels entitled because they are best and everyone else is inferior. dx?

A

Narcissistic cluster B

69
Q

Personality disorder where pt can do very little on their own, nor can they be alone. Dx?

A

Dependant Cluster C

70
Q

Personality disorder where pt feels inadequate and are extremely sensitive to negative commments. Reluctant to try new things. fear of embarassment.

A

Avoidant Cluster C

71
Q

Personality disorder where pt is preoccupied by detail, rules, regulations, neatness. ego defense is isolation, putting up walls of self restraint and detail orientation that keep away any sign of emotional affect. Dx?

A

Obsessive compulsive Cluster C

72
Q

Making the unreasonable seem acceptable. What ego defense?

A

Rationalization

73
Q

Set aside unconscious feelings and express exact opposite feelings. What ego defense?

A

Reaction formation

74
Q

Resorting to child like behaviro often seen in hospital. What ego defense?

A

Regression

75
Q

Taking instinctive drives like sex and funneling that energy into a socially acceptable behavior like studying, behavior or emotion. What ego defense?

A

Sublimation

76
Q

The conscious process of pushing thoughts into the preconscious. The conscious decision to delay paying attention to an emotion or need in order to cope with present reality. What ego defense?

A

Suppression

77
Q

Lack of conscious manipulation of somatic sx. Dx?

A

Somatoform disorder

78
Q

Consciously faking or manipulating sx for purpose of assuming the “sick” role but not for material gain. Dx?

A

Factitious disorder

79
Q

Consciously faking sx for purpose of material gain. Dx?

A

Malingering

80
Q

Factitious disorder with predominantly physical (not psychologic) sx/ Dx?

A

Munchhausen syndrome

81
Q

pt claims nonexistant sx in someone else under his/her care. Ie parent brings in “sick” child. Dx?

A

Munchhausen syndrome by proxy.

82
Q

Whats the treatment of factitious disorder?

A

Nearly impossible.

83
Q

Often female pts

A

Somatization disorder

Tx: continuity of care - schedule regular appointments.

84
Q

Pt with neurologic sx, not consciously faked ie. sensory defecits, stcking and glover sesory deficit begins exactly at wrist. Pt rarely gets hurt and all studies indicate intact neurologic pathways. Dx? Tx?

A

Conversion disorder - identify stressor

Tx: supportive, sx resolve

85
Q

Preocupation with sz, pt does not complain of many sx, but misinterprets them as evidence of something serious. Dx? Tx?

A

Hypochondriasis

Tx: regular visits to MD, but try not to order labs/imaging. Psychotherapy.

86
Q

Pt with concern with body, usually picks one feature and imagines deficits that other people don’t see. Dx? Tx?

A

Body dysmorphic disorder.

SSRI can help, surgery not recommended.

87
Q

Review psychological tests chart

A

p. 363

88
Q

Child

A

Autism

89
Q

Autism without the langauge impairment. Dx?

A

Asperger’s syndrome

90
Q

Vaccines cause autism. T or F?

A

FALSE

91
Q

How do preschool children present with depression? Treatment?

A

hyperactive and agressive.

Tx: SSRI is controversial, family Tx is a major consideration.

92
Q

Child who is bit too attached to his parents or any other figures in his life. Child is worried something will happen to these beloved figures. Dx? Tx?

A

Seperation anxiety disorder.

Tx: dednsensitizing tx, in some cases imipramine is used.

93
Q

How do you differentiate oppositional defiant vs conduct disorder? Tx?

A

Bark vs. bite
Oppositional - pt argumentative, tempermental, esp with people they know.

Conduct - bully others, start fights, violate/destroy property.

Tx: strict rule setting and expected consequences

94
Q

Inability to focus or perform tasts completely, easily distracterd by random stimuli.

A

Attention defict sx

95
Q

Child is unable to sit still, talks excessively, and can never wait his turn in games.

A

Hyperactivity sx

96
Q

Before what age do sx need to be present to diagnose ADHD?

A

Before age 7

97
Q

What is the tx for ADHD?

A

Methylphenidate.

98
Q

Children with ADHD have a higher liklihood of developing what adult disorders?

A

Conduct disorder and antisocial personality

99
Q

Pt with involuntary tics, sterotyped repetitive movements or vocalizations present for >1 year. Dx? Tx?

A

Tourette’s syndrome

Haldoperidol

100
Q

What is coprolalia?

A

Vocal tics in tourettes that are often obscene or socially unacceptable.

Psychotherapy not helpful.

101
Q

Eating disorder where pt has decreased self worth and body image. Pt is 85% below expected body weight.

A

Anorexia

102
Q

Why does amenorrhea occur in anorexic pts?

A

Because of weight loss

103
Q

Eating disorder characterized by binge eating where pt has normal BMI.

A

Bulimia

104
Q

What 2 physical findings are suggestive of purging?

A

abrasions over knuckles, dental erosions

105
Q

How to treat eating disorders?

A

Hospitalize anorexic to get pt’s weight back to normal.,

Monitor electrolytes

Psychotherapy

106
Q

How can you screen for alcoholism?

A

CAGE questionaire
C- cut down
A- annoyed about being asked about drinking
G- guilty for drinking
E - eye opener need a drink in the morning

107
Q

Pt with agitation, irritability, decreased appetitie, dormications, cardiac arrythmia or infarction, stroke, seizure and nosebleeds. What is pt intoxicated with? Tx?

A

Cocaine/amphetamine

Tx: benzodiazepine for sz
Ca channel blockers for ischemia

108
Q

Pt with intense fleeting euphoria, decreased memory.. Triad of decreased consciousness, pinpoint pupils, and respiratory depression should always lead to a suspicion of ______. Dx? tx?

A

Heroin/opiods

Tx: naloxone to reverse acute intoxication

Withdrawl - tx with a long methadone taper

109
Q

Pt with intense psychosis, violence, rhabdomyolysis, hyperthermia. Intoxication with…? Tx?

A

PCP

Tx with supportive, benzos or haldoperidol for psychosis

110
Q

Pt with sensation enchanced, color richer, music more profound,tastes heightened. Intoxication with? Treatment?

A

Intox with LSD, supportive treatment

111
Q

______ identity is based on biology

A

Sexual

112
Q

______ identity is based on self-perception

A

Gender

113
Q

What age do children have a firm conception of their gender identity?

A

age 3

114
Q

A pt seemingly possess different personalities that can each take control at a given time. Pt hx might include childhood trauma. Dx? Tx?

A

Dissociative disorder (Multiple personality disorder)

Tx focuses on gradual integration of these personalities

115
Q

Syndrome of forgetting a great deal of personal information

A

Amnesia

116
Q

Syndrome of sudden travel to another place, with inability to remember the past and confusion of present identity.

A

Fuge

117
Q

Do amnesia or fuge involve shifting between different identities?

A

No

118
Q

Any behavioral or emotional sx that occurs in response to stressful life events in excess of what is normal. Dx requires sx within 3 months of stressor and must disappear within 6 months of stressor disappearing. Dx?

A

Adjustment disorder

119
Q

Pt unable to reisist the drive to peform certain actions harmful to themselves or others. These people feel anxiety before the action and gratification afterwards

A

Impulse control disorders

120
Q

Discrete EPISODES of agressive behavior far in excess of any possible stressor. Dx?

A

Intermittent explosive disorder

121
Q

Impulse to steal. Often feels guilty after.

A

Kleptomania

122
Q

Purposeful fire setting. Often fascination. Dx?

A

Pyromania

123
Q

Pt with hair pulling, causing observable hair loss.

A

Trichotillomania

124
Q

What are 2 normal types of sleep?

A

REM and NREM

125
Q

What is stage 1 of sleep characterized by?

A

Alpha waves and then theta waves

126
Q

Stage 2 sleep is characterized by..?

A

Sleep spindles

127
Q

Stage 3 and 4 sleep is characterized by..?

A

Delta wave sleep (most difficult to wake from)

128
Q

What is REM sleep characterized by?

A

Dreaming

129
Q

Unable to fall asleep or stay asleep recurrently over a 1 mo period.

A

Insomnia

130
Q

Difficulties with sleep is called…

A

Dyssomnias

131
Q

Recurrent sleep attachs associated with REM sleep and day dreaming.

A

Narcolepsy

132
Q

Periods of apnea occuring during sleep

A

Sleep apnea

133
Q

What are the 3 types of sleep apnea?

A

Obstructive: increased inspiratory effor that fails to result in decerased airflow

Mixed obstructive/central: periods of no inspiratory effor followed by inspiratory effect that is obstructed by collapse of oropharyngeal airway.

Central: loss of inspiratory effort

134
Q

What is pickwickian syndrome?

A

central alvelolar hypoventillation.

135
Q

What is the triad of sx for pickwickian syndrome?

A

somnolence, obesity and erythrocytosis

136
Q

Child with suddenly sitting up in bed with diaphoresis, tachycardia and feeling frightened. Not fully awake. Pt goes to sleep after episode. Dx?

A

Night terror

137
Q

During what phase of sleep do night terrors occur?

A

NREM

138
Q

During what stage of sleep do nightmares occur?

A

REM sleep

139
Q

Pt gets out of bed and wanders around. No memory of events. Occurs in NREM sleep. Dx?

A

Sleepwalking

140
Q

Pt with irresistable urge to move limbs. Can be primary with no known cause or secondary to iron deficiency, dopamine deficiency or hypothyroidism. Dx? tx?

A

Restless leg syndrome.
Dx with labs to r/o underlying cause.
Tx: dopamine antagonist and treat underlying cause.

Boards and Wards Complete (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions