Psychiatry: PreTest Flashcards

Question

Medication for nocturnal enuresis

Answer 1

-imipramine

Answer 2

==\> slowed cardiac conduction ==\> fatal heart block

Answer 3

1. bereavement is less than 2 mo. 2. adj. d/o = \> 2mo. + some dysfxn

Answer 4

* 30-50% * left \> right lobe * frontal \> more posterior

Answer 5

* sleep deprivation * tx = increase sleep

Answer 6

* poor psych/childhood development ==\> psychopathology

Answer 7

* Li/mood stabilizers treat mania \> depression * Bipolar depression * supplement w/antidepressant * taper as soon as sx resolve 2/2 high rate of induced mania (up to 30%) * buproprion = slightly lower risk of mania

Answer 8

depression

Answer 9

1. Freud: Depression = anger turned towards self 2. Beck: Depression = cognitive patterns are negative 3. Bowlby: poor attachment predisposes to psychopathalogy 4. Sullivan: interpersonal relationships are important

Answer 10

1. ECT effect \>= anti-dperessants 2. Uses 1. MDD not responding to meds 2. highly suicidal 3. severe psychotic sx 4. medically ill who cannot tolerate anti-dep meds 5. Parkinson's dz w/MDD (also decreases extrapyramidal sx) 3. Safe, relatively few contraindications

Answer 11

1. Lithium 2. Thyroid hormones 3. Stimulants 4. Estrogens 5. Light therapy

Answer 12

* Major depression is not a rare occurrence in children * presentation of juvenile depression often differs from adult * irritable, aggressive, withdrawn, or clingy instead of sad * In school-age children, the main manifestation = loss of interest in friends and school * psychotic sx = common * Up to one-third of the children dx with MDD ==\> dx of bipolar disorder later * medications may be used but response is different from adults

Answer 13

PET ==\> decreased blood flow/metabolism @ frontal lobe

Answer 14

* Buspirone and benzodiazepines have different chemical structures * buspirone’s potency is equivalent to the potency of diazepam * takes one to two weeks for the antianxiety effects to appear ==\> not useful for anxiety conditions that require acute intervention. * Buspirone is less sedating than benzodiazepines and appears to have less potential for abuse.

Answer 15

* Three major cognitive behavioral techniques, usually used in combination: exposure, cognitive restructuring, and social skills training. * Several classes of medications have also been proven effective in the treatment of social phobia, including MAO inhibitors, SSRIs, benzodiazepines, and beta blockers. * Buspirone can be useful when social phobia and generalized anxiety disorder are comorbid

Answer 16

SSRIs (sertraline), tricyclic antidepressants (imipramine), and benzodiazepines (lorazepam)

Answer 17

* locus ceruleus = @ floor of the fourth ventricle in the anterior pons. * main noradrenergic nucleus of the brain ==\> regulates arousal, attention, and autonomic tone * connection with the amygdala ==\> stimulated by exposure to threats * hyperactivated in PTSD

Answer 18

* nucleus basalis of Meynert is connected to cognitive functions and memory * This nucleus degenerates in Alzheimer’s dementia.

Answer 19

* The raphe nuclei are the main source of serotonin in the central nervous system * connected with the regulation of mood, pain, and aggression

Answer 20

* Dreaming * Increase in blood pressure and heart rate * penile tumescence

Answer 21

* Hurler’s syndrome = accumulation of mucopolysaccharidoses. * Hurler’s syndrome starts during the first year of life and causes death before age 10.

Answer 22

* Rett’s syndrome, a pervasive developmental disorder, is characterized by a devastating progressive deterioration of cognitive, social, and motor functions that starts between age 5 months and 18 months, after an initial period of normal development

Answer 23

L. frontal lobe

Answer 24

* Partial complex seizures usually (90% of the time) originate from the temporal lobe. * Auras that consist of unpleasant odors often originate from the tip of the temporal lobe, the uncus, an area involved in processing olfactory sensations.

Answer 25

Non-rem sleep

Answer 26

Glutamic and aspartic acids have excitatory properties.

Answer 27

The biogenic amines include the catecholamines such as dopamine, norepinephrine, epinephrine, histamine, and the indolamine serotonin.

Answer 28

Neuropeptides include beta-endorphin, somatostatin, and vasopressin.

Answer 29

The anterior nucleus facilitates sexual interest and specific sexual behaviors. The ventromedial nucleus acts as a satiety center and stimulation of this area reduces appetite. This nucleus acts by inhibiting the lateral nucleus, which stimulates appetite. The posterior nucleus, along with the contiguous reticular activating system, controls levels of arousal. Lesions in these areas cause lethargy and somnolence. The supraoptic and paraventricular nuclei produce vasopressin and oxytocin.

Answer 30

1. ventromedial = suppress; lateral = stimulate 2. anterior 3. supraoptic 4. posterior

Answer 31

* Oral: 0-1yo * Anal: 1-3yo ==\> ~potty-training experience impacts development; harsh =\> anal-retentive * Phallic: 3-5/6yo * Latency: 5/6 - puberty ==\> sexual impulses are repressed and sublimated (re: defense mechanisms) towards school work, hobbies and friendships. Tendency toward orderliness, attention to de- tails, and collecting things. Under stress, these traits may become exagger- ated

Answer 32

* Theory of early infantile development on the basis of observations of normal and pathological mother-child interactions * 1. autistic phase (0-2mo.): sleeping; no interest in interpersonal relationships * 2. symbiosis (2-6mo.): psychological fusion or lack of differentiation between mother and child. * 3. separation-individuation (6-36mo.): child develops a concept of him- or herself as different and separated from the mother. * a. differentiation (6-10mo.): initial awareness that mother is different from self * b. practicing (10-16mo.): enthusiastic exploration of environment * c. rapprochement (16-24mo.): need to know where mother is/checking in 2/2 awareness that indepence = vulnerability * d. object constancy (24-36mo.): integration of good/bad aspects of mother and self * object constancy must develop to allow for mature and stable relationship formation

Answer 33

* Melanie Klein’s theory of infantile psy- chological development * during which the infant realizes that the “bad mother” who frustrates the child’s wishes and the “good mother” who nurtures him or her are the same person * child worries that rage at the “bad mother” may also destroy the good

Answer 34

* theory of cognitive development based on way children relate to world * ensorimotor (18–24 months) * pre-operational (2 to 5–7 years) * egocentrism * concrete operational (6–11 years) * formal operational (11 years to adulthood)

Answer 35

* early mother-child relationship * child is able to develop a separate and stable identity only if the child’s needs are met by his or her mother’s empathic anticipation * "holding environment" = positive environment created by the mother * "transitional object" = toy/blanket that represent comforting substitue for primary caregiver

Answer 36

* 8 stages of ego development during the life cycle * stages = turning points: physical, cognitive, social, and emotional changes ==\> internal crisis; resolution leads to psych growth or regression 1. trust vs. mistrust (0-18mo.): if needs are met, the world seems good 2. autonomy vs. shame (18mo.-3yrs): nurtured/encouraged ==\> self-esteem and autonomy 3. initiative vs. guilt (3-5yo): expands horizons, fantasies of power but sense of guilt w/broken rules 4. industry vs. inferiority (5-13yo): psych health depends on opportunities for new skills and pride with accomplishments 5. identity vs. role confusion (13-21) 6. Intimacy vs. isolation 7. Generativity vs. stagnation 8. Integrity vs. despair

Answer 37

* Temperament = inherited set of traits present at birth; stable during first years of life to be modified by interpersonal experiences * variations in several categories: rhythmicity, adaptability, intesity of rxn, quality of mood, attention span, etc.

Answer 38

* component of Jung theory * part of the unconscious personality that contains all the traits and qualities that are unacceptable to an individual

Answer 39

* part of Jungian psychology * universal, symbolic images that recur in dreams and are part of the “collective uncon- scious.”

Answer 40

* part of Jung theory * animus = masculine elements of woman's personality * anima = female traits of male personality

Answer 41

* Kohut’s theory * individuals who require other people’s constant validation to maintain a marginal self-esteem have suffered a “narcissistic injury” during childhood due to parental neglect or lack of empathy

Answer 42

* id = contains the instinctual drives * ego = whose function is to find an equilibrium between gratification of the instinctual drives and the rules of society (and the demands of the superego) * superego = the agency that contains the internalized parental and societal rules and dictates to the ego what is not to be done * ego ideal = component of superego; internal standard of what one should be to be approved * ego and superego have unconscious and conscious components

Answer 43

* shame = consequence of not liv- ing up to one’s ego ideal * guilt = consequence of transgressing the superego’s prohibitions

Answer 44

* per Spitz: "analytic depression" * children who are emotionally deprived do not grow well even when an adequate amount of food is available * lack of adequate nurturing, they become apathetic, withdrawn, and less interested in feeding, which in turn causes failure to thrive

Answer 45

sublimation = satisfaction of an objectionable impulse is obtained by using socially acceptable mean

Answer 46

* Primary gain refers to the relief of tension and conflict produced by the development of symptoms. * In addition to the internal reduction of distress, the symptoms may gratify wishes or impulses (secondary gain). * e.g. increased attention/sympathy, relief from obligations, monetary compensation

Answer 47

* All Freud's theory of dreams/meaning * wish fulfillment = one of the goals of dreams * dream work = process through which the latent content of the dream is transformed into the more acceptable manifest content * Condensation, displacement, and symbolic representation = primary processes and can make the manifest content of the dream quite bizarre * Secondary revision = a process guided by the ego, intervenes at the end of the dream work to make the manifest content more rational and acceptable to the dreamer

Answer 48

buproprion

Answer 49

* olanzapine * clozapine

Answer 50

* Priapism, an abnormally prolonged erection, is estimated to happen in 1 in every 10,000 patients treated with trazodone. * The risk for this side effect is higher during the first month of treatment and at low doses.

Answer 51

* cryopetadine (antihistamine) * yohimbine * bethanecol * amantadine * buproprion

Answer 52

* nonsteroidal anti- inflammatory drugs * ibuprofen * naproxen * diclofenac * indomethacin * ==\> increase plasma lithium levels and have been associated with toxicity * mechanism of action: inhibition of renal tubular prostaglandin synthesis.

Answer 53

* high * haloperidol * fluphenazine * intermediate * molindone * perphenazine * low * chlorpromazine * thioridazine

Answer 54

* valproic acid * carbamazepine

Answer 55

cardiac (Ebstein's)

Answer 56

* alpha-2 agonists * clonidine * guanfacine

Answer 57

* low anticholinergic = high potency antipsychotics * haloperidol * fluphenazine * high antichoinergic * low potency antipsychotics * chlorpromazine * thioridazine * clozapine

Answer 58

* high-potency 2/2 less anticholinergic activity * haloperidol * fluphenazine

Answer 59

* marked psychomotor disturbances * prolonged immobility, posturing, extreme negativism (the patient actively resists any attempts made to change his or her position) or waxy flexibility (the patient maintains the position in which he or she is placed) * mutism, echolalia (repetition of words said by another person), and echopraxia (repetition of movements made by another person) * Periods of immobility and mutism can alternate with periods of extreme agitation (catatonic excitement).

Answer 60

* formal thought d/o: disturbance of flow of ideation including thought blocking, poverty of speech, flight of ideas * examples: circumstanstiality, tangentiality, clanging, loose associations etc. * Delusions, ideas of reference, hallucinations = disturbances of thought content

Answer 61

1. agranulocytosis 2. risk for seizures

Answer 62

* low-potency neuroleptics, in particular, chlorpromazine * photosensitization effect ==\> sun- burn, patchy discoloration of the skin, and rashes when the patients expose themselves to the sun without adequate protection

Answer 63

1. amok = dissociative episode characterized by violent agitation and aggressive and homicidal behavior precipitated by insult or brooding (Malaysia) 2. koro = characterized by a sudden and intense anxiety connected to the belief that the penis is receding into the body and that death will follow when it has totally disappeared (South/East Asia) 3. Dhat = characterized by anxiety, hypochondriac concern about semen discharge, and fatigue (India) 4. Sangue dormido = numbness, tremor, paralysis, convulsions, strokes, and heart attacks (Portugese Cape Verdians) 5. Ghost sickness = preocuppation w/death and dead people (Native American)