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Shelf Exam Study Materials > Psychiatry: UWorld > Flashcards

Psychiatry: UWorld Flashcards

1
Q

Physical signs of PCP intoxication

A

-nystagmus -hypertension -tachycardia -ataxia -dysarthria -m. rigidity

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2
Q

Physical signs of LSD intoxication

A

-sweating -tachycardia -pupillary dilatation -palpitations -tremors -poor coordination

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3
Q

Cocaine intoxication

A

-anxiety, aggression, agitation -psychosis or delirium -feeling of bugs crawling on skin -high or low BP -tachycardia or bradycardia -sweating -pupil dilation -N/V -insomnia -OD ==> cardiac arrhythmias, MI, seizures stroke

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4
Q

Reaction formation

A

defense mechanism in which person does the opposite of an expressed thought or emotion

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5
Q

Conversion d/o dx

A

-sx of altered neurologic fxn (motor or sensory) -precipitated by psych stressor -not feigned or intentionally produced -no medical/organic cause -sx cause significant social or occupational

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6
Q

Dissociative identity vs. Dissociative amnesia vs. Dissociative fugue

A

-DID = multiple distinct identities -DA = memory disturbance usually w/traumatic event -DF = memory disturbance w/travel away from home

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7
Q

Model of psychosis

A

-mesolimbic pathway = (excess) dopamine ==> psychotic sx -mesocortical = (less) dopamine ==> negative sx -tuberoinfundibular = prolactin control -nigrostriatial = voluntary movement ==> SEs of anti-psychotic meds (tardive dyskinesia, EPS, akithisia)

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8
Q

MDD dx criteria

A
  • >2 weks - at least 5/9 criteria (SIGECAPS) - significant impairment
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9
Q

GAD criteria

A

-excessive worry/anxiety about multiple event + -6 months of 3+ sx: -impaired sleep -poor concentration -easy fatigability -irritability -m. tension -restlessness

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10
Q

Typical patient/focus for interpersonal psychotherapy

A

-relationship conflicts -life role transitions -grief -focus: current relationships/conflicts

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11
Q

Typical patient/focus for supportive psychotherapy

A

-pt: lower fxning, in crisis, psychotic, cognitively impaire -focus: coping skills, foster understanding, build adaptive defense mechanisms

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12
Q

Typical patient/focus for psychodynamic psychotherapy

A

-pt: higher functioning, persistent patterns of dysfunction, more neurotic -focus: unconscious conflicts, past relationships/conflicts, break down defense mechanisms

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13
Q

Typical patient/focus for CBT

A

-pt: persistent maladaptive thoughts, avoidance -focus: identify and challenge maladaptive thoughts, behavioral techniques (breathing, goal setting)

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14
Q

Typical patient/focus for dialectical behavioral therapy

A

-pt: borderline personality d/o, self injury -focus: acceptance & change, improve emotion regulation, manage self harm

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15
Q

Typical patient/focus for biofeedback

A

-pt: prominent physical responses accompany psych sx -focus: improve awareness/control over physiologic rxns, lower stress, integrate mind/body

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16
Q

Avg. risk of bipolar and impact of family history

A

-avg = 1% -1st degree relative = 5-10%

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17
Q

Rationalization vs. Intellectualization

A

-rationalization = justify behavior to avoid difficult truth/protect self esteem -intellectualization = using intellect to avoid uncomfortable feelings

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18
Q

Tx for co-morbid depression with chronic/serious illness

A

-SSRIs

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19
Q

Depression vs. Adjustment d/o

A

-Depression criteria=5/9 SIGECAPS; must have anhedonia or low mood; may occur in response to stressors; >2wks; social or occupational dysfunction -Adjustment d/o = w/in 3 mo. of stressor, lasts no more than 6 mo. after stressor ends, does not meet full criteria for depression

20
Q

Circumstantiality = Tangential = Loose associations =

A

**characteristics of disorganized thinking -circumstantial = very detailed answers that deviate from topic but eventually return to topic/question -tangential = abrupt deviations that is minimally relevant w/out return to original subject -loose associations = little logical connection/association between phrases/thoughts

21
Q

Manic vs. Hypomanic episode

A

-Bipolar = elevated/irritable mood, increased energy, + 3-4 or DIGFAST -Manic = severe sx, 1 week+, marked impairment, +/- psychosis -hypomanic = less severe sx, >=4 days, no hospitalization, no psychosis

22
Q

Delirium vs. Psychosis

A

-Delirium = fluctuating consciousness w/abnormal cognitive exam -Psychosis = hallucinations/delusions w/normal cognitive exam

23
Q

Common cause of medication-induced psychosis

A

-glucocorticoids: particularly @ high doses or in elderly pts.

24
Q

Tx of adjustment d/o

A
  1. psychotherapy 2. SSRIs if needed as adjunct
25
Q

Neuroimaging findings in Autism

A

increased total brain volume

26
Q

Neuroimaging findings in OCD

A

abnormal orbitofrontal cortex and striatum

27
Q

Neuroimaging findings in Panic

A

decreased volume of amygdala

28
Q

Neuroimaging findings in PTSD

A

Decreased hippocampal volume

29
Q

Neuroimaging findings in Schizophrenia

A

loss of cortical tissue with enlargement of cerebral ventricles

30
Q

Alprazolam: generic name, duration of action

A

-“Xanax” -short-acting benzodiazepine

31
Q

Adverse effects of ECT

A

-amnesia (antero and retro) -prolonged seizures -delirium -H/A -nausea -skin burns

32
Q

Characteristics of narcolepsy

A

-overwhelming daytime sleepiness -cataplexy = sudden loss of m. tone w/strong emotion

33
Q

Tx of narcolepsy

A

-sleep habits, minimize EtOH, avoid meds that cause drowsiness -1. Modafinil = chemically novel stimulant -2nd line = amphetamine stimulants -sodium oxybate ==> decreased cataplexy (but has potential for abuse)

34
Q

Conduct vs. Antisocial

A

-conduct = starting usually before age 13 -Antisocial = only to pt. > 18yo

35
Q

DDx of psychotic disorders

A

-Brief psychotic d/o -Schizophreniform d/o -Schizophrenia -Shizoaffective d/o -Delusional d/o

36
Q

Brief psychotic d/o criteria

A

-psychosis for greater than 1 day but less than 1 month -sudden onset, full return to fxn

37
Q

Schizophreniform d/o criteria

A
  • >1 mo &
38
Q

Schizophrenia critera

A
  • >6 mo. (w/at least 1 mo. of active sx) - requires fxnl decline
39
Q

Delusional d/o

A

-delusions > 1mo; no fxnl decline outside of delusions

40
Q

Initial social intervention after acute psychotic episode

A

-minimize conflict and stress @ home -family psychosocial interventions

41
Q

Antipsychotic extrapyramidal effects

A

-acute dystonic rxn = sudden sustained contraction of neck, mouth, tongue, eye -akathisia = restlessness -parkinsonism = gradual tremor, rigidity, bradykinesia -tardive dyskinesia = gradual (>1-6 mo. of tx), abnormal movement of face, mouth, extremities

42
Q

Tx of acute dystonic rxn

A

benztropine (anticholinergic) or dyphenhydramine (antihistamine)

43
Q

Tx of akathisia

A

benzodiazepine

44
Q

Tx of parkinsonism

A

anticholinergics: benztropine or amantadine

45
Q

MDMA intoxication medical consequences

A

-MDMA (ecstasy/molly) = stimulant -HTN -Tachycardia -hyperthermia -serotonin syndrome -hyponatremia ==> coma, seizures, death

Shelf Exam Study Materials (18 decks)

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