Psychology Flashcards
What are the 4 mature defense mechanisms?
Altruism
Humor
Sublimation
Suppression
Schizoaffective disorder: clinical features
Requires assessing longitudinal course of illness and determining if there is a period of at least 2 weeks of psychotic sx in absence of mood sx. Schizoaffective disorder is distinguished from schizophrenia by presence of mood sx for majority of illness. Distinguished from bipolar disorder because in bipolar disorder, psychotic sx occur EXCLUSIVELY during manic or depressive episodes.
What defense mechanism is being used by an IVDA who contracts Hep C and blames condition on inadequate control of Hep C within community using?
Distortion (altered perception of disputing aspects of external reality in an effort to make it more acceptable)
What defense mechanism is being used by a woman who focuses on her children’s needs instead o thinking about her father’s dx of cancer?
Suppression – intentionally postponing exploration of anxiety provoking thoughts by substituting other thoughts.
What test is abnormal in up to 50% of patients with depression?
Dexamethasone
Clinical features of childhood disintegrative disorder.
Age of onset 3-4 years. Marked regression in multiple areas of functioning after at least 2 years of apparently normal development. Significant loss of expressive or receptive language skills, social skills or adaptive behavior, bowel or bladder control, play or motor skills. More common in boys.
3 neurotransmitter changes seen in anxiety
Increased NE
Decreased GABA, 5-HT
3 neurotransmitter changes seen in depression
Decreased NE
Decreased 5-HT, dpamine
3 neurotransmitter changes seen in Huntington’s
Decreased GABA, ACh
Increased dopamine
3 neurotransmitter changes seen in Parkinson’s disease
Decreased dopamine
Increased 5-HT, ACh
Adjustment disorder
Symptoms out of proportion and within 3 months of stressor. CANNOT persist longer than 6 months.
Most common type of schizophrenia
Paranoid. Also has best prognosis.
Risk for schizophrenia in MZ twin? Sibling?
Twin: 50%
Sibling: 10%
What causes negative sx in schizophrenia?
Decreased DA in prefrontal cortex/mesocortical tracts. This is why typical antipsychotics make negative sx worse. They block DA everywhere; therefore, if you already have low DA in mesocortical treat and then block it, your negative sx worsen.
Blood chemistry you’d expect for bulimic/anorexic patient
High HCO3 Low Cl, K High carotene High LFTs (liver cannot make glycogen therefore its under stress) High amylase
Pathophys behind refeeding syndrome
During prolonged fasting the body aims to conserve muscle and protein breakdown by switching to ketone bodies derived from fatty acids as the main energy source. The liver decreases its rate of gluconeogenesis thus conserving muscle and protein. Many intracellular minerals become severely depleted during this period, although serum levels remain normal. Importantly, insulin secretion is suppressed in this fasted state and glucagon secretion is increased. During refeeding, insulin secretion resumes in response to increased blood sugar; resulting in increased glycogen, fat and protein synthesis. This process requires phosphates, magnesium and potassium which are already depleted and the stores rapidly become used up. Formation of phosphorylated carbohydrate compounds in the liver and skeletal muscle depletes intracellular ATP and 2,3-diphosphoglycerate in red blood cells, leading to cellular dysfunction and inadequate oxygen delivery to the body’s organs. Refeeding increases the basal metabolic rate. Intracellular movement of electrolytes occurs along with a fall in the serum electrolytes, including phosphate, potassium and magnesium. Glucose, and levels of the B1 vitamin thiamine may also fall. Cardiac arrhythmias are the most common cause of death from refeeding syndrome, with other significant risks including confusion, coma and convulsions and cardiac failure.
Biggest risk factor for delirium?
Age. Underlying dementia is #2.
EEG findings in delirium?
Diffuse background slowing of rhythm. Psychosis, on the other hand, has a normal EEG.
Time frame for alcoholics between last drink and DTs?
48-72 hours.
How quickly is alcohol metabolized?
Zero order kinetics. 25 mg/hr.
How long does it usually take for an alcoholic to develop seizures (from time of last drink)
12-24 hours with bimodal peak at 8 and 48 hours.
Most specific test for ETOH consumption in past 10 days
CArbohydrate-defiicent transferrin.
Less specific: elevated GGT, AST more than 2x ALT.
Why might a patient on opiates have dilated pupils?
Hypoxia secondary to respiratory depression can cause pupil dilations.
Opiate withdrawal sx
Joint and muscle pain Photophobia Goosebumps Diarrhea, GI cramps Tachycardia, HTN Dilated pupils Anxiety, depression
PCP intoxication sx
Horizontal nystagmus
Dilated pupils
Ataxia
Acute psychosis
Cocaine/Amphetamine withdrawal sx
Suicidal ideation
Hypersomnia
Depression
Anergia
According to Piaget, what age is the sensorimotor stage when you learn of object permanence?
birth-3 years
Acoridng to piaget, which age is preoperational stage when a child becomes more egocentric?
3-5 years
According to Piaget, at what age does a child learn death is permanent?
Concrete operational stage: 6-11 years
When is the trust vs mistrust stage according to Erikson?
Birth-1 year
When is the autonomy vs shame stage according to ERikson?
1-3 years
When is the initiative vs guilt stage according to Erikson?
3-5 years
When is the industry vs inferiority stage according to erikson?
6-11 years
IQ for mild, moderate, severe, and profound MR
Mild: 55-70
Moderate: 40-55
Severe: 25-40
Profound: <25
Seizures, MVP, dilation of aorta, tremors, ataxia, ADHD-like behavior with MR. What does the patient most likely have?
Fragile X – most common cause of inherited MR!
Cafe au last spots, seizures, large head, autosomal DOMINANT
NF I
Coarse facies, short stature, cloudy cornea, MR, autosomal recessive
Hurler syndrome
Hypotonia, hypogonadism, hyperphagia, skin picking, aggression, MR. Deletion on paternal Chr 15.
Prader-Willi
Seizures, strabismus, sociable with episodic laughter. Deletion on maternal Chr 15.
Angelman
Elfin-appearance, friendly, increased empathy and verbal reasoning ability. Deletion on Chr 7.
Williams
Seizures, chorioretinitis, hearing impairments, periventricular calcifications, petechiae at birth, hepatitis.
Congenital CMV
Seizures, hearing impairments, cloudy cornea/retinitis, heart defects, low birth weight
Congenital rubella
