psychology Flashcards
1
Q
Positive reinforcement
A
giving a reward
2
Q
Negative reinforcement
A
taking away an aversive stimuli
3
Q
positive punishment
A
application of aversive stimulus
4
Q
Negative punishment
A
removal of desired reward
5
Q
Transference
A
patient projects feelings onto physician
6
Q
countertransference
A
physician projects feelings onto patient
7
Q
Mature defenses
A
Sublimation
Altruism
Suppression
Humor
“adults wear a SASH”
everything else is ego/immature defnse
8
Q
Fixation
A
partially remaining at a more childish level of development (vs regression)
ex)surgeon throws a tantrum
9
Q
Identification
A
largely unconscious assumption of the characteristics,qualities, or traits of another person or group
ex) doing things like your favorite person
10
Q
Reaction formation
A
replacing a warded off idea or feeling with an unconsciously derived emphasis on its opposite
ex) a patient with lustful thoughts enters a monastery
11
Q
Sublimation
A
replacing an unacceptable wish with a course of action that is similar to the wish but socially acceptable
ex) aggressive urges are channeled into excellign in sports
12
Q
Altruism
A
alleviating negative feelings via unsolicited generosity, which provides gratification
13
Q
Suppression
A
Intentionally withholding an idea or feeling from conscious awareness
14
Q
Humor
A
appreciating the amusing nature of an anxiety provoking or adverse situation
15
Q
vulnerable child syndrome
A
parents perceive child as especially susceptible to illness or injury and so misses school too much
16
Q
ADHD
A
dx before 12 yrs
6 months of symptoms
17
Q
Disruptive mood dysregulation disorder
A
dx before 10 yo
severe and recurrent temper outbursts out of proportion to situation
child angry in between outburts
18
Q
Oppositional defiant disorder
A
enduring pattern of hostile, defiant behavior towards authority figures in teh absence of serious violation of social norms
19
Q
separation anxiety must last ___
A
> =4wks
normal between age 3-4
20
Q
Tourette syndrome onset before age ___
A
18 yo
caprolalia is the involuntary obscene speech
21
Q
Loss of orentation
A
first time –> place –> person
22
Q
korsakoff syndrome
A
amnesia (anterograde>retrograde) caused by vit B1 deficiency and associated with destruction of mammillary bodies
alcoholics
late neuropsychiatric manifestation of Wernicke encephalopathy which is due to vit B1 def with triad of confusion, ophthalmoplegia, ataxia
confabulations are characteristic
23
Q
Depersonalization/derealization disorder
A
detachment from self or ones environment
24
Q
Dissociative amnesia
A
cant remember important personal info
25
Dissociative identity dis order
multiple personality disorder
dissociative fugue - abrupt travel or wandering associated with traumatic circumstances
26
Delirium
"waxing and waning" level of consciousness with acute onset; rapid decrease in attention span and level of arousal
27
hallucinations vs illusions
hallucinations - perceptions in the absence of external stimuli
illusions- misperception of real external stimuli
28
___ hallucinations are more commonly a feature of medical illness
visual
29
____ hallucinations are more commonly a feature of psychiatric illness
Auditory
30
_____ hallucinations occur while going to sleep
hypnagogic
31
_____ hallucinations occur while waking up
hypnopompic
32
schizophrenia
>6 months
increase dopaminergic activity and decreased dendritic branching
must have at least 1 : delusions, hallucinations, disorganized speech
other: disorganized or catatonic behavior, negative symptoms
need 2 at least for >1 month
men younger than women
33
brief psychotic disorder
>= 1 positive symptom lasting < 1 month
34
Schizophrenia disorder
>= 2 symptoms lasting 1-6 months
35
Schizoaffective disorder
schizophrenia in addition to major mood disorder.
must have >2 wks of psychotic symptoms without major mood episode
36
hypomanic
no psychotic features
lasts >= 4 consecutive days
37
Bipolar I
1 manic episode +/- a hypomanic or depressive episode
38
Bipolar II
hypomanic and a depressive epiosode
no history of manic episodes
39
cyclothymic disorder
milder form of bipolar lasting >= 2 years
mild depressive and hypomanic
40
Major depressive disorder
atleast 5 symptoms for >= 2 wks
must also have depressed mood
SIG E CAPS
```
Sleep disturbance
Interest loss
Guilt or worthlessness
Energy loss
Concentration problems
Appetite
Psychomotor retardation or agitiation
Suicidal
```
41
persistent depressive disorder (dysthymia)
milder
>=2 symptoms lasting >= 2 years
No more than 2 months without depressive symptoms
42
MDD with seasonal pattern
>=2years
| >= 2 symptoms with seasonal pattern
43
depression effect on sleep
```
decrease slow wave sleep
decrease REM latency
Increase REM early in sleep cycle
Increase total REM sleep
Repeated nighttime awakenings
Early morning awakening (terminal insomnia)
```
44
postpartum blues vs depression
blues is 2-3 days
depression is >= 2 wks
develop during pregnancy or within 4 wks of delivery
45
grief stages
denial,anger,bargaining,depression, acceptance
46
Suicide risk factors
SAD PERSONS
```
Sex (male)
Age
Depression
Previous attempt
Ethanol or drug use
RAtional thinking loss
Sickness
Organized plan
No spouse or other social support
Stated future intent
```
47
Panic disorder
recurrent unexpected panic attachs not associated with a known trigger
palpitations, paresthesias, depersonalization, derealization, abdominal distress or nausea, light headed, intesne fear of dying,chest pain, chocking, sweating, SOB, shaking etc
need 4
attacks then followed by atleast >= 1 month of >= 1 of :
persistent concerns of additional attacks
worrying about consequences of aattaches
behavior changes related to attacks
48
Generalized anxiety disorder
>6 months of anxiety unrelated to specific person,situation, or event
49
adjustment disorder
within 3 months of stressor
| lasting <6 months
50
OCD
ego dystonic - behavior inconsistent with ones own beliefs and attitudes
51
OCPD
ego syntonic - behavior consistent with ones own beliefs and attitudes
52
PTSD
> 1 month
53
Acute stress disorder
3 days to 1 month
54
Cluster A personality disorders
paranoid
schizoid
schizotypal
55
schizoid
voluntarily socially withdrawn, limited expression of emotions, likes social isolation
56
schizotypal
eccentric, interpersonal awkwardness, magical thinking
"odd-type"
57
Cluster B personality disorders
Antisocial
Borderline
Histrionic
Narcissistic
58
Cluster C personality disorders
```
Avoidant
Obsessive compulsive (ego-syntonic, unaware)
Dependent
```
59
Do avoidant PD pts have desire for relationships
yes! but afraid
60
Malingering
symptoms intentional
motivation is intentional
looking for external gain (time off from work)
61
Factitious disorders
```
symptoms intentional
motivation unconscious
internal fain (play sick role)
```
munchausen syndrome - imposed on self
munchausen snydrome by proxy
62
Somatic symptom and related disorders
symptoms unconscious
motivation unconscious
somatic symptom disorder - body complains associated with excessive persistent thought and anxiety about symptoms
conversion disorder- loss of sensory or neuro function often following an acute stressor (going blind)
illness anxiety disorder- hypocondriac
63
BMI needed for anorexia nervosa
<18.5
64
refeeding syndrome
increases insuling --> hypophosphatemia,hypokalemia, hypomagnesmia --> cardiac complications, rhabdomyolysis, seizures
65
Bulimia nervosa, weight change?
atleast 3 months
normal weight range
dorsal hand calluses from induced vomiting (russel sing)
66
What is contraindicated in bulimic patients
buproprion
67
Treanssexual vs transvestite
live as opposite sex
dress like opposite sex
68
sleep terror occurs during ___ sleep cycle
NON-REM and thus no memory of it
69
If you can remember your dream it was during
REM sleep
70
Narcolepsy is caused by
decreased hypocretin (orexin) production in lateral hypothalamus
71
Stages of change in overcomin substance addiction
1) precontemplation - hasn't acknowledged problem
2) contemplation - acknowledging problem
3) preparation/determination - getting ready to change
4) action/willpower - changing
5) maintenance
6) relapse
72
Serotonin syndrome
any drug that increases 5-HT
increased neuromuscular activity (clonus, hyperreflexia,hyperotnia), autonomic stimulation(hyperthermia etc), agitation
tx with cyproheptadine (5-HT2 antagonist)
73
Carcinoid syndrome
carcinoid tumor
diarrhea, flushing, wheezing, right heart failure
tx with octreotide
74
Hypertensive crisis
Eating tyramine rich foods while taking MAO inhibitor
tyramine displaces other NT in the synaptic cleft and increases sympathetic stimulation
tx: phentolamine
75
Neuroleptic malignant syndrome
antipsychotics + general predisposition
Myoglobinuria, fever, encephalopathy, vitals unstable, increase enzymes, rigid muscles
tx with dantrolene, dopamine agonist and discontinue the causative agent
76
Malignant hyperthermia
inhaled anesthetics, succinylcholine + genetic predisposition
fever, sever mm contractions
tx with dantrolene
77
Delirium tremens
alcohol withdrawal after 2-4 days
altered mental status, autonomic hyperactivity, anxiety, seizures, tremors, psychomotor agitation, insomnia, nausea
tx with benzodiazepines
78
Acute dystonia
typical antipsychotics, anticonvulsants, metoclopramide
sudden onset of mm spasm, stiffness, oculogyric crisis that occurs within hours to days after med use. Laryngeal spasm requiring intubation
tx with benztropine or diphenhydramine
79
Lithium toxicity
change in lithium dosage or concurrent use of thiazides, ACE inhibs, NSAIDs, or other nephrotoxic agents
nausea, vomiting, slurred speech, hyperreflexia, seizures, ataxia, nephrogenic diabetes insipidus
discontinue lithium, hdrate aggressively with isotonic sodium chloride, consider hemodialysis
80
Tricyclic antidepressant toxicity
TCA overdose
resp depression, hyperpyrexia, prolonged QT interval
Convulsions, coma, cardiotoxicity (arrhythmia due to Na channel inhibition)
Use NaHCO3 to prevent arrhythmia
81
what is a sensitive indicator of alcohol use
alpha-glutamyltransferase (GGT)
AST value 2xALT value
82
how long after alcohol withdrawal can you get alchohol hallucinosis
12-48 hrs and usually visual
83
Patient is euphoric, has resp and CNS depression, a decreased gag reflex and pinpoint pupils. The patient is now experiencing a seizure. what type of toxicity does the patient have
opioid (depressant)
tx with naloxone
84
Patient is sweating, has dilated pupils, piloerections, fever, rhinorrhea, lacrimation, yawning, nausea, stomach cramps, diarrhea. What is the patient experiencing
opioid withdrawal
tx with methadone and buprenorphine
85
Patient has marked resp depression due to toxicity. After a few days of not taking this drug, the patient now has delirium and life threatening cardiovascular collapse
Barbiturates
86
Patient is ataxic, has minor resp depression. On withdrawal, you notice the patient has sleep disturbance, depression, and rebound anxiety, and seizure
benzodiazepines
87
Patient is euphoric, has grandiosity, pupillary dilation, prolonged wakefulness and attention, hypertension, tachycardia, anorexia, paranoia, and fever. More severe toxicity shows cardiac arrest, seizures,
Amphetamines
treatment in benzos for agitation and seizures
88
Patient has impaired judgement, pupillary dilation, hallucination, paranoid ideations, angina, sudden cardiac death. Chronic use results in perforated nasal septum due to vasoconstriction and resulting ischemic necrosis
cocaine (stimulant)
tx with alpha blockers, benzos
Beta blockers ARE NOT recommended
89
Patient is restless, has increased diuresis, mm twitching. Upon withdrawal the pt has a headache, difficulty concentrating, flu like symptoms
Caffeine
90
Patient is restless and on withdrawal the patient has irritability, anxiety, restlessnss, difficulty concentration
nicotine
tx is nicotine patch, gum, lozenges
bupropion/varenicline
91
Patient presents with violent tendencies, impulsivity, psychomotor agitation, nystagmus, tachycardia, hypertension, analgesia, psychosis, and delirium, seizures
phencyclidine (PCP)
trauma is most common complication
92
Patient has perceptual distortion, depersonalization, anxiety, paranoia, psychosis, possible flashbacks
lysergic acid diethylamide
93
Patient is euphoric, has anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawal, increased appetite, dry mouth, conjunctival injection, hallucinations. Withdrawal results in irritability, anxiety, depression, insomnia, restlessness, decreased appetite
Marijuana (cannabinoid)
pharm form is dronabinol
94
patient presents with euphoria, disinhibition, hyperactivity, distorted sensory and time perception, teeth clenching. Life threatening effects inc lude hypertension, tachy, hyperthermia, hyponatremia, serotonin syndrome. Withdrawal results in depression, fatigue, change in appetite, difficulty concentrating, anxiety
MDMA (ecstasy)
95
treatment for alcoholism
disulfiram to condition abstaining, acamprosate, naltrexone to reduce cravings, supportive care
96
Wernicke encephalopathy which is due
to vit B1 def with triad of confusion, ophthalmoplegia, ataxia
associated with periventricular hemorrhage/necrosis of mammillary bodies
tx with IV vit B1
