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psychology Flashcards

1
Q

Positive reinforcement

A

giving a reward

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2
Q

Negative reinforcement

A

taking away an aversive stimuli

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3
Q

positive punishment

A

application of aversive stimulus

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4
Q

Negative punishment

A

removal of desired reward

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5
Q

Transference

A

patient projects feelings onto physician

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6
Q

countertransference

A

physician projects feelings onto patient

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7
Q

Mature defenses

A

Sublimation
Altruism
Suppression
Humor

“adults wear a SASH”

everything else is ego/immature defnse

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8
Q

Fixation

A

partially remaining at a more childish level of development (vs regression)

ex)surgeon throws a tantrum

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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

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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

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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

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12
Q

Altruism

A

alleviating negative feelings via unsolicited generosity, which provides gratification

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13
Q

Suppression

A

Intentionally withholding an idea or feeling from conscious awareness

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14
Q

Humor

A

appreciating the amusing nature of an anxiety provoking or adverse situation

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15
Q

vulnerable child syndrome

A

parents perceive child as especially susceptible to illness or injury and so misses school too much

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16
Q

ADHD

A

dx before 12 yrs

6 months of symptoms

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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

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18
Q

Oppositional defiant disorder

A

enduring pattern of hostile, defiant behavior towards authority figures in teh absence of serious violation of social norms

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19
Q

separation anxiety must last ___

A

> =4wks

normal between age 3-4

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20
Q

Tourette syndrome onset before age ___

A

18 yo

caprolalia is the involuntary obscene speech

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21
Q

Loss of orentation

A

first time –> place –> person

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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

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23
Q

Depersonalization/derealization disorder

A

detachment from self or ones environment

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24
Q

Dissociative amnesia

A

cant remember important personal info

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25
Q

Dissociative identity dis order

A

multiple personality disorder

dissociative fugue - abrupt travel or wandering associated with traumatic circumstances

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26
Q

Delirium

A

“waxing and waning” level of consciousness with acute onset; rapid decrease in attention span and level of arousal

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27
Q

hallucinations vs illusions

A

hallucinations - perceptions in the absence of external stimuli
illusions- misperception of real external stimuli

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28
Q

___ hallucinations are more commonly a feature of medical illness

A

visual

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29
Q

____ hallucinations are more commonly a feature of psychiatric illness

A

Auditory

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30
Q

_____ hallucinations occur while going to sleep

A

hypnagogic

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31
Q

_____ hallucinations occur while waking up

A

hypnopompic

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32
Q

schizophrenia

A

> 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

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33
Q

brief psychotic disorder

A

> = 1 positive symptom lasting < 1 month

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34
Q

Schizophrenia disorder

A

> = 2 symptoms lasting 1-6 months

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35
Q

Schizoaffective disorder

A

schizophrenia in addition to major mood disorder.

must have >2 wks of psychotic symptoms without major mood episode

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36
Q

hypomanic

A

no psychotic features

lasts >= 4 consecutive days

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37
Q

Bipolar I

A

1 manic episode +/- a hypomanic or depressive episode

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38
Q

Bipolar II

A

hypomanic and a depressive epiosode

no history of manic episodes

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39
Q

cyclothymic disorder

A

milder form of bipolar lasting >= 2 years

mild depressive and hypomanic

40
Q

Major depressive disorder

A

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
Q

persistent depressive disorder (dysthymia)

A

milder
>=2 symptoms lasting >= 2 years
No more than 2 months without depressive symptoms

42
Q

MDD with seasonal pattern

A

> =2years

>= 2 symptoms with seasonal pattern

43
Q

depression effect on sleep

A 
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
Q

postpartum blues vs depression

A

blues is 2-3 days
depression is >= 2 wks

develop during pregnancy or within 4 wks of delivery

45
Q

grief stages

A

denial,anger,bargaining,depression, acceptance

46
Q

Suicide risk factors

A

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
Q

Panic disorder

A

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
Q

Generalized anxiety disorder

A

> 6 months of anxiety unrelated to specific person,situation, or event

49
Q

adjustment disorder

A

within 3 months of stressor

lasting <6 months

50
Q

OCD

A

ego dystonic - behavior inconsistent with ones own beliefs and attitudes

51
Q

OCPD

A

ego syntonic - behavior consistent with ones own beliefs and attitudes

52
Q

PTSD

A

> 1 month

53
Q

Acute stress disorder

A

3 days to 1 month

54
Q

Cluster A personality disorders

A

paranoid
schizoid
schizotypal

55
Q

schizoid

A

voluntarily socially withdrawn, limited expression of emotions, likes social isolation

56
Q

schizotypal

A

eccentric, interpersonal awkwardness, magical thinking

“odd-type”

57
Q

Cluster B personality disorders

A

Antisocial
Borderline
Histrionic
Narcissistic

58
Q

Cluster C personality disorders

A 
Avoidant 
Obsessive compulsive (ego-syntonic, unaware)
Dependent
59
Q

Do avoidant PD pts have desire for relationships

A

yes! but afraid

60
Q

Malingering

A

symptoms intentional
motivation is intentional
looking for external gain (time off from work)

61
Q

Factitious disorders

A 
symptoms intentional
motivation unconscious
internal fain (play sick role)

munchausen syndrome - imposed on self
munchausen snydrome by proxy

62
Q

Somatic symptom and related disorders

A

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
Q

BMI needed for anorexia nervosa

A

<18.5

64
Q

refeeding syndrome

A

increases insuling –> hypophosphatemia,hypokalemia, hypomagnesmia –> cardiac complications, rhabdomyolysis, seizures

65
Q

Bulimia nervosa, weight change?

A

atleast 3 months

normal weight range

dorsal hand calluses from induced vomiting (russel sing)

66
Q

What is contraindicated in bulimic patients

A

buproprion

67
Q

Treanssexual vs transvestite

A

live as opposite sex

dress like opposite sex

68
Q

sleep terror occurs during ___ sleep cycle

A

NON-REM and thus no memory of it

69
Q

If you can remember your dream it was during

A

REM sleep

70
Q

Narcolepsy is caused by

A

decreased hypocretin (orexin) production in lateral hypothalamus

71
Q

Stages of change in overcomin substance addiction

A

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
Q

Serotonin syndrome

A

any drug that increases 5-HT

increased neuromuscular activity (clonus, hyperreflexia,hyperotnia), autonomic stimulation(hyperthermia etc), agitation

tx with cyproheptadine (5-HT2 antagonist)

73
Q

Carcinoid syndrome

A

carcinoid tumor

diarrhea, flushing, wheezing, right heart failure

tx with octreotide

74
Q

Hypertensive crisis

A

Eating tyramine rich foods while taking MAO inhibitor

tyramine displaces other NT in the synaptic cleft and increases sympathetic stimulation

tx: phentolamine

75
Q

Neuroleptic malignant syndrome

A

antipsychotics + general predisposition

Myoglobinuria, fever, encephalopathy, vitals unstable, increase enzymes, rigid muscles

tx with dantrolene, dopamine agonist and discontinue the causative agent

76
Q

Malignant hyperthermia

A

inhaled anesthetics, succinylcholine + genetic predisposition

fever, sever mm contractions

tx with dantrolene

77
Q

Delirium tremens

A

alcohol withdrawal after 2-4 days

altered mental status, autonomic hyperactivity, anxiety, seizures, tremors, psychomotor agitation, insomnia, nausea

tx with benzodiazepines

78
Q

Acute dystonia

A

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
Q

Lithium toxicity

A

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
Q

Tricyclic antidepressant toxicity

A

TCA overdose

resp depression, hyperpyrexia, prolonged QT interval

Convulsions, coma, cardiotoxicity (arrhythmia due to Na channel inhibition)

Use NaHCO3 to prevent arrhythmia

81
Q

what is a sensitive indicator of alcohol use

A

alpha-glutamyltransferase (GGT)

AST value 2xALT value

82
Q

how long after alcohol withdrawal can you get alchohol hallucinosis

A

12-48 hrs and usually visual

83
Q

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

A

opioid (depressant)

tx with naloxone

84
Q

Patient is sweating, has dilated pupils, piloerections, fever, rhinorrhea, lacrimation, yawning, nausea, stomach cramps, diarrhea. What is the patient experiencing

A

opioid withdrawal

tx with methadone and buprenorphine

85
Q

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

A

Barbiturates

86
Q

Patient is ataxic, has minor resp depression. On withdrawal, you notice the patient has sleep disturbance, depression, and rebound anxiety, and seizure

A

benzodiazepines

87
Q

Patient is euphoric, has grandiosity, pupillary dilation, prolonged wakefulness and attention, hypertension, tachycardia, anorexia, paranoia, and fever. More severe toxicity shows cardiac arrest, seizures,

A

Amphetamines

treatment in benzos for agitation and seizures

88
Q

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

A

cocaine (stimulant)

tx with alpha blockers, benzos

Beta blockers ARE NOT recommended

89
Q

Patient is restless, has increased diuresis, mm twitching. Upon withdrawal the pt has a headache, difficulty concentrating, flu like symptoms

A

Caffeine

90
Q

Patient is restless and on withdrawal the patient has irritability, anxiety, restlessnss, difficulty concentration

A

nicotine

tx is nicotine patch, gum, lozenges

bupropion/varenicline

91
Q

Patient presents with violent tendencies, impulsivity, psychomotor agitation, nystagmus, tachycardia, hypertension, analgesia, psychosis, and delirium, seizures

A

phencyclidine (PCP)

trauma is most common complication

92
Q

Patient has perceptual distortion, depersonalization, anxiety, paranoia, psychosis, possible flashbacks

A

lysergic acid diethylamide

93
Q

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

A

Marijuana (cannabinoid)

pharm form is dronabinol

94
Q

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

A

MDMA (ecstasy)

95
Q

treatment for alcoholism

A

disulfiram to condition abstaining, acamprosate, naltrexone to reduce cravings, supportive care

96
Q

Wernicke encephalopathy which is due

A

to vit B1 def with triad of confusion, ophthalmoplegia, ataxia

associated with periventricular hemorrhage/necrosis of mammillary bodies

tx with IV vit B1

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