Step 1 first aid Flashcards
Classical conditioning
natural response is elicited by a conditioned/learned stimulus that was previously presented with unconditioned stimulus
Operant condition
particular action is elicited because it produces a punishment or reward
Difference between operant condition and classical conditioning
- Operant: voluntary responce
- Classical: Involuntary response
Name 3 types of operant conditioning
Reinforcement
Punishment
Extinction
Reinforcement
target behavior is followed by desired award ( positive reinforcement) or removal of aversive stimulus ( negative reinforcement)
Punishment
repeated application of averse stimulus (positive) or removal of desired reward (negative) to extinguish unwanted behavior
Extinction
discontinuation of reinforcement eventually eliminates behavior
Transference
patient projects feelings about formative or other important persons into physician
Countertransference
doctor projects feelings about formative or other important persons into patient
psychiatrist is seen as parent
transference
patient reminds physician of younger sibling
countertransference
Tantrum
- acting out
- expressing unacceptable feelings and thoughts through actions
A common reaction in a newly diagnosed AIDS cancer patients
- Denial
- Avoiding the awareness of some painful reality
Mother yells at her child, because her husband yelled at her
- Displacement
- Transferring avoided ideas and feelings to a neutral person or object
Extreme forms can result in dissociative identity disorder (multiple personality disorder)
- Dissociation
- temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress
Adults fixating on video games
- Fixation
- Partially remaining at a more childish level of development
A patient boasts about his physician and his accomplishments while ignoring any flaws
- Idealization
- Expressing extremely positive thoughts of self and others while ignoring negative thoughts
Abused child later becomes child abuser
- identification
- modeling behavior after another person who is more powerful (though not necessarily admired)
In a therapy session, patient diagnosed with cancer focuses only on rates of survival
- Intellectualization
- Using facts and logic to emotionally distance oneself from a stressful situation
Describing murder in graphic detail with no emotional response
- Isolation (of affect)
- Separating feelings from ideas and events
Disgruntled employee is repeatedly late to work
- Passive aggression
- failing to meet the needs/expectations of other as an indirect show of opposition
A man who wants to cheat on his wife accuses his wife of being unfaithful
- Projection
- Attributing an unacceptable internal impulse to an external source
After getting fired, claiming that the job was not important anyway
- Rationalization
- Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame
A patient with libidinous thoughts enters a monastery
- Reaction formation
- Replacing a warded-off idea or feeling by an (unconsciously derived) emphasis on its opposite
Seen in children under stress such as illness, punishment, or birth of a new sibling ( bedwetting in a previously toilet-trained child when hospitalized)
- Regression
- Involuntary turning back the maturational clock and going back to earlier modes of dealing with the world
A 20-year-old does not remember going to counseling during his parent’s divorce 10 years earlier
- Repression
- Involuntarily withholding an idea or feeling from conscious awareness
A patient says that all the nurses are cold and insensitive but that the doctors are warm and friendly
- Splitting
- Believing that people are either all good of all bad at different times due to intolerance of ambiguity. Commonly seen in borderline personality disorder.
what are the 4 major mature ego defenses
- Sublimation
- Altruism
- Suppression
- Humor
Teenager’s aggression toward his father is redirected to perform well in sports
Sublimation
- replacing an unacceptable wish with a course of action that is similar to the wish but does conflict with one’s value system
Mafia boss makes large donation to charity
Altruism
- alleviating negative feelings via unsolicited generosity
Choosing to not worry about the big game until it is time to play
Suppression
-Intentionally withholding an idea or feeling from conscious awareness; temporary
Nervous medical student jokes about board
Humor
- Appreciating the amusing nature of an anxiety-provoking or adverse situation
Long term deprivation of infant results in
4 W’s
- weak: failure to thrive
- Wordless: poor language
- Wanting: socially
- Wary: lack of basic trust
ADHD is diagnosed before what age
12
How is Rett syndrome inherited? Which gender usually gets it?
X-linked dominant, mostly in girls
Sterotyped hand-wringing and deceleration of head growth should point you towrds
Rett Syndrome
Treatment for conduct disorcer
psychotherapy such as CBT
treatment for oppositional defiant disorder
psychotherapy such as CBT
Conduct disorder patient has a likely hood to have what after 18 years of age
antisocial
Onset age for separation anxiety disorder
7-9
treatment for separation anxiety disorder
CBT, play therapy, family therapy
Coprolalia
involuntary obscene speech
Tourette syndrome is associated with what
OCD and ADHD
treatment for Tourette syndrome
- high-potency antipsychotics
- tetrabenazine
- gaunfacine
- clonidine
neurotransmitter changes in Alzheimer
decrease: ACh
increase: glutamte
neurotransmitter changes in anxiety
decrease: GABA, serotonin
increase: norepinephrine
neurotransmitter change in depression
decrease: norepinephrine, serotonin, dopamine
neurotransmitter changes Huntington disease
decrease: GABA, ACh
increase: dopamine
neurotransmitter changes in Parkinson disease
decrease: dopamine
increase: ACh
neurotransmitter changes in schizophrenia
increase: dopamine
In what order do people loose orientation
time
place
person
Karsakoff syndrome
Amnesia (anterograde more so retrograde) caused by vitamin B1 deficiency
- destruction of mammillary bodies
- confabulations are characteristic
Dissociative amnesia
inability to recall important personal information
Dissociative identity disorder
- formally known as multiple personality disorder
- 2 or more distinct identities
Depersonalization/derealization disorder
Persistent feelings of detachment or estrangement from one’s own body, thoughts, perceptions, and actions or one’s environment
- reality testing intact
define delirium
“waxing and waning” level of consciousness with acute onset
Most common presentation of altered mental status in inpatient setting
delirium
what does EEG show for delirium
diffuse slowing EEG
Delirium reversible or irreversible
reversible
define dementia
decrease intellectual function without affecting level of consciousness
- memory loss
apraxia
inability to perform particular action
aphasia
loss of ability to understand and express speech
agnosia
inability to interpret sensory
Alzheimer patient who develops pneumonia is at increase risk for what
delirium
EEG for dementia
normal
distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thinking
psychosis
Unique, false beliefs that persist despite the facts
delusions
perceptions in the absence of external stimuli
hallucinations
misperceptions of real external stimuli
illusion
when does hypnagogic occur
occurs while going to sleep
when does hypnopompic occur
occurs while waking from sleep
visual hallucinations are commonly seen in who
medical illnes
auditory hallucinations are commonly seen in who
psychiatric features
olfactory hallucinations typically occur when
temporal lobe epilepsy
how is schizophrenia diagnosed
2 of the following and 1 should be from 1-3
- delusions
- hallucinations
- disorganized speech
- disorganized behavior
- negative symptoms
how long does brief psychotic disorder last
less than 1 month
how long does schizophreniform last
1-6 months
frequent use of what drug is associated with psychosis/schizophrenia
cannabis
Schizoaffactive
- Uninterrupted periods of major mood episode ( major depression or manic) concurrent with Schizophrenia criteria A.
- Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode ( manic or depression)
fixed, persistent, false belief system lasting greater than 1 month
delusional disorder