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Step 1 first aid Flashcards

1
Q

Classical conditioning

A

natural response is elicited by a conditioned/learned stimulus that was previously presented with unconditioned stimulus

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2
Q

Operant condition

A

particular action is elicited because it produces a punishment or reward

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3
Q

Difference between operant condition and classical conditioning

A
  • Operant: voluntary responce

- Classical: Involuntary response

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4
Q

Name 3 types of operant conditioning

A

Reinforcement
Punishment
Extinction

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5
Q

Reinforcement

A

target behavior is followed by desired award ( positive reinforcement) or removal of aversive stimulus ( negative reinforcement)

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6
Q

Punishment

A

repeated application of averse stimulus (positive) or removal of desired reward (negative) to extinguish unwanted behavior

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7
Q

Extinction

A

discontinuation of reinforcement eventually eliminates behavior

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8
Q

Transference

A

patient projects feelings about formative or other important persons into physician

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9
Q

Countertransference

A

doctor projects feelings about formative or other important persons into patient

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10
Q

psychiatrist is seen as parent

A

transference

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11
Q

patient reminds physician of younger sibling

A

countertransference

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12
Q

Tantrum

A
  • acting out

- expressing unacceptable feelings and thoughts through actions

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13
Q

A common reaction in a newly diagnosed AIDS cancer patients

A
  • Denial

- Avoiding the awareness of some painful reality

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14
Q

Mother yells at her child, because her husband yelled at her

A
  • Displacement

- Transferring avoided ideas and feelings to a neutral person or object

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15
Q

Extreme forms can result in dissociative identity disorder (multiple personality disorder)

A
  • Dissociation

- temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress

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16
Q

Adults fixating on video games

A
  • Fixation

- Partially remaining at a more childish level of development

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17
Q

A patient boasts about his physician and his accomplishments while ignoring any flaws

A
  • Idealization

- Expressing extremely positive thoughts of self and others while ignoring negative thoughts

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18
Q

Abused child later becomes child abuser

A
  • identification

- modeling behavior after another person who is more powerful (though not necessarily admired)

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19
Q

In a therapy session, patient diagnosed with cancer focuses only on rates of survival

A
  • Intellectualization

- Using facts and logic to emotionally distance oneself from a stressful situation

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20
Q

Describing murder in graphic detail with no emotional response

A
  • Isolation (of affect)

- Separating feelings from ideas and events

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21
Q

Disgruntled employee is repeatedly late to work

A
  • Passive aggression

- failing to meet the needs/expectations of other as an indirect show of opposition

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22
Q

A man who wants to cheat on his wife accuses his wife of being unfaithful

A
  • Projection

- Attributing an unacceptable internal impulse to an external source

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23
Q

After getting fired, claiming that the job was not important anyway

A
  • Rationalization

- Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame

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24
Q

A patient with libidinous thoughts enters a monastery

A
  • Reaction formation

- Replacing a warded-off idea or feeling by an (unconsciously derived) emphasis on its opposite

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25
Q

Seen in children under stress such as illness, punishment, or birth of a new sibling ( bedwetting in a previously toilet-trained child when hospitalized)

A
  • Regression

- Involuntary turning back the maturational clock and going back to earlier modes of dealing with the world

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26
Q

A 20-year-old does not remember going to counseling during his parent’s divorce 10 years earlier

A
  • Repression

- Involuntarily withholding an idea or feeling from conscious awareness

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27
Q

A patient says that all the nurses are cold and insensitive but that the doctors are warm and friendly

A
  • 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.
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28
Q

what are the 4 major mature ego defenses

A
  1. Sublimation
  2. Altruism
  3. Suppression
  4. Humor
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29
Q

Teenager’s aggression toward his father is redirected to perform well in sports

A

Sublimation
- replacing an unacceptable wish with a course of action that is similar to the wish but does conflict with one’s value system

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30
Q

Mafia boss makes large donation to charity

A

Altruism

- alleviating negative feelings via unsolicited generosity

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31
Q

Choosing to not worry about the big game until it is time to play

A

Suppression

-Intentionally withholding an idea or feeling from conscious awareness; temporary

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32
Q

Nervous medical student jokes about board

A

Humor

- Appreciating the amusing nature of an anxiety-provoking or adverse situation

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33
Q

Long term deprivation of infant results in

A

4 W’s

  • weak: failure to thrive
  • Wordless: poor language
  • Wanting: socially
  • Wary: lack of basic trust
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34
Q

ADHD is diagnosed before what age

A

12

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35
Q

How is Rett syndrome inherited? Which gender usually gets it?

A

X-linked dominant, mostly in girls

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36
Q

Sterotyped hand-wringing and deceleration of head growth should point you towrds

A

Rett Syndrome

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37
Q

Treatment for conduct disorcer

A

psychotherapy such as CBT

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38
Q

treatment for oppositional defiant disorder

A

psychotherapy such as CBT

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39
Q

Conduct disorder patient has a likely hood to have what after 18 years of age

A

antisocial

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40
Q

Onset age for separation anxiety disorder

A

7-9

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41
Q

treatment for separation anxiety disorder

A

CBT, play therapy, family therapy

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42
Q

Coprolalia

A

involuntary obscene speech

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43
Q

Tourette syndrome is associated with what

A

OCD and ADHD

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44
Q

treatment for Tourette syndrome

A
  • high-potency antipsychotics
  • tetrabenazine
  • gaunfacine
  • clonidine
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45
Q

neurotransmitter changes in Alzheimer

A

decrease: ACh
increase: glutamte

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46
Q

neurotransmitter changes in anxiety

A

decrease: GABA, serotonin
increase: norepinephrine

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47
Q

neurotransmitter change in depression

A

decrease: norepinephrine, serotonin, dopamine

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48
Q

neurotransmitter changes Huntington disease

A

decrease: GABA, ACh
increase: dopamine

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49
Q

neurotransmitter changes in Parkinson disease

A

decrease: dopamine
increase: ACh

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50
Q

neurotransmitter changes in schizophrenia

A

increase: dopamine

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51
Q

In what order do people loose orientation

A

time
place
person

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52
Q

Karsakoff syndrome

A

Amnesia (anterograde more so retrograde) caused by vitamin B1 deficiency

  • destruction of mammillary bodies
  • confabulations are characteristic
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53
Q

Dissociative amnesia

A

inability to recall important personal information

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54
Q

Dissociative identity disorder

A
  • formally known as multiple personality disorder

- 2 or more distinct identities

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55
Q

Depersonalization/derealization disorder

A

Persistent feelings of detachment or estrangement from one’s own body, thoughts, perceptions, and actions or one’s environment
- reality testing intact

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56
Q

define delirium

A

“waxing and waning” level of consciousness with acute onset

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57
Q

Most common presentation of altered mental status in inpatient setting

A

delirium

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58
Q

what does EEG show for delirium

A

diffuse slowing EEG

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59
Q

Delirium reversible or irreversible

A

reversible

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60
Q

define dementia

A

decrease intellectual function without affecting level of consciousness
- memory loss

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61
Q

apraxia

A

inability to perform particular action

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62
Q

aphasia

A

loss of ability to understand and express speech

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63
Q

agnosia

A

inability to interpret sensory

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64
Q

Alzheimer patient who develops pneumonia is at increase risk for what

A

delirium

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65
Q

EEG for dementia

A

normal

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66
Q

distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thinking

A

psychosis

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67
Q

Unique, false beliefs that persist despite the facts

A

delusions

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68
Q

perceptions in the absence of external stimuli

A

hallucinations

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69
Q

misperceptions of real external stimuli

A

illusion

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70
Q

when does hypnagogic occur

A

occurs while going to sleep

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71
Q

when does hypnopompic occur

A

occurs while waking from sleep

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72
Q

visual hallucinations are commonly seen in who

A

medical illnes

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73
Q

auditory hallucinations are commonly seen in who

A

psychiatric features

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74
Q

olfactory hallucinations typically occur when

A

temporal lobe epilepsy

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75
Q

how is schizophrenia diagnosed

A

2 of the following and 1 should be from 1-3

  1. delusions
  2. hallucinations
  3. disorganized speech
  4. disorganized behavior
  5. negative symptoms
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76
Q

how long does brief psychotic disorder last

A

less than 1 month

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77
Q

how long does schizophreniform last

A

1-6 months

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78
Q

frequent use of what drug is associated with psychosis/schizophrenia

A

cannabis

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79
Q

Schizoaffactive

A
  1. Uninterrupted periods of major mood episode ( major depression or manic) concurrent with Schizophrenia criteria A.
  2. Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode ( manic or depression)
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80
Q

fixed, persistent, false belief system lasting greater than 1 month

A

delusional disorder

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81
Q

folie a duex

A

delusional disorder shared by individuals in close relationships

82
Q

how long must a manic episode last

83
Q

how is manic episode diagnosed

A 
causes impairment 
3 of DIGFAST
-distractibility 
- insomnia
- grandiosity 
- flight of ideas 
- agitiation 
- decrease need for sleep 
- talkativeness
84
Q

what is hypomanic episode

A

same as manic but does not need hospitalization

- 4 days for diagnosis

85
Q

bipolar I

A

1 manic episode +/- hypomanic or depressive episode

86
Q

bipolar II

A

hypomanic and depressive episode

87
Q

cyclothymic disorder

A

2 years

- fluctuating between mild depressive and hypomanic symptoms

88
Q

diagnose major depressive disorder

A

5/9 for 2 or more weeks of SIGECAPS

89
Q

dysthymic ( persistent depressive disorder)

A

depression lasting 2 years

90
Q

depressed patients have what changes in their sleep

A
  • decrease slow-wave sleep, REM latency

- increase: REM early in sleep cycle, total REM sleep

91
Q

postpartum mood distrubances have an onset within

92
Q

treatment for postpatrum depression

A

CBT and SSRI

93
Q

treatment for maternal “blues”

A

supportive

94
Q

is ECT safe to use in pregnancy

95
Q

risk factors for suicide completion

A

SAD PERSONS

  • sex: male
  • age: young adult or elderly
  • Depression
  • Previous attempt
  • ethanol
  • rational thinking loss
  • sickness
  • organized plan
  • no spouse or support
  • stated future intent
96
Q

What are the symptoms of Panic disorder

A

PANICS

  • Palpitations, paresthesias, depersonlization
  • abdominal distress
  • nausea
  • Intense fear of dying, intense fear of loosing control
  • chest pain, chills, choking
  • sweating, shaking, shortness of breath
97
Q

first line treatment for panic atticks

A

CBT, SSRI, venlafaxine

98
Q

how do you diagnose panic attacks

A

attack followed by 1 month of 1 of:

  1. persistent concern of additional attacks
  2. worrying about consequences of attack
  3. behavioral change related to attacks
99
Q

Does the person recognize fear is excessive in specific phobia

100
Q

what is social anxiety disorder

A

exaggerated fear of embarrassment in social situations

101
Q

treatment for social anxiety disorder

A

CBT, SSRI, Venlafaxine

- for occasional anxiety-inducing situations: benzodiazepine or beta-blocker

102
Q

Agroaphobia

A

exaggerated fear of open or enclosed places

103
Q

what is agoraphobia associated with

A

panic disorder

104
Q

treatment for agoraphobia

A

CBT, SSRI and MAO inhibitors

105
Q

How long must generalized anxiety disorder last

A

greater than 6 months

106
Q

first line treatment for generalized anxiety disorder

A

CBT, SSRI, SNRI

107
Q

second line treatment for generalized anxiety disorder

A

Buspirone, TCA, Benzodiazepines

108
Q

adjustment disorder

A 
emotional symptoms (anxiety, depression) causing impairment following an identifiable psychosocial stressor (divorce, illness)
- lasting less than 6 months
109
Q

treatment for adjustment disorder

110
Q

difference between obsessive-compulsive disorder and obsessive-complusive personality disorder

A

compulsive disorder: ego-dystonic

personality: ego- sync

111
Q

treatment for obsessive-compulsive disorder

A

CBT, SSRI, clomipramine

112
Q

body dysmorphic disorder

A

preoccupation with minor or imagined defect in appearance

- impaired functioning

113
Q

treatment for body dysmorphic disorder

114
Q

treatment for post-traumatic stress disorder

A

CBT, SSRI, venlafaxine

115
Q

how long must post-traumatic stress disorder last

A

greater than 1 month

116
Q

How long does acute distress disorder last

A

between 3 days and 1 month

117
Q

Malingering

A

patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific secondary external gain

118
Q

factitous disorder

A

patient consciously creates physical and/or psychological symptoms to order assume sick role, primary gain

119
Q

Munchausen sydnrome

A

factitious disorder imposed on self

120
Q

Manchausen syndrome by proxy

A

factitious disorder imposed on another

121
Q

Somatic symptoms disorder

A

variety of bodily complaints (pain, fatigue) lasting for months to years ( unconscious)

122
Q

Conversion disorder

A

loss of sensory or motor function (paralysis, blindness, mutism) following an acute stressor

123
Q

la belle indifference

A

loss of sensory or motor function, often following an acute stressor, patient is aware of but sometimes indifferent toward symptoms, in conversion disorder

124
Q

illness anxiety disorder

A

excessive preoccupation with acquiring or having a serious illness, minimal somatic symptoms

125
Q

pseudocyesis

A

false, nondelusional belief of being pregnant

126
Q

one word to describe cluster A, B, C personality disorders

A

Weird, wild, worried

127
Q

personality A

A

Paranoid
Schizoid
Shizotypal

128
Q

personality B

A

Antisocial
Boderline
Histrionic
Narcissistic

129
Q

Personality C

A

Avoidant
Obsessive-compulsive
dependent

130
Q

refeeding syndrome

A
  • increase insulin
  • hypophosphotemia
  • cardiac complications
131
Q

what is the BMI in anorexia

A

less than 18.5

132
Q

binge eating disorder

A

regular episodes of excessive, uncontrollable eating without inappropriate compensatory behavior

133
Q

binge eating disorder increases the risk for what

134
Q

transsexualism

A

desire to live as the opposite sex

135
Q

transvestism

A

paraphilia, wearing clothes of the opposite sex

136
Q

sleep terror disorder occurs when at night?

A

during non-REM sleep

137
Q

when do nightmares occur at night

138
Q

what causes narcolepsy

A

decrease hypocretin production in lateral hypothalamus

139
Q

cataplexy

A

loss of all muscle tone following strong emotional stimulus, such as laughter in some patients

140
Q

treatment of narcolepsy

A

daytime stimulants: amphetamines, modafinil

night time: sodium oxybate

141
Q

6 stages of overcoming substance addiction

A
  1. precontemplation
  2. contemplation
  3. preparation/determination
  4. action/willpower
  5. maintenance
  6. relapse
142
Q

what is a sensitive indicator of alcohol use

A

gamma- glutamyltransferase

143
Q

how do you treat opioid intoxication

144
Q

how do you treat opioid withdrawel

A

methadone or buprenorphine

145
Q

treatment for cocaine overdose

A

alpha blockers

benzodiazepines

146
Q

ataxia, nystagmus, violence and memory loss is what overdose

A

phencyclidine

147
Q

difference between phencyclidine and lysergic acid diethylamide

A

nystagmus is phencyclidine

148
Q

MOA of naloxone and buprenorphine

A

antagonist and partial agonist

149
Q

MOA of naltrexone

A

long-acting opioid antagonist

150
Q

treatment for alcoholism

A

disulfiram

151
Q

when do delirium tremens peak from alcohol withdrawal

A

2-4 days after last drink

152
Q

when do alcoholic hallucinosis peak from alcohol withdrawal

A

12-48 hours

153
Q

MOA of methylphenidate

A

increase catecholamines ( norepinephrine and dopamine) in synaptic cleft

154
Q

“-azines”

A

antipyschotics

155
Q

high potency antipyschotics

A

Try to Fly High

Trifluoperazine
Fluphenazine
Haloperidol

156
Q

Low potency antipsychotics

A

Cheating Thieves are Low

Chlorpromazine
Thioridazine

157
Q

side effects of high potency antipsychotics

A

extrapyramidal symptoms

158
Q

side effects of low potency antipyschotics

A

anticholinergic
antihistamine
alpha1 blockade effect

159
Q

side effect of chlorpromazine

A

corneal deposits

160
Q

side effect of thioridazine

A

retinal deposits

161
Q

treatment for extrapyramidal side effects from antipsychotics

A

Benztropine
Diphenhydramine
Benzodiazepine

162
Q

side effect from blocking muscarinic receptors

A

dry mouth

constipation

163
Q

side effects from blocking alpha1

A

orthostatic hypotension

164
Q

side effects from blocking histamine

165
Q

what is tardive dyskinesia

A

orofacial chorea

166
Q

what is neuroleptic malignant syndrome

A

FEVER

fever
encephalopathy
vitals unstable
enzymes increase, creatine kinase
Rigidity of muslces
167
Q

what is the onset of NMS symptoms for antipsychotics

A

ADAPT

days: acute dystonia
months: akathisia
years: tardive dyskinesia

168
Q

what is a common side effect for both atypical and typical antipsychotics

A

prolonged QT interval

169
Q

MOA for atypical antipsychotics

A

D2 antagonist

Serotonin, alpha 1 and histamine 1 blocker antagonist

170
Q

Lithium side effects

A

LMNOP

Lithium 
Movement ( tremor) 
Nephrogenic diabetes insipidus 
hypOthyroidism 
pregnancy ebstein anomaly
171
Q

drug contraindications for lithium

A

Thiazide
Ace inhibitor
NSAIDS
(any drug that decreases GFR)

172
Q

MOA for buspirone

A

stimulates serotonin receptors

173
Q

what is Buspirone used to treat

A

generalized anxiety disorder

174
Q

compare buspirone with benzos

A

buspirone: does not cause sedation, addiction, or tolerance

- does not interact with alcohol

175
Q

Buspirone how long does it take to start working

176
Q

Name the SSRI

A

Fluoxetine
Paroxetine
Sertaline
Citalopram

177
Q

MOA for SSRI

A

Serotonin reptake inhibitors

178
Q

how long does it take for SSRI to take affect

179
Q

clinical use for SNRI

A

Depression
Generalized anxiety disorder
Diabetic neuropathy

180
Q

Adverse effects of SNRI

A

Increase Blood Pressure
sedation
nausea

181
Q

What is Venlafaxine specifically indicated for

A

social anxiety disorder
panic disorder
PTSD
OCD

182
Q

Characterize serotonin syndrome

A
  • neuromuscular Activity (clonus, hyperflexia)
  • Autonomic stimulation (hyperthermia)
  • Agitation
183
Q

what is used to treat serotonin syndrome

A

cyproheptadine

184
Q

MOA for tricyclic antidepressants

A

block repute of norepinephrine and serotonin

185
Q

Side effects of tricyclic antidepressants

A

sedation
alpha 1 blockade (postural hypotension)
anticholinergic (dry mouth, urinary retention, tachycardia)
prolong QT interval

186
Q

treatment for tricyclic antidepressents and why

A

NaHCO3- arrhythmias are due to Na channel inhibition

187
Q

Name the Monoamine Oxidase inhibitors

A 
MAO Takes Pride In Shanghai
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline
188
Q

MOA of MAOI

A

increases levels of amine neurotransmitters ( norepinephrine, serotonin, and dopamine)

189
Q

Clinical use for MAOI

A

atypical depression

anxiety

190
Q

adverse effects of MAOI

A 
Hypertensive crisis ( with tyramine) 
CNS stimulation
191
Q

what is MAOI contraindicated with

A 
SSRI 
TCA
St. John's wort
mepredine
dextromethorphan
192
Q

Can a patient take another serotonergic drug with MAOI?

A

wait 2 weeks after stopping MAOI before starting

193
Q

What are the atypical antidepressants

A

Bupropion
Mirtazapine
Trazodone
Vernicline

194
Q

MOA for Bupropion

A

Increase norepinephrine and dopamine

195
Q

Bupropion toxicity

A

seizures in anorexic or bulimic

headache

196
Q

MOA for Mirtazapine

A
  • alpha2-antagonist (increase release of NE and 5-HT)
  • Potent 5-HT2 and 5-HT3 antagonist
  • H1 antagonist
197
Q

Toxicity for Mirtazapine

A
  • sedation
  • weight gain, increase appetite
  • dry mouth
198
Q

MOA for Trazadone

A

blocks 5-HT2, Alpha1-adrenergic and H1 receptors

199
Q

toxicity for Trazadone

A

sedation, priapism

200
Q

MOA of Varenicline

A

Nicotonic ACh receptor partial agonist

201
Q

what drugs are used for smoking cessation

A

Bupropion

Varenicline

202
Q

Which atypical antidepressant does not cause sedation

Psychology (21 decks)

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