Step 1 first aid Flashcards
(202 cards)
1
Q
Classical conditioning
A
natural response is elicited by a conditioned/learned stimulus that was previously presented with unconditioned stimulus
2
Q
Operant condition
A
particular action is elicited because it produces a punishment or reward
3
Q
Difference between operant condition and classical conditioning
A
- Operant: voluntary responce
- Classical: Involuntary response
4
Q
Name 3 types of operant conditioning
A
Reinforcement
Punishment
Extinction
5
Q
Reinforcement
A
target behavior is followed by desired award ( positive reinforcement) or removal of aversive stimulus ( negative reinforcement)
6
Q
Punishment
A
repeated application of averse stimulus (positive) or removal of desired reward (negative) to extinguish unwanted behavior
7
Q
Extinction
A
discontinuation of reinforcement eventually eliminates behavior
8
Q
Transference
A
patient projects feelings about formative or other important persons into physician
9
Q
Countertransference
A
doctor projects feelings about formative or other important persons into patient
10
Q
psychiatrist is seen as parent
A
transference
11
Q
patient reminds physician of younger sibling
A
countertransference
12
Q
Tantrum
A
- acting out
- expressing unacceptable feelings and thoughts through actions
13
Q
A common reaction in a newly diagnosed AIDS cancer patients
A
- Denial
- Avoiding the awareness of some painful reality
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
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
16
Q
Adults fixating on video games
A
- Fixation
- Partially remaining at a more childish level of development
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
18
Q
Abused child later becomes child abuser
A
- identification
- modeling behavior after another person who is more powerful (though not necessarily admired)
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
20
Q
Describing murder in graphic detail with no emotional response
A
- Isolation (of affect)
- Separating feelings from ideas and events
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
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
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
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
25
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
26
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
27
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.
28
what are the 4 major mature ego defenses
1. Sublimation
2. Altruism
3. Suppression
4. Humor
29
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
30
Mafia boss makes large donation to charity
Altruism
| - alleviating negative feelings via unsolicited generosity
31
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
32
Nervous medical student jokes about board
Humor
| - Appreciating the amusing nature of an anxiety-provoking or adverse situation
33
Long term deprivation of infant results in
4 W's
- weak: failure to thrive
- Wordless: poor language
- Wanting: socially
- Wary: lack of basic trust
34
ADHD is diagnosed before what age
12
35
How is Rett syndrome inherited? Which gender usually gets it?
X-linked dominant, mostly in girls
36
Sterotyped hand-wringing and deceleration of head growth should point you towrds
Rett Syndrome
37
Treatment for conduct disorcer
psychotherapy such as CBT
38
treatment for oppositional defiant disorder
psychotherapy such as CBT
39
Conduct disorder patient has a likely hood to have what after 18 years of age
antisocial
40
Onset age for separation anxiety disorder
7-9
41
treatment for separation anxiety disorder
CBT, play therapy, family therapy
42
Coprolalia
involuntary obscene speech
43
Tourette syndrome is associated with what
OCD and ADHD
44
treatment for Tourette syndrome
- high-potency antipsychotics
- tetrabenazine
- gaunfacine
- clonidine
45
neurotransmitter changes in Alzheimer
decrease: ACh
increase: glutamte
46
neurotransmitter changes in anxiety
decrease: GABA, serotonin
increase: norepinephrine
47
neurotransmitter change in depression
decrease: norepinephrine, serotonin, dopamine
48
neurotransmitter changes Huntington disease
decrease: GABA, ACh
increase: dopamine
49
neurotransmitter changes in Parkinson disease
decrease: dopamine
increase: ACh
50
neurotransmitter changes in schizophrenia
increase: dopamine
51
In what order do people loose orientation
time
place
person
52
Karsakoff syndrome
Amnesia (anterograde more so retrograde) caused by vitamin B1 deficiency
- destruction of mammillary bodies
- confabulations are characteristic
53
Dissociative amnesia
inability to recall important personal information
54
Dissociative identity disorder
- formally known as multiple personality disorder
| - 2 or more distinct identities
55
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
56
define delirium
"waxing and waning" level of consciousness with acute onset
57
Most common presentation of altered mental status in inpatient setting
delirium
58
what does EEG show for delirium
diffuse slowing EEG
59
Delirium reversible or irreversible
reversible
60
define dementia
decrease intellectual function without affecting level of consciousness
- memory loss
61
apraxia
inability to perform particular action
62
aphasia
loss of ability to understand and express speech
63
agnosia
inability to interpret sensory
64
Alzheimer patient who develops pneumonia is at increase risk for what
delirium
65
EEG for dementia
normal
66
distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thinking
psychosis
67
Unique, false beliefs that persist despite the facts
delusions
68
perceptions in the absence of external stimuli
hallucinations
69
misperceptions of real external stimuli
illusion
70
when does hypnagogic occur
occurs while going to sleep
71
when does hypnopompic occur
occurs while waking from sleep
72
visual hallucinations are commonly seen in who
medical illnes
73
auditory hallucinations are commonly seen in who
psychiatric features
74
olfactory hallucinations typically occur when
temporal lobe epilepsy
75
how is schizophrenia diagnosed
2 of the following and 1 should be from 1-3
1. delusions
2. hallucinations
3. disorganized speech
4. disorganized behavior
5. negative symptoms
76
how long does brief psychotic disorder last
less than 1 month
77
how long does schizophreniform last
1-6 months
78
frequent use of what drug is associated with psychosis/schizophrenia
cannabis
79
Schizoaffactive
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)
80
fixed, persistent, false belief system lasting greater than 1 month
delusional disorder
81
folie a duex
delusional disorder shared by individuals in close relationships
82
how long must a manic episode last
1 week
83
how is manic episode diagnosed
```
causes impairment
3 of DIGFAST
-distractibility
- insomnia
- grandiosity
- flight of ideas
- agitiation
- decrease need for sleep
- talkativeness
```
84
what is hypomanic episode
same as manic but does not need hospitalization
| - 4 days for diagnosis
85
bipolar I
1 manic episode +/- hypomanic or depressive episode
86
bipolar II
hypomanic and depressive episode
87
cyclothymic disorder
2 years
| - fluctuating between mild depressive and hypomanic symptoms
88
diagnose major depressive disorder
5/9 for 2 or more weeks of SIGECAPS
89
dysthymic ( persistent depressive disorder)
depression lasting 2 years
90
depressed patients have what changes in their sleep
- decrease slow-wave sleep, REM latency
| - increase: REM early in sleep cycle, total REM sleep
91
postpartum mood distrubances have an onset within
4 weeks
92
treatment for postpatrum depression
CBT and SSRI
93
treatment for maternal "blues"
supportive
94
is ECT safe to use in pregnancy
yes
95
risk factors for suicide completion
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
What are the symptoms of Panic disorder
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
first line treatment for panic atticks
CBT, SSRI, venlafaxine
98
how do you diagnose panic attacks
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
Does the person recognize fear is excessive in specific phobia
yes
100
what is social anxiety disorder
exaggerated fear of embarrassment in social situations
101
treatment for social anxiety disorder
CBT, SSRI, Venlafaxine
| - for occasional anxiety-inducing situations: benzodiazepine or beta-blocker
102
Agroaphobia
exaggerated fear of open or enclosed places
103
what is agoraphobia associated with
panic disorder
104
treatment for agoraphobia
CBT, SSRI and MAO inhibitors
105
How long must generalized anxiety disorder last
greater than 6 months
106
first line treatment for generalized anxiety disorder
CBT, SSRI, SNRI
107
second line treatment for generalized anxiety disorder
Buspirone, TCA, Benzodiazepines
108
adjustment disorder
```
emotional symptoms (anxiety, depression) causing impairment following an identifiable psychosocial stressor (divorce, illness)
- lasting less than 6 months
```
109
treatment for adjustment disorder
CBT, SSRI
110
difference between obsessive-compulsive disorder and obsessive-complusive personality disorder
compulsive disorder: ego-dystonic
| personality: ego- sync
111
treatment for obsessive-compulsive disorder
CBT, SSRI, clomipramine
112
body dysmorphic disorder
preoccupation with minor or imagined defect in appearance
| - impaired functioning
113
treatment for body dysmorphic disorder
CBT
114
treatment for post-traumatic stress disorder
CBT, SSRI, venlafaxine
115
how long must post-traumatic stress disorder last
greater than 1 month
116
How long does acute distress disorder last
between 3 days and 1 month
117
Malingering
patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific secondary external gain
118
factitous disorder
patient consciously creates physical and/or psychological symptoms to order assume sick role, primary gain
119
Munchausen sydnrome
factitious disorder imposed on self
120
Manchausen syndrome by proxy
factitious disorder imposed on another
121
Somatic symptoms disorder
variety of bodily complaints (pain, fatigue) lasting for months to years ( unconscious)
122
Conversion disorder
loss of sensory or motor function (paralysis, blindness, mutism) following an acute stressor
123
la belle indifference
loss of sensory or motor function, often following an acute stressor, patient is aware of but sometimes indifferent toward symptoms, in conversion disorder
124
illness anxiety disorder
excessive preoccupation with acquiring or having a serious illness, minimal somatic symptoms
125
pseudocyesis
false, nondelusional belief of being pregnant
126
one word to describe cluster A, B, C personality disorders
Weird, wild, worried
127
personality A
Paranoid
Schizoid
Shizotypal
128
personality B
Antisocial
Boderline
Histrionic
Narcissistic
129
Personality C
Avoidant
Obsessive-compulsive
dependent
130
refeeding syndrome
- increase insulin
- hypophosphotemia
- cardiac complications
131
what is the BMI in anorexia
less than 18.5
132
binge eating disorder
regular episodes of excessive, uncontrollable eating without inappropriate compensatory behavior
133
binge eating disorder increases the risk for what
diabetes
134
transsexualism
desire to live as the opposite sex
135
transvestism
paraphilia, wearing clothes of the opposite sex
136
sleep terror disorder occurs when at night?
during non-REM sleep
137
when do nightmares occur at night
REM
138
what causes narcolepsy
decrease hypocretin production in lateral hypothalamus
139
cataplexy
loss of all muscle tone following strong emotional stimulus, such as laughter in some patients
140
treatment of narcolepsy
daytime stimulants: amphetamines, modafinil
| night time: sodium oxybate
141
6 stages of overcoming substance addiction
1. precontemplation
2. contemplation
3. preparation/determination
4. action/willpower
5. maintenance
6. relapse
142
what is a sensitive indicator of alcohol use
gamma- glutamyltransferase
143
how do you treat opioid intoxication
naloxone
144
how do you treat opioid withdrawel
methadone or buprenorphine
145
treatment for cocaine overdose
alpha blockers
| benzodiazepines
146
ataxia, nystagmus, violence and memory loss is what overdose
phencyclidine
147
difference between phencyclidine and lysergic acid diethylamide
nystagmus is phencyclidine
148
MOA of naloxone and buprenorphine
antagonist and partial agonist
149
MOA of naltrexone
long-acting opioid antagonist
150
treatment for alcoholism
disulfiram
151
when do delirium tremens peak from alcohol withdrawal
2-4 days after last drink
152
when do alcoholic hallucinosis peak from alcohol withdrawal
12-48 hours
153
MOA of methylphenidate
increase catecholamines ( norepinephrine and dopamine) in synaptic cleft
154
"-azines"
antipyschotics
155
high potency antipyschotics
Try to Fly High
Trifluoperazine
Fluphenazine
Haloperidol
156
Low potency antipsychotics
Cheating Thieves are Low
Chlorpromazine
Thioridazine
157
side effects of high potency antipsychotics
extrapyramidal symptoms
158
side effects of low potency antipyschotics
anticholinergic
antihistamine
alpha1 blockade effect
159
side effect of chlorpromazine
corneal deposits
160
side effect of thioridazine
retinal deposits
161
treatment for extrapyramidal side effects from antipsychotics
Benztropine
Diphenhydramine
Benzodiazepine
162
side effect from blocking muscarinic receptors
dry mouth
| constipation
163
side effects from blocking alpha1
orthostatic hypotension
164
side effects from blocking histamine
sedation
165
what is tardive dyskinesia
orofacial chorea
166
what is neuroleptic malignant syndrome
FEVER
```
fever
encephalopathy
vitals unstable
enzymes increase, creatine kinase
Rigidity of muslces
```
167
what is the onset of NMS symptoms for antipsychotics
ADAPT
days: acute dystonia
months: akathisia
years: tardive dyskinesia
168
what is a common side effect for both atypical and typical antipsychotics
prolonged QT interval
169
MOA for atypical antipsychotics
D2 antagonist
| Serotonin, alpha 1 and histamine 1 blocker antagonist
170
Lithium side effects
LMNOP
```
Lithium
Movement ( tremor)
Nephrogenic diabetes insipidus
hypOthyroidism
pregnancy ebstein anomaly
```
171
drug contraindications for lithium
Thiazide
Ace inhibitor
NSAIDS
(any drug that decreases GFR)
172
MOA for buspirone
stimulates serotonin receptors
173
what is Buspirone used to treat
generalized anxiety disorder
174
compare buspirone with benzos
buspirone: does not cause sedation, addiction, or tolerance
| - does not interact with alcohol
175
Buspirone how long does it take to start working
1-2 weeks
176
Name the SSRI
Fluoxetine
Paroxetine
Sertaline
Citalopram
177
MOA for SSRI
Serotonin reptake inhibitors
178
how long does it take for SSRI to take affect
4-8 weeks
179
clinical use for SNRI
Depression
Generalized anxiety disorder
Diabetic neuropathy
180
Adverse effects of SNRI
Increase Blood Pressure
sedation
nausea
181
What is Venlafaxine specifically indicated for
social anxiety disorder
panic disorder
PTSD
OCD
182
Characterize serotonin syndrome
- neuromuscular Activity (clonus, hyperflexia)
- Autonomic stimulation (hyperthermia)
- Agitation
183
what is used to treat serotonin syndrome
cyproheptadine
184
MOA for tricyclic antidepressants
block repute of norepinephrine and serotonin
185
Side effects of tricyclic antidepressants
sedation
alpha 1 blockade (postural hypotension)
anticholinergic (dry mouth, urinary retention, tachycardia)
prolong QT interval
186
treatment for tricyclic antidepressents and why
NaHCO3- arrhythmias are due to Na channel inhibition
187
Name the Monoamine Oxidase inhibitors
```
MAO Takes Pride In Shanghai
Tranylcypromine
Phenelzine
Isocarboxazid
Selegiline
```
188
MOA of MAOI
increases levels of amine neurotransmitters ( norepinephrine, serotonin, and dopamine)
189
Clinical use for MAOI
atypical depression
| anxiety
190
adverse effects of MAOI
```
Hypertensive crisis ( with tyramine)
CNS stimulation
```
191
what is MAOI contraindicated with
```
SSRI
TCA
St. John's wort
mepredine
dextromethorphan
```
192
Can a patient take another serotonergic drug with MAOI?
wait 2 weeks after stopping MAOI before starting
193
What are the atypical antidepressants
Bupropion
Mirtazapine
Trazodone
Vernicline
194
MOA for Bupropion
Increase norepinephrine and dopamine
195
Bupropion toxicity
seizures in anorexic or bulimic
| headache
196
MOA for Mirtazapine
- alpha2-antagonist (increase release of NE and 5-HT)
- Potent 5-HT2 and 5-HT3 antagonist
- H1 antagonist
197
Toxicity for Mirtazapine
- sedation
- weight gain, increase appetite
- dry mouth
198
MOA for Trazadone
blocks 5-HT2, Alpha1-adrenergic and H1 receptors
199
toxicity for Trazadone
sedation, priapism
200
MOA of Varenicline
Nicotonic ACh receptor partial agonist
201
what drugs are used for smoking cessation
Bupropion
| Varenicline
202
Which atypical antidepressant does not cause sedation
Bupropion
