Test 1

Question 1

Attachment

Answer 1

The emotional dependence of the infant on its mother

Question 2

Attachment theory was developed by

Answer 2

John Bowlby and says that a secure attachment between mother and child affects the child’s ability to form healthy relationships later in life.

Question 3

Bonding refers

Answer 3

to the mother’s feelings for her infant

Question 4

Serum PCR is the test of choice to examine

Answer 4

the number of trinucleotide repeats (>35 in adults and >60 in children) to diagnose Huntington’s disease (HD).

Question 5

A chromosomal karyotype can reveal

Answer 5

macroscopic defects in chromosomes such as deletions, translocations, or trisomies.

Question 6

Urine porphobilinogens and aminolevulinic acid, when detected in urine in excessive amounts, are diagnostic of

Answer 6

acute intermittent porphyria.

Question 7

_____ ceruloplasmin, when low, is diagnostic of

Answer 7

Serum; Wilson’s disease.

Question 8

Acute intermittent porphyria presents with

Answer 8

abdominal pain, tachycardia, tingling in hands and feet, paranoia, and hallucinations.

Question 9

Creutzfeldt–Jakob disease is diagnosed by CSF assay for

Answer 9

14-3-3 proteinase inhibitor proteins.

Question 10

______ lobe lesions cause patients to appear profane, irritable, and irresponsible.

Answer 10

Orbitofrontal

Question 11

When presented with cases that involve personality changes, one should suspect pathology in the ______ ______. Also, deficits in executive functioning usually involve the ______ _____.

Answer 11

frontal lobes

Question 12

_____ ______ lesions cause apathy, characterized by limited spontaneous movement, gesture, and speech.

Answer 12

Medial frontal

Question 13

_____ _____ lesions can cause depression.

Answer 13

Left frontal

Question 14

_____ ______lobe lesions can cause mania.

Answer 14

Right frontal

Question 15

Coprolalia is the

Answer 15

compulsive utterance of obscene words, as seen in Tourette’s disorder.

Question 16

Ailurophobia is

Answer 16

a dread of cats.

Question 17

cohort study

Answer 17

in which a well-defined population is followed over a period of time.

Question 18

Cohort studies are also known as

Answer 18

longitudinal studies.

Question 19

Cohort studies provide direct estimates of

Answer 19

risk associated with a suspected causative factor.

Question 20

A case–control study is

Answer 20

a retrospective study that examines persons without a particular disease.

Cases: People who have the disease or condition under study

Controls: A similar group of people who do not have the disease or condition

Question 21

Case-control studies are often used to produce an

Answer 21

odds ratio.

Question 22

In a ____ _____, specially selected patients receive a course of treatment, whereas another group does not.

Answer 22

clinical trial

The goal is to determine the effectiveness of the treatment.

Question 23

Cross-sectional surveys describe the

Answer 23

prevalence of a disease in a population at a particular point in time.

Question 24

Crossover studies are

Answer 24

a variation of the double-blind study, wherein the placebo and treatment groups switch at some point during the study.

Question 25

Piaget described stages of

Answer 25

cognitive development

sensorimotor,
preoperational thought,
concrete operations
formal operations.

Question 25

Freud was

Answer 25

the founder of psychoanalysis, giving us the oral, anal, phallic, and latency stages of development.

Question 25

Mahler developed

Answer 25

stages of separation–individuation to describe how children develop identity that is separate from their mothers.

Her stages were normal autism, symbiosis, differentiation, practicing, rapprochement, and object constancy.

Question 26

Erikson developed an

Answer 26

eight-stage life cycle

trust vs mistrust,
autonomy vs shame and doubt, initiative vs guilt,
industry vs inferiority,
identity vs role diffusion,
intimacy vs self-absorption, generativity vs stagnation, and
integrity vs despair and isolation.

Question 27

Side effects of lithium

Answer 27

Several cutaneous side effects are possible with lithium, including acne and follicular and maculopapular eruptions. Lithium can both cause and exacerbate psoriasis. Alopecia has also been reported. Major side effects of lithium include gastrointestinal complaints, tremors, diabetes insipidus, hypothyroidism, weight gain, cardiac arrhythmia, and edema. Frequently tested is the fact that in patients suffering from psoriasis, lithium can precipitate psoriasis flare-ups. Another high-yield fact about lithium is that lithium decreases the kidney’s ability to respond to antidiuretic hormone (ADH),

Question 28

The usual brain autopsy finding in someone who dies shortly after presenting with the clinical triad of mental confusion, ophthalmoplegia, and gait ataxia is

Answer 28

microhemorrhages in the periventricular gray matter, particularly around the aqueduct and third and fourth ventricles.

Question 29

Frontal and temporal lobe atrophy is consistent with

Answer 29

Pick’s dementia.

Question 30

Parkinson’s disease would result in

Answer 30

depigmentation of the pars compacta of the substantia nigra in the midbrain.

Question 31

Diffuse Lewy bodies can be seen in both

Answer 31

Parkinson’s disease and Alzheimer’s disease.

Question 32

Subcortical white matter lesions perpendicular to the ventricles

Answer 32

(also called Dawson’s fingers) are consistent with a demyelinating disease, such as multiple sclerosis.

Question 33

Meperidine is used for and contraindicated with what psychiatric medication?

Answer 33

Contraindicated with an MAOI.

Labor medication for pain.

Question 34

What can be given with MAOIs?

Answer 34

Lithium, esketamine

Question 35

Major side effects of the MAOIs.

Answer 35

Orthostatic hypotension, weight gain, edema, sexual dysfunction, and insomnia.

Question 36

Which two MAOIs often do not require a tyramine-free diet at low doses?

Answer 36

Moclobemide and the selegiline patch only weakly potentiate the pressor effects of tyramine

Question 37

Avoid benzos in delirium because

Answer 37

A benzodiazepine given to a delirious patient can worsen the delirium and further disinhibit the patient, making him or her more agitated.

Question 38

The best choice for tranquilizing agitated patients is

Answer 38

haloperidol.

Question 39

Lithium and ADH

Answer 39

lithium decreases the kidney’s ability to respond to antidiuretic hormone (ADH), resulting in decreased fluid resorption from the distal tubules and increased urine output.

Question 40

Side effect of lamotrigine

Answer 40

liver failure, and pancreatitis, Stevens–Johnson syndrome, anemia, thrombocytopenia,

Question 41

Wilsons Dz labs

Answer 41

LOW Serum cerulopasm
HIGH Urine copper

Question 42

Pseudocyesis

Answer 42

False Pregnancy

Question 43

Korsakoff psychosis includes what additional symptoms from Wernikes?

Answer 43

Hallucinations and confabulation

Question 44

What do you give first for Wernicke’s?

Answer 44

thiamine before glucose because glucose can cause wernicke’s encephalopathy

Question 45

What other condition can lead to Wernickes?

Answer 45

Hyperemesis Gravidarum.

Question 46

Primary prevention is when

Answer 46

a clinician does something to prevent the onset of a disease.

Reducing causative agents, reducing risk factors, increasing host resistance, or interfering with the transmission of a disease.

Question 47

Secondary prevention is when

Answer 47

one identifies a disease in its early stages and seeks prompt treatment.

Question 48

Tertiary prevention involves

Answer 48

reducing deficits caused by an illness to obtain the highest possible level of functioning.

Question 49

often described in conjunction with small-cell lung carcinoma.

Answer 49

Lambert-Eaton myasthenic syndrome.

Paraneoplastic abnormality of presynaptic acetylcholine release

Question 50

a rapidly occurring demyelinating disease that can present with ascending pain, paralysis, sensory loss, or any combination of these symptoms.

Answer 50

Guillain–Barré syndrome, also known as acute inflammatory demyelinating polyneuropathy (AIDP)

Question 51

Callosal thinning and atrophy are hallmarks of

Answer 51

multiple sclerosis.

Question 52

___ ___ pathology can be seen in vitamin B12 deficiency polyneuropathy with loss of vibration and joint position sensation.

Answer 52

Dorsal column

Question 53

first and most important priority is protecting the patient from

Answer 53

harm … not looking at their chart

The first responsibility is to keep both patient and staff from being harmed.

Question 54

positive and negative reinforcement is part of operant conditioning developed by

Answer 54

Skinner.

Question 55

Bandura is a proponent of

Answer 55

social learning theory, which says we learn through modeling others and through social interaction.

Question 56

Ethosuximide is the treatment of choice for uncomplicated absence seizures, the clinical presentation depicted in this question. Failing ethosuximide, the next best choice would be

Answer 56

valproic acid, which has efficacy in partial complex, primary generalized, and absence seizure types.

Question 57

Anti Seizure med that induces its own metabolism

Answer 57

Carbamazepine induces its own metabolism.

Question 57

Dopamine is associated with the induction of

Answer 57

aggression.

Question 58

Extinction occurs when

Answer 58

the conditioned stimulus is constantly repeated without the unconditioned stimulus until the response evoked by the unconditioned stimulus eventually disappears.

Question 59

Williams’ syndrome is an autosomal ____ mental retardation syndrome that occurs by a ____ deletion that includes the elastin locus on chromosome 7q11–q23. Patients with the disorder have short stature, unusual facial features that include depressed nasal bridge (an upturned nose), broad forehead, widely spaced teeth, and elfin-like facies, as well as thyroid, renal, and cardiovascular anomalies.

Answer 59

dominant

hemizygous

Psychiatric symptoms include anxiety, hyperactivity, and hypermusicality.

Question 60

The thematic apperception test is used to test

Answer 60

normal personality and involves showing pictures and having the patient come up with stories.

The patient’s most accepted and conscious traits and motives are attributed to the character closest to the patient in sex, age, and appearance. More unconscious or unacceptable traits are attributed to those characters most unlike the patient.

Question 61

All drugs in the triptan class act as potent agonists at ___ and ___ receptors.

Answer 61

5-HT 1B and 5-HT 1D

Although these receptors reside principally on intracranial blood vessels, they may have an effect on the coronary arteries as well and could theoretically cause vasoconstriction, vasospasm, and acute myocardial infarction. Therefore these agents are contraindicated in patients with coronary ischemic heart disease and those with uncontrolled hypertension.

Question 62

Alexia without agraphia is seen with lesions involving the

Answer 62

splenium of the corpus callosum.

Question 63

Alexia without agraphia, also known as pure alexia or word blindness, is a rare neurological condition that prevents people from reading but allows them to write and understand spoken language. It’s caused by damage to the occipital region of the brain, usually from a stroke or lesion in the dominant occipital lobe and posterior corpus callosum.

Question 64

This is a clear description of the Malaysian cultural syndrome of Amok. It consists of a sudden rampage, which can include homicide and/or suicide, and ends in exhaustion and amnesia. Koro is a delusion that occurs in Asian males who believe the penis will disappear into the abdomen and cause death. Piblokto occurs in female Eskimos of northern Greenland. It involves anxiety, depression, confusion, depersonalization, and derealization and ends in stuporous sleep and amnesia. Wihtigo is a delusional fear displayed by Native American Indians of being turned into a cannibal through possession by a supernatural monster, the Wihtigo. Mal de ojo is a syndrome found in those of Mediterranean descent involving vomiting, fever, and restless sleep. It is thought to be caused by the evil eye.

Question 65

The palmomental reflex and Myerson’s sign are two of the classical, so-called frontal release signs. The palmomental reflex is positive when the chin muscle contracts as the thenar eminence of the palm contralateral to the brain lesion is stroked with a blunt instrument. Myerson’s sign is the presence of a persistence of the glabellar reflex of blinking upon confrontation of the forehead by tapping with a finger. The blinking normally should extinguish after several taps of the forehead, but in the presence of frontal lobe damage, the response does not extinguish as rapidly.

Question 66

_____ is the major excitatory neurotransmitter in the brain.

Answer 66

Glutamate

Question 67

Glycine is

Answer 67

inhibitory. The other major neuroamine neurotransmitter.

Question 68

Diazepam does what to the liver

Answer 68

Makes underlying liver issues worse

Question 69

The neurotransmitters associated with anxiety are ____, ____, _____.

Answer 69

norepinephrine, serotonin, and GABA.

Question 70

Noradrenergic neurons are found primarily in the

Answer 70

locus ceruleus.

Question 71

Serotonergic neurons are located primarily in the

Answer 71

raphe nuclei in the pons.

Question 72

Myasthenia gravis (MG) is an autoimmune neurologic disorder involving the

Answer 72

production of autoantibodies against postsynaptic nicotinic acetylcholinergic receptor sites on muscle.

Question 73

About 10% of patients with MG have

Answer 73

thymoma.

Question 74

Edrophonium

Answer 74

Only for diagnosing MG.

Edrophonium chloride (Tensilon), a short-acting cholinergic agent, is used to diagnose the disorder clinically, and pyridostigmine (Mestinon) is used to treat the disorder on an ongoing basis.

Question 75

Generalized slow activity consisting of theta and delta waves with focal areas of hyperactivity is the EEG pattern of delirium. An important characteristic of this pattern is that the rhythm is slowed. Choice A is the pattern for absence seizures. This is a commonly asked pattern on examinations. Choice B is normal adult drowsiness. Choice C is a normal pattern seen when the eyes are closed. Upon awakening, the posterior alpha rhythm is replaced by random activity. Right temporal spikes, choice E, are significant for a seizure focus. In addition to the aforementioned information, the appearance of delta waves is considered abnormal and should raise concern regarding a structural lesion, except if the patient is asleep.

Question 76

In fetishism a person, usually a male, obtains sexual arousal from an inanimate object, such as women’s undergarments, a glove, or a shoe. This needs to go on for at least 6 months to qualify for the diagnosis and often involves sexual fantasies directed at the object.

Question 77

Frotteuristic disorder involves

Answer 77

becoming sexually aroused by touching and rubbing against a nonconsenting person.

Question 78

Transvestism is a pattern of

Answer 78

sexual arousal from cross-dressing, usually seen in a heterosexual male. The answer to this question is not transvestism because the patient was wearing women’s undergarments only under his traditional male work clothes. He was not going to work dressed as a female. It is not dressing like a woman that arouses him, but a fantasy connected with an inanimate object, namely his wife’s undergarments.

Question 79

tic douloureux

Answer 79

trigeminal neuralgia

Question 80

trigeminal neuralgia (tic douloureux). It is usually unilateral. It usually affects the

Answer 80

upper two branches of the fifth nerve (V2 and V3).

Question 80

This is the classical clinical picture of temporal (also called giant cell) arteritis, a systemic vasculitis of the medium-sized vessels. Women are affected more often than men (about 3:1). The disease occurs in the elderly, usually over 50 years of age. Clinically, the disease can present as new-onset or change in headache with fever, fatigue, myalgia, night sweats, weight loss, and jaw claudication (tiredness upon chewing). About 25% of patients have polymyalgia rheumatica. The temporal artery can demonstrate tenderness to palpation with induration and diminished or absent pulse. The most feared complication is irreversible and sudden vision loss as a result of central retinal artery occlusion. The initial test of choice is the serum erythrocyte sedimentation rate (ESR), which is virtually always elevated. Temporal artery biopsy is the gold standard diagnostic test of choice in the face of an elevated ESR. The treatment of choice is prednisone. Brain imaging would not reveal the abnormality. Lumbar puncture for CSF xanthochromia is done to diagnose subarachnoid hemorrhage. Carotid dissection does not involve systemic constitutional symptoms but usually presents with ipsilateral stroke-like deficits due to arterial embolization.

Question 81

The concept that mental disorders have different outcomes was pioneered by Emil Kraepelin. He was the first to differentiate between the course of chronic schizophrenia and that of manic psychosis. He used the term dementia praecox, borrowing it from the work of French psychiatrist Morel. Eugen Bleuler later renamed it as schizophrenia and stressed that it need not have a deteriorating course. Winnicott was one of the central figures in the school of object relations theory. He developed the concepts of the “good enough mother” and the “transitional object.” Sigmund Freud is the founder of classical psychoanalysis. Heinz Kohut is best known for his writings on narcissism and self-psychology.

Question 82

Briquet’s syndrome aka

Answer 82

Somatic symptom disorder

Question 83

Cluster headache is a rare type of headache occurring in approximately 0.5% of the population. Sufferers are usually males in their 20s and 30s. Most sufferers experience episodic cycles of 4 to 12 weeks’ duration that are predominant in the spring and fall seasons. Attack periods can be considered chronic, that is, lasting 1 year or more without remission or with remission periods of less than 2 weeks’ duration. Attacks can last anywhere from 15 minutes to 3 hours. They can occur as often as eight times a day or as infrequently as once every other day. The attacks are generally nocturnal. Alcohol consumption is a common trigger. The attacks are excruciatingly painful and retro-orbital in location. Pain can radiate to the teeth, neck, and temporal regions and can be accompanied by ipsilateral autonomic symptoms. Patients prefer moving their head or pacing rather than lying still. Abortive therapies include oxygen by nasal cannula, sumatriptan subcutaneous injection, and ergotamine. Prophylactic therapies include prednisone, verapamil, divalproex sodium, methysergide, and lithium.

Question 84

Although ______ can increase blood pressure in some patients, it does not cause hypertensive crises by itself and is not contraindicated in patients with high blood pressure.

Answer 84

Buproprion

Question 85

TBI cannot get which antidepressant?

Answer 85

Wellbutrin

Question 86

_____ and _____ are not contraindicated with MAOIs.

Answer 86

Lithium and phentolamine

Levodopa and spinal anesthetics containing epinephrine are also part of a long list of medications that should not be mixed with MAOIs.

Question 87

Acetaminophen overdose does not generally affect the peripheral nervous system.

Question 88

Methylphenidate will increase TCA levels, as will some antipsychotics

Question 89

Based on the information given, this is most likely a case of SIADH that has been caused by the paroxetine. SSRI-induced SIADH is most common in elderly patients. It can present with irritability, personality changes, decreased appetite, nausea and vomiting, weakness, confusion, hallucinations, and in severe cases can lead to seizure, stupor, and coma.

Question 90

As ADH levels rise, the body holds onto water. Urine output goes down, and urine is more concentrated. Increased blood volume dilutes sodium, and sodium levels drop. To avoid confusion on standardized examinations, let’s compare this with the picture seen in psychogenic polydipsia and with that in diabetes insipidus. In psychogenic polydipsia the patient is drinking excessively. Urine output goes up, and urine is more dilute. Because there is so much water coming into the body from excessive drinking, the serum sodium drops. In diabetes insipidus there is an inability to properly concentrate the urine. Urine output goes up, and urine is more dilute. As water is moved out of the body and is not replaced, serum sodium becomes more concentrated, and laboratory values for sodium increase.

Question 91

The clinical picture depicted in this question is that of dermatomyositis. Dermatomyositis is an autoimmune disease that affects skin and muscle. Skin rash appears generally with the onset of muscle weakness. The rash is classically purplish and is mainly seen on the face and eyelids. It can also appear on the neck, elbows, and knees, which are often reddened and indurated. Serum CPK levels are often elevated. EMG results reflect myopathy and muscle irritability. The hallmark finding on muscle biopsy is perifascicular atrophy and “ghost” fibers. There is a strong relationship between dermatomyositis and occult neoplasm in up to 50% of patients with the disorder. The usual neoplasm is carcinoma and can be in the lung, breast, stomach, or ovary most typically. A cancer workup is essential in patients found to have dermatomyositis.

Question 92

The most significant genetic risk factor is believed to be homozygosity for the inheritance of the E4 allele of apolipoprotein E (apo E). Apo E4 has been associated with chromosome 19.

Question 93

The most significant genetic risk factor is believed to be homozygosity for the inheritance of the E4 allele of apolipoprotein E (apo E). Apo E4 has been associated with chromosome 19.

Question 94

____ _____ is notorious for causing hirsutism in women, facial dysmorphism, and gingival hypertrophy.

Answer 94

Phenytoin sodium (Dilantin)

Question 95

The clinical picture depicted in this question is known as a “Saturday night palsy,” which is synonymous for a radial nerve entrapment. Entrapment of the radial nerve at the axilla often results from prolonged armpit compression when the arm is draped over the edge of a chair or when a patient is on crutches. A radial nerve palsy of this kind results in weakness of the extensor muscles of the wrist and fingers, triceps weakness, and supinator weakness. Such compression injury usually resolves in 1 to 2 months. Ulnar nerve entrapment can occur either at the elbow or at the wrist. Elbow trauma may result in ulnar nerve entrapment in the cubital tunnel. Other causes include arm compression during surgery under general anesthesia. Ulnar nerve compression results in weakness of the flexor carpi ulnaris, intrinsic hand muscles, and fourth and fifth finger deep flexor weakness. Median nerve entrapment at the wrist can result in a classic carpal tunnel syndrome. This is the most common of the entrapment neuropathies. Tenosynovitis of the transverse carpal ligament places pressure on the median nerve in the tunnel, resulting in nocturnal hand paresthesias of the thumb and index and middle fingers. There may be sensory loss, thenar atrophy, and a positive Tinel’s sign in about 60% of cases. Tinel’s sign is positive when percussion of the nerve over the wrist results in paresthesias in the median nerve territory. Flexing the hand at the wrist for about 1 minute or more is called Phalen’s maneuver and can result in similar paresthesias. Injury to the median nerve is sustained with use of handheld vibrating tools and repetitive forceful use of the hands and wrists compromising the carpal tunnel. The diagnostic test of choice for carpal tunnel syndrome is needle EMG and nerve conduction studies, which reveal delayed sensory latency across the wrist. Musculocutaneous nerve injury can occur with brachial plexus injuries, such as by shoulder dislocation, compression to the shoulder during surgical anesthesia, or by repetitively carrying heavy objects over the shoulder (carpet carrier’s palsy). Weakness in the biceps and brachialis is the hallmark of musculocutaneous nerve injury. The suprascapular nerve is a pure motor nerve of the brachial plexus.

Entrapment injury can occur after repetitive forward traction at the shoulder. Diffuse aching pain in the posterior shoulder is a usual symptom. EMG demonstrates denervation of the infraspinatus and supraspinatus muscles.

Question 96

Piaget proposed four stages of

Answer 96

cognitive development: the sensorimotor stage, the stage of preoperational thought, the concrete operations stage, and the formal operations stage.

Question 97

By 2 to 3 years of age, almost all children have a concept of being either male or female. Infants begin exploring their genitalia by 15 months of age. Children also develop interest in others’ genitals, leading to exploration and exhibition. Sexual curiosity and sex play increase during puberty but are normally present before puberty. They are not a sign of anything abnormal, nor are they a result of watching television, homosexuality, hormonal imbalance, or premature development.

Answer 97

Just FYI that sex play is normal at 10 y/o

Question 98

When cocaine is chronically used, this disturbance of normal

Answer 98

dopamine metabolism leads to depletion of dopamine.

Cocaine has also been shown to be associated with decreased levels of cerebral blood flow.

Patients recovering from cocaine addiction show a drop in neuronal activity and a decreased activity of dopamine, which can persist for up to a year and a half after stopping the drug.

Question 99

Pergolide is

Answer 99

a long-acting dopamine agonist approved in 1982 for the treatment of Parkinson’s Disease.

Question 100

Ziprasidone (Geodon) stands alone as the one atypical antipsychotic that inhibits

Answer 100

serotonin and norepinephrine reuptake.

Question 101

Ziprasidone (Geodon) stands alone as the one atypical antipsychotic that inhibits

Answer 101

serotonin and norepinephrine reuptake. All of the atypical antipsychotics block the 5-HT 2A and dopamine D2 receptors.

Question 102

Aripiprazole causes ___ weight gain than most of the other atypical antipsychotics.

Answer 102

less

Interestingly, because it has less risk of prolactin elevation, aripiprazole would be a good choice for a patient with a prolactin-secreting tumor who develops psychosis.

Studies have shown lower prolactin elevation with aripiprazole than other antipsychotics.

Question 103

The raphe nuclei of the brainstem, predominantly in the pons, are the major sites of

Answer 103

serotonergic cell bodies.

Question 104

Wilson’s disease is an autosomal ___ disorder of abnormal copper metabolism. It is linked to chromosome ___. This results in excessive deposition of ____ in the brain, with a predilection for the ____ ____. The most useful laboratory test is ____ _____, which is decreased.

Answer 104

recessive

13

copper

basal ganglia

serum ceruloplasmin

Question 105

The mesolimbic pathway of dopaminergic neurons, starting at the _____ and projecting to the _______, is thought to be highly involved in the sense of reward one gets from cocaine use and is a major mediator of cocaine’s effects.

Answer 105

ventral tegmental area; nucleus accumbens

It is very involved in amphetamine’s effects as well.

Question 106

Of the many psychological tests used today, the reliability of the ________ is among the highest.

Answer 106

Wechsler Adult Intelligence Scale

Retesting of people, even at later ages, rarely reveals higher IQ scores. The scores are consistent and repeatable. As such, it is the most reliable of the choices given. It also has a very high validity in identifying mental retardation and predicting future school performance. There is also a childhood version of the same test, the Wechsler Intelligence Scale for Children.

Question 107

Drive therory

Answer 107

Freud

Question 108

Freud’s drive therory

Answer 108

e theory focused on basic instincts or drives that motivated human behavior. These drives were libido and aggression. In Freud’s model, a drive has four parts. The “source” is the part of the body from which the drive comes. The “impetus” is the amount of intensity of the drive. The “aim” is any action that discharges the tension. The “object” is the target of the action.

Question 109

A type I error occurs when

Answer 109

the null hypothesis is rejected when it should have been retained. It is the equivalent of saying that a true difference exists between two samples when the difference is due solely to chance.

Question 109

Aaron Beck is the

Answer 109

originator of cognitive behavioral therapy. In this theory, patients’ assumptions affect their cognitions, which in turn affect their mood.

Question 109

Power is the probability of

Answer 109

finding the difference between two samples. It is the probability of rejecting the null hypothesis when it should be rejected.

Question 110

Probability is the

Answer 110

likelihood that an event will occur. A probability of 1 means it will occur, a probability of 0 means that it will not.

Question 111

PCP can be found in the urine up to

Answer 111

8 days after use.

Question 112

APP is the protein that makes up the

Answer 112

amyloid plaques found in the brain in Alzheimer’s disease, encoded by a gene found on chromosome 21.

Question 113

Carbamazepine side effect and test

Answer 113

CBC would be the first test to order because of the risk of significant side effects on the hematopoietic system.

Carbamazepine also has a vasopressin-like effect and can cause water intoxication and hyponatremia.

Carbamazepine interacts significantly with the cytochrome P450 system and as such has many interactions with many drugs. Great care should be taken when prescribing carbamazepine with other medications.

Question 114

With respect to laboratory tests and anorexia, a frequently tested fact is that in anorexia, levels of ____ and ____ are decreased

Answer 114

luteinizing hormone LH and follicle-stimulating hormone FSH are decreased.

Question 115

Many of the antipsychotic medications block dopamine in the

Answer 115

tuberoinfundibular tract.

Question 116

Highest prevalence of mental illness is for

Answer 116

anxiety disorders.

More than 30 million people in the United States have an anxiety disorder. About 17.5 million have depression.

Question 117

There is an association between pathological gambling and mood disorders, particularly

Answer 117

major depressive disorder (MDD).

There is also an association with panic, OCD, and agoraphobia, but the association with MDD is greater.

Question 118

____ ____ _____involves being convinced that one has a serious disease based on misinterpretation of bodily sensations.

Answer 118

Illness anxiety disorder

Question 119

Studies of _____ clearly demonstrate that children whose biological parents were alcoholics are at increased risk for alcoholism, even when brought up by adopted families in which neither parent has an alcohol problem.

Answer 119

adoptees

Question 120

Internuclear ophthalmoplegia is a classic brainstem finding on neurologic examination of patients with demyelinating lesions of multiple sclerosis (MS). The lesion localizes to the

Answer 120

medial longitudinal fasciculus (MLF) of the brainstem.

Question 121

Pathological gambling is categorized by the DSM 5 as

Answer 121

a non–substance-related addictive disorder found under Substance-Related and Addictive Disorders.

Question 122

Social skills training is an important part of

Answer 122

psychiatric rehabilitation

Question 123

Lhermitte’s sign is

Answer 123

a transient neurologic sign described by patients as a sensation of an electric shock that descends down the spine or the extremities upon neck flexion. It is most often suggestive of MS but can also be seen in other conditions involving the cervical spinal cord, such as disk herniations, trauma, and tumors.

Question 124

Russell’s sign is

Answer 124

positive when cuts or scrapes to the backs of the hands are noted, which are a result of the teeth scraping the fingers while vomiting.

Question 125

THC and what cause paranoia

Answer 125

Amphetamines (due to amphetamine psychosis)

Question 126

____ ____ have the highest risk of becoming violent.

Answer 126

Substance abusers

Question 127

ideal patient for psychodynamic psychotherapy should have

Answer 127

the capacity for psychological mindedness, have at least one meaningful relationship, be able to tolerate affect, respond well to transference interpretation, be highly motivated, have flexible defenses, and lack tendencies toward splitting, projection, or denial.

Question 128

MRI scan reveals

Answer 128

numerous subcortical white matter demyelinating lesions that would be expected to enhance with gadolinium contrast early on during an attack, and enhancement can persist up to 8 weeks after an acute attack.

Question 129

von Recklinghausen’s disease

Answer 129

NF1 caused by a mutation in the NF1 gene on chromosome 17.

most common of the neurocutaneous illnesses,

Patients with NF1 need to have any two of the following seven criteria to carry the diagnosis: six or more café-au-lait spots, axillary or inguinal freckling, optic glioma, two or more neurofibromas or one plexiform neurofibroma, a first-degree relative with NF1, two or more Lisch nodules (hamartomas of the iris), and characteristic bony lesion, such as thinning of long bones or sphenoid dysplasia.

Question 130

Beck Anxiety Inventory is a self report questionnaire that is use best for

Answer 130

Discriminating between anxiety and depression

Question 131

The revised Koss-Butcher critical item set on the ____ is a list of 22 items related specifically to depressed suicidal ideation

Answer 131

MMPI-2

Question 132

Self reported instruments specifically designed for assessment for known predictors of suicidal behavior are (2)

Answer 132

Beck hopelessness scale and scuidade intent scale

Question 133

University of Rhode Island Change Assessment

Answer 133

measure developed to assess a patient;s readiness to change in reation to the use of drugs, alcohol, and nicotine.

Question 134

Positive and Negative syndrome scale

Answer 134

PANSS

measuring symptom severity of patients with schizophrenia

Question 135

Overt agression scale - modified

Answer 135

Rates the patient’s aggressive behavior over the past week

Question 136

Buss-Durkee Hostility Inventory

Answer 136

44 items that measure level of hostility in 3 categories: verbal aggression, physical aggression, and anger.

Question 137

State-trait anger expression inventory - 2

Answer 137

intensity of anger as an emotional state (State Anger) and the disposition to experience angry feelings as a personality trait (Trait Anger)

Question 138

Anger, Irritability, and assault questionnaire

Answer 138

impulsive aggression in outpatients, self reported

Question 139

Overcontrolled hostility scale

Answer 139

identify individuals whose massive repression of hostile or aggressive impulses leads to episodic acts of violence

Question 140

Right hemispheric lesions present most often with

Answer 140

Visuospatial deficits

Question 141

Left hemispheric lesions most associated with

Answer 141

Language issues

Question 142

WAIS-IV digit span test

Answer 142

auditory attention and working memory messure

Question 143

California learning test II

Answer 143

verbal learning & memory in older adolescents & adults.

Question 144

Token Test

Answer 144

Comprehension of spoken instructions.

It measures the capability to carry out commands of varying complexity

Question 145

Wisconsin Card sorting test

Answer 145

test of set-shifting, which is the capability to show flexibility when exposed to changes

Question 146

Judgment of Line Orientation test

Answer 146

visuospatial perception

Question 147

Honesty

Answer 147

a moral duty to be truthful with patients about their conditions, medications, procedures, and risks.

Question 148

Fidelity

Answer 148

the principle of being loyal to patients and prioritizing their well-being above all else.

Question 149

Respect

Answer 149

intrinsic, unconditional value of all persons

Question 150

Integrity

Answer 150

encompassing honesty, keeping one’s word, and consistently adhering to principles of professionalism, even when it is not easy to do so.

Question 151

Altruism

Answer 151

voluntary action that aims to improve another person’s welfare, even when it comes at a personal cost and without the expectation of reward.

Question 152

Veracity

Answer 152

principle of truth-telling, or being honest

Question 153

a rapidly occurring demyelinating disease that can present with ascending pain, paralysis, sensory loss, or any combination of these symptoms.

Answer 153

Lambert–Eaton myasthenic syndrome

Question 154

The clinical hallmark of AIDP is

Answer 154

a loss of deep tendon reflexes in the extremities.

Question 155

Lambert–Eaton myasthenic syndrome tests of choice

Answer 155

The tests of choice are EMG and nerve conduction studies, which usually reveal loss of the H reflex and decreased nerve conduction velocities.

Question 156

AIDP

Answer 156

Lambert–Eaton myasthenic syndrome

Question 157

Theory that people attribute their own behavior to situational causes and the behavior of others to personality traits.

Answer 157

Attribution theory

This then affects their feelings and behavior.

Question 158

Hull …

Answer 158

did work in the neurophysiologic aspects of learning, developing a drive reduction theory of learning.

Question 159

Learned helplessness is

Answer 159

developed by Seligman

Organisms become depressed and apathetic because no matter what it does, its environmental circumstances never change.

Question 160

Kandel studied.

What does his theory state?

Answer 160

Habituation and sensitization.

Habituation theory says that an animal can learn to stop responding to a repeated stimulus.

Sensitization theory says that an organism can be taught to respond more easily to a stimulus or be made more sensitive to that stimulus.

Question 161

Pavlov developed classical conditioning. In classical conditioning, a

Answer 161

neutral stimulus is paired with one that evokes a response so that eventually the neutral stimulus comes to evoke the same response.

Involuntary

Question 162

NF2 is caused by a

Answer 162

mutation in the NF2 gene on chromosome 22.

must have bilateral acoustic schwannomas to meet criteria for this condition. If the schwannoma is unilateral, the patient meets criteria only with a first-degree relative with NF2.

Question 163

The treatment of an acute MS attack is generally

Answer 163

with intravenous corticosteroids. This may or may not be followed with an oral prednisone taper.

NO – Intravenous immunoglobulin therapy and plasmapheresis are treatments for MG and Guillain–Barré syndrome – not for MS.

Question 164

Criteria for pathological gambling include

Answer 164

preoccupation with gambling, gambling increased sums of money to obtain excitement, being unsuccessful at stopping or cutting back, gambling to escape dysphoric mood, lying to significant others about gambling, loss of important relationships over gambling, committing illegal acts to be able to gamble, relying on others to pay the bills because of money lost gambling, and a desire to keep going back to break even.

Question 165

cocaine can be found in urine up to

Answer 165

up to 8 hours after use

Question 166

heroin can be found in the urine up to

Answer 166

up to 72 hours after use

Question 167

Self-psychology is the theory of

Answer 167

Kohut.

Question 168

The locus ceruleus of the brainstem contains a high number of

Answer 168

adrenergic neurons and mediates the effects of opiates and opioids.

Question 169

Serotonin is associated with

Answer 169

decreased aggression. In particular, the CSF levels of 5-hydroxyindoleacetic acid (5-HIAA), a major serotonin metabolite, have been shown to be inversely correlated with the frequency of aggression.

Question 170

GABA is the major

Answer 170

inhibitory neurotransmitter of the brain and is associated with decreased aggression.

Question 171

Glycine is an

Answer 171

inhibitory neurotransmitter and, as such, is not associated with increased aggression. As a general rule, it is thought that cholinergic and catecholaminergic mechanisms seem to be involved in the induction of aggression, and serotonin and GABA seem to inhibit such behavior.

Question 172

As a general rule, it is thought that ___ and ___ mechanisms seem to be involved in the induction of aggression, and ___ and ___ seem to inhibit such behavior.

Answer 172

cholinergic, catecholaminergic

serotonin, GABA

Question 173

Wilson’s Disease symptoms

Answer 173

The most frequent neurologic manifestations are parkinsonism, flapping tremor, ataxia, dystonia, and bulbar signs, such as dysphagia and dysarthria. Signs of liver failure are usually present. The treatment of choice is penicillamine, a copper-chelating agent, which in many cases can reverse the deficits of the disease.

Question 174

Serum ACE level would be a screening test for

Answer 174

sarcoidosis

Question 175

Lumbar puncture for CSF oligoclonal bands and myelin basic protein would be a useful supportive test (in addition to brain and/or spinal cord MRI) for

Answer 175

multiple sclerosis.

Question 176

The ventral tegmental area, substantia nigra, and nucleus accumbens are all ____ areas and are parts of the major neuronal pathways involved in the pathophysiology of ____.

Answer 176

dopaminergic

schizophrenia

Question 177

ziprasidone unique blockade of the ____ receptor.

Answer 177

5-HT 1A

Question 178

All of the atypical antipsychotics block the ___ and ____ receptors.

Answer 178

5-HT 2A ; dopamine D2

Question 179

The Halstead–Reitan battery helps find the

Answer 179

location of brain lesions and differentiates between those who are brain damaged and those who are neurologically intact. It consists of a series of 10 tests. The

Question 180

MMPI is a

Answer 180

personality assessment used to find areas of psychopathologic functioning. It consists of more than 500 statements to which the patient must respond “true,” “false,” or “cannot say.”

Question 181

The BPRS is used to assess

Answer 181

the severity of psychosis in schizophrenia.

Question 182

The clinical picture is the classic tetrad of acalculia, agraphia (without alexia), right and left confusion, and finger agnosia (the inability to name fingers) is ….

Answer 182

Gerstmann’s syndrome usually involves left parietal lobe damage (left angular gyrus).

Question 183

During the concrete operations stage the child begins to deal with information outside of him or herself and to see things from others’ perspectives. The child also develops conservation, which is the idea that although objects may change, they can maintain characteristics that allow them to be recognized as the same (for example, different leaves may be different shapes and colors but are all leaves). The concept of reversibility is also understood at this stage. It says that things can change form and shape and then go back again (for example, ice to water to ice).

Question 184

Glutamate is the precursor to ____.

Answer 184

GABA

Question 185

The major inhibitory neurotransmitters are ___ and ___.

Answer 185

GABA and glycine

Question 186

____ works on the NMDA receptor and four types of non-NMDA receptors.

Answer 186

Glutamate

Question 187

The ____ receptor is bound by PCP.

Answer 187

NMDA

Question 188

Glutamate is thought to be very important in learning and memory.

Answer 188

Glutamate is also important in the theory of excitotoxicity, which postulates that excessive glutamate stimulation leads to excessive intracellular calcium and nitric oxide concentrations and cell death.

Question 189

Locations for glutamate in the brain include

Answer 189

cerebellar granule cells,
striatum,
hippocampus,
pyramidal cells of the cortex,
thalamocortical projections, and
corticostriatal projections.

Question 190

Understimulation of the NMDA receptor by glutamate has been found to cause ____; therefore glutamate is thought to play some role in ____, although the exact nature of that role is yet unclear.

Answer 190

psychosis; schizophrenia

Question 191

best explains pathological gambling

Answer 191

random reinforcement: the reward is given only a fraction of the time at random intervals to keep the gambler guessing and trying to anticipate when he or she will win.

Question 192

child’s temperament is based on _____

Answer 192

at 8mo, temperament is a function of its genes. Environment plays more of a role when older

Question 193

If a mistake is made

Answer 193

briefly acknowledge and move on

Question 194

failure to develop cohesive self-awareness

Answer 194

identity diffusion

Question 195

Selective perception (or attention) bias

Answer 195

depressed patient only sees/recalls the negative behaviors/events around them based on frame of reference. TV only has bad news on.

Question 196

Cognitive distortions

Answer 196

are exaggerated and irrational thoughts, identified in cognitive therapy and its variants, which in theory perpetuate some psychological disorders –> magnify or minimize

Question 197

catastrophizing

Answer 197

one subtype of magnification, which is the inability to foresee anything other than the worst possible outcome

Question 198

interpretation

Answer 198

making something that was unconscious conscious. It is an explanatory statement that links a feeling, thought, behavior, or symptom to its unconscious meaning.

Question 199

Clarification

Answer 199

reformulating what the patient has said to create a coherent view of what has been communicated.

Question 200

Empathic validation

Answer 200

demonstration of the therapist’s empathic understanding of the patient’s internal state.