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112 Cards in this Set

  • Front
  • Back
Woman with anxiety about a gynecologic exam is told to relax and imagine going through the steps of the exam. What process does this exemplify?
Systematic desensitization
65 yo man is diagnosed with incurable metastatic pancreatic adenocarcinoma. his family asks you, the doctor, not to tell the patient. What do you do?
Assess whether telling patient will negatively affect his health. if not,tell him.
Man admitted for chest pain is medicated for VT. The next day he jumps out of bed and does 50 push-ups to show the nurses he has not had a heart attack. What defense mechanism is he using?
You find yourself attracted to your 26 yo pt. What do you say?
Nothing/ professional conduct and possible chaperone
Large group of people is followed over 10 years. Every 2 years, it is determined who develops heart disease and who does not. What type of study is this?
Girl can groom herself, can hop on 1 foot and has an imaginary friend. How old is she?
Man has flashbacks about his girlfriend's death 2 months ago following a hit-and-run accident. He often cries and wishes for the death of the culprit. What is the Dx?
Normal Bereavement
36 yo woman with a strong history of breast Ca refuses a mammogram because she heard it hurts. What do you do?
Discuss risks and benefits of not having a mammogram.
4 yo girl complains of a burning feeling in her genitalia; otherwises she behaves and sleeps normally. Smear of discharge shows N. Gonorrhoeae. How was she infected?
Sexual abuse
72 yo man insists on stopping tx for his heart condition b/c it makes him feel funny. What do you do?
investigate funny feeling and alternate treatments
Observational study. Sample chosen based on presence (cases) or absence (controls) of disease. Information collected about risk factors
Case-control study
Observational study. Sample chosen on presence or absence of risk factors. Subjects followed over time for development of disease.
Cohort study
Pooling data from several studies to achieve greater statistical power.
Experimental study. Compares therapeutic benefits of 2 or more treatments, or treatment and placebo
Clinical Trial
Occurs when 1 outcome is systematically favored over another.
Non-random assignment to study group
Selection Bias
Occurs when 1 outcome is systematically favored over another.
Knowledge of presence of disorder alters recall by subjects
Recall bias
Occurs when 1 outcome is systematically favored over another.
Subjects are not representative; therefore results are not generalizable
Sampling bias
Occurs when 1 outcome is systematically favored over another.
Information gathered at an inappropriate time
Late-look bias
Prevalence =
Total cases in population at a given time / total population
Incidence =
New cases in pop. over a given time period / total pop at risk
Incidence = new incidents
Sensitivity =
# of true positives / all people with disease
False negative = 1 - sensitivity
SNOUT = SeNsitivity rules OUT
Specificity =
# of true negatives / all people without disease
False positive = 1 - specificity
SPIN = SPecificity rules IN
Postive predictive value
# of true positives / # of people who tested positive
Negative predicitive value
# of true negatives / number of people who tested negative for disease
Type I error
Stating a difference when there is not a difference

Convicting an innocent man
Type II error
Stating there is not a difference when there is.

Setting a guilty man free.
Power =
1-B(type II)

Increase sample size, increases power. There is power in numbers
T-test checks
difference between the means of 2 groups
ANOVA checks
difference between the means of 3 or more groups
X^2 checks
difference between 2 or more %'s or proportions of categorical outcomes
Correlation coefficient (r)
r is always between -1 and 1
Disease prevention
Primary = prevent disease occurence
Secondary = early detection
Tertiary = reduce disability from disease
Reportable diseases
B A SSSMMART chicken or you're gone
Hep B, Hep A, Salmonella, Shigella, Syphilis, Measles, Mumps, AIDS, Rubella, Tuberculosis, Chicken Pox, Gonorrhea
E is for elderly
Aid is for destitute
Exceptions to confidentiality
Potential serious harm to others
Likelihodd of harm to self is serious
No alternative means exist to warn or protect others
Physicians interventions to prevent harm to others.
Malpractice 4 D's
Dereliction of duty
Direct cause of said damage
Low birth weight
< 2500 grams
Infant deprivation effects
4 W's
Deprivation for greater than 6 months can lead to irreversible changes
Anaclitic depression
Depression in an infant owing to continued separation from caregiver - can result in failure to thrive. Infant becomes withdrawn and unresponsive
Regression in children
Children regress to younger behavior under stress, physical illness, punishment, birth of new sibling, tiredness
Developmental milestones - 3 months
Holds head up, moro reflex disappears, social smile
Developmental milestones - 4 - 5 months
Rolls front to back, sits when propped, recognizes people
Developmental milestones - 7 - 9 months
Sits alone, crawls, Stranger anxiety, orients to voice
Developmental milestones - 12 - 14 months
Upgoing babinski disappears,
Developmental milestones - 15 months
Walks, Few words, separation anxiety
Developmental milestones - toddler - 12 - 24 months
Climbs stairs, stacks 3 blocks, Object permanence
Developmental milestones - toddler - 18-24 months
Stacks 6 blocks, Rapprochment
Developmental milestones - toddler - 24 - 36
Core Gender identity
Developmental milestones - toddler - 24 - 48 months
Parallel play
Developmental milestones - preschool - 30 - 36 months
Stacks 9 blocks, toilet training
Developmental milestones - preschool - 3 years
Rides tricycle, copies line or circle drawing, group play
Developmental milestones - pre-school - 4 years
Simple drawings (stick figure) hops on 1 foot, Cooperative play, imaginary friends
Developmental milestones - school age - 6 - 11 years
Reads, understands death, Development of conscience (super-ego), same sex friends, ID with same sex parent
Developmental milestones - adolescence
11 years for girls
13 years for boys
Abstract reasoning, formation of personality
Grief - normal bereavement lasts?
6 months to 1 year, may experience illusions
Kubler-Ross grief stages
Death Arrives Bringing Grave Adjustments
> 1 stage can be present at once
Stress effects
Stress induces production of free fatty acids, 17-OH corticosteroids, lipids, cholesterol, catecholamines. May exacerbate physical disorders
Sexual dysfunction

Dick doesn't point!
Stanford-Binet IQ test
Mental age/ chronological age x 100
IQ<70 = MR
IQ<40 = severe MR
IQ<20 = profound MR
Classical conditioning
LS paired with US to elicit CS
Pavlov's classical experiment with dogs - ringing the bell provoked salivation
Operant conditioning
Action elicits reward
Postive reinforcement - reward provokes action
Negative reinforcement - removal of aversive stimulus increases behavior
Patient projects feelings of other people onto physician
Doctor projects feelings about people onto patient
Structural theory of mind
Id = Primal urges, sex, and aggression
Superego = Moral values, conscience
Ego = Mediator between unconscious mind and real world
Topographic theory of the mind
Conscious - what you are aware of
Pre-conscious - what youare able to make conscious with effort
Unconscious - what you are not aware of
Oedipus complex
Repressed sexual feelings of a child for opposite-sex parent, accompanied by rivalry with same-sex parent.
Guilty feelings alleviated by unsolicited generosity toward others
Appreciating the amusing nature of an anxiety-provoking or adverse situation
Process whereby one replaces and unacceptable wish with a course of action that is similar to the wish but does not conflict with one's value system
Voluntary (unlike other defenses) witholding of an idea or feeling from conscious awareness
Mature women wear a SASH
Sublimation, Altruism, Suppression, Humor
Unacceptable feelings and thoughts are expressed through actions
Acting out - immature
Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress
Dissociation - immature
Avoidance of awareness of some painful reality
Denial - immature
Process whereby avoided ideas and feelings are transferred to some neutral person or object
Displacement - immature
Partially remaining at a more childish level of development
Fixation - immature
Modeling behavior after another person who is more powerful
Identification - immature
Separation of feelings from ideas and events
Isolation - immature
An unacceptable internal impulse is attributed to an external source
Projection - immature
Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame
Rationalization - immature
Process whereby a warded off idea or feeling is replaced by an (unconciously derived)emphasis on its opposite
Reaction formation - immature
Turning back the maturational clock and going back to earlier modes of dealing with the world
Regression - immature
Involuntary withholding of an idea or feeling from conscious awareness
Repression - immature
Belief that people are either good or bad
Splitting - immature
Risk factors for suicide
Sex (M), Age, Depression, Previous attempt, Ethanol, Rational thought, Sickness, Organized plan, No spouse, Social support lacking
Reflexes present at birth - Extension of limbs when startled
Moro reflex
Reflexes present at birth - nipple seeking
Rooting reflex
Reflexes present at birth - grasps object in palm
Palmar reflex
Reflexes present at birth - Large toe dorsiflexes with plantar stimulation
Babinski reflex
Changes in sensorium
Memory loss
Major depressive episode - SIG E CAPS
Sleep disturbances
Loss of interest
Loss of energy
Loss of concentration
Change in appetite
Psychomotor retardation
Suicidal ideations
Depressed mood
Manic episode - DIG FAST
Flight of ideas
Increase in goal-directed Activity or agitation
Pressured Speech
Panic disorder - PANIC
Abdominal distress
Increased perspiration
Chest pain, chills, choking
Cluster A personality disorders - weird
Paranoid, schizoid, Schizotypal
Cluster B personality disorders - wild
Antisocial, Borderline, Histrionic, Narcissitic
Cluster C personality disorders - worried
Avoidant, Obsessive-compulsive, Dependent
Childhood disorders - Severe communication problems, repetitive behavior, unusual abilities (savants)
Autistic disorder
Childhood disorders - milder form of autism, normal intelligence, lack social skills
Asperger syndrome
Childhood disorders - X-linked disorder appearing only in girls, loss of development and MR appearing at age 4
Rett disorder
Childhood disorders - Limited attention span and hyperactivity
Childhood disorders - continued behavior violating social norms.
Conduct disorder
Childhood disorders - motor / vocal tics and involuntary profanity
tourette's syndrome

Tx: Haloperidol
Childhood disorders - Fear of loss of attachment figure leading to factitious complaints to avoid going to school
Separation anxiety disorder

Common in children age 7-8
Perceptions in the absence of external stimuli
Misinterpretations of actual external stimuli
False beliefs not shared with other members of culture that are firmly maintained in spite of obvious proof to the contrary
Visual and auditory hallucinations are commmon
Olfactory hallucinations
Aura to psychomotor epilepsy
Tactile hallucinations "bugs"
Cocaine bugs