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159 Cards in this Set

  • Front
  • Back
In the US do we have more cases of gonorrhea or AIDS?
gonorrhea
Do we have more cases of chlamidia or gonorrhea?
chlamidia
more cases of lyme or legionaires disease?
lyme
More salmonella or tB?
salmonella
more mumps or measles?
mumps
What is the most common childhood infectious reportable disease?
chicken pox
What are two medications that is given to mothers with HIV in order to prevent transmission to the child?
AZT and neverapine
What is the down side of AZT?
it must be taken consistently across the course of the pregnancy and delivery, and thus it sometimes doesn't work due to patient non-adherence
What drug is a new alternative to AZT and why is it sometimes a better choice?
You only have to give neveripine twice. Once to the mother during labor and once to the child after birth.
What type of pathway is the addiction pathway in the brain and what is the specific path of the pathway
The addiction pathway is a dopamine pathway and it goes from the:

MEDIAL FOREBRAIN BUNDLE (MFB) to the
NUCLEUA ACCUMBENS (NAC) to the
VENTRAL TEGMENTAL AREA (VTA)
What is the leading cause of mental retardation?
second?
Leading is fetal alcohol syndrome.
Second is Down's syndrome
What questions do you ask to see if a person has an alcohol problem?
CAGE Questoins:
Even tried to CUT down on comsumption and not succeeded?
Even been ANNOYED about criticism concerning your drinking?
Ever felt GUILTY about your dringking behavior?
Ever had to take a drink as an EYE-OPENER in the morning to relieve the anxiety and shakiness?
What drug is given so that when mixed with alcohol it makes the person feel horrible?
Disulfram
Why does disulfram not work that great in reality?
alcoholics will wait until the disulfram is wearing off and them drink again
Chemically, how does disulfram work?
inhibits breakdown of what by what?
Disulfram inhibits the breakdown of ACETALDEHYDE by ALDEHYDE DEHYDROGENASE
How is alcohol broken down in the body?
Alcohol is broken down by alcohol dehydrogenase to acetaldehyde. Acetaldehyde is broken down by aldyehyde dehydrogenase to acetic acid
what drug is given to prevent alcoholic from relapsing?
Acamprosate
What type of receptor does alcohol effect and what is the effect?
Alcohol abuse increases the number of glutamate receptors
How does acamprosate have it's effect?
Asamprosate lowers the number of glutamate receptors. By reducing the number of glutamate receptors it lowers alcoholics inpulse to drink.
How are seizures related to alcoholics?
seizures can effect people who drink too much or are going through detoxification.
What is a medication to prevent these alcohol related seizures?
give benzodiazapines
What is a good benzodiazapine to give in order to prevent seizures?
Lorazapam
What medication can be given in order to make alcohol taste bad?
naltrexone
on naltrexone, what percentage of alcoholics will relapse?
without naltrexone?
with naltrexone = 50%
without= 95%
What is the mechaniam of amphetamines?
release Dopamine
What is the mechanism of cocaine?
prevent re-uptake of dopeamine
What does someone look like on amphetamines or cocaine?
snxious, lots of energy , looking everywhere, paranoid, and the effect on pupils is in another question.
What happens to the pupils of someone on amphetamines or cocaine?
dialated pupils
Wheat happens when someone is on withdrawl from amphetamines and cocaine?
depression, fatigue, INCREASED APPITITE, and nightmares
Why is the appitite so high for people coming off of amphetamines and cocaine?
because you have been using so much energy while of the amphetamines or cocaine that you must now make up for the expenditure.
Why are amphetamines and cocaine so addictive?
they go directly to the dopamine pathway for pleasure...median frontal bundle, nucleus accumbens, ventral tegmental area.
What type of psych disorder might you look like if on cocaine?
paranoid schitzophrenia
What is the treatment for people who have had too much amphetamines or cocaine?
the same as for schitxophrenia...antipsychotics
very basically, how do the antipsychtics work?
they drive dopamine levels down
What does bromocriptine do and why is it given to for with drawl from cocaine?
It actually increases dopamine becaue the withdrawl procedure needs to be a stair step down procedure.
What is the mechanism of caffeine?
what does this result in?
they antagonize adenosine receptors
this results in increased cAMP in the cells with the affected adenosine receptors.
What does someone look like on cannabis?
Slow respone time, impaired judgement, increased appitite.
What is the very basic mechanism of cannibus.
works of inhibitory G protein and GABA and increases serotonin
what are two examples of hallucinogens?
LSD and mescaline
What happens when high on hallucinogens?
HALLUCINATE
anxiety
ideas of reference (you think everything is about you - someone parts car across street, you think they are coming to see you)
depersonalization
PUPILLAREY DILATION,
lack of coordination
are hallucinogens addicting?
no, there are no withdrawl reactions
is cannibus addicting?
no, there are no withdrawl reactions
what is the mechanism of hallucinogens?
they are partial agonists at the postsynaptic serotonin receptors.
What are some other things associated with LSD?
flashbacks, after been off for a while you can have flashbacks, and synesthesias (this is when you hear a smell or see a sound)
What is a very rare but serious side effect of LSD?
life threatening convulsions
how can you tell when someone has been using inhalants.
they are belligerent (hostile and confrontative), impaired judgemetn, lack of coordination, and lethargy.
What is a visible sign that someone has been using inhalants?
crusting around the breathing orifaces due to the buildup of the inhalant
are inhalants addicting
no, no withdrawly reaction
What transmiter do inhalants work on?
GABA
What region of the brain is effected by the inhalants and what does this cause?
ceerebellum is effected and this causes a lack of coordination.
who uses inhalants
people who are young, poor, and not very drug sophistocated. they are not usually using other drugs.
what is hte mechanism for nicotine?
agonisT at Ach receptors, activates the adictive dopeamine pathway, increases glutamate
is nicotine addictive
yes VERY!
what is the main example of an opiate
heroin
how can you tell if someone is high on opiates?
pupullary CONSTRICTION, constipation, drowsiness, bacially just a complete slowdown of the body, the slow down can lead to coma.
What is the withdrawl from opiates (eg. heroin) like?
the withdrawl is not life threatening, you will simply have flu like symptoms along with PUPILLARY DILATION.
what is the mechanism for opiates?
acts on the opiate receptors and the locus cereleus pathway (noradrenergic)
What are the treatments for opiate addiction and what does each do?
naloxone - induces withdrawl instead of waiting for it but the problem is the short half life
naltrexone - induces withdrawl like naloxone but has a longer half life
clonidine - although not always necessary clonidine can ease the symptoms of withdrawl although the symptoms are relatively minor
methadone and LAMM (levo-ac-aretyl-methadol) - as addicting as, if not more addicting than, opiates themselves but by giving it out it keeps crime down but the withdrawl symptoms are longer. One positive aspect of methanone is that it is taken orally and thus the drug user does not have to use needles.
what is someone like when they are high on phencyclidine?
they are hostile agressive and VERY DIFFICULY TO CONTROL, they have a decreased response to pain, are very ver paranoid and very violent
how do people usually take PCP?
in combination with another drug such as a heroin injection or marajuana cigarette
What is the mechanism for PCP?
it is an antagonist to the NMDA glutamate receptors, prevents influx of CA++ ions, and activate dopaminergic neurons
What is the intervention for someone on PCP?
NON-STIMULATING ENVIRONMENT
and them calmly strap them into restraints.
give vitamin C to steep up the urinary claearance
give benzodiazapines to calm him down
give anti psychotics, eg. haldol, also to calm him down
what is someone like if they have taken too many barbituates or benzodiazapines?
they look drunk
What is the withdrawl from benzos and barbs like?
this class is most likely to kill you in withdrawl.
you have autonomic hyperactivity, tremors, hyperactivity, hallucinations, anxiety, and grand mal seizures.
what is the sedative hypnotics (benzos and barbs) mechanism?
work on GABA, they have cross tolerance (you need increasingly larger doses of drug B because you have been taking drug A)
what is another name for ecstacy?
MDMA
what is ecstacy made of?
amphatamine combined with a hallucinogen
what is the concequence of ecstacy?
destruction of serotonin receptors (increased impulsiveness)

destruction of connections between brain cells (memory gaps)
what are the long term consequences of anabolic steroids?
cardiomyopathy, bone mineral loss with later osteoporosis, hypertension, diabetes, mood lability, depression , and atypical psychosis
what are the presenting signs of anabolic steriods
skin atrophy, spontaneous bruising, acne, low serum potassium levels
which drugs do not have withdrawal reactoins
hallucinogens, inhalants, cannabis, and pcp
schitzophrenic dilusional disorder can occur with which drugs? (patient presents as schitzophrenic)
amphetamines, cocaine, hallucinogens, cannibus, or phencyclodine
patient come in with paranoia

most likely, which drug is he on
cocaine/amphetamine intoxication
patient come in with depressoin

most likely, which drug is he on
cocaine/amphetamine withdrawal
patient come in with arrhythmias

most likely, which drug is he on
cocaine intoxication
patient come in with violence

most likely, which drug is he on
PCP
patient come in with vertical nystagmus

most likely, which drug is he on
PCP
patient come in with pinpoint pupils

most likely, which drug is he on
opiate overdose
what is the treatment for someone who has pinpoint pupils due to an opiate overdose?
naloxone
patient come in with flu-like

most likely, which drug is he on
opiate withdrawal
patient come in with flashbacks

most likely, which drug is he on
LSD
patient come in with seizures

most likely, which drug is he on
benzoid withdrawal
patient come in with death

most likely, which drug is he on
barbituate withdrawal
what is the treatment for someone who is exhibiting flu-like symptoms due to opiate withdrawl?
clonidine
What is the definition of pedophilis
sexual urges toward children
What is the definition of exhibitionism
espose genitals to stranger
What is the definition of voyeurism
pleasure from watching others
What is the definition of sadism
pleasure derived from others' pain
What is the definition of masochism
sexual pleasure derived form being abused or dominated
What is the definition of fetishism
focus on objects
What is the definition of transvestite fetishism
men in female clothes
what is it called when a person is biologically male, thinks he is male, and he is attracted to females?
heterosexual
what is it called when a person is biologically male, gender identity is male, prefered partner is female, but he likes dressing in womens clothing in order to get arousal and gratificatoin.
transvestite fetishism
what is it when someone is biologically male, thinks that he is female, and thus is attracted to males?
transsexual
what is it called if biologically I am a man, I think that I am a man, and I am attracted to men
homosexuality
What is the definition of frotteurism?
male gets satisfaction from rubbing of genitals against fully clothed women
What is the definition of zoophilia?
animals are preferred in sexual fantasies or practices
What is the definition of coprophilia?
sex and defecation (you just like something to roll around in or it is part of a humiliation ritual)
What is the definition of urophilia?
combining sex and urination
What is the definition of necrophilia?
preferred sex with cadavers
What is the definition of hypoxyphilia?
altered state of consciousness secondary to hypoxia while experiencing orgams.
How is hypophilia accomplished?
autoerotic asphyxiation (boy strangles himself and then masterbates to orgasm)
poppers
amyl nitrate
nitric oxide
what are the sexual effects of neuroleptics
may lead to erectile dysfunction
what are the sexual effects of dopamine agonists
enhanced erection
what are the sexual effects of trazodone
priapism
what are the sexual effects of beta-blockers and tricyclics
erectile dysfunction
SSRIs
may inhibit orgasm
what is the definition of priapism?
prolonged erection in the absence of sexual stimulatoin
what are the four types of sexual disorders?
desire disorders, arousal disorders, orgasm disorders, sexual pain disorders
What are the two sexual desire disorders?
hypoactive
and
sexual aversion
what are the two sexual arousal disorders?
female sexual arousal disorder
and
male erectile disorder (impotence)
What medications may lead to the perception of decreased sexual arousal?
antihistamine
and
anticholinergic
what is the main treatment for male erectile disorder?
SILDENAFIL (viagra)
what are the three orgasm disorders?
anorgasmia, inhibited male orgasm, and premature ejaculation
what are the sexual pain disorders?
dyspareunia
and
vaginismus
what is dyspareunia
recurrent and persistent pain before, during, or after intercourse in either man or woman
what is vaginismus
involuntary muscle constriction of the outer third of the vagina
what is a good treatment for vaginismus
Hegar dilators
what is ego-syntonic homosexuality?
agrees with sense of self, person is comfortable
what is ego-dystonic homosexuality?
disagrees with sense of self, makes person uncomfortable
what is stimulus generalization?
tendency to respond to similar stimuli with similar response (eg. white coats make you feel sick due past experience with chemotherapy)
What is extinction when considering classic conditioning?
breaking the connection between UCS and CS
how is operant conditioning different from classical conditioning?
in operant conditioning there a new response to the old stimulus, but in classical conditioning the is a new stimulus which results in the same old response.
what are the four types of reinforcement?
punishment, extinction, positive reinforcement, and negative reinforcement
what are three therapies based on classical conditioning?
systematic desensitization, exposure, and aversive conditioning
what are the extreme forms of exposure therapy?
flooding or implosion
in operant conditioning, what is shaping?
shaping is the successive approximations of the desired response
what are some general points about defenses?
-all defenses are unconscious
-defenses change over time
-defencses are adaptive as well as pathologic
-psychopathology is an issue of intensity and extent
What are the four types of defenses?
Narcissistic defenses
Immature defenses
Anxiety defenses
Mature defenses
What is common for the narcissistic defenses?
the since of self is very flimsy, the boundry between self and other is relitavely fluid
What are the three narcissistic defenses?
projection
denial
splitting
What is projection defense?
i have some thought or idea that is mine, but I don't percieve it as mine, I see it as out there in the world. Basically, what is in me I see as out there.
What defense is this?

man is furious at wife, he comes home from work and even though in reality his wife is not made the first thing he says is, "Whoa, why are you mad at me?" when he is actually mad at her.
projection
what is splitting?
there is on middle ground
everything is one extreme or the other.
everything is black and white. there is no gray
What is a disorder where you frequently see splitting?
borderline personality disorder
What are immature defenses?
blocking
regression
somatization
introjection
what is blocking
temporary or transient block in thinking, or an inability to remember
what is regression
returning to an earlier stage of development. "acting childish" or at least younger than is typical for that individual
what is somatization defense?
thoughts and anxieties are converted into bodily symptoms. Feeling are manifest as physical symptoms rather than psychological distress.
what are the somatiform disorders?
it is simply excessive use of the somatization defense.
what is introgection?
features of external world or persons are taken in and made part of the self. The opposite of projection
What is it if you see a doctor who you want to be like when you practice and you conciously adopt many of his tendencies?
this is imitation, no introjection. introjection must be unconcious
What is displacement?
changing the target of an emotion or drive, while the person having the feeling remains the same
what is repression?
an idea or feeling is eliminated from consciousness. The content may once have been known, but now has become inaccessible.
what is suppression (mature defense)?
it is like repression, but with the right cues, the memory can come back again.
what defense is it when a man is yelled at by his boss goes home and gets mad at his wife?
displacement, because he is actually mad at his boss but he is taking it out on his wife
what is isolation of affect?
reality is accepted, but with out the expected human emotional response to that reality.
what is intellectualization?
affect is striped away and replaced by an excessive use of intellectual processes. by focusing on the intellectual content you do not have to focus on the unwanted feelings.
what is the acting out defense?
massive amotional or behavioral outburst to cover up underlying feeling or idea. strong action or emotions to cover up unacceptable emotions
in what disorders is acting out common?
common in borderline and antisocial personality disorder.
what is the rationalization defense?
rational explanations are used to justify attitudes, beliefs, or behaviors that are unacceptable.
what is the reaction formation defense?
an unacceptable impulse is transformed into its opposite. a global reversal in which love is exxpressed as hate, for example. for example, two coworkers fight all of the time because they really love each other.
what is the undoing defense
acting out the reverse of unaccptable behavior. repairs of fixes the inpulse
what is the passive aggressive defense?
nonperformace or poor perforance after setting up the expectation of performance. secretary tells her boss she will send the imporant document and then goes home without sending document.
what is the dissociation defense?
separates self from one's experience. third person rather than first person experience. the facts of the events are accepted, but the self is protected from the full impact of the experience.
what dissosiative disorder is associated the dissociateion defense taken too far?
multiple personality disorder (identity disorder)
what are the three mature defenses?
humor
sublimation
suppression
what is the humor defense?
permits the overt expression of feelings and thoughts without personal discomfort
what is the sublimation defense?
impulse-gratification is achieved by channeling the unacceptable impulse into a socially acceptable direction. the unacceptable impulse becomes the motive force for social benefit.