Psych Ctk

Front 1

IQ:
Normal
mentally retarded
severe MR
profound MR

Back 1

NL = 100+/-15

MR=<70
severe MR = <40
profound MR <20

Front 2

mouse presses a button to get food

mouse presses a button to avoid shock

kid gets grounded if he talks back

kid gets candy if he makes an A=________; no candy to kid, kid makes an F=_______

why do we care?

Back 2

positive reinforcement

negative reinforcement (elicit behavior by REMOVING an AVERSE stimulus)

punishment (eliminated behavior with AVERSE stimulus)

positive reinforcement/extinction (eliminate behavior w/ discont reinforcement)

pattern of reinforcement determines how long it lasts - so if you have continuous reward=rapid extinction vs variable ratio to reward = slow extinction

Front 3

Transference vs countertransferance

Back 3

transferance = pt projects feelings ontio physician

countertransferance = doctor projects on pt

Front 4

Mature forms of Ego defenses (mediator b/w primal urges and actions or id and superego)

Back 4

Altruism - generosity toward others releives guild

Humor - make light of stressful situation

Sublimation - making the best of a bad situation

Suppression - voluntarily withholding an ideal/feeling from conscious awareness - procrastination for example

Front 5

difference between Repression and Suppression

Back 5

Repression - involuntarily suppression

Suppression - voluntary

Front 6

difference between displacement and projection

Back 6

displacement: transferring feelings to a neutral place (mom's pissed about work -- gets pissed at kids)

projection = projecting your own emotions and someone else -- i want to cheat on my boyfriend, so I suspect he is cheating

Front 7

differenc between fixation and regression

Back 7

fixation = remaining at a more childish level of development - Men fixated on sports games

vs

regression = going back to earlier modes of "dealing"---bedwetting in kids who are pody trained

Front 8

dissociatoin vs splitting

what d/o are each ascribed to

Back 8

dissociation = drastic change in personality = temporarily to avoid emotional stress>>MPS or dissociative identity d/o

splitting: a person is all good or all bad - can't deal with ambiguity -- BPS

Front 9

healing fractures on x-ray, UTIs, subdural hematomas, and retinal hemorrhage and/or detachment are all signs of __________

peak incidence? gender?
is this the most common type?

Back 9

child abuse

femaly 9-12yo

no - child neglect is most common

Front 10

decreased muscle tone, poor language skills, withdrawn, wt loss, disrupted perception, delyaed speech...all of these sx in an infant may indicate ______

complications

Back 10

depirvation of affection or anaclitic depression due to hospitalism

irreversible changes and infant death

Front 11

6yo with difficulity in school, hyperactivity, impusliveness, inattention

dx?
onset?
CT?
tx?

Back 11

ADHD

before age seven

low frontal lobe volumes

methylphenidate, amphetamines, atomoxetine

Front 12

physical agression, destruction of property and theft

vs

defiance of authority figures, hostility

dx?
difference?

Back 12

1. conduct d/o - >18yo, behavior violates social norms

2. Oppositional defiant d/o: onset at age 8; does not violate social norms -- seen with ADHD

Front 13

sudden rapid recurrant nonrhythmic type motor movements, tics, vocalizations

onset usually ______

tx?

Back 13

Tourretts (must have motor and vocal tics present --w/o one or the others, just motor/vocal tic d/o) -- sx for > 1yr

onset <18yo

tx=antipsychs (halopirdol)

Front 14

language impairment - sig = may not speak in a 3 yo

poor social interactions
repetitive behaviors

dx?
ddx?

Back 14

Autistic d/o ---pts have below normal intelligence and have severe language impediment

vs

Aspergers (milder form ) = all-absorbing interests/knowledge about random things BUT no language impairment or cognitive deficits and have normal intelligence. still have social impairment

Front 15

NL development until 4yo, then regresses>>metnal retardation, loss of verbal skills, ataxia, hand wringing

d/o?
similar to what?
ddx?

Back 15

Rett's d/o (XL d/o)
usually in girls (boys die in womb or in infancy) - motor abnormalities are gradual

Chilhood disentegrative d/o: loss of recetpive and expressive language skills, social skills, bowel/bladder funciton, motor skills after 2+ years of normal development. more common in boys

Front 16

inability to recall important personal information subsequent to trauma or stress

inability to remember things prior to CNS trauma

anterograde amnesia + some retrograde amnesia + confabulations

Back 16

dissociative amnesia

retrograde amnesia

korsakoff amnesia - bilateral mammillary body damage -due to ETOH and thiamin deficiency

Front 17

waxing and wanling levels of conciousness with acute onset, disorganized thinking, hallucinations, cognitive dysfunction - sx worse at night + autonomic dysfunction

common causes?
EEG?
age of onset?
drugs that solicit effect?

Back 17

delirium

EEG = abnormal

Drugs = Barb withdrawal, PCP intox

infection = CNS meningitis

High fever illness/acute illness

can affects children and adults/elderly

Front 18

gradual decline in cognition w/no change in level of consciousness + aphasia, personality changes, impaired judgement

infections that can cause this?
ddx this with pseudo cases and just plain aging

Back 18

dementia

HIV, CJD

NL EEG + severe memory loss (can't name objects in hand), lower IQ + major dysruptive life change tx: NMDA antag or Acetylcholinesterase inhib if DAT

nl aging = minor memory loss -- only change

pseduodementia/depressive=moderate memory change, nl IQ, disruptive to life TX = antidep

Front 19

ants crawling on my skin

dx?
tx?

Back 19

ETOH withdrawal

or Cocaine intox

= tactile hallucinations

tx with benzos

Front 20

auditory hallucinations are a signature of what dz? associated with a change in levels of what NT?

presents at what age?
sx have to last how long to dx?

Back 20

schizophrenia
increase in dopamine (ddx decr in dopamine = parkinsons)

20's to 30's
>6 mo

Front 21

ddx schizophrenia with delusional d/o

for schizo - if sx last 1-6mo? if sx <1 mo? if at least 2 weeks of stability with psychotic sx and a major depressive, manic or mixed episode?

Back 21

both have dellusions

schizo = nonfunctioning; >6mo
if sx1-6mo = schiphreniform
if <1mo=brief psychotic d/o; schizoaffective

delusional = functioning; >1mo

Front 22

distractibility
irresponsibility
grandiosity
flight of ideas
Activity is high/Agitation
Sleep lack of
Talkative - pressured speech

sx for >1 wk

tx CI for this?

seen in what d/o?

how do know the diff?

Back 22

manic episode -- need 3 or more of DIG FAST

antidepressants

bipolar and schizoaffective d/o (can be bipolar or depressive)

bipolar = one manic or hypomanic episode

schizoaffective = that + psychotic sx

Front 23

flat affect, soical withdral, lack of motivation, lack of speech or though

delusions, hallucinationns, disorganzed speech, disorganized/catatonic behavior

Back 23

negative sx of schizo
tx with atypical antipsych

positive sx of schizo
tx with typical or atypcial antipsych

Front 24

risk for suicide is high with which d/o?

Back 24

bipolar
schiophrenia
major depressive episodes
single
ETOH
men
teenagers
elderly

Front 25

Depression sx:

mild for 2yrs

recurrent with 2+ major depressive episodes and sx intervals of 2mo

occurs in the winter time

lasts 2 wks

Back 25

sx: SIG E CAPS
sleep disturbance
Interest loss (anhedonia)
Guilt/worthless
Energly loss
Concentratoin loss
Appetite/wt change
psychomotor retardation/agitation
Suididal
Depressed

dysthmia

major depressive d/o

seasonal affective d/o

major depressive episode (need 5 of the above listed sx)

Front 26

dpressed patients have more ________ sleep; decreased __, and _________-. with repeated nighttime awakenings and early morning wakenings (this is a ringer!)

NT that is affiliated with REM

Back 26

increased: REM early in sleep cycle and total REM (think B waves/high frequnce/low Amp sleep)

decreased slow wave slee (delta waves, low f/high A) and low REM latency

ACH

Front 27

hypersomnia, overeating, mood reactivity/responsive to positive events, wt gain, sensitive to rejection.

tx?

how do you tx the other variant?

tx if refractory?

Back 27

Atypical depression

MAOIs and SSRIs

SSRIs, SNRIs, TCAs

if depression with insomnia = mirtzapine

electorconvulsive therapy - can cause retrograde/anterograde amnesia so do this unilaterally to lower SE

Front 28

young woman in her 20s comes in with palpitations, paresthesias, ab distress, nausea, chills, choking -- has had this before -- fear of having heart attack or going crzy...you dx? tx?

ddx with specific phobia ; social phobias

ddx with generalized anxiety d/o

Back 28

panic d/o
tx: SSRIs = first line; TCAs and Benzos too

specific phobias are CUED by presence or anticipatoin of a specific object or situation where panic attacks are not cued -- onset in adolescnece PT RECOGNIZES THAT THIS FEAR IS EXCESSIVE WITH SPECIFIC PHOBIAS; TX=desensitization ; social phobias can be tx with SSRIs

gen anx d/o is a pattern of uncontrollable axiety -- no discrete episodes like panic d/o -- this is all the time and lasts at least 6 months and is UNRELATED to a specfic person, situation or event (unlike phobia) + diff sleeping, concentration, tired all the time; usually have GI issuels, muslce tension; tx with benzos , buspirone, SSRIs

all 3 can be tx with SSRIs
Panic and Gen with Benzos too

Front 29

ddx obsessive compulsive PERSONALITY d/o vs obsessive compulsive disorder

Back 29

OC personality = ego syntonic = behavior is consistent with their beliefs - they don't think anything is wrong - preoccupied with order, perfectionism and control

OC d/o = ego dystonic - they know that their shit isn't right -- assoc with tourrets - no control/perfectionism here -- have intrusive thoughts and compelled to act in repetitive manners to releive their anxiety

can tx all 3 w/ SSRIs

Front 30

PTSD vs acute stress d/o

nt mares, flashbacks, of traumatic evnet

Back 30

PTSD=sx last >1month after event
tx with SSRIs and psycotherapy

Acute stress d/o sx from 2d to 1mo...later = PTSD

Front 31

if you have emotional sx (anxiety or depression) following an event/stressor that lasts < 6months

Back 31

adjustment d/o

Front 32

faking sick to avoid work, or to get drugs but avoid tx

faking sick to get medical attention and willing to undergo invasive procedures

psudosx of illness following stress - motor or sensory

psuedosx = pain only; 30-40

pseudosx = pain, GI, and neuro; female < 30

Back 32

malingering

factitous - munchhausens

conversion d/o

pain d/o

somatization d/o

Front 33

social withdrawal +

hypersensitivity to rejection, feelings of inadequacy, desires relationships with others

vs

voluntary withdrawal, reserved, limited emotional expression, can't form social relationships

Back 33

avoidant personality d/o

vs

schizoid personality d/o

Front 34

disregard for and violation of rights of others in a man > 18

unstable mood and self mutilation + feelings of emptiness and splitting

gradiosity, sense of entitlement, excessive admiration - responds to criticism with rage

attention seeking, sexually prevocative, overly concerned with appearance

Back 34

antisocial personality d/o - think conn men

BPS

narcisitic - melissa

histrionic - don juan

Front 35

Nausea, vomiting, constipatoin, pinpoint pupils,, decreased HR and RR
tx?

Back 35

opioids tox (morphine, heroine, methadone)

tx = naloxone or clonidine

Front 36

tachy, htn, anxiety, hallucinations, delusions, confusion, ants crawling on body, agitatoin, tremor

Back 36

ETOH w/draw

DTs

tx = benzo

similar to cocaine tox but here you have pupil dilations, and parinois with angina and the risk of sudden cardiac death

Front 37

depressants that can cause intox

most have what SE for withdrawal?

Back 37

ETOh, opioids, barbs, benzos

seixure

only one that doesn't is opioid withdrawal.

Front 38

dilated pupils, sweating with goose bumps, diarrhea, stomach cramps, can't eat, can't sleep

you give?

Back 38

Opioid withdrawal

tx: naloxone + buprenorphine or methadone

Front 39

cocaine, nicotine, amphetamines and caffeine are all _________

intox with these can cause ________, except for cocaine which has the risk for ______

Back 39

stimulants

cardiac arryth; HTN, insomnia, tachy, and agitation, dilated pupils

SCD

Front 40

withdrawal of these drugs cause depression and HA

intox with this can cause dilerium and vertical/horizontal nystagmus, fever, and violence!!

intox with this can cause anxiety, flashbacks, hallucinations, and dilated puils

intox with this can cause paranoiad delusions

Belligerence...you think

Back 40

amphetamines and cocaine

PCP

LSD

marijuana and cocaine -- with pot - think dry mouth and slowed perception of time; with cocaine think delusions and hallucinatoins

PCP