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252 Cards in this Set
- Front
- Back
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habituation is _____
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decreased response to a stimulus
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rewards on a variable schedule are _______
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difficult to extinguish
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derealization means ______
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feel unreal b/c environmen is strange/flat/dull
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idea of reference means ______
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pt thinks event is related to him, but it's not
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continuous amnesia?
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forget all events after trauma except for immediate past
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depersonalization?
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feeling detached from body or mind
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dissociative fugue
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sudden unexplained travel away from one's home
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dissociative amnesia
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amenesia in the setting of emotional or physical trauma
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perseveration
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pointless repitition of a word, phrase, or idea
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projective identification
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pt attributes unacceptable thoughts or feelings to those around him and also to has the feelings himself
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sublimation
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channeling unacceptable impusles to acceptable actions
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tolerance
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need increasing amts for same effects
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withdrawal
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emotional
behavioral physiological |
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dependence
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significant impairment, anguish
withdrawal and tolerance |
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abuse
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less frequent use than dependence.
thus does not involve tolerance and withdrawal sx |
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in depression,
_______ sleep latency ________ REM latency |
increased (take longer to fall asleep)
decreased (get to REM faster) |
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types of schizophrenia?
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paranoid
disorganized undifferentiated catatonic residual (negative sx) |
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first line agent for psychotic depression
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ECT
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absolute contraindication to ECT?
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recent MI
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derealization is ______ and commonly occurs in _______
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feeling of unreality of external world...
complex partial seizures |
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sleep paralysis is a feature of ______
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narcolepsy
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idipathic hypersomnolence is distinguished from narcolepsy by
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long and un-refreshing naps
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hypnagogic hallucinations are
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vivid dreams upon waking or sleeping in narcolepsy
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reciprocal inhibition
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when one response to a stimulus is substituted for another, as in systematic desensitization
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rationalization v. intellectualization
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in rationalization, the motives are hidden
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la belle indifference
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indifference to deficit of body seen in conversion disorder
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folie a deux
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shared delusion from influence of someone else
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displacement
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guy gets yelled at, takes it out on wife
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hypnogogic is ____
hypnopompic is ____ |
going to sleep
waking up from sleep |
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marijuana is a _______
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hallucinogen
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IQ would belong in ______
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axis II
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bulemia best treated with _____
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cognitive behavioral therapy
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sleep terror and sleep walking occurs in ____
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stage 3/4 sleep
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for expressive language d/o, r/o ____ with _____
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MR with IQ test
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calculated percentage of expected weight for dx of ____
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anorexia (85% or less)
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esophageal pH monitoring to confirm dx of ______
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rumination d/o
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coprolalia
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repeting obscene words, like in Tourette's
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most common visual hallucinations in child?
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substance induced
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interview question for bulemia:
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Tell me about the scratches on your hand
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psychomotor agitation commonly seen in ____ with MDD compared to ____
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children...adolescents
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most common method of suicide in kids?
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ingestion
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most common method that teens die by?
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firearms
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_______ for bedwetting
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DDAVP
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childhood anxiety often has co-morbid ______
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depression (50% of the time)
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flumazenil
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for reversing sedation of benzos
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for lead toxicity
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EDTA
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Rett's
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head growth
hand movements language psychomotor retardation girls only |
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conduct d/o often associated with
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SA and/or ADHD
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adjustment d/o lasts ___
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less than 6 months
(otherwise, MDD) |
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33% of Type 1 DM develop __
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adjustment d/o
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best place for kid with HIV
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foster home
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first line for Tourette's
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clonidine
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initial sx of Tourettes?
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eye tic
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Tourette's
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multiple motor tics and 1 or more vocal tic
onset before 18 tics at least 1 year |
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most common cause for MR
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early alterations in embryonic development
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stimulant meds have increased risk for developing ___
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tics.
use TCAs instead of h/o tics |
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enuresis commonly occurs in ___
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normal boys
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tell age and gender, ride tricycle at age __
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3
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copy square, identify L hand at age __
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5
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more favorable prognosis in autism if __
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able to converse
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hypercholesterolemia common in ...
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anorexia
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autistic children lack ___
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stranger anxiety (at 7-8 months)
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low self-esteem, learning disabilities associated with ___
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ADHD
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understanding of death at age
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7-8
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acting out
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unconscious wish expressed through action
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adverse affect of clonidine upon administration?
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sedation
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punishment is not appropriate at age
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4, b/c no concept of stealing
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anti-social personality dx requires
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conduct d/o before age 15
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what could cause chronic rectal bleed and anemia?
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stereotypic movement d/o
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autistic children lack ___
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stranger anxiety (at 7-8 months)
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hypotension, bradycardia, lanugo?
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anorexia
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low self-esteem, learning disabilities associated with ___
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ADHD
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for learning d/o, r/o
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vision problem
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understanding of death at age
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7-8
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acting out
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unconscious wish expressed through action
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delerium after MAO OD should be treated with __
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lorazepam (Ativan)
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wait at least ___days after d/c MAOI before giving ___, or else you get _______
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14....serotonergic agent...serotonin syndrome (too much serotonin)
SSRI TCA venlafaxine buspirone (non-benzo anxiolytic) |
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adverse affect of clonidine upon administration?
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sedation
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serotonin syndrome
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myoclonic jerks
tachycardia fever HTN autonomic instability death |
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punishment is not appropriate at age
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4, b/c no concept of stealing
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features of atypical depression? Tx?
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weight gain, mood reactivity, hypersomnia
MAOIs |
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anti-social personality dx requires
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conduct d/o before age 15
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atypical with lowest incidence of parkinsonism?
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olanzapine
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what could cause chronic rectal bleed and anemia?
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stereotypic movement d/o
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hypotension, bradycardia, lanugo?
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anorexia
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for learning d/o, r/o
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vision problem
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delerium after MAO OD should be treated with __
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lorazepam (Ativan)
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wait at least ___days after d/c MAOI before giving ___, or else you get _______
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14....serotonergic agent...serotonin syndrome (too much serotonin)
SSRI TCA venlafaxine buspirone (non-benzo anxiolytic) |
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serotonin syndrome
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myoclonic jerks
tachycardia fever HTN autonomic instability death |
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features of atypical depression? Tx?
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weight gain, mood reactivity, hypersomnia
MAOIs |
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atypical with lowest incidence of parkinsonism?
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olanzapine
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retinal pigmentation occurs with
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high dose thioridazine
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most potent benzo?
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Klonopin (clonazapam)
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labs before starting lithium?
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kidney: BUN, Cr, UA, lytes
thyroid: |
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______ raise lithium levels.
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NSAIDS.
except ASA or silundac |
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2 most common SE with methylphenidate (Ritalin)
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insomnia
lack of appetite |
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greatest relief for Tourette's?
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D2 blockers
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only med that improves TD is
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clozapine
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treat borderlines with
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SSRI and antipsychotic
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tx for bulemia, purging type?
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fluoxetine
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drugs for anorexia?
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generally don't have a role
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what's SSRI discontinuation syndrome?
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lethargy, n/v, fatigue, crying spells 1-3 days after stopping
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what to do about SSRI discontinuation syndrome?
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restart and then taper.
if fluoxetine, don't bother (long half-life) |
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of the SSRIs, ______ increases carbamazapine. _________ does not
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fluoxetine increases
paroxetine does not |
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Lithium causes _____ on EKG
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TWI (usually not clnically significant)
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chlomipramine most efficacious for
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OCD
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pt presenting c altered level of consciousness should get
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IV dextrose
naloxone thiamine |
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detox heroin with
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clonidine (suppress sympathetic response to withdrawal).
naltrexone is for initial resuscitation |
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for bipolar and neuropathic pain?
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gabapentin
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side effect of olanzapine?
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weight gain
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SE of risperidone?
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orthostatic hypotension
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just like an typical anti-psychotic at high doses?
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risperidone
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first line for primary insomnia?
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benzos (short-acting)
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good SSRI for panic d/o?
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fluvoxamine
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use _____ for bipolar and pregnancy
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ECT or lamotrigine (Lamictal)
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class of drug most dangerous when abruptly withdrawn?
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sedative-hypnotics
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alcoholic with liver problems, withdrawing. which benzos?
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those not metabolized much by liver: lorazepam, oxazepam
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SSRI that increases risk of suicide in kids?
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paroxetine
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drug that can cause pancreatitis?
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valproic acid
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sialorrhea common SE of ______ treat with ______
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clozapine
PTU |
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modern standard for insanity defense?
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American Law Institute Test
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signs of Wernicke's encephalopathy?
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bilateral abducens palsy
ataxia global confusion with apathy |
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in PTSD, sx persist for ____ weeks
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4
less is acute stress d/o |
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electrolyte findings in bulemia?
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hypokalemia
hypomagnesemia hypochlorimic m. alkalosis high amylase enlarged parotid glands |
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pharmacotherapy for bulemia?
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SSRI, or TCA
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seizures occur ____ hrs after cessation of alcohol
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12-72 hrs
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clues to alcohol withdrawal?
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HTN, tachycardia
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mgmt of opiate withdrawal?
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clonidine
buprenorphine methadone (lorazepam for elevated vital sings) |
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sudden d/c of sedative-hypnotics can cause
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siezures
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drug of choice for managing agitation/confusion from delirium?
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haloperidol.
anticholinergics exacerbate lorazepam paradoxically exacerbates, esp. elderly |
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what SSRI SE is shared with depressive symptomatology?
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insomnia
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adjustment d/o within ___ months
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3
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tx for adjustment d/o
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psychotherapy
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GAD occurs greater than __ months
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6
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tx for panic d/o?
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SSRI
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d/o with mostly neurologic complaints?
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conversion d/o
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factitious d/o
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sx not intentionally produced for any particular reason
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mild MR is an IQ score of
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50-70
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what is pimozide?
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for Tourette's
can prolong QT |
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sx of cocaine crash?
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hunger
bad dreams suicidal ideation increased appetite |
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sx of cannabis abuse?
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conjunctival injection
increased appetite dry mouth |
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r/o _____ before giving anti-depressants
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bipolar d/o
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increased cortisol found in ____
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depression
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strongest genetic link?
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bipolar
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antidepressents ____ mania
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exacerbate, precipitate
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first-degree relatives of bipolar have ___ % risk
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25
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when should you think of porphyria?
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abdominal pain and psychiatric sx
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delerium can produce any type of hallucinations.
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okay? okay.
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lesion in Kluver-Bucy?
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amygdala
hyperphage, hypersexuality, docility |
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regardless of binging/purging, what puts you into category of anorexia?
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missing 3 periods
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elevated BUN
elevated cortisol anemia normal TSH response |
anorexia
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___% MDD pts fail dex supression
___ % blunted TRH response |
50%
30% |
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heroin addics need at least __mg methadone
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60mg
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what's hypomania?
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sx of mania, but no psychiatric hospitalization or functional impairment
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SE of TCAs?
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anti-cholinergic
anti-adrenergic |
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elevated GGT associated with ___
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alcoholism
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duration of brief psychotic d/o?
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less than 1 month
|
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time for PTSD?
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more than 4 weeks.
prior is acute stress d/o |
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lifetime suicide risk in schizophrenics?
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10%
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what is countertransference?
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feelings evoked in doctor by patient
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projection?
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saying someone else is X when in fact your are X
|
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percent of pts responding to placebo affect?
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33%
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% of patients responding to SSRI?
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60-70%
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negative sx are a _____ prognostic indicator
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poor
|
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___% of identical twins have schizophrenia
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50%
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__% kids have schizophrenia if parent has it
|
12
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most common presenting sx of MS?
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depression
|
|
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__% cases of impotence have phsychologic etiology
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90%
|
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____ reduced in CSF of suicidal, impulsive, violence, aggression
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5-HIAA
|
|
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left MCA stroke often presents with ___
|
depression
|
|
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mean age of onset of bipolar d/o?
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30yrs
|
|
|
tyramine-rich food?
|
alcohol
sauerkraut salami |
|
|
meds for PMDD
|
OCPs
paroxetine spironolactone alprazolam |
|
|
other stigmata of schizophrenia?
|
smooth-pursuit eye movements
short-term memory difficulties sensory gating deficits (habituation) |
|
|
sudden onset neurologic deficit in context of stressor
|
conversion d/o
|
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neurologic, GI, sexual complaints
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somatic d/o
|
|
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hypochondriasis?
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belief pt has specific illness
|
|
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which predictive factor most assoicated with suicide risk?
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age 45 and older
|
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often causes psychosis and depressive sx?
|
glucocorticoids
|
|
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most dangerous withdrawal syndromes?
|
alcohol and BENZOS
|
|
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rorschach test?
|
inkblots
|
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Hamilton
|
depression rating scale
|
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dysthymia will never have ____
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psychotic features
|
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in obsessive-compuslive personality d/o, person lacks ___
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insight
|
|
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PTSD sx for at least __ months
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1
|
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acute stress d/o is less than __ months
|
1
|
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PTSD associated with high incidence of ___
|
substance abuse or depression
|
|
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what is buspirone?
|
anxiolytic
|
|
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adjustment d/o?
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sx begin w/in 3 months
end in 6 months |
|
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life threatening event
|
PTSD (versus adjustment d/o)
|
|
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abandonment
self-image emptiness repeated suicide attempts |
borderline personality d/o
|
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histrionic personality d/o pts are more _______ than borderline
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functional
|
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rationalization is ___
intellectualization is ___ |
create explanations
avoid negative feelings by intellecutalizing |
|
|
_________ therapy breaks down defenses to acheive more optimal level of functioning
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psychodynamic psychotherapy.
personality change is another goal. |
|
|
______ therapy strengthens current defense mechanisms
|
supportive
|
|
|
_______ therapy corrects faulty ideas
|
cognitive
|
|
|
hypnosis is contracindicated in _______ d/o
|
psychotic
|
|
|
concentrates on a focal conflict?
|
brief psychodynamic psychotherapy
|
|
|
drugs for acute treatment of mania?
|
haloperidol
(mood stabilizers take weeks to take effect) |
|
|
mood stabilizer associated with lower white count?
|
carbemazepine
|
|
|
what to do if you suspect somatization d/o?
|
assess for psychiatric illness
frequent f/u to build therapeutic alliance |
|
|
because of vitamin deficiency in heavy drinkers, you can see _________-
|
peripheral neuropathy
|
|
|
elevated OR low liver enzymes in ____
|
chronic alcoholism
|
|
|
lowest incidence of suicide in
|
black women
|
|
|
most common neuro complaints in conversion d/o?
|
mutism
paralysis blindness |
|
|
munchaushen by proxy often have co-morbid
|
depression
|
|
|
tx for panic d/o?
|
SSRI
|
|
|
tx for hypertensive crisis?
|
alpha blocker, like phentolamine
|
|
|
clozapine can induce ___
|
siezures
|
|
|
gingival hyperplasia associated with ____
|
phenytoin
|
|
|
serial sevens assess _____
digit recall assess ____ |
concentration
attention |
|
|
loxapine, pimozide and perphenazine are _____
|
typical anti-psychotics
|
|
|
dialectical behavioral therapy
|
pt wants to improve and is doing the best s/he can
|
|
|
dry as a bone, mad as a hatter, etc, is _______ toxicity
|
anticholinergic
|
|
|
if pt not tolerating benztropine (or other anti-cholinergic), give ____
|
amantadine
|
|
|
suppression is ________
|
conscious
a mature defense |
|
|
denial is a _______ defense
|
narcissitic
|
|
|
hypomania lasts at least ___ days
|
4
|
|
|
approximate or ridiculous answers?
|
Gasner's syndrome
|
|
|
tx of MDD in elderly, high risk of suicide, heart dz?
|
ECT
|
|
|
features of atypical depression?
|
1. mood reactivity and 2 of these:
2. weight gain, hypersomnia, leaden paralysis, rejection sensitivity |
|
|
cataplexy is ___
catalepsy is ___ |
sudden loss of muscle tone
immobile position maintained |
|
|
don't give dextrose before giving thiamine, or you'll exacerbate Wernicke's encephalopathy.
|
okay? okay
|
|
|
what to do if pt presenting with NMS?
|
d/c meds
(benefits of dantrolene unclear) |
|
|
naloxone injection can confirm dx of ________
|
dependence by precipitating opiate withdrawal
|
|
|
reversible w/u of dementia?
|
RPR, thyroid function tests, B12, folate
|
|
|
what meds reduce binging and purging?
|
anti-depressants
|
|
|
mortality from anorexia?
|
20%
|
|
|
signs of antiocholinesterase toxicity?
|
nausea, vomiting, siezure.
give atropine |
|
|
tx for hallucinations in alcohol withdrawal?
|
haloperidol
just treat hallucinations with anti-psychotics |
|
|
which TCA is more serotonergic?
|
amitriptyline
|
|
|
rapid relief of depression from medical illness?
|
methylphenidate (stimulants)
|
|
|
2nd line for ADHD?
|
another stimulant
|
|
|
test to evaluate IQ in a kid?
|
WISC
|
|
|
test a 75 yo woman with memory difficulty with ___
also for IQ in people >15 |
Weschler Adult Intelligence Scale--Revised
|
|
|
Rorschach test (inkblots) assess _______--
|
personality
|
|
|
score below __ suggests dementia on MMSE
|
24
|
|
|
Wisconsin card sorting test assesses
|
executive function
|
|
|
Rey-Osterrieth tests is sensitive to copying and lack attention seen in ______
|
lesions of R parietal lobe
|
|
|
confusion, muscle twitching, abdominal cramps ?
|
nicotine intoxication
|
|
|
what to do if NMS?
|
d/c meds, supportive treatment
|
|
|
what to do with anti-depressant meds and pregnancy?
|
d/c anti-depressant meds
|
|
|
benzos and the elderly
|
USE WITH CAUTION! Contribute to delirium
|
|
|
decreases alcohol cravings?
|
naltrexone
|
|
|
more potent anti-psychotics have
less ______ and ______ SE |
anti-cholinergic and orthostatic
|
|
|
how is mirtazapine SE profile different than SSRI?
|
causes weight gain and increased appetite
|
|
|
increases diastolic BP?
|
venlafaxine
|
|
|
_______ increase lithium levels
|
thiazide diuretics, NSAIDS except aspirin and sulindac
|
|
|
fluoxetine good for ______
fluvoxamine good for ______ |
bulemia
panic d/o |
|
|
buspiron even though it's an anxiolytic, is no good for panic d/o.
|
okay? okay
Use SSRI |
|
|
most common serious complication of NMS?
|
rhabdo
|
|
|
what does meperidine + MAOI cause?
|
hypertensive crisis
|
