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252 Cards in this Set

  • Front
  • Back
habituation is _____
decreased response to a stimulus
rewards on a variable schedule are _______
difficult to extinguish
derealization means ______
feel unreal b/c environmen is strange/flat/dull
idea of reference means ______
pt thinks event is related to him, but it's not
continuous amnesia?
forget all events after trauma except for immediate past
depersonalization?
feeling detached from body or mind
dissociative fugue
sudden unexplained travel away from one's home
dissociative amnesia
amenesia in the setting of emotional or physical trauma
perseveration
pointless repitition of a word, phrase, or idea
projective identification
pt attributes unacceptable thoughts or feelings to those around him and also to has the feelings himself
sublimation
channeling unacceptable impusles to acceptable actions
tolerance
need increasing amts for same effects
withdrawal
emotional
behavioral
physiological
dependence
significant impairment, anguish
withdrawal and tolerance
abuse
less frequent use than dependence.
thus does not involve tolerance and withdrawal sx
in depression,
_______ sleep latency
________ REM latency
increased (take longer to fall asleep)
decreased (get to REM faster)
types of schizophrenia?
paranoid
disorganized
undifferentiated
catatonic
residual (negative sx)
first line agent for psychotic depression
ECT
absolute contraindication to ECT?
recent MI
derealization is ______ and commonly occurs in _______
feeling of unreality of external world...
complex partial seizures
sleep paralysis is a feature of ______
narcolepsy
idipathic hypersomnolence is distinguished from narcolepsy by
long and un-refreshing naps
hypnagogic hallucinations are
vivid dreams upon waking or sleeping in narcolepsy
reciprocal inhibition
when one response to a stimulus is substituted for another, as in systematic desensitization
rationalization v. intellectualization
in rationalization, the motives are hidden
la belle indifference
indifference to deficit of body seen in conversion disorder
folie a deux
shared delusion from influence of someone else
displacement
guy gets yelled at, takes it out on wife
hypnogogic is ____
hypnopompic is ____
going to sleep
waking up from sleep
marijuana is a _______
hallucinogen
IQ would belong in ______
axis II
bulemia best treated with _____
cognitive behavioral therapy
sleep terror and sleep walking occurs in ____
stage 3/4 sleep
for expressive language d/o, r/o ____ with _____
MR with IQ test
calculated percentage of expected weight for dx of ____
anorexia (85% or less)
esophageal pH monitoring to confirm dx of ______
rumination d/o
coprolalia
repeting obscene words, like in Tourette's
most common visual hallucinations in child?
substance induced
interview question for bulemia:
Tell me about the scratches on your hand
psychomotor agitation commonly seen in ____ with MDD compared to ____
children...adolescents
most common method of suicide in kids?
ingestion
most common method that teens die by?
firearms
_______ for bedwetting
DDAVP
childhood anxiety often has co-morbid ______
depression (50% of the time)
flumazenil
for reversing sedation of benzos
for lead toxicity
EDTA
Rett's
head growth
hand movements
language
psychomotor retardation
girls only
conduct d/o often associated with
SA and/or ADHD
adjustment d/o lasts ___
less than 6 months
(otherwise, MDD)
33% of Type 1 DM develop __
adjustment d/o
best place for kid with HIV
foster home
first line for Tourette's
clonidine
initial sx of Tourettes?
eye tic
Tourette's
multiple motor tics and 1 or more vocal tic
onset before 18
tics at least 1 year
most common cause for MR
early alterations in embryonic development
stimulant meds have increased risk for developing ___
tics.

use TCAs instead of h/o tics
enuresis commonly occurs in ___
normal boys
tell age and gender, ride tricycle at age __
3
copy square, identify L hand at age __
5
more favorable prognosis in autism if __
able to converse
hypercholesterolemia common in ...
anorexia
autistic children lack ___
stranger anxiety (at 7-8 months)
low self-esteem, learning disabilities associated with ___
ADHD
understanding of death at age
7-8
acting out
unconscious wish expressed through action
adverse affect of clonidine upon administration?
sedation
punishment is not appropriate at age
4, b/c no concept of stealing
anti-social personality dx requires
conduct d/o before age 15
what could cause chronic rectal bleed and anemia?
stereotypic movement d/o
autistic children lack ___
stranger anxiety (at 7-8 months)
hypotension, bradycardia, lanugo?
anorexia
low self-esteem, learning disabilities associated with ___
ADHD
for learning d/o, r/o
vision problem
understanding of death at age
7-8
acting out
unconscious wish expressed through action
delerium after MAO OD should be treated with __
lorazepam (Ativan)
wait at least ___days after d/c MAOI before giving ___, or else you get _______
14....serotonergic agent...serotonin syndrome (too much serotonin)
SSRI
TCA
venlafaxine
buspirone (non-benzo anxiolytic)
adverse affect of clonidine upon administration?
sedation
serotonin syndrome
myoclonic jerks
tachycardia
fever
HTN
autonomic instability
death
punishment is not appropriate at age
4, b/c no concept of stealing
features of atypical depression? Tx?
weight gain, mood reactivity, hypersomnia
MAOIs
anti-social personality dx requires
conduct d/o before age 15
atypical with lowest incidence of parkinsonism?
olanzapine
what could cause chronic rectal bleed and anemia?
stereotypic movement d/o
hypotension, bradycardia, lanugo?
anorexia
for learning d/o, r/o
vision problem
delerium after MAO OD should be treated with __
lorazepam (Ativan)
wait at least ___days after d/c MAOI before giving ___, or else you get _______
14....serotonergic agent...serotonin syndrome (too much serotonin)
SSRI
TCA
venlafaxine
buspirone (non-benzo anxiolytic)
serotonin syndrome
myoclonic jerks
tachycardia
fever
HTN
autonomic instability
death
features of atypical depression? Tx?
weight gain, mood reactivity, hypersomnia
MAOIs
atypical with lowest incidence of parkinsonism?
olanzapine
retinal pigmentation occurs with
high dose thioridazine
most potent benzo?
Klonopin (clonazapam)
labs before starting lithium?
kidney: BUN, Cr, UA, lytes
thyroid:
______ raise lithium levels.
NSAIDS.
except ASA or silundac
2 most common SE with methylphenidate (Ritalin)
insomnia
lack of appetite
greatest relief for Tourette's?
D2 blockers
only med that improves TD is
clozapine
treat borderlines with
SSRI and antipsychotic
tx for bulemia, purging type?
fluoxetine
drugs for anorexia?
generally don't have a role
what's SSRI discontinuation syndrome?
lethargy, n/v, fatigue, crying spells 1-3 days after stopping
what to do about SSRI discontinuation syndrome?
restart and then taper.
if fluoxetine, don't bother (long half-life)
of the SSRIs, ______ increases carbamazapine. _________ does not
fluoxetine increases
paroxetine does not
Lithium causes _____ on EKG
TWI (usually not clnically significant)
chlomipramine most efficacious for
OCD
pt presenting c altered level of consciousness should get
IV dextrose
naloxone
thiamine
detox heroin with
clonidine (suppress sympathetic response to withdrawal).

naltrexone is for initial resuscitation
for bipolar and neuropathic pain?
gabapentin
side effect of olanzapine?
weight gain
SE of risperidone?
orthostatic hypotension
just like an typical anti-psychotic at high doses?
risperidone
first line for primary insomnia?
benzos (short-acting)
good SSRI for panic d/o?
fluvoxamine
use _____ for bipolar and pregnancy
ECT or lamotrigine (Lamictal)
class of drug most dangerous when abruptly withdrawn?
sedative-hypnotics
alcoholic with liver problems, withdrawing. which benzos?
those not metabolized much by liver: lorazepam, oxazepam
SSRI that increases risk of suicide in kids?
paroxetine
drug that can cause pancreatitis?
valproic acid
sialorrhea common SE of ______ treat with ______
clozapine
PTU
modern standard for insanity defense?
American Law Institute Test
signs of Wernicke's encephalopathy?
bilateral abducens palsy
ataxia
global confusion with apathy
in PTSD, sx persist for ____ weeks
4
less is acute stress d/o
electrolyte findings in bulemia?
hypokalemia
hypomagnesemia
hypochlorimic m. alkalosis
high amylase
enlarged parotid glands
pharmacotherapy for bulemia?
SSRI, or TCA
seizures occur ____ hrs after cessation of alcohol
12-72 hrs
clues to alcohol withdrawal?
HTN, tachycardia
mgmt of opiate withdrawal?
clonidine
buprenorphine
methadone
(lorazepam for elevated vital sings)
sudden d/c of sedative-hypnotics can cause
siezures
drug of choice for managing agitation/confusion from delirium?
haloperidol.
anticholinergics exacerbate
lorazepam paradoxically exacerbates, esp. elderly
what SSRI SE is shared with depressive symptomatology?
insomnia
adjustment d/o within ___ months
3
tx for adjustment d/o
psychotherapy
GAD occurs greater than __ months
6
tx for panic d/o?
SSRI
d/o with mostly neurologic complaints?
conversion d/o
factitious d/o
sx not intentionally produced for any particular reason
mild MR is an IQ score of
50-70
what is pimozide?
for Tourette's
can prolong QT
sx of cocaine crash?
hunger
bad dreams
suicidal ideation
increased appetite
sx of cannabis abuse?
conjunctival injection
increased appetite
dry mouth
r/o _____ before giving anti-depressants
bipolar d/o
increased cortisol found in ____
depression
strongest genetic link?
bipolar
antidepressents ____ mania
exacerbate, precipitate
first-degree relatives of bipolar have ___ % risk
25
when should you think of porphyria?
abdominal pain and psychiatric sx
delerium can produce any type of hallucinations.
okay? okay.
lesion in Kluver-Bucy?
amygdala

hyperphage, hypersexuality, docility
regardless of binging/purging, what puts you into category of anorexia?
missing 3 periods
elevated BUN
elevated cortisol
anemia
normal TSH response
anorexia
___% MDD pts fail dex supression
___ % blunted TRH response
50%
30%
heroin addics need at least __mg methadone
60mg
what's hypomania?
sx of mania, but no psychiatric hospitalization or functional impairment
SE of TCAs?
anti-cholinergic
anti-adrenergic
elevated GGT associated with ___
alcoholism
duration of brief psychotic d/o?
less than 1 month
time for PTSD?
more than 4 weeks.
prior is acute stress d/o
lifetime suicide risk in schizophrenics?
10%
what is countertransference?
feelings evoked in doctor by patient
projection?
saying someone else is X when in fact your are X
percent of pts responding to placebo affect?
33%
% of patients responding to SSRI?
60-70%
negative sx are a _____ prognostic indicator
poor
___% of identical twins have schizophrenia
50%
__% kids have schizophrenia if parent has it
12
most common presenting sx of MS?
depression
__% cases of impotence have phsychologic etiology
90%
____ reduced in CSF of suicidal, impulsive, violence, aggression
5-HIAA
left MCA stroke often presents with ___
depression
mean age of onset of bipolar d/o?
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
neurologic, GI, sexual complaints
somatic d/o
hypochondriasis?
belief pt has specific illness
which predictive factor most assoicated with suicide risk?
age 45 and older
often causes psychosis and depressive sx?
glucocorticoids
most dangerous withdrawal syndromes?
alcohol and BENZOS
rorschach test?
inkblots
Hamilton
depression rating scale
dysthymia will never have ____
psychotic features
in obsessive-compuslive personality d/o, person lacks ___
insight
PTSD sx for at least __ months
1
acute stress d/o is less than __ months
1
PTSD associated with high incidence of ___
substance abuse or depression
what is buspirone?
anxiolytic
adjustment d/o?
sx begin w/in 3 months
end in 6 months
life threatening event
PTSD (versus adjustment d/o)
abandonment
self-image
emptiness
repeated suicide attempts
borderline personality d/o
histrionic personality d/o pts are more _______ than borderline
functional
rationalization is ___
intellectualization is ___
create explanations
avoid negative feelings by intellecutalizing
_________ therapy breaks down defenses to acheive more optimal level of functioning
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