First Aid- Usmle: Psychiatry

Front 1

Infant deprivation effects: What are the effects of Infant deprivation(ID) ?

Back 1

1. decreased muscle tone 2. poor language skills, 3.poor socialization 4 lack of basic trust, 5. Anaclitic depression, 6. weight loss 7. physical illness [Anaclitic: Psychological dependence on others]

Front 2

Infant deprivation effects: The four W's are used to describe the effects of infant deprivation?

Back 2

Weak, Wordless, Wanting (socially), Wary

Front 3

Infant deprivation effects: Complication of severe infant deprivation?

Back 3

For longer than 6months - changes may be irreversible. Infant death is possible with severe deprivation.

Front 4

Anaclitic depression: What is Anaclitic depression?

Back 4

Depression in an infant due to continued separation caregiver? Results in withdrawal and unresponsiveness.

Front 5

Regression in children: Cause of regression in a child?

Back 5

common in children under stress. E.g toilet trained child who bedwets when hospitalized

Front 6

childhood early-onset disorders (p. 133): True or false: Children with ADHD have normal intelligence

Back 6

TRUE

Front 7

childhood early-onset disorders (p. 133): What is the treatment for ADHD

Back 7

Methyphenidate (ritalin)

Front 8

childhood early-onset disorders (p. 133): What is the name given to continued behavior violating social norms?

Back 8

Conduct disorder

Front 9

childhood early-onset disorders (p. 133): What is oppositional defiant disorder?

Back 9

A noncompliant child in the absence of criminality

Front 10

childhood early-onset disorders (p. 133): What is the age of onset of tourette's syndrome?

Back 10

Before 18

Front 11

childhood early-onset disorders (p. 133): What is the treatment for tourette's syndrome?

Back 11

Haloperidol

Front 12

childhood early-onset disorders (p. 133): What is the name given to a fear of loss of attachment figure leading to factitious physical complaints?

Back 12

Seperation anxiety disorder

Front 13

childhood early-onset disorders (p. 133): What is the typical age for seperation anxiety disorder?

Back 13

7 or 8

Front 14

childhood early-onset disorders (p. 133): What disorder is characterized by repetitive behaviors, unusual abilities, and below normal intelligence?

Back 14

Autism

Front 15

pervasive developmental disorders : What are the characteristics of Autism? Do they have normal intelligence?

Back 15

repetitive behavior, language disability, and social problems; no

Front 16

pervasive developmental disorders (p. 133): What is the treatment for autism?

Back 16

Communication skill and social skill training

Front 17

pervasive developmental disorders (p. 133): What is the name of a mild form of autism? Do they have normal intelligence?

Back 17

Asperger syndrome: Like autism (repetitive behavior and lack of social skills) but language abilities are intact. No

Front 18

pervasive developmental disorders (p. 133): True or false: Children with aspberger's syndrome has normal intelligence and lack social or cognitive defects?

Back 18

TRUE

Front 19

pervasive developmental disorders (p. 133): What is the only X-linked childhood personality disorder?

Back 19

Rett disorder

Front 20

pervasive developmental disorders (p. 133): Rett syndrome starts at which age?

Back 20

4

Front 21

pervasive developmental disorders (p. 133): What are the symptoms fo rett disorder?

Back 21

Loss of development, and mental retardation?

Front 22

pervasive developmental disorders (p. 133): Why does Rett disorder appear only in women?

Back 22

Male fetuses die in utero.

Front 23

Child abuse: List evidence of physical abuse in a child.

Back 23

Healed fractures(xray) Cigarette burns Hematoma, multiple bruises Retinal hemorrhage or detachment

Front 24

Child abuse: In physical child abuse - who is normally the abuser?

Back 24

Usually female and the primary caregiver

Front 25

Child abuse: Number of yearly child abuse related deaths?

Back 25

3000/yr (USA)

Front 26

Child abuse: List evidence of sexual abuse in a child.

Back 26

Genital, anal trauma STDs, UTI

Front 27

Child abuse: In sexual child abuse - who is normally the abuser?

Back 27

Known to victim, usually male

Front 28

Child abuse: What is the peak incidence of sexual abused (age range)?

Back 28

9-12 years of age

Front 29

Developmental milestones (motor, cog/social): DEVELOPMENTAL MILESTONES

Back 29

p 124

Front 30

Developmental milestones (motor, cog/social): (list motor and cognitive/social milestones for each age)

Back 30

0

Front 31

Developmental milestones (motor, cog/social): 3months

Back 31

Motor: Holds head up, Moro reflex disapear Cog/Social: Social smile

Front 32

Developmental milestones (motor, cog/social): 4-5mo

Back 32

Motor: Rolls front to back, sits when proped Cog/social: Recognizes people

Front 33

Developmental milestones (motor, cog/social): 7-9mo

Back 33

Motor: sits alone Cog/social:Stranger anxiety,recognize voices

Front 34

Developmental milestones (motor, cog/social): 12-14mo

Back 34

Motor:Babinski disapears

Front 35

Developmental milestones (motor, cog/social): 15mo

Back 35

Motor: walks Cog/social:few words, separation anxiety

Front 36

Developmental milestones (motor, cog/social): Toddler

Back 36

0

Front 37

Developmental milestones (motor, cog/social): 12-24mo

Back 37

Motor: climbs stairs, stacks 3 blocks Cog/Social: Object permanence

Front 38

Developmental milestones (motor, cog/social): 18-24

Back 38

Motor: Stacks 6 blocks Cog/social: Raprochement

Front 39

Developmental milestones (motor, cog/social): 24-48mo

Back 39

Cog/social: parallel play

Front 40

Developmental milestones (motor, cog/social): 24-36mo

Back 40

Cog/social: Core gender identity

Front 41

Developmental milestones (motor, cog/social): Preschool

Back 41

0

Front 42

Developmental milestones (motor, cog/social): 30-36mo

Back 42

Cog/social: Toilet training

Front 43

Developmental milestones (motor, cog/social): 3yrs

Back 43

Motor: rides tricycle, copies line or circle drawing Cog/Social: Group play

Front 44

Developmental milestones (motor, cog/social): 4yrs

Back 44

Simple drawing (stick figure), hops on 1foot Cog/social: co-operative play

Front 45

Developmental milestones (motor, cog/social): School age

Back 45

0

Front 46

Developmental milestones (motor, cog/social): 6-11yrs

Back 46

Cog/Social: Development of conscience (superego), same-sex friends, identification with same sex parent.

Front 47

Developmental milestones (motor, cog/social): Adolescence (Puberty)

Back 47

0

Front 48

Developmental milestones (motor, cog/social): 11yrs(girls) , 13yrs(boys)

Back 48

Abstract reasoning (formal operations), formation of personality.

Front 49

Neurotransmitter changes with Disease : Determine what NT increase or decrease with listed disease.

Back 49

0

Front 50

Neurotransmitter changes with Disease : Anxiety?

Back 50

increase NE, decrease serotonin (5'HT) decrease GABA

Front 51

Neurotransmitter changes with Disease : Depression?

Back 51

decrease NE, decrease serotonin

Front 52

Neurotransmitter changes with Disease : Alzheimer's dementia?

Back 52

decrease Ach

Front 53

Neurotransmitter changes with Disease : Huntington's disease?

Back 53

decrease GABA, decrease Ach

Front 54

Neurotransmitter changes with Disease : Schizophrenia?

Back 54

Increase dopamine

Front 55

Neurotransmitter changes with Disease : Parkinson's disease

Back 55

decrease dopamine

Front 56

Orientation (Psychiatry) : How can you elicit if a patient is orientated?

Back 56

1. Patient's ability to know name, date and time, what his or her present circumstnces are

Front 57

Orientation (Psychiatry) : Arrange (Place, time, Person) from 1st to last - in orientation loss.

Back 57

1st: Time 2nd:Place Last:Their name

Front 58

Orientation (Psychiatry) : What is Anosognosia?

Back 58

Unaware that one is ill

Front 59

Orientation (Psychiatry) : What is Autotopagnosia?

Back 59

Unable to locate one's own body parts.

Front 60

Orientation (Psychiatry) : What is Depersonalization?

Back 60

Body seems unreal or dissociated

Front 61

Amnesia types : What is Anterograde amnesia?

Back 61

Inability of remember things that occurred after a CNS insult (no new memory)

Front 62

Amnesia types : What is Korsakoff's amnesia? Associated behaviours?

Back 62

A classic anterograde amnesia - caused by thiamine deficiency. Is associated with confabulations.

Front 63

Amnesia types : In Korsakoff's amnesia - what CNS structure is destroyed? What population is it is most prevelant in?

Back 63

Bilarteral destruction of Mammilary bodies. Alcoholics

Front 64

Amnesia types : What is Retrograde amnesia?

Back 64

Inability to remember things that occurred before a CNS insult.

Front 65

Amnesia types : What type of amnesia is a complication of ECT (electroconvulsive therapy)?

Back 65

Retrograde amnesia

Front 66

Delerium & Dementia (p. 129): What are the symptoms of delerium?

Back 66

Decreased attention span and arousal, disorganized thinking, hallucinations, illusions, misperceptions, disturbance in sleep-wake cycle, cognitive dysfunction

Front 67

Delerium & Dementia (p. 129): What is the pattern of onset of delerium?

Back 67

Rapid onset, waxing and waning.

Front 68

Delerium & Dementia (p. 129): What is the most common psychiatric illness on medical and surgical floors? Is it reversible?

Back 68

Delirium; reversible

Front 69

Delerium & Dementia (p. 129): What class of drugs is associated with delerium?

Back 69

anticholinergics

Front 70

Delerium & Dementia (p. 129): What are the symptoms of dementia?

Back 70

Gradual loss in cognition: Multiple cognitive deficits- memory, aphasia, apraxia, agnosia, loss of abstract thought, behavioral or personality changes, impaired judgement.

Front 71

Delerium & Dementia (p. 129): What are the differences between delerium and dementia?

Back 71

Dementia: alert patient, gradual onset,normal EEG. Delirium: rapid onset, abnormal EEG.

Front 72

Delerium & Dementia (p. 129): Dementia may mimic what other illness in the elderly?

Back 72

Depression

Front 73

Hallucination vs. illusion vs. delusion (p.133): What is a hallucination?

Back 73

A perception in the absence of actual external stimuli.

Front 74

Hallucination vs. illusion vs. delusion (p.133): What is an illusion?

Back 74

A misinterpretation fo actual external stimuli

Front 75

Hallucination vs. illusion vs. delusion (p.133): What is a delusion?

Back 75

A false belief that is not shared with other members of culture or subculture, which is firmly maintained in spite of evidence to the contrary

Front 76

What is a loose association?

Back 76

Disorders in the form of thought (the way ideas are tied altogether

Front 77

Hallucination vs. illusion vs. delusion (p.133): True or false: A delusion is a disorder in the content of thought?

Back 77

TRUE

Front 78

Hallucination vs. illusion vs. delusion (p.133): True or false: A loose association is a disorder in the form ot thought?

Back 78

TRUE

Front 79

Dissociative fugue: what is it? What does it lead to? Is it a result of substance of abuse or general medical conditon?

Back 79

abrupt change in geogrphic location with inability to recall past, confusion about personal idetntity, or assumption of a new identity. Leads to distress or impairment. Not the result of substance about or general medical condition.

Front 80

Hallucinations (p. 133): True or false: Visual hallucinations are rare in schizophrenia?

Back 80

FALSE

Front 81

Hallucinations (p. 133): What type of hallucination occurs as an aura of psychomotor epilepsy?

Back 81

Olfactory

Front 82

Hallucinations (p. 133): What type of hallucination is rarest?

Back 82

Gustatory

Front 83

Hallucinations (p. 133): What type of hallucination is common in DT's and in cocaine abusers?

Back 83

Tactile

Front 84

Hallucinations (p. 133): What type of hallucination occurs while going to sleep?

Back 84

Hypnagogic

Front 85

Hallucinations (p. 133): What type of hallucination occurs while waking from sleep?

Back 85

Hypnopompic

Front 86

Schizophrenia: what are the characterics?

Back 86

periods of psychosis and disturbed behavior with a decline in functioning

Front 87

Schizophrenia: periods of psychosis and disturbed behavior last how long? What is it called if lasts for 1-6 months? Less then one month?

Back 87

6 months; schizophreniform disorder; brief psychotic disorder, usually stress related.

Front 88

Schizophrenia: 4 positive symptoms?

Back 88

hallucinations (often auditory), delusions, disorganized or catatonic disorder (strange behavior), disorganized though (loose associations)

Front 89

Schizophrenia: 4 negative symptoms?

Back 89

flat affect, social withdrawal, Lack of speech of thought, lack of motivation

Front 90

Schizophrenia: 5 subtypes

Back 90

disorganized (with regard to speech, behavior, and affect), catatonic (automatisms), paranoid (delusions), undifferentiated (elements of all types), residual

Front 91

Schizophrenia: etiology

Back 91

genetic factors outweigh environmental factors

Front 92

Schizophrenia: lifetime prevalence

Back 92

1.5%; males=females; blacks=whites.

Front 93

Schizophrenia: different presentation in men and women

Back 93

presents earlier in men

Front 94

Schizophrenia: schizophrenia +a major depressive, manic, or mixed (both) episode is called?

Back 94

schizoaffective disorder

Front 95

Schizophrenia: 2 subtypes of schizoaffective disorder

Back 95

bipolar or depressive

Front 96

Schizophrenia: Structural theory of the mind

Back 96

C2

Front 97

Schizophrenia: how many structures?

Back 97

Freud had 3

Front 98

Schizophrenia: primal urges, sex, aggression - things you want

Back 98

Id

Front 99

Schizophrenia: moral values, conscience - you know you can't have it

Back 99

Superego

Front 100

Schizophrenia: bridge and mediator between unconscious mind and external world - conflict mediator

Back 100

Ego

Front 101

Manic episode: How long must abnormally and persistently elevated mood or irritability be present for to be called a manic episode?

Back 101

1 week

Front 102

Manic episode: What are the symptoms of a manic episode?

Back 102

Distractability, insomnia, grandiosity, flight of ideas, increase in goal directed activity or psychomotor agitation, pressured speech, thoughtlessness (DIG FAST)

Front 103

Manic episode: How many of those symptoms must be present to be considered a manic episode?

Back 103

3

Front 104

Manic episode: True or false: A hypomanic episode does not cause marked impairment in social or occupational function or necessitate hospitalization?

Back 104

TRUE

Front 105

What is the drug of choice for bipolar disorder?

Back 105

lithium

Front 106

How many manic episodes does it take to define bipolar disorder?

Back 106

1

Front 107

How many hypomanic episodes does it take to define bipolar disorder?

Back 107

1

Front 108

What type of bipolar disorder involves hypomanic episodes? Manic episodes?

Back 108

Type II; Type I

Front 109

A milder form of bipolar disorder is called? How long does it have to last for?

Back 109

cyclothymic disorder; lasting at least 2 years.

Front 110

Major depression (p. 129): What are the two main characteristics of major depression?

Back 110

Depressed mood, anhedonia (lost of interest)

Front 111

Major depression (p. 129): What are the nine symptoms of depression?

Back 111

Sleep disturbances, loss of Interest, Guilt or feeling of worthless ness, loss of Energy, loss of Concentration, change in Appetite/weight, Psychomotor retardation, Suicidal ideations, depressed mood (SIG E CAPS)

Front 112

Major depression (p. 129): How many of those symptoms do you need and for how long?

Back 112

5 symptoms for 2 weeks.

Front 113

Major depression (p. 129): What is the definition of recurrant major depressive disorder?

Back 113

2 or more episodes with 2 month symptom free interval

Front 114

Major depression (p. 129): What is the lifetime prevalence of major depression in men?

Back 114

5-12%

Front 115

Major depression (p. 129): What is the lifetime prevalence of major depression in women?

Back 115

10-25%

Front 116

Major depression (p. 129): A mild depressive episode is called? How long does it have to last for?

Back 116

dysthymia; 2 years.

Front 117

Major depression (p. 129): ECT is painful, true or false?

Back 117

FALSE

Front 118

Major depression (p. 129): What are the side effects of ECT?

Back 118

due to anesthesia: disorientation, anterograde and retrograde amnesia

Front 119

Sleep in Depressed Patient: What are the major changes in sleep pattern in depressed patients?

Back 119

decreased slow-wave (non REM - Delta), decreased REM latency, increased REM early in sleep cycle, increase total REM sleep, repeated nigttime awakenings, early morning awakening (important screening question)

Front 120

Risk factors for suicide compleiton? Which sex succeeds at suicide and which tries more often?

Back 120

SAD PERSONS: Sex (male), Age (teenage and elderly), Depression, Previous attempt, Ethanol or drug use, loss of Rational thinking, Sickness (medical illness, 3 or more prescription medications), Organized plan, No spouse (divorced, widowed, single, especially if childless), Social support is lacking. Women try more often; men succeed more often.

Front 121

Panic disorder (p. 131): How long does it take a panic attack (intense fear and discomfort) to peak?

Back 121

10 minutes

Front 122

Panic disorder (p. 131): What are the symptoms of panic attack?

Back 122

palpitations, abdominal distress, nausea, increased perspiration, chest pain, chills, and choking (PANIC)

Front 123

Panic disorder (p. 131): How many of those must be present to call it a panic disorder?

Back 123

4

Front 124

Panic disorder (p. 131): What psychiatric disorder has a high prevalence during the step 1 exam?

Back 124

panic disorder

Front 125

Phobia (p. 131): What is a phobia? Trx?

Back 125

Excessive or unreasonable fear cued by presence or anticipation of a specific object or entity. Trx: systematic desensitization.

Front 126

Phobia (p. 131): True or false: a patient has insight into their own phobia

Back 126

TRUE

Front 127

Phobia (p. 131): Gamophobia is fear of what?

Back 127

marriage

Front 128

Phobia (p. 131): Algophobia is fear of what?

Back 128

pain

Front 129

Phobia (p. 131): Acrophobia is fear of what?

Back 129

heights

Front 130

Phobia (p. 131): Agoraphobia is fear of what?

Back 130

open places (fear of being in public place or situation from which escape may be difficult)

Front 131

PTSD (p. 131): What are the symptoms of PTSD?

Back 131

Traumatic event is persistently reexperienced as nightmares or flashbacks

Front 132

PTSD: What responses are involved?

Back 132

fear, helplessness, or horror

Front 133

PTSD (p. 131): How long must the symptoms last to be called PTSD?

Back 133

1 month, causing distress or social/ occupational impairment.

Front 134

PTSD (p. 131): PTSD often follows which disorder?

Back 134

Acute stress disorder (lasts up to 2-4 weeks)

Front 135

Other anxiety disorders (p.131): What is adjustment disorder

Back 135

Emotional symptoms including anxiety or depression causing impairment following a psychosocial stressor (i.e. divorce, moving), lasting less than 6 months

Front 136

Other anxiety disorders (p.131): True or false: general anxiety is related to a specific person, situation, or event?

Back 136

FALSE

Front 137

Other anxiety disorders (p.131): What are the symptoms of generalized anxiety disorder?

Back 137

GI symptoms, fatigue, and difficulty concentrating

Front 138

Personality (p.131): What is a personality trait?

Back 138

an enduring pattern of perceiving, relating to, and thinking about the environment and oneself.

Front 139

Munchausen's (p. 130): Is munchausen's syndrome involve conscious or unconscious motivation?

Back 139

Unconscious.

Front 140

Somatoform disorders (p. 130): What are the characteristics of conversion?

Back 140

Symptoms suggest motor or sensory neurologic or physical disorder, but physical exam and tests are negative

Front 141

Somatoform disorders (p. 130): True or false, somatoform disorders are more common in women?

Back 141

TRUE

Front 142

Somatoform disorders (p. 130): What is a prolonged pain that is not explained by an illness?

Back 142

Somatoform pain disorder

Front 143

Somatoform disorders (p. 130): What is the misinterpretation of normal physical findings leading to a persistent fear of serious illness in spite of medical reassurance?

Back 143

Hypochondriasis

Front 144

Somatoform disorders (p. 130): What are the characteristics of somatization disorder?

Back 144

A variety of complaints involving multiple organ systems

Front 145

Somatoform disorders (p. 130): What is the disorder where a patient believes their own anatomy is malformed?

Back 145

body dysmorphic disorder

Front 146

Somatoform disorders (p. 130): What is the false belief of being pregnant associated with objective physical signs of pregnancy?

Back 146

pseudocyesis

Front 147

What is primary gain?

Back 147

What a symptom does for a patient's internal psychic economy

Front 148

What is secondary gain?

Back 148

What a symptom gets a patient (sympathy or attention)

Front 149

What is tertiary gain?

Back 149

What the caretaker gets.

Front 150

Personality (p.131): What is a personality trait?

Back 150

an enduring pattern of perceiving, relating to, and thinking about the environment and oneself.

Front 151

Personality (p.131): True or false: a personality disorder does not cause impairment of social or occupational functioning?

Back 151

FALSE

Front 152

Personality (p.131): True or false: a patient with a personality disorder is aware of their problem

Back 152

FALSE

Front 153

Personality (p.131): What are the cluster A personality disorders?

Back 153

Paranoid, schizoid, schizotypal (Weird)

Front 154

Personality (p.131): What are the cluster B personality disorders?

Back 154

Antisocial, borderline, histrionic, narcissistic (Wild)

Front 155

Personality (p.131): What are the cluster C personality disorders?

Back 155

Avoidant, obsessive compulsive, dependant (Worried)

Front 156

Personality (p.131): What cluster has a genetic association with anxiety disorders?

Back 156

C (worried)

Front 157

Personality (p.131): What cluster has a genetic association with mood disorders?

Back 157

B (Wild)

Front 158

Personality (p.131): What cluster has a genetic association with schizophrenia?

Back 158

A (weird)

Front 159

Personality (p.131): What are the characteristics of paranoid personality disorder?

Back 159

Distrust, suspiciousness, and projection as a defense mechanism

Front 160

Personality (p.131): What personality disorder involves limited emotional expression, voluntary social withdrawal, content with social isolation?

Back 160

Schizoid

Front 161

Personality (p.131): What personality disorder involves interpersonal awkwardness, odd thought patterns and appearance?

Back 161

Schizotypal

Front 162

Personality (p.131): What personality disorder involves a disregard for others, crimality, and conduct disorders, and occurs more in males?

Back 162

Antisocial

Front 163

Personality (p.131): What personality disorder involves unstable mood and behavior, impulsiveness, emptiness, and occurs more often in women?

Back 163

Borderline

Front 164

Personality (p.131): What personality disorder involves excessive emotionality, somatization, attention seeking, sexually provocative, and overly concerned with appearance?

Back 164

Histrionic

Front 165

Personality (p.131): What PD involves grandiosity, a sense of entitlement ,may react to critism with rage?

Back 165

Narcissistic

Front 166

Personality (p.131): What PD is sensitive to rejection, socially inhibited, timid, and has feelings of inadequacy?

Back 166

Avoidant

Front 167

Personality (p.131): What PD is preoccupied with order, perfectionism, and control?

Back 167

Obsessive-compulsive

Front 168

Personality (p.131): What PD is submissive and clinging, excessively needs to be taken care of, and has low self confidence?

Back 168

Dependant

Front 169

Personality (p.131): Characterization of Cluster A personality disorders

Back 169

Odd or eccentric; cannot develop meaningful social relationships. No psychosis

Front 170

Personality (p.131): Characterization of Cluster B personality disorders

Back 170

Dramatic, emotional, erractic

Front 171

Personality (p.131): Characterization of Cluster C personality disorders

Back 171

anxious or fearful

Front 172

Schizo-: Differences of the following: schizioid, schizotypical, schizophrenic, schizoaffective

Back 172

schizioid, schizotypal (schizoid + odd thinking), schizophrenic (greater odd thinking than schizotypal), schizoaffective (schizpphrenia+ mood disorder)

Front 173

Eating disorders (p.133): What are the symptoms of anorexia nervosa?

Back 173

Excessive dieting, body image distortion, increase in exercise. Sever weight loss, amenorrhea, anemia, and electrolyte disturbances.

Front 174

Eating disorders (p.133): What are the symptoms of bulimia nervosa?

Back 174

Binge eating followed by self-induced vomiting or use of laxatives. Parotitis, enamel erosion, increase in amylase, and esophageal varices from vomiting

Front 175

Eating disorders (p.133): True or false: Bulimia nervosa involves normal body weight?

Back 175

TRUE

Front 176

Substance Dependence: List the maladaptive pattern of substance dependence?

Back 176

1. Tolerance, 2. Withdrawal, 3. Substance taken in larger amounts than intended., 4. Persistent desire or attempts to cutdown, 5. Lots of energy spent trying get substance, 6. Important socia, occupational or recreational activities given up or reduced because of substance use., 7. Continued use in spite of knowledge of the problems that it causes

Front 177

Substance Dependence: What is the definition of substance dependence?

Back 177

The presence of 3 or more maladaptive signs in 1year

Front 178

Substance Abuse: Definition of substance abuse?

Back 178

Maladaptive pattern leading to significant impairment or distress.

Front 179

Substance Abuse: List 4 symptoms of substance abuse?

Back 179

1. Recurrent use resulting in failure to fulfill major obligation at work, school or home, 2. Recurrent use in physically harzardous situations?, 3. Recurrent substance - related legal problems, 4. Continued use in spite of persistnent problems caused by use., - Only 1 or more are reguired to met the criteria of substance abuse.

Front 180

Substance Abuse: definiation of withdrawal

Back 180

a substance-specific syndrome with signs and symptoms often opposite to those seen in intoxiacation and not attributable to another medical condition.

Front 181

Substance abuse (p. 128): Disinhibition, emotional lability, slurred speech, ataxia, coma, and blackouts are symptoms of which drug?

Back 181

Alcohol

Front 182

Substance abuse (p. 128): CNS depression, nausea and vomiting, constipation, pupillary constriction, and seizures are the signs of which drug?

Back 182

Opioids

Front 183

Substance abuse (p. 128): Psychomotor agitation, impaired judgement, pupillary dilation, hypertension, tachycardia, euphoria, prolonged wakefullness and attention, cardiac arrhythmias, delusions, hallucianations, and fever are side effects of which drug?

Back 183

Amphetamines

Front 184

Substance abuse (p. 128): Euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, hypertension, hallucinations, paranoid ideations, angina, and sudden cardiac death are symptoms of which drug?

Back 184

Cocaine

Front 185

Substance abuse (p. 128): Belligerance, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homocidality, psychosis, and delerium are side effects of which drug?

Back 185

PCP

Front 186

Substance abuse (p. 128): Anxiety, depression, del.usions, visual hallucinations, flashbacks, and pupil dilation are side effects of which drug?

Back 186

LSD

Front 187

Substance abuse (p. 128): Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawl, increased appetite, dry mouth, and hallucinations are symptoms of which drug?

Back 187

Marijuana

Front 188

Substance abuse (p. 128): Low safety margin and respiratory depression are characteristics of which drug?

Back 188

Barbiturates

Front 189

Substance abuse (p. 128): Amnesia, ataxia, somnolesence, minor respiratory effects, and addictictive effects with alcohol are the characteristics of which drug?

Back 189

Benzodiazepines

Front 190

Substance abuse (p. 128): Restlessness, insomnia, increased diuresis, muscle twitching, cardiac arrhythmias are the side effects of which drug?

Back 190

Caffeine

Front 191

Substance abuse (p. 128): Restlessness, anxiety, insomnia, and arrhytmias are the side effects of whicch drug?

Back 191

nicotine

Front 192

Substance abuse (p. 128): A craving for cheetos and the desire to watch "old school" are the side effects of which drug?

Back 192

marijuana

Front 193

Substance abuse (p. 128): What are the symptoms of alcohol withdrawl?

Back 193

Tremor, tachycardia, hypertension, malaise, nausea, seizures, DTs, agitation, hallucinations

Front 194

Substance abuse (p. 128): What are the symptoms of opioid withdrawl?

Back 194

anxiety, insomnia, anorexia, sweating, dilated pupils, piloerection, fever, rhinorrhea, nausea, stomach cramps, diarrhea, and yawning

Front 195

Substance abuse (p. 128): What are the symptoms of amphetamine withdrawl?

Back 195

Post use crash of depression, lethargy, headache, stomach cramps, hunger, hypersomnolence

Front 196

Substance abuse (p. 128): What are the symptoms of cocaine withdrawl

Back 196

Post use crash of suicidality, hypersomnolence, fatigue, malaise, severe craving

Front 197

Substance abuse (p. 128): What are the symptoms of PCP withdrawl

Back 197

Recurrance of symptoms due to reabsorption, with sudden onsets of severe random violence

Front 198

Substance abuse (p. 128): What are the side effects of barbiturate withdrawl?

Back 198

Anxiety, seizures, delerium, life threatening CV collapse.

Front 199

Substance abuse (p. 128): What are the side effects of benzodiazepine withdrawl?

Back 199

Rebound anxieety, seizures, tremor, insomnia.

Front 200

Substance abuse (p. 128): What are the side effects of caffeine withdrawl?

Back 200

Headache, lethargy, depression, weight gain

Front 201

Substance abuse (p. 128): What are the side effects of nicotine withdrawl?

Back 201

Irritabilty, headache, anxiety, weight gain, craving, tachycardia?

Front 202

Substance abuse (p. 128): When do DT's occur?

Back 202

2-5 days after last drink

Front 203

Substance abuse (p. 128): What is the treatment for DTs?

Back 203

Benzodiazepines

Front 204

Substance abuse (p. 128): What is the sequence of symptoms experienced in DT's?

Back 204

Autonomic hyperactivity --> psychotic symptoms --> confusion

Front 205

Substance abuse (p. 128): What is a competetive inhibitor of heroin?

Back 205

Naloxone

Front 206

Substance abuse (p. 128): What diagnoses are associated with heroin addiction?

Back 206

hepatitis, abscesses, overdose, hemorrhoids, AIDS, right sided endocarditis.

Front 207

Substance abuse (p. 128): What drug is used for long term maintinence or heroin detox?

Back 207

methadone

Front 208

Alcoholism: tremor, tachcardia, hypertension, malaise, nausea, delirium tremens are symtpoms of what?

Back 208

alcohol withdrawal

Front 209

Alcoholism: when do you get symptoms of alcohol withdrawal?

Back 209

in case of physiological tolerance and dependence when intake is interrupted

Front 210

Alcoholism: what is disulfiram and how does it work?

Back 210

disulfiram is a pharmacological treatment of alcoholism - negatively conditions patient against EtOH

Front 211

Alcoholism: a good possible referral to sustain EtOH abstinence in alcoholics

Back 211

Alcoholics Anonymous and other peer groups

Front 212

Alcoholism: 3 mechanisms of EtOH action

Back 212

1) interpolates into membranes --> toxic effects, partic. in brain 2) alcohol dehydrogenase converts EtOH to acetaldehyde, forms adducts with proteins and nucleic acids, converted to acetate, Ac-CoA, FA synthesis, fatty liver 3) increased NADH/NAD ratio

Front 213

Complications of alcoholism: Condition in which these are seen: hepatitis and cirrhosis, pancreatitis, dilated cardiomyopathy, peripheral neuropathy, cerebellar degeneration, Wernicke-Korsakoff syndrome, testicular atrophy and hyperestrinism, and Mallory-Weiss syndrome

Back 213

alcoholism

Front 214

Complications of alcoholism: name histological type of cirrhosis in alcoholism

Back 214

micronodular cirrhosis

Front 215

Complications of alcoholism: accompanying symptoms of alcoholic cirrhosis

Back 215

jaundice, hypoalbuminemia, coagulation factor deficiences, portal hypertension

Front 216

Complications of alcoholism: list clinical findings in alcoholic cirrhosis besides jaundice

Back 216

peripheral edema and ascites, encephalopathy, neurologic manifestations (asterixis, flaping tremor of hands)

Front 217

Complications of alcoholism: What is the cause of Wernicke-Korsakoff syndrome?

Back 217

thiamine (B1) deficiency, particularly in alcoholics

Front 218

Complications of alcoholism: what is the presenting triad of Wernicke's encephalopathy?

Back 218

psychosis, ophthalmoplegia, and ataxia

Front 219

Complications of alcoholism: distinguishing features of Korsakoff's from Wernicke's

Back 219

in Korsakoff, also *memory loss*, confabulation,confusion.

Front 220

Complications of alcoholism: is Korsakoff's syndrome reversible?

Back 220

No.

Front 221

Complications of alcoholism: Tx for Wernicke-Korsakoff syndrome

Back 221

IV Vitamin B1 (thiamine)

Front 222

Complications of alcoholism: What is Mallory-Weiss syndrome?

Back 222

longitudinal lacerations at the gastroesophageal junction caused by excessive vomiting (for ex., in alcoholism) with failure of LES relaxation that could lead to fatal hematemesis

Front 223

Intelligence testing: How does the Stanford-Binet test calculate IQ?

Back 223

mental age/chronological age * 100

Front 224

Intelligence testing: How does the Wechsler Adult Intelligence Scale calculate intelligence?

Back 224

11 subtests - 6 verbal, 5 performance

Front 225

Intelligence testing: What is the mean IQ?

Back 225

100, standard deviation = 15

Front 226

Intelligence testing: what are the IQ values for profound, severe, and moderate to mild mental retardation?

Back 226

<20, <40, and <70 (or two standard deviations below the mean)

Front 227

Intelligence testing: What determines IQ scores - based on correlation?

Back 227

most highly correlated with school achievement, also correlated with genetic factors

Front 228

Intelligence testing: Are intelligence tests objective or projective?

Back 228

objective

Front 229

Classical conditioning: salivation (a natural response) is elicited by a bell (a --- stimulus) that has been associated with food (a natural stimulus), not necessarily a reward

Back 229

conditioned, or learned

Front 230

Operant conditioning: a particular action is elicited because it produces a ---.

Back 230

reward

Front 231

Operant conditioning: an action (pressing a button) is produced because, for example, a mouse wants food

Back 231

positive reinforcement

Front 232

Operant conditioning: an action (pressing a button) is produced because, for example, a med student wants to avoid shock

Back 232

negative reinforcement - NOT punishment

Front 233

Reinforcement schedules: pattern of reinforcement determines what?

Back 233

how quickly a behavior is learned and extinguished if not rewarded

Front 234

Reinforcement schedules: how quickly is a behavior on a continuous schedule (i.e., vending machine use) extinguished when not rewarded?

Back 234

most rapidly

Front 235

Reinforcement schedules: what schedule shows the slowest extinction when not rewarded?

Back 235

variable ratio (gambling)

Front 236

Transference and countertransference: sometimes a patient projects feelings stemming from personal life onto his or her physician, and sometimes the physician projects feelings stemming from personal life onto the patient

Back 236

transference and countertransference, respectively

Front 237

Topographic theory of the mind: Name the components of this theory

Back 237

CPU - Conscious, Preconscious, Unconscious

Front 238

Topographic theory of the mind: Conscious

Back 238

what you're aware of

Front 239

Topographic theory of the mind: Preconscious

Back 239

what you are able to make conscious with effort (like phone number or SSN)

Front 240

Topographic theory of the mind: Unconscious

Back 240

what you are not aware of (what you don't know you don't know)

Front 241

Topographic theory of the mind: the central goal of Freudian psychoanalysis

Back 241

to make the patient aware of what is hidden in his/her unconscious

Front 242

Oedipus complex: define oedipus complex

Back 242

repressed sexual feelings of a child for the oposite sex parent, accompanied by rivalry with same-sex parent - described by Freud

Front 243

Ego defenses: Your --- has many ---, or automatic and unconscious reactions to psychological stress.

Back 243

ego defenses

Front 244

Ego defenses: Name the mature ego defenses

Back 244

Mature women wear a SASH: Sublimation, Altruism, Supression, Humor

Front 245

Ego defenses: using ---, one replaces an unacceptable wish with a course of action similar but not conflicting with one's values

Back 245

sublimation

Front 246

Ego defenses: --- is unsolicited generosity toward others that alleviates guilty feelings

Back 246

altruism

Front 247

Ego defenses: unlike other defenses, this is a voluntary withholding of an idea or feeling from conscious awareness

Back 247

supression

Front 248

Ego defenses: one uses ---, or appreciates the amusing nature to alleviate anxiety-provoking or adverse situations

Back 248

humor

Front 249

Ego defenses: Acting out, dissociation, denial, displacement, fixation, identification, isolation, projection, rationalization, reaction formation, regression, repression, splitting are all ---.

Back 249

immature

Front 250

Ego defenses: the three D's of immaturity

Back 250

Dissociation, Denial, Displacement

Front 251

Ego defenses: by --- --- or throwing a tantrum, unacceptable feelings and thoughts are expressed through actions

Back 251

acting out

Front 252

Ego defenses: the extreme forms of these temporary, drastic changes in personality memory, consciousness, or motor behavior can result in multiple personalities, or --- --- ---.

Back 252

dissociation; dissociative identity disorder

Front 253

Ego defenses: this is a common reaction in which one avoids awareness of some painful reality

Back 253

denial

Front 254

Ego defenses: a mother might transfer avoided anger at her husband by yelling at her child

Back 254

displacement

Front 255

Ego defenses: partially remaining at a more childish level of development, like men's fascination with sports games

Back 255

fixation

Front 256

Ego defenses: victim of child abuse becomes abuser

Back 256

identification

Front 257

Ego defenses: separation of feelings from ideas and events like describing murder in graphic detail with no emotional response

Back 257

isolation

Front 258

Ego defenses: when a man who wants another woman thinks his wife is cheating on him, he is ---.

Back 258

projecting

Front 259

Ego defenses: when one wants to avoid self-blame, one might say a job wasn't important anyway after not getting it

Back 259

rationalization

Front 260

Ego defenses: this is described by someone with libidinous thoughts enters a monastery

Back 260

reaction formation

Front 261

Ego defenses: --- occurs when one turns back the maturational clock, going back to earlier modes of dealing with the world - like children in stress who wet the bed

Back 261

regression

Front 262

Ego defenses: involuntary withholding of an idea or feeling from conscious awareness

Back 262

repression

Front 263

Ego defenses: belief that people are either good or bad

Back 263

splitting

Front 264

Topographic theory of the mind: Name the components of this theory

Back 264

CPU - Conscious, Preconscious, Unconscious

Front 265

Topographic theory of the mind: Conscious

Back 265

what you're aware of

Front 266

Topographic theory of the mind: Preconscious

Back 266

what you are able to make conscious with effort (like phone number or SSN)

Front 267

Topographic theory of the mind: Unconscious

Back 267

what you are not aware of (what you don't know you don't know)

Front 268

Topographic theory of the mind: the central goal of Freudian psychoanalysis

Back 268

to make the patient aware of what is hidden in his/her unconscious

Front 269

Oedipus complex: define oedipus complex

Back 269

repressed sexual feelings of a child for the oposite sex parent, accompanied by rivalry with same-sex parent - described by Freud

Front 270

Antipsychotics (neuroleptics): what is another name for antipsychotics

Back 270

neuroleptics

Front 271

Antipsychotics (neuroleptics): name 4 antipsychotic drugs

Back 271

thioridazine, haloperidol, fluphenazine, chlorpromazine

Front 272

Antipsychotics (neuroleptics): how do you keep benzos straight from antipsychotics

Back 272

Benzos help 3rd year Jon Kazam be less anxious around patients: Shazam Kazam! Without antipsychotics patients talk like a crazy 'zine (well, not perfect, but I'm working on it)

Front 273

Antipsychotics (neuroleptics): what is the mechanism of most antipsychotics

Back 273

block dopamine D2 receptors

Front 274

Antipsychotics (neuroleptics): what is the clinical application of antipsychotics

Back 274

schizophrenia, psychosis

Front 275

Antipsychotics (neuroleptics): what are the side effects of antipsychotics

Back 275

extrapyramidal side effects (EPS), sedation, endocrine, muscarinic blockade, alpha blockade, histamine blockade

Front 276

Antipsychotics (neuroleptics): what is a long-term effect of antipsychotic use

Back 276

tardive dyskinesia

Front 277

Antipsychotics (neuroleptics): what is neuroleptic malignant syndrome

Back 277

a side effect of antipsychotics; rigidity, autonomic instability, hyperpyrexia

Front 278

Antipsychotics (neuroleptics): how do you treat neuroleptic malignant syndrome

Back 278

dantrolene, dopamine agonists

Front 279

Antipsychotics (neuroleptics): what is tardive dyskinesia

Back 279

side effect of neuroleptics; stereotypic oral-facial movements, may be due to dopamine receptor sensitization

Front 280

Antipsychotics (neuroleptics): what is the "rule of 4" with EPS side effects from antipsychotic drugs

Back 280

evolution of EPS side effects: 4 hours -- acite dystonia, 4 days -- akinesia, 4 weeks -- akasthesia, 4 months -- tardvie dyskinesia

Front 281

Antipsychotics (neuroleptics): is tardvie dyskinesia reversible

Back 281

often irreversible

Front 282

Antipsychotics (neuroleptics): what is fluphenazine used for

Back 282

schizophrenia, psychosis

Front 283

Atypical antipsychotics: name 3 atypical antipsychotics

Back 283

clozapine, olanzapine, risperidone

Front 284

Atypical antipsychotics: what type of antipsychotic is clozapine

Back 284

atypical

Front 285

Atypical antipsychotics: what type of antipsychotic is olanzapine

Back 285

atypical

Front 286

Atypical antipsychotics: what type of antipsychotic is risperidone

Back 286

atypical

Front 287

Atypical antipsychotics: what is the mechanism of atypical antipsychotics

Back 287

block 5-HT2 and dopamine receptors

Front 288

Atypical antipsychotics: what is the mechanism of clozapine

Back 288

block 5-HT2 and dopamine receptors

Front 289

Atypical antipsychotics: what is the mechanism of olanzapine

Back 289

block 5-HT2 and dopamine receptors

Front 290

Atypical antipsychotics: what is the mechanism of risperidone

Back 290

block 5-HT2 and dopamine receptors

Front 291

Atypical antipsychotics: what is the clinical application of clozapine

Back 291

schizophrenia positive and negative symptoms

Front 292

Atypical antipsychotics: what is the clinical application of olanzapine

Back 292

schizophrenia positive and negative symptoms, OCD, anxiety disorder, depression

Front 293

Atypical antipsychotics: what is the clinical application of risperidone

Back 293

schizophrenia positive and negative symptoms

Front 294

Atypical antipsychotics: how are atypical antipsychotics different from classic ones

Back 294

atypicals treat positive and negative symptoms of schizophrenia, fewer extrapyramidal and anticholinergic side effects than classic antipsychotics

Front 295

Atypical antipsychotics: which antipsychotics should be used to treat positive and negative symptoms of schizophrenia

Back 295

atypical ones -- clozapine, olanzapine, risperidone

Front 296

Atypical antipsychotics: which antipsychotics should be used for fewer side effects

Back 296

atypical ones -- clozapine, olanzapine, risperidone

Front 297

Atypical antipsychotics: what is a potential toxicity of clozapine

Back 297

agranulocytosis

Front 298

Atypical antipsychotics: which antipsychotic drug can cause agranulocytosis

Back 298

clozapine

Front 299

Atypical antipsychotics: what test must be done weekly on patients taking clozapine

Back 299

WBC count because of potential agranulocytosis

Front 300

Lithium: what is the mechanism of action of lithium

Back 300

unknown; may be related to inhibition of phosphoinositol cascade

Front 301

Lithium: what is the clinical application of lithium

Back 301

mood stabilizer for bipolar disorder

Front 302

Lithium: how does lithium help people with bipolar disorder

Back 302

prevents relapse and acute manic episodes

Front 303

Lithium: what are the side effects of lithium

Back 303

tremor, hypothyroidism, polyuria, teratogenic

Front 304

Lithium: is it OK for women taking lithium to get pregnant

Back 304

NO -- teratogenic

Front 305

Lithium: what does lithium cause polyuria

Back 305

ADH antagonist --> nephrogenic diabetes insipidus

Front 306

Antidepressants: What do the following drugs inhibit: 1. MAO inhibitors, 2. Desipramine/maprotilline, 3. Mirtazapine and 4. Fluoxetine/trazodone?

Back 306

1. MAO 2. NE reuptake 3. Alpha 2-R 4. 5HT reuptake

Front 307

Antidepressants: All of the above actions are ------synaptic

Back 307

PRE

Front 308

List the Tricyclic Antidepressants: What are the three C's of their toxicity?

Back 308

Convulsions, Coma, Cardiotoxicity (arrythmias). Also respiratory depression, hypyrexia.

Front 309

List the Tricyclic Antidepressants: How about toxicity in the eldery?

Back 309

confusion and hallucinations due to anticholinergic SE

Front 310

List the Tricyclic Antidepressants: What is the mechanism of TCA?

Back 310

block reuptake of NE and 5HT

Front 311

List the Tricyclic Antidepressants: What is the clinical uses of TCAs?

Back 311

Endogenous depresion. Bed wetting - imipramine. OCD- clomipramine.

Front 312

List the Tricyclic Antidepressants: How are tertiary TCA's different than secondary in terms of side effects?

Back 312

Amitriptyline (tertiary) has more anti-cholinergic effects than do secondary (nortriptyline). Desipramine is the least sedating.

Front 313

List the Tricyclic Antidepressants: what are the SE of TCAs?

Back 313

sedation, alpha blocking effects, atropine-like anti cholinergic side effects (tachycardia, urinary retention)

Front 314

List the Tricyclic Antidepressants: Fluoxetine, sertraline, paroxetine, citalopram are what class of drugs?

Back 314

pg 311 SSRI's for endogenous depression

Front 315

List the Tricyclic Antidepressants: How long does it take an anti-depressant to have an effect?

Back 315

2-3weeks

Front 316

List the Tricyclic Antidepressants: How does the toxicity differ fromTCA's and what are they?

Back 316

Fewer than TCA's. CNS stimulation - anxiety, insomnia, tremor, anorexia, nausea, and vomiting.

Front 317

List the Tricyclic Antidepressants: What toxicity happens with SSRI's and MAO inhibitors given together?

Back 317

Seratonin Syndrome! Hyperthermia, muscle rigidity, cardiovascular collapse

Front 318

List the Tricyclic Antidepressants: What are heterocyclics?

Back 318

pg 312 2nd and 3rd generation antidepressants with varied and mixed mechanisms of action. Used major depression.

Front 319

List the Tricyclic Antidepressants: Examples of heterocyclics?

Back 319

trazodone, buproprion, venlafaxine, mirtazapine, maprotiline

Front 320

List the Tricyclic Antidepressants: Which one is used for smoking cessation?

Back 320

Buproprion. Mechanism not known. Toxicity - stimulant effects, dry mouth, aggrevation of pyschosis

Front 321

List the Tricyclic Antidepressants: Which one used in GAD?

Back 321

Venlafaxine - inhibits 5HT and DA reuptake. Toxicity - stimulant effects

Front 322

List the Tricyclic Antidepressants: which one blocks NE reuptake

Back 322

maprotiline

Front 323

List the Tricyclic Antidepressants: Which one increases release of NE and 5HT via alpha 2 antagonism?

Back 323

mirtazapine. Also potent 5HT Rantagonist. Toxicity - sedation, increase serum cholesterol, increase apetite

Front 324

List the Tricyclic Antidepressants: What is trazodone and it' SE?

Back 324

primarily inhibits seratonin reuptake. Toxicity - sedation, nausea, priapism, postural hypotension

Front 325

Give 2 examples of MAO: Mechanism and Clinical Uses?

Back 325

non selevtive MAO inhibition. Atypical antidepressant, anxiety, hypochondriasis

Front 326

Give 2 examples of MAO: What is the toxicity with tyramine ingestion (in foods) and meperidine?

Back 326

Hypertensive crisis

Front 327

Give 2 examples of MAO: Other toxicities?

Back 327

CNS stimulation, contraindicated with SSRI's or B-agonists

Front 328

What is the mechanims of selgiline (deprenyl)?: what is the clinical use and toxicity?

Back 328

adjunctive agent to L-dopa for Parkinsons. May enhance adverse effects of L-dopa