Psychiatry Shelf Review I

Front 1

Describe mood v affect

Back 1

pt's subjective experience v objective signs of emotional state

Front 2

illusion v hallucination

Back 2

misperception of stimulus/something's there v perception of non-existent stimulus

Front 3

obsession v compulsion

Back 3

recurrent,distressing thought (never an action) v repetitive actions performed to relieve anxiety (act can be a thought, but more often is a physical action)

Front 4

circumstantial v tangential v loose association

Back 4

giving excessive details but not necessarily changing topic v wandering from topic to topic where each transition following logically, often forgetting the question that was asked v jumping from topic to topic without clear connections (All 3 related to thought process)

Front 5

word salad v clanging

Back 5

nonsensical grammatical constructions where words are thrown out v words rhyme with one another

Front 6

hypnaogoic v hypnopompic hallucinations

Back 6

during the period going to sleep v during the period of awakening. both commonly occur in healthy individuals; hypnoaGOgic (GO to sleep) & hypnoPOmpic (POpping up from sleep)

Front 7

Define delirium

Back 7

acute onset; characterized by inattention (can't repeat days of week in reverse, serial 7s, etc); waxing and waning course, and reversal of sleep-wake cycle

Front 8

T/F: delirium can be caused by conditions other than general medical conditions

Back 8

False

Front 9

Define Dementia

Back 9

amnesia + loss of cognitive function defined as one of the following: aphasia, agnosia, apraxia, poor executive function (includes sequencing, organizing, abstraction, planning)

Front 10

Alzheimer's type vs vascular dementia

Back 10

A: MCC of dementia; often linear decline; definitive dx requires TISSUE vs V: step-wise decline corresponding with descrete vascular insults

Front 11

Dementia vs Pseudodementia

Back 11

demented patients tend to confabulate (they don't want to be seen as demented) vs pseduodementia occurs as a result of depression (tend to over-exaggerate their deficits)

Front 12

mild cognitive impairment v benign senescent forgetfullness

Back 12

MCI: sub-syndromal dementia (only amnesia, agnosia, aphasia, apraxia, executive dysfunction) BSF: normal aging (forgot where placed the keys, etc.)

Front 13

Suicide attempt v parasuicidal gestures

Back 13

SA: intent of dying; PG:aimed at getting attention (but succeed sometimes!)

Front 14

active v passive suicidal ideation

Back 14

Active = "i want to die" or "i want to kill myself"; Passive = "i'd rather be dead" or "things would be better off if i weren't here"

Front 15

Anticholinergic toxidrome

Back 15

hot as a hare, dry as a bone, red as abeet, mad as a hatter, blind as a bat!

Front 16

Anticholinergic v sympathomimetic (cocaine, amphetamines, etc) toxidromes

Back 16

Same. Except that in sympathomimetics, patients will also be diaphoretic. PSNS post synaptic neurons use ACh and SNS PSN use norepi except at sweat glands (Ach is used instead!)

Front 17

What is the triad of wernicke's encephalopathy? Immediate treatment?

Back 17

confusion, ataxia, opthalmoplegia (usually abducens (6th CN)). Give IV Thiamine (B1), which is involved in the metabolism of glucose.

Front 18

Triad for normal-pressure hydrocephalus.

Back 18

urinary incontinence, dementia, ataxia (wet, wacky, wobbly).

Front 19

List the dopamine (DA) pathways that mediate EPS. Tetrad?

Back 19

EPS: nigrostriatal (think substantia nigra - degenerated in PD) --> acute dystonic rxn, akathisia, parkinsonism, TD

Front 20

List the dopamine pathway that mediate +sx in schizophrenia

Back 20

excessive DA in mesolimbic system

Front 21

List the dopamine pathway that mediates -sx in schizophrenia

Back 21

mesocortical: low DA responsible for -sx in schizophrenia. This explains why typical antipsychotics (solely DA antagonism) do not improve -sx

Front 22

List the dopamine pathway that mediate hyperprolactinemia

Back 22

tuberoinfundibular (DA = pRL inhibitor) --> antipsychotics (esp haloperidol and atypical, respiradone) can cause gynecomastia & galactorrhea.

Front 23

List tetrad for Narcolepsy

Back 23

excessive daytime sleepiness, hypnoGOgic hallucinations, cataplexy (loss of motor tone in context of emotion i.e. laughing/crying) & sleep paralysis

Front 24

4 D's of malpractice

Back 24

duty (presence of MD-pt relationship), dereliction/deviation (from standard of care), damage, direct causation. "derelection of duty directly caused damages"

Front 25

5 types of schizophrenia in DSM-IV-TR

Back 25

Catatonic, disorganized, paranoid, residual, undifferentiated.

Front 26

catatonic schizophrenia

Back 26

excessive/inhibited psychomotor activity

Front 27

disorganized schizophrenia

Back 27

prominent disorganization (speech or behavior)

Front 28

Which schizophrenia has the worst prognosis?

Back 28

disorganized type

Front 29

"burnt out" schizophrenia of later life; prominent negative sx

Back 29

residual type

Front 30

Undifferentiated schizophrenia

Back 30

Not catatonic, disorganized, paranoid or residual?

Front 31

Which type of schizophrenia has the BEST prognosis?

Back 31

Paranoid Schizophrenia: prominent delusions/hallucinations

Front 32

5 core symptoms (criteria A) of schizophrenia

Back 32

two of the following are required > 1 month: delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms

Front 33

3 exceptions to the requirement for meeting criterion A of schizophrenia

Back 33

1. bizarre delusions 2. AH of two voices giving a running commentary of pt's life or 3. AH of two voices conversing with each other sufficient to meet criterion A.

Front 34

6 types of delusions in DSM IV-TR

Back 34

persecutory (same as paranoia), erotomanic (belief that someone of higher stature is in love with pt), somatic (e.g. internal organis rotting) gradiose (common with psychosis associated with mania), Jealous, Mixed

Front 35

6 specifiers for MDD in DSM IV

Back 35

with: 1) psychotic features (treat the "depression" and psychosis will resolve, versus schizoaffective d/o); 2) melancholic features (anhedonia, early morning awakening, excessive guilt, mood does not reach with pleasure stimuli; 3) Atypical features (hyperphagia/hypersomnia, reactive mood, rejection sensitivity); 4) seasonal pattern (SA d/o, tx is light therapy or SSRI); with 5) catatonic features, or with 6) postpartum onset (w/in 4 weeks of parturition)

Front 36

Give two examples projective tests

Back 36

1) Rorschach test (inkblots): especially useful for identifying psychotic d/o or paranoia 2) Thematic apperception test: pt tells stories about depressing pictures

Front 37

Give 3 examples of intelligence test and their appropriate age ranges.

Back 37

WAIS (ages 16-75; includes verbal and visuospatial sections; average 100 w / SD of 15) Standord-Binet Test (age 2-23); Wechsler intelligence scale for children-revised (WISC-R) ages 6- 16

Front 38

What is the MMPI-2?

Back 38

Minnesota multiphasic personality inventory: pathology + patterns of behavior