First aid psychiatry
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Created by:
justcrutchy on March 26, 2012
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158 terms
Terms | Definitions |
|---|---|
 How is the Stanford-Binet IQ calculated? What is the mean and SD? | mental age/chronological age *100; 100; SD of 15 |
| What IQ threshold is used to define mental retardation? Severe MR? Profound MR? | <70; <40; <20 |
| What is the difference between habituation and sensitization? | Habituation - repeated stimulation leads to decreased response; sensitization - leads to increased response |
| What is the difference between classical and operant conditioning? | Classical - present conditioned stimulus (bell) and unconditioned stimulus (food) simultaneously; operant - do something to get reward or avoid punishment |
| What is the difference between negative reinforcement and punishment? | negative reinforcement - removal of averse stimulus elicits behavior; punishment - application of aversive stimulus extinguishes unwanted behavior |
| What is the difference between transference and countertransference? | transference - patient onto doctor; countertransference - doctor onto patient |
| What are the Id, Ego, & Superego responsible for? | Id - Instinct (primal urges, food, sex, aggression); Superego - moral values, conscience; Ego - mediator |
| Temporary, drastic changes in personality, memory, consciousness, or motor behavior to avoid emotional stress: (dissociation/denial/displacement/regression/repression).Give example. | dissociation; (e.g. multiple personality disorder) |
| Process whereby avoided ideas and feelings are transferred to some neutral person or object: (acting out/displacement/projection/splitting). | displacement (e.g. mother places blame on child b/c she is angry at her husband) |
| Partially remaining at a more childish level of development: (acting out/dissociation/denial/fixation/identification/regression). Give example. | fixation. (e.g. men fixating on sports games) |
| Modeling behavior after another person who is more powerful (though not necessarily admired). (displacement/identification/projection). Example. | identification. (e.g. abused child identifies himself as an abuser) |
| Describing murder in graphic detail with no emotional response. (Dissociation/denial/displacement/fixation/isolation of affect/repression). | isolation of affect: separation of feelings from ideas and events |
| An unacceptable internal impulse is attributed to an external source: A man who wants another woman thinks his wife is cheating on him. (dissociation/denial/displacement/projection). | projection |
| A patient with libidinous thoughts enters a monastery (process whereby a warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite. (dissociation/displacement/reaction formation/repression). | reaction formation |
| Belief that people are either all good or all bad at different times due to intolerance of ambiguity. (Displacement/rationalization/reaction formation/splitting). | splitting |
| Process whereby one replaces an unacceptable with with a course of action that is similar to the wish but does not conflict with one's value system. (dissociation/displacement/isolation of affect/rationalization/reaction formation/repression/sublimation). | sublimation |
| Voluntary witholding of an idea or feeling from conscious awareness. (repression/suppression). | suppression (repression - involuntary) |
| Depression in an infant attributable to continued separation from caregiver. Name? | Anaclitic depression (hospitalism) |
| Physical abuse of a child is most likely caused by whom? | female and primary caregiver |
| Sexual abuse of a child is most likely caused by whom? What is the most likely age range of the child? | male known to victim; 9-12 |
| The most common form of child maltreatment is child (physical abuse/sexual abuse/neglect). | neglect |
| What is the onset of ADHD? | before age 7 |
| Which drugs are used to treat ADHD? | methylphenidate (ritalin); amphetamines (dexedrine); atomoxetine (nonstimulant SNRI) |
| Repetitive and pervasive behavior violating social norms (physical aggression, destruction of property, theft). (Conduct disorder/oppositional defiant disorder/childhood disintegrative disorder). | Conduct disorder (antisocial personality disorder after 18 years of age) |
| T/F. Coprolalia (obscene speech) is by definition found in all people with Tourette's syndrome. | F. only 20% |
| Tourette's syndrome is associated with what other disorder? | OCD |
| How is Tourette's treated? | antipsychotics (e.g. haloperidol) |
| What is the difference between Asperger's and Autism? | Asperger's - milder form of autism; no language impairment |
| Girl with loss of development, mental retardation, loss of verbal abilities, ataxia, & sterotyped hand-wringing. What's the disorder? | Rett's disorder: X-linked in girls (males die in utero or shortly after birth) |
| Marked regression in multiple areas of functioning after at least 2 years of apparently normal development. Disorder? | childhood disintegrative disorder |
| Neurotransmitter changes with anxiety? | increased NE, decreased serotonin, decreased GABA (think: NE and serotonin are associated with anxiety and depression) |
| Neurotransmitter changes with depression? | decreased NE, decreased serotonin, decreased dopamine (think: NE and serotonin are associated with anxiety and depression; Decreased Dopamine Depression) |
| Neurotransmitter changes with Alzheimer's dementia? | decreased acetylcholine (think A & A, but decreased) |
| Neurotransmitter changes with Huntington's disease? | decreased GABA, decreased acetylcholine |
| Neurotransmitter changes with schizophrenia? | increased dopamine (think schizOphrenia, dOpamine) |
| Neurotransmitter changes with Parkinson's disease? | decreased dopamine, increased serotonin, increased acetylcholine (think parkinsOn, dOpamine) |
| Korsakoff's amnesia is (anterograde/retrograde) amnesia caused by _____ deficiency. It leads to bilateral destruction of what? | anterograde; thiamine deficiency; destruction of mammillary bodies |
| What is delirium? | waxing and waning level of consciousness with acute onset |
| Which of the following presents with an abnormal EEG: (delirium/dementia). | delirium |
| What's the difference between a hallucination and an illusion? | hAllucination - Absence of external stimuli |
| What is the difference between hypnagogic and hypnopompic hallucinations? | HypnaGOgic - going to sleep; Hypnopompic - waking up |
| Visual hallucinations are most commonly seen in (delirium/schizophrenia/psychomotor epiliepsy/brain tumor/alcohol withdrawal/cocain abuse). | delirium |
| Auditory hallucinations are most commonly seen in (delirium/schizophrenia/psychomotor epiliepsy/brain tumor/alcohol withdrawal/cocain abuse). | schizophrenia |
| Olfactory hallucinations are most commonly seen in (delirium/schizophrenia/psychomotor epiliepsy/brain tumor/alcohol withdrawal/cocain abuse). | psychomotor epiliepsy & brain tumors |
| Tactile hallucinations are most commonly seen in (delirium/schizophrenia/psychomotor epiliepsy/brain tumor/alcohol withdrawal/cocaine abuse). | alcohol withdrawal, cocaine abusers |
| What's the difference between a brief psychotic and schizophreniform disorder? | Brief - < 1 month; schizophreniform - 1-6 months |
| A diagnosis of schizophrenia requires 2 or more of what symptoms? | delusion; hallucination; disorganized speech; disorganized behavior; (flat affect, social withdrawal, lack of motivation, lack of speech or thought) |
| Dissociative identity disorders are more common in (men/women) and are associated with a history of what? | women; sexual abuse (formerly called multiple personality disorder) |
| What is depersonalization disorder? | persistent feelings of deatchment or estrangement from one's own body, a social situation, or the environment |
| What is the difference between bipolar I and II? | I - manic; II - hypomanic |
| How do you treat bipolar disorder? | mood stabilizers: lithium, valproic acid, carbamazepine |
| What are symptoms of major depression? | SIG E CAPS: Sleep, Interest, Guilt, Energy Concentration, Appetite, Psychomotor retardation, Suicidal, Depressed mood) |
| What is the difference between atypical depression and major depression? | Atypical - ability to experience improved mood in response to positive events vs. persistent sadness in major depression |
| How are panic disordres treated? | cognitive behavioral therapy, SSRIs, TCAs, benzodiazepines |
| What drug is used to treat social phobias? | SSRI |
| How is OCD treated? | SSRI or clomipramine |
| How do you treat generalized anxiety disorder? | benzodiazepines, buspirone, SSRIs |
| What is the difference between a factitious disorder, malingering, and a somatoform disorder? | factitious disorder - goal is to get medical attention; malingering - goal is to get secondary gain (e.g. insurance compensation); somatoform - unconscious |
| Munchausen's syndrome is an example of (a factitious disorder/malingering). | factitious disorder (make up to get attention) |
| What is a conversion disorder? | sudden loss of sensory or motor function often following acute stressor; patient is aware but indifferent toward symptoms; more common in adolescents and young adults |
| What are cluster A personality disorders characterized by? B? C? | A - Wierd; B - Wild, C - Wacky |
| Cluster A personality disorders are characterized by what? What are 3 types? | "Wierd": accusatory, aloof, awkward; Paranoid; Schizoid (socially isolated, SchizoiD - Distant); Schizotypal (SchizoTypal - magical Thinking) |
| Projection is a major defense mechanism of (paranoid/schizoid/schizotypal) personality disorders. | paranoid (note: projection - unacceptable internal impulse is attributed to an external source) |
| What is schizoid in the context of cluster A personality disorders? | voluntary social withdrawal, CONTENT with social isolation (e.g. obsession with video games) |
| What is schizotypal in the context of cluster A personality disorders? | eccentric appearance, odd beliefs or magical thinking |
| Cluster B personality disorders are characterized by what? What are 3 examples? | "Wild": Bad to the Bone; Antisocial (criminality); Borderline (unstable mood); Histrionic (excessive emotionality); Narcissistic) |
| What is antisocial in the context of clusber B personality disorders? | disregard for and violation of rights of others, criminality |
| Splitting is a major defense mechanism of (antisocial/borderline/histrionic/narcissistic) personality disorders. | borderline (splitting - belief that people are all good or all bad) |
| Cluster C personality disorders are characterized by what? What are 3 examples? | "Worried"; cowardly, compulsive, clingy; Avoidant (socially inhibited, but desire); Obsessive compulsive (behavior consistent with own beliefs and attitudes (vs. OCD)); Dependent |
| What does avoidant mean in the context of cluster C personality disorders? | hypersensitive to rejection, socially inhibited, DESIRES relationships with others. |
| What is the difference between schizoid and avoidant? | both withdrawan; schizoid - content with isolation; avoidant - wants relationships with others |
| Put in order of severity: schizoaffective, schizoid, schizophrenic, schizotypal. | schizoid, schizotypal, schizophrenic, schizoaffective (also has bipolar or depressive mood disorder) |
| What is the difference between schizotypal and schizoid? Schizoaffective vs. schizophrenic? | Schizotypal - schizoid + odd thinking; Schizoaffective - add bipolar or depressive to schizophrenic |
| What length of time must something last to be classified as schizophrenia? | 6 months (1-6 months -> schizophreniform; <1 month -> brief psychotic) |
| Anorexia nervosa commonly coexists with what other psychiatric condition? | depression |
| What is the difference between transvestite and transsexual? | Transvestite - paraphilia; transsexual - desire to be opposite sex |
| What lab measurements indicate alcohol use? | serum gamma-glutamyltransferase; lab AST value is twice ALT value |
| What drug is used for alcohol dependence? | naltrexone |
| What is a symptom of alcohol withdrawal? How do you treat it? | delirium tremens; benzodiazepines |
| Pinpoint pupils. Depressant. Which one? | opioid |
| Constipation. Depressant. Which one? | opioid |
| How is opioid intoxication treated? | naloxone, naltrexone |
| What drug is used to treat benzodiazepine intoxication? | flumazenil (competitive GABA antagonist) |
| How is cocaine intoxication treated? | benzodiazepines |
| Nicotine is a (stimulant/depressant). | stimulant |
| Nicotine withdrawal. Other than giving small amounts of nicotine, what else can you give? | bupropion & varenicline |
| Vertical and horizontal nystagmus in a hallucinogen. Which one? | PCP |
| Which of the following drugs leads to flashbacks: (PCP/LSD/Marijuana/amphetamines). | LSD |
| What are two options for treating heroin withdrawal? | methadone (long-acting oral opiate); suboxone (naloxone + buprenorphine) |
| Whernicke-Korsakoff syndrome is caused by what? What are its symptoms? | thiamine deficiency; confusion, opthalmoplegia (paralysis of extraocular muscle), ataxia |
| What is mallory-weiss syndrome, and what can be its cause? | longitudinal lacerations at the gastresophageal junction caused by excessive vomiting; alcoholism |
| What is delirium tremens, and what can be its cause? | Life-threatening alcohol withdrawal syndrome that peaks 2-5 days after last drink; alcohol |
| How is delirium tremens treated? | benzodiazepines |
| Treatment for anorexia/bulimia. | SSRIs |
| Treatment for anxiety. | benzodiazepines, buspirone, SSRIs |
| Treatment for ADHD | methylphenidate (ritalin), amphetamines (dexedrine) |
| Treatment for atypical depression | MAOi, SSRIs |
| Treatment for bipolar disorder. | lithium, valproic acid, carbamazepine, typical antipsychotics |
| Treatment for depression with insomnia. | mirtazapine |
| Treatment for OCD. | SSRIs, clomipramine |
| Treatment for panic disorder. | SSRIs, TCAs, benzodiazepines |
| Treatment for PTSD. | SSRIs |
| Treatment for schizophrenia. | antipsychotics |
| Treatment for Tourette's syndrome. | antipsychotics (haloperidol) |
| How do amphetamines work? | increase catacholamines at the synaptic cleft, especially NE and dopamine |
| What are names of antipsychotics (neuroleptics)? | haloperidol + "-azine"s (e.g. trifluoperazine, fluphenazine, thioridazine, chlorpromazine) |
| How do antipsychotics work? | block dopamine D2 receptors (increase cAMP) |
| Antipsychotics are mainly used to treat what? | schizophrenia (primarily positive symptoms), Tourette's |
| Antipsychotics (neuroleptics) are (quickly/slowly) removed from the body. Why? | slowly b/c stored in fat |
| Dopamine receptor antagonism->hyperprolactinemia->galactorrhea. Side effect of what class of drugs? | antipsychotics |
| What is neuroleptic malignant syndrome? What class of drugs causes it? How do you treat it? | rigidity, myoglobinuria, autonomic instability, hyperpyrexia; antipsychotics (haloperidol, "azine"s); treat using dantrolene, bromocriptine) |
| Tardive dyskinesia is a side effect of which class of drugs? | antipsychotics |
| Which of the following cause anticholinergic, antihistamine, and alpha blockade effects: (chlorpromazine/fluphenazine/haloperidol/thioridazine/trifluoperazine). | chlorpromazine, thioridazine (they are low potency antipsychotics) |
| Which of the following causes corneal deposits? Retinal deposits? (chlorpromazine/fluphenazine/haloperidol/thioridazine/trifluoperazine). | Chlorpromazine - Corneal; Thioridazine - reTinal |
| What are examples of atypical antipsychotics? | "apine" and "idone"; (e.g. olanzapine, clozapine, quetiapine, resperidone, ziprasidone) (note: "azine" refers to typical antipsychotics) |
| How do atypical antipsychotics work? | block dopamine, serotonin, alpha, and H1 receptors |
| Which of the following may cause significant weight gain: (aripiprazole/clozapine/olanzapine/quetiapine/risperidone/ziprasidone). | clozapine/olanzapine |
| Which of the following may cause agranulocytosis: (aripiprazole/clozapine/olanzapine/quetiapine/risperidone/ziprasidone). | clozapine (must watch clozapine clozely) (require weekly WBC monitoring) (note: agranulocytosis may predispose to infections) |
| What are side effects of lithium? | LMNOP: Lithium side effects - Movement (tremor), Nephrogenic diabetes insipidus, hypOthyroidism, Pregnancy problems |
| What would you use to treat generalized anxiety disorder? How does it work? | buspirone; stimulates serotonin receptors (gives a boost) |
| Name tricyclic antidepressants. | "triptyline" & "pramine" & "pin": amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine (note amoxapine is a tricyclic antidepressant, not an atypical antipsychotic) (think: amiTRIptyline, norTRIptyline->TRIcyclic) (think: 3 is a prime number) |
| How do tricyclic antidepressants work? | block reuptake of NE and serotonin |
| Which drug would you use to treat bedwetting? | imipramine (tricyclic) |
| Which drug would you use to treat OCD? | clomipramine (tricyclic) |
| What are toxicities of tricyclic antidepressants? How do you treat it? | TRI-C's: convulsions, coma, cardiotoxicity; NaHCO3 for CV toxicity |
| Name 4 SSRIs. | fluoxetine, paroxetine, sertraline, citalopram |
| What is serotonin syndrome? | SSRIs combined with any drug that increases serotonin (e.g. MAOi)->hyperthermia, muscle rigidity, cardiovascular collapse, flushing, diarrhea, seizures) |
| How can you treat serotonin syndrome? | fluids, benzodiazepines for control of delirium, cooling measure for hyperthermia, neuromuscular blockers such as dantrolene for hyperthermia, muscle rigidity, and prevention of rhabdomyolysis (also cyproheptadine, a serotonin receptor antagonist) |
| Name 2 SNRIs. | venlafaxine, duloxetine |
| Name 4 MAOi's. | phenelzine, tranylcypromine, isocarboxazid, selegiline (selective MAO-B inhibitor) |
| How do MAOi's work? | increase levels of amine neurotransmitters (NE, serotonin, dopamine) |
| Hypertensive crisis with tyramine ingestion and beta-agonists. Which drug class? | MAOi's (note: tyramine is found in wine and cheese) |
| When is bupropion used? | smoking cessation |
| How does mirtazapine work? | alpha-2 antagonist (increase release of NE and serotonin); also potent serotonin receptor antagonist |
| What is maprotiline? How does it work? | atypical antidepressant; blocks NE reuptake |
| How does trazodone work? | inhibits serotonin reuptake |
| Priapism. Which atypical antidepressant? | trazodone (called trazoBONE due to male-specific side effects) |
| What is aversive conditioning? What is an example? | part of classical conditioning; unwanted behaviors are punished by noxious and aversive stimuli; e.g. disulfiram |
| What is adjustment disorder? | depression or anxiety in the setting of a spychosocial stressor |
| Mood stabilization. Not lithium. What are 2 options? | carbamazepine & valproic acid |
| How does reserpine work? | deplete central and peripheral catecholamines and depress sympathetic nerve function->vasodilation and sedation; can cause depression (think: catecholamines) |
| Childlike. Schizophrenia. Which kind: (catatonic/disorganized/paranoid/residual/undifferentiated). | disorganized |
| What is the treatment of choice for social phobia disorders? | SSRIs (e.g. fluoxetine) |
| "azine" What is it? What about "apine"? | typical antipsychotic; apine - atypical antipsychotic |
| How does selegiline work? What is it used for? | MAOi; Parkinson's |
| What is tranylcypromine? | MAOi |
| What is citalopram? | SSRI |
| What is sertraline? | SSRI |
| How long must symptoms of schizophrenia last before being diagnosed as schizophrenia? What if it lasts less than that time? | > 6 months; 1-6 months - schizophreniform; <1 month - brief psychotic disorder |
| What is schizoaffective disorder? | schizophrenia + mood disorder (e.g. depression, mania) |
| Depression is associated with (increased/decreased) REM sleep. | increased |
| How do you treat narcolepsy? | methylphenidate |
| Sore throat and fevers. Person with both "positive" and "negative" symptoms of schizophrenia. What drug caused it? | clozapine->agranulocytosis->risk of infections |
| What is clomipramine? | tricyclic antidepressant (think: "pramine"-prime-3-tricyclic) |
| What is risperidone? | atypical antipsychotic "idone" |
| Anorexia. Which antidepressant would cause seizures? | bupropion |
| What is first line treatment for multiple personality disorder? | antipsychotic (e.g. haloperiodol or risperidone) |
| How do you treat acute dystonia caused by antipsychotics? | anticholinergic (e.g. benztropine) (note: beta-blockers can treat akathisia (restless leg)) |
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