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Psych Flashcards

1
Q

What must be seen in mental retardation

A

Deficits in both intellectual functioning and social adaptive functions

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2
Q

Epidemiology of mental retardation

A

M>F

Highest incidence in school age

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3
Q

Level of functioning w/ IQ 50-70

A

6th grade education
Work and live independently
Needs help in stressful situations

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4
Q

Level of functioning w/ IQ 30-40 to 50-55

A

2nd grade education
Work w/ supervision
Needs help in mild stressful situations

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5
Q

Level of functioning w/ IQ 20-25 to 35-40

A

Little to no speech

Limited in ability to self-care

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6
Q

Level of functioning w/ IQ

A

Needs continuous care and supervision

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7
Q

Rx Mental retardation

A

Genetic counseling, prenatal care, safe environment for expectant mothers
Rx medical disorder if it’s the cause
Special education
Behavioral therapy

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8
Q

What are pervasive developmental disorders

A

Characterized by social interactions behavior and language

Occur before age 3

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9
Q

Which childhood developmental disorder has a greater incidence in girls

A

Rett

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10
Q

Features of autism

A 
Lacks peer relationships and social smile
Poor eye contact
Absent/bizarre speech
Repetitive behaviors
Self-injurious
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11
Q

Features of Rett

A 
Progressive encephalopathy
Microcephaly
Hand-wringing
Loss of speech
Ataxia
Psychomotor retardation
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12
Q

Features of childhood disintegrative disorder

A

NL development for 2 yrs then marked regression

Loss of language, social interaction, motor fn, bladder fn

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13
Q

Features of Asperger

A

Problems with social interaction and behaviors
No language or intellectual deficits
Preoccupied with rules

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14
Q

Rx Autism

A

Improve relationships

Behavior modification

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15
Q

Rx Rett

A

Symptomatic rx
Behavior therapy
Physiotherapy

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16
Q

Rx childhood disintegrative disorder

A

Improve relationships

Behavioral modification

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17
Q

Rx Asperger

A

Improve relationships

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18
Q

What must be ruled out if child doesn’t respond to name being called

A

Deafness

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19
Q

ADHD

A

Inattention, short attention span or hyperactivity that interferes with daily functioning for >6mos usually starting at age 7 in 2 locations

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20
Q

First line rx ADHD

A

Methylphenidate

Dextroamphetamine

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21
Q

Side effects of First line ADHD meds

A

Insomnia
Decreased appetite
HA

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22
Q

Second line rx ADHD

A

Atomoxetine - chosen over 1st line due to better side effect profile

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23
Q

Who gets oppositional defiant disorder

A

Age 8

Boys before puberty, Equal after

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24
Q

Who gets conduct disorder

A

M>F

Parents have antisocial personality disorder and alcohol dependence

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25
Q

Features of oppositional defiant disorder

A

Argue, lose temper, blame others

Problems with authority

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26
Q

Features of Conduct disorder

A

Break rules

Bully, cruelty to animals, fighting, use weapons, crime

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27
Q

Rx oppositional defiant disorder

A

Teach parents appropriate child management skills

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28
Q

Rx conduct disorder

A

Behavioral intervention using rewards for prosocial and non-aggressive behavior

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29
Q

Tourette

A

Multiple tics for >1yr before 18

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30
Q

Common motor tics in tourette

A

Head shaking

Blinking

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31
Q

Common vocal tics in tourette

A

Grunting
Throat clearing
Coughing

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32
Q

Epidemiology of tourettes

A

M>F by age 7

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33
Q

Rx Tourette

A

DA antagonists (risperidone)

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34
Q

Major depression

A

At least 2 weeks of anhedonia + 4 of

  • Weight changes
  • Sleep changes
  • Poor concentration
  • Thoughts of death and worthlessness
  • Psychomotor disturbances
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35
Q

MC medical cause of depression

A

Hypothyroidism

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36
Q

MC neuro cause of depression

A

Parkinson

Dementia

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37
Q

First line Rx depression

A

SSRI - Increase the dose if some but not full response

Psychotherapy

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38
Q

SSRI to use if depression + neuropathic pain

A

Duloxetine

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39
Q

SSRI to use if depression who is fearful of weight gain or sexual side effects

A

Buproprion

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40
Q

What are manic symptoms

A 
Elevated mood
Increased self esteem
Distractibility
Pressured speech
Decreased need for sleep
Increase in goal-directed activity
Racing thoughts
Excessive involvement in pleasurable activities
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41
Q

What to r/o in bipolar

A

Cocaine or amphetamine use

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42
Q

Bipolar

A

Manic sx for at least 1 week

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43
Q

How long do hypomanic sx last for

A

Less than a week

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44
Q

Rx acute mania

A

Lithium

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45
Q

Rx bipolar depression

A

Lithium or lamotrigine

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46
Q

Rx acute mania with severe sx

A

Atypical antipsychotics

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47
Q

Dysthymia

A

Depressed mood lasting throughout the day for 2 or more years

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48
Q

Rx dysthymia

A

Antidepressants

Psychotherapy

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49
Q

Cyclothymia

A

Hypomanic episodes and mild depression for more than 2 years

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50
Q

Rx cyclomania

A

Li
Valproate
Carbamazepine
Psychotherapy

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51
Q

Characteristics of atypical depression

A 
Increased sleep
Increased weight
Increased appetite
Worse in evening
Extremities feel heavy
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52
Q

Rx atypical depression

A

SSRIs or MAOIs

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53
Q

Rx seasonal affective disorder

A

Phototherapy

Bupropion

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54
Q

Onset of postpartum blues

A

Immediately to up to 2 weeks after birth

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55
Q

Onset of postpartum depression

A

Within 1-3 months after birth

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56
Q

Onset of postpartum psychosis

A

Within 2-3 weeks after birth

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57
Q

Sx postpartum blues

A

Sadness
Mood lability
Tearfulness

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58
Q

Sx postpartum depression

A

Depressed mood
Wt changes
Sleep changes
Excessive axiety

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59
Q

Sx postpartum psychosis

A

Depression
Delusions
Thoughts of harm

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60
Q

Mother wants to harm baby

A

Postpartum psychosis

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61
Q

Rx postpartum blues

A

Nothing, self-limited

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62
Q

Rx postpartum depression

A

Antidepressants

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63
Q

Rx postpartum psychosis

A

Antipsychotics
Li
Antidepressants

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64
Q

Duration of bereavement

A

Less than 6 months but can go on longer

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65
Q

Dx of major depression over bereavement

A 
Thoughts of death
Morbid preoccupation of worthlessness
Marked psychomotor retardation
Psychosis
Prolongued functional impairment
Sx last longer than 2 months
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66
Q

AE TCAs

A 
Hypotension
Dry mouth
Constipation
Arrhythmias
Sexual side effects
Wt gain
GI disturbances
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67
Q

AE MOAs

A

Hypertensive crisis w/ foods high in tyramine

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68
Q

AE SSRIs

A

HA
Wt changes
Sexual side effects
GI disturbances

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69
Q

AE SNRIs

A 
HTN
Blurry vision
Wt changes
Sexual side effects
GI disturbances
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70
Q

AE Bupropion

A

Seizures

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71
Q

AE Trazodone

A

Priapism

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72
Q

AE Mirtazipine

A

Wt gain

Sedation

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73
Q

AE Lithium

A

Tremors, wt gain, GI disturbance, nephrotoxic, teratogen
Leukocytosis DI
Confusion, ataxia, lethargy, abnormal reflexes

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74
Q

AE Valproic acid

A

Tremors, wt gain, GI disturbance, hepatotoxic, teratogen

Alopecia, hyponatremia, coma

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75
Q

AE Almotrigine

A

SJS

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76
Q

AE ECT

A

HA

Transient memory loss

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77
Q

Most effective treatment for depression

A

ECT

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78
Q

When is ECT given for depression

A

Suicidal pts who don’t respond to therapy

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79
Q

Sx of serotonin syndrome

A

Cognitive effects - agitation, confusion, hallucinations
ANS Sx
Somatic effects - tremors, myoclonus

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80
Q

Rx serotonin syndrome

A

Stop SSRI
Rx Sx
Cyproheptadine

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81
Q

Duration of brief psychotic episode

A

> 1 day

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82
Q

Duration of schizophreniform

A

> 1 mo

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83
Q

Duration of Schizophrenia

A

> 6mo

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84
Q

Rx all psychotic disorders

A

Antipsychotics

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85
Q

Important for diagnosing schizophrenia

A

UDS to rule out cocaine or amphetamines

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86
Q

Schizophrenia type with earliest onset and worst prognosis

A

Disorganized

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87
Q

Schizophrenia w/ lack of positive sx

A

Residual

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88
Q

When to hospitalize schizophrenics

A

Acutely psychotic

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89
Q

Schophrenic needs meds in emergency situation w/ IM injection, what to give

A

Olazapine

Ziprazidone

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90
Q

Rx schizophrenic, non-compliant

A

Risperidone (long-acting)

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91
Q

Rx schizophrenic who don’t respond to typical or atypical

A

Clozapine

92
Q

AE Olanzapine

A

DM

Wt gain

93
Q

AE Risperidone

A

More incidence of Movement disorders

94
Q

AE Quetiapine

A

Less incidence of Movement Disorders

95
Q

AE Ziprasidone

A

Prolonged QT

96
Q

AE Clozapine

A

Agranulocytosis - monitor CBC

97
Q

Onset of acute dystonia

A

Hrs to days

98
Q

Onset of akathisia

A

Weeks

99
Q

Onset of tardive dyskinesia

A

6 months

100
Q

Onset of NMS

A

No time limit

101
Q

Sx of acute dystonia

A

Muscle spasms

  • Torticollis
  • Laryngeal spasms
  • Occulogyric crisis
102
Q

Sx akathisia

A

Restlessness, rocking

103
Q

Sx tardive dyskinesia

A

Abnormal involuntary movement of head, limb, trunk

Perioral movements most common

104
Q

Sx NMS

A

Muscle rigidity
Fever
ANS changes
Agitation, confusion

105
Q

Rx acute dystonia

A

Benztropine
Trihexyphenidyl
Diphenhydramine

106
Q

Commonly causes acute dystonia

A

Haloperidol

107
Q

Rx akathisia

A

Reduce dose
BBs
Switch to atypical

108
Q

Rx tardive dyskinesia

A

Switch to atypical

Clozapine has least risk

109
Q

Rx NMS

A

Dantroline or Bromocriptine

110
Q

What is delusional disorder

A

Non-bizarre delusions for >1mo and no impairment in level of functioning

111
Q

Do pts w/ delusional disorder have hallucinations

A

No

112
Q

Rx delusional disorder

A

Atypical antipsychotics

Psychotherapy

113
Q

Panic disorder

A

Intense anxiety w/ feelings of dread and doom

4 Sx of ANS hyperactivity lasting

114
Q

What is panic disorder sometimes associated with

A

Agoraphobia

115
Q

Epidemiology of Panic Disorder

A

W>M

116
Q

What must be r/o to make the dx of panic disorder

A

Thyroid disease
Hypoglycemia
Cardiac disease

117
Q

Rx panic disorder

A

SSRIs

Benzos (begin w/ both and taper benzo)

118
Q

Rx panic attack

A

Alprazolam (benzo only)

119
Q

Rx phobia

A

Behavior modification

Relaxation techniques

120
Q

Social anxiety

A

Fear of embarrassment in social situations

121
Q

What are obsessions

A

Thoughts that are intrusive and increase anxiety

122
Q

What are compulsions

A

Rituals intended to lower anxiety

123
Q

What can OCD coexist with

A

Tourette

124
Q

Rx OCD

A

SSRIs

125
Q

Difference between PTSD and acute stress disorder

A

PTSD - >1mo

ASD - >2 days,

126
Q

Rx stress disorders

A

Paroxetine and sertraline
Prazosin for nightmares
Relaxation techniques
Psychotherapy

127
Q

Main feature of generalized anxiety disorder

A

Chronic worrying about things that do not merit concern

128
Q

How long do the sx of GAD last

A

> 6mos

129
Q

Rx GAD

A

SSRIs

Venlafaxine, Buspirone

130
Q

AE benzos

A 
Sedation
Confusion
Memory deficits
Resp depression
Addiction
131
Q

AE Buspirone

A

HA
Nausea
Dizziness

132
Q

Indication for Lorazepam

A

Emergency (IM)

133
Q

Indication for Clonazepam

A

Addiction is a concer

134
Q

Indication for Chlordiazepoxide, oxazepam, lorazepam

A

Alcohol withdrawal

135
Q

Indication for Alprazolam

A

Panic disorder

136
Q

Indication for Flurazepam, temazepam, triazolam

A

Hypnotics

137
Q

When is Flumazenil used

A

OD is acute with NO chronic dependence

138
Q

What can flumazenil cause

A

Seizure in benzo-dependent pt

139
Q

Define intoxication

A

Reversible experience causing physio or psychological changes

140
Q

Define withdrawal

A

Cessation or reduction causes psychological or physiological changes

141
Q

Define abuse

A

Maladaptive pattern of use leading to adverse consiquences

142
Q

Define dependence

A

Maladaptive behavior leading to tolerance
Withdrawal when trying to cut down
Continue despite adverse consequences

143
Q

Rx alcohol intoxication

A

Mechanical ventilation if severe

144
Q

Rx amphetamine/cocaine intoxication

A

Antipsychotics +/- benzos +/- antihypertensives

145
Q

Rx hallucinogen intoxication

A

Antipsychotics +/- benzos +/- talking down

146
Q

Rx inhalant intoxication

A

Antipsychotics

147
Q

Rx opiate intoxication

A

Naloxone

148
Q

Rx PCP intoxication

A

Antipsychotics +/- benzos +/- talking down

149
Q

Rx anabolic steroid intoxication

A

Antipsychotics

150
Q

Sx alcohol withdrawal

A

Tremors
Hallucinations
Seizures
DTs

151
Q

Sx amphetamine/cocaine withdrawal

A 
Anxiety
Tremulousness
HA
Increased appetite
Depression
Risk of suicide
152
Q

Sx opiate withdrawal

A 
Fever, chills
Lacrimation
ABD cramps
Muscle spasms
Diarrhea
153
Q

Sx anabolic steroid withdrawal

A

Depression
HA
Anxiety
Increased concern over body physical state

154
Q

Rx alcohol withdrawal

A

Benzos
Thiamine
Multivitamins
Folate

155
Q

Rx amphetamine/cocaine withdrawal

A

Bupropion +/- bromocriptine

156
Q

Rx opiate withdrawal

A

Clonidine
Methyldopa
Buprenorphine

157
Q

How long is substance detox in hospital

A

5-10 days

158
Q

How long is substance rehabilitation

A

28 days or more

159
Q

Pharma rx for substance abuse

A

Disulfram
Naltraxone
Acamprosate

160
Q

What are somatoform disorders

A

Physical sx w/ no medical explanation

161
Q

Somatization disorder

A

4 Pain
2 GI
1 Sexual
1 Pseudoneuro

162
Q

Hypochondriasis

A

Believe they have specific disease despite constant reassurance

163
Q

Conversion disorder

A

Pt unconcerned about own impairment

164
Q

Body dysmorphic disorder

A

Pt believes some body part is abnormal/defective/misshapen

165
Q

Pain disorder

A

Presence of pain and has psychological factors associated

166
Q

Rx somatization disorder

A

Individual psychotherapy

167
Q

Factitious disorder

A

Fake an illness to get attention

May even harm themselves

168
Q

Who has factitious disorder

A

Women with an Hx of being employed in healthcare

169
Q

Malingering

A

Conscious production of signs and sx for an obvious gain

170
Q

When is malingering diagnosed

A

Discrepancy between pt complaints and actual physical or lab findings
Lack of cooperation from pt

171
Q

Adjustment disorder

A

Maladaptive reaction to identifiable stressor

Sx occur within 3mos of stressor and remit within 6mos of removal of stressor

172
Q

Paranoid personality

A

Suspicious mistrustful

Questions loyalty of family/friends

173
Q

Schizoid personality

A

Happy loner
Chooses to engage in solitary activities
Emotional coldness

174
Q

Schizotypal personality

A

Magical thinking

Brief psychotic episodes

175
Q

Histrionic personality

A

Must be center of attention

176
Q

Antisocial personality

A

Failure to conform to social rules
Aggressive towards others
Over 18

177
Q

Borderline personality

A

Feelings of emptiness and inappropriate anger

“Splitting”

178
Q

Narcissistic personality

A

Grandiose sense of self

179
Q

Avoidant personality

A

Unwilling to get involved with people due to feelings of inadequacy

180
Q

Dependent personality

A

Unable to assume responsibility for day to day decisions

181
Q

Obsessive compulsive personality

A

Preoccupied with details

182
Q

Rx personality disorders

A

Individual psychotherapy

Meds if mood or anxiety present

183
Q

Which personality disorders are associated w/ psychotic symptoms

A

Borderline

Schizotypal

184
Q

Features of anorexia nervosa

A 
Failure to maintain normal body weight
Body image disturbance
Deny emaciated condition
Great concern with appearance
Purge, fast, laxative and diuretic abuse
Amenorrhea
185
Q

Most commonly gets anorexia

A

Girls 14-18

186
Q

EKG changes in anorexia

A

Rhythm disorders due to hypokalemia

187
Q

MCC death anorexia

A

Arrhythmia

188
Q

Rx anorexia

A

Hospitalization
Psychotherapy
Behavioral therapy
SSRIs

189
Q

Features of bulemia nervosa

A

Frequent binge eating
Lack of control of overeating episodes
Purging, laxative/diuretic abuse, fasting, excessive exercise

190
Q

Who gets bulemia

A

Women later in adolescence than anorexia

Normal wt w/ Hx obesity

191
Q

Rx bulemia

A

Psychotherapy

SSRIs

192
Q

What is narcolepsy

A

Excessive daytime sleepiness and abnormalities of REM

193
Q

Management of narcolepsy

A

Forced daytime naps
Modafinil to keep awake
Methylphenidate and dextromethorphan GHB at night

194
Q

What are sleep attacks

A

Irresistible sleepiness

Refreshed upon awaking

195
Q

What is cataplexy

A

Sudden loss of muscle tone

196
Q

What are hypnogogic and hypnopompic hallucinations

A

Hallucinations while going to sleep and waking up

197
Q

What is sleep paralysis

A

Pt awake but unable to move

198
Q

What is insomia

A

Inability to initiate or maintain sleep

199
Q

Rx insomnia

A

Sleep hygiene techniques

Behavior modification

200
Q

Medical Rx for insomnia

A

Zolpidem
Eszopiclone
Zaleplon

201
Q

Sexual identity

A

Based on secondary sexual characteristics

202
Q

Gender identity

A

Based on person’s sense of maleness/femaleness

Established by age 3

203
Q

Gender role

A

External patterns of behavior reflecting inner gender identity

204
Q

Sexual orientation

A

Person’s choice of love object

205
Q

Impotence

A

Inability to attain or maintain an erection

206
Q

Premature ejactulation

A

Before or just after penetration

Usually 2/2 anxiety

207
Q

Dyspareunia

A

Pain associated w/ intercourse

208
Q

Vaginismus

A

Involuntary contraction of outer 1/3 of vagina preventing penile insertion

209
Q

Rx most types of sexual dysfunction

A

Psychotherapy

210
Q

Who commonly has paraphilias

A

Men

211
Q

What are paraphilias

A

Recurrent sexually arousing occurring for >6months

Cause distress/anxiety and adversely affect level of functioning

212
Q

Exhibitionism

A

Expose oneself to strangers

213
Q

Fetishism

A

Non-living objects

214
Q

Pedophilia

A

Prepubescent children

215
Q

Masochism

A

Humiliation

216
Q

Sadism

A

Physical or psychological suffering of victim is exciting

217
Q

Transvestic fetishism

A

Cross dressing for sexual gratification

218
Q

Frotteurism

A

Rubbing genitals against nonconsenting person

219
Q

Rx paraphilias

A

Individual psychotherapy
Behavior modification
Antiandrogens or SSRIs

220
Q

Gender identity disorder

A

Persistent discomfort and sense of inappropriateness regarding pt’s assigned sex
More often in Men

221
Q

Rx gender identity disorder

A

Sex reassignment

Individual psychotherapy

222
Q

MCC death from suicide

A

Guns

223
Q

Presentation of suicidal individual

A

Recent attempt
Complaints of suicidal thoughts
Admission of suicidal thoughts
Demonstration of suicidal behaviors

224
Q

RFs for suicide

A 
ACCESS TO FIREARMS
Older Men
Social isolation
Psychiatric illness/drug abuse
Perceived hopelessness
Previous attempts
225
Q

Rx suicidal pt

A

Hospitalize

Take threats seriously

Step 2 CK (21 decks)

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