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(***) (U-World) All Subjects > Psychiatric/Behavioral & Substance Abuse > Flashcards

Psychiatric/Behavioral & Substance Abuse Flashcards

1
Q

not thinking about behavior modification =

thinking about it =

planning behavior modification =

putting plan into action =

maintaining new behavior

A

Precontemplation

contemplation

preparation

action

maintenance

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2
Q

recurrent episodes of binge eating, followed by compensatory behavior, excessive preoccupation with body weight and shape, normal weight weight or above normal =

treatment with nutritional rehab, CBT, and ________

A

bulimia nervosa

SSRI fluoxetine

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3
Q

_______ blocks the ________ receptor and blocks the rewarding and reinforcing effects of alcohol to reduce CRAVING

A

naltrexone

mu opioid

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4
Q

evaluation of a patients access to _____ is a key part of suicide risk assessment

A

guns

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5
Q

depressed mood, low energy, loss of interest, insomina, weight loss, poor concentration almost every day for >2 weeks =

even if hypothyroidism diagnosed, TSH is _______, so not a consequence of this

A

Major Depressive Disorder

normal

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6
Q

_______ is a pure opioid Receptor antagonist and used to treat opioid intox and OD. It has the greatest affinity for ____ receptor

A

Naloxone

Mu

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7
Q

acute onset of tremulousness, agitation, elevated pulse and BP 48hrs following admission is suggestive of _______. FIrst line therapy is _______ such ________ in order to prevent progression to seizure and delrium. Long acting agents are preferred unless the patient has liver disease, then shorter acting agents like lorazepam and oxazepam are preferred

A

alcohol withdrawal

benzos

chlordiazepoxide or diazepam

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8
Q

based on the principle of _____ the prescription of medications likely to do more harm than good should be avoided, even if requested by patients (stimulants for ADHD in patient with many risk factors)

A

nonmaleficence

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9
Q

_______ for Bipolar Disorder has a very narrow therapuetic index and presents toxicity as gradual worsening confusion, agitation, ataxia, tremors/fasciculations. This toxicity can be precipitaed by volume depletion and drug interactions with _______, ACEI, and NSAIDs

A

Lithium

thiazide diuretics

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10
Q

_____________ in college student preparing for finals can present with paranoid ideation and must be differentiated from primary psychiatric disorders. Physical signs of stimulant intoxication include tachycardia, HTN, hyperthermia, diaphoresis, and mydriasis

A

Stimulant intoxication

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11
Q

_______ medications are the first line treatment for ADHD. They work by increasing the availability of _______ and _____ in the PFC

A

Stimulant

NE and DA

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12
Q

Key defense mechanisms:

expressing unacceptable feelings through actions =

behaving as if an aspect of reality does not exist =

transferring feelings to a more acceptable object =

using intellect to avoid uncomfortable feelings =

avoiding conflict by expressing hositility convertly =

attributing ones own feelings to others =

justifying behavior to avoid difficult truths =

responding to a manner opposite to one’s actual feelings

reverting to earlier developmental stage =

seeing others as all good or all bad =

channeling impulses into socially acceptable behaviors =

putting unwanted feelings aside to cope with reality =

A

acting out

denial

displacement

intellectualization

passive aggression

projection

rationalization

reaction formation

regression

splitting

sublimation

suppression

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13
Q

depression, suicidal ideation, impulsivity in women in the setting of feeling rejected; persistent pattern of unstable and intense relationships, substance abuse, unsafe sex, recurrent suicidal behaviors or threats, inappropriate or intense anger, chronic feelings of emptiness =

A

Borderline personality disorder

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14
Q

pervasive pattern of distrust and suspiciousness beginning in early adulthood and occurring in a variety of settings

A

paranoid personality disorder

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15
Q

intentional falsification or inducement of symptoms (induction of infection in the absence of obvious rewards)

A

Factitious disorder

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16
Q

_________ involves a neutral stimulus being repeatedly paired with non neutral stimulus that elicits an unconditioned response. Over time the neutral stimulus (stethoscope) is able to evoke a conditioned response (sweating, anxiety) in absence of non neutral stimulus (physician girl is scared of)

A

Classical conditioning

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17
Q

the new onset of anxiety in a patient with no prior psychiatric history and prominent physical findings on examination suggest that the anxiety is more likely due to a _______ such as ________

A

medical condition

hyperthyroidism

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18
Q

patient initially presents with depression and insomnia, given a medication, then comes back 3 weeks later in a full blown manic episode, with a family history of bipolar disorder. Disorder?

induced by __________ such as ________

A

Bipolar disorder

antidepressants, sertraline

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19
Q

buspirone is a _________ used in the treatment of GAD. It is not useful in the treatment of acute anxiety due to its ________, lacks muscle relaxant or anticonvulsant properties, and carries no risk of dependence

A

nonbenzodiazepine anxiolytic

slow onset of action

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20
Q

treatment resistant schizophrenia or schizophrenia assoicatied with suicidality =

adverse effects =

A

clozapine

agranulocytosis (monitor neutrophil count)

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21
Q

_______ is characterized by psychotic symptoms (delusions, hallucinations, disorganized speech, behavior, negative symptoms) lasting greater than 1 month and less than 6 months

greater than 6 months =

less than 1 month =

A

Schizophreniform disorder

Schizophrenia

Brief Psychotic disorder

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22
Q

recurrent, unexpected panic attacks and avoidance of potential triggers =

A

Panic disorder

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23
Q

in order to manage somatic symptom disorder, physicians should __________, limit unnecessary workout and referrals, reassure the patient that a serious illness has been ruled out, legitimize symptoms, decrease stress, improve coping strategies, and only refer to mental health once a physician/patient relationship is well established

A

schedule regular visits with the same provider

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24
Q

smoked drug, uncoordinated, jerky movements, assaults bouncer, fights off 4 officers, immune to pain, visual hallucinations, agitation and sedation altering states, HTN, tachycardic, vertical nystagmus =

works primarily as a n

A

PCP induced psychosis

NMDA receptor antagonist

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25
Q

acute treatment of agitation, psychosis in the presence of delirium in an elderly patient with UTI =

A

haloperidol

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26
Q

sexual dysfunction is seen in up to 50% of patients treated with ______. Bupropion, a _____________ is a first line treatment for MDD that does not cause this side effect

A

SSRIs

NDRI

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27
Q

mature defense mechanism involving the conscious choice not to dwell on a particular thought or feeling =

A

suppression

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28
Q

___________ are the most common adverse effects of psychostimulate medications used to treat ADHD such as methylphenidate

A

decreased appetite and insomnia

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29
Q

acute panic disorder treatment =

acts by positive allosteric modulation of the ____ receptor

A

Benzodiazepine

GABAa

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30
Q

multiple persistent deficits in social communication and interactions currently or history involving lack of social engagement, repetitive play, insistence on sameness =

A

Autism spectrum disorder

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31
Q

reversible, acute confusional state in the presence of a likely bacterial infection =

gradual progressive irreversible confused state with remote memory sparing =

A

delirium

dementia

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32
Q

recurrent episodes of chest pain, tachycardia, SOB, sweating, and tremulousness in a young, otherwise healthy patient with normal ECG are consistent with _______

administration of _______ results in rapid relief

A

panic disorder

benzos

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33
Q

_________ consists of anxiety >4 weeks in children and >6months in adults due to separation from those to whom the patient is attached. Physical symptoms and nightmares may accompany anxiety

A

Separation anxiety disorder

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34
Q

in the US, the majority of OD deaths are caused by

A

opioids

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35
Q

distracted, impulsive, grandiosity, flight of ideas, increased activity, decreased need for sleep, talkativeness (DIGFAST) is most likely _______ and can occur with or without psychotic features. _______ involves hypomanic episodes and major depressive episodes

A

BPDI

BPDII

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36
Q

replacing unacceptable feelings and impulses with their extreme opoosites =

A

reaction formation

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37
Q

______ acts by inhibiting the presynaptic reuptake of NE, DA, and 5HTP. Intoxicated patients develop agitation, tachycardia, HTN, and light responsive mydriasis due to increase ______ activity. It is also a potent vasoconstrictor and can cause myocardial ischemia and atrophy of nasal mucosa and septum

A

Cocaine

sympathetic

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38
Q

chlorpromazie and thioridazine are ______ first generation anti-psychotics, while haloperidol and fluphenazine are _______ first generation anti-psychotics. Fluphenazine will have a higher chance of ________ symptoms as an adverse effect

A

low potency

high potency

extrapyramidal

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39
Q

______ is typically the first symptom of alcohol withdrawal

A

tremulousness

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40
Q

treatment for _______ includes scheduled daytime naps and psychostimulants such as ________ for daytime sleepiness

A

nacrolepsy

modafinil

41
Q

at age 2, a child should have a vocabulary of ______ and be using 2 word phrases. Parents concerns about delayed milestones should be validated, and that further assessment and regular monitoring are essential

A

50-200 words

42
Q

all patients experiencing a major depressive episode should be carefully screened for __________ to rule out bipolar disorder

A

past manic episodes

43
Q

nausea, vomiting, abdominal pain, muscle aches, dilated pupils, yawning, lacrimation are _______ withdrawal symptoms

A

heroin

44
Q

PTSD (symptoms longer than 1 month) =

A

SSRI, SNRI

45
Q

__________ is characterized by recurrent intrusive thoughts (obsessions) and repetitive time consuming rituals (compulsions) that the individual feels driven to perform

A

Obsessive-compulsive disorder

46
Q

______ is a sedating antidepressant often used as a hypnotic to treat insomnia associated with depression. It has been associated with the rare but serious side effect of priapism

A

Trazodone

47
Q

long term panic disorder treatment =

immediate

A

SSRI/SNRI and CBT

Benzo

48
Q

subjective restlessness with inability to sit still in a patient being treated for schizophrenia successfully is due to =

called

A

antipsychotic treatments

akathisia

49
Q

Clozapine and olanzabine can cause ________ syndrome, so fasting glucose and lipids should be measured regularly

A

metabolic

50
Q

the most common causes of death with TCA OD are ______ and refractory hypotension due to the ______ of fast sodium channels in cardiac myocytes

A

cardiac arrhythmias

inhibition

51
Q

___________ side effects include DI, hypothyroidism, tremor, ebstein anomaly

A

Lithium

52
Q

preoccupation with >1 perceived physical defects, appear slight to others, repetitive behavior or mental acts performed in response, significant distress or impairment, specific insight

A

body dysmorphic disorder

53
Q

peer behavior has a strong influence on adherence in ______ due to desire to fit in

A

teens

54
Q

not excessive or out of proportion to severity of stressor, no significant functional impairment, just sad =

A

normal stress response

55
Q

drug induced parkinsonism is a type of extrapyramidal symptom caused by medications that block _______ such as ________

A

D2 receptors

Benztropine

56
Q

patients who experience major depressive and hypomanic episodes are diagnosed with _________

A

BPD2

57
Q

young kid, new friends, inappropriate laughter, increased appetitie, slowed reaction time, tachycardia and conjunctival injection =

A

marijuana

58
Q

methadone is a drug of choice for maintenance treatment of opioid use because it is potent and

A

long acting

59
Q

involuntary movments after chronic use of antipsychotics such as lip smacking, choreoathetoid movements =

A

tardive dyskinesia

60
Q

hallucinations of recently deceased relatives in children are part of the -________

A

normal grief reaction

61
Q

Risperidone and other antipsychotics cause _________ by blocking D2 receptors on lactotrophs leading to elevated prolactin levels, amenorrhea, galactorrhea, and breast soreness

A

hyperprolactinemia

62
Q

________ is characterized by loss of speech and motor skills, deceleration of head growth, sterotypic hand movements after a period of normal development. It mainly affects girls and is associated with mutations in _______

A

Rett syndrome

MECP2

63
Q

the anticonvulsant ______ also has mood stabilizing properties and is an effective maintenance therapy for Bipolar disorder

A

valproate

64
Q

by age ____ a child is expected to play imaginateively in parallel, speak in simple sentences, copy a circle, use utensils, and ride a tricycle

A

3

65
Q

short term acting benzos or intermediate term acting benzos such as _____ or _______ are preferred as a temporary treatment during the initiation period for SSRIs in anxiety treatment

A

triazolam

lorazepam

66
Q

patient develops hyperthermia, HTN, tachycardia, agitation, confusion, tremor, hyperreflexia, myoclonus, GI symptoms, diaphoresis after a round of antibiotics in the hospital =

due to _______ which has some MAOI activity combined with patients current SSRI/SNRI/TCA

A

serotonin syndrome

linezolid

67
Q

to avoid serotonin syndrome, patients must wait at least 2 weeks after discontinuing an MAOI (phenyelzine) before initiating SSRI therapy (Sertraline) allowing time for ______

A

MAO regeneration

68
Q

patients showing drug seeking behavior should, physician should obtain ________

A

confirmation of the patients prescription history

69
Q

patient experiencing a manic episode, receives multiple doses of antipsychotic medication to control him, develops hyperthermia, muscle rigidity, and confusion =

contrast to serotonin syndrome, these patients do not exhibit ______ and clonus

A

Neuroleptic malignant syndrome

hyperreflexia

70
Q

a ________ is characterized by difficulties with learning key academic skills like reading, writing, or mathematics. Kids will display symptoms of anxiety, inattention, or hyperactivity when under stress

A

learning disorder

71
Q

specific phobias are best treated with

A

behavioral therapy

72
Q

child aggressive toward people and animals, destruction of property, serious violation of rules, deceitfulness or theft =

if adult =

A

conduct disorder

antisocial disorder

73
Q

eccentric, odd thoughts, perceptions and behavior =

preferes to be a loner, detached, unemotional =

A

Schizotypal

Schizoid

74
Q

patient overdose with cutaneous flushing, dry oral mucosa, dilated poorly reactive pupils, confusion, which drug?

why?

A

TCAs (amitriptyline)

strong anticholinergic adverse effects)

75
Q

____________ is the strongest single risk factor for suicide

A

previous suicide attempt

76
Q

mania, delusions, hallucinations in the absence of any other mood episode over lifetime =

A

schizoaffective

77
Q

_________ is characterized one more more delusions in the absence of other psychotic symptoms. Behavior is not obviously bizarre and functioning is not significantly impaired apart from the direct impact of the delusions

A

delusional disorder

78
Q

misattribution of one’s unacceptable feelings or thoughts to another person who does not actually have them

A

projection

79
Q

multiple motor and vocal tics for >1 year with no obvious cause =

treatment with antipsychotics, alpha 2 adrenergic agonists, and behavioral therapy

A

Tourette disorder

80
Q

persistent or recurrent feelings of detachment from or being outside ones self, derealization, but intact reality testing

A

depersonalization/derealization disorder

81
Q

_______ is an eating disorder characterized by low body weight, intense fear of becoming fat, and distorted body image, bradycardia, hypotension, osteoporosis, amenorrhea, and cardiac atrophy as a result of malnutriton and starvation

A

anorexia nervosa

82
Q

GAD should be treated long term with SSRIS or SNRIs like

A

citalopram

83
Q

patients with _________ often experience executive dysfunction and personality changes secondary to impairment of the organizational, restraint, and motivational symptoms. Changes in social behavior can manifest in variable ways. _______ lesions more often associated with apathy and ________ lesions with disinhibition

A

front lobe injury

left sided

right sided

84
Q

increased appetite and sleep, leaden paralysis, rejection sensitivity, and mood reactivity are hallmarks of _________ can respond well to MAOI like ________

A

atypical depression

phenelzine

85
Q

depression, fatigue, hypersomnia, hyperphagia, vivid dreams, history of drug use, due to withdrawla of

A

cocaine

86
Q

______ is the unconscious shifting of emotions associated with signfiicant from ones past to a person in the present

A

Transference

87
Q

bilateral parotid gland enlargement, erosion of tooth enamel, irregular menses, abnormal electrolytes

A

bulimia nervosa

88
Q

____________ is a severe subtype of unipolar major depression characterized by symptoms meeting criteria for a major depressive episode and the presence of delusions or hallucinations

A

major depressive disorder with psychotic features

89
Q

_______ involves excessive fears of scrutiny or embarrassment in social or performance situations, resulting in significant distress and functional impairment

A

social anxiety disorder

90
Q

nonpharmacologi treatments for insomnia include sleep hygiene, stimulus control, relaxation, sleep restriction, and cognitive behavioral therapy. stimulus control focuses on eliminating stimulating bedroom activities and ____________

A

getting into bed only when sleepy

91
Q

MDD treatment

A

SSRIs or TCAs

92
Q

_______ is characterized by chronic depressed mood and at least 2 other depressive symptoms lasting for at least 2 years

A

persistent depressive disorder (dysthymia)

93
Q

________ is maladaptive pattern of behavior characterized by social inhibition, feelings of inadequacy and fear of embarrassment and rejection. Patients have the desire for social interaction unlike _____

A

Avoidant personality disorder

Schizoid

94
Q

___________ are the treatment of choice for OCD

A

SSRIs

95
Q

______ is the compulsive consumption of a nonfood or nonstaple food source for >1month

common in

A

pica (ice eating)

pregnancy

96
Q

recurrent episodes of early ejaculation accompanied by a sense of lack of control

A

premature ejaculation

97
Q

________ is a behavioral disorder of childhood characterized by argumentative and defiant behavior toward authority figures. It does not involve the more severe violations of the basic rights of others seen in conduct disorder

A

Oppositional defiant disorder

98
Q

________ is a first line antidepressant with amphetamine like properties, it is not associated with sexual side effects or weight gain, however, it is associated with an increased _____ risk at high doses.

A

Bupropion

Seizure

(***) (U-World) All Subjects (20 decks)

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