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Term 3 > Module 1 > Flashcards

Module 1 Flashcards

1
Q

Differentiate between provisional diagnosis and “unspecified”/”other specified”.

A

Provisional: assume criteria will be met, but patient information is unavailable

Unspecified: Does not specify why a patient fails to meet criteria for a specific disorder

Other specified: Other specified eating disorder, insufficient frequency binge/purge

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2
Q

What is a mental disorder?

A

Disturbance of behavior, emotional regulation, cognition that leads to functional impairment (social, occupational, other important activities)

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3
Q

What is the final category of mental disorder in DSM?

A

Other focus clinical attention – not a mental disorder, but may benefit from clinical scrutiny or intervention (i.e. uncomplicated bereavement)

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4
Q

Differentiate between the old axis system and the new DSM-5 model.

A

Axis: bio-psycho-social
New: List of disorders to avoid implying that there is a fundamental distinction between psychiatric and medical illness

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5
Q

What are the 7 anxiety disorders?

A
  1. Panic
  2. Agoraphobia
  3. Social anxiety disorder
  4. Specific phobia
  5. Generalized anxiety disorder
  6. Separation anxiety
  7. Selective mutism
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6
Q

What is the general theme, cause and treatment for anxiety disorders?

A

Theme: inappropriate anxiety elicited by inappropriate cues, excessive in intensity/duration

Cause: overstimulation HPA axis
Treatment: CBT, Anxiolytic meds – Benzo/SSRI

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7
Q

What is classic conditioning?

A

Physical symptoms become associated with fear response; can trigger anxiety

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8
Q

What is on the differential for an anxiety disorder?

A

A medical condition (i.e. tumor, hyperthyroidism)

Substance induced anxiety (i.e. caffeine)

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9
Q

Define anhedonia

A

Inability to feel pleasure

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10
Q

Panic disorder

A

Recurrent, unexpected panic attacks greater than 1 month

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11
Q

Agoraphobia

A

Fear of escape

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12
Q

Specific phobia

A

Excessive, disproportional fear of object/situation (> 6 months)

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13
Q

Social anxiety disorder

A

Excessive, disproportional fear of object/situation

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14
Q

Generalized anxiety disorder

A

Uncontrolled anxiety about multiple events occurring majority of days

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15
Q

OCD

A

Recurrent obsessions (thoughts, impulses, images) and compulsions (actions/behaviors); don’t need to be related

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16
Q

PANDAS

A

Pediatric autoummune neuropsych disorder associated with strept infection

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17
Q

What is the Yale-Brown OCD Scale? (Y-BOCS)

A

Objective scale to qualify and quantify symptoms and severity of OCD. Useful for measuring changes over time

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18
Q

Hoarding disorder

A

Difficulty parting with possessions

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19
Q

BDD

A

Imagined/minor body defect - face

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20
Q

Excoriation disorder

A

Skin picking/lesions

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21
Q

Tricotillomania

A

Hair pulling

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22
Q

Differentiate between PTSD and ASD

A

Time – ASD usually starts/resolves within 1 month

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23
Q

What is adjustment disorder?

A

Psycho-social stressor – ordinary life experience; acute onset 3-6 months in duration; goes away once the person has adapted to the stressor?

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24
Q

Somatic symptom disorder

A

More than one somatic disorder; excessive thoughts, feelings, behavior; persistent symptomology

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25
Q

What are the 4 criteria for PTSD?

A
  1. Intrusion- dreams, recollection, recurring feelings
  2. Avoidance- thoughts, places, conversations
  3. Negative alterations cognition/mood
  4. Alterations in arousal/reactivity
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26
Q

Illness anxiety disorder

A

Preoccupation with having an illness despite no somatic symptoms

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27
Q

Conversion disorder

A

Incompatibility between symptoms and neurological findings

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28
Q

Factitious disorder vs. Malingering

A

No external incentive for factitious

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29
Q

What are the 2 major dissociative disorders?

A
  1. D Amnesia disorder +/- fugue

2. D Identity disorder

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30
Q

T/F Dissociative disorders are a way to cope with stress

A

True

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31
Q

What are the 3 types of dissociative amnesia?

A
  1. Localized (to time)
  2. Selective
  3. Generalized
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32
Q

How do you differentiate between physical vs. psychological amnesia?

A

Mental status exam; physical – anterograde

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33
Q

What is fugue?

A

Purposeful travel

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34
Q

What is the formal name for multiple personality disorder?

A

Dissociative identity disorder

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35
Q

Differentiate between depersonalization and derealization.

A

Depersonalization: thoughts, feelings, actions, sensation
Derealization: surroundings

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36
Q

What is the DDx for dissociative disorders

A

Metabolic, neuro, other pathology

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37
Q

How are dissociative disorders treated?

A

CBT +/- therapy

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38
Q

T/F Substance disorders affect males > females

A

True (young males)

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39
Q

What are the 5 major pillars of drug addiction

A
  1. Stimulation reward circuitry
  2. Stimulation reward pathway – prefrontal/alters self-control
  3. Physical withdrawal
  4. Decreaed dopamine availability (protracted abstin)
  5. Environment + internal cues
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40
Q

How does a clinician assess substance problems?

A

CAGE, FOY

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41
Q

What are the factors that contribute to the risk of becoming addicted?

A
  1. Genetics (50%)

2. Psycho-social: age, method admin, culture, job, other mental illness

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42
Q

What are the accepted number of drinks per day and week for men and women?

A

Men: 4, 14
Women: 3, 7

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43
Q

Formication

A

Bugs under skin (sedative withdrawal)

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44
Q

Cell bodies for neurons that release NE are in:

A

Locus ceruleus (trauma center)

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45
Q

Locus ceruleus is inhibited by

A

Opioids

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46
Q

Cell bodies for neurons that relase 5-HT are in:

A

Raphae nucleus

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47
Q

What is the difference between Schedule 1 & Schedule 5 drug?

A

Schedule 1: Cannot prescribe/administer

Schedule 5: Least harmful

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48
Q

What are the 3 major substance disorders?

A
  1. Intoxication
  2. Withdrawal
  3. Substance use disorder
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49
Q

What type of pharmacological therapy can be used for addiciton?

A

Benzos/ETOH (STM)
Decrease craving – block effect of drug
Aversion therapy

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50
Q

The major excitatory/inhibitory neurotransmitters in the brain…

A

Excitatory: Glutamate (NMDa)
Inhibitory: GABA

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51
Q

How many areas are in the association cortex for the cortex vs. limbic system?

A

Cortex: 2
Limbic: 3

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52
Q

What types of drugs utilize GABA channels?

A

Barbs and benzos

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53
Q

T/F Anti-anxiety drugs suppress the locus cereulus

A

True

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54
Q

What drug, if administered during a trauma, can decrease the risk of PTSD development in the future?

A

Morphine

55
Q

Following anoxia, Glutamate is released from ____ into ______ which further stimulates more release of glutamate.

A

ICF into ECF

56
Q

Differentiate between dorsolateral and orbital pre-frontal.

A

Dorsolateral: thinking – apathy, inactivity, planning
Orbital: Limbic connections (Gage), feelings, social behavior

57
Q

When it comes to hypothetical thinking, there are 2 major routes in the brain…

A

PTO: L-language, sequential; R-spatial, facial recognition

Dorso-lateral pre-frontal: abstract thinking, memory, planning

58
Q

Prosody; which hemisphere?

A

Subtle aspects of speech / R-hemisphere

59
Q

The 4 major categories of drugs…

A
  1. Opioids - narcotics, analgesia, euphoria, heroin
  2. Sedatives - ETOH, benzo, barbs
  3. Hallucinogens - LSD, PCP, ketamine
  4. Stimulants - Amphetamines, cocaine
60
Q

Differentiate between Naloxone and Naltrexone

A

Naloxone - treat an overdose – STM opioid R blocker

Naltrexone - long-acting opioid receptor blocker to block effects during relapse

61
Q

Differentiate between methadone and buprenorphine

A

Methadone: Schedule 2 (can only be administered)
Buprenorphine: Schedule 3

62
Q

T/F Withdrawal from opioids can be lethal

A

False – like the flu

63
Q

3 potential pharmacological treatments for ETOH abuse:

A

Naltrexone -block pleasurable effects
Disulfiram (Antabuse)
Acamprosate (NMDA R antag); decreased unpleasant feelings with protracted abstinance

64
Q

T/F Withdrawal from sedatives can be lethal

A

True

65
Q

What are the 3 categories of hallucinogens? Which category has withdrawal?

A

Classic- LSD
Cannabis- Withdrawal!
Dissociative anesthetics- PCP

66
Q

Pupils: dilated, red, nystagmus (Name that hallucinogen)

A

Dilated: LSD
Red: Cannabis
Nystagmus: PCP

67
Q

T/F Withdrawal from stimulants can be life threatening.

A

False

68
Q

Name 2 drugs that can be used for treatment of nicotine withdrawal

A

Buproprion (Zyban), Varenicline (Chantix)

69
Q

Name the classes of anti-psychotic drugs

A
  1. Classic – Chlorpromazine, Haldol (EPS)
  2. Atypical – First (Clozapine, D3/D4 - EPS, + agranulocytosis); Newer (Olazepine, quetiapine, ziprasidone – less blood monitoriting)
70
Q

Schizophrenia results from a functional deficit in the _______________ _____________ tracts from the ventral tegmental area to the pre-frontal cortex

A

Ascending dopamine

71
Q

There are 4 major dopamine pathways, associated with 3 disorders

A

MB/ventral tegmentum: Schizophrenia
Nigrostriatal: Parkinson’s
Tuberoinfundibular: gynecomastia
Retina/Olfactory bulb

72
Q

Binary vs. Continuous variables (chi2, t-test, Fisher’s exact, rank sum)

A

Binary: Fisher’s exact, chi2
Continuous: T-test, rank sum

73
Q

T/F Schizophrenia is associated with too little DA in one tract, which is improved by blocking DA in another tract

A

True

74
Q

Schizophrenia is associated with >= ___ of the following symptoms for one month, for a total duration of ____ months

A

2; 6

75
Q

Active phase schizophrenia symptoms

A

Delusions, hallucinations, disorganized speech/thoughts, disorganized/catatonic behavior

76
Q

Differentiate between good/bad prognosis Schzophrenia symptoms

A

Good: late onset, rapid, + symptoms
Bad: early, slow onset, - symptoms

77
Q

Blocking D2 receptor can have the following side effects:

A

Non-adherence, weight gain, impotence, extrapyramidal symptoms

78
Q

What are the key things to tell patients on anti-psychotics?

A

Not addicting, treat side effects (restlessness, nervousness), avoid amphetamines, L-dope, tardive dyskinesia

79
Q

______________ (drug) blocks DA reuptake and can potentates the effect of DA

A

Cocaine

80
Q

A pleasure center in the brain

A

Nucleus accumbens

81
Q

____________ transporters are considered the brain’s cocaine receptors

A

DA

82
Q

Delusional disorder

A

> 1 month, normal function, erotomania, grandiose, jealous, somatic

83
Q

Brief psychotic episode

A

1 day-1 month (>=1 core symptoms)

84
Q

Schizophreniform

A

1-6 months (>=2 core symptoms)

85
Q

Schizoaffective disorder

A

Major mood disorder (active phase schizophrenia >=2 weeks)

86
Q

Male hyopactive sexual desire disorder

A

Decreased libido

87
Q

Female sexual interest/arousal disorder

A

Decreased libido

88
Q

Female orgasmic disorder

A

Delay/low intensity orgasm

89
Q

Genito-pelvic pain/penetration disorder

A

Pain during intercourse

90
Q

How do you assess sexual dysfunction disorders?

A 
Sexual history (psycho/phsyio)
Medication side effect, drugs, medical problems
91
Q

Snap gauge test

A

Roll of stamps/erection

92
Q

What is sensate focus?

A

Focus on non-coital foreplay

93
Q

What is the overall treatment strategy for sexual dysfunction?

A

P- permission
LI- limited sex edu
SS- specific suggestions, sensate
IT- intensive therapy

94
Q

When does a paraphilia become a disorder?

A

When it is done on non-consenting people

95
Q

Frotteuristic

A

Touching/rubbing in crowded places

96
Q

T/F Serotonin dysregulation can be associated with paraphillic disorders

A

True

97
Q

What is covert sensitization?

A

Aversion therapy – imagining an unpleasant situation

98
Q

What is medroxyprogesterone acetate (Depo Provera)?

A

Anti-androgen, can be used to decrease testosterone levels and libido

99
Q

Differentiate between anorexia and bullimia with respect to weight.

A

Bullimia: normal or over-weight

100
Q

What are the clinical questions to ask about eating disorders?

A 
Sick / induce vomiting 
Control / lose control?
One stone (14 lbs)
Fat / believe fat?
Food / dominate?
101
Q

Differentiate between bipolar I and II and cyclothymic disorder

A

Bipolar I: at least 1 manic
Bipolar II: at least 1 hypomanic & major depressive episode
Cyclothymic: mild hypomania/depression

102
Q

Differentiate between a manic and hypomanic episode.

A

Manic: 3 of 7 days, + self-esteem, no sleep, talkative, flight ideas, distractable
Hypomanic: 4 days, no psychotic features, no impairment in function

103
Q

What is the minimum time for a major depressive episode?

A

2 weeks

104
Q

What are symptoms of a major depressive episode?

A

> =5 – Depressed mood or loss of interest

+ sleep, guilt, energy, concentration, appetite, psychomotor, suicide

105
Q

What is persistent depressive disorder?

A

2 years; chronic major depressive disorder/dysthmia

106
Q

What is disruptive mood dysregulation?

A

Persistent irritability (age 6-18); starts at age 10

107
Q

Reactive sadness and bereavement are…

A

Normal reactions to minor/major loss that does not interfere with function

108
Q

The trauma center in the brain is _________________, which is inhibited by these types of drugs ___________________.

A

LC, which is inhibited by opioids

109
Q

Intra/Extracellular: MAO, COMT

A

MAO-intraneurally

COMT- extraneurally

110
Q

NE cell bodies are located here:

A

locus cereuleus

111
Q

T/F NE is upregulated in mania and decreased in depression (along with 5-HT)

A

T

112
Q

How is bipolar disorder treated pharmacologically?

A

Lithium/Anti-epileptics – mood stabilizers

Quetiapine: atypical anti-psychotics

113
Q

How are mood disorders treated?

A

Psychotherapy, SSRI, tricyclics, MAOI

114
Q

T/F ECT can induce new neuron generation in the hippocampus

A

T

115
Q

Narcolepsy is characterized by these 3 features:

A

Cataplexy (loss of muscle tone), decreased hypocretin (hypothalamic neuropeptide), PSG anormalities (decreased REM, but sleep onset REM)

116
Q

Differentiate between hypnogogic and hypnompic.

A

Hypnogogic: sleep onset hallucinations

117
Q

Decreased/Incresed/Dysregulated: NE, 5-HT

Mania vs. Depression

A

Depression: NE decreased
Mania: NE increased

118
Q

Piaget’s 4 factors that influence cognitive development

A
  1. Nervous system maturation
  2. Experience/Environmental stimulation
  3. Social transmission of information
  4. Equilibration: assimilation/accommodation; exisiting constructs are changed as a result of new experiences
119
Q

What are effects of insecure attachment in early childhood?

A
  1. Deprivation/ socially incompetent
  2. Traumatic sepn/ anaclitic depression
  3. Lack of human contact –> failure to thrive
    .
120
Q

Language 2-3 months, 3-4 months, 10 months, 12 months, 24 monts

A 
2-3: coo
3-4: babbling
10: babbling household jargon
12: one word
24: two words
24+: sentences
121
Q

What are the four categories of attachment and their causes?

A
  1. Securely attached
  2. Insecurely – anxious avoidant (comfort denied to child), anxious resistant (parental inconsistency), disorganized (abuse/parental depression)
122
Q

T/F Echolalia is a red flag for development. What is it?

A

True; repeating communicative speech

123
Q

The 4 categories of the Denver development scale

A
  1. Gross motor
  2. Fine motor
  3. Personal/social
  4. Language
124
Q

Worldwide causes of death (neonate - 5 yrs old)

A
  1. Neonatal deaths
  2. Acute respiratory infection
  3. Diarrhea
125
Q

US infant deaths < 1 y.o.

A
  1. Congenital abnormalities
  2. LBW
  3. SIDS
126
Q

US deaths 1-4; 5-16; 16-19

A

1-4

  1. Unintentional injury
  2. Congenital abnormality
  3. Homicide

5-16

  1. Unintentional injury
  2. Malignant neoplasm
  3. Congenital abnormality

16-19

  1. Unintentional injury
  2. Homicide
  3. Suicide
127
Q

What is the single most important determinant of health?

A

Poverty

128
Q

Describe Piaget’s 4 stages of cognitive development.

A
  1. Sensorimotor (senses and actions)
  2. Preoccupational (lacks logic)
  3. Concrete operational (logical reasoning)
  4. Formal operational (abstract reasoning)
129
Q

Describe Kohlberg’s stages of moral reasoning.
Punishment orientation, reward orientation, good boy/good girl, authority orientation, social contract orientation, ethical orientation

A

Avoid punishment
Obtain rewards
Conform to avoid disapproval
Uphold social rules to avoid guilt

130
Q

What are the 5 stages of dying process?

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
131
Q

What are the 3 stages of grief?

A
  1. Acute disbelief
  2. Grief work
  3. Resolution
132
Q

What is the most common complaint of the terminally ill patient?

A

Pain

133
Q

How do the following people mourn:

  • Infant
  • Children
  • Adolescent
  • Adult
  • Elderly
A

Infant - withdrawn
Child - cliniging, hyperactivity, self-blame
Adolescent - impulsive, substance x, sex
Adult - illness, substance x, grieving
Elderly - withdrawn, high death rate within 1 year

Term 3 (3 decks)

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