Psy Guy Flashcards
(147 cards)
1
Q
{{BLANK}} is the only phobia w/ a paradoxical response of bradycardia, hypotension, and fainting
A
Blood-inj. phobia
1
Q
SANS activation during blood injury. phobia creates a {{BLANK}} response/fainting
A
vasovagal
2
Q
A social phobia is more likely to develop after?
A
Stressful or humiliating
3
Q
Panic Dx must be present as a panic attack along w/ {{BLANK}} to be diagnosed
A
> 1 month of concern/effects from the attack
4
Q
{{BLANK}} is the main cause of the S/Sx of panic disorder
A
Hypocapnia
5
Q
A person w/ agoraphobia is scared to…
A
Be in public places (10% remission w/o Tx)
6
Q
1 reason people use marijuana is
A
anxiety
7
Q
1 reason people D/C marijuana is
A
anxiety
8
Q
DOC for specific phobias
A
CBT (incl. exposure)
9
Q
Flooding Tx is dangerous in phobia Tx why?
A
Can either work or make worse
10
Q
EtOH works similarly to {{BLANK}} in the treatment (self) for SAD
A
BZDs
11
Q
T/F: Current treatments are over 50% effective in the treatment of SAD (e.g., SSRI, SNRI, BZD, etc.)
A
True
12
Q
T/F: SSRIs have not been shown to be more efficacious than placebo in the Tx of panic dx
A
False
13
Q
T/F: CBT & antidepressants (e.g., SSRI) have been shown to be equally effective in the tx of panic dx
A
True
14
Q
What is true about the Tx of GAD (i.e., C&C meds)
A
SSRI/SNRI all have same degree of efficacy (just pick one)
15
Q
T/F: CBT has been shown to be more efficacious in the tx of GAD
A
False
16
Q
{{BLANK}} is 2nd amongst all diseases/injuries leading to disability
A
MDD
17
Q
What is the main goal of treating MDD (initially)?
A
If untreated, try to Tx & make episode short –> remission more likely
18
Q
What is true about MDD recurrence?
A
High rate (esp. if long 1st episode & untreated)
19
Q
{{BLANK}} is 2-3 x higher in primary care and PCPs tend to be the sole provider for many (> 50%) pts w/ mental illness
A
MDD
20
Q
Expalin the Dx criteria for MDD (superficial explanation)
A
SIG E CAPS
* Sleep
* Interests
* Guilt
* Energy
* Concentration
* Appetite
* Psychomotor agitation/retardation
* Suicidal ideation
NOTE: must also have depressed mood
21
Q
Is MDD heritable? Why or why not?
A
- Yes (40%)
- 1st degree FMH = 2-4x risk
22
Q
Depression is a Dx sign for {{BLANK}} cancer before the patient even knows about their cancer
A
Pancreatic cancer
23
Q
What is important about the Tx of adjustment disorder?
A
identify the stressor & refer to therapist
24
What adjustment disorders are more common in children?
Conduct & Conduct w/ emotions
25
When initiating pharmacotherapy for a mental illness you should keep in mind to?
Lowest dose, shortest duration
26
In depression, remission occurs more often if you {{BLANK}}
initiate pharmacotherapy
27
The most important characteristics of therapy for tx of depression is?
Relationship between therapist & Pt
28
{{BLANK}} is an effective treatment for depression but requires general anesthesia and is reserved for refractory cases
ECT
29
{{BLANK}} blocks ECT facilitated muscle movements
Succinylcholine (effects only seen on EEG)
30
What are notable SE/ADR from ECT?
* Acute confusion
* Anterograde amnesia
* Retrograde amnesia
31
{{BLANK}} is more effective than any other tx for MDD
ECT (70-90%)
32
What does rapid cycling mean in BP?
≥ 4 mood episodes within 12 months
33
T/F: A BP pt is less likely to have another manic episode after the first
False, 90% have recurrent mood episodes
34
A manic episode in a BP pt typically precedes
Depressive episode
35
In BP pts, they have a high-risk of dying by?
Suicide
| 15x higher than normal; 25% completed suicides are due to BP
36
What is true when you compare suicides between BP I & BP II?
In BP II, suicides are more lethal
37
What is the mnemonic used in BP Dx?
DIG FAST
* Distractable
* Insomnia
* Grandiosity
* Flight of ideas
* Activity (increased)
* Social (increased)
* Traumatic experiences
38
If a pt is hospitalized due to their manic episode, what do they have?
BP I
| BP II = hypomania = no hospital
39
To Dx BP II, the pt must exhibit both?
* Hypomania
* Depression
40
Seasonal affective disorder is most common?
* winter
* northern latitudes (E.g., NY)
41
What is the Tx for seasonal affective disorder?
10,000 lux light x 30 mins per day
| Must hit pupil but don't look straight into it the entire time
42
Why should someone w/ BP be maintained on a mood stabilizer even after S/Sx resolution?
* Relapse is 85% x 5 years
* Tx reduces suicidality & violent behavior
43
{{BLANK}} must be maintained at a level of 0.8-1.2 x 5 days to know if it is working but has shown to reduce the risk of suicide in PB patients
Lithium
| Caution: hydration should be maintained (increase/decrease -- affects tx
44
You will know if valproate has reached target levels of 50-125 within {{BLANK}} days
3 days
| lithium x 5 days
45
{{BLANK}} is a mood stabilizer that carries the risk of SJS/TENS that can be fatal
Lamotrigine
46
What is the main diff between sensory dilirium & dementia?
* Delirium: resolves
* Dementia: progressive
47
How common is delirium?
End of life > ICU > nursing home/acute care facility > old age
48
Most Dx'd w/ AZD are?
* 75-84: 53%
* ≥ 85: 40%
| AZD is repsonsible for 60-90% of dementias
49
What is the avg. survival time after Dx of AZD?
10 years
| up to 20 years in some cases
50
What do AZD pts typically die from?
Aspiration
51
What are common characteristics of the late-stage AZD pt?
* Mutism
* Bed-bound
52
What is the avg survival time after Dx of Frontotemporal neurocognitive Dx?
3-4 yrs after Dx
| 6-11 yrs after initial Sx appearance
53
What are risk factors of **frontotemporal neurocognitive disorder**?
* 40% have FMH of early-onset NCD
* 10% autosomal dominant pattern
54
A person with lewy body dementia (NCD) given a regular dose of antipsychotics can display what reaction?
Increased SE/ADR
* They are more sensitive
* This reaction can help lead to Dx
55
What is the avg. survival time for NCD -- lewy body dementia?
5-7 yrs after clinical presentation
56
{{BLANK}} is typically present for at least 1-year prior to the onset of **motor sx** in **lewy body dementia**
cognitive decline --> motor decline
57
What are risk factors for vascular NCD?
* HTN
* DM
* Smoking
* Obesity
* High Chol
* High homocysteine
* A-fib
58
TBIs can lead to {{BLANK}} and {{BLANK}}
| Sequela
depression; aggression
59
In alcohol abuse, most NCDs are maintained within the first {{BLANK}} months unless the person did not reach abstinence until after 50 yo
30-40% within first 2 months
60
{{BLANK}} infection can lead to NCD
HIV; 30-50% display NCD
| Rapid progression; infants & children may display delay
61
In HD, {{BLANK}} abnormalities can predate motor abnormalities by ~15 yrs
psych/congitive --> motor
62
How do obsessions & compulsions interact w/ one another?
* Obsession: they try to suppress
* Compulsion: attempt to neutralize w/ action
63
Commonly, a {{BLANK}} disorder is seen in OCD patients
Tic
64
Similar to BP, {{BLANK}} is a common component in OCD
suicidality
| 25% attempt; 50% think about it
65
1st line for OCD?
CBT
66
What is true regarding pharmacotherapy in OCD?
Pts need higher dose SSRI or clomipramine
67
If a patient has a comorbid eating disorder along w/ body dysmorphia, what is treated first?
Eating disorder (more deadly)
68
When is body dysmorphia typically Dx'd?
before 18 yo (2/3 of pts)
69
Hoarding is typically seen in {{BLANK}} adults
older
70
{{BLANK}} is when someone finds pleasure in the pulling of hairs (e.g., scalp, eyelashes, etc.)
Trichotillomania
71
{{BLANK}} is when someone is constantly picking their skin leaving lesions and even eating the skin
Excoriation
72
Excoriation typically begins w/ a {{BLANK}} condition
Dermatologic (acne)
73
In what domains is someone abnormal regarding **general personality disorder**?
* Cognition
* Affectivity
* Interpersonal functioning
* Impulse control
74
How common are personality disorders in the U.S.?
15% of U.S. population
75
C&C paranoid personality disorder versus delusion.
* Paranoid = lot of people
* Delusion = subset or individual
76
How do people with paranoid personality disorder acquire confirmation?
They are "combative" in conversation & receive hostility from others that confirms their expectations
| They expect/suspect people/world is out to get them
77
Why do you not commonly see individuals for schizoid personality dx?
* Lack of social skills
* Lack of desire for social life
* Prefer isolation
* Longers
| They don't usually present because they are okay
78
C&C schizotypal versus schizoid.
* Schizotypal = magical
* Schizoid = loner
79
When do you typically run into a person w/ schizotypal dx? (clincally setting)
* 30-50% have MDD
* You see them for that
80
Psycopaths & sociopaths are typical of {{BLANK}} disorder
Antisocial personality disorder
81
What is the only Dx where a person must of had S/Sx/Dx of another illness?
* Antisocial personality disorder
* Dx/Hx of Conduct disorder (< 15 yo)
82
Where is the highest prevalence of antisocial personality disorder patients?
* Prisons, jails, SUD clinics, etc.
* Think, Wolf of Wallstreat, Bernie Madoff
83
People w/ {{BLANK}} disorder present a superficial charm, grandiosity, and expertise to ordinary people
Antisocial personality disorder
| They are really callous, cynical, self-inflated, expoitative
84
A person w/ antisocial personality disorder can become more stable after?
reaching 4th decade of life
85
Someone w/ {{BLANK}} disorder is more likely to die from violent/traumatic means
Antisocial personality disorder
86
What is a classic case of **borderline personality disorder**?
* Relationship w/ ups/downs
* They or partner creates (e.g., I'm going to leave)
* They threaten suicide or attempt to get partner back
* Cycle continues
87
Relationships of someone w/ borderline personality disorder will improve after?
* 30-40 yo
* Better functioning w/o major cyclic pattern
* Also, 10-yrs outpatient Tx, 50% no longer qualify for Dx
88
1st line for borderline personality disorder?
DBT
89
{{BLANK}} are hypersexual and get depressed if not the center of attention
Histrionic personality disorder
90
C&C narcissistic versus borderline
* Narcissistic: what they present
* Borderline: internal (what they can get)
91
The true issue of **narcissistic personality disorder** is?
* vulnerable self-esteem
* Very sensitive to criticism
| Criticism can haunt them and leave them enraged
92
What happens as a person w/ narcissistic personality disorder ages?
They are bothered by new onset of physical limitations
93
T/F: narcissistic adolescent children will grow up to have worse S/Sx
False, it typically goes away
94
Individuals w/ {{BLANK}} disorder want love and companionship but are afraid of rejection
Avoidant personality disorder
95
How do people w/ avoidant personality dx get confirmation?
* Act fearful/intense
* Elicit ridicule/derision from others
* Confirms their worries
96
Individuals w/ {{BLANK}} disorder have a major self-doubt & want to solely rely on someone for their life
Dependent personality disorder
97
Who are characteristic OCPD patients?
* High achievers (e.g., med students)
98
Why does a person w/ OPCD have trouble w/ relationships?
They are more logical than emotional
99
Why do people w/ OPCD have trouble getting tasks completed?
Difficulty in prioritization
100
{{BLANK}} is the 1st line Tx for personality disorders
Psychotherapy
101
{{BLANK}} is most effective psychotherapy for BPD
DBT
* Decrease suicidality
* Decrease hospitalizations
102
C&C illness anxiety dx versus somatic dx
* Somatic: they complain about Sx only not dx
* Illness: say they have dx
103
A child walks in on their parents having sex, they then report they are blind. What dx do they have?
Conversion dx
| remember, they display la belle indifference
104
C&C Malingering versus factitious disorder
* Factitious: they don't want an external reward just looked at like a hero or "babied"
* Malingering: want an external reward (e.g., money)
105
Someone w/ rumination disorder is likely to suffer from {{BLANK}}
Intellectual disability
106
The #1 prerequisite to have anorexia nervosa is to display {{BLANK}}
Underweight (low BMI)
107
T/F: Someone w/ anorexia is typically always thinking about food
True
108
An overweight "model" presents to you w/ eroded enamel, calluses along their phalagneal dorsum (right hand) and enlarged parotid glands. What do you suspect?
Bulima nervosa
109
Weight Tx may initiate {{BLANK}} disorder
Bine-eating
| Eat more after dieting/cheat meals
110
If you surroundings appear "dream-like" while in war you may have?
Derealization
111
If you feel like you are "outside your body" you may be experiencing?
Depersonalization
112
Roughly {{BLANK}}% of people w/ experience at least one episode of depersonalization/derealization in their lifetime
50%
113
What is the epidemiology behind PTSD?
* Veterans
* Females
114
C&C ASD versus PTSD
* ASD: Dx within 1 month
* PTSD: Dx 1-6 months
115
T/F: If adopted, a child will escape the increased risk of SUD (EtOH) assoc. w/ their FMH
False, FMH risk is inherited for EtOH abuse (3-4x more likely)
116
When does alcohol abuse typically present?
| HINT: Traveling
Air travel (must D/C to travel on plane)
* Pt experiences agitation, anxiety, HA, diaphoresis
* May have seizures, hallucinations, delirium tremens
117
Cannabis-related Dx is more common in?
Native Americans & Alaska natives
118
**Auditory hallucinations** are most assoc. w/ {{BLANK}}
Schizophrenia
119
**Visual hallucinations** are most assoc. w/ {{BLANK}}
Substance use
120
**Vertical nystagmus** and **strength** are assoc. w/ {{BLANK}}
PCP
121
Why would someone experience a resurgence of lysergic acid after D/C of the drug?
Goes into adipose tissue & can get back into system to elicit effects
122
Pupillary **dilation** is seen w/ {{BLANK}}
Cocaine & Stimulants
123
Pupillary **constriction** is seen w/ {{BLANK}}
Opioids
124
What BZD is preferred to tx EtOH withdrawal in someone w/ liver dysfunction?
Lorazepam
| Probably oxazepam & temazepam too
125
What BZD is preferred to Tx EtOH withdrawal if there is no increase in LFTs?
Chlordiazepoxide
126
C&C Bizarre versus non-bizarre delusions
* Bizarre: possible
* Non-bizarre: impossible (e.g., cat in anus watching me at night)
127
C&C Delusion vs hallucinations
* Delusions: belief
* Hallucinations: experience (w/o stimuli)
128
C&C Delusional vs schizophreniform vs schizphrenic disorders
* Delusional: 1 day to 1 month
* Schizophreniform: 1 month to 6 months
* Schizophrenia: > 6 months
129
{{BLANK}} delusion is the belief someone you watch on TV is in love w/ you
Erotomanic
130
{{BLANK}} delusions are the thought you are special to the human race (e.g., Jesus Christ 2.0)
Grandiose
131
{{BLANK}} delusions are the belief you have an unfaithful partner (w/o evidence)
Jealous
132
The most common delusion is?
Persecutory
133
In {{BLANK}} delusions, the person believes that someone/something is out to get them and may repeatedly sue them or resort to violence
Persecutory
134
In {{BLANK}} delusions the person believes a fould odor is coming from them (or infestation, parasite, etc.)
Somatic
135
What is the risk factors of schizophrenia?
* Late winter/early spring
* Urban environment
* Perinatal hypoxia
* Greater partneral age
136
What is true regarding suicide risk of schizophrenic patients?
Risk is higher after recent episode or hospitalization
| MONITOR after
137
Why is life expectancy reduced in schizophrenic patients?
Metabolic effects
138
Why do majority of schizophrenic patients ingest tobacco/nicotine?
Works as an antipsychotic on nicotinic receptors
139
Risk of suicide w/ schizoaffective dx is increased when?
having depressive symptoms
140
Stimulant use can cause {{BLANK}} hallucinations making the person think bugs are crawling on them
Tactile
141
What should you do when someone is admitted for psychosis?
* Drug screen (7-25% of episodes are due to SUD)
* PMH
* Hx
142
{{BLANK}} reduce/eliminate S/Sx of schizophrenia in about 70% of patients
Antipsychotics
143
{{BLANK}} is the most effective anti-schizophrenic but has an increased risk of agranulocytosis
Clozapine
144
{{BLANK}} is a 2nd gen antipsychotic w/ an increased risk of gynecomastia
Risperidone
145
How do you initiate a LAI antipsychotic?
* Give inj.
* Give PO med x 2-4 wks
* Gives time for LAI to get into system
146
What is the Tx for catatonia?
| Catatonia: mutism, posturing, grimacing; mind going to fast to talk
* BZD or ECT
* Slows mind down enough for them to display activity (e.g., talk)
