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Psych Flashcards

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1
Q

Projection vs displacement

A

Projection: Unacceptable impulse is attributed to someone else (Man who cheated thinks wife is cheating on him). Displacement: Unacceptable feelings are transferred to some neutral person or object (yell at kid because you were yelled at)

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2
Q

Reaction formation vs sublimation

A

Reaction formation: Warded off feeling is replaced by emphasis on its opposite (man with libidinous thoughts enters a monastery). Sublimation: Mature defense –> replace unacceptable wish with course of action similar to the wish but is acceptable (aggression –> sports).

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3
Q

Altruism, according to step 1

A

Guilty feelings alleviated by generosity toward others

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4
Q

Fixation vs regression

A

Fixation: partially remaining at a more childish level of development (ex fixating on sports games). Regression: going back to earlier state of development (happens with stressed kids)

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5
Q

Repression vs suppression

A

Repression is involuntarily withholding idea or feeling from consciousness, suppression is VOLUNTARILY doing that.

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6
Q

Symptoms start age 1-4 –> regression, loss of verbal abilities, MR, ataxia, and stereotyped hand-wringing. Only in girls.

A

Rett’s disorder. X linked, boys die.

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7
Q

3-4 year olds. Marked regression in multiple areas of functioning after at least 2 years of normal development. More common in boys.

A

Childhood disintegrative disorder.

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8
Q

NT changes with anxiety

A

Increased NE, decreased GABA and serotonin

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9
Q

NT changes with depression

A

Decreased NE, GABA and serotonin

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10
Q

NT changes with Huntingtons

A

Decreased GABA and ACh, increased DA

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11
Q

NT changes with Parkinsons

A

Decreased DA, increased serotonin, increased ACh

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12
Q

Which part of mental status exam: Name, place, date

A

Orientation. Lost time first, then place, then person.

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13
Q

Which part of mental status exam: Follow multistep commands

A

Comprehension

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14
Q

Which part of mental status exam: Recite months of year backwards

A

Concentration

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15
Q

Which part of mental status exam: Recall 3 unrelated words after 5 minutes

A

Short term memory

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16
Q

Which part of mental status exam: Details of significant life events

A

Long term memory

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17
Q

Which part of mental status exam: Write a sensible sentence with a noun and verb

A

Language

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18
Q

Which part of mental status exam: Draw a clockface

A

Visuospatial

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19
Q

Schizophrenia vs schizophreniform

A

> 6 months

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20
Q

Schizoaffective

A

Schizo + mood (bipolar or depressive).

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21
Q

Brief psychotic disorder

A

<1 month

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22
Q

Dissociative identity vs depersonalization vs dissociative fugue

A

ID: multiple personality. Deperson: detachment. Fugue: can’t recall past

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23
Q

Cyclothymic disorder

A

Like the dysthymia of bipolar. Lasts at least 2 years and cycles between dysthymia and hypomania

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24
Q

Acute stress disorder cutoff

A

1 month, then PTSD

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25
GAD vs adjustment disorder
6 months
26
Somatization disorder
MULTIPLE ORGAN SYSTEMS!
27
Schizoid vs schizotypal
Schizoid = aloof and doesn't want relationships, schizotypal is eccentric. Both cluster A
28
Substance dependence vs abuse
Abuse is using it even though it is causing clinically significant impairment or distress
29
Sensitive indicator of alcohol use?
GGT
30
What NT plays a role in morphine tolerance?
Glutamate. Can give ketamine for prevention
31
What do you NOT get tolerant to with opioids
Miosis and constipation
32
Flumezanil
Benzo antagonist
33
Pentazocine
Partial mu agonist activity and weak antagonist activity, causes withdrawal symptoms of opiates
34
Varenicline
Nicotine partial agonist at AChR so prevents full effects of smoking
35
Buprenorphine
Partial mu agonist, long acting with fewer withdrawal symptoms than methadone when given with naloxone.
36
What is the cause of most OD related deaths?
Opioid prescription painkillers. More than heroin OD and cocaine combined
37
Delirium tremens. What is it? When does it peak? Progression? Treatment?
Life-threatening alcohol withdrawal syndrome that peaks 2-5 days after last drink. Starts with ANS hyperactivity, then psychotic symptoms and confusion. Treatment is benzos
38
First symptom of severe alcohol withdrawal. When does it occur?
Starts with tremulousness (shakes) 5-10 hours after last drink!
39
Neuroleptic antipsychotics: high potency
Try flu, Hal. Haloperidol, trifluoperazine, fluphenazine. Extrapyramidal side effects. Block D2 to increase cAMP.
40
Neuroleptic antipsychotics: low potency. What are they and important side effects.
Chlorpromazine, thioridazine. See dirty side effects (anticholinergic, antihistamine, alpha 1 blockade). EYE--> chlorpromazine --> corneal deposits, thioridazine --> reTinal deposits.
41
Evolution of extrapyramidal side effects of neuroleptics and treatments for each state
4 hr: acute dystonia (muscle spasm, stiffness, oculogyric crisis (sustained elevation of eyes in upward position) --> treat with antihistamines or anticholinergics 4 day: akathisia (restlessness) --> treat with beta blocker 4 weeks: bradykinesia (parkinsonism) --> treat with anticholinergics or amantidine 4 months: tardive dyskinesia
42
Dantrolene
Treats neuroleptic malignant syndrome and malignant hyperthermia
43
Neuroleptic malignant syndrome
FEVER: Fever, Encephalopathy, Vitals unstable, Elevated enzymes, Rigidity of muscles
44
Respiridone side effects
Risprolactone --> extrapyramidal. Despair-a-done--> makes you fat. Weight gain, diabetes, extrapyramidal
45
Olanzapine: side effects
Metabolanzapine. Metabolic syndrome, weight gain, diabetes
46
Quetiapine: side effects
Quiet (no weight gain or diabetes) BUT cataracts. Quetaracts
47
Ariprazole: side effects
Partial agonist at D2 --> more extrapyramidal than any other atypical. Aripyramidazole
48
Clozapine: side effects
``` Clawesomepine: most effective Closet awful --> all the bad SE's of atypicals and more -Weight gain and diabetes -Decreased seizure threshold -Agranulocytosis -Orthostatic hypotension (alpha blocker) ```
49
Ziprasidone: side effects
Skinny like zebra: no weight gain. Zip --> may need to zap heart (long QT) Pra --> extrapyramidal
50
How do you treat acute mania?
Mood stabilizer (lithium, valproate, or carbamazepine) plus atypical antipsychotic (olanzapine)
51
Lithium AE's
LMNOP. Lithium --> Movement, Nephrogenic diabetes insipidus,hypOthyroidism (weight gain, dry skin, hair loss, constipation, bradycardia), Pregnancy problems (cardiac malformations, Ebstein's anomaly). Lithium is reabsorbed at proximal tubule following Na+. so anything that increases Na+ reabsorption increases lithium toxicity. Thiazides, ACEis, NSAIDs (ACEi's and NSAIDs not known why).
52
MOA of buspirone. Use?
Stimulates 5-HT1A receptors. First line for GAD. Doesn't do panic.
53
Serotonin syndrome: What does it look like, common drugs that cause it, and treatment?
Symptoms: Excitation: Hyperreflexia, clonus, rigidity ANS: Hyperthermia, tachy, tremor, sweat Mental status: Agitation, confusion Treat with cyproheptadine (5HT2 antagonist). Common drug interactions: Antidepressants: SSRIs, SNRIs, MAOis, tricyclics Analgesics: tramadol Anti-emetics: Ondansetron (5-HT3 antagonist) Antibiotics: Linezolid Neuropsychiatric: Triptans
54
Duloxetine
SNRI. Depression and indicated for diabetic peripheral neuropathy.
55
MOA of tricyclics
Block reuptake of NE and serotonine. But also blocks alpha 1 and muscarinic.
56
Tricyclic toxicity treatment
NaHCO3 for CV toxicity --> inhibition of Na fast channels.
57
MAOi uses
Atypical depression: mood reactivity, leaden fatigue, rejection sensitivity, reversed vegetative (increased sleep and appetite).
58
Toxicity of bupropion
Stimulant side effects, headache, seizure in bulemic patients. No sexual side effects
59
Mirtazapine
Alpha 2 antagonist (increases release of NE and serotonin) and 5-HT2 and 5-HT3 antagonist. Atypical antidepressant. Causes sedation, weight gain, dry mouth.
60
Maprotiline
Blocks NE reuptake. Atypical antidepressant. Toxicity: sedation, orthostatic hypotension
61
Trazadone
Inhibits serotonin reuptake. Used for insomnia, high doses needed for antidepressant effects. Causes priapism --> trazobone.

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