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USMLE MS > psych > Flashcards

psych Flashcards

1
Q

type of conditioning that deals with involuntary response, and linking it to a previously unrelated stimulus

A

classical conditioning

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2
Q

type of learning where an action produces a reward or punishment

A

operant conditioning

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3
Q

type of learning where target behavior (response) is followed by removal of aversive stimulus (if you do this I will stop hurting you)

A

negative reinforcement

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4
Q

type of learning where repeated application of aversive stimulus stops unwanted behavior (if you do this I will hurt you)

A

punishment

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5
Q

discontinuation of positive or negative reinforcement eliminates behavior

A

extinction

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6
Q

patient projects feelings about other people onto physician (psychiatrist is seen as a parent)

A

transference

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7
Q

doctor projects feelings about other important people into patient (patient reminds physician of younger sibling)

A

countertransference

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8
Q

ego defense example: tantrum (expressing unacceptable feelings through action)

A

acting out

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9
Q

ego defense example: dissociative identity, multiple personality disorder (temproary drastic change in personality, memory, motor behavior to avoid emotional stress)

A

dissociation

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10
Q

ego defense example:avoiding awareness of a painful reality

A

denial

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11
Q

ego defense example: mom yells at child because husband yelled at her. (transferring avoided ideas to a neutral person/object)

A

displacement

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12
Q

ego defense example: men focusing a lot of attention on sports (partially remaining at a more childish level of development)

A

fixation

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13
Q

ego defense example: abused child identifies with an abuser (modeling behavior after another more powerful person, not always admired)

A

identification

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14
Q

ego defense example: describing something terrible with no emotion (separating feelings from ideas/events)

A

isolation of affect

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15
Q

ego defense example: man who wants another woman thinks his wife is cheating on him (attributing unacceptable internal impulse to external source)

A

projection

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16
Q

ego defense example: after not getting a good grade, saying you didn’t really care about your grades anyway (proclaiming a logical reason for actions actually done for another reason, avoiding self blame)

A

rationalization

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17
Q

ego defense example: patient with libidinous thoughts enters monastery (replacing a warded off idea or feeling (unconscious) by doing the opposite)

A

reaction formation

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18
Q

ego defense example: toilet trained kids bedwetting after a new stress in their lives (going back to early modes of dealing with the world)

A

regression

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19
Q

ego defense example:nor remembering a traumatic experience. (involutarily withholding a feeling or idea)

A

repression

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20
Q

ego defense example: pt saying all nurses are cold, all doctors are warm (believing people are all good or all bad at different times, intolerance of ambiguity.)

A

splitting (often seen in borderline personality disorder)

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21
Q

what are the four mature defenses

A

altruism, humor, sublimation, suppression (adults wear a SASH)

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22
Q

displacement vs projection

A

transferring avoided feelings to neutral person or object, vs. attributing an internal impulse to external source (he hurt me so I will hurt you vs. I want to hurt you and i will believe it is because you are hurting me)

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23
Q

fixation vs regression

A

staying at a childish level, vs going back to a previous way of dealing with the world after having progressed

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24
Q

reaction formation vs sublimation

A

replacing warded off idea with the opposite vs replacing it with something similar which does not conflict with one’s morals

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25
Q

repression vs suppression

A

involuntarily withholding a feeling from awareness vs. intentionally withholding a feeling from awareness

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26
Q

ego defense example: mafia boss makes large charity donation (alleviating guilty feelings with unsolicited generosity to others)

A

altruism

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27
Q

ego defense example: nervous medical student jokes about boards (appreciating amusing nature of anxiety provoking, or adverse event)

A

humor

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28
Q

ego defense example:teenager’s aggression to father turned into doing well in sports (replacing unacceptable wish into something that is similar but still within ones values)

A

sublimation

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29
Q

ego defense example: choosing not to panic about the board exams. (intentional withholding of idea or feeling from awareness)

A

supression

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30
Q

hyperactivity/inattention in multiple settings, onset under 12 y/o. Dz and does it persist to adulthood, associated with what physical brain changes

A

ADHD. persists in 50% adults, decreased frontal lobe volume/metabolism

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31
Q

repetitive and pervasive behavior violating others basic rights. Dz and what is the diagnosis after age 18 often

A

conduct disorder, antisocial personality disorder

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32
Q

pattern of hostile defiant behavior to authority figures but not serious violates of social norms

A

oppositional defiant disorder

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33
Q

sudden rapid recurrent stereotyped motor and vocal tics. onset before 18. Dz, and how long must it last before making a diagnosis

A

tourettes, must last >1 year.

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34
Q

overwhelming fear of separation from home or attachment figure. factitious physical complains to avoid going to school. onset 7-9 yrs. Dz and how to treat

A

Separation anxiety disorder, SSRI

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35
Q

X linked disorder seen in girls. (males die). regression, intellectual disability, ataxia, hand wringing, loss of verbal abilities

A

Rett disorder

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36
Q

for orientation, what is order of loss of place, time, person

A

time lost first, then place, then person.

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37
Q

NT changes in Alzheimers

A

ACh up

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38
Q

NT changes in anxiety

A

NE up, GABA and 5HT down

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39
Q

NT changes in depression

A

D, NE, 5HT down

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40
Q

NT changes in huntingtons

A

GABA, ACh down, D up

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41
Q

NT changes in Parkinsons

A

D down, ACh, 5HT up

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42
Q

NT changes in Schizophrenia

A

D up

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43
Q

what kind of amnesia do you get in wernike korsakoff?

A

anterograde amnesia

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44
Q

Schizophrenia, how long until you can made the dianosis, what is the diagnostic criteria

A

6 months. must have at least 2 of the symptoms (I think at least one has to be positive)

note DECREASED DENDRITIC BRANCHING

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45
Q

positive symptoms of schizophrenia

A

delusion, hallucination, disordered speech, disorganized or catatonic behavio

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46
Q

negative sx of schizophrenia

A

flat affect social withdrawal, lack of motivation

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47
Q

are schizophrenic patients at increased risk for suicide?

A

YES

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48
Q

schizophrenia: who presents earlier, males or females, how about overall prevalence

A

males present earlier but overall prevalence is equal

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49
Q

schizophrenia like symptoms that last <1 month. what usually causes it

A

brief psychotic disorder, usually stress related

50
Q

schizophrenia like sx that last 1 mo to 6 mo

A

schizophreniform disorder

51
Q

at last 2 wks of stable mood with pschyotic sx, and a major depressive, manic, or mixed episode. (can either be the bipolar or depressive subtype)

A

schizoaffective disorder

52
Q

presence of 2 or more distinct identities. more common in what sex, associated with history of …

A

dissociative identity disorder. women, sexual abuse PTSD depression, substance abuse, somatoform conditions

53
Q

persistant feeling s of detachment or estrangement from ones own body, thoughts, actions. or from ones environment

A

depersonalization or derealization if environment

54
Q

what are the sx of manic episode, how to diagnose

A

at least 1 wk, either hospitalized or have 3 of DIGFAST.
distractability, irresponsibility, grandiosity, flight of ideas, Agitation/increased goal directed Activity, Sleep decreased need, Talkative/pressured speech

55
Q

what is a hypomanic episode

A

like mainic, but doesn’t cause marked impairment in social or occupational functioning, or hospitalization

56
Q

Bipolar 1 vs Bipolar 2

A

bipolar 1 is at least 1 manic episode with or without hypomanic or depressive episode.
Bipolar 2 defined by presence of a hypomanic and a depressive episode.

57
Q

what is cyclothymic disorder

A

dysthymia and hypomania, milder form of bipolar, lasting at least 2 years

58
Q

major depression diagnosis

A

episodes last 6-12 months. at least of 5 of SIGECAPS, for 2 or more wks. must include depressed mood/anhedonia. occur more frequently as dz progressess.

sleep disturbance, loss of interest, guilt, energy loss, concentation issues, apetite up or down. psychomotor retardation,suicidal ideations

59
Q

what is dysthymia, or persisent depressive disorder

A

milder depression, lasting at least 2 yrs

60
Q

what is seasonal affective disorder

A

sx associated with winter season, improves with full spectrum bright light

61
Q

sleep changes in depression

A

decreased slow wave, REM latency. increased REM early, increased total REM. Waking up early in the morning (important screen), repeated nighttime awakenings

62
Q

how is atypical depression different from classical? is it more or less common

A

weight gain, increased apatite leaden paralysis, sensitive to interpersonal rejection, mood reactivity (can briefly experience improved mood in response to positive events) it is the most common subtype of depression

63
Q

maternal blues vs postpartum depression vs postpartum psychosis

A

all onset within 4 wks.
depressed mood, tearful, fatigue, resolves within 10 days
depressed affect, anxiety, poor concentration that lasts 3 wks to a year or more!
delusion, hallucination, confusion, homicidal or suicidal ideations possible, lasts days to 6 wks.

64
Q

pathologic grief

A

excessive grief that lasts >6-12 mo.

65
Q

What can you use electroconvulsive tx for?

A

Major depression in pregnant women, or refractory to other treatment. or if immediate response needed like acute suicidality.

66
Q

risks for suicide completion

A

SAD PERSONS. Sex (male), Age (teenager or elderly), Depression, Previous attempt, Ethanol/drug use, Rational thinking, Sickness (medical with 3 or more prescriptions), Organized plan, No spouse, Social support lacking.

67
Q

Diagnosis of panic disorder

A

a panic attack with at least one month of one of the following: concern about new attacks, worrying about consequences of attack, behavioral change from attack

68
Q

What the sx in panic disorder, does genetics play a role?

A 
PANICS. strong enetic component
Paresthesia, palpitation
abdominal distress
nausea
intense fear or dying or losing control, LIght headedness
chest pain, chills, chocking, 
sweating shaking SOB
69
Q

exaggerated fear of embarrassment in social situations, and how to treat

A

social anxiety disorder, SSRI

70
Q

fear of open or enclosed places, using public transportation, being in lines, crowds, leaving home alone

A

agoraphobia

71
Q

uncontrollable anxiety for at least 6 months, unrelated to specific person, situation, or event. and sleep issues, GI issues, fatigue. and how to treat

A

generalized anxiety disorder, SSRI, SNRI, buspirone, CBT

72
Q

emotional symptoms causing functional impairment after an identifiable pychosocial stress (divorce, illness). How long does it have to last?

A

adjustment disorder, lasting <6 mo.

73
Q

recurrent intrusive thoughts/feelings/sensation relieved by repetitive actions. often not in line with ones own beliefs or attitudes. what is it, how to treat, what is it associated with?

A

OCD, SSRI or clomipramine, associated with tourette

74
Q

preoccupation with minor or imagined defect in appearance, leading to significant emotional distress, impaired fxn, often seek cosmetic surgery

A

body dysmorphic disorder

75
Q

PTSD vs acute stress disorder

A

PTSD (reexperiences with nightmares, flashbacks, fear, avoidance of associated stimuli, increased arousal) disturbance lasts >1 month. Tx with SSRI, psychotherapy

Acute stress lasts 3 days to 1 month

76
Q

conscious attempt to deceive with faked sx, for external gain (skipping work, getting compensation)

A

malingering

77
Q

conscious attempt to deceive with faked sx, for primary internal gain, psychological gain.

A

factitious

78
Q

unconscious faked sx. variety of complaints from one organ system for months to years, excessive thoughts about sx. may co occur with a medical illness

A

somatic symptom disorder

79
Q

sudden loss of sensory or motor function, (paralysis, blindness, mutism) following acute stressor. sometimes pt is indifferent towards symptoms (la belle indifference)

A

conversion disorder

80
Q

general term for inflexible maladaptive pattern of behavior that causes subjective distress and impaired functioning. ppl usually are not aware of the problem

A

personality disorders

81
Q

Cluster A personality disorders

A

Weird. cant make meaningful social relationships. no psychosis. genetic association with schizophrenia. Accusatory, Aloof, Awkward

82
Q

distrust and suspicious, projection as a major defense mechansim

A

paranoid

83
Q

voluntary social withdrawal, limited emotional expression, content with social isolation

A

schizoid (vs avoidant)

84
Q

Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness.

A

schizotypal

85
Q

Cluster B personality disorders

A

Wild. dramatic, emotional, genetic association to mood disorders and substance abuse

86
Q

Disregard for and violation of rights of others. criminal, impulsive, (males>females). History of conduct disorder!

A

antisocial

87
Q

unstable mood and interpersonal relationships. impulsive, self mulitation, boredom, emptiness. females>males. splitting is a major defense mechanism

A

borderline

88
Q

excessive emotionality, excitability, attention seeking, sexually proactive, overly concerned with appearance

A

histrionic

89
Q

grandiosity, sense of entitlement, lacks emapthy. often demands to be best, and reacts to criticism with rage, needs excessive admiration

A

narcissistic

90
Q

cluster C personality disorders

A

Worried. anxious, fearful, genetic association with anxiety disorders

91
Q

hypersenstive to rejection ,socially inhibited, timid, feelings of inadequacy, desires relationships with others!

A

avoidant (vs schizoid where they are content with isolation)

92
Q

preoccupation with order, perfectionism, egosyntonic, but behavior is consistent with ones own beliefs and attitudes

A

obsessive compulsive personality disorder (vs OCD)

93
Q

put the schizo disorders in order from least to greatest impact on functionality, or worse symptoms

A

schizoid < schizotypal (some odd thinking) < schizophrenic (even more odd thinking) < schizoaffective (schizophrenic psychotic sx and bipolar or depression)

94
Q

anorexia: some complications

A

metatarsal stress fractures, lanugo (fine body hair), anmeia, electrolyte imbalances. osteoporosis due to decreased estrogen over time.

95
Q

bulemia: some complications

A

parotits, enamel erosion, electroyte disturbances, alkalosis, doral hand calluses (russel sign, from inducing vomiting)

96
Q

what is transsexualism vs transvestism

A

desire to live as opposite sex vs cross dressing.

97
Q

sleep terrors vs nightmares. what stage of sleep? do you remember them?

A

non REM vs REM. you don’t remember sleep terrors, do remember nightmares. you wake up screaming in middle of night

98
Q

hypnagogic and hypnapompic hallucinations. feeling rested after naps, cataplexy (sudden loss of all muscle tone). associated with decreased production of what in the hypothalamus? how to treat

A

narcolepsy. decreased orexin production in lateral hypothalamus. strong genetic component, tx with day time stimulants like amphetamines, modafinil, and with nighttime sodium oxybate (GHB)

99
Q

amphetamine intoxication

A

euphoria, paranoia, pupillary dialation, HTN. cardiac arrest seizure

100
Q

amphetamine withdrawal

A

anhedonia, increased appetite, hypersomnolence, existential crisis

101
Q

cocaine intox and how to treat

A

impared judgement, pupillary dialtion. hallucinations (also tactile). paranoia, angina, sudden cardiac death. tx with benzos. hyperglycemia due to adrenergic stimulation

102
Q

cocaine withdrawal

A

hypersomnolence, malaise, severe psychological craving. depression, suicidality

103
Q

PCP intoxication and tx

A

billigerance, impulsiveness, fever, analgesia, vertical and horizonal nystagmus, homocidality, psychosis, delirium, seizures. death from trauma due to violence. Tx: benzos, rapid acting antipsychotics

104
Q

PCP withdrawal

A

depression, anxiety, irritability, restlessness, anergia, disturbance of thought and sleep

105
Q

LSD intox

A

perceptual distortion visual auditory. depersonalization, anxiety, paranoia, psychosis, possible flashbacks

106
Q

heroin addiction increases risk of :

A

hepatitis, abcesses, OD, hemorrhoids, AIDS, right sided endocarditis.

107
Q

what do you use naltrexone for?

A

a long acting opioid antagonist for relapse prevention once detoxified

108
Q

treatment for ADHD

A

methylphenidate

109
Q

treatment for alcohol withdrawal

A

benzodiazepines

110
Q

treatment for Anxiety

A

SSRI, SNRI, buspirone (1st line)

111
Q

treatment for bipolar disorder

A

mood stabilizers (lithium, valproate carbamazepine), atypical antipsychotics

112
Q

treatment for bulimia

A

SSRI

113
Q

treatment for depression

A

SSRI, SNRI, TCA, bupriopion, mirtazapine (esp if insomnia)

114
Q

treatment for OCD

A

SSRI, clomipramine

115
Q

treatment for panic disorder

A

SSRI, venlafaxine, benzos

116
Q

treatment for PTSD

A

SSRI

117
Q

treatment for schizophrenia

A

antipsychotics

118
Q

treatment for social phobia

A

SSRI, Beta blockers

119
Q

treatment for tourette syndrome

A

antipsychotics (haloperidol, risperidone)

120
Q

delusional disorder (vs sphizophreniform, and shizotypal)

A

1 or more delusions for at least 1 month. No other psychotic sx (unlike schizophreniform). Behavior is not obviously bizarre or odd. in paranoid you don’t have clear delusions, just suspiciousness or odd beliefs.

121
Q

sx of cannibis use

A

conjunctival injection, tachycardia, increased appetitie, dry mouth. inappropriate laughter

USMLE MS (4 decks)

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