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USMLE Step 1-2015 > psych > Flashcards

Flashcards in psych Deck (74):
1

Autisim is associated with what diseases

mental retardation (intellectual disability), tuberous sclerosis, fragile x

2

Alzheimer disease NT changes

decrease ACh increase glutamate

3

Anxiety NT changes

increase NE, decrease GABA, decrease 5-HT

4

depression NT changes

decrease NE, decrease 5-HT, decrease dopamine

5

huntington disease NT changes

decrease GABA, decrease Ach, increase dopamine

6

parkinson disease NT changes

decrease dopamine increase Ach

7

schizophrenia NT changes

increase dopamine

8

Order of loss in terms of orientation

1st: time 2nd: place 3rd: person

9

What is dissociative fugue?

aburupt ravel or wandering during a period of dissociative amnesia, associated with traumatic circumstances

10

In elderly ppl what can present like dementia and what should you screen for?

Depression and hypothyroidism (pseudodementia)-->measure TSH, b12 levels

11

Time period schizophrenia

>6 months

12

time period brief psychotic disorder

13

time period schizophreniform disorder

lasting 1-6 months

14

time period schizoaffective disorder

lasting >2 weeks (schizophrenia with episodic superimposed major depression or mania (or both))

15

time period delusional disorder

>1 month

16

time period of manic episode

lasts at least 1 week

17

time period for hypomanic episode

lasts at least 4 consecutive days

18

Difference btwn hypomanic and manic

manic has severe mood disturbance with persistently elevated, expansive, or irritable mood while mood disturbance not severe enough in hypomanic

19

Treatment of bipolar and what can make it worse?

Treatment is mood stabilizer (lithium, carbamazepine, valproic acid), atypical antipsychotics. Antidepressants can percipitate mania

20

how long does cyclothymic disorder last for diagnosis?

at least 2 years

21

What does electroconvulsive therapy do?

produces grand mal seizure in an anesthetized patient

22

Access of patients to what item increases risk of suicide?

firearms

23

Infant deprivation effects (4 W's)

Wanting (infant withdrawn/unresponsive)
Wary (lack of basic trust)
Weak (failure to thrive)
Wordless (lack of socialization skills)

24

3 parts to psychosis

Delusions, Hallucinations (usually auditory), Disorganized speech

25

Often occur as an aura of psychomotor epilepsy and in brain tumors

Olfactory

26

Common in alcohol withdrawal and also seein in cocain abusers as bugs crawling on one's skin

Tactile

27

Occurs while goign to sleep sometimes seen in narcolepsy hallucination

Hypnogogic

28

Occurs while waking from sleep sometimes seen in narcolepsy

Hypnopompic

29

Hyperactive pathway in schizophrenia

mesolibic-mesocortical pathway

30

Persistent feelings of detachment or estrangement from one's own body, thosughts, perceptions, and actions (__) or ones environment (_____)

Depersonalization

Derealization

31

Characteristics of MANIC episode

Distractibility, Irresponsibility (seeks pleasure w/o regard to consequences), Grandiosity (inflated self esteem), Flight of Ideas, Increase in goal directed Activity/psychomotor Agitation, decrease need for Sleep, Talkativeness or pressured speech

32

How long does major depressive episodes last?

6-12 months

33

Criteria for depression

SIG E CAPS
1) Sleep disturbance
2) Loss of interest
3) Guilt or feelings of worthlessness
4) Energy loss and fatigue
5) Concentration problems
6) Appetite/weight changes (usually decreased)
7) Psychomotor retardation or agitation
8) Suicidal ideations

34

Main difference btwn atypical depression and major depression

Improved mood with positive events

35

Depression vs anxiety sleep stages?

Think of norepinephrine (decreased in depression so incrreased REM sleep; increased in anxiety so decreased rem sleep)

36

Length of pathologic grief

> 6 months

37

Risk factors for suicide

Sex (male)
Age (teenager or elderly)
Depression
Previous attempt
Ethanol or drug use
loss or Rational thinking
Sickness (medical illness, 3 or more prescription)
Organized plan
No spouse
Social support lacking

38

What is not considered pathologic grief

Hallucinations (eg hearing voice of deceased love one) in the absence of other psychotic symptoms are not pathologic

39

Panic disorder criteria

PANICS
Palpitations
Paresthesias
Abdominal distress
Nausea
Intense fear of dying or losing
lIght headedness
Chest pain/Chills/Choking/disConnectedness
Sweating
Shaking
Shortness of breath

40

Diagnosis of panic disorder

Attack + 1 month (or more ) of following
-Persistent concern of additional attacks
-Worrying about consequences of attack
-Behavioral change related to attacks

41

Length of generalized anxiety disorder vs adjustment disorder

> 6 months,

42

PTSD vs Acute stress disorder time period

> 1month, 3 days to one month

43

enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and onself

Personality trait

44

Inflexible, maladaptive and rigidly pervasive behavior causing distress + impaired functioning

Personality disorder

45

Pervasive distrust and suspiciousness; projection is major defense mechanism

Paranoid

46

Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

Schizotypal

47

Unstable mood and interpersonal relationships, impulsivity, self-mutiliation, boredom, snese of emptiness; splitting major defencse

Borderline

48

Excessive emotionality and excitability, attention seeking, sexually provocative, overlly concerned with appearance

Historinic

49

Submissive and clingy, excessive need to be taken care of, low self-confidence

dependent

50

Preoccupation with order, perfectionism, and control and behavior is consistent with ones own beliefs or values

OCPD

51

Transsexualism vs Transvestism?

Transsexualism-desire to live as opposite sex through surgery and hormone therapy
Tresvestism-paraphilia, not gender dysphoria. Wearig clothes of opposite sex

52

Stages of change in overcoming substance addiction

1) Precontemplation
2) contemplation
3) preparation/determination
4) action/willpower
5) maintenance
6) relapse

53

1st symptom of alcohol withdrawal

tremouslousness (5-10 hr after) w/ gi distress, anxiety, agitation, autonomic disturbance (increase HR, respiration, body temp)

54

2nd major symptom of alcohol withdrawal

DT (48-72 hours after)

55

Treatment of opioid intoxication

naloxone, naltrexone

56

Treatment of opioid withdrawal

methadone, buprenorphine

57

How does opioid withdrawal present?

"Flu-like symptoms"--> sweating, dilated pupils, piloerection ("cold turkey"), fever, rhinorrhea, yawning, nausea, stoach cramps, diarrhea

58

ADHD treatment

Stimulants (e.g. methylphenidate)

59

Alcohol withdrawal treatment

Long acting benzodiazepines (eg chlordiazepoxide loarazepam, diazepam)

60

Bipolar disorder treatment

Lithium, valproate (mood stabilitzing), atypical antipsychotics

61

Bulimia treatment

SSRI

62

Depression treatment

SSRI

63

GAD treatment

SNRI SSRI

64

OCD treatment

SSRI, clomipramine

65

PAnic disorder treatment

SSRI, venlafaxine, benzodiazepine

66

PTSD treatment

SSRI, venlafaxine

67

Schizophrnia tratment

Atypical antipsychotics

68

Social phobia treatment

SSRI, B blocker

69

Tourette syndrome treatmen

Antipsychotics (e.g. fluphenazine, pimozide, tetrabenazine, clonidine)

70

PCP acts at what receptor and what does it do?

Acts as a NMDA receptor antagonist leading to excess release of excitatory neurotransmitters

71

LSD acts at what receptor and what does it do?

Acts on the 5-HT serotonin receptor

72

Heroin addiction treatment?

Methadone-long term oral opiate with good oral bioavailability for heroin detoxification or long-term maintenance

Naloxone+buprenorphine-antagonist +partal agonist. Naloxone not orally bioavailable, withdrawal if injected

Naltrexone-long-acting opioid antagonist used for relapse prevention once detoxified

73

Untreated Wernicke encephalopathy can lead to what?

Irreversible memory loss in korsakoff syndrome

74

Triad of wernicke encephalopathy

Ataxia, confusion NOT confabulations , ophthalmoplegia