Psychiatry

Question 0

Countertransference

Answer 0

Physician projecting feelings onto the patient

Question 1

Transference

Answer 1

patient projecting feelings onto physician

Question 2

Ego Defenses

Answer 2

• tantrums
• reaction formation
• repression
• sublimation (redirecting aggression)

Question 3

ADHD

Answer 3

Onset <7yrs

• limited attention
• poor impulse control
• hyperactivity, emotional lability
• normal intelligence

Question 4

Conduct Disorder

Answer 4

repetitive and pervasive behavior violating social norms
onset 18 then Antisocial Personality Disorder)
-physical aggression, theft…

Question 5

Tourette’s Syndrome

Answer 5

Onset 1yr

-may be associated with OCD

Question 6

Separation Anxiety Disorder

Answer 6

Commonly onset at 7-8yrs
Overwhelming fear of separation from home or figure
-poss lead to factitious complaints

Question 7

Korsakoff’s Amnesia

Answer 7

caused by thiamine deficiency (Vit B1): alcoholism

• destruction of mammary bodies
• usually anterograde amnesia

Question 8

Anterograde amnesia

Answer 8

inability to remember after CNS insult

Question 9

retrograde amnesia

Answer 9

inability to remember before the CNS injury

Question 10

Dissociative Amnesia

Answer 10

Inability to remember personal information

-person picks up and moves to a new place with a new life

Question 11

Delerium

Answer 11

Usually 2* to other illness
-waxing/waning levels of consciousness (acute)
-rapid decrease in attention/arousal
**often VISUAL hallucinations (schizo –> AUDITORY)
disturbance in sleep-wake cycle
cognitive dysfunction

Question 12

Dementia

Answer 12

Gradual decline in cognition without affecting consiousness

• memory loss, aphasia, apraxia, agnosia, behavioral changes, impaired judgement
• normal EEG
• Alzheimers, cerebral infarcts, HIV, Pick disease, CJD, substance abuse

Question 13

Psychotic disorder

Answer 13

distorted perception of reality (psychosis)
- delusions: fixed false beliefs
- hallucinations: sensory input w/o external stimuli
- disorganized thinking
(also illusions: misinterpreting external stimuli)
(loose associations: unrelated ideas are connected)

Question 14

Schizophrenia

Answer 14

Chronic disorder with periods of psychosis, disturbed thoughts/behavior, and decline in functioning that lasts >6mos
Needs 2:
-delusions
-hallucinations (usually AUDITORY)
-disorganized speech/loose associations
-disorganized/catatonic behavior
Also:
-flat affect
-social withdrawal
-lack of speech/thought

Question 15

Brief psychotic disorder

Answer 15

sx of schizophrenia lasting <1mo

-usually stress related

Question 16

Schizophreniform Disorder

Answer 16

Sx of schizophrenia lasting 1-6mo

Question 17

Schizoaffective Disorder

Answer 17

> 2 weeks: psychotic sx, stabile mood, with major depressive or manic episode (bipolar and depressive subtypes)

Question 18

Delusional Disorder

Answer 18

> 1mo: fixed, persistent, non-bizarre belief system

normal functioning

Question 19

Shared Psychotic Disorder

Answer 19

Development of delusions in a person close to the person with delusional disorder

Question 20

Risk Factors for Suicide

Answer 20

-male
-teen/elderly
-depression
-past suicide attempt
-alcohol/drug abuse
-loss of rational thinking
-polypharmacy
-organized plan
-no social support
Women try more often, Men more successful

Question 21

Cluster A personality disorder

Answer 21

"wierd"
Odd or eccentric inability to develop meaningful social relationships. No psychosis.
-Paranoid
-Schizoid
-Schizotypal

Question 22

Paranoid Personality Disorder

Answer 22

Cluster A:
pervasive distrust and suspiciousness
major defense: projection

Question 23

Schizoid Personality Disorder

Answer 23

Cluster A:
Voluntary social withdrawal
limited emotional expression
content with social isolation (not avoidant)

Question 24

Schizotypal Personality Disorder

Answer 24

Cluster A: | Eccentric appearance, odd beliefs, or magical thinking, interpersonal awkwardness

Question 25

Cluster B Personality Disorders

Answer 25

``` "Wild" dramatic, emotional, erratic genetic association with mood disorders/substance abuse -antisocial -borderline -historionic -narcissistic ```

Question 26

Antisocial Personality Disorder

Answer 26

``` Cluster B: Disregard for and violation of rights of others Criminality M>F Conduct disorder if <18yrs ```

Question 27

Borderline Personality Disorder

Answer 27

Cluster B: Unstable mood and interpersonal relationships, impulsiveness, self-mutilation, boredom, sense of emptiness F>M major defense: splitting

Question 28

Histrionic Personality Disorder

Answer 28

Cluster B: Excessive emotionality and excitability Attention seeking, sexually provocative, overly concerned with appearance

Question 29

Narcissistic Personality Disorder

Answer 29

Cluster B: Grandiosity, sense of entitlement lacks empathy, requires excessive admiration often demands the "best" and reacts poorly to criticism --> rage

Question 30

Cluster C Personality Disorders

Answer 30

``` "Worried" Anxious or fearful Genetic association with anxiety disorders -Avoidant -Obsessive-Compulsive -Dependent ```

Question 31

Avoidant Personality Disorder

Answer 31

Cluster C: Hypersensitive to rejection, socially inhibited, timid, feelings of inadequacy desires relationships with others (unlike Schizoid PD)

Question 32

Obsessive Compulsive Personality Disorder

Answer 32

Cluster C: Preoccupation with order, perfectionism, and control ego syntonic: behavior is consistent with one's own beliefs and attitudes (vs. OCD)

Question 33

Dependent Personality Disorder

Answer 33

Cluster C: Submissive and clinging, excessive need to be taken care of Low self confidence

Question 34

Dementia with Lewy Bodies

Answer 34

- prominent visual hallucination and parkinsonian features early - eosinophilic inclusion bodies in cerebral cortex and brainstem

Question 35

Frontotemporal Dementia

Answer 35

- Tau inclusion bodies - Chromosome 17 - disinhibition, shallow affect - loss of expressive language with severe naming difficulties

Question 36

Huntington Disease

Answer 36

Atrophy of Striatum (esp. caudate nucleus) | - autosomal dominant: chromosome 4

Question 37

Crutzfeld-Jakob Disease

Answer 37

Prion disease --> spongiform changes in brain - rapidly progressive dementia (months) - severe cerebellar and/or extrapyramidal signs with myoclonus

Question 38

Vascular dementia

Answer 38

risk factors: ↑ BP, diabetes, prior strokes | stepwise deterioration