Test 1 Flashcards
1
Q
Attachment
A
The emotional dependence of the infant on its mother
2
Q
Attachment theory was developed by
A
John Bowlby and says that a secure attachment between mother and child affects the child’s ability to form healthy relationships later in life.
3
Q
Bonding refers
A
to the mother’s feelings for her infant
4
Q
Serum PCR is the test of choice to examine
A
the number of trinucleotide repeats (>35 in adults and >60 in children) to diagnose Huntington’s disease (HD).
5
Q
A chromosomal karyotype can reveal
A
macroscopic defects in chromosomes such as deletions, translocations, or trisomies.
6
Q
Urine porphobilinogens and aminolevulinic acid, when detected in urine in excessive amounts, are diagnostic of
A
acute intermittent porphyria.
7
Q
_____ ceruloplasmin, when low, is diagnostic of
A
Serum; Wilson’s disease.
8
Q
Acute intermittent porphyria presents with
A
abdominal pain, tachycardia, tingling in hands and feet, paranoia, and hallucinations.
9
Q
Creutzfeldt–Jakob disease is diagnosed by CSF assay for
A
14-3-3 proteinase inhibitor proteins.
10
Q
______ lobe lesions cause patients to appear profane, irritable, and irresponsible.
A
Orbitofrontal
11
Q
When presented with cases that involve personality changes, one should suspect pathology in the ______ ______. Also, deficits in executive functioning usually involve the ______ _____.
A
frontal lobes
12
Q
_____ ______ lesions cause apathy, characterized by limited spontaneous movement, gesture, and speech.
A
Medial frontal
13
Q
_____ _____ lesions can cause depression.
A
Left frontal
14
Q
_____ ______lobe lesions can cause mania.
A
Right frontal
15
Q
Coprolalia is the
A
compulsive utterance of obscene words, as seen in Tourette’s disorder.
16
Q
Ailurophobia is
A
a dread of cats.
17
Q
cohort study
A
in which a well-defined population is followed over a period of time.
18
Q
Cohort studies are also known as
A
longitudinal studies.
19
Q
Cohort studies provide direct estimates of
A
risk associated with a suspected causative factor.
20
Q
A case–control study is
A
a retrospective study that examines persons without a particular disease.
Cases: People who have the disease or condition under study
Controls: A similar group of people who do not have the disease or condition
21
Q
Case-control studies are often used to produce an
A
odds ratio.
22
Q
In a ____ _____, specially selected patients receive a course of treatment, whereas another group does not.
A
clinical trial
The goal is to determine the effectiveness of the treatment.
23
Q
Cross-sectional surveys describe the
A
prevalence of a disease in a population at a particular point in time.
24
Q
Crossover studies are
A
a variation of the double-blind study, wherein the placebo and treatment groups switch at some point during the study.
25
Piaget described stages of
cognitive development
sensorimotor,
preoperational thought,
concrete operations
formal operations.
25
Freud was
the founder of psychoanalysis, giving us the oral, anal, phallic, and latency stages of development.
25
Mahler developed
stages of separation–individuation to describe how children develop identity that is separate from their mothers.
Her stages were normal autism, symbiosis, differentiation, practicing, rapprochement, and object constancy.
26
Erikson developed an
eight-stage life cycle
trust vs mistrust,
autonomy vs shame and doubt, initiative vs guilt,
industry vs inferiority,
identity vs role diffusion,
intimacy vs self-absorption, generativity vs stagnation, and
integrity vs despair and isolation.
27
Side effects of lithium
Several cutaneous side effects are possible with lithium, including acne and follicular and maculopapular eruptions. Lithium can both cause and exacerbate psoriasis. Alopecia has also been reported. Major side effects of lithium include gastrointestinal complaints, tremors, diabetes insipidus, hypothyroidism, weight gain, cardiac arrhythmia, and edema. Frequently tested is the fact that in patients suffering from psoriasis, lithium can precipitate psoriasis flare-ups. Another high-yield fact about lithium is that lithium decreases the kidney’s ability to respond to antidiuretic hormone (ADH),
28
The usual brain autopsy finding in someone who dies shortly after presenting with the clinical triad of mental confusion, ophthalmoplegia, and gait ataxia is
microhemorrhages in the periventricular gray matter, particularly around the aqueduct and third and fourth ventricles.
29
Frontal and temporal lobe atrophy is consistent with
Pick’s dementia.
30
Parkinson’s disease would result in
depigmentation of the pars compacta of the substantia nigra in the midbrain.
31
Diffuse Lewy bodies can be seen in both
Parkinson’s disease and Alzheimer’s disease.
32
Subcortical white matter lesions perpendicular to the ventricles
(also called Dawson’s fingers) are consistent with a demyelinating disease, such as multiple sclerosis.
33
Meperidine is used for and contraindicated with what psychiatric medication?
Contraindicated with an MAOI.
Labor medication for pain.
34
What can be given with MAOIs?
Lithium, esketamine
35
Major side effects of the MAOIs.
Orthostatic hypotension, weight gain, edema, sexual dysfunction, and insomnia.
36
Which two MAOIs often do not require a tyramine-free diet at low doses?
Moclobemide and the selegiline patch only weakly potentiate the pressor effects of tyramine
37
Avoid benzos in delirium because
A benzodiazepine given to a delirious patient can worsen the delirium and further disinhibit the patient, making him or her more agitated.
38
The best choice for tranquilizing agitated patients is
haloperidol.
39
Lithium and ADH
lithium decreases the kidney’s ability to respond to antidiuretic hormone (ADH), resulting in decreased fluid resorption from the distal tubules and increased urine output.
40
Side effect of lamotrigine
liver failure, and pancreatitis, Stevens–Johnson syndrome, anemia, thrombocytopenia,
41
Wilsons Dz labs
LOW Serum cerulopasm
HIGH Urine copper
42
Pseudocyesis
False Pregnancy
43
Korsakoff psychosis includes what additional symptoms from Wernikes?
Hallucinations and confabulation
44
What do you give first for Wernicke's?
thiamine before glucose because glucose can cause wernicke's encephalopathy
45
What other condition can lead to Wernickes?
Hyperemesis Gravidarum.
46
Primary prevention is when
a clinician does something to prevent the onset of a disease.
Reducing causative agents, reducing risk factors, increasing host resistance, or interfering with the transmission of a disease.
47
Secondary prevention is when
one identifies a disease in its early stages and seeks prompt treatment.
48
Tertiary prevention involves
reducing deficits caused by an illness to obtain the highest possible level of functioning.
49
often described in conjunction with small-cell lung carcinoma.
Lambert-Eaton myasthenic syndrome.
Paraneoplastic abnormality of presynaptic acetylcholine release
50
a rapidly occurring demyelinating disease that can present with ascending pain, paralysis, sensory loss, or any combination of these symptoms.
Guillain–Barré syndrome, also known as acute inflammatory demyelinating polyneuropathy (AIDP)
51
Callosal thinning and atrophy are hallmarks of
multiple sclerosis.
52
___ ___ pathology can be seen in vitamin B12 deficiency polyneuropathy with loss of vibration and joint position sensation.
Dorsal column
53
first and most important priority is protecting the patient from
harm ... not looking at their chart
The first responsibility is to keep both patient and staff from being harmed.
54
positive and negative reinforcement is part of operant conditioning developed by
Skinner.
55
Bandura is a proponent of
social learning theory, which says we learn through modeling others and through social interaction.
56
Ethosuximide is the treatment of choice for uncomplicated absence seizures, the clinical presentation depicted in this question. Failing ethosuximide, the next best choice would be
valproic acid, which has efficacy in partial complex, primary generalized, and absence seizure types.
57
Anti Seizure med that induces its own metabolism
Carbamazepine induces its own metabolism.
57
Dopamine is associated with the induction of
aggression.
58
Extinction occurs when
the conditioned stimulus is constantly repeated without the unconditioned stimulus until the response evoked by the unconditioned stimulus eventually disappears.
59
Williams’ syndrome is an autosomal ____ mental retardation syndrome that occurs by a ____ deletion that includes the elastin locus on chromosome 7q11–q23. Patients with the disorder have short stature, unusual facial features that include depressed nasal bridge (an upturned nose), broad forehead, widely spaced teeth, and elfin-like facies, as well as thyroid, renal, and cardiovascular anomalies.
dominant
hemizygous
Psychiatric symptoms include anxiety, hyperactivity, and hypermusicality.
60
The thematic apperception test is used to test
normal personality and involves showing pictures and having the patient come up with stories.
The patient’s most accepted and conscious traits and motives are attributed to the character closest to the patient in sex, age, and appearance. More unconscious or unacceptable traits are attributed to those characters most unlike the patient.
61
All drugs in the triptan class act as potent agonists at ___ and ___ receptors.
5-HT 1B and 5-HT 1D
Although these receptors reside principally on intracranial blood vessels, they may have an effect on the coronary arteries as well and could theoretically cause vasoconstriction, vasospasm, and acute myocardial infarction. Therefore these agents are contraindicated in patients with coronary ischemic heart disease and those with uncontrolled hypertension.
62
Alexia without agraphia is seen with lesions involving the
splenium of the corpus callosum.
63
Alexia without agraphia, also known as pure alexia or word blindness, is a rare neurological condition that prevents people from reading but allows them to write and understand spoken language. It's caused by damage to the occipital region of the brain, usually from a stroke or lesion in the dominant occipital lobe and posterior corpus callosum.
64
This is a clear description of the Malaysian cultural syndrome of Amok. It consists of a sudden rampage, which can include homicide and/or suicide, and ends in exhaustion and amnesia. Koro is a delusion that occurs in Asian males who believe the penis will disappear into the abdomen and cause death. Piblokto occurs in female Eskimos of northern Greenland. It involves anxiety, depression, confusion, depersonalization, and derealization and ends in stuporous sleep and amnesia. Wihtigo is a delusional fear displayed by Native American Indians of being turned into a cannibal through possession by a supernatural monster, the Wihtigo. Mal de ojo is a syndrome found in those of Mediterranean descent involving vomiting, fever, and restless sleep. It is thought to be caused by the evil eye.
65
The palmomental reflex and Myerson’s sign are two of the classical, so-called frontal release signs. The palmomental reflex is positive when the chin muscle contracts as the thenar eminence of the palm contralateral to the brain lesion is stroked with a blunt instrument. Myerson’s sign is the presence of a persistence of the glabellar reflex of blinking upon confrontation of the forehead by tapping with a finger. The blinking normally should extinguish after several taps of the forehead, but in the presence of frontal lobe damage, the response does not extinguish as rapidly.
66
_____ is the major excitatory neurotransmitter in the brain.
Glutamate
67
Glycine is
inhibitory. The other major neuroamine neurotransmitter.
68
Diazepam does what to the liver
Makes underlying liver issues worse
69
The neurotransmitters associated with anxiety are ____, ____, _____.
norepinephrine, serotonin, and GABA.
70
Noradrenergic neurons are found primarily in the
locus ceruleus.
71
Serotonergic neurons are located primarily in the
raphe nuclei in the pons.
72
Myasthenia gravis (MG) is an autoimmune neurologic disorder involving the
production of autoantibodies against postsynaptic nicotinic acetylcholinergic receptor sites on muscle.
73
About 10% of patients with MG have
thymoma.
74
Edrophonium
Only for diagnosing MG.
Edrophonium chloride (Tensilon), a short-acting cholinergic agent, is used to diagnose the disorder clinically, and pyridostigmine (Mestinon) is used to treat the disorder on an ongoing basis.
75
Generalized slow activity consisting of theta and delta waves with focal areas of hyperactivity is the EEG pattern of delirium. An important characteristic of this pattern is that the rhythm is slowed. Choice A is the pattern for absence seizures. This is a commonly asked pattern on examinations. Choice B is normal adult drowsiness. Choice C is a normal pattern seen when the eyes are closed. Upon awakening, the posterior alpha rhythm is replaced by random activity. Right temporal spikes, choice E, are significant for a seizure focus. In addition to the aforementioned information, the appearance of delta waves is considered abnormal and should raise concern regarding a structural lesion, except if the patient is asleep.
76
In fetishism a person, usually a male, obtains sexual arousal from an inanimate object, such as women’s undergarments, a glove, or a shoe. This needs to go on for at least 6 months to qualify for the diagnosis and often involves sexual fantasies directed at the object.
77
Frotteuristic disorder involves
becoming sexually aroused by touching and rubbing against a nonconsenting person.
78
Transvestism is a pattern of
sexual arousal from cross-dressing, usually seen in a heterosexual male. The answer to this question is not transvestism because the patient was wearing women’s undergarments only under his traditional male work clothes. He was not going to work dressed as a female. It is not dressing like a woman that arouses him, but a fantasy connected with an inanimate object, namely his wife’s undergarments.
79
tic douloureux
trigeminal neuralgia
80
trigeminal neuralgia (tic douloureux). It is usually unilateral. It usually affects the
upper two branches of the fifth nerve (V2 and V3).
80
This is the classical clinical picture of temporal (also called giant cell) arteritis, a systemic vasculitis of the medium-sized vessels. Women are affected more often than men (about 3:1). The disease occurs in the elderly, usually over 50 years of age. Clinically, the disease can present as new-onset or change in headache with fever, fatigue, myalgia, night sweats, weight loss, and jaw claudication (tiredness upon chewing). About 25% of patients have polymyalgia rheumatica. The temporal artery can demonstrate tenderness to palpation with induration and diminished or absent pulse. The most feared complication is irreversible and sudden vision loss as a result of central retinal artery occlusion. The initial test of choice is the serum erythrocyte sedimentation rate (ESR), which is virtually always elevated. Temporal artery biopsy is the gold standard diagnostic test of choice in the face of an elevated ESR. The treatment of choice is prednisone. Brain imaging would not reveal the abnormality. Lumbar puncture for CSF xanthochromia is done to diagnose subarachnoid hemorrhage. Carotid dissection does not involve systemic constitutional symptoms but usually presents with ipsilateral stroke-like deficits due to arterial embolization.
81
The concept that mental disorders have different outcomes was pioneered by Emil Kraepelin. He was the first to differentiate between the course of chronic schizophrenia and that of manic psychosis. He used the term dementia praecox, borrowing it from the work of French psychiatrist Morel. Eugen Bleuler later renamed it as schizophrenia and stressed that it need not have a deteriorating course. Winnicott was one of the central figures in the school of object relations theory. He developed the concepts of the “good enough mother” and the “transitional object.” Sigmund Freud is the founder of classical psychoanalysis. Heinz Kohut is best known for his writings on narcissism and self-psychology.
82
Briquet’s syndrome aka
Somatic symptom disorder
83
Cluster headache is a rare type of headache occurring in approximately 0.5% of the population. Sufferers are usually males in their 20s and 30s. Most sufferers experience episodic cycles of 4 to 12 weeks’ duration that are predominant in the spring and fall seasons. Attack periods can be considered chronic, that is, lasting 1 year or more without remission or with remission periods of less than 2 weeks’ duration. Attacks can last anywhere from 15 minutes to 3 hours. They can occur as often as eight times a day or as infrequently as once every other day. The attacks are generally nocturnal. Alcohol consumption is a common trigger. The attacks are excruciatingly painful and retro-orbital in location. Pain can radiate to the teeth, neck, and temporal regions and can be accompanied by ipsilateral autonomic symptoms. Patients prefer moving their head or pacing rather than lying still. Abortive therapies include oxygen by nasal cannula, sumatriptan subcutaneous injection, and ergotamine. Prophylactic therapies include prednisone, verapamil, divalproex sodium, methysergide, and lithium.
84
Although ______ can increase blood pressure in some patients, it does not cause hypertensive crises by itself and is not contraindicated in patients with high blood pressure.
Buproprion
85
TBI cannot get which antidepressant?
Wellbutrin
86
_____ and _____ are not contraindicated with MAOIs.
Lithium and phentolamine
Levodopa and spinal anesthetics containing epinephrine are also part of a long list of medications that should not be mixed with MAOIs.
87
Acetaminophen overdose does not generally affect the peripheral nervous system.
88
Methylphenidate will increase TCA levels, as will some antipsychotics
89
Based on the information given, this is most likely a case of SIADH that has been caused by the paroxetine. SSRI-induced SIADH is most common in elderly patients. It can present with irritability, personality changes, decreased appetite, nausea and vomiting, weakness, confusion, hallucinations, and in severe cases can lead to seizure, stupor, and coma.
90
As ADH levels rise, the body holds onto water. Urine output goes down, and urine is more concentrated. Increased blood volume dilutes sodium, and sodium levels drop. To avoid confusion on standardized examinations, let’s compare this with the picture seen in psychogenic polydipsia and with that in diabetes insipidus. In psychogenic polydipsia the patient is drinking excessively. Urine output goes up, and urine is more dilute. Because there is so much water coming into the body from excessive drinking, the serum sodium drops. In diabetes insipidus there is an inability to properly concentrate the urine. Urine output goes up, and urine is more dilute. As water is moved out of the body and is not replaced, serum sodium becomes more concentrated, and laboratory values for sodium increase.
91
The clinical picture depicted in this question is that of dermatomyositis. Dermatomyositis is an autoimmune disease that affects skin and muscle. Skin rash appears generally with the onset of muscle weakness. The rash is classically purplish and is mainly seen on the face and eyelids. It can also appear on the neck, elbows, and knees, which are often reddened and indurated. Serum CPK levels are often elevated. EMG results reflect myopathy and muscle irritability. The hallmark finding on muscle biopsy is perifascicular atrophy and “ghost” fibers. There is a strong relationship between dermatomyositis and occult neoplasm in up to 50% of patients with the disorder. The usual neoplasm is carcinoma and can be in the lung, breast, stomach, or ovary most typically. A cancer workup is essential in patients found to have dermatomyositis.
92
The most significant genetic risk factor is believed to be homozygosity for the inheritance of the E4 allele of apolipoprotein E (apo E). Apo E4 has been associated with chromosome 19.
93
The most significant genetic risk factor is believed to be homozygosity for the inheritance of the E4 allele of apolipoprotein E (apo E). Apo E4 has been associated with chromosome 19.
94
____ _____ is notorious for causing hirsutism in women, facial dysmorphism, and gingival hypertrophy.
Phenytoin sodium (Dilantin)
95
The clinical picture depicted in this question is known as a “Saturday night palsy,” which is synonymous for a radial nerve entrapment. Entrapment of the radial nerve at the axilla often results from prolonged armpit compression when the arm is draped over the edge of a chair or when a patient is on crutches. A radial nerve palsy of this kind results in weakness of the extensor muscles of the wrist and fingers, triceps weakness, and supinator weakness. Such compression injury usually resolves in 1 to 2 months. Ulnar nerve entrapment can occur either at the elbow or at the wrist. Elbow trauma may result in ulnar nerve entrapment in the cubital tunnel. Other causes include arm compression during surgery under general anesthesia. Ulnar nerve compression results in weakness of the flexor carpi ulnaris, intrinsic hand muscles, and fourth and fifth finger deep flexor weakness. Median nerve entrapment at the wrist can result in a classic carpal tunnel syndrome. This is the most common of the entrapment neuropathies. Tenosynovitis of the transverse carpal ligament places pressure on the median nerve in the tunnel, resulting in nocturnal hand paresthesias of the thumb and index and middle fingers. There may be sensory loss, thenar atrophy, and a positive Tinel’s sign in about 60% of cases. Tinel’s sign is positive when percussion of the nerve over the wrist results in paresthesias in the median nerve territory. Flexing the hand at the wrist for about 1 minute or more is called Phalen’s maneuver and can result in similar paresthesias. Injury to the median nerve is sustained with use of handheld vibrating tools and repetitive forceful use of the hands and wrists compromising the carpal tunnel. The diagnostic test of choice for carpal tunnel syndrome is needle EMG and nerve conduction studies, which reveal delayed sensory latency across the wrist. Musculocutaneous nerve injury can occur with brachial plexus injuries, such as by shoulder dislocation, compression to the shoulder during surgical anesthesia, or by repetitively carrying heavy objects over the shoulder (carpet carrier’s palsy). Weakness in the biceps and brachialis is the hallmark of musculocutaneous nerve injury. The suprascapular nerve is a pure motor nerve of the brachial plexus.
Entrapment injury can occur after repetitive forward traction at the shoulder. Diffuse aching pain in the posterior shoulder is a usual symptom. EMG demonstrates denervation of the infraspinatus and supraspinatus muscles.
96
Piaget proposed four stages of
cognitive development: the sensorimotor stage, the stage of preoperational thought, the concrete operations stage, and the formal operations stage.
97
By 2 to 3 years of age, almost all children have a concept of being either male or female. Infants begin exploring their genitalia by 15 months of age. Children also develop interest in others’ genitals, leading to exploration and exhibition. Sexual curiosity and sex play increase during puberty but are normally present before puberty. They are not a sign of anything abnormal, nor are they a result of watching television, homosexuality, hormonal imbalance, or premature development.
Just FYI that sex play is normal at 10 y/o
98
When cocaine is chronically used, this disturbance of normal
dopamine metabolism leads to depletion of dopamine.
Cocaine has also been shown to be associated with decreased levels of cerebral blood flow.
Patients recovering from cocaine addiction show a drop in neuronal activity and a decreased activity of dopamine, which can persist for up to a year and a half after stopping the drug.
99
Pergolide is
a long-acting dopamine agonist approved in 1982 for the treatment of Parkinson's Disease.
100
Ziprasidone (Geodon) stands alone as the one atypical antipsychotic that inhibits
serotonin and norepinephrine reuptake.
101
Ziprasidone (Geodon) stands alone as the one atypical antipsychotic that inhibits
serotonin and norepinephrine reuptake. All of the atypical antipsychotics block the 5-HT 2A and dopamine D2 receptors.
102
Aripiprazole causes ___ weight gain than most of the other atypical antipsychotics.
less
Interestingly, because it has less risk of prolactin elevation, aripiprazole would be a good choice for a patient with a prolactin-secreting tumor who develops psychosis.
Studies have shown lower prolactin elevation with aripiprazole than other antipsychotics.
103
The raphe nuclei of the brainstem, predominantly in the pons, are the major sites of
serotonergic cell bodies.
104
Wilson’s disease is an autosomal ___ disorder of abnormal copper metabolism. It is linked to chromosome ___. This results in excessive deposition of ____ in the brain, with a predilection for the ____ ____. The most useful laboratory test is ____ _____, which is decreased.
recessive
13
copper
basal ganglia
serum ceruloplasmin
105
The mesolimbic pathway of dopaminergic neurons, starting at the _____ and projecting to the _______, is thought to be highly involved in the sense of reward one gets from cocaine use and is a major mediator of cocaine’s effects.
ventral tegmental area; nucleus accumbens
It is very involved in amphetamine’s effects as well.
106
Of the many psychological tests used today, the reliability of the ________ is among the highest.
Wechsler Adult Intelligence Scale
Retesting of people, even at later ages, rarely reveals higher IQ scores. The scores are consistent and repeatable. As such, it is the most reliable of the choices given. It also has a very high validity in identifying mental retardation and predicting future school performance. There is also a childhood version of the same test, the Wechsler Intelligence Scale for Children.
107
Drive therory
Freud
108
Freud’s drive therory
e theory focused on basic instincts or drives that motivated human behavior. These drives were libido and aggression. In Freud’s model, a drive has four parts. The “source” is the part of the body from which the drive comes. The “impetus” is the amount of intensity of the drive. The “aim” is any action that discharges the tension. The “object” is the target of the action.
109
A type I error occurs when
the null hypothesis is rejected when it should have been retained. It is the equivalent of saying that a true difference exists between two samples when the difference is due solely to chance.
109
Aaron Beck is the
originator of cognitive behavioral therapy. In this theory, patients’ assumptions affect their cognitions, which in turn affect their mood.
109
Power is the probability of
finding the difference between two samples. It is the probability of rejecting the null hypothesis when it should be rejected.
110
Probability is the
likelihood that an event will occur. A probability of 1 means it will occur, a probability of 0 means that it will not.
111
PCP can be found in the urine up to
8 days after use.
112
APP is the protein that makes up the
amyloid plaques found in the brain in Alzheimer’s disease, encoded by a gene found on chromosome 21.
113
Carbamazepine side effect and test
CBC would be the first test to order because of the risk of significant side effects on the hematopoietic system.
Carbamazepine also has a vasopressin-like effect and can cause water intoxication and hyponatremia.
Carbamazepine interacts significantly with the cytochrome P450 system and as such has many interactions with many drugs. Great care should be taken when prescribing carbamazepine with other medications.
114
With respect to laboratory tests and anorexia, a frequently tested fact is that in anorexia, levels of ____ and ____ are decreased
luteinizing hormone LH and follicle-stimulating hormone FSH are decreased.
115
Many of the antipsychotic medications block dopamine in the
tuberoinfundibular tract.
116
Highest prevalence of mental illness is for
anxiety disorders.
More than 30 million people in the United States have an anxiety disorder. About 17.5 million have depression.
117
There is an association between pathological gambling and mood disorders, particularly
major depressive disorder (MDD).
There is also an association with panic, OCD, and agoraphobia, but the association with MDD is greater.
118
____ ____ _____involves being convinced that one has a serious disease based on misinterpretation of bodily sensations.
Illness anxiety disorder
119
Studies of _____ clearly demonstrate that children whose biological parents were alcoholics are at increased risk for alcoholism, even when brought up by adopted families in which neither parent has an alcohol problem.
adoptees
120
Internuclear ophthalmoplegia is a classic brainstem finding on neurologic examination of patients with demyelinating lesions of multiple sclerosis (MS). The lesion localizes to the
medial longitudinal fasciculus (MLF) of the brainstem.
121
Pathological gambling is categorized by the DSM 5 as
a non–substance-related addictive disorder found under Substance-Related and Addictive Disorders.
122
Social skills training is an important part of
psychiatric rehabilitation
123
Lhermitte’s sign is
a transient neurologic sign described by patients as a sensation of an electric shock that descends down the spine or the extremities upon neck flexion. It is most often suggestive of MS but can also be seen in other conditions involving the cervical spinal cord, such as disk herniations, trauma, and tumors.
124
Russell’s sign is
positive when cuts or scrapes to the backs of the hands are noted, which are a result of the teeth scraping the fingers while vomiting.
125
THC and what cause paranoia
Amphetamines (due to amphetamine psychosis)
126
____ ____ have the highest risk of becoming violent.
Substance abusers
127
ideal patient for psychodynamic psychotherapy should have
the capacity for psychological mindedness, have at least one meaningful relationship, be able to tolerate affect, respond well to transference interpretation, be highly motivated, have flexible defenses, and lack tendencies toward splitting, projection, or denial.
128
MRI scan reveals
numerous subcortical white matter demyelinating lesions that would be expected to enhance with gadolinium contrast early on during an attack, and enhancement can persist up to 8 weeks after an acute attack.
129
von Recklinghausen’s disease
NF1 caused by a mutation in the NF1 gene on chromosome 17.
most common of the neurocutaneous illnesses,
Patients with NF1 need to have any two of the following seven criteria to carry the diagnosis: six or more café-au-lait spots, axillary or inguinal freckling, optic glioma, two or more neurofibromas or one plexiform neurofibroma, a first-degree relative with NF1, two or more Lisch nodules (hamartomas of the iris), and characteristic bony lesion, such as thinning of long bones or sphenoid dysplasia.
130
Beck Anxiety Inventory is a self report questionnaire that is use best for
Discriminating between anxiety and depression
131
The revised Koss-Butcher critical item set on the ____ is a list of 22 items related specifically to depressed suicidal ideation
MMPI-2
132
Self reported instruments specifically designed for assessment for known predictors of suicidal behavior are (2)
Beck hopelessness scale and scuidade intent scale
133
University of Rhode Island Change Assessment
measure developed to assess a patient;s readiness to change in reation to the use of drugs, alcohol, and nicotine.
134
Positive and Negative syndrome scale
PANSS
measuring symptom severity of patients with schizophrenia
135
Overt agression scale - modified
Rates the patient's aggressive behavior over the past week
136
Buss-Durkee Hostility Inventory
44 items that measure level of hostility in 3 categories: verbal aggression, physical aggression, and anger.
137
State-trait anger expression inventory - 2
intensity of anger as an emotional state (State Anger) and the disposition to experience angry feelings as a personality trait (Trait Anger)
138
Anger, Irritability, and assault questionnaire
impulsive aggression in outpatients, self reported
139
Overcontrolled hostility scale
identify individuals whose massive repression of hostile or aggressive impulses leads to episodic acts of violence
140
Right hemispheric lesions present most often with
Visuospatial deficits
141
Left hemispheric lesions most associated with
Language issues
142
WAIS-IV digit span test
auditory attention and working memory messure
143
California learning test II
verbal learning & memory in older adolescents & adults.
144
Token Test
Comprehension of spoken instructions.
It measures the capability to carry out commands of varying complexity
145
Wisconsin Card sorting test
test of set-shifting, which is the capability to show flexibility when exposed to changes
146
Judgment of Line Orientation test
visuospatial perception
147
Honesty
a moral duty to be truthful with patients about their conditions, medications, procedures, and risks.
148
Fidelity
the principle of being loyal to patients and prioritizing their well-being above all else.
149
Respect
intrinsic, unconditional value of all persons
150
Integrity
encompassing honesty, keeping one's word, and consistently adhering to principles of professionalism, even when it is not easy to do so.
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Altruism
voluntary action that aims to improve another person's welfare, even when it comes at a personal cost and without the expectation of reward.
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Veracity
principle of truth-telling, or being honest
153
a rapidly occurring demyelinating disease that can present with ascending pain, paralysis, sensory loss, or any combination of these symptoms.
Lambert–Eaton myasthenic syndrome
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The clinical hallmark of AIDP is
a loss of deep tendon reflexes in the extremities.
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Lambert–Eaton myasthenic syndrome tests of choice
The tests of choice are EMG and nerve conduction studies, which usually reveal loss of the H reflex and decreased nerve conduction velocities.
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AIDP
Lambert–Eaton myasthenic syndrome
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Theory that people attribute their own behavior to situational causes and the behavior of others to personality traits.
Attribution theory
This then affects their feelings and behavior.
158
Hull ...
did work in the neurophysiologic aspects of learning, developing a drive reduction theory of learning.
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Learned helplessness is
developed by Seligman
Organisms become depressed and apathetic because no matter what it does, its environmental circumstances never change.
160
Kandel studied.
What does his theory state?
Habituation and sensitization.
Habituation theory says that an animal can learn to stop responding to a repeated stimulus.
Sensitization theory says that an organism can be taught to respond more easily to a stimulus or be made more sensitive to that stimulus.
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Pavlov developed classical conditioning. In classical conditioning, a
neutral stimulus is paired with one that evokes a response so that eventually the neutral stimulus comes to evoke the same response.
Involuntary
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NF2 is caused by a
mutation in the NF2 gene on chromosome 22.
must have bilateral acoustic schwannomas to meet criteria for this condition. If the schwannoma is unilateral, the patient meets criteria only with a first-degree relative with NF2.
163
The treatment of an acute MS attack is generally
with intravenous corticosteroids. This may or may not be followed with an oral prednisone taper.
NO -- Intravenous immunoglobulin therapy and plasmapheresis are treatments for MG and Guillain–Barré syndrome -- not for MS.
164
Criteria for pathological gambling include
preoccupation with gambling, gambling increased sums of money to obtain excitement, being unsuccessful at stopping or cutting back, gambling to escape dysphoric mood, lying to significant others about gambling, loss of important relationships over gambling, committing illegal acts to be able to gamble, relying on others to pay the bills because of money lost gambling, and a desire to keep going back to break even.
165
cocaine can be found in urine up to
up to 8 hours after use
166
heroin can be found in the urine up to
up to 72 hours after use
167
Self-psychology is the theory of
Kohut.
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The locus ceruleus of the brainstem contains a high number of
adrenergic neurons and mediates the effects of opiates and opioids.
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Serotonin is associated with
decreased aggression. In particular, the CSF levels of 5-hydroxyindoleacetic acid (5-HIAA), a major serotonin metabolite, have been shown to be inversely correlated with the frequency of aggression.
170
GABA is the major
inhibitory neurotransmitter of the brain and is associated with decreased aggression.
171
Glycine is an
inhibitory neurotransmitter and, as such, is not associated with increased aggression. As a general rule, it is thought that cholinergic and catecholaminergic mechanisms seem to be involved in the induction of aggression, and serotonin and GABA seem to inhibit such behavior.
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As a general rule, it is thought that ___ and ___ mechanisms seem to be involved in the induction of aggression, and ___ and ___ seem to inhibit such behavior.
cholinergic, catecholaminergic
serotonin, GABA
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Wilson's Disease symptoms
The most frequent neurologic manifestations are parkinsonism, flapping tremor, ataxia, dystonia, and bulbar signs, such as dysphagia and dysarthria. Signs of liver failure are usually present. The treatment of choice is penicillamine, a copper-chelating agent, which in many cases can reverse the deficits of the disease.
174
Serum ACE level would be a screening test for
sarcoidosis
175
Lumbar puncture for CSF oligoclonal bands and myelin basic protein would be a useful supportive test (in addition to brain and/or spinal cord MRI) for
multiple sclerosis.
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The ventral tegmental area, substantia nigra, and nucleus accumbens are all ____ areas and are parts of the major neuronal pathways involved in the pathophysiology of ____.
dopaminergic
schizophrenia
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ziprasidone unique blockade of the ____ receptor.
5-HT 1A
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All of the atypical antipsychotics block the ___ and ____ receptors.
5-HT 2A ; dopamine D2
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The Halstead–Reitan battery helps find the
location of brain lesions and differentiates between those who are brain damaged and those who are neurologically intact. It consists of a series of 10 tests. The
180
MMPI is a
personality assessment used to find areas of psychopathologic functioning. It consists of more than 500 statements to which the patient must respond “true,” “false,” or “cannot say.”
181
The BPRS is used to assess
the severity of psychosis in schizophrenia.
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The clinical picture is the classic tetrad of acalculia, agraphia (without alexia), right and left confusion, and finger agnosia (the inability to name fingers) is ....
Gerstmann’s syndrome usually involves left parietal lobe damage (left angular gyrus).
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During the concrete operations stage the child begins to deal with information outside of him or herself and to see things from others’ perspectives. The child also develops conservation, which is the idea that although objects may change, they can maintain characteristics that allow them to be recognized as the same (for example, different leaves may be different shapes and colors but are all leaves). The concept of reversibility is also understood at this stage. It says that things can change form and shape and then go back again (for example, ice to water to ice).
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Glutamate is the precursor to ____.
GABA
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The major inhibitory neurotransmitters are ___ and ___.
GABA and glycine
186
____ works on the NMDA receptor and four types of non-NMDA receptors.
Glutamate
187
The ____ receptor is bound by PCP.
NMDA
188
Glutamate is thought to be very important in learning and memory.
Glutamate is also important in the theory of excitotoxicity, which postulates that excessive glutamate stimulation leads to excessive intracellular calcium and nitric oxide concentrations and cell death.
189
Locations for glutamate in the brain include
cerebellar granule cells,
striatum,
hippocampus,
pyramidal cells of the cortex,
thalamocortical projections, and
corticostriatal projections.
190
Understimulation of the NMDA receptor by glutamate has been found to cause ____; therefore glutamate is thought to play some role in ____, although the exact nature of that role is yet unclear.
psychosis; schizophrenia
191
best explains pathological gambling
random reinforcement: the reward is given only a fraction of the time at random intervals to keep the gambler guessing and trying to anticipate when he or she will win.
192
child's temperament is based on _____
at 8mo, temperament is a function of its genes. Environment plays more of a role when older
193
If a mistake is made
briefly acknowledge and move on
194
failure to develop cohesive self-awareness
identity diffusion
195
Selective perception (or attention) bias
depressed patient only sees/recalls the negative behaviors/events around them based on frame of reference. TV only has bad news on.
196
Cognitive distortions
are exaggerated and irrational thoughts, identified in cognitive therapy and its variants, which in theory perpetuate some psychological disorders --> magnify or minimize
197
catastrophizing
one subtype of magnification, which is the inability to foresee anything other than the worst possible outcome
198
interpretation
making something that was unconscious conscious. It is an explanatory statement that links a feeling, thought, behavior, or symptom to its unconscious meaning.
199
Clarification
reformulating what the patient has said to create a coherent view of what has been communicated.
200
Empathic validation
demonstration of the therapist's empathic understanding of the patient's internal state.
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