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Psychiatry

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Substance withdrawal - signs are often opposite of intoxication
the tx for OCD
Number of major depressive episodes constitute major depressive disorder
100 - 15
behavioral - physiologic - cognitive state caused by cessation or reduction of heavy and prolonged substance use - clinical signs

2. Body dysmorphic disorder
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens
preoccupation with minor or imagined defect in appearance leading to significant emotional distress or impaired functioning
the tx for GAD
variety of complaints in multiple organ symptoms - pain - GI - sexual - pseudo neurologic over years

3. Hallucination
perceptions in the absence of external stimulus
an unacceptable internal impulse is attributed to an external source
doctor projects feelings about formative or other important persons onto patient
behavior achieved following reward of closer and closer approximations of desired behavior

4. Calculates IQ as mental age/chronological age x 100
the tx for opiod intox and withdrawal
the treatment for EtOH intox and withdrawal
Separation of feelings from ideas and events
Stanford - binet

5. 6 months
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse
the time frame for brief pyschotic disorder
the evidence for child neglect
How long infant deprivation can last before it leads to irreversible changes

6. Isolation of affect - describing murder in graphic detail with no emotional response
maladaptive pattern leading to clinically significant impairment or distress
psychiatric disorder associated with tourrettes - and the treatment
Separation of feelings from ideas and events
prolonged pain with no physical findings - psychosocial factors play an important role in severity exacerbation or maintenance

7. CPS
Where child neglect is reported
intox is marked respiratory depression - intox = delerium - life threatening CV collapse
associated with winter season - improves in response to full spectrum light exposure
the tx for GAD

8. Personality trait
an enduring repetitive pattern of perceiving - relating to - and thinking about about the environment and oneself
development of delusions in a person in a close relationship with delusional disorder
the definition of alcoholism
the stages of change in overcoming substance addiction

9. Delirium
the age of onset of ADHD
How long episodes of major depressive episode usually last
pieces of evidence for sexual child abuse
waxing and waning level of conciousness with acute onset leading to rapid decrease in attention span/level of arousal - acute changes in mental status - disorganized thinking - hallucinations etc

10. Sleep disturbances - loss of interest - guilt or feelings of worthlessness - loss of Energy - loss of Concentration - Appetite/weight changes - psychomotor retardation or agitation - suicidal ideations - depressed mood - 5 of 9 with anhedonia/depress
SIG E CAPS and the criteria for dx
partially remaining at more childish level of development
misinterpretations of actual external stimulus
both illness and motivation are subconcious - sx not intentionally produced or feigned

11. ECT - disorientation amnesia - usually resolves in 6 months
odd or eccentric; inability to develop meaningful social relationships
the time frame for brief pyschotic disorder
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse
treatment option for MDD refractory to opther treatment - produces painelss seizure in anesthetized patient - tx and major adverse affects

12. Schizophrenia
What ego dystonic means in relation to OCD
less than what percentage of ideal body weight is common in anorexia nervosa
auditory hallucinations common
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse

13. Conduct disorder <18 - antisocial personality disorder > 18
repetitive and pervasive behavior violating social norms - disorder - and name change after 18
intox = belligerence - impulsiveness - fever - psychomotor agitation - vertical and horizontal nystagmus - tachycardia - homicidality - psychosis - delirium. Withdrawal = depression - anxiety - irritability - restlessness - anergia - disturbances of
hypersomnia - overeating - mood reactivity - weight gain and sensitivity to rejection
Separation of feelings from ideas and events

14. Dipoloar or depressive
the two types of schizoaffective disorder
process whereby avoided ideas and feelings are transferred to some neutral person or object
the time frame for schizophreniform disorder
Causes of dementia

15. Rett's disorder
variety of complaints in multiple organ symptoms - pain - GI - sexual - pseudo neurologic over years
x- linked disorder in girls - sx apparent 1-4 - regression - MR - loss of verbal abilities - ataxia - and hand wringing
the concern with use of antidepressants in pts with bipoloar disorder
Diagnosis requres 2 of 5 of which sx

16. Illusion
Stanford - binet
the 4 W's of deprived babies?
misinterpretations of actual external stimulus
reward received after every response - rapidly extinguished - vending machine

17. Tourrette's
sudden rapid - recurrent - nonrhythmic stereotyped motor movements or vocalizations that persist for >1 yr
Moral values - conscience can lead to self blame and attacks of ego
proclaiming logical reasons for actions actually performed for other reasons - to avoid self blame
suboxone and the rational of adding an antagonist

18. Fixation - men fixating on sports games
preoccupation with minor or imagined defect in appearance leading to significant emotional distress or impaired functioning
SAD PERSONS
x- linked disorder in girls - sx apparent 1-4 - regression - MR - loss of verbal abilities - ataxia - and hand wringing
partially remaining at more childish level of development

19. Flumazenil - competitive GABA antagonist
<40 and <20
the tx for BDZ intox - MOA
abrupt change in geographic location with inability to recall past - confusion about personal identity - or assumption of a new identity - associated with traumatic circumstances
the treatments for ADHD

20. 6-12 months
inbability to recall important personal information - usually subsequent to severe trauma or stress
How long episodes of major depressive episode usually last
misinterpretations of actual external stimulus
waxing and waning level of conciousness with acute onset leading to rapid decrease in attention span/level of arousal - acute changes in mental status - disorganized thinking - hallucinations etc

21. Delusional disorder
excessive dieting +/- purging - intense fear of gaining weight - body image distortion - increase exercise
fixed persistent - nonbizarre belief system lasting >1 month not impaired - self limited
the time frame for brief pyschotic disorder
waxing and waning level of conciousness with acute onset leading to rapid decrease in attention span/level of arousal - acute changes in mental status - disorganized thinking - hallucinations etc

22. Regression - seen in children under stress and in patients on dialysis (crying)
autism with unusual abilities
PANICS
turning back the maturational clock and going back to earlier modes of dealing with the world
heroin users at increased risk of...

23. Blacks=whites - males = females - 1.5% lifetime prev
gets schizophrenia and the prev
process whereby avoided ideas and feelings are transferred to some neutral person or object
the serum markers of alcohol use
tactile hallucinations common

24. MAOi - SSRIs
a hypomanic episode
the tx for atypical depression
dramatic - emotional or erratic
the EEG findings in dementia

25. Cocaine
at least 2 weeks of stable mood with psychotic sx plus a major depressive - manic or mixed episode
pieces of evidence for sexual child abuse
intox = impaired judgement - pup dilation - hallucinations (tactile) - paranoid ideations - angina - sudden cardiac death. Withdrawal = suicidality - hypersomnolence - malaise - severe psychological craving
guilty feelings alleviated by unsolicitied generosity towards others

26. Modeling (social learning)

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27. Supression - not thinking about the USMLE until the week of the exam
voluntary withholding of an idea or feeling fromk concious awareness
patient conciously fakes or claims to have a disorder in order to gain a specific secondary gain and avoids medical treatmen - complaints cease after gain
the EEG findings in dementia
child neglect

28. In what disease is ACH decrease?
Alzheimers
reward received after every response - rapidly extinguished - vending machine
severe language impairment and poor social interactions - greater focus on objects than people - repetitive behavior - below normal intelligence
strong persistant cross gender identification

29. Variable ratio reinforcement schedule
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
the tx for GAD
reward received after random number of responses - slowly extinguished - slot machine
distinct period of abnormally and persistently elevated - expansive - irritable mood lasting at least 1 week

30. To make the patient aware of hidden in their unconcious
the tx of W- K syndrome
the central goa of freudian psychoanalysis
Causes of dementia
When to hypnopompic hallucinations take place

31. PTSD
PANICS
persistent re - experiencing of a previous traumatic event
the stages of change in overcoming substance addiction
inbability to recall important personal information - usually subsequent to severe trauma or stress

32. Alcohol
development of delusions in a person in a close relationship with delusional disorder
intox is marked respiratory depression - intox = delerium - life threatening CV collapse
associated with winter season - improves in response to full spectrum light exposure
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens

33. 3000 deaths/yr in the US
removal of aversive stimulus elicits behavior - mouse presses button to avoid shock
the epi of physical child abuse
behavior acquired by watching others and assimilating actions into one's own repetoire
Korsakoff's psychosis

34. Physiologic tolerance and dependence with symptoms of withdrawal when intake is interrupted
at least 2 weeks of stable mood with psychotic sx plus a major depressive - manic or mixed episode
the epi of sexual abuse
the definition of alcoholism
potential tx for nicotine withdrawal

35. Boys
strong persistant cross gender identification
gender autism is more common in
the associations/complications of bulimia nervosa
intox = CNS depression - N/V - constipation - pup cxn - seizures withdrawal = sweating - pup diltaed - piloerection - rever - rhinorrhea - N - stomach cramps - diarrhea

36. In what disease does NE decrease - 5HT decrease and DA decrease?
Drugs with what kind of affect can lead to a state of delirium
the triad of Wernicke's encephalopathy
Depression
intox = impaired judgement - pup dilation - prolonged wakefulness and attention - delusions - hallucinations - fever. Withdrawal = stomach cramps - hunger - hypersomnolence

37. Hepatitis - abscesses - OD - hemorrhoids - AIDS - right sided endocarditits
How long marijuana is detectable in the urine after last use
heroin users at increased risk of...
intox = restlessness. Withdrawal = irritability - anxiety - craving
x- linked disorder in girls - sx apparent 1-4 - regression - MR - loss of verbal abilities - ataxia - and hand wringing

38. Aura of psychomotor epilepsy and in brain tumors
milder form of depression lasting at least 2 years
inflexible - maladaptive - and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning - persons usually not aware of problem - presents early in adulthood
the tx for bipolar disorder
olfactory hallucinations common

39. Alcoholic cirrhosis - hepatitis - pancreatitis - peripheral neuropathy - testicular atrophy
the tx for atypical depression
the complications of alcoholism
the evidence for child neglect
cyclothymia disorder

40. Retrograde amnesia
fear that is excessive or unreasonable and interferes with with nl fxn - cued by presence or antiicipation of a specific object or situatio - person recognizes fear is excessive
reward received after every response - rapidly extinguished - vending machine
inability to remember things that occurred before CNS insult
modeling behavior after another person is more powerful - though not necessarily admired

41. Extinction
learning in which a natural response is elicited by a conditioned - or learned stimulus that previously was presented in conjuction with an unconditioned stimulus
Long acting oral opiate for heroine detox or long term maintenance
perceptions in the absence of external stimulus
discontinuation of reinforcement eliminates behavior

42. Depersonalization disorder

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43. Munchausen's syndrome by proxy
exaggerated fear of embarrasment in social situations - disorder and tx
illness in a child is caused by a caregiver - motivation is to assume sick role by proxy
Stanford - binet
SAD PERSONS

44. Naloxone + buprenorphine - naloxone not active when taken orally only when injected - withdrawal sx only occur if injected cuts down abuse
suboxone and the rational of adding an antagonist
prolonged pain with no physical findings - psychosocial factors play an important role in severity exacerbation or maintenance
depressant intoxication - nonspecific
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens

45. In what disease is GABA decrease and ACH decrease?
the most common psychiatric illness on medical and surgical floors and the most common cause of this pyschiatric disorder
learning in which a natural response is elicited by a conditioned - or learned stimulus that previously was presented in conjuction with an unconditioned stimulus
an enduring repetitive pattern of perceiving - relating to - and thinking about about the environment and oneself
Huntingtons

46. Amphetamines
intox = impaired judgement - pup dilation - prolonged wakefulness and attention - delusions - hallucinations - fever. Withdrawal = stomach cramps - hunger - hypersomnolence
How long episodes of major depressive episode usually last
the treatments for ADHD
modeling behavior after another person is more powerful - though not necessarily admired

47. Substance abuse
persistent re - experiencing of a previous traumatic event
proclaiming logical reasons for actions actually performed for other reasons - to avoid self blame
maladaptive pattern leading to clinically significant impairment or distress
inability to remember things that occurred after CNS insult

48. Naltrexone and BDZ
the treatment for EtOH intox and withdrawal
Parkinsons
maladaptive pattern leading to clinically significant impairment or distress
the central goa of freudian psychoanalysis

49. In what diseaese is DA decrease - 5HT increase - and increase ACH?
turning back the maturational clock and going back to earlier modes of dealing with the world
Chronic mental disorder with periods of pyschosis - disturbed behavior and though and decline in fxn that lasts > 6 months
bing eating +/- purging self induced vomiting - use of laxatives - diuretics or emetics
Parkinsons

50. Bilateral destruction of mammilary bodies - some retrograde amnesia - alcholics - and assoc with confabulations

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