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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. Splitting - a pt that says all nurses are nice and all doctors are bad
define bipolar disorder and distinguish I from II
limited attention span and poor impulse control - hyperactivity - motor impairment - emotional lability
belief that people are either all good or all bad at different times due to intolerance or ambiguity
SIG E CAPS and the criteria for dx

2. Dipoloar or depressive
dramatic - emotional or erratic
factors are most important in the etiology of schizophrenia
the EEG findings in dementia
the two types of schizoaffective disorder

3. Continuous reinforcement schedule
this drug is a risk factor for schizophrenia in teens
Anxiety
process whereby avoided ideas and feelings are transferred to some neutral person or object
reward received after every response - rapidly extinguished - vending machine

4. EtOH withdrawal - cocaine abusers
delerium tremens symptoms
tactile hallucinations common
process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with ones value system
<40 and <20

5. Atypical depression
hypersomnia - overeating - mood reactivity - weight gain and sensitivity to rejection
whenhypnagogic hallucinations take place
the two types of schizoaffective disorder
the epi of sexual abuse

6. Depersonalization disorder

7. Delirium
an enduring repetitive pattern of perceiving - relating to - and thinking about about the environment and oneself
visual hallucinations common
whenmen vs women present with schizophrenia
heroin users at increased risk of...

8. Personality trait
anxious - fearful
treatment option for MDD refractory to opther treatment - produces painelss seizure in anesthetized patient - tx and major adverse affects
an enduring repetitive pattern of perceiving - relating to - and thinking about about the environment and oneself
intox = marked anxiety or depression - delusions - visual hallucinations - flashbacks and pup dilation

9. Autism
whering clothes of the opposite sex
factors are most important in the etiology of schizophrenia
severe language impairment and poor social interactions - greater focus on objects than people - repetitive behavior - below normal intelligence
overwhelming fear of separation from home or loss of attachment figure that can lead to factitious physical complaints to avoid going to school

10. Cluster A personality disorder
inbability to recall important personal information - usually subsequent to severe trauma or stress
odd or eccentric; inability to develop meaningful social relationships
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
child neglect

11. Mood elevation - decrease anxiety - sedation - behavior disinhibition - respiratory depression
How long infant deprivation can last before it leads to irreversible changes
depressant intoxication - nonspecific
intense fear and discomfort peaking in 10 minutes
doctor projects feelings about formative or other important persons onto patient

12. Adjustment disorder
the types of cluster B personality disorder
emotional symptoms causing impairment following an identifiable stressor (divorce - illness) and lasting <6 months
Chronic mental disorder with periods of pyschosis - disturbed behavior and though and decline in fxn that lasts > 6 months
Drugs with what kind of affect can lead to a state of delirium

13. CBT - SSRI - TCI - BDZ
intox = restlessness. Withdrawal = irritability - anxiety - craving
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
milder form of autism with normal intel - repetitive behavior and problems with social relationships - no language impairment
the tx for panic disorder

14. Delusions - hallucinations - disorganizaed speech - disorganized or catatonic behavior and negative sx
intox = ataxia - minor respiratory depression
chronic factitious disorder with physical signs and symptoms - mutliple hospital admissions and invasive procedures
perceptions in the absence of external stimulus
Diagnosis requres 2 of 5 of which sx

15. Peak incidence 9-12 years of age
intox = marked anxiety or depression - delusions - visual hallucinations - flashbacks and pup dilation
the time frame for schizophreniform disorder
the epi of sexual abuse
gustatroy hallucinations common

16. Boys
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
gender autism is more common in
behavioral - physiologic - cognitive state caused by cessation or reduction of heavy and prolonged substance use - clinical signs
causes wernicke - korsakoff syndrome

17. Postpartum depression - 10 to 15%
Gradual change in cognition with no change in level of conciousness - memory deficits - aphasia - apraxia - loss of abstract thought
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
sudden loss of sensory or motor fxn often following an acute stressor - pt is aware but indifferent
postpartum depressed affect - anxiety - poor concentration - lasts 2 weeks to 2 months - disorder + incidence

18. Maternal blues 50 to 85%
less than what percentage of ideal body weight is common in anorexia nervosa
the most common psychiatric illness on medical and surgical floors and the most common cause of this pyschiatric disorder
postpartum depressed affect - tearfullness fatigue - usually resolves within 10 days - disorder + incidence
anxious - fearful

19. Substance dependence - tolerance - withdrawal - substance taken in larger amounts over longer time than desired - persistant desire or unsuccesful attempts to cut down - lots of energy spet obtaining - using or recovering from substance - important s
How long episodes of major depressive episode usually last
whenhypnagogic hallucinations take place
maladaptive pattern of substance use with 3 or more of these 7 criteria
guilty feelings alleviated by unsolicitied generosity towards others

20. Severe and profound MR?
When to hypnopompic hallucinations take place
the goal of the ego defenses
<40 and <20
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse

21. 85 percent
emotional symptoms causing impairment following an identifiable stressor (divorce - illness) and lasting <6 months
visual hallucinations common
less than what percentage of ideal body weight is common in anorexia nervosa
preoccupation with minor or imagined defect in appearance leading to significant emotional distress or impaired functioning

22. Dissociative identity disorder
Long acting oral opiate for heroine detox or long term maintenance
fixed persistent - nonbizarre belief system lasting >1 month not impaired - self limited
visual hallucinations common
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse

23. Loose associations
the tx for opiod intox and withdrawal
suboxone and the rational of adding an antagonist
intox = ataxia - minor respiratory depression
disorders in the form of through - the way ideas are tied together

24. Delirium
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
less than what percentage of ideal body weight is common in anorexia nervosa
inability to remember things that occurred before CNS insult
visual hallucinations common

25. Oppositional defiant disorder
How long episodes of major depressive episode usually last
enduring pattern of hostile - defiant behavior towards authority figures in the absence of serious violations of social norms
the 3 types of cluster C personality disorder
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress

26. Habituation - simple learning
the evidence for child neglect
the 4 W's of deprived babies?
repeated stimulation leads to decrease response
discontinuation of reinforcement eliminates behavior

27. Hallucination
false beliefs not shared with other members of culture/subcutlure that are firmly maintained in spite of obvoius proof to the contrary
learning in which a particular ation is elicited because it produces a reward
postpartum depressed affect - tearfullness fatigue - usually resolves within 10 days - disorder + incidence
perceptions in the absence of external stimulus

28. Postpartum psyschosis - .1 to .2%
Postpartum delusions - confusion - unusual behavior - homicidal/suicidal ideations or attempts - lasts 4 to 6 weeks
guilty feelings alleviated by unsolicitied generosity towards others
repeated stimulation leads to decrease response
<40 and <20

29. Shared delusional disorder
development of delusions in a person in a close relationship with delusional disorder
Longitudinal lacerations of the gastroesophogeal junction caused by excessive vomiting
causes wernicke - korsakoff syndrome
the order of loss of orientation

30. Sublimation - actress using an experience of abuse to enhance her acting
process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with ones value system
the tx for GAD
persistant feelings of detachment or estrangement from one's own body - a social situation - or the environment
guilty feelings alleviated by unsolicitied generosity towards others

31. Reaction formation - a patient with libidinous thoughts enters a monastery
inbability to recall important personal information - usually subsequent to severe trauma or stress
Postpartum delusions - confusion - unusual behavior - homicidal/suicidal ideations or attempts - lasts 4 to 6 weeks
patient conciously creates physical and or psychological symptoms in order to assume the sick role and get medical attention - primary gain
process whereby a warded off idea or feeling is replaced by an unconsiously derived emphasis on its opposite

32. Dysthymia followed by hypomania
cyclothymia disorder
prolonged pain with no physical findings - psychosocial factors play an important role in severity exacerbation or maintenance
Stanford - binet
What ego dystonic means in relation to OCD

33. Manic episdoe
What korsakoff's amnesia can lead to - who do you see it in and it also associated with
intox = ataxia - minor respiratory depression
Postpartum delusions - confusion - unusual behavior - homicidal/suicidal ideations or attempts - lasts 4 to 6 weeks
distinct period of abnormally and persistently elevated - expansive - irritable mood lasting at least 1 week

34. Unconcious mental processes to resolve conflict and prevent feelings of anxiety and depression
avoidance of awareness of a some painful reality
tactile hallucinations common
lifetime prevalance of tourrette's in the gen pop - and the chance of coprolalia
the goal of the ego defenses

35. In what disease does NE increase - GABA decrease - and 5HT decrease?
treatment option for MDD refractory to opther treatment - produces painelss seizure in anesthetized patient - tx and major adverse affects
whering clothes of the opposite sex
bing eating +/- purging self induced vomiting - use of laxatives - diuretics or emetics
Anxiety

36. Acting out
tantrums
the 4 W's of deprived babies?
Where child neglect is reported
How long marijuana is detectable in the urine after last use

37. Normal intel - trouble in school
overwhelming fear of separation from home or loss of attachment figure that can lead to factitious physical complaints to avoid going to school
milder form of depression lasting at least 2 years
In ADHD - typical intelligence and school performance
IQ<70

38. Body dysmorphic disorder
the tx of W- K syndrome
the tx for alcoholism
preoccupation with minor or imagined defect in appearance leading to significant emotional distress or impaired functioning
gender autism is more common in

39. Depression
anterograde amnesia caused by thiamine deficiency
gender autism is more common in
exaggerated fear of embarrasment in social situations - disorder and tx
in elderly patients who present with dementia - the concern

40. Palp - parasthesias - abdominal distress - nausea - intense fear of dying or losing control - lIght headedness - chest pain - chills - choking - disConnectedness - sweating - shaking - SOB
desire to live as the opposite sex - through surgery or hormone tx
associated with winter season - improves in response to full spectrum light exposure
postpartum depressed affect - anxiety - poor concentration - lasts 2 weeks to 2 months - disorder + incidence
PANICS

41. Nl
the typical abuser in sexual abuse
factors are most important in the etiology of schizophrenia
Depression
the EEG findings in dementia

42. Weak - wordless - wanting - and wary - decrease muscle tone - poor language skills - poor socialization skills - lack of basic trust - anaclitic depression - weight loss - physical illness

43. PCP
intox = belligerence - impulsiveness - fever - psychomotor agitation - vertical and horizontal nystagmus - tachycardia - homicidality - psychosis - delirium. Withdrawal = depression - anxiety - irritability - restlessness - anergia - disturbances of
mediator between primal urges and accepted behavior
the non specific signs of stimulant intox and withdrawal
How long does the disturbance last in PTSD

44. Female primary caregiver
the tx for alcoholism
Korsakoff's psychosis
the typical abuser in physical child abuse
excessive dieting +/- purging - intense fear of gaining weight - body image distortion - increase exercise

45. In what disease is ACH decrease?
SIG E CAPS and the criteria for dx
the common causes of lack or orientation
the tx for bipolar disorder
Alzheimers

46. Behavior inconsistent with ones own beliefs and attitudes - as opposed to OC personality disorder
process whereby avoided ideas and feelings are transferred to some neutral person or object
the triad of Wernicke's encephalopathy
What ego dystonic means in relation to OCD
prolonged pain with no physical findings - psychosocial factors play an important role in severity exacerbation or maintenance

47. 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
Huntingtons
overwhelming fear of separation from home or loss of attachment figure that can lead to factitious physical complaints to avoid going to school
sudden rapid - recurrent - nonrhythmic stereotyped motor movements or vocalizations that persist for >1 yr

48. Inc mania - high suicide risk
hypersomnia - overeating - mood reactivity - weight gain and sensitivity to rejection
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 BDZ intox - MOA
the concern with use of antidepressants in pts with bipoloar disorder

49. Seasonal affective disorder
marked regression in multiple areas of fxn after at least 2 years of nl development - loss of expressive or receptive language skills - social - adaptive behavior - bowel or bladder control - more common in boys
SIG E CAPS and the criteria for dx
associated with winter season - improves in response to full spectrum light exposure
Separation of feelings from ideas and events

50. Personality disorder
Moral values - conscience can lead to self blame and attacks of ego
intense fear and discomfort peaking in 10 minutes
the tx for opiod intox and withdrawal
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