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Psychiatry

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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. LSD
the triad of Wernicke's encephalopathy
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
heroin users at increased risk of...
intox = marked anxiety or depression - delusions - visual hallucinations - flashbacks and pup dilation

2. Negative reinforcement
removal of aversive stimulus elicits behavior - mouse presses button to avoid shock
patient projects feelings about formative or other important persons onto physician
whenhypnagogic hallucinations take place
the central goa of freudian psychoanalysis

3. Severe and profound MR?
persistant feelings of detachment or estrangement from one's own body - a social situation - or the environment
<40 and <20
the time frame for schizophreniform disorder
the tx for bipolar disorder

4. Schizophrenia
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
patient projects feelings about formative or other important persons onto physician
intox = belligerence - impulsiveness - fever - psychomotor agitation - vertical and horizontal nystagmus - tachycardia - homicidality - psychosis - delirium. Withdrawal = depression - anxiety - irritability - restlessness - anergia - disturbances of
Chronic mental disorder with periods of pyschosis - disturbed behavior and though and decline in fxn that lasts > 6 months

5. Men early 20s - women late 20s early 30s
Separation of feelings from ideas and events
mediator between primal urges and accepted behavior
whenmen vs women present with schizophrenia
patients ability to know who he or she is - what date and time is and wht his or her present circumstances are...

6. Supression - not thinking about the USMLE until the week of the exam
the tx of W- K syndrome
causes wernicke - korsakoff syndrome
voluntary withholding of an idea or feeling fromk concious awareness
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse

7. Avoidant - hypersensitive to rejection - timid - obsessive/compulsive - preoccupation with order - ego syntonic - dependent - submissive and clinging
the time frame for schizophreniform disorder
cyclothymia disorder
whenmen vs women present with schizophrenia
the 3 types of cluster C personality disorder

8. Inc mania - high suicide risk
tantrums
process whereby a warded off idea or feeling is replaced by an unconsiously derived emphasis on its opposite
behavior acquired by watching others and assimilating actions into one's own repetoire
the concern with use of antidepressants in pts with bipoloar disorder

9. Naltrexone and BDZ
psychiatric disorder associated with tourrettes - and the treatment
the treatment for EtOH intox and withdrawal
lifetime prevalance of tourrette's in the gen pop - and the chance of coprolalia
the associations/complications of bulimia nervosa

10. Marijuana
the common sx of PTSD
intox = euphoria - anxiety - paranoid delusions - perception of slowed time - impaired judgment - social withdrawal - increase appetite - dry mouth hallucinations. Withdrawal = irritability - depression - insomnia - N - anorexia
intox is marked respiratory depression - intox = delerium - life threatening CV collapse
causes wernicke - korsakoff syndrome

11. Extinction
the evidence for child neglect
behavioral - physiologic - cognitive state caused by cessation or reduction of heavy and prolonged substance use - clinical signs
behavior achieved following reward of closer and closer approximations of desired behavior
discontinuation of reinforcement eliminates behavior

12. Reaction formation - a patient with libidinous thoughts enters a monastery
chronic factitious disorder with physical signs and symptoms - mutliple hospital admissions and invasive procedures
process whereby a warded off idea or feeling is replaced by an unconsiously derived emphasis on its opposite
How long does the disturbance last in PTSD
inability to remember things that occurred before CNS insult

13. Unconcious mental processes to resolve conflict and prevent feelings of anxiety and depression
tactile hallucinations common
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 types of cluster B personality disorder
the goal of the ego defenses

14. Delirium
at least 2 weeks of stable mood with psychotic sx plus a major depressive - manic or mixed episode
Stanford - binet
sudden loss of sensory or motor fxn often following an acute stressor - pt is aware but indifferent
visual hallucinations common

15. Flumazenil - competitive GABA antagonist
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
the tx for BDZ intox - MOA
reward received after every response - rapidly extinguished - vending machine
modeling behavior after another person is more powerful - though not necessarily admired

16. Presence of at least one manic (I) or hypomanic (II) episode - depressive sx occur eventually
This gross neurological finding is associated with ADHD
the order of loss of orientation
define bipolar disorder and distinguish I from II
the EEG findings in dementia

17. Substance abuse
partially remaining at more childish level of development
Where child neglect is reported
DIG FAST
maladaptive pattern leading to clinically significant impairment or distress

18. Yes
the tx for BDZ intox - MOA
Is body weight maintained within nl range in bulimia nervosa
fixed persistent - nonbizarre belief system lasting >1 month not impaired - self limited
intox = impaired judgement - pup dilation - prolonged wakefulness and attention - delusions - hallucinations - fever. Withdrawal = stomach cramps - hunger - hypersomnolence

19. Dec frontal lobe volumes
milder form of depression lasting at least 2 years
repetitive and pervasive behavior violating social norms - disorder - and name change after 18
This gross neurological finding is associated with ADHD
suboxone and the rational of adding an antagonist

20. >1month
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
auditory hallucinations common
How long does the disturbance last in PTSD
neurologic outcome associated with W- K syndrome

21. Gender identity disorder
abrupt change in geographic location with inability to recall past - confusion about personal identity - or assumption of a new identity - associated with traumatic circumstances
chronic factitious disorder with physical signs and symptoms - mutliple hospital admissions and invasive procedures
repetitive and pervasive behavior violating social norms - disorder - and name change after 18
strong persistant cross gender identification

22. Dissociative amnesia
inbability to recall important personal information - usually subsequent to severe trauma or stress
Chronic mental disorder with periods of pyschosis - disturbed behavior and though and decline in fxn that lasts > 6 months
100 - 15
emotional symptoms causing impairment following an identifiable stressor (divorce - illness) and lasting <6 months

23. Rationalization - after getting fired saying the job wasn't that important anyway
intox = euphoria - anxiety - paranoid delusions - perception of slowed time - impaired judgment - social withdrawal - increase appetite - dry mouth hallucinations. Withdrawal = irritability - depression - insomnia - N - anorexia
turning back the maturational clock and going back to earlier modes of dealing with the world
proclaiming logical reasons for actions actually performed for other reasons - to avoid self blame
Diagnosis requres 2 of 5 of which sx

24. 2 or more within a symptom free interval of 2 months
reward received after random number of responses - slowly extinguished - slot machine
the most common psychiatric illness on medical and surgical floors and the most common cause of this pyschiatric disorder
Number of major depressive episodes constitute major depressive disorder
the common sx of PTSD

25. Munchausen's syndrome
chronic factitious disorder with physical signs and symptoms - mutliple hospital admissions and invasive procedures
Anxiety
Longitudinal lacerations of the gastroesophogeal junction caused by excessive vomiting
Moral values - conscience can lead to self blame and attacks of ego

26. Childhood disintegrative disorder
pieces of evidence for sexual child abuse
How long episodes of major depressive episode usually last
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
sudden rapid - recurrent - nonrhythmic stereotyped motor movements or vocalizations that persist for >1 yr

27. Anorexia nervosa
excessive dieting +/- purging - intense fear of gaining weight - body image distortion - increase exercise
In ADHD - typical intelligence and school performance
causes wernicke - korsakoff syndrome
exaggerated fear of embarrasment in social situations - disorder and tx

28. Female primary caregiver
the epi of sexual abuse
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens
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 typical abuser in physical child abuse

29. 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
What korsakoff's amnesia can lead to - who do you see it in and it also associated with
overwhelming fear of separation from home or loss of attachment figure that can lead to factitious physical complaints to avoid going to school
pieces of evidence for sexual child abuse

30. Stress of physical illness - punishment - birth of a new sibling - fatigue (bedwetting in a previously toilet trained child when hospitalized
gender autism is more common in
causes wernicke - korsakoff syndrome
Under these conditions do children regress to younger patterns of behavior
IQ<70

31. Cocaine
100 - 15
intox = impaired judgement - pup dilation - hallucinations (tactile) - paranoid ideations - angina - sudden cardiac death. Withdrawal = suicidality - hypersomnolence - malaise - severe psychological craving
discontinuation of reinforcement eliminates behavior
severe language impairment and poor social interactions - greater focus on objects than people - repetitive behavior - below normal intelligence

32. Personality trait
auditory hallucinations common
the tx for panic disorder
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens
an enduring repetitive pattern of perceiving - relating to - and thinking about about the environment and oneself

33. Altruism - mafia boss makes a large donation to charity
patients ability to know who he or she is - what date and time is and wht his or her present circumstances are...
This gross neurological finding is associated with ADHD
When separation anxiety disorder usually presents
guilty feelings alleviated by unsolicitied generosity towards others

34. Classical conditioning - pavlov's dogs
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse
inability to remember things that occurred before CNS insult
learning in which a natural response is elicited by a conditioned - or learned stimulus that previously was presented in conjuction with an unconditioned stimulus
autism with unusual abilities

35. Munchausen's syndrome by proxy
intox = impaired judgement - pup dilation - hallucinations (tactile) - paranoid ideations - angina - sudden cardiac death. Withdrawal = suicidality - hypersomnolence - malaise - severe psychological craving
illness in a child is caused by a caregiver - motivation is to assume sick role by proxy
the common causes of lack or orientation
neurologic outcome associated with W- K syndrome

36. The criteria for mental retardation?
IQ<70
intox = restlessness - increase diureis - muscle twitching
partially remaining at more childish level of development
misinterpretations of actual external stimulus

37. Delusions
severe language impairment and poor social interactions - greater focus on objects than people - repetitive behavior - below normal intelligence
false beliefs not shared with other members of culture/subcutlure that are firmly maintained in spite of obvoius proof to the contrary
process whereby avoided ideas and feelings are transferred to some neutral person or object
guilty feelings alleviated by unsolicitied generosity towards others

38. Healed fractures on xray - cigarrette burns - sudbural hematomasm multiples bruises - retinal hemorrhage or detachment
delerium tremens symptoms
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
pieces of evidence of physical child abuse
cyclothymia disorder

39. Illusion
misinterpretations of actual external stimulus
modeling behavior after another person is more powerful - though not necessarily admired
maladaptive pattern of substance use with 3 or more of these 7 criteria
learning in which a particular ation is elicited because it produces a reward

40. In what disease is ACH decrease?
Korsakoff's psychosis
depressant withdrawal - nonspecific
Alzheimers
repeated stimulation leads to decrease response

41. Autism
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
the 5 types of schizophrenia
severe language impairment and poor social interactions - greater focus on objects than people - repetitive behavior - below normal intelligence
the complications of alcoholism

42. ADHD
fixed persistent - nonbizarre belief system lasting >1 month not impaired - self limited
limited attention span and poor impulse control - hyperactivity - motor impairment - emotional lability
the definition of alcoholism
100 - 15

43. Projection - a man who wants another women thinks his wife is cheating on him
proclaiming logical reasons for actions actually performed for other reasons - to avoid self blame
an unacceptable internal impulse is attributed to an external source
postpartum depressed affect - tearfullness fatigue - usually resolves within 10 days - disorder + incidence
Anxiety

44. 1-6 months
the time frame for schizophreniform disorder
psychiatric disorder associated with tourrettes - and the treatment
prolonged pain with no physical findings - psychosocial factors play an important role in severity exacerbation or maintenance
Gradual change in cognition with no change in level of conciousness - memory deficits - aphasia - apraxia - loss of abstract thought

45. Dysthymia followed by hypomania
the various types of cluster A personality disorder
cyclothymia disorder
the tx for OCD
proclaiming logical reasons for actions actually performed for other reasons - to avoid self blame

46. To make the patient aware of hidden in their unconcious
PANICS
Is body weight maintained within nl range in bulimia nervosa
learning in which a natural response is elicited by a conditioned - or learned stimulus that previously was presented in conjuction with an unconditioned stimulus
the central goa of freudian psychoanalysis

47. While going to sleep
primal urges - freud
strong persistant cross gender identification
whenhypnagogic hallucinations take place
intox = ataxia - minor respiratory depression

48. Calculates IQ as mental age/chronological age x 100
olfactory hallucinations common
doctor projects feelings about formative or other important persons onto patient
Stanford - binet
depressant withdrawal - nonspecific

49. Aura of psychomotor epilepsy and in brain tumors
the tx for GAD
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens
olfactory hallucinations common
x- linked disorder in girls - sx apparent 1-4 - regression - MR - loss of verbal abilities - ataxia - and hand wringing

50. Gamma glutamyltransferase - GGT - AST 2x ALT
the serum markers of alcohol use
depression in an infant attributable to continued separation from caregiver - infant beceomes withdrawn and unresponsive - disorder and prognosis
in elderly patients who present with dementia - the concern
Stanford - binet