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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. Dec bone density - severe weight loss - metatarsal stress fractures - amenorrhea - anemia - lytes disturbances - depression
In ADHD - typical intelligence and school performance
intox = euphoria - anxiety - paranoid delusions - perception of slowed time - impaired judgment - social withdrawal - increase appetite - dry mouth hallucinations. Withdrawal = irritability - depression - insomnia - N - anorexia
application of aversive stimulus extinguishes unwanted behavior
the complications/associations of anorexia nervosa

2. SSRIs - clomipramine
cyclothymia disorder
How long episodes of major depressive episode usually last
fixed persistent - nonbizarre belief system lasting >1 month not impaired - self limited
the tx for OCD

3. Physiologic tolerance and dependence with symptoms of withdrawal when intake is interrupted
the definition of alcoholism
What ego dystonic means in relation to OCD
voluntary withholding of an idea or feeling fromk concious awareness
doctor projects feelings about formative or other important persons onto patient

4. Mood stabilizers - Li - valproic acid - carbamazepine - atypical antipsychotics
Stanford - binet
the concern with use of antidepressants in pts with bipoloar disorder
the tx for bipolar disorder
x- linked disorder in girls - sx apparent 1-4 - regression - MR - loss of verbal abilities - ataxia - and hand wringing

5. Mood elevation - decrease anxiety - sedation - behavior disinhibition - respiratory depression
the time frame for schizophreniform disorder
Drugs with what kind of affect can lead to a state of delirium
depressant intoxication - nonspecific
gets schizophrenia and the prev

6. Postpartum psyschosis - .1 to .2%
When to hypnopompic hallucinations take place
Postpartum delusions - confusion - unusual behavior - homicidal/suicidal ideations or attempts - lasts 4 to 6 weeks
repeated stimulation lead sot increase response
persistent re - experiencing of a previous traumatic event

7. Mallory weiss syndrome
SIG E CAPS and the criteria for dx
potential tx for nicotine withdrawal
the typical abuser in sexual abuse
Longitudinal lacerations of the gastroesophogeal junction caused by excessive vomiting

8. Rationalization - after getting fired saying the job wasn't that important anyway
the goal of the ego defenses
involunatary withholding of an idea or feeling from conscious awareness
proclaiming logical reasons for actions actually performed for other reasons - to avoid self blame
reward received after every response - rapidly extinguished - vending machine

9. Behavior inconsistent with ones own beliefs and attitudes - as opposed to OC personality disorder
potential tx for nicotine withdrawal
excessive dieting +/- purging - intense fear of gaining weight - body image distortion - increase exercise
persistant feelings of detachment or estrangement from one's own body - a social situation - or the environment
What ego dystonic means in relation to OCD

10. 1-6 months
intox = restlessness. Withdrawal = irritability - anxiety - craving
Depression
dramatic - emotional or erratic
the time frame for schizophreniform disorder

11. Aspergers
dramatic - emotional or erratic
repeated stimulation leads to decrease response
milder form of autism with normal intel - repetitive behavior and problems with social relationships - no language impairment
Separation of feelings from ideas and events

12. Depression
misinterpretations of actual external stimulus
Huntingtons
postpartum depressed affect - tearfullness fatigue - usually resolves within 10 days - disorder + incidence
in elderly patients who present with dementia - the concern

13. Generalized anxiety disorder
variety of complaints in multiple organ symptoms - pain - GI - sexual - pseudo neurologic over years
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
causes wernicke - korsakoff syndrome
pattern of uncontrollable anxiety for at least 6 months - associated with sleep disturbances - fatigue - GI distirbance - difficulty concentrating

14. Extinction
in elderly patients who present with dementia - the concern
DIG FAST
the triad of Wernicke's encephalopathy
discontinuation of reinforcement eliminates behavior

15. Denial - can occur in new AIDS or cancer diagnosis
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
the typical abuser in sexual abuse
PANICS
avoidance of awareness of a some painful reality

16. Cocaine
exaggerated fear of embarrasment in social situations - disorder and tx
emotional symptoms causing impairment following an identifiable stressor (divorce - illness) and lasting <6 months
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
intox = impaired judgement - pup dilation - hallucinations (tactile) - paranoid ideations - angina - sudden cardiac death. Withdrawal = suicidality - hypersomnolence - malaise - severe psychological craving

17. OCD
presence of 2 or more distinct identities or personality states - most common in women - associated with a history of sexual abuse
discontinuation of reinforcement eliminates behavior
recurring - intrussive thoughts - feelings or sensations that cause severe distress - relieved in part by performance of repeititive actions
inability to remember things that occurred after CNS insult

18. Severe and profound MR?
the definition of alcoholism
variety of complaints in multiple organ symptoms - pain - GI - sexual - pseudo neurologic over years
<40 and <20
repeated stimulation leads to decrease response

19. EtOH - drugs - fluid/lytes imbalance - head trauma - hypoglycemia - nutritional def
How long marijuana is detectable in the urine after last use
the common causes of lack or orientation
Causes of dementia
variety of complaints in multiple organ symptoms - pain - GI - sexual - pseudo neurologic over years

20. Humor - nervous med student jokes about boards
Huntingtons
appreciating the amusing nature of an anxiety provoking or adverse situation
delerium tremens symptoms
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

21. Amphetamines
intox = impaired judgement - pup dilation - prolonged wakefulness and attention - delusions - hallucinations - fever. Withdrawal = stomach cramps - hunger - hypersomnolence
persistant feelings of detachment or estrangement from one's own body - a social situation - or the environment
Parkinsons
chronic factitious disorder with physical signs and symptoms - mutliple hospital admissions and invasive procedures

22. Delirium
gustatroy hallucinations common
mediator between primal urges and accepted behavior
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
Number of major depressive episodes constitute major depressive disorder

23. Hepatitis - abscesses - OD - hemorrhoids - AIDS - right sided endocarditits
heroin users at increased risk of...
the tx for GAD
SAD PERSONS
child neglect

24. 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
exaggerated fear of embarrasment in social situations - disorder and tx
the tx for bipolar disorder
SIG E CAPS and the criteria for dx
Alzheimers

25. Retrograde amnesia
learning in which a natural response is elicited by a conditioned - or learned stimulus that previously was presented in conjuction with an unconditioned stimulus
intox = impaired judgement - pup dilation - prolonged wakefulness and attention - delusions - hallucinations - fever. Withdrawal = stomach cramps - hunger - hypersomnolence
inability to remember things that occurred before CNS insult
bing eating +/- purging self induced vomiting - use of laxatives - diuretics or emetics

26. Yes
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
Is body weight maintained within nl range in bulimia nervosa
whenmen vs women present with schizophrenia
patient projects feelings about formative or other important persons onto physician

27. Fixation - men fixating on sports games
partially remaining at more childish level of development
heroin users at increased risk of...
reward received after every response - rapidly extinguished - vending machine
involunatary withholding of an idea or feeling from conscious awareness

28. Intox = mood elevation - psychomotor agitation - insomnia - cardiac arrhythmias - tachycardia - anxiety. Withdrawal = post use crash - depression - weight gain - lethargy - HA
the non specific signs of stimulant intox and withdrawal
distinct period of abnormally and persistently elevated - expansive - irritable mood lasting at least 1 week
maladaptive pattern of substance use with 3 or more of these 7 criteria
whenhypnagogic hallucinations take place

29. Alcohol
Postpartum delusions - confusion - unusual behavior - homicidal/suicidal ideations or attempts - lasts 4 to 6 weeks
Schizophrenia
repeated stimulation leads to decrease response
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens

30. Male - known to the victim
reward received after every response - rapidly extinguished - vending machine
visual hallucinations common
the typical abuser in sexual abuse
Moral values - conscience can lead to self blame and attacks of ego

31. Ego - take it and you will get in trouble
preoccupation with a fear of having a serious illness despite medical evaluation and assurance
mediator between primal urges and accepted behavior
learning in which a particular ation is elicited because it produces a reward
intox - emotional liability - slurred speech - ataxia - coma - blackouts. Withdrawal - severe is delerium tremens

32. 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
100 - 15
the tx for alcoholism
maladaptive pattern of substance use with 3 or more of these 7 criteria
Gradual change in cognition with no change in level of conciousness - memory deficits - aphasia - apraxia - loss of abstract thought

33. <1mo - usually stress related
the time frame for brief pyschotic disorder
the goal of the ego defenses
partially remaining at more childish level of development
odd or eccentric; inability to develop meaningful social relationships

34. Failure to provide adequate food - shelter - supervision - education and/or affection - most common form of child maltreatment
tantrums
child neglect
heroin users at increased risk of...
belief that people are either all good or all bad at different times due to intolerance or ambiguity

35. Caffeine
distinct period of abnormally and persistently elevated - expansive - irritable mood lasting at least 1 week
olfactory hallucinations common
the typical abuser in sexual abuse
intox = restlessness - increase diureis - muscle twitching

36. Men early 20s - women late 20s early 30s
the tx for atypical depression
perceptions in the absence of external stimulus
whenmen vs women present with schizophrenia
the time frame for brief pyschotic disorder

37. Oppositional defiant disorder
whenmen vs women present with schizophrenia
potential tx for nicotine withdrawal
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
enduring pattern of hostile - defiant behavior towards authority figures in the absence of serious violations of social norms

38. Substance withdrawal - signs are often opposite of intoxication
the stages of change in overcoming substance addiction
behavioral - physiologic - cognitive state caused by cessation or reduction of heavy and prolonged substance use - clinical signs
illness in a child is caused by a caregiver - motivation is to assume sick role by proxy
the tx for panic disorder

39. Aura of psychomotor epilepsy and in brain tumors
How long does the disturbance last in PTSD
olfactory hallucinations common
pattern of uncontrollable anxiety for at least 6 months - associated with sleep disturbances - fatigue - GI distirbance - difficulty concentrating
Postpartum delusions - confusion - unusual behavior - homicidal/suicidal ideations or attempts - lasts 4 to 6 weeks

40. Countertransference
whering clothes of the opposite sex
doctor projects feelings about formative or other important persons onto patient
involunatary withholding of an idea or feeling from conscious awareness
sudden rapid - recurrent - nonrhythmic stereotyped motor movements or vocalizations that persist for >1 yr

41. Irreversible memory loss - confabulation - personality change

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42. Occurs while waking up
<40 and <20
process whereby a warded off idea or feeling is replaced by an unconsiously derived emphasis on its opposite
both illness and motivation are subconcious - sx not intentionally produced or feigned
When to hypnopompic hallucinations take place

43. Methylphenidate - amphetamines - atomoxetine
at least 2 weeks of stable mood with psychotic sx plus a major depressive - manic or mixed episode
partially remaining at more childish level of development
intox = belligerence - impulsiveness - fever - psychomotor agitation - vertical and horizontal nystagmus - tachycardia - homicidality - psychosis - delirium. Withdrawal = depression - anxiety - irritability - restlessness - anergia - disturbances of
the treatments for ADHD

44. Flumazenil - competitive GABA antagonist
How long episodes of major depressive episode usually last
depressant withdrawal - nonspecific
the tx for BDZ intox - MOA
a hypomanic episode

45. Personality disorder
desired reward produces action - mouse presses button for food
lifetime prevalance of tourrette's in the gen pop - and the chance of coprolalia
fixed persistent - nonbizarre belief system lasting >1 month not impaired - self limited
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

46. Identification - abused models abuser
emotional symptoms causing impairment following an identifiable stressor (divorce - illness) and lasting <6 months
modeling behavior after another person is more powerful - though not necessarily admired
the tx for BDZ intox - MOA
limited attention span and poor impulse control - hyperactivity - motor impairment - emotional lability

47. Separation anxiety disorder
disorders in the form of through - the way ideas are tied together
overwhelming fear of separation from home or loss of attachment figure that can lead to factitious physical complaints to avoid going to school
a hypomanic episode
the EEG findings in dementia

48. Bulimia nervosa
hypersomnia - overeating - mood reactivity - weight gain and sensitivity to rejection
bing eating +/- purging self induced vomiting - use of laxatives - diuretics or emetics
this drug is a risk factor for schizophrenia in teens
define bipolar disorder and distinguish I from II

49. Classical conditioning - pavlov's dogs
learning in which a particular ation is elicited because it produces a reward
strong persistant cross gender identification
learning in which a natural response is elicited by a conditioned - or learned stimulus that previously was presented in conjuction with an unconditioned stimulus
prolonged pain with no physical findings - psychosocial factors play an important role in severity exacerbation or maintenance

50. Tourrette's
dramatic - emotional or erratic
sudden rapid - recurrent - nonrhythmic stereotyped motor movements or vocalizations that persist for >1 yr
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
both illness and motivation are subconcious - sx not intentionally produced or feigned