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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. OCD
patient conciously creates physical and or psychological symptoms in order to assume the sick role and get medical attention - primary gain
recurring - intrussive thoughts - feelings or sensations that cause severe distress - relieved in part by performance of repeititive actions
intox = restlessness. Withdrawal = irritability - anxiety - craving
an enduring repetitive pattern of perceiving - relating to - and thinking about about the environment and oneself

2. 6-12 months
illness in a child is caused by a caregiver - motivation is to assume sick role by proxy
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
PANICS
How long episodes of major depressive episode usually last

3. 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
SAD PERSONS
SIG E CAPS and the criteria for dx
the stages of change in overcoming substance addiction
avoidance of awareness of a some painful reality

4. Negative reinforcement
fixed persistent - nonbizarre belief system lasting >1 month not impaired - self limited
removal of aversive stimulus elicits behavior - mouse presses button to avoid shock
false beliefs not shared with other members of culture/subcutlure that are firmly maintained in spite of obvoius proof to the contrary
sudden rapid - recurrent - nonrhythmic stereotyped motor movements or vocalizations that persist for >1 yr

5. 2 or more within a symptom free interval of 2 months
Number of major depressive episodes constitute major depressive disorder
repetitive and pervasive behavior violating social norms - disorder - and name change after 18
the triad of Wernicke's encephalopathy
How long marijuana is detectable in the urine after last use

6. Denial - can occur in new AIDS or cancer diagnosis
desire to live as the opposite sex - through surgery or hormone tx
repeated stimulation leads to decrease response
avoidance of awareness of a some painful reality
Long acting oral opiate for heroine detox or long term maintenance

7. Genital/anal trauma - STDs and UTIs
pieces of evidence for sexual child abuse
associated with winter season - improves in response to full spectrum light exposure
intox = restlessness - increase diureis - muscle twitching
maladaptive pattern of substance use with 3 or more of these 7 criteria

8. Behavior inconsistent with ones own beliefs and attitudes - as opposed to OC personality disorder
behavior acquired by watching others and assimilating actions into one's own repetoire
What ego dystonic means in relation to OCD
learning in which a particular ation is elicited because it produces a reward
the most common psychiatric illness on medical and surgical floors and the most common cause of this pyschiatric disorder

9. Dissociation - can lead to multiple personality disorder
behavior acquired by watching others and assimilating actions into one's own repetoire
temporary - drastic changes in personality - memory or conciousness or motor behavior to avoid emotional stress
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
treatment option for MDD refractory to opther treatment - produces painelss seizure in anesthetized patient - tx and major adverse affects

10. Dysthymia
tantrums
the treatment for maternal blues - depression - psychosis
dramatic - emotional or erratic
milder form of depression lasting at least 2 years

11. Isolation of affect - describing murder in graphic detail with no emotional response
Separation of feelings from ideas and events
avoidance of awareness of a some painful reality
chronic factitious disorder with physical signs and symptoms - mutliple hospital admissions and invasive procedures
learning in which a natural response is elicited by a conditioned - or learned stimulus that previously was presented in conjuction with an unconditioned stimulus

12. In what disease does NE decrease - 5HT decrease and DA decrease?
Depression
visual hallucinations common
repetitive and pervasive behavior violating social norms - disorder - and name change after 18
milder form of autism with normal intel - repetitive behavior and problems with social relationships - no language impairment

13. Body dysmorphic disorder
behavior acquired by watching others and assimilating actions into one's own repetoire
the central goa of freudian psychoanalysis
Huntingtons
preoccupation with minor or imagined defect in appearance leading to significant emotional distress or impaired functioning

14. Calculates IQ as mental age/chronological age x 100
auditory hallucinations common
Stanford - binet
Number of major depressive episodes constitute major depressive disorder
the 4 W's of deprived babies?

15. Illusion
misinterpretations of actual external stimulus
repeated stimulation leads to decrease response
Schizophrenia
illness in a child is caused by a caregiver - motivation is to assume sick role by proxy

16. Marijuana
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 = impaired judgement - pup dilation - hallucinations (tactile) - paranoid ideations - angina - sudden cardiac death. Withdrawal = suicidality - hypersomnolence - malaise - severe psychological craving
repeated stimulation lead sot increase response
Where child neglect is reported

17. Retrograde amnesia
inability to remember things that occurred before CNS insult
reward received after every response - rapidly extinguished - vending machine
an unacceptable internal impulse is attributed to an external source
variety of complaints in multiple organ symptoms - pain - GI - sexual - pseudo neurologic over years

18. Bulimia nervosa
preoccupation with a fear of having a serious illness despite medical evaluation and assurance
the epi of sexual abuse
a hypomanic episode
bing eating +/- purging self induced vomiting - use of laxatives - diuretics or emetics

19. SSRIs - clomipramine
olfactory hallucinations common
the tx for OCD
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
modeling behavior after another person is more powerful - though not necessarily admired

20. Alcoholic cirrhosis - hepatitis - pancreatitis - peripheral neuropathy - testicular atrophy
exaggerated fear of embarrasment in social situations - disorder and tx
neurologic outcome associated with W- K syndrome
the complications of alcoholism
the central goa of freudian psychoanalysis

21. Identification - abused models abuser
bing eating +/- purging self induced vomiting - use of laxatives - diuretics or emetics
reward received after every response - rapidly extinguished - vending machine
the complications/associations of anorexia nervosa
modeling behavior after another person is more powerful - though not necessarily admired

22. There are rare
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 associations/complications of bulimia nervosa
proclaiming logical reasons for actions actually performed for other reasons - to avoid self blame
gustatroy hallucinations common

23. Repression - not remebering a conflictual or traumatic experience
the time frame for schizophreniform disorder
lifetime prevalance of tourrette's in the gen pop - and the chance of coprolalia
preoccupation with a fear of having a serious illness despite medical evaluation and assurance
involunatary withholding of an idea or feeling from conscious awareness

24. Parotitis - enamel erosion - lytes disturbances - alkalosis - dorsal hand calluses from inducing vomit
the associations/complications of bulimia nervosa
the two types of schizoaffective disorder
intox = CNS depression - N/V - constipation - pup cxn - seizures withdrawal = sweating - pup diltaed - piloerection - rever - rhinorrhea - N - stomach cramps - diarrhea
guilty feelings alleviated by unsolicitied generosity towards others

25. 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
treatment option for MDD refractory to opther treatment - produces painelss seizure in anesthetized patient - tx and major adverse affects
a hypomanic episode
the tx for opiod intox and withdrawal

26. Seasonal affective disorder
desire to live as the opposite sex - through surgery or hormone tx
whenmen vs women present with schizophrenia
inability to remember things that occurred before CNS insult
associated with winter season - improves in response to full spectrum light exposure

27. Schizoaffective disorder
the order of loss of orientation
inbability to recall important personal information - usually subsequent to severe trauma or stress
intox = impaired judgement - pup dilation - hallucinations (tactile) - paranoid ideations - angina - sudden cardiac death. Withdrawal = suicidality - hypersomnolence - malaise - severe psychological craving
at least 2 weeks of stable mood with psychotic sx plus a major depressive - manic or mixed episode

28. Avoidant - hypersensitive to rejection - timid - obsessive/compulsive - preoccupation with order - ego syntonic - dependent - submissive and clinging
the tx for atypical depression
process whereby a warded off idea or feeling is replaced by an unconsiously derived emphasis on its opposite
the 3 types of cluster C personality disorder
the associations/complications of bulimia nervosa

29. Korsakoff's amnesia
anxious - fearful
development of delusions in a person in a close relationship with delusional disorder
anterograde amnesia caused by thiamine deficiency
sudden loss of sensory or motor fxn often following an acute stressor - pt is aware but indifferent

30. Vit B1 - thiamine
How long episodes of major depressive episode usually last
the evidence for child neglect
the tx of W- K syndrome
intox = impaired judgement - pup dilation - prolonged wakefulness and attention - delusions - hallucinations - fever. Withdrawal = stomach cramps - hunger - hypersomnolence

31. MAOi - SSRIs
appreciating the amusing nature of an anxiety provoking or adverse situation
the tx for atypical depression
discontinuation of reinforcement eliminates behavior
Chronic mental disorder with periods of pyschosis - disturbed behavior and though and decline in fxn that lasts > 6 months

32. 6 months
How long infant deprivation can last before it leads to irreversible changes
the tx for atypical depression
an enduring repetitive pattern of perceiving - relating to - and thinking about about the environment and oneself
an unacceptable internal impulse is attributed to an external source

33. Panic disorder
the complications of alcoholism
pattern of uncontrollable anxiety for at least 6 months - associated with sleep disturbances - fatigue - GI distirbance - difficulty concentrating
intense fear and discomfort peaking in 10 minutes
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

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

35. Failure to provide adequate food - shelter - supervision - education and/or affection - most common form of child maltreatment
the epi of physical child abuse
100 - 15
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
child neglect

36. Somatization disorders
development of delusions in a person in a close relationship with delusional disorder
both illness and motivation are subconcious - sx not intentionally produced or feigned
the epi of sexual abuse
gender autism is more common in

37. Shaping (social learning)
depressant intoxication - nonspecific
Depression
this drug is a risk factor for schizophrenia in teens
behavior achieved following reward of closer and closer approximations of desired behavior

38. Female primary caregiver
How long infant deprivation can last before it leads to irreversible changes
the typical abuser in physical child abuse
the time frame for brief pyschotic disorder
desire to live as the opposite sex - through surgery or hormone tx

39. Positive reinforcement
partially remaining at more childish level of development
desired reward produces action - mouse presses button for food
postpartum depressed affect - anxiety - poor concentration - lasts 2 weeks to 2 months - disorder + incidence
the 4 W's of deprived babies?

40. Maternal blues 50 to 85%
postpartum depressed affect - tearfullness fatigue - usually resolves within 10 days - disorder + incidence
discontinuation of reinforcement eliminates behavior
dramatic - emotional or erratic
How long infant deprivation can last before it leads to irreversible changes

41. Normal intel - trouble in school
Causes of dementia
the concern with use of antidepressants in pts with bipoloar disorder
child neglect
In ADHD - typical intelligence and school performance

42. Rett's disorder
process whereby a warded off idea or feeling is replaced by an unconsiously derived emphasis on its opposite
x- linked disorder in girls - sx apparent 1-4 - regression - MR - loss of verbal abilities - ataxia - and hand wringing
intox = belligerence - impulsiveness - fever - psychomotor agitation - vertical and horizontal nystagmus - tachycardia - homicidality - psychosis - delirium. Withdrawal = depression - anxiety - irritability - restlessness - anergia - disturbances of
the epi of physical child abuse

43. Anorexia nervosa
belief that people are either all good or all bad at different times due to intolerance or ambiguity
excessive dieting +/- purging - intense fear of gaining weight - body image distortion - increase exercise
desire to live as the opposite sex - through surgery or hormone tx
both illness and motivation are subconcious - sx not intentionally produced or feigned

44. Like manic but without marked impairement in fxning - no pyschotic features
This gross neurological finding is associated with ADHD
partially remaining at more childish level of development
a hypomanic episode
application of aversive stimulus extinguishes unwanted behavior

45. Blacks=whites - males = females - 1.5% lifetime prev
emotional symptoms causing impairment following an identifiable stressor (divorce - illness) and lasting <6 months
intox = belligerence - impulsiveness - fever - psychomotor agitation - vertical and horizontal nystagmus - tachycardia - homicidality - psychosis - delirium. Withdrawal = depression - anxiety - irritability - restlessness - anergia - disturbances of
gets schizophrenia and the prev
the tx for bipolar disorder

46. Aspergers
milder form of autism with normal intel - repetitive behavior and problems with social relationships - no language impairment
the epi of physical child abuse
process whereby a warded off idea or feeling is replaced by an unconsiously derived emphasis on its opposite
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

47. <1mo - usually stress related
the evidence for child neglect
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 most common psychiatric illness on medical and surgical floors and the most common cause of this pyschiatric disorder
the time frame for brief pyschotic disorder

48. Mallory weiss syndrome
Drugs with what kind of affect can lead to a state of delirium
the 3 types of cluster C personality disorder
Longitudinal lacerations of the gastroesophogeal junction caused by excessive vomiting
Long acting oral opiate for heroine detox or long term maintenance

49. Gamma glutamyltransferase - GGT - AST 2x ALT
the 5 types of schizophrenia
Under these conditions do children regress to younger patterns of behavior
partially remaining at more childish level of development
the serum markers of alcohol use

50. Delirium
visual hallucinations common
Korsakoff's psychosis
SIG E CAPS and the criteria for dx
the time frame for brief pyschotic disorder