1
Q
Dissociation
A
-Drastic change in personality to avoid emotional stress
2
Q
Displacement
A
- Avoided feelings transferred to neutral party.
- Mom yells at kid because angry at husband
3
Q
Fixation
A
- Overly engrossed in minmally important activity
- Spend all time playing video games/watching sports
4
Q
Identification
A
- Modelling behavior after powerful figure.
- Abused child thinks he is a child abuser
5
Q
Isolation
A
- Separate feelings from events
- Talk about a murder in a non schalant sort of way
6
Q
Projection
A
- Internal impulse attributed to external source.
- Man looking at other women accuses wife of cheating
7
Q
Rationalization
A
- Rationalizine poor outcome
- After being fired saying, that job wasn’t good anyways
8
Q
Reaction Formation
A
- Replace bad feelings with opposite.
- Adulterous man joins a monastery
9
Q
Regression
A
- Turning back maturity clock
- Kid begins wetting bed at birth of new sibling
10
Q
Repression/blocking
A
-Involuntarily supressing memories
11
Q
Splitting
A
-All good or all bad
12
Q
Altruism
A
-Mob boss gives large donation to charity
13
Q
Humor
A
-Nervous student laughs at test
14
Q
Sublimation
A
- Turning painful emotions into positive outcome
- Anger at abusive father spurs kid to perform well in sports
15
Q
Supression
A
Voluntarily witholding thoughts. Don’t think about test until it is here.
16
Q
ADHD
A
-Childhood, diagnosed by seven. Inability to sit and learn. Normal intelligence but learning difficulties. Decreased volume in frontal lobe.
-Tx: methylphenidate: DA and NE uptake inhbibitor in the frontal lobe
Tx: atomoxetine: selective NE uptake inhibitor
17
Q
Concduct Disorder
A
- Disregard for others and rules. Theft, assault etc. Seen in childhood
- Can lead to antisocial personality disorder in adult
18
Q
Oppositional Defiant Disoreder
A
- Disrgard for authority without seriously breaking social norms.
- Weak form of conduct disorder. Diagnosis cannot exist together
19
Q
Tourrettes Syndrom
A
- Spontaneous involuntary tics that last for greater than 1 yr.
- Diagnosed before age 18
- Commonly seen in pts with OCD
- Inherited with variable penetrance
- Give antipsychoitcs (dopamine antagonists)
20
Q
Separation Anxiety
A
- 7-9 profound response outside of normal
- Tx: SSRI and behavioral therapy
21
Q
Autism
A
- Impaired language and interaction skills. Focus more on objects than on people.
- Repeated sterotypic behavior.
- Is always present from birth.
- More common in boys 5:1
- Usually below normal intelligence, but not always
22
Q
Aspergers
A
- Mild form of autism with all consuming obsessions.
- Repetitive behavior and problems with social interactions
23
Q
Rett’s Syndrome
A
- x linked, seen only in girls. Boys die in utero
- Normal until 1-4 yrs of age when total loss of abilities ensues.
- Loss of language, bladder control. Wringing movements of hands. Mental Retardation
24
Q
Childhood Disintegrative disorder
A
- Normal until 3-4 yrs then has loss of learned skills including language and bladder control.
- More commonly seen in males
25
Neurotransmitter changes in diseased states
- Anxiety: Elevated NE decreased 5HT and GABA
- Depression: Decrease in all (NE, DA, 5HT)
- Alzhiemers: loss Ach (Nucleus meynert)
- Huntingtons: Loss GABA and Ach. Increase in DA
- Schizophrenia: Increase in DA
- Parkinson's: Loss DA, Increase in Ach and 5HT
26
Amnesia
- Retrograde: can't remember before insult
- Anterograde: can't form new memories since insult
- Korsakoff's: alcholoic antergrade amnesia with confabulations
- Dissociative: Involuntary loss of memories. Usually associated with trauma or stress.
27
Delerium
- Rapid onset, Waxing and waning changes in conciousness, perception, hallucinations.
- Usually due to secondary illness and seen on inpatients.
- Shows abnormal EEG
- May be caused by anticolinergic drugs
- Treat with haloperidol
28
Dementia
- Gradual loss of memory and cognition.
- Will have normal EEG.
- Normal aging does not interfere with activities of daily living where dementia does.
- Pseudodementia is onset of dementia like symptoms tht are caused by depression. Usually patient is in 50's-70's but not always.
29
Psychosis
-Caracterized by hallucinations, dillusions, and diorganized speaking and thinking
30
Hallucinations
- Perceptions in the absence of stimuli.
- Visual: Usually seen in medical illness not psychiatric
- Auditory: See in psychiatric more than medical
- Olfactory: usually part of aura prior to siezure. Tumor or epilepsy (olfactory in temporal lobe)
- Tactile: Usually seen in acoholics, delerium tremens
- Termed hypnogogic if occurs when falling asleep and hypnopompic if occurs when waking up
31
Schizophrenia
- Psychosis that occurs for longer than 6 months.
- Must have 2 out of 4 positive symptoms (hallucinations, dillusions, disorganized speech, disorganized catatonic behavior)
- Negative symptoms: Flat affect, withdrawl, and lack of motivation
- Subtypes: Paranoid(dellusions), Disorganized, Catatonic, undifferentiated (parts of all)
- Increased risk with marijuanna smoking
- Increased risk of suicide
- Underlying pathology is elevated dopamine, treat with antipsychotics that block dopamine (Haloperidole)
- Large genetic component
32
Brief Psychotic Disorder
-Psychosis lasting less than 1 month, usually stress related
33
Schizophreniform
-Psychosis lasting 1-6 months
34
Schizoaffective
- Psychosis in the presence of affective disorder.
| - Bipolar or depressive
35
Schizophrnia gradient
-Brief Psychotic, Schizophrniform, shcizophrenic, sphizoaffective
36
Delusional Disorder
-Fixed dellusional thoughts for greater than 1 month that do not interfere with daily life.
37
Dissociative Disorder
-Multiple personalities, continuation of defense mechanism
38
Dissociative Fugue
-Rare, pt will have major change in geographical location and will not know how it occured.
39
Manic Episode
- Lasts greater than 3 weeks. DIGFAST
- Distractability, Irresponsibility, Grandiosity, Flight of ideas, Activity and Agitation, Sleep decreased, Talkative speech
- Causes interference with daily life. Difference between hypomanic
40
Hypomanic
-Manic symptoms that don't interefere with daily life.
41
Bipolar
- Experiencing symptoms of mania with symptoms of depression.
- When treating always give mood stabilizer (Lithium, Valproate, Carbemazapine) or else you will induce mania with an increased risk of suicide.
42
Cyclothymia
- Experiencing depression and hypomania for greater than 2 years.
- Longer and more watered down version of bipolar
43
Major Depressive Disorder
- SIGMECAPS, usually lasts 6-12 months, but must last more than 2 weeks. Must experience 5/9 and must include a depressed mood
- Occurs in women 10-25% and men 5-12%
- Sleep changes
- Interest loss
- Guilt and worthlessness
- Mood, required.
- Energy loss
- Concentration loss
- Appetite changes
- Psychomotor retardation
- Suicidal ideation
44
Dysthymia
- Long term depression with lesser symptoms than major depressive disorder.
- Must occur for greater than 2 years
45
Seasonal Effective Disorder
-Mild depression that occurs in winter with loss of light. Improves with increased light
46
Atypical Depression
- More common than major depressive.
- Have similiar symptoms that are more mild. (increased appetite, psychomotor retardation, increased sleep)
- Improves with positive experiences.
47
Post Partum Blues
- Common, 50-85%.
- Depressed mood, tearfullness, fatigue.
- Resolves in 2 weeks. No treatment indicated
48
Post Partum Depression
- 10-15%
- Depressed mood, anxiety, poor concentratoin.
- Lasts longer than 14 days. Major distinguishing factor from blues
- Treat with psychotherapy and antideperssants
49
Post Partum Psychosis
- 0.1-0.2%
- Hallucinations, dellusions, Confusion
- Suidicadal/homicidal ideation
- Serious problem
- 4-6 weeks post partum
- Tx with antipsychotics, antidepressants, and maybe inpatient to prevent from harming baby or others.
50
Electroconvulsive Therapy
- Shocks that cause a painless siezure. Used in extreme situations and in pregnancy.
- May cause memory problems
51
Anxiety
-30% women and 19% of men. Mainstay of treatment in all disorders is SSRI
52
Panic Disorder
- Extreme but brief physical symptoms
| - SSRI, Benzo's, Venlafaxine
53
Specific Phobia
- Pt is aware of irrationality, not usually treated or treated with desensitization
- Social phobia is sometimes treated with SSRIs
54
OCD
-SSRI or Clomipramine
55
PTSD
Flashbacks and increased arousal that occur for greater than 1 month
56
Acute Distress Disorder
-PTSD symptoms that last less than 1 month. Tx is usually supportive
57
Malingering
-Faking an illness for secondary gain
58
Factious Disorder
- Causing oneself to be sick/injured
- Munchausen syndrome: OK with having many invasive tests run
- Munchausen by Proxy: Use kid as sick/injured role
59
Somatization
-Multiple varried complaints. More common in women
60
Hypochondriasis
-Obsession with having serious illness
61
Body Dismorphic Disorder
-Obseission with minor or imagined physical flaws
62
Pain Disorder
-All complaints revolve around pain
63
Paranoid Personality
-Excessive suspision, Projection is main defense mechanism
64
Schozoid
-Voluntarily excessively withdrawn, minimal social interaction
65
Schizotypal
-Wild and magic beliefs. Creates social awkardness
66
Antisocial
- Often from conduct disorder
| - Disregard for law or others well-being
67
Borderline
-Unstable mood and relationships. Often self mutilation. Feelings of emptiness. Females more likely than males
68
Histrionic
-Need for attention and obsession with appearance. Sexually provacative
69
Naracistic
-Grandiose sense of self and entitlement. Meets criticism with rage.
70
Avoidant
-Excessive fear of rejection. Often has few or poor relationships. Desires relationships, but can't have them as opposed to schizoid.
71
Obsessive Compulsive
- Not OCD. Actions occur in accordance with beliefs
| - Obsession with order and perfection.
72
Dependent
-Submissive, clingy, low self confidence
73
Anorexia
- Obsession with false self image
- Weight less than 85% of ideal. Difference between bulliumia
- Physical signs: Anemia, osteoporosis, amenorrhea, etc.
74
Bullemia
- Binge and purge.
- Normal Body Weight. Different from anorexia
- Phsyical Signs: Erosion of enamel, scars on back of hands, parotitis.
75
Transgender
-Extreme desire to be opposite sex, seek surgery or hormonal fix
76
Transvestite
- Paraphilia
| - Desire to be opposite sex in dress only.
77
Substance Dependence
- 3 or more of the following signs in a year
- Use in larger quantities and for longer time
- Causes impairment in life responsibilies
- Requires excessive time/effort to acquire
- Failed attempt at quitting
- Tolerance
- Withdrawl
- Use in spite of awareness of problem
78
Substance Abuse
- Causes impairment in social and occupational responsibility
- Physical Harm
- Legal Harm
- Persistant use in spite of these
79
Stages of change
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
- Relapse
80
Alcohol Intoxication and Withdraw
- Intoxication: Stupor, respiratory depression, coma, elevated GGT and AST>ALT.
- Withdrawl: Brief causes hangover (acetylaldehyde). 1-2 days may cause hallucinations. 2-5 days is delerium tremens(tachycardia, Hypertension, siezures, hallucinations). Tx Benzos.
81
Disulfiram like drugs
- Cause accumulation of acetyladehyd
| - Metronidazole, griseofulvin, sulfonylureas, cephalosporins
82
Opiods
- Intoxication: Pinpoint pupils, respiratory depression, coma, constipation. Treat with naloxone. Do not give oxygen as drive to breath is oxygen mediated
- Withdrawl: Overwhelming sympathetics. Sweating, piloerection, dilated pupils, naseau, cramps
83
Oipiod addiction
- Methadone is a long acting mu agonist that has decreased abuse potentional and will limit withdrawl
- Buprenorphine is a partial mu agonist that when given with naltrexone (minimize cravings) can aid in withdrawl and cravings.
84
Barbituates
- Intoxication: respiratory depression. Tx with respiratory support
- Withdawl: Delerium and CV collapse
85
Benzodiasepines
```
-Intoxiacation: Minimal respiratory depression, ataxia. Flumezanil is a benzodiazepine binding site antagonist.
Ultra short (midazolam) and short (triazolam, oxazolam)
```
-Witdrawl: sleep disturbance and anxiety
86
Amphetamines
- Block reuptake of NE and Dopamine and others in synaptic cleft
- Intoxication: SANS symptoms: dilated pupil, agitation, grandiosity, tachycardia, anorexia, cardiac arrest and siezure
- Withdrawl: Depression, anhedonia, hypersomnolence
87
Cocaine
- Block NT reuptake similair to amphetamines
- Intoxication: Dilated pupils, grandiosity, hallucinations, paranoia, cardiac arrest, angina.
- Withdrawl:Solmnolence, malaise, suicidal ideation
88
Nicotine Withdrawl
Irritability and cravings
| -Tx: Buprpion and varenicline
89
PCP
- Analog of ketamine, antagonist of NMDA-R. Also binds Nm which leads to superhuma strength and possible rhabdomyolysis.
- Intoxication: Agression, nystagmus, homocidality, analgesia, psychosis, delerium. Tx: rapid acting benzos (midazolam)
90
LSD
- Perceptual distortions, psychosis, possible flashbacks
| - Minimal withdrawl
91
Marijuana
-Binds canabanoid R, and antimuscarininc
Intoxication: Paranoia, delusions, inreased appetite. Dry mouth and conjunctival injection from antimuscarinic and alpha blockade.
-Used medicinally for antiemesis and increase appetite (AIDS and Chemo)
-Linked to higher rates of schizophrenia
-Withdrawl: Irritability, depression insomnia. Peaks in 48hrs and lasts 5-7 days. Lipophilic and stays in system for 10 days.
92
Awake EEG
low amplitude high frequency. When eyes close amplitude increases slightly. alpha and beta waves
93
NREM1
-Light sleep with high frequency low amplitude theta waves
94
NREM2
-Theta waves waves with interposed K complexes and sleep splindles that are higher amplitude
95
NREM3
-High ampliude delta wave sleep
96
REM
-High frequency low amplitude waves. Like being awake, but complete paralysis. ACh is main NT. NE will decrease REM sleep.
97
Depression
-Increase REM sleep with repeated awakenings
98
Narcolepsy
- Repeated intrusion of sleep pre-empted by an auora/hallucination
- Tx Modafanil/amphetamines during day
- Sodium oxybate at night
- Associated with psyhosis and mutations in orexin
99
Nightmares and Terrors
Terrors are in NREM sleep
| -Mares in REM sleep
Boards Path
flashcards
Decks in class (20)
# Cards
-
Neuro Path202
-
Psych99
-
Neuro Cards 182
-
Micro Cards 12
-
Repro Cards Q2
-
General Path45
-
Heme Once109
-
Endocrine116
-
GI Cards 12
-
Endo Cards 11
-
Reproductive239
-
Renal Path126
-
Cardio Path189
-
Respiratory Path98
-
MSI Path116
-
Biochem 27
-
Behavioral Science66
-
Questions 5-1411
-
Immunology109
-
Pathology37
