Term
| What is transference and countertransference? |
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Definition
Transference = pt projects feelings about formative or other impt persons onto physician
Countertransference = Dr projects feelings about formative or other impt persons onto pt |
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Term
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Definition
| Process whereby avoided ideas and feelings are transferred to some neutral person of object. ex hitting a wall when mad |
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Term
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Definition
| Partially remaining at a more childish level of development (vs regression = turning back maturational clock) ex men fixating on sports games |
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Term
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Definition
| unacceptable internal impulse is attributed to an external source. ex a man who wants another woman thinks his wife is cheating on him |
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Term
| What is reaction formation? |
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Definition
| Warded-off idea or feeling is replaced by an emphasis on the opposite. ex. pt w/ libidinous thoughts enters a monastery |
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Term
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Definition
| belief that people are either all good or all bad at different times due to intolerance of ambiguity. Seen in borderline personality disorder |
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Term
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Definition
| Process whereby one replaces an unacceptable wish w/ a course of action that is similar to the wish but does not conflict with one's value system. ex actress uses experience of abuse to enhance her acting |
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Term
| What are the mature ego defenses? |
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Definition
| Mature women wear a SASH: Sublimation, Altruism, Suppression, Humor |
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Term
| What are the effects of infant deprivation? Deprivation for how long can lead to irreversible changes? |
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Definition
The 4 W's: Weak, Wordless, Wanting (socially) and Wary
Deprived babies say Wah, Wah, Wah, Wah
>6 mos can be irreversible |
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Term
| What are the childhood and early-onset disorders? |
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Definition
| ADHD, COnduct disorder (<18yo), Oppositional defiant disorder (absence of serious violations of social norms), Tourette's (assoc w/ OCD), Separation anxiety disorder |
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Term
| What are the diagnostic criteria for Tourette's? How is it treated? |
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Definition
Tics that persist for >1yr. Coprolalia only in 20%. Assoc w/ OCD. Onset <18yo
Tx w/ antipsychotics |
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Term
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Definition
X linked in GIRLS
Sx's followed by regression characterized by loss of development, MR, loss of verbal abilities, ataxia and sterotyped hand-wringing |
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Term
| What is childhood disintegrative disorder? |
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Definition
| Marked regression in multiple areas of functioning after at least 2 yrs of normal dev. Common onset b/w 3-4yo. BOYS |
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Term
| What is the difference between Autism and Asperger's? |
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Definition
| Asperger's is milder form. All-absorbing interests, reptitive behavior and problems w/ social relationships. Unlike autism have normal intelligence and lack verbal or cognitive deficits. NO language impairment |
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Term
| What are the neurotransmitter changes associated with Anxiety, Depression, Alzheimer's, Huntington's, Schizophrenia, and Parkinson's? |
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Definition
Anxiety = increased NE, decreased GABA and serotonin
Depression = decreased NE, serotonin and Dopamine
Alz = decreased ACh
Huntington's = decreased GABA and ACh
Schizo = increased dopamine
Parkinson's = decreased dopamine, increased serotonin and increased ACh |
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Term
| How is delirium different from dementia? |
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Definition
| Delirium is assoc w/ a disease and is a waxing and waning level of consciousness w/ acute onset. Decreased attention span and arousal. Abnormal EEG. REVERSIBLE (dementia isn't usually) Dementia is decreased cognition but no change in consciousness w/ nl EEG. |
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Term
| What are hallucinations vs illusions vs delusions? |
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Definition
Hallucinations = perceptions in the absence of external stimuli
Illusions = misinterpretations of actual external stimuli
Delusions = false beliefs not shared w/ other members of culture that are firmly maintained in spite of obvious proof to the contrary. |
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Term
| Hypnagogic vs/ hypopompic hallucinations |
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Definition
HypnaGOgic = while GOing to sleep
HypnoPOMPic = while waking (POMPous upon awakening) |
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Term
| What is the diagnostic criteria for Schizophrenia? |
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Definition
| 2 or more of symptoms: delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, "Negative sx's" (flat affect, social withdrawal,lack of motivation, lack of speech or thought. |
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Term
| What are the 5 subtypes of schizophrenia? |
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Definition
| Paranoid, disorganized, catatonic, undifferentiated, residual |
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Term
| What is the greater cause of schizophrenia, genetic or environment? |
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Definition
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Term
| What is difference b/w schizophrenia, brief psychotic disorder, schizophreniform disorder, and schizoaffective disorder? |
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Definition
Schizophrenia = >6mos
Brief psychotic dx = <1mo
Schizophreniform = 1-6mo
Schizoaffective disorder = at least 2 weeks of stable mood w/ psychotic sx's + major depressive, manic or mixed episode. (bipolar or depressive) |
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Term
| What is delusional disorder? |
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Definition
Fixed, persistent nonbizarre belief system lasting >1mo. Functioning not otherwise impaired.
Can be shared (folie a deux) |
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Term
| What are the dissociative disorders? |
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Definition
Dissociative identity (multiple personality) assoc w/ hx of sexual abuse
Depersonalization dx = feelings of detachment from one's body, situation or environment.
Dissociative Fuge = abrupt change in geographic location w/ inability to recall past, confusion about personal identity or assumption of new identity. |
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Term
| What defines a manic episode? |
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Definition
at least 1 week
3+ of DIG FAST:
Distractibility, Irresponsibility, Grandiosity, Flight of ideas, increased Activity/Agitation, decreased Sleep, Talkativeness |
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Term
| What is bipolar disorder? |
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Definition
at least 1 manic/hypomanic episode and depressive symptoms always occur eventually.
Tx w/ mood stabilizers or atypical antipsychotics |
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Term
| What is cyclothymic disorder? |
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Definition
| dysthymia and hypomania; milder form of bipolar that lasts at least 2 years |
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Term
| What are the diagnostic criteria for major depressive episode? |
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Definition
Lasts 6-12 months. W/ at least 5/9 for 2+ weeks of SIG E CAPS
Major depressive disorder = 2+ major depressive episodes w/ a symptoms-free interval or 2 months |
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Term
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Definition
| milder form of depression lasting at least 2 years |
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Term
| What is atypical depression? |
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Definition
Hypersomnia, overeating and mood reactivity (ability to experience improved mood w/ positive events). Assoc w/ wt gain and sensitivity to rejection.
Tx w/ MAOi's and SSRIs |
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Term
| What are the different postpartum mood disturbances? |
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Definition
Maternal (postpartum) blues = resolves w/in 10 days (tx supportively)
Postpartum depression = 2weeks-2months (tx w/ antidepressants or psychotherapy)
Postpartum psychosis = delusions, confusions, unusual behavior and homi/suicidal attempts. days to 4-6weeks. Tx w/ antipsychotics, antidepressants, inpt hospitalization |
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Term
| What defines panic disorder? How is it treated? |
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Definition
PANICS peaking w/in 10mins: Palpitations, Paresthesias, Abdominal distress, Nausea, Intense fear of dying/losing control, lIght-headedless, Chest pain, Chills, Choking, disConnectedness, Sweating, Shaking, SOB.
Tx w/ CBT, SSRIs, TCAs, benzos |
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Term
| How is social phobia treated? |
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Definition
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Term
| How is OCD treated? What other disease is it most associated with? |
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Definition
Assoc w/ Tourette's
Tx w/ SSRIs, clomipramine (TCA) |
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Term
| How is PTSD diagnosed? Treated? How is acute stress disorder different? |
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Definition
Lasting >1mo
Tx w/ psychotherapy, SSRIs
Acute stress disorder last 2 days-1mo |
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Term
| How long must generalized anxiety disorder be present to be diagnosed? |
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Definition
at least 6 months
Tx w/ benzos, buspirone (stims 5-HT rec), SSRIs |
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Term
| How is adjustment disorder different from generalized anxiety disorder? |
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Definition
| Adjustment has identifiable psychosocial stressor and lasts <6mo (>6mos chronic stressor) |
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Term
| What is the difference b/w malingering and factitious disorder? |
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Definition
Malingering = attaining a secondary gain
Factitious dx = primary gain is medical tx |
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Term
| What are the different somatoform disorders? |
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Definition
| Somatization disorder = multiple organ systems (at least 4 pain, 2 GI, 1 sexual and 1 pseudoneurologic) over yrs Conversion = loss of sensory or motor fxn following acute stressor (1 symptom) Hypochondriasis Body Dysmorphic dx Pain disorder = prolonged pain w/ no physical finding |
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Term
| What are the Cluster A Personality disorders? |
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Definition
Odd or eccentric, assoc w/ schizophrenia
Paranoid
Schizoid = voluntary social withdrawal and content
Schizotypal = odd beliefs + magical thinking |
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Term
| What are the Cluster B Personality Disorders? |
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Definition
Dramatic, emotional, erratic (assoc w/ mood disorders and substance abuse)
Antisocial (conduct dx if <18, M>F) --> Antisocial = sociopath
Borderline = unstable mood, impulsive, self-mutilations (F>M)
Histrionic
Narcissistic |
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Term
| What are the cluster C personality disorders? |
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Definition
Anxious or fearful, assoc w/ anxiety
Avoidant = feeling of inadequacy in relationships (vs schizoid = doesn't care)
Obsessive-Compulsive
Dependent |
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Term
| What lab test can be done to test alcohol use. What is treatment for intox? |
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Definition
Serum gamma-glutamyltransferase (GGT)
AST twice ALT
Tx is naltrexone |
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Term
| What are the signs of alcohol withdrawal? |
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Definition
severe = delirium tremens (potentially fatal)
Tx = benzos |
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Term
| What are the signs of opioid withdrawal? What is the treatment for withdrawal and intox? |
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Definition
Dilated pupils, piloerection, flulike sx's
Tx withdrawal symptomatically
Tx intox w/ naloxone/naltrexone |
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Term
| What are the major risks of barbiturate OD and withdrawal? |
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Definition
OD = marked respiratory depression
Withdrawal = cardiovascular collapse |
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Term
| What can be used to treat benzo OD? |
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Definition
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Term
| What are the symptoms of cocaine intoxication? What can treat it? |
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Definition
impaired judgement, pupillary dilation, hallucinations, paranoid ideations, angina, sudden cardiac death.
Tx w/ benzos |
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Term
| What are the signs of PCP intoxications? |
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Definition
| Belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, homicidality, psychosis, delirium |
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Term
| What are the signs of LSD intoxication? |
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Definition
| Marked anxiety/depression, delusions, visual hallucinations, flashbacks, pupillary dilation |
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Term
| What can be used to treat heroin addiction? |
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Definition
| Naloxone + buprenorphine (partial agonist) = long acting w/ fewer w/d sx's than methadone. Naloxone works if injected (so dissuades IV injection) |
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Term
| What are the major side effects of Chlorpromazine and Thioridazine (typical antipsychotics)? |
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Definition
Chlorpromazine = Corneal deposits
Thioridazine = Retinal deposits |
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Term
| What are the typical antipsychotics? |
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Definition
Haloperidol + the -azines
Block D2 receptors |
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Term
| What are the typical antipsychotics and what do they do? |
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Definition
It's ATYPICAL for OLd CLOSets to QUIETly RISPER from A to Z
Olanzapine, clozapine, quetiapine, reiperidone, aripiprazole, ziprasidone
Block 5-HT, dopamine, alpha and H1 receptors |
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Term
| What atypical antipsychotic has the biggest side effect? |
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Definition
| Clozapine = agranulocytosis |
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Term
| What are the toxicities of Lithium? |
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Definition
| Hypothyroidism, nephrogenic DI, teratogen (ebstein anomaly and malformation fo great vessels), tremor |
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Term
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Definition
Stimulates 5-HT receptors
For anxiety
No dependence but delayed clinical response (2 weeks) |
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Term
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Definition
Block reuptake of NE and serotonin
SE's = Convulsions, Coma, Cardiotox
-pramines, nortriptyline, doxepin and amoxapine |
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Term
| What are the SSRIs? Side effects? |
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Definition
Fluoxetine, paroxetine, sertraline, citalopram
Sexual dysfunction, Serotonin syndrome (hyperthermia, mm rigidity, cardiovasc collapse, flushing, diarrhea, seizures
Tx serotonin sx w/ CYPROHEPTADINE |
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Term
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Definition
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Term
| What are the MAOi's? Major side effect? |
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Definition
Phenelzine, tranylcypromine, isocarboxazid, selegiline
SE = hypertensive crisis w/ tyramine ingestion (cheese, sausage, wine), sexual dysfunction |
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Term
| What does bupropion do? What is it used for? |
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Definition
Smoking cessation and atypical antidepressant
Increases NE and dopamine (unk mechanism)
NO SEXUAL SIDE EFFECTS |
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Term
| What does Mirtazapine do? |
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Definition
| alpha-2 antagonist (increased release of NE and serotonin) |
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Term
| What does Maprotiline do? |
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Definition
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Term
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Definition
Inhibits serotonin reuptake
Called TrazoBONE --> causes priapism |
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