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Psychiatry
| Question | Answer |
|---|---|
| What are the five major diagnostic axes? | 1. clinical disorders 2. personality disorders and mental retardation 3. physical conditions and disorders 4. psychosocial and environmental problems 5. Global assessment of functioning |
| 1. Transference 2. Countertransference | 1. patient projects feelings about a person onto physician 2. physician projects feelings about a person onto the patient |
| 1. Id 2. Ego 3. Superego | 1. primal urges 2. mediator between primal urges and behavior 3. moral values |
| Unacceptable feeling and thoughts are covered up and expressed through actions | acting out |
| Separating self from one's own experience to avoid emotional stress | Dissociation |
| Defense mechanism used in: 1. obsessive compulsive disorder 2. borderline personality disorder | 1. undoing 2. splitting |
| 1. involuntary withholding of an idea or feeling from conscious awareness 2. conscious avoidance of some painful reality 3. voluntary withholding an idea from conscious awareness | 1. repression 2. denial 3. suppression |
| A man who wants another woman thinks his wife is unfaithful. What is the defense mechanism? | 1. projection 2. unacceptable internal impulse is attributed to another person |
| Transferring avoided ideas and feelings to some neutral person or object | displacment |
| Unacceptable impulse channeled into something that is not in conflict with one's value system | sublimation |
| Grief is normal up until how long? | 1 year; usually less than 6 months |
| Autistic disorders are usually diagnosed after age 2 by what two characteristics? | 1. no separation anxiety 2. no verbal/nonverbal communication |
| What is Rett's disorder and what symptoms are characteristic? | 1. X-linked disorder seen almost exclusively in girls 2. loss of development, mental retardation and hand-wringing starting at age 1-4 |
| Marked regression in multiple areas of functioning after at least 2 years of apparently normal development. | childhood disintegrative disorder |
| What are the symptoms of Korsakoff's syndrome? | 1. impaired recent memory 2. anterograde amnesia 3. +/- confabulation |
| What are the two most common causes of delirium? | 1. anticholinergic drugs 2. UTI |
| How long must an episode last to be considered mania? | at least 1 week |
| Hypersomnia, overeating and mood reactivity (ability to experience improved mood in response to positive events). | atypical depression |
| How long must postpartum blues last before it is considered depression? | 2 weeks |
| Sleep disturbance, irritability, and poor concentration after a divorce. | adjustment disorder |
| How is obsessive-compulsive personality disorder different obsessive-compulsive disorder? | in personaility disorder, behavior is consistent with one's own beliefs and attitudes (ego-syntonic) |
| What is the triad seen in Wernicke's encephalopathy? | 1. confusion 2. ocular abnormalities 3. ataxia |
| What part of the brain is effected in: 1. Wernicke's 2. Korsakoff | 1. cerebellar vermis 2. mamillary bodies |
| Delerium tremens 1. How long till it peaks? 2. what are the first symptoms to appear? | 1. 2-5 days 2. tachycardia, tremors, anxiety |
| 1. Dementia with stepwise increase in severity + focal neurological signs 2. Confirmatory test | 1. multi-infarct dementia 2. CT/MRI |
| Dementia with resting tremor | 1. Lewy Body Dementia 2. Parkinson's disease |
| 1. What is the clinical triad of normal pressure hydrocephalus? 2. Which symptom is most likely to improve with treatment | 1. Dementia + ataxia + urinary incontinence 2. dementia |
| 1. Dementia + obesity + coarse hair + constipation 2. Confirmatory test | 1. Hypothyroidism 2. TSH |
| 1. Dementia + diminished vibratory sensation 2. Confirmatory test | 1. Vitamin B12 deficiency 2. Serum B12 |
| Delirium + elevated BP + papilledema | Hypertensive encephalopathy |
| Delirium + tachycardia + tremor | thyrotoxicosis |
| First line treatment for a dangerously agitated patient with delerium. | quetiapine |
| Differential for delerium. | AEIOU TIPS 1. alcohol 2. electrolytes 3. iatrogenic drugs 4. Oxygen (hypoxia) 5. Uremia 6. Trauma 7. Infection 8. Poisons 9. Seizures |
| What are the most common causes of dementia (3)? | 1. Alzheimer's 2. Vascular 3. Major depression ("pseudodementia") |
| Most common focal neurologic symptoms seen in vascular dementia? | 1. pseudobulbar palsy 2. dysarthria 3. dysphagia |
| Dementia with visual hallucination. | Lewy body dementia |
| What are the prenatal infections and toxins that can cause mental retardation? | TORCH 1. toxo 2. other (syphilis, AIDS, alcohol/illicit drugs) 3. rubella 4. CMV 5. herpes simplex |
| What are the three areas of learning disorders? | 1. reading 2. mathematics 3. writing |
| What percentage of children with autism are also mentally retarded? | ~70% |
| Stereotyped hand movements and failure to progress developmentally in a young female child. | Rett's Disorder |
| At what age in urinary continence and bowel control usually reached? | age 4 |
| What areas of an individuals life do personality disorders effect? | CAPRI 1. Cognition 2. Affect 3. Personal Relationships 4. Impulse control |
| What are the negative symptoms of schizophrenia? | 5 A's 1. Anhedonia 2. Affect 3. Alogia (poverty of speech) 4. Avolition (apathy) 5. Attention (poor) |
| How does PTSD differ from acute stress disorder? | 1. PTSD sypmtoms last > 1 month 2. Acute stress disorder symptoms last < 1 month |
| How does adjustment disorder differ from PTSD? | adjustment disorder is the presence of psychological symptoms after a stressful but non-life-threatening event |
| What neurotransmitter is effected in: 1. Alzheimer's 2. Anxiety 3. OCD | 1. ↓ acetylcholine 2. ↑ NE, ↓ GABA 3. ↓ serotonin |
| How does Creutzfeldt-Jakob Disease present on EEG? | Periodic sharp waves/spikes |
| What is the difference between cause of amnesia amnestic disorders and dissociative disorders? | amnesia in amnestic disorders is always secondary to an underlying medical condition or substance use while dissociative disorders is related to a stressful life event |
| 1. What is primary gain? 2. Secondary gain? | 1. expression of unacceptable feelings as physical symptoms in order to avoid facing them 2. use of symptoms to benefit the patient |
| What is hypochondriasis | either fear of having a disease or convinced that one is present |
| Failure to resist aggressive impulses that result in assault or property destruction. Out of proportion to triggering events. | Intermittent explosive disorder |
| Recurrent pulling out of one's hair, resulting in visible hair loss. | Trichotillomania |
| What are the two subcategories of anorexia nervosa? | 1. restrictive type - eats little and may vigorously exercise 2. binge eating/purging type - eat in binges followed by purging, laxatives, excessive exercise or diuretics |
| What are the two subcategories of bulimia? | 1. Purging - involves vomiting, laxatives or diuretics 2. Nonpurging - involves excessive exercise or fasting |
| What is the difference between nightmare disorder and night terror disorder? | 1. nightmare disorder has repeated awakenings with recall of dreams 2. in night terror disorder patients do not remember episodes |
| What are the 4 elements of informed consent? | NARCC 1. Name/purpose of treatment 2. Alternatives 3. Risks/benefits 4. Consequences of refusing treatment 5. Capacity to make an informed decision |
| 4 D's of malpractice | Dereliction (neglect) of a Duty that led Directly to Damages |
Created by:
amichael@siumed.edu
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