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Psych_FA
| Question | Answer |
|---|---|
| What are the mature ego defenses? | SASH: sublimation, altruism, suppression, humor |
| Unacceptable feelings and thoughts are expresses through actions. This describes? | Acting out |
| Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress. | Dissociation |
| Avoidance of awareness of some painful reality. | Denial |
| Process whereby avoided ideas and feelings are transferred to some neutral person or object. | Displacement |
| Partially remaining at a more childish level of development. | Fixation |
| Modeling behavior after another person who is more powerful (though not necessarily admired). | Identification |
| Separation of feelings from ideas and events. | Isolation of affect |
| An unacceptable internal impulse is attributed to an external source. | Projection |
| Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame. | Rationalization |
| Process whereby a warded-off idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite. | Reaction formation |
| Turning back the maturational clock and going back to earlier modes of dealing with the world. | Regression |
| Involuntary withholding of an idea or feeling from conscious awareness. | Repression |
| Belief that people are either all good or all bad at different times due to intolerance of ambiguity. | Splitting |
| Guilty feelings alleviated by unsolicited generosity toward others. | Altruism |
| Appreciating the amusing nature of an anxiety-provoking or adverse situation. | Humor |
| Process whereby one replaces an unacceptable wish with a course of action that is similar to the wish but does not conflict with one's value system | Sublimation |
| Voluntary withholding of an idea or feeling from conscious awareness. | Suppression |
| Mafia boss makes large donation to charity. | Altruism |
| Nervous medical student jokes about the boards. | Humor |
| Aggressive impulses used to succeed in business ventures. | Sublimation |
| Choosing not to think about the USMLE until the week of the exam. | Suppression |
| What neurotransmitters are associated with anxiety? | increased NE, dec GABA, dec serotonin |
| What neurotransmitters are associated with depression? | dec NE, dec serotonin, dec dopamine |
| What neurotransmitters are associated with Alzheimer's dementia? | dec ACh |
| What neurotransmitters are associated with Huntington's disease? | dec GABA, dec ACh |
| What neurotransmitters are associated with schizophrenia? | inc dopamine |
| What neurotransmitters are associated with Parkinson's disease? | dec dopamine, inc ACh |
| Inability to remember things that occurred before a CNS insult. | Retrograde amnesia |
| Inability to remember things that occurred after a CNS insult. | Anterograde amnesia |
| Classic anterograde amnesia caused by thiamine deficiency. | Korsakoff's amnesia |
| Leads to bilateral destruction of mammillary bodies. | Korsakoff's amnesia |
| Seen in alcoholics, and associated with confabulations. | Korsakoff's amnesia |
| Inability to recall important personal information, usually subsequent to severe trauma or stress | Dissociative amnesia |
| Waxing and waning level of consciousness | Delirium |
| Rapid decrease in attention span and level of arousal. | Delirium |
| Characterized by acute changes in mental status, disorganized thinking, hallucinations (often visual), illusions, misperceptions, disturbance in sleep-wake cycle, cognitive dysfunction. | Delirium |
| Most common psychiatric illness on medical and surgical floors. Abnormal EEG. | Delirium |
| Gradual decrease in cognition characterized by memory deficits, aphasia, apraxia, agnosia, loss of abstract though, behavioral/personality changes, impaired judgment. Patient alert with no change in level of consciousness. | Dementia |
| What is the difference between dementia and delirium? | delirium has change in level of consciousness and abnormal EEG. dementia has no change in level of consciousness with normal EEG. |
| Which is reversible, dementia or delirium? | delirium |
| What is it called when someone has perceptions in the absence of external stimuli? | hallucinations |
| What is it called when someone has misinterpretations of actual external stimuli? | illusions |
| What is it called when someone has false beliefs not share with other members of culture/subculture that are firmly maintained in spite of obvious proof to the contrary? | delusions |
| What are disorder in the form of thought (the way ideas are tied together)? | loose associations |
| Which type of hallucinations are common in delirium? | visual hallucinations |
| Which type of hallucinations are common in schizophrenia? | auditory hallucinations |
| What often occurs as an aura of psychomotor epilepsy? | olfactory hallucination |
| Which type of hallucinations are common in alcohol withdrawal (e.g. fornication - ants) and also seen in cocaine abusers? | tactile hallucinations |
| Which type of hallucination occurs while GOing to sleep? | hypnaGOgic hallucination |
| Which type of hallucination occurs while waking from sleep? | hypnopompic hallucination |
| Periods of psychosis and disturbed behavior with a decline in functioning lasting >6 months describes what? | schizophrenia |
| How do you diagnose schizophrenia? | 2+ of ff ("positive symptoms"): 1. delusions 2. hallucinations - auditory 3. disorganized speech (loose association) 4. "negative symptoms" - flat affect, social withdrawal, lack of motivation, lack of speech or thought |
| Unstable mood and interpersonal relationships, impulsivenesss, sense of emptiness seen more in females than males describes which personality disorder? | borderline |
| Borderline personality disorder is associated with which major defense mechanism? | splitting |
| Imipramine is commonly used for what? | bedwetting |
| What is the MOA of TCAs? | block reuptake of NE and serotonin |
| What age do children begin cooperative play? | 4 yrs |
| Patients with major depressive disorder experience which type of sleep? | increased REM |
| Motor or sensory symptoms such as paralysis, blindness, or mutism following an acute stressor describes what? | conversion disorder (somatoform) |
| What distinguishes PTSD from acute stress disorder? | PTSD lasts >1 month and Acute stress disorder lasts between 2 days to 1 month |
| Patient is belligerent, impulsive, has fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, and delirium. What did this patient take? | PCP |
| Excessive emotionality and excitability, attention seeking, sexually provocative, and overly concerned with appearance describes which personality disorder? | histrionic |
| MOA of methylphenidate (ritalin)? | inc presynaptic NE vesicular release (like amphetamines) |
| Tx for alcohol withdrawal? | benzodiazepines |
| Tx for anorexia/bulimia? | SSRIs |
| Tx for anxiety? | benzodiazepines (venlafaxine), buspirone, SSRIs (paroxetine, sertraline) |
| Tx for ADHD? | methylphenidate (ritalin), amphetamines (dexedrine) |
| Tx for atypical depression? | MAO inhibitors, SSRIs |
| Tx for bipolar disorder? | "mood stabilizers": lithium, valproic acid, carbamazepine, atypical antipsychotics |
| Tx for depression? | SSRIs, NSRIs, TCAs |
| Tx for depression w/ insomnia? | mirtazapine |
| Tx for OCD? | SSRIs, clomipramine |
| Tx for panic disorder? | SSRIs, TCAs, benzodiazepines |
| Tx for PTSD? | SSRIs |
| Tx for schizophrenia (positive symptoms)? | antipsychotics (neuroleptics) |
| Tx for Tourette's syndrome? | antipsychotics (haloperidol) |
| What are the extrapyramidal SE of antipsychotics (neuroleptics) that occur after 4 hrs? | acute dystonia (muscle spasm, stiffness, oculogyric crisis) |
| What are the extrapyramidal SE of antipsychotics (neuroleptics) that occur after 4 days? | akinesia (parkinsonian symptoms) |
| What are the extrapyramidal SE of antipsychotics (neuroleptics) that occur after 4 wks? | akathisia (restlessness) |
| What are the extrapyramidal SE of antipsychotics (neuroleptics) that occur after 4 months? | tardive dyskinesia |
| What are the symptoms for neuroleptic malignant syndrome (NMS) that occur with antipsychotics? | (FEVER) fever, encephalopathy, vitals unstable, elevated enzymes, rigidity of muscles |
| Tx for schizophrenia (useful for both positive and negative symptoms)? | atypical antipsychotics |
| MOA of antipsychotics (neuroleptics)? | block dopamine D2 receptors |
| What are the antipsychotics (neuroleptics)? | Hally took flight to chicago: haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine |
| Which antipsychotics (neuroleptics) have high potency? | haloperidol, trifluoperazine, fluphenazine |
| Which antipsychotics (neuroleptics) have low potency? | thioridazine, chlorpromazine - non-neurologic SE |
| What are the endocrine SE of antipsychotics (neuroleptics)? | galactorrhea from hyperprolactinemia from dopamine receptor antagonism |
| What are the SE from blocking muscarinic, alpha, and histamine receptors? | M (dry mouth, constipation), alpha (hypotension), and histamine (sedation) |
| What are the atypical antipsychotics? | COARQZ: clozepine, olanzapine, risperidone, aripiprazole, quetiapine, ziprasidone |
| MOA of atypical antipsychotics? | block 5-HT2, a, H1, and dopamine (D4) receptors |
| Which atypical antipsychotic is also used for OCD, anxiety, depression, mania, Tourette's? | olanzapine |
| Which atypical antipsychotic may cause agranulocytosis so it requires weekly WBC monitoring? | clozapine |
| Which atypical antipsychotic is associated with hyperprolactinemia which can cause amenorrhea with the least SE? | Risperidone |
| What are the SE of Lithium? | movement (tremor), nephrogenic DI, hypothyroidism, pregnancy problems |
| What other drugs can cause lithium toxicity? | thiazides and NSAIDs |
| MOA of buspirone? | stimulates 5-HT1A receptors |
| What is buspirone used for? | GAD b/c does not cause sedation or addition |
| What are the TCAs? | (I CAN DAD) imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin, amoxapine |
| Which channels are affected with TCAs? | fast Na channel conduction is blocked -> arrhythmia -> MCC of death |
| Clinical use for TCAs? | major depression, bedwetting, OCD |
| Which TCA is used for OCD? | clomipramine |
| What are the SE of TCAs? | atropine-like (anticholinergic) SE (tachycardia, urinary retention) |
| Which TCAs have more anticholinergic effects? | Tertiary TCAs (amitriptyline) > secondary TCAs (nortriptyline) |
| Which TCA is the least sedating? | desipramine |
| What are the toxicities in TCAs? | Tri-C's: convulsions, coma, cardiotoxicity (arrhythmias) |
| What are the other toxicities in TCAs besides the tri-C's? | respiratory depression and hyperpyrexia |
| What toxicity occurs with nortriptyline (TCA) in the elderly? | confusion and hallucinations due to anticholinergic SE |
| What is the tx for CV toxicity with TCAs? | NaHCO3 |
| What are the SSRIs? | fluoxetine, paroxetine, sertraline, citalopram |
| Clinical use for SSRIs? | depression, OCD, anxiety |
| Toxicity of TCAs? | GI distress, sexual dysfunction (anorgasmia) |
| How long does it take for antidepressants to have an effect? | 2-3 wks |
| What toxicity occurs with SSRIs and any drug that increases serotonin (e.g. MAO inhibitors)? | serotonin syndrome - hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea |
| Tx of serotonin syndrome? | cyproheptadine |
| MOA of cyproheptadine? | histamine antagonist w/ nonspecific 5HT1 & 5HT2 receptor antagonist properties |
| How does bupropion (wellbutrin) work? | increase NE and dopamine via unknown mechanism |
| Toxicity of bupropion (wellbutrin)? | stimulant effects (tachycardia, insomnia), headache, seizure in bulimic patients |
| Which antidepressant is good b/c it has no sexual SE? | bupropion (wellbutrin) |
| Which antidepressant is also used in GAD? | venlafaxine |
| How does venlafaxine work? | inhibits serotonin and NE reuptake |
| What toxicity can occur with venlafaxine? | MC inc BP, also stimulant effects, sedation, nausea |
| How does duloxetine work? | inhibits serotonin and NE reuptake |
| What is an indication for duloxetine? | diabetic peripheral neuropathy |
| Toxicity of duloxetine? | same as venlafaxine |
| MOA of mirtazapine? | a2 antagonist (inc release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist |
| Toxicity of mirtazapine? | sedation, inc appetite, weight gain, dry mouth |
| MOA of maprotiline? | blocks NE reuptake |
| Toxicity of maprotiline? | sedation, orthostatic hypotension |
| MOA of trazodone? | primarily inhibit serotonin reuptake |
| Clinical use of trazodone? | insomnia, as high doses are needed for antidepressant effects |
| Toxicity of trazodone? | sedation, nausea, pripism, postural hypotension |
| What is the drug of choice for patients with depression and sleep disorders? | trazodone |
| What drug can trazodone be used with to treat depression accompanied with insomnia? | fluoxetine (SSRI) |
| What are the MAO inhibitors? | phenelzine, tranylcypromine |
| MOA of MAO inhibitors? | nonselective MAO inhibition -> inc levels of amine NTs |
| Clinical use of MAO inhibitors? | atypical depression, anxiety, hypochondriasis, resistant depression |
| Toxicity of MAO inhibitors? | hypertensive crisis with tyramine ingestion and B-agonists; CNS stimulation |
| MAO inhibitors are CI with which drugs? | SSRIs or meperidine (to prevent serotonin syndrome) |
| What makes serotonin? | tryptophan |
| What is the other byproduct of tryptophan other than serotonin? | niacin |
| Tx for acute anxiety? | alprazolam |
| Tx for chronic anxiety? | clonazepam |
| What is the MOA of meperidine? | block reuptake of 5-HT |
Created by:
eandres1
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