| 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 |
