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38 Cards in this Set
- Front
- Back
Describe mood v affect
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pt's subjective experience v objective signs of emotional state
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illusion v hallucination
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misperception of stimulus/something's there v perception of non-existent stimulus
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obsession v compulsion
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recurrent,distressing thought (never an action) v repetitive actions performed to relieve anxiety (act can be a thought, but more often is a physical action)
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circumstantial v tangential v loose association
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giving excessive details but not necessarily changing topic v wandering from topic to topic where each transition following logically, often forgetting the question that was asked v jumping from topic to topic without clear connections (All 3 related to thought process)
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word salad v clanging
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nonsensical grammatical constructions where words are thrown out v words rhyme with one another
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hypnaogoic v hypnopompic hallucinations
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during the period going to sleep v during the period of awakening. both commonly occur in healthy individuals; hypnoaGOgic (GO to sleep) & hypnoPOmpic (POpping up from sleep)
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Define delirium
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acute onset; characterized by inattention (can't repeat days of week in reverse, serial 7s, etc); waxing and waning course, and reversal of sleep-wake cycle
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T/F: delirium can be caused by conditions other than general medical conditions
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False
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Define Dementia
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amnesia + loss of cognitive function defined as one of the following: aphasia, agnosia, apraxia, poor executive function (includes sequencing, organizing, abstraction, planning)
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Alzheimer's type vs vascular dementia
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A: MCC of dementia; often linear decline; definitive dx requires TISSUE vs V: step-wise decline corresponding with descrete vascular insults
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Dementia vs Pseudodementia
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demented patients tend to confabulate (they don't want to be seen as demented) vs pseduodementia occurs as a result of depression (tend to over-exaggerate their deficits)
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mild cognitive impairment v benign senescent forgetfullness
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MCI: sub-syndromal dementia (only amnesia, agnosia, aphasia, apraxia, executive dysfunction) BSF: normal aging (forgot where placed the keys, etc.)
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Suicide attempt v parasuicidal gestures
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SA: intent of dying; PG:aimed at getting attention (but succeed sometimes!)
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active v passive suicidal ideation
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Active = "i want to die" or "i want to kill myself"; Passive = "i'd rather be dead" or "things would be better off if i weren't here"
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Anticholinergic toxidrome
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hot as a hare, dry as a bone, red as abeet, mad as a hatter, blind as a bat!
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Anticholinergic v sympathomimetic (cocaine, amphetamines, etc) toxidromes
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Same. Except that in sympathomimetics, patients will also be diaphoretic. PSNS post synaptic neurons use ACh and SNS PSN use norepi except at sweat glands (Ach is used instead!)
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What is the triad of wernicke's encephalopathy? Immediate treatment?
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confusion, ataxia, opthalmoplegia (usually abducens (6th CN)). Give IV Thiamine (B1), which is involved in the metabolism of glucose.
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Triad for normal-pressure hydrocephalus.
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urinary incontinence, dementia, ataxia (wet, wacky, wobbly).
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List the dopamine (DA) pathways that mediate EPS. Tetrad?
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EPS: nigrostriatal (think substantia nigra - degenerated in PD) --> acute dystonic rxn, akathisia, parkinsonism, TD
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List the dopamine pathway that mediate +sx in schizophrenia
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excessive DA in mesolimbic system
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List the dopamine pathway that mediates -sx in schizophrenia
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mesocortical: low DA responsible for -sx in schizophrenia. This explains why typical antipsychotics (solely DA antagonism) do not improve -sx
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List the dopamine pathway that mediate hyperprolactinemia
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tuberoinfundibular (DA = pRL inhibitor) --> antipsychotics (esp haloperidol and atypical, respiradone) can cause gynecomastia & galactorrhea.
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List tetrad for Narcolepsy
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excessive daytime sleepiness, hypnoGOgic hallucinations, cataplexy (loss of motor tone in context of emotion i.e. laughing/crying) & sleep paralysis
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4 D's of malpractice
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duty (presence of MD-pt relationship), dereliction/deviation (from standard of care), damage, direct causation. "derelection of duty directly caused damages"
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5 types of schizophrenia in DSM-IV-TR
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Catatonic, disorganized, paranoid, residual, undifferentiated.
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catatonic schizophrenia
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excessive/inhibited psychomotor activity
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disorganized schizophrenia
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prominent disorganization (speech or behavior)
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Which schizophrenia has the worst prognosis?
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disorganized type
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"burnt out" schizophrenia of later life; prominent negative sx
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residual type
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Undifferentiated schizophrenia
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Not catatonic, disorganized, paranoid or residual?
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Which type of schizophrenia has the BEST prognosis?
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Paranoid Schizophrenia: prominent delusions/hallucinations
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5 core symptoms (criteria A) of schizophrenia
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two of the following are required > 1 month: delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms
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3 exceptions to the requirement for meeting criterion A of schizophrenia
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1. bizarre delusions 2. AH of two voices giving a running commentary of pt's life or 3. AH of two voices conversing with each other sufficient to meet criterion A.
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6 types of delusions in DSM IV-TR
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persecutory (same as paranoia), erotomanic (belief that someone of higher stature is in love with pt), somatic (e.g. internal organis rotting) gradiose (common with psychosis associated with mania), Jealous, Mixed
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6 specifiers for MDD in DSM IV
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with: 1) psychotic features (treat the "depression" and psychosis will resolve, versus schizoaffective d/o); 2) melancholic features (anhedonia, early morning awakening, excessive guilt, mood does not reach with pleasure stimuli; 3) Atypical features (hyperphagia/hypersomnia, reactive mood, rejection sensitivity); 4) seasonal pattern (SA d/o, tx is light therapy or SSRI); with 5) catatonic features, or with 6) postpartum onset (w/in 4 weeks of parturition)
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Give two examples projective tests
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1) Rorschach test (inkblots): especially useful for identifying psychotic d/o or paranoia 2) Thematic apperception test: pt tells stories about depressing pictures
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Give 3 examples of intelligence test and their appropriate age ranges.
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WAIS (ages 16-75; includes verbal and visuospatial sections; average 100 w / SD of 15) Standord-Binet Test (age 2-23); Wechsler intelligence scale for children-revised (WISC-R) ages 6- 16
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What is the MMPI-2?
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Minnesota multiphasic personality inventory: pathology + patterns of behavior
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