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255 Cards in this Set
- Front
- Back
classical conditioning = |
learning in which a natural response (saliva) is elicited by a learned (conditioned) stimulus (the bell) that previously was presented with an unconditioned stimulus (food) |
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features of classical conditioning: |
1. ~~stimulus |
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operant conditioning = |
learning in which a particular action is elicited b/c it produces a punishment or reward |
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features of operant conditioning: |
1. ~~reward |
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terms wrt operant conditioning: |
1. positive reinforcement |
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negative reinforcement = |
**removal** of aversive stimulus |
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punishment = |
repeated administration of aversive stimulus extinguishes unwanted behavior |
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extinction = |
discontinuation of reinforcement (pos OR neg), which eventually eliminates behavior |
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transference = |
pt projects feelings about formative or other important figure onto physician |
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counter-transference = |
doctor projects feelings about formative or otherwise important person (e.g. son) onto pt |
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ego defenses = defense mechanisms = |
unconscious mental processes used to resolve conflict and prevent undesirable feelings |
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mature defense mechanisms: |
SASH |
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Suppression = |
**intentional** withholding of idea or feeling from conscious awareness |
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Sublimation = |
replacing an unacceptable drive or feeling (e.g. sexual, violent) with a nl/noble one that doesn't conflict with one's value system |
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immature defense mechanisms: |
acting out |
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acting out = |
expressing unacceptable feelings through misbehavior, |
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dissociation = |
temporary, drastic change in: |
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fixation = |
acting at a more-childish level of development, |
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identification = |
modeling behavior after a more-powerful person (good or bad) |
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isolation of affect = |
no emotion; |
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projection = |
attributing an unacceptable, internal impulse to someone else |
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rationalization = |
purporting rational reasons for actions actually performed for other reasons, usually to avoid self-blame |
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reaction formation = |
replacing a warded-off feeling by emphasis on its opposite |
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regression = |
turning back the maturity and using earlier modes of dealing with the worlds |
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repression = |
involuntary withholding of a feeling from consciousness |
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splitting = |
categorizing e/t and e/b into either ALL good or ALL bad |
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long-term effects of depriving an infant of affection: |
1. dec. muscle tone |
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**the four W's of depriving an infant of affection:** |
Weak |
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deprivation of affection for >6 mths may lead to _________________ changes |
irreversible |
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severe deprivation can result in: |
infant death |
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evidence of physical abuse of a child: |
1. spiral fractures on X-ray |
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3 signs of sexual abuse in children: |
1. anal/oral trauma |
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the child abuser is usually the closest caregiver, and therefore usually: |
the mother |
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the sexual abuser of a child is usually: |
1. known to the child |
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child abuse causes ~__________ deaths per year |
3,000 |
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peak incidence of sexual child abuse = |
9-12 y.o. |
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child neglect = |
failure to provide a child with adequate food, shelter, supervision, education, and/or affection |
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evidence of child neglect: |
1. poor hygiene |
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facets of ADHD: |
1. onset before 12 y.o. |
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treatment of ADHD = |
1. CNS stimulant (Methylphenidate, amphetamines) |
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conduct disorder = |
behavior that violates others and shows a poor sense of morality |
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after 18 yo, kids with conduct disorder will be diagnosed with: |
Antisocial Personality Disorder |
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oppositional defiant disorder = |
enduring defiance of authority figures WITHOUT serious violations of social norms |
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Tourette's syndrome = |
1. onset before 18 y.o. |
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treatment for Tourette's = |
1. antipsychotics |
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separation anxiety disorder = |
1. onset around 8 years |
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treatment of separation anxiety disorder = |
1. SSRI's |
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pervasive developmental disorders are characterized by: |
difficulties with language and failure to acquire/early loss of social skills |
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2 examples of pervasive developmental disorders: |
1. autism spectrum |
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autism spectrum disorder: |
1. poor social interactions |
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Rett disorder = |
X-linked disorder seen almost exclusively in girls (affected males die in utero or soon after) |
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symps of Rett disorder: |
1. start between 1 and 4 y.o. |
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"alert and oriented x3" ~~ |
pt's ability to know: |
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7 common causes of loss of orientation: |
1. alcohol |
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order of loss of orientation goes in this order: |
first, don't know time/date |
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retrograde amnesia = |
inability to remember things that occurred BEFORE a CNS insult |
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anterograde amnesia = |
NO NEW memory |
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Korsakoff amnesia = |
classic anterograde amnesia caused by thiamine deficiency and the associated destruction of mammillary bodies |
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3 other features of Korsakoff amnesia: |
1. may also include retrograde amnesia |
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dissociative amnesia = |
inability to recall important personal info, usually subsequent to severe trauma or stress |
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dissociative amnesia may be accompanied by: |
dissociative fugue |
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cognitive disorder = |
significant change in cognition (memory, attn, language, judgment) from previous level of function. |
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cognition disorder includes: |
1. dementia |
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features of delirium: |
1. waxing and waning lvl of consciousness |
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delirium is the m.c. presentation of AMS in: |
the inpatient setting |
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treatment of delirium = |
1. address UC |
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features of dementia: |
1. *gradual dec. in cognition |
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dementia is characteried by: |
1. **memory deficits |
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in elderly pts, depression can sometimes look like: |
dementia |
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irreversible causes of dementia = |
1. Alz |
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reversible causes of dementia: |
1. NPH (nl P hydrocephalus) |
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a pt with dementia can easily develop: |
delirium |
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psychosis = |
a distorted perception of reality |
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"disorganized speech" ~~ |
words strung together with loose associations |
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types of hallucinations: |
1. visual |
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schizophrenia = |
psychosis + disturbed behavior + decline in function |
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4 features of schizophrenia: |
1. ~~ inc. DOPA activity |
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frequent cannabis use is associated with: |
schizophrenia/psychosis in teens |
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diagnosis of shczophrenia requires 2 or more of the following: |
1. delusions |
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in men, schizophrenia presents: |
late teens, early 20's |
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brief psychotic disorder = |
psychosis **<1 month** |
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schizophreniform disorder = |
schizophrenic symps ***1-6 mths*** |
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schizoaffective disorder = |
***at least 2 weeks*** of *stable mood* with psychotic symps, |
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2 subtypes of schizoaffective disorder: |
1. bipolar schizoaffective |
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delusional disorder = |
fixed, persistent, untrue belief system lasting |
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dissociative identity disorder = |
presence of 2 or more distinct identities or personality states |
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dissociative identity disorder is associated with a history of the following: |
1. sexual abuse |
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depersonalization/derealization disorder = |
persistent feelings of detachment or estrangement from: |
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mood disorder = |
abnl range of moods or emotional states, with loss of control over them |
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4 common mood disorders: |
1. MDD |
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a manic episode has to last for at lesast __________________ in order to be diagnosed as such |
1 week |
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diagnosis of mania requires either hospitalization or: |
DIG FAST |
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hypomania = |
a less-severe mania that DOESN'T cause marked impairment in social and/or occupational functioning and doesn't require hosp. |
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Bipolar Disorder I = |
at least 1 manic episode +/- hypomanic or depressive state |
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Bipolar Disorder II = |
hypomanic episode + depressive episode |
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in the maintenance phase of Bipolar Disorders, the pt's mood and functioning are: |
nl |
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use of antidepressants in a pt with Bipolar may cause: |
mania |
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Cyclothymic disorder = |
dysthymia + hypomania |
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dysthymia = persistent depressive disorder = |
mild depression, lasting at least 2 years |
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treatment of Bipolar Disorder = |
1. mood stabilizers |
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Major Depressive disorder (MDD): depressive episodes usually last: |
6 to 12 months |
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to diagnose MDD, must have 5 of these 9 symps for **2 or more weeks** |
SAG E CAPS D |
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6 changes in sleep stages in pts with depression: |
1. dec. slow-wave sleep |
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atypical depression: |
1. ability to experience (brief) elevations in mood |
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treatment of atypical depression = |
1. MAOI's |
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what is the m.c. subtype of depression? |
atypical depression |
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postpartum mood disturbances occur within: |
4 weeks of delivery |
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postpartum blues = |
depressed affect, tearfulness, and fatigue 2-3 days after delivery, |
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treatment for postpartum blues = |
reassurance |
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postpartum depression = |
depressed affect, anxiety, and poor concentration |
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treatment for postpartum depression = |
1. antidepressants |
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postpartum psychosis = |
delusions/hallucinations, confusion, unusualy behavior, and possible homicidal/suicidal ideations |
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treatment for postpartum psychosis = |
1. antipsychotics |
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nl bereavement is characterized by: |
1. shock |
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duration of nl bereavement ~~ |
6-12 months |
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pathologic grief is characterized by: |
1. excessively intense grief |
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ECT = treatment for: |
1. MDD that is refractory to other treatments |
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ECT produces a painless: |
sez |
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adverse effects of ECT include: |
1. disorientation |
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risk factors for completing a suicide: |
SAD PERSONS |
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wrt suicide, women: |
try more often; |
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anxiety disorder = |
inappropriate fear or worry that results in social/occupational impairment |
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4 types/exampes of anxiety disorders: |
1. panic disorder |
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panic disorder = at least 4 of the following: |
PANICS L |
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panic disorders have a strong: |
genetic component |
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treatment for Panic Disorder = |
1. CBT |
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diagnosis of Panic Disorder requires: |
1. attack + |
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people with phobias recognize: |
that the fear is excessive |
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social anxiety disorder = a type of phobia = |
exaggerated fear of embarrassment in social situations, e.g. speaking to a crowd |
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treatment for social anxiety disorder = |
SSRI's |
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GAD = |
at least *6 months* of uncontrollable anxiety that is NOT related to anything specific |
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features of GAD: |
1. sleep disturbance |
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treatment of GAD = |
1. SSRI's |
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adjustment disorder = |
1. emotional symps |
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OCD = |
recurring, unwanted thoughts that are relieved by a the performance of repetitive actions |
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treatment of OCD = |
1. SSRI's |
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Body Dysmorphic disorder = |
PD that has a preoccupation with a minor or imagined defect in appearance, leading to significant emotional distress or impaired functioning |
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PTSD = |
persistent re-experience of previous traumatic event |
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features of PTSD = |
1. nightmares or flashbacks |
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treatment for PTSD = |
1. psychotherapy |
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Acute Stress Disorder = |
PTSD symps that last *between 3 days and 1 month* |
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Somatoform disorders = |
group of disorders in which a pt's psychological stress manifests as physical symps |
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3 examples of a Somatoform Disorder: |
1. Somatization disorder |
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Somatic symp. disorder = Somatization Disorder = |
1. variety of complaints |
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conversion disorder = |
sudden loss of a neuro function (motor OR sensory) |
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in conversion disorder, the pt is aware of the neuro loss but is often: |
unconcerned |
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with PD's the pt is usually NOT: |
aware of a problem |
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PD's are split into 3 clusters, A, B and C, which are often characterized as: |
Weird, |
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Cluster A PD's include: |
1. Paranoid PD |
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Paranoid PD often includes _________________ (defense mechanism) |
projection |
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Schizoid: |
1. voluntary social withdrawal |
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Schizotypal: |
1. eccentric appearance |
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Cluster B PD's = |
1. Histrionic |
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Histrionic PD: |
1. attn-seeking |
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Antisocial PD |
1. = conduct disorder of adults |
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to be diagnosed with Antisocial PD, you need to be: |
1. >18 y.o. |
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Narcissistic PD: |
1. entitlement |
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Borderline PD: |
1. sense of emptiness |
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Cluster C PD's include: |
1. Avoidant PD |
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Avoidant PD: |
1. hypersensitive to rejection |
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OCPD: |
1. perfectionism |
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Dependent PD: |
1. submissive and clingy |
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Anorexia Nervosa = |
excessive dieting +/- purging |
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features of anorexia nervosa: |
1. body image distortion |
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osteoporosis from anorexia is caused by: |
decreased EST over time |
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Bulimia Nervosa = |
binge eating +/- purging |
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features of bulimia Nervosa: |
1. body wt near nl |
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gender dysphoria = |
persistent cross-gender identification and discomfort with one's own sex |
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transexualism = |
desire to live as the opposite sex, |
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transvestism = |
cross-dressing |
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sexual dysfunction includes: |
1. sexual desire disorders |
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differential dx of sexual dysfunction includes: |
1. drugs |
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sleep terror = |
periods of screaming in the middle of the night |
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5 features of sleep terror: |
1. occurs during SLOW-wave sleep (3 and 4) |
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narcolepsy = falling straight into REM sleep; caused by: |
decreased orexin production in the L hypothalamus |
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narcolepsy is associated with: |
1. hypnagogic or hypnopompic hallucinations |
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treatment of narcolepsy = |
1. daytime, CNS stimulants |
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substance use disorder = |
maladaptive pattern of substance use with 2 or more of the following for at least **1 year** |
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6 stages of change in overcoming substance addiction: |
1. precontemplation |
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heroin addiction => increased risk for: |
1. hepatitis |
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3 treatments for heroin addiction: |
1. Methadone |
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Methadone = |
long-acting oral opioid |
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Naloxone = |
opioid partial agonist |
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Buprenorphine = |
mixed opioid agonist-antagonist |
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5 complications of alcoholism: |
1. alcoholic cirrhosis |
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treatment of alcoholism = |
1. Disulfirim |
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Wernicke-Korsakoff syndrome = |
triad of confusion, ataxia, and ophthalmoplegia (Wernicke encephalopathy) + memory loss with confabulation (filling in gaps of memory with made-up ones) |
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W-K syndrome is associated with: |
periventricular hemorrhage/necrosis of mamillary bodies |
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Wernicke encephalopahty (and thus W-K syndrome) is caused by: |
thiamine deficiency (Vit. B1) |
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Mallory-Weiss syndrome = |
longitudinal, partial-thickness tear at the gastroesophageal junction, |
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2 features of Mallory-Weiss syndrome: |
1. often presents with hematemesis |
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Delirium Tremens (DTs) = |
life-threatening alcohol withdrawal syndrome that peaks 2-5 days after last drink |
|
symps of DTs, in order of appearance: |
1. autonomic system hyperactivity |
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treatment of DTs = |
Benzo's |
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mechanism of CNS stimulants like Methylphenidate, Phentermine, amphetamines: |
increase catecholamines at the synaptic cleft, |
|
clinical use of CNS stimulants: |
1. ADHD |
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typical antipsychotics = neuroleptics = first-gen antipsychotics: |
1. Haloperidol |
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mechanism of firt-gen antipsychotics: |
all block D2 r's, |
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indications for first-gen antipsychotics = |
1. Schizophrenia of primarily-pos. symps |
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all first-gen antipsychotics are highly lipid soluble, and thus stored in: |
fat |
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SE's of first-gen antipsychotics: |
1. endocrine (e.g. hyperprolactinemia => galactorrhea) |
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3 HIGH-potency neuroleptics: |
1. Haloperidol |
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Extra-pyramidal symps have a progression: |
4-hour acute dystonia (muscle spasms, stiffness, oculogyric crisis) |
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treatment for EPSymps = |
1. Benztropine (anticholinergic) |
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special SE's of Haloperidol = |
1. NMS |
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2 low-potency neuroleptics: |
4. Chlorpromazine |
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special SE of Chlorpromazine = |
Corneal deposits |
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special SE of Thioridazine = |
reTinal deposits |
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SE's of LOW-potency neuroleptics = |
non-neurologic SE's |
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NMS = Neuroleptic Malignant Syndrome = |
FEVER |
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treatment for NMS = |
1. Dantrolene (check mech) |
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atypical antipsychotics = second-gen antipsychotics: |
1. Olanzapine |
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indications for atypical antipsychotics: |
1. Schizophrenia (positive and negative symps) |
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second-gen antipsychotics have fewer EPS and anticholinergic SE's than first-gen; some special SE's: |
1. Olanzapine and Clozapine may cause significant wt gain |
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Clozapine must be: |
watched closely, due to risk of agranulocytosis |
|
2 indications for Lithium: |
1. mood stabilizer for Bipolar |
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SE's of Lithium: |
1. Tremor |
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fetal cardiac defects due to Lithium uuse: |
1. Ebstein anomaly |
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narrow therapeutic window of Lithium requires: |
close monitoring of its serum levels |
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metabolism of Lithium: |
1. 100% renal excretion |
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mechanism of Buspirone: |
stimulator of 5-HT1A r's |
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indication for Buspirone: |
GAD |
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features of Buspirone: |
1. does NOT cause sedation, addiction, or tolerance |
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4 SSRI's: |
1. Ci-talo-pram |
|
indications for SSRI's: |
1. MDD |
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SE's of SSRI's: |
1. GI distress |
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7 symps of SER Syndrome: |
1. hyperthermia |
|
treatment for SER Syndrome: |
Cyproheptadine |
|
4 meds that cause risk of SER Syndrome: |
SSRI's |
|
2 SNRI's: |
1. Venlafaxine |
|
mechanism of SNRI's: |
inhibit reuptake of SER and NOR |
|
indications for SNRI's: |
1. MDD |
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SE's of SNRI's: |
1. inc. BP |
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TCA's: |
1. Am-i-trip-tyline |
|
mechanism of Tricyclic Antidepressants (TCA's): |
block reuptake of SER and NOR |
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indications for TCA's: |
1. MDD |
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SE's of TCA's: |
1. sedation |
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tertiary TCA's like Amitriptyline have more anticholinergic effects than: |
secondary ones like Nortriptyline |
|
Desipramine is less sedating than other TCA's, but has a higher: |
sez incidence |
|
OD of TCA's => |
1. triple-C's: Convulsions, Coma, Cardiotoxicity (arrhythmias) |
|
treatment for TCA arrhythmias = |
NaHCO3 |
|
MAOI's: |
1. Phenelzine |
|
MAOI's => |
dec . breakdown of SER, NOR, DOPA |
|
indications for MAOI's: |
1. atypical depression |
|
SE's of MAOI's: |
1. risk of hypertensive crisis with ingestion of tyramine (wine and cheese) |
|
MAOI's are contraindicated with: |
1. SSRI's/SNRI's |
|
3 Atypical Antidepressants: |
1. Bupropion |
|
2 indications for Bupropion: |
1. MDD |
|
mechanism of Bupropion: |
increases NOR and DOPA |
|
SE's of Bupropion = |
1. stimulant effects (tachy/insomnia) |
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2 mechanisms of Mirtazapine: |
1. alpha2-antagonist |
|
4 SE's of Mirtazapine: |
1. sedation |
|
mechanism of Trazodone: |
blocks 5HT2 and a1-adrenergic r's |
|
indications for Trazodone: |
insomnia, |
|
SE's of Trazodone: |
1. sedation |