Term
| What is a Rorschach test? |
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Definition
| Ink blot test. Ex: Interpret a picture as a butterfly (trying to discover the pts inner thoughts |
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Term
| What is Thematic Apperception Test (TAT)? |
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Definition
| Focuses on dominant drives, emotions, sentiments, complexes, attitudes and conflicts. Subject is shown pictures and asked to make up a story (normally given in two sessions, one day apart) |
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Term
| In reference to diagnostic coding, what is Axis I? |
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Definition
| Clinical disorders (substance related disorders and major mental illness including mood, anxiety and psychotic disorders), other conditions that impact the clinical picture. |
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Term
| In reference to diagnostic coding, what is Axis II? |
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Definition
| Personality disorders, mental retardation. |
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Term
| In reference to diagnostic coding, what is Axis III? |
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Definition
| General medical conditions, particularly those that are ongoing, or have historically impacted the clinical picture such asa closed head trauma. |
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Term
| In reference to diagnostic coding, what is Axis IV? |
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Definition
| Problems with psychological functioning and environment |
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Term
| In reference to diagnostic coding, what is Axis V? |
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Definition
| Global assessment of functioning (typically 2 numbers are assigned according to the GAF scale to assess the current level of functioning and the highest level over the past year) |
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Term
| In regards to Schizophrenia Hx, what are the 4 A's? |
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Definition
1. Associations
2. Affect
3. Autism
4. Ambivalence |
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Term
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Definition
| A break from reality. Manifested by disturbances in the formation and content of thoughts- includes hallucinations, delusions and abnormal thoughts |
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Term
| What causes Psychosis? Is it a sx or illness? |
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Definition
| Caused by a variety of conditions that affect the functioning of the brain. It is a SYMPTOM, not an illness. |
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Term
| What are the positive sx of Schizophrenia? |
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Definition
1. Delusions
2. Hallucinations
3. Behavioral dyscontrol
4. Thought Disorder |
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Term
| What are the negative sx of Schizophrenia? |
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Definition
1. Affective flattening
2. Alogia (speaking very little or a lack of spont. content in conversion- poverty of speech)
3. Avolition- loss of ability to initiate goal-directed activity
4. Anhedonia- loss of ability to experience emotions
5. Attentional Impairment |
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Term
| What is Bipolar I? What is the age of onset? |
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Definition
| Alternation of full manic and depressive episodes with a high risk of suicide. Onset: 18 yo |
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Term
| What is Bipolar II? Average age of onset? |
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Definition
| Alternation of major depression with hypomania. Onset: 22 yo |
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Term
| What are the DSM IV Criteria for Schizophrenia? |
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Definition
1. Two or more psychotic sx for 1 month (shorter if tx)
2. Impairment in social or occupational functioning.
3. Not due to medical, neurological or substance-induced disorder |
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Term
| What is OCD? When does it usually begin? More common in men or women? |
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Definition
| Preoccupation with specific ideas or thoughts (obsessive) and unable to resist repeated behaviors (compulsive). Begins before adulthood, MC in women |
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Term
| What therapies are helpful for OCD pts? |
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Definition
1. Exposure and response prevention therapies
2. Serotonin-related drugs |
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Term
| In reference to OCD, the DSM-IV-TR Criteria for Compulsions are? |
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Definition
1. Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to the rules the must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are designed to neutralize or prevent or are clearly excessive. |
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Term
| The DSM IV "Clusters" are composed of Cluster's A, B, C's. Define each. |
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Definition
Cluster A- often appear odd/eccentric
Cluster B- often appear dramatic, emotional or erratic
Cluster C- often appear anxious or fearful |
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Term
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Definition
1. Paranoid- distrustful and suspicious of others
2. Schizoid- detached from social relationships; restricted range emotional expression.
3. Schizotypal- Discomfort with close relationships; cognitive/perceptual disorders; eccentric behaviour |
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Term
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Definition
1. Antisocial- disregard for, and frequent violations of, the rights of others
2. Borderline: Instability of relationships, self-image, emotions, control over impulses.
3. Histrionic: excessive emotionality and attention seeking
4. Narcissistic- grandiosity, need for admiration and lack of empathy |
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Term
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Definition
1. Avoidant- social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
2. Dependent- excessive need to be taken care of, leading to submissive and clinging behavior
3. Obsessive-Compulsive- preoccupied with orderliness and perfectionism at expense of flexibility |
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Term
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Definition
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Term
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Definition
| replying to questions in an oblique, tangential or irrelevant way |
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Term
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Definition
| Ideas slip off the track onto another which is obliquely related or unrelated |
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Term
| What are loosening of associations? |
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Definition
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Term
| What is private word usuage? |
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Definition
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Term
|
Definition
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Term
| In reference to delusions what is thought broadcasting? |
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Definition
| Delusion that one is capable of inserting thoughts into other individuals minds, or that others can perceive them |
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Term
| In reference to delusions, what is thought insertion? |
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Definition
| Delusion that thoughts are being inserted into ones' mind by someone else |
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Term
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Definition
| Involves loss of nerve cells within the brain due to amyloid plaque formation and neurofibrillary tangles; develops structural obstruction within the brain. |
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Term
| What are the 3 major characteristics of Alzheimer's Dz? |
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Definition
1. Reduced activity of the NT Ach
2. Involves the role of amyloid plaques (apoE-2, apoE-3, apoE-4
3. Involves the subsequent atrophy of the brain |
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Term
| Chlorpromazine (Thorazine) was used in the 1950's. It is what type of medication? |
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Definition
| Antipsychotic but tx only + sx |
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Term
1. Typical antipsychotics (older) are used to tx_______.
2. Atypical antipsychotics (newer) are used tx _______. |
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Definition
1. + sx
2. + and - sx (broad receptor spectrum) |
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Term
6 Atypical antipsychotics:
Mechanism of action? |
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Definition
1. Risperidone
2. Olanzapine
3. Quentiapine
4. Clozapine
5. Ziprasidone
6. Ariprprazole (new-partial DA antagonist)
MOA- DA antagonists |
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Term
| Immediate neuroleptic SE include? Definition of each? |
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Definition
1. Parkinsonism
2. Acute dystonia- nearly always develops a few wks after the start of a DA blocking agent or substantial increase of a dose; characterized as a syndrome of sustained muscle contractions, frequently causing twisting and repetitive movements or abnormal posture
3. Acute akathisia- restlessness |
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Term
| Example and definition of a delayed neuroleptic SE? |
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Definition
| Tardive dyskinesia- involuntary movements of the tongue, lips, face, trunk and extremities |
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Term
| Example and definition of an emergent neuroleptic SE? |
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Definition
| Neuroleptic Malignant Syndrome- The combination of hyperthermi, regidity and autonomic dysregulation |
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Term
| What are the 8 characteristics of delirium? |
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Definition
Delirium is a clouded state of consciousness involving:
1. Acute, onset, fluctuating, reversible disturbance
2. Difficulty in concentration
3. Disruption of the sleep-waking cycle
4. Incoherent speech
5. Memory impairment for recent events
6. Perceptual distrubances (delusions and hallucinations)
7. Mood/activity swings
8. Disorganized thoughts |
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Term
| What are the 3P's that define a personality disorder? Define them. |
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Definition
It is NOT a personality disorder unless the behavior is:
1. Problematic- causes clinically sign. distress or problems for self or others, may be difficulties in social life, work, law
2. Persistent: pattern is stable and long standing, present since early adulthood or adolescence and con't to adulthood
3. Pervasive- patter is inflexible, present in a broad range of personal or social situations |
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Term
| Alzheimer's Dz involves a progressive deterioration of ? This leads to difficulty in? |
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Definition
Cerebral cortex and hippocampus.
Concentration and memory loss |
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Term
| The DSM-IV Criteria for Dementia in relation to Alzheimer's include (4): |
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Definition
1. Multiple cognitive deficits that develop gradually and steadily
2. Predominant impairment in memory, orientation, judgement and reasoning
3. Can include agitation, confusion, depression, anxiety or combativeness
4. Sx are usually more pronounces at end of day (sundowning) |
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Term
| What are the 4 main characteristics of a histrionic personality disorder? |
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Definition
1. Discontent when not the center of attention
2. Inappropriate sexual seduction or provocative
3. Exaggerated expression: theatrical displays of emotion and self-dramatization
4. Easily influences by others and circumstances |
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Term
| What are the 5 main characteristics of an antisocial personality disorder? |
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Definition
1. Unlawful behavior; repeated acts that are grounds for arrest
2. Deceitfulness, lying, use of aliases, or conning others for pleasure or profit
3. Impulsivity; failure to plan
4. Recklessness; disregard for the safety of self and others
5. Lack of remorse; indifference to hurting, mistreating or violating the rights of others; rationalizing having done so
NOTE- The individual is at least 18 with a hx of conduct disorder before 15 yo |
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Term
| What are the 8 main characteristics of a Narcissistic Personality Disorder? |
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Definition
1. Grandiose sense of self importance
2. Preoccupations with fantasies of success, wealth, power, brilliance, beauty or ideal love
3. Beliefs related to being special or unique or only understood by other unique people
4. Requires excessive admiration
5. Sense of entitlement
6. Lack of empathy
7. Envious of others
8. Arrogant behavior |
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Term
| What are the 5 main characteristics of a borderline personality disorder? |
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Definition
1. Unstable, intense relationships; extremes of idealization and devaluation
2. Identity disturbance; unstable self image
3. Impulsivity which is self-damaging or depreciating
4. Recurrent suicidal threats or gestures; self-destructive or self-mutlitating behavior
5. Inappropriate, intense anger; difficulty controlling anger |
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Term
| The 3A's for cognitive deficits in Alzheimer's includes: |
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Definition
1. Aphasia- difficulty with language
2. Apraxia- Impaired motor functioning
3. Agnosia- Failure to recognize objects |
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Term
| Alzheimer's pts have cognitive deficits with: |
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Definition
Planning, organizing, sequencing or abstracting info; loss of executive fxn.
These impairments have a marked - impact on social and occupational functioning |
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Term
| The nature and progression of Alzheimer's Dz is: (3) |
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Definition
1. Deterioration is slow during the early and later stages, but rapid during middle stages
2. Average survival time is about 8 yrs
3. Onset usually occurs in the 60s or 70s, but may occur eariler |
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Term
| Prevalence of Alzheimer's Dz is greater in? |
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Definition
| Poorly educated persons and women. |
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Term
| Neuropathology of Alzheimer's includes: (3) |
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Definition
1. Senile plaques (beta-amyloid protein)
2. Neurofibrillary tangles (loss of synapses, dementia)
3. Ach- major loss of nicotinic receptors, GLUTAMATE |
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Term
New drug for tx of Alzeimer's:
MOA? |
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Definition
1. Namenda (memantine)
2. Inhibits glutamate NT system |
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Term
| Meds for helping to improve Alzheimer's Sx? |
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Definition
1. Cholinesterase inhibitors (Aricept, Exelon, Reminyl)
2. Memantine |
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Term
| Meds for delaying the onset of AD? |
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Definition
| Cholinesterase inhibitors (Aricept, Exelon, Reminyl) |
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Term
| Possible etiology in AD includes: |
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Definition
Trauma- Concussion, Contusion
1. Occult head trauma if recent fall
2. Highly correlated to the sport of boxing
3. Dementia pugilistica |
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Term
| Sx of a dysthymic disorder includes: (5) |
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Definition
1. Depressed/Irritable Mood
2. Presence of two of the following (Appetitie disturbance, sleep disturbance, low energy/fatigue, poor concentration of difficulties making decision, feelings of hopelessness)
3. Present for 2 yr period (One yr in children and adolescents)
4. No evidence of a major depressive episode during the first 2 yrs (one year for children)
5. NO MANIC OR HYPOMANIC EPISODE |
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Term
| What are the sx of a cyclothymia disorder (3)? |
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Definition
1. At least 2 yrs (one yr for children and adolescents) presence of numerous periods with depressed mood or loss of interest or pleasure that did not meet criterion A (5 sxs) of Major Depression
2. During 2-yr period (1 yr in children and teens) of disturbance, never w/out hypomanic or depressive sx for more than 2 months at a time
3. No evidence of MDD or manic episode during the first 2 yrs of disturbance |
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Term
| What characterizes a brief psychotic disorder? |
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Definition
1. only having a + sx from schizoprenia (delusions, hallucinations)
2. duration from one day to one month |
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Term
| What is schizophreniform? |
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Definition
| Meets + and - criteria from schizophrenia and is longer than one month but less than 6 months |
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Term
| What is a schizoaffective disorder? |
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Definition
| Meets the criteria for a major depressive or manic episode and psychotic sx of schizophrenia, along with 2 wks of psychotic sx in the absence of mood sx |
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Term
| What is a Generalized Anxiety Disorder? |
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Definition
| Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities |
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Term
| What is a specific phobia? |
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Definition
| Fears related to specific objects, people or situations; clinically sign. anxiety provoked by exposure to a specific feared object or situation, often leading to avoidance behavior (spiders, snakes, etc) |
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Term
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Definition
| Intense incapacitiating fear and embarrassment when dealing with others |
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Term
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Definition
| Fear of leaving home (with or without panic attacks) |
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Term
| What is the recommended tx for phobic disorders? |
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Definition
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Term
| Are phobias more common in males or females? |
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Definition
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Term
| What are the 11 blood tests used to screen for dementia? |
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Definition
1. Electrolytes
2. Liver FTs
3. Kidney FTs
4. Glucose
5. TFTs
6. Vitamin B12
7. Folate
8. CBC
9. ESR
10. VDRL
11. HIV |
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Term
| What are the diagnostic tests used to screening for dementia? |
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Definition
1. Blood tests
2. EKG
3. Chest Xray
4. U/A
5. Anatomical brain scan- MRI, CT* ( cheapest)
6. Assessment of functional brain activity
7. Reaction Times
8. Heavy metal screen
9. 24 hr urine
10. Genotyping |
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Term
| What dx tests are used to assess functional brain activity in dementia pts? |
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Definition
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Term
| Reaction times in the elderly are usually? What dx tests can test for reaction time? |
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Definition
| Slowed, esp when complex reasoning is required. CSF analysis- elevated tau, decreased amyloid |
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Term
| Genotyping is used to detect for what in alzheimer's pts? |
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Definition
Apo-lipoprotein-e (for supporting dx)
1. 2- PROTECTIVE
2. 3
3. 4- responsible for EARLY ONSET |
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Term
| Confirmation for brain scan in dementia cases helps to: |
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Definition
1. Confirm atrophy pattern
2. SPECT, PET- estimation of regions of physiologic dysfunction, areas of infarction
3. Helps family to visualize problem |
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Term
| Major Depressive Disorder is characterized by (5 of the following): |
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Definition
*Must include one of 1st 2, occurring almost every day for 2 wks:
1. Depressed mood*
2. Pleasure or interest loss*
3. Appetite
4. Sleep disturbance- too much/little
5. Agitation or retardation
6. Fatigue
7. Feelings of worthlessness or guilt
8. Difficulty concentrating or deciding
9. Recurrent thoughts of death |
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Term
| A single episode of a major depressive disorder is characterized by: |
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Definition
| An absence of mania or hypomania |
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Term
| Recurrent episodes of a major depressive disorder are characterized by: |
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Definition
| 2 major depression episodes separated by at least a 2 month period with more or less normal functioning/mood |
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Term
| What is an amnesic disorder? |
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Definition
| Memory impairment not due to delirium, dementia that is of psychological basis or substance induced. |
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Term
| What is a transient amnesic disorder? |
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Definition
|
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Term
| What is a chronic amnesic disorder? |
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Definition
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Term
| How is a personality disorder defined? |
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Definition
| Enduring pattern of inner experiences and behaviour that deviates markedly from the expectations of the individuals' culture |
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Term
| What is traveler's amnesia? |
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Definition
| Memory impairment that occurs following a nap on an airplane after taking a short acting hypnotic (alprazolam, triazolam, zolpidem) |
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Term
| What is Korsakoff syndrome? |
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Definition
Neuronal damage that results from thiamine def. in association with chronic alcohol abuse.
Usually preceded by wernicke encephalitis (ataxia, confusion, occulomotor palsy)
Typically precipitated by admin of glu to malnourished alcoholics w/out concomitant parenternal thiamine
Confabulations (koraskoff psychosis) is a hallmark finding. |
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Term
| What is a panic disorder? |
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Definition
| Periodic, discrete bouts of panic that occur abruptly and peak within 10 min. |
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Term
| What are the sx of a panic disorder? |
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Definition
| Palpitations, SOB, chest pain, choking sensation, faintness, dizziness |
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