Term
Are hallucinations common in narcolepsy patients? |
|
Definition
Yes. Both hypnagogic (just before sleep) and hypnopompic (with awakening) are both common. |
|
|
Term
|
Definition
Sudden collapse (falls asleep) while awake. |
|
|
Term
|
Definition
Person stops breathing for at least 10 seconds during sleep. |
|
|
Term
Distinguish between central and obstructive sleep apnea. |
|
Definition
"In central sleep apnea, there is no respiratory effort. In Obstructive sleep apnea, there is respiratory effort against airway obstruction." |
|
|
Term
Does narcolepsy have a genetic component? |
|
Definition
Yes. Studies have shown a strong genetic component of narcolepsy. |
|
|
Term
Does REM sleep increase or decrease with age? |
|
Definition
|
|
Term
Extraocular movements during REM sleep are due to what portion of the brain? |
|
Definition
Parapontine Reticular Formation/Conjugate Gaze Center |
|
|
Term
How often does REM sleep occur? |
|
Definition
Every 90 minutes (duration may increase during the night) |
|
|
Term
Name 1 neurotransmitter change associated with Alzheimer's disease |
|
Definition
|
|
Term
Name 1 neurotransmitter change associated with Parkinson's disease |
|
Definition
|
|
Term
Name 1 neurotransmitter change associated with Schizophrenia |
|
Definition
|
|
Term
Name 2 effects of stress on the body. |
|
Definition
"1. Induces production of FFA, 17-OH corticosteroids, lipids, cholesterol, and catecholamines 2. Affects water reabsorption, muscular tonicity, gastrocolic reflex, and mucosal circulation |
|
|
Term
Name 2 neurotransmitter changes associated with depression. |
|
Definition
Decreased NE and serotonin (5-HT) |
|
|
Term
Name 2 neurotransmitter changes associated with Huntington's disease. |
|
Definition
|
|
Term
Name 3 changes in sleep stages often found in people with depression. |
|
Definition
1. Reduced slow-wave sleep 2. Decreased REM latency 3. Early morning awakening (important screening question) |
|
|
Term
Name 3 possible findings in non-REM sleep. |
|
Definition
Sleepwalking, night terrors, and bedwetting" |
|
|
Term
Name 4 physiological actions found in REM sleep. |
|
Definition
"Increased/variable pulse, rapid eye movements, increased/variable blood pressure, and penile/clitoral tumescence" |
|
|
Term
Name 5 possible findings in REM sleep. |
|
Definition
"Dreaming, loss of motor tone, possible memory processing function, erection, and increased brain 02 use" |
|
|
Term
Name 5 possible waveform patterns seen in the various sleep/wake stages. |
|
Definition
"Alpha, Beta (highest frequency, lowest amplitude), Theta, Delta (lowest frequency, highest amplitude), Sleep spindles with K-complexes" |
|
|
Term
Name 7 functions of the frontal lobe. |
|
Definition
"Concentration, Orientation, Language, Abstraction, Judgment, Motor regulation, Mood" |
|
|
Term
Name a possible chronic outcome of sleep apnea |
|
Definition
|
|
Term
Name five findings associated with sleep apnea. |
|
Definition
"Obesity, loud snoring, systemic/pulmonary HTN, arrhythmias, and possibly sudden death." |
|
|
Term
What 3 things does the differential diagnosis for sexual dysfunction include? |
|
Definition
"1. Drugs (e.g. antiHTN, neuroleptics, SSRIs, and ethanol) 2. Diseases (e.g. depression and diabetes) 3. Psychological (e.g. performance anxiety) |
|
|
Term
What is a common treatment for narcolepsy? |
|
Definition
Stimulants (e.g. amphetamines) |
|
|
Term
What is a helpful mnemonic for the order of the corresponding waveform patterns in each stage of sleep? |
|
Definition
At night, BATS Drink Blood." |
|
|
Term
What is considered the key to initiating sleep? |
|
Definition
Serotonergic predominance of the raphe nucleus |
|
|
Term
|
Definition
Person falls asleep suddenly |
|
|
Term
What is the most notable change in function in a frontal lobe lesion? |
|
Definition
|
|
Term
What is the principal neurotransmitter involved in REM sleep? |
|
Definition
|
|
Term
What medication shortens stage 4 sleep and can be used to treat enuresis? |
|
Definition
|
|
Term
What medication shortens stage 4 sleep and is useful in the treatment of night terrors and sleepwalking? |
|
Definition
|
|
Term
What neurotransmitter can reduce REM sleep? |
|
Definition
|
|
Term
What percentage of time is spent in REM sleep? |
|
Definition
|
|
Term
What percentage of time is spent in stage 1 sleep? |
|
Definition
|
|
Term
What percentage of time is spent in stage 2 sleep? |
|
Definition
|
|
Term
What percentage of time is spent in stage 3-4 sleep? |
|
Definition
|
|
Term
What phenomenon caused REM sleep to be known as 'paradoxical' or 'desynchronized' sleep? |
|
Definition
The EEG pattern during REM sleep is the same as the EEG of a person that is awake and alert. |
|
|
Term
"What waveform pattern is seen in a young adult who is awake (eyes open), alert, and has active mental concentration?" |
|
Definition
|
|
Term
What waveform pattern is seen in a young adult who is awake but has his/her eyes closed? |
|
Definition
|
|
Term
What waveform pattern is seen in a young adult who is in deeper (stage 2) sleep? |
|
Definition
Sleep spindles and Kcomplexes |
|
|
Term
What waveform pattern is seen in a young adult who is in light (stage 1) sleep? |
|
Definition
|
|
Term
What waveform pattern is seen in a young adult who is in REM sleep? |
|
Definition
|
|
Term
"What waveform pattern is seen in a young adult who is in the deepest, Non-REM (stage 3-4) sleep? " |
|
Definition
|
|
Term
A person who is unable to remember things that occurred after a CNS insult? |
|
Definition
|
|
Term
Anterograde amnesia caused by thiamine deficiency? |
|
Definition
|
|
Term
Are DT's life threatening? |
|
Definition
|
|
Term
Are the illness production and motivation in somatoform disorders consicous drives? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week" |
|
|
Term
|
Definition
Discrete period of intense fear and discomfort peaking in 10 minutes with 4/5 characteristics |
|
|
Term
|
Definition
being unaware that one is ill |
|
|
Term
|
Definition
Discrete period of intense fear and discomfort peaking in 10 minutes with 4/5 characteristics |
|
|
Term
|
Definition
being unaware that one is ill |
|
|
Term
|
Definition
Being unable to locate one's own body parts |
|
|
Term
Define Conversion disorder. |
|
Definition
symptoms suggest motor or sensory neurologic or physical disorder, but tests and PE are negative" |
|
|
Term
Define depersonalization. |
|
Definition
body seems unreal or dissociated |
|
|
Term
Define Personality disorder |
|
Definition
"when patterns become inflexible and maladaptive, causing impairment in social or occupational functioning or subjective distress" |
|
|
Term
Define Personality trait. |
|
Definition
"an enduring pattern of perceiving, relating to, and thinking about the environment and oneself that is exhibited in a wide range of important social and personal contexts" |
|
|
Term
|
Definition
false beliefs not shared by other memebers of culture/ subculture that are firmly maintained in spite of obvious proof to the contrary |
|
|
Term
Describe a Paranoid Personality |
|
Definition
distrustful and suspicious; projection is main defense mech |
|
|
Term
Describe a Schizoid Personality. |
|
Definition
voluntary social withdrawl; no psychosis; limited emotional expression |
|
|
Term
Describe a Schizotypal Personality. |
|
Definition
"interpersonal awkwardness, odd thought patterns and appearance" |
|
|
Term
Does the person who has the phobia recognize their fear as excessive? |
|
Definition
yes, they are exhibiting insight" |
|
|
Term
Does the phobic fear interfere with normal routine? |
|
Definition
|
|
Term
|
Definition
perceptions in the absence of external stimuli |
|
|
Term
How are Cluster A personalities described? |
|
Definition
as odd or ecentric; cannot develop meaningful social relationships; Weird |
|
|
Term
How are Cluster B personalities described? |
|
Definition
Dramatic, emotional, or erratic; Wild" |
|
|
Term
How are Cluster C personalities described? |
|
Definition
Anxious and fearful, 'Worried'" |
|
|
Term
How is a major depressive disorder characterized? |
|
Definition
Recurrent-requires 2 or more depressive episodes with a symptom free interval of 2 months |
|
|
Term
How is a major depressive episode characterized? |
|
Definition
5 of the following for 2 weeks, including (1) depressed mood or (2) anhedonia: Sleep disturbances, Loss of Interest, Guilt, Loss of Energy, Loss of Concentration, Change in Appetite, Psychomotor retardation, Suicidal ideation, Depressed mood" |
|
|
Term
How is maladaptive pattern of substance abuse defined? |
|
Definition
3 or more of the above signs in 1 year |
|
|
Term
How is Schizophrenia described? |
|
Definition
periods of psychosis and disturbed behavior lasting >6months, |
|
|
Term
How long does the disturbance due to PSSD last? |
|
Definition
> 1 month and causes distress or social/ occupational impairment |
|
|
Term
How many criteria sets exist for bipolar disorder? |
|
Definition
6 separate criteria exist for bipolar disorders with combinations of manic, hypomanic, and depressed episodes" |
|
|
Term
How many hallucination types are there? Name them. |
|
Definition
"7; Visual, Auditory, Olfactory, Gustatory, Tactile, Hypnagogic, Hypnopompic |
|
|
Term
How many heroin addicts are there in the US? |
|
Definition
|
|
Term
How would you decribe a dependent personality? |
|
Definition
"submissive and clinging, excessive need to be taken care of, low self-confidence" |
|
|
Term
How would you decribe an obsessive-compulsive? |
|
Definition
preoccupation with order, perfectionism and control" |
|
|
Term
How would you describe a Borderline personality? |
|
Definition
unstable mood and behavior; impulsive, sense of emptiness" |
|
|
Term
How would you describe a histrionic personality? |
|
Definition
"excessive emotionally, somatization, attention seeking, sexually provocative" |
|
|
Term
How would you describe an Antisocial? |
|
Definition
as having a disregard for and violation of rights of others, criminality" |
|
|
Term
How would you describe an avoidant personality? |
|
Definition
"sensitive to rejection, socially inhibited, timid, feelings of inadequacy" |
|
|
Term
How would you desribe a Narcissistic personality? |
|
Definition
"grandiosity; sense of entitlement, many demand 'top' physician/best health care" |
|
|
Term
"If a patient consciously fakes or claims to have a disorder in order to attain a specific gain, how is this behavior described?" |
|
Definition
|
|
Term
|
Definition
"misinterpretation of actual external stimuli, ex. Mistaking coat rack for man" |
|
|
Term
In what kind of disorder does a person consciously create symptoms in order to assume a sick role and get medical attention? |
|
Definition
|
|
Term
|
Definition
NO, it is schedule I (ie. not prescribable)" |
|
|
Term
Is the motivation concious in Munchausen's by proxy? |
|
Definition
|
|
Term
Name the 5 subtypes of schizophrenia. |
|
Definition
Disorganized, Catatonic, paranoid, Undifferentiated, Residual" |
|
|
Term
Name the types of Cluster B personalities. |
|
Definition
"Antisocial, Borederline, Histrionic, Narcissistic" |
|
|
Term
To be a manic episode what characteristic behaviors must be present? |
|
Definition
"3 or more of the following: Distractibility, Insomnia, Grandiosity, Flight of Ideas, Inc in Activity/pyschomotor agitation, Pressured Speech, Thoughtlessness" |
|
|
Term
Whar are the signs of barbituate withdrawl? |
|
Definition
Anxiety, seizures, delirium, life-threatening CV collapse" |
|
|
Term
Whar are the signs of nicotine withdrawl? |
|
Definition
Irritablility, headache, anxiety, weight gain, craving, tachycardia" |
|
|
Term
Whare are the 4 A's of schizophrenia? |
|
Definition
"Ambivalence(uncertainty), Autism(self-preoccupation and lack of communication), Affect(blunted), Associations (loose)" |
|
|
Term
Whare are the characteristics of Dementia? |
|
Definition
development of mulitple cognitive deficits: memory, apahasia, apraxia, agnosia, loss of abstract thought, behavioral/personality changes, impaired judgement" |
|
|
Term
Whare are the signs of Benzodiazepine intox? |
|
Definition
Amnesia, ataxia, somnolence, minor resp depression" |
|
|
Term
Whare are the signs of caffeine intox? |
|
Definition
restlessness, insomina, increased diuresis, muscle twitching, cardiac arrhythmias" |
|
|
Term
Whare are the signs of Marijuana intox? |
|
Definition
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired jugdment, social withdrawl, increased appetite, dry mouth and hallucinations" |
|
|
Term
Whare are the signs of PCP intoxication? |
|
Definition
Belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis and delirium" |
|
|
Term
What are 2 opioid comptetitive inhibitors? |
|
Definition
|
|
Term
What are some common causes of delirium? |
|
Definition
substance use/abuse or medical illness |
|
|
Term
What are some related diagnoses of Heroin addicts? |
|
Definition
"Hepatitis, abscesses, OD, hemorrhoids(reason enough to shy away), AIDS, and rightsided endocarditis" |
|
|
Term
What are the 5 characteristics of panic? |
|
Definition
Palipitations, Abdominal distress, Nausea, Increased perspiration, Chest pains, chills and choking" |
|
|
Term
What are the 6 somatoform disorders? |
|
Definition
conversion, somatoform pain disorder, hypochondriasis, somatization disorder, body dysmorphic disorder, pseudocyesis" |
|
|
Term
What are the characteristics of Delirium? |
|
Definition
"Decreased attention span and level of arousal, disorganized thinking, hallucinations, illusions, misperceptions, disturbance of sleep-wake cycle, cognitive dysfxn" |
|
|
Term
What are the etiologic factors for schizophrenia? |
|
Definition
genetics and environment, genetics outweigh env" |
|
|
Term
What are the maladaptive signs of substance use? |
|
Definition
"Tolerance, Withdrawl, Substance taken in larger amounts than intended, Persistent desire or attempst to cut down, lots of energy spent trying to obtain substance, withdrawl from responsibility, used continued in spite of knowing the problems that it cause" |
|
|
Term
What are the negative symptoms of schizophrenia? |
|
Definition
flat affect, social withdrawl, thought blocking, lack of emotion" |
|
|
Term
What are the Positive symptoms of Schizophrenia? |
|
Definition
Hallucinations, delusions, strange behavior and loose associations" |
|
|
Term
What are the signs of alcohol use? |
|
Definition
"Disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts" |
|
|
Term
What are the signs of alcohole withdrawl? |
|
Definition
Tremor, Tachycardia, HTN, malaise, nausea, seizures, delirium tremens, tremulousness, agitation, hallucinations" |
|
|
Term
What are the signs of Amphetamine intoxication? |
|
Definition
"Psychomotor agitation, impaired judgement, pupillary dilation, HTN, tachycardia, euphoria, prolonged wakefulness and attention, cardiac arrhythmias, delusions, hallucinations, fever" |
|
|
Term
What are the signs of Amphetamine withdrawl? |
|
Definition
Post-use crash, including anxiety, lethargy, headache, stomach cramps, hunger, severe depression, dysphoric mood, fatigue, insomnia/ hypersomnia" |
|
|
Term
What are the signs of Barbiutate intox? |
|
Definition
|
|
Term
What are the signs of benzo withdrawl? |
|
Definition
Rebound anxiety, seizures, tremor, insomnia" |
|
|
Term
What are the signs of caffeine withdrawl? |
|
Definition
"Headache, lethargy, depression, weight gain" |
|
|
Term
What are the signs of cocaine intoxication? |
|
Definition
"Euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, HTN, hallucinations (including tactile:bugs on skin), paranoid ideations, angina, and sudden cardiac death" |
|
|
Term
What are the signs of cocaine withdrawl? |
|
Definition
Hypersomnolence, fatigue, depression, malaise, severe craving, suicidality" |
|
|
Term
What are the signs of LSD intoxication? |
|
Definition
"Marked anxiety and depression, delusions, visual hallucinations and flashbacks" |
|
|
Term
What are the signs of narcotic abstinence syndrome? |
|
Definition
dilated pupils, lacrimation, rhinorrhea, sweating, yawning, irritability, and muscle aches" |
|
|
Term
What are the signs of opioid intoxication? |
|
Definition
CNS depression, nausea and vomiting, constipation, pupillary constriction, seizures" |
|
|
Term
What are the signs of opioid withdrawl? |
|
Definition
Anxiety, insomnia, anorexia, sweating/piloerection(cold turkey), fever, rhinorrhea, nausea, stomach cramps, diarrhea, flu-like symptoms, yawning" |
|
|
Term
What are the signs of PCP withdrawl? |
|
Definition
"Recurrence of intoxication symptoms due to reabsorption in GI tract, sudden onset of severe, random, homicidal violence" |
|
|
Term
What are the symptoms of DT's(in order of appearance)? |
|
Definition
"ANS Hyperactivity (tachycardia, tremors, and anxiety), Psychotic symptoms (hallucinations, delusions), confusion" |
|
|
Term
What are the symptoms of nicotine intoxication? |
|
Definition
"Restlessness, insomnia, anxiety, arrhythmias" |
|
|
Term
What are the types of Cluster A personalities? |
|
Definition
"Paranoid, Schizoid, Schizotypal" |
|
|
Term
What are the types of Cluster C personalities? |
|
Definition
Avoidant, Obsessive- Compulsive, Dependent" |
|
|
Term
What are treatment options of phobias? |
|
Definition
systematic desensitization |
|
|
Term
What can be confused with dementia in elderly? |
|
Definition
|
|
Term
What complication result from ECT? |
|
Definition
complications associated with anesthesia and retrograde amnesia |
|
|
Term
What does exposure to object of phobia evoke? |
|
Definition
|
|
Term
What drug is used for long term maintenance of heroin detox? |
|
Definition
|
|
Term
What else is classically associated with Korsakoff's? |
|
Definition
Confabulations, ie. Making it up as you go along" |
|
|
Term
What is a hallmark sign of heroin addiction? |
|
Definition
|
|
Term
What is a Hypomanic Episode? |
|
Definition
it is like a manic episode except mood disturbance is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization; no psychotic features |
|
|
Term
What is a pain somatoform disorder? |
|
Definition
pain that is not explained completely by illness |
|
|
Term
|
Definition
fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or entity" |
|
|
Term
What is a schizoaffective disorder? |
|
Definition
a combo of schizophrenia and a mood disorder |
|
|
Term
What is a somatization disorder? |
|
Definition
Varitey of complaints in multiple organ systems |
|
|
Term
What is Cyclothymic disorder? |
|
Definition
milder form of bipolar lasting at least 2 years |
|
|
Term
What is dementia characterized by? |
|
Definition
commonly irreversible memory loss |
|
|
Term
What is destroyed in Korsakoff's Amnesia? |
|
Definition
Mamillary bodies(bilaterally |
|
|
Term
What is drug of choice for bipolar? |
|
Definition
|
|
Term
|
Definition
milder form of depression lasting at least 2 years |
|
|
Term
What is Electroconvulsive Therapy(ECT)? |
|
Definition
a tx option for major depressive disorder refractory to other tx. It is painless and produces a seizure with transient memory loss and disorientation. |
|
|
Term
|
Definition
misinterpretation of normal physical findins, leading to preoccupation with and fear of having a serious medical illness in spite of medical reassurance" |
|
|
Term
What is it called when a parent causes their child to become ill in order to receive attention? |
|
Definition
|
|
Term
What is post-traumatic stress disorder? |
|
Definition
when a person experienced or witnessed an event that involoved actual or threatened death or serious injury. The traumatic event is reexperienced; person persistently avoids stimuli associated with the trauma and experiences persistent symptoms of increas |
|
|
Term
|
Definition
what the symptom does for the patient's internal psychic economy |
|
|
Term
What is retrograde amnesia a complication of? |
|
Definition
ECT-electroconvulsive therapy(shock) |
|
|
Term
|
Definition
What the symptoms gets the patient(sympathy or attention) |
|
|
Term
|
Definition
|
|
Term
What is the criterion for dx of substance abuse? |
|
Definition
One or more of the following in 1 year: Recurrent use resulting in failure to complete responsiblities, recurrent use in physically hazardous situations, recurrent legal problems, continued use in spite of persistent problems of use" |
|
|
Term
What is the definition of substance abuse? |
|
Definition
maladaptive pattern of use leading to clinically significant impairment or distress, symptoms have not met criteria for dependence" |
|
|
Term
What is the difference between delusions and loos associations? |
|
Definition
delusion is a disorder in the content of thought(the actual idea) where a loose association is a disorder in the form of thought(the way the idea is tied together) |
|
|
Term
what is the fear of heights? |
|
Definition
|
|
Term
what is the fear of marriage? |
|
Definition
|
|
Term
what is the fear of open places? |
|
Definition
|
|
Term
what is the fear of pain? |
|
Definition
|
|
Term
|
Definition
|
|
Term
What is the inability to remember things that happened before CNS insult? |
|
Definition
|
|
Term
What is the key to delirium diagnosis? |
|
Definition
Waxing and waning level of conciousness that develops rapidly |
|
|
Term
What is the key to dementia diagnosis? |
|
Definition
rule out delirium-patient is alert, no change in level of conciousness. More often gradual onset. |
|
|
Term
What is the lifetime prevalence for Major Depressive Disorder in Males and Females: |
|
Definition
13% for males, and 21% for females" |
|
|
Term
What is the lifetime prevalence for schizophrenia? |
|
Definition
1.5%-(males/females, blacks/whites) presents earlier in men" |
|
|
Term
What is the most common psych illness on medical and surgical floors? |
|
Definition
Delirium, often reversible" |
|
|
Term
What is the order of loss or orientation? |
|
Definition
|
|
Term
What is the response to the traumatic event? |
|
Definition
intense fear, helplessness or horror" |
|
|
Term
What is the trigger for DT's? |
|
Definition
|
|
Term
What patient population will you see Korsakoff's? |
|
Definition
|
|
Term
What questions do you have to answer when assessing an patient's orientation? |
|
Definition
Is the patient aware of him/ herself as a person? Does the patient know his/her name? |
|
|
Term
What syndrome is manifested by a chronic history of multiple hospital admissions and willingness to receive invasive procedures? |
|
Definition
|
|
Term
Whate is body dysmorpic disorder? |
|
Definition
patient is convinced that part of one's own anatomy is malformed |
|
|
Term
|
Definition
false belief of being pregnant associated with objective signs of pregnancy |
|
|
Term
When are the halluinations common? |
|
Definition
Visual(acute organic brain syndrom), Auditory (Schizophrenia), Olfactory(aura of psychomotor epilepsy), Gustatory (rare), Tactile(DT's and Cocaine abusers), Hypnagogic(while going to sleep), Hypnopmpic(while waking from sleep)" |
|
|
Term
|
Definition
2-5 days after last drink |
|
|
Term
When must a painc disorder be dx? |
|
Definition
in the context of the occurrence |
|
|
Term
"Who are more likely to be antisocial, male or female?" |
|
Definition
|
|
Term
Who are more likely to be borderline, male or female?" |
|
Definition
|
|
Term
Who do you need to see to witness caffeine withdrawl approx every six weeks? |
|
Definition
|
|
Term
|
Definition
Obligation to respect pts as individuals and to honor their preferences in medical care |
|
|
Term
Legally, what does informed consent require?" |
|
Definition
"- discussion of pertinent information- obtaining the patient's agreement to the plan of care- freedom from coercion" |
|
|
Term
Pt autonomy vs. beneficence: when does autonomy win out? |
|
Definition
"If pt makes an informed decision, ultimately, the pt. has the right to decide." |
|
|
Term
What 3 proofs are required for a sucessful malpractice civil suit for neglegence? |
|
Definition
"- Dr. breach of duty to patient- pt. suffers harmbreach of duty causes harm Note--beyond reasonable doubt not needed, just more likely than not" |
|
|
Term
What are the 4 exceptions to confidentiality? |
|
Definition
potential harm to others is serious- likelihood of harm is great- no alternative means exist to warn or to protect those at risk- Drs. Can take steps to prevent harm" |
|
|
Term
What are the 4 exceptions to informed consent? |
|
Definition
pt. lacks decision-making capacity (not letally competent)- implied consent in an emergencytherapeutic privelege-- withholding information when disclosure would severly harm the pt or undermine informed decision-making capacitywaver-- pt. waves " |
|
|
Term
What are the 5 signs of a pt's decision-making capacity? |
|
Definition
"- pt. makes and communicates a choice- pt. is informed- decision remains stable over time- decision consistent w/ pt's values and goals- decision not a result of delusions or hallucinations" |
|
|
Term
What are the types of written advance directives? |
|
Definition
"- LIVING WILLS--pt. directs Dr. to withhold/withdraw lifesustaining tx if the pt develops terminal disease or enters a persisitent vegative state- DURABLE POWER OF ATTORNEY-- pt designates a surrohate to make medical decisions in an event pt. loses deci" |
|
|
Term
|
Definition
Dr. have special ethical responsibility to act in the pt's best interest. Pt. autonomy may conflict with beneficience |
|
|
Term
|
Definition
Confidentiality respects pt. privacy and autonomy. Disclosure to family and friends should be guided by what pt. would want. Pt can waive right to confidentiality (i.e. to insurance co.) |
|
|
Term
|
Definition
Do no harm. But, if benefits of intervention outweigh risks, pt may make an informed decision to proceed." |
|
|
Term
What must patients understand in informed consent? |
|
Definition
"- risks- benefitsalternatives, which includes no intervention" |
|
|
Term
When is an oral directive valid? |
|
Definition
Incapacitated patient's prior oral statements commonly used as guide, but problems arise from variance in interpretation. if pt was INFORMED, directive is SPECIFIC, pt. MAKES A CHOICE and decision is REPEATED over time, the oral directive is more valid." |
|
|
Term
At what ages does sexual abuse in children peak? |
|
Definition
|
|
Term
At what time (minutes after birth) do you run an APGAR score? |
|
Definition
"after 1 min. and 5 min., score 0-2 in 5 categories (10 is perfect score)" |
|
|
Term
|
Definition
|
|
Term
Irreversible changes of long term deprivation of affection occurs after how long? |
|
Definition
|
|
Term
Physical abuse in children leads to how many deaths in the U.S.? |
|
Definition
|
|
Term
What are evidence of physical abuse in children? |
|
Definition
"- healed fractures on x-raycigarette burns- subdural hematomas- multiple bruises- retinal hemorrhage or detachment" |
|
|
Term
At what ages does sexual abuse in children peak? |
|
Definition
|
|
Term
At what time (minutes after birth) do you run an APGAR score? |
|
Definition
"after 1 min. and 5 min., score 0-2 in 5 categories (10 is perfect score)" |
|
|
Term
|
Definition
|
|
Term
Irreversible changes of long term deprivation of affection occurs after how long? |
|
Definition
|
|
Term
Physical abuse in children leads to how many deaths in the U.S.? |
|
Definition
|
|
Term
What are evidence of physical abuse in children? |
|
Definition
"- healed fractures on x-raycigarette burns- subdural hematomas- multiple bruises- retinal hemorrhage or detachment" |
|
|
Term
What are evidence of sexual abuse in children? |
|
Definition
genital/anal trauma, STDs, UTIs" |
|
|
Term
What are the 5 changes in the elderly? |
|
Definition
1. sexual changes: sexual interest does NOT decrease (men: slower erection/ejaculation, longer refractory period; women: vaginal shortening, thinning, dryness) 2. sleep patterns: decreased REM, decreased slowwave sleep, increased sleep latency, increase" |
|
|
Term
What are the 5 components of the APGAR score at birth? |
|
Definition
"- A= Apperance (color)- P= Pulse- G= Grimace (reflex irritability)- A= Activity (muscle tone)- R= Respiration" |
|
|
Term
What are the 7 effects of long-term deprivation of affection? |
|
Definition
1. Weak 2. Wordless 3. Wanting (socially) 4. Wary (lack trust) 5. Weight loss 6. anaclitic depression 7. physical illness [Hint: 5 W's and 2 more]" |
|
|
Term
What are the development milestones at about 3 years old in preschool? |
|
Definition
group play- rides tricyclecopies line or circle drawing" |
|
|
Term
What are the development milestones at about 4 years old in preschool? |
|
Definition
"- cooperative play- simple drawings (stick figure)- hops on 1 foot" |
|
|
Term
What are the developmental milestones at about 12-14 months old in infancy? |
|
Definition
|
|
Term
What are the developmental milestones at about 15 months old in infancy? |
|
Definition
"- walking- few wordsseparation anxiety" |
|
|
Term
What are the developmental milestones at about 3 months old in an infant? |
|
Definition
"- holds head up- social smile- Moro reflex disappears" |
|
|
Term
What are the developmental milestones at about 4-5 months old in an infant? |
|
Definition
"- rolls on back- sits when propped" |
|
|
Term
What are the developmental milestones at about 7-9 months old in infancy? |
|
Definition
"- stranger anxiety- sits alone- orients to voice" |
|
|
Term
What are the developmental milestones during adolescence? |
|
Definition
"- abstract reasoning (formal operations)- formation of personality" |
|
|
Term
What are the developmental milestones during the schoolage years (6-11y/o)? |
|
Definition
"- development of conscience (superego)- same-sex friends- identification with same-sex parent" |
|
|
Term
What are the Kubler-Ross dying stages? |
|
Definition
Denial-Anger-Barganing- Grieving-Acceptance, don't occur necessarily in this order [Hint: Death Arrives Brining Grave Adjustments]" |
|
|
Term
What are the risks of low birth weight? |
|
Definition
assoc. w/ gtr. Incidence of physical and emotional problems. Complications include:- infectionsrespiratory distress syndrome- necrotizing entercolitis- persistent fetal circulation" |
|
|
Term
What can cause regression to younger behavior in children? |
|
Definition
Stress:- physical illnesspunishment- birth of new sibling- tiredness" |
|
|
Term
What causes low birth weight? |
|
Definition
prematurity or intrauterine growth retardation |
|
|
Term
What is anaclitic depression? |
|
Definition
depression in an infant owing to continued separation from caregiver--can result in failure to thrive. Infant becomes withdrawn and unresponsive |
|
|
Term
|
Definition
"normal bereavement characterized by shock, denial, guilt, and somatic symptoms, Typically lasts 6mo. to 1yr." |
|
|
Term
What is pathologic grief? |
|
Definition
includes excessively intense or prolonged grief or grief that's delayed, inhibited, or denied" |
|
|
Term
What is the result of severe long-term deprivation of affection? |
|
Definition
|
|
Term
When can a child parallel play? |
|
Definition
Toddler, 24-48 months old" |
|
|
Term
When does a child achieve core gender identity? |
|
Definition
Toddler, 24-36 months old" |
|
|
Term
When does a child achieve object permanence? |
|
Definition
Toddler, 12-24 months old" |
|
|
Term
When does a child achieve rapprochement? |
|
Definition
Toddler, 18-24 months old" |
|
|
Term
When does a child become toilet trained? |
|
Definition
Preschool, 30-36 months old" |
|
|
Term
When is adolescence for boys and for girls? |
|
Definition
Boys: 13 years old Girls: 11 years old" |
|
|
Term
Who is usually the abuser in physical abuse in children? |
|
Definition
|
|
Term
Who is usually the abuser in sexual abuse in children? |
|
Definition
known to victim, usually male" |
|
|
Term
Case-control studies are often? |
|
Definition
Retrospective (case control) |
|
|
Term
Characteristics of a normal statistical distribution? |
|
Definition
Gaussian = Bell Shaped ( mean=median=mode ) |
|
|
Term
Country with highest divorce rate |
|
Definition
|
|
Term
Define a bimodal distribution |
|
Definition
Peaks on either side of the median |
|
|
Term
|
Definition
Pooling data from several studies to achieve greater statistical power |
|
|
Term
|
Definition
Asymmetry with the tail on the left (mean |
|
|
Term
|
Definition
Asymmetry with the tail on the right (mean>median>mode) |
|
|
Term
|
Definition
The trueness of test measurements |
|
|
Term
Define Alternate Hypothesis |
|
Definition
Hypothesis that there is some difference |
|
|
Term
Define Coefficient of Determination |
|
Definition
r^2 (Correlation coefficient squared) |
|
|
Term
Define Correlation coefficient (r ) |
|
Definition
Always between -1 and 1. Absolute value indicates the strength of correlation. |
|
|
Term
Define Negative Predictive Value |
|
Definition
Number of true negatives / number that tested neg. for disease |
|
|
Term
Define Positive Predictive Value |
|
Definition
Number of true positives / number that tested pos. for disease or the prob. Of having a condition, given a pos. test" |
|
|
Term
|
Definition
"The consistency of a test (reliability), absence of random error" |
|
|
Term
Define Primary Disease Prevention |
|
Definition
Prevent occurrence, e.g., vaccination" |
|
|
Term
|
Definition
Disease risk in exposed group / disease risk in unexposed group; a/a+b / c/ c+d |
|
|
Term
|
Definition
Reproducibility of a test; repeat measurements are the same |
|
|
Term
Define Secondary Disease Prevention |
|
Definition
Early detection of disease, e.g., Pap smear" |
|
|
Term
|
Definition
Standard Error of the Mean; standard deviation / square root of n (sample size) |
|
|
Term
|
Definition
Number of true positives / all people with disease |
|
|
Term
|
Definition
Number of true negatives / number of all people w/o the disease |
|
|
Term
Define Tertiary Disease Prevention |
|
Definition
"Reduce disability form disease, e.g. insulin for diabetics" |
|
|
Term
Define the Power of a study |
|
Definition
Probability of rejecting a null hypothesis when it is false |
|
|
Term
|
Definition
Whether a test truly measures what it purports to measure; the appropriateness of a test |
|
|
Term
Do divorcees remarry frequently? |
|
Definition
|
|
Term
How do disease prevalence and positive predictive value relate? |
|
Definition
Higher prevalence = Higher Positive Predictive Value |
|
|
Term
How do prevalence and incidence relate to disease length? |
|
Definition
P>I for chronic diseases; P=I for acute diseases |
|
|
Term
How do SEM and Standard Deviation relate? |
|
Definition
SD > SEM; as n increases, SEM decreases" |
|
|
Term
How do you measure the 'power' of a study or the probability that the study will see a difference if one exists? |
|
Definition
|
|
Term
How does alpha relate to the Type I error? |
|
Definition
"It is the probability of making a Type I error, is equal to p (p is usually <.05)" |
|
|
Term
How does beta relate to the Type II error? |
|
Definition
Beta is the probability of making a Type II error |
|
|
Term
|
Definition
35,000,000 (approx. 13%)" |
|
|
Term
"If the 95% confidence interval for OR of RR includes 1, what does this mean?" |
|
Definition
That the study is inconclusive |
|
|
Term
In what age group will the greatest population increase be seen in? |
|
Definition
|
|
Term
Increasing sample size will affect the Power of a study how? |
|
Definition
|
|
Term
Is divorce related to industrialization? |
|
Definition
|
|
Term
Is HIV positivity a reportable disease? |
|
Definition
|
|
Term
|
Definition
Teenage marriages, Mixed religions, Low socioeconomic status" |
|
|
Term
Memory aid for Medicare/ Medicaid |
|
Definition
MedicarE=Elderly; MedicaiD=Destitute |
|
|
Term
Preventive services needed for Alcoholism |
|
Definition
"Influenza, pneumococcal immunizations; TB test" |
|
|
Term
Preventive services needed for Diabetes |
|
Definition
"Eye, foot exams; Urine test" |
|
|
Term
Preventive services needed for Drug Abuse |
|
Definition
"HIV, TB tests; hepatitis immunization" |
|
|
Term
Preventive services needed for High-risk sexual behavior |
|
Definition
"HIV, Hep B, syphilis, gonorrhea, chlamydia tests" |
|
|
Term
Preventive services needed for Homeless, Refugee, or Immigrant" |
|
Definition
|
|
Term
Preventive services needed for Obesity |
|
Definition
|
|
Term
Random error yields poor? |
|
Definition
|
|
Term
Relative Risk is used for what kind of study? |
|
Definition
|
|
Term
Systematic error yields poor? |
|
Definition
|
|
Term
|
Definition
|
|
Term
Unlike specificity and sensitivity, what are predictive values dependent on?" |
|
Definition
Prevalence of disease in the population |
|
|
Term
What are risk factors for suicide? |
|
Definition
"White, male, alone, prior attempts, presence and lethality of plan, medical illness, alcohol or drug use, on 3 or more prescription meds." |
|
|
Term
What are the leading causes of death in AGE 1-14? |
|
Definition
Injuries, cancer, congenital anomalies, homicide, heart disease" |
|
|
Term
What are the leading causes of death in AGE 15-24? |
|
Definition
"Injuries, homicide, suicide, cancer, heart disease" |
|
|
Term
What are the leading causes of death in AGE 25-64? |
|
Definition
Cancer, heart disease, injuries, stroke, suicide" |
|
|
Term
What are the leading causes of death in AGE 65+? |
|
Definition
"Heart disease, cancer, stroke, COPD, pneumonia" |
|
|
Term
What are the leading causes of death in INFANTS? |
|
Definition
Congenital anomalies, SIDS, short gestation, respiratory distress syndrome, maternal complications during pregnancy" |
|
|
Term
What are the most common surgeries? |
|
Definition
"Dilation and curettage, hysterectomy, tonsillectomy, sterilization, hernia repair, oophorectomy, cesarean section, cholecystectomy" |
|
|
Term
What are the reportable diseases? |
|
Definition
"AIDS, chickenpox, gonorrhea, hepatitis A and B, measles, mumps, rubella, salmonella, shigella, syphilis, and tuberculosis" |
|
|
Term
What does a t-test check? |
|
Definition
The difference between two means (Mr. T is mean) |
|
|
Term
What does an ANOVA analyze? |
|
Definition
Variance of 3 or more variables (Analysis of Variance) |
|
|
Term
What does SAD PERSONS represent? |
|
Definition
Sex (male), Age, Depression, Previous attempt, Ethanol, Rational thought, Sickness, Organized plan, No spouse, Social support lacking" |
|
|
Term
What factors influence the Power of a study? |
|
Definition
1)The total # of endpoints experienced by a population; 2) Difference in compliance between treatment groups |
|
|
Term
What is a case-control study? |
|
Definition
Observational study. Sample chosen based on presence or absence of disease. Info collected about risk factors. |
|
|
Term
What is a Clinical trial? |
|
Definition
Experimental study. Compares benefit of 2 or more treatments. |
|
|
Term
|
Definition
Observational study. Sample chosen based on presence or absence of Risk Factors. Subjects followed over time for disease development. (Framingham study) |
|
|
Term
What is a memory key for suicide risk factors? |
|
Definition
|
|
Term
What is a Null Hypothesis? |
|
Definition
Hypothesis of no difference, e.g., no assoc. between disease and risk factor" |
|
|
Term
What is a pitfall of Metaanalysis? |
|
Definition
Cannot overcome limitations of individual studies or bias in study selection |
|
|
Term
What is a Type I error (alpha)? |
|
Definition
Stating that an effect of difference exists when one really does not |
|
|
Term
What is a Type II error (beta) |
|
Definition
Stating that there is not an effect or difference when actually there is |
|
|
Term
What is an Odds Ratio used for? |
|
Definition
Approximates relative risk when prevalence is not too high; OR = ad/bc |
|
|
Term
What is Chi-Square test used for? |
|
Definition
To check differences between 2 or more percentages or proportions of categorical outcomes |
|
|
Term
What is desirable for confirmatory tests? |
|
Definition
|
|
Term
What is desirable for screening tests? |
|
Definition
High sensitivity is desirable for a screening test |
|
|
Term
|
Definition
Number of new cases in a population per unit time |
|
|
Term
|
Definition
Fed. And State assistance for those on welfare or who are indigent |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Fed. Program for the Elderly |
|
|
Term
|
Definition
Total number of cases in a population at a given time (incidence x disease duration) |
|
|
Term
What is the False Negative Ratio? |
|
Definition
|
|
Term
What is the False Positive Ratio? |
|
Definition
|
|
Term
What is the highest quality study? |
|
Definition
What is the highest quality study? |
|
|
Term
|
Definition
The probability of making a Type I error. |
|
|
Term
What percent of medical costs will those >35 incur? |
|
Definition
|
|
Term
What type of studies are Odds Ratios used for? |
|
Definition
Retrospective (case control) |
|
|
Term
|
Definition
During the 2nd to 3rd year. |
|
|
Term
Which sex has the most surgeries? |
|
Definition
|
|
Term
Are intelligence tests objective or projective tests? |
|
Definition
|
|
Term
|
Definition
Unacceptable feelings and thoughts are expressed through actions |
|
|
Term
|
Definition
Guilty feelings alleviated by unsolicited generosity toward others |
|
|
Term
Define classical conditioning. |
|
Definition
Learning in which a natural response is elicited by a conditioned stimulus that previously was presented in conjunction with an unconditioned stimulus |
|
|
Term
|
Definition
Avoidance of awareness of some painful reality |
|
|
Term
|
Definition
Process whereby avoided ideas and feelings are transferred to some neutral person or object |
|
|
Term
|
Definition
Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress" |
|
|
Term
|
Definition
automatic and unconscious reactions to phychological stress |
|
|
Term
|
Definition
Partially remaining at a more childish level of development |
|
|
Term
|
Definition
Appreciating the amusing nature of an anxietyprovoking or adverse situation |
|
|
Term
|
Definition
Modeling behavior after another person |
|
|
Term
|
Definition
Separation of feelings from ideas and events |
|
|
Term
Define operant conditioning. |
|
Definition
Learning in which a particular action is elicited because it produces a reward |
|
|
Term
|
Definition
An unacceptable internal impulse that is attributed to an external source |
|
|
Term
|
Definition
"Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame" |
|
|
Term
Define reaction formation. |
|
Definition
Process whereby a wardedoff idea or feeling is replaced by an (unconsciously derived) emphasis on its opposite |
|
|
Term
|
Definition
Turning back the maturational clock and going back to earlier modes of dealing with the world |
|
|
Term
|
Definition
Involuntary withholding of an idea or feeling from conscious awareness. |
|
|
Term
|
Definition
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. |
|
|
Term
|
Definition
Voluntary (unlike other defenses) withholding of an idea of feeling from conscious awareness |
|
|
Term
Give an example of classical conditioning. |
|
Definition
Pavlov's dogs (ringing of a bell provoked salivation in dogs) |
|
|
Term
Give an example of continuous reinforcement schedule. |
|
Definition
A person gets upset when a vending machine doesn't work |
|
|
Term
Give an example of negative reinforcement of opperative conditioining. |
|
Definition
a mouse presses a button to avoid shock (do not confuse with punishment) |
|
|
Term
Give an example of positive reinforcement of opperative conditioning. |
|
Definition
a mouse presses a button to get food |
|
|
Term
Give an example of preconscious topography. |
|
Definition
remembering your phone number |
|
|
Term
Give an example of variable ratio reinforcement schedules. |
|
Definition
A person continuing to play a slot machine at a casino |
|
|
Term
Is IQ testing more highly correlated with genetics or school achievement? |
|
Definition
|
|
Term
Name 4 characteristics of psychoanalysis. |
|
Definition
costly-lengthy-intensiveplaces great demands on the patient" |
|
|
Term
What are Freud's three structures of the mind |
|
Definition
|
|
Term
What are the four factors in hopelessness? |
|
Definition
"-Sense of Impotence (powerlessness)-Sense of Guilt-Sense of Anger-Sense of loss/Deprivation leading to depression (Mnemonic IGAD!)" |
|
|
Term
What are the immature ego defenses? (12) |
|
Definition
Acting out, Disassociation, Denial, Displacement, Fixation, Identification, Isolation, Projection, Rationalization, Reaction formation, Regression, Repression" |
|
|
Term
What are the MATURE ego defenses? (4) |
|
Definition
"-Sublimation-Altruism- Suppression-Humor (Mneumonic: Mature women wear a SASH)" |
|
|
Term
What are the two most famous forms of intelligence testing? |
|
Definition
Stanford-Binet and Wechsler |
|
|
Term
What are two factors with which IQ scores are correlated? |
|
Definition
Genetics and school achievement |
|
|
Term
What is an example of acting out? |
|
Definition
|
|
Term
What is an example of altruism? |
|
Definition
Mafia boss makes large donation to charity |
|
|
Term
What is an example of denial. |
|
Definition
A common reaction in newly diagnosed AIDS and cancer patients |
|
|
Term
What is an example of displacement? |
|
Definition
Mother yells at child because she is angry at her husband |
|
|
Term
What is an example of dissociation? |
|
Definition
Extreme forms can result in multiple personalities (dissociative identity disorder). |
|
|
Term
What is an example of fixation? |
|
Definition
Men fixating on sports games |
|
|
Term
What is an example of humor? |
|
Definition
Nervous medical student jokes about the boards |
|
|
Term
What is an example of identification? |
|
Definition
Abused child becomes an abuser |
|
|
Term
What is an example of isolation? |
|
Definition
Describing murder in graphic detail with no emotional response |
|
|
Term
What is an example of projection? |
|
Definition
A man who wants another woman thinks his wife is cheating on him |
|
|
Term
What is an example of rationalization? |
|
Definition
Saying the job was not important anyway, after getting fired" |
|
|
Term
What is an example of reaction formation? |
|
Definition
A patient with libidinous thoughts enters a monastery |
|
|
Term
What is an example of regression? |
|
Definition
Seen in children under stress (eg., bedwetting) and in patients on dialysis (eg., crying)" |
|
|
Term
What is an example of sublimation? |
|
Definition
Aggressive impulses used to succeed in business ventures |
|
|
Term
What is an example of suppression? |
|
Definition
Choosing not to think about the USMLE until the week of the exam |
|
|
Term
What is negative reinforcement? |
|
Definition
the removal of an aversive stimulus so as to increase behavior |
|
|
Term
What is positive reinforcement? |
|
Definition
the desired reward which produces an action |
|
|
Term
What is the basic mechanism underlying all ego defenses? |
|
Definition
|
|
Term
What is the central goal of Freudian psychoanalysis? |
|
Definition
To make the patient aware of what is hidden in his/her unconscious |
|
|
Term
What is the IQ criteria for diagnosis of mental retardation? |
|
Definition
IQ lower than 70 (or 2 standard deviations below the mean) |
|
|
Term
What is the topographical term used in psychoanalysis to describe what you are not aware of? |
|
Definition
|
|
Term
What is the topographical term used in psychoanalysis used to describe what you are able to make conscious with effort? |
|
Definition
|
|
Term
What is the topographical term used in psychoanalysis used to describe what you are aware of? |
|
Definition
|
|
Term
What number is defined as the mean for standard IQ testing? |
|
Definition
100 (with a standard deviation of 15) |
|
|
Term
What term fist described by Freud is used to refer to repressed sexual feelings of a child for the opposite-sex parent, accompanied by rivalry with same-sex parent?" |
|
Definition
|
|
Term
What term is used to describe the form of insight therapy developed by Freud which is often used for changing chronic personality problems? |
|
Definition
|
|
Term
What thought structures is the Ego responsible for? |
|
Definition
Bridge and mediator between the unconscious mind and the world (Think-Deals with conflict) |
|
|
Term
What thought structures is the Id responsible for? (3 things) |
|
Definition
" - Primal urges-sex agression (Think-'I want it')" |
|
|
Term
What thought structures is the Superego responsible for? (2 things) |
|
Definition
Moral values-conscience (Think-'You know you cant have it')" |
|
|
Term
What type of behavior requires a continuous reinforcement schedule? |
|
Definition
behavior which shows the most rapid extinction when not rewarded |
|
|
Term
What type of behavior requires a variable ratio reinforcement schedule? |
|
Definition
behavior which shows the slowest extinction when not rewarded |
|
|
Term
Which is the conditioned (learned) stimulus in Pavlov's experiment? |
|
Definition
|
|
Term
Which is the natural response in Pavlov's experiment? |
|
Definition
|
|
Term
Which is the unconditioned stimulus in Pavlov's experiment? |
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Definition
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