USMLE (Fach) / Psychiatry (Lektion)
In dieser Lektion befinden sich 106 Karteikarten
USMLE First Aid
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- Child abuse Physical abuse: - Fractures (eg, ribs, long bone spiral, multiple in differents stages of healing)- Bruises (eg, trunk, ear, neck)- Burns (eg, cigarette, buttocks/thighs)- Subdural hematomas/retinal ...
- Neurotransmitter changes with disease Alzheimer: ↓ ACh, ↑ glutamate Anxiety: ↑ norepinephrine, ↓ GABA, 5-HT Depression: ↓ norepinephrine, 5-HT, dopamine Huntington disease: ↓ GABA, ACh, ↑ dopamine Parkinson disease; ↓ ...
- Rett syndrome X-linked dominant disorder seen almost exclusively in girls (affected males die in utero) Symptoms become apparent around ages 1-4- regression- loss of development- loss of verbal abilities- intellectual ...
- Tourette syndrome - Onset before age 18.- Males > Females Characterized by both multiple motor & ≥1 vocal tics that persist for >1 year.- Motor: Facial grimacing, blinking, head/neck jerking, shoulder shrugging, tongue ...
- Loss of orientation - alchohol - drugs - fluid/electrolyte imbalance - head trauma - hypoglycemia - infection - nutritional deficiencies
- Delirium "Waxing and waning" level of consciousness with acute onset. Reversible.- Rapid ↓ in attention span and level of arousal. Characterized by:- disorganized thinking- hallucinations (often visual)- misperceptions- ...
- Dementia ↓ in intellectual function without affecting level of consciousness - memory deficits- apraxia- aphasia- agnosia- loss of abstract thought- behavioral/personality changes - increased risk for dilirium ...
- Delusional disorder Diagnosed following one month of nonbizarre delusions that are usually focused around a particulat ropic e.g., infidelity of patient's wife Delusions are not attributable to another psychiatri disorder. ...
- Acting out Expressing unacceptable feelings and thoughts through actions. Example: A young boy throws a temper tantrum when he does not get the toy he wants.
- Denial Avoiding the awareness of some painful reality. Example: A patient with cancer plans a full-time work schedule despite being warned of significant fatigue during chemotherapy.Example: A woman prepares ...
- Displacement Redirection of emotions or impulses to a neutral person or object (vs projection). Example: A teacher is yelled at by the principle. Instead of confronting the principal directly, the teacher goes home ...
- Dissociation Temporary, drastic change in personality, memory, consciousness, or motor behavior to avoid emotional stress. Patient has incomplete or no memory of traumatic event. Example: A victim of sexual abuse ...
- Fixation Partially remaining at a more childish level of development (vs regression). Example: A surgeon throws a tantrum in the operating room because the last case ran very late.
- Intellectualization Using facts and logic to emotionally distance oneself from a stressful situation. Example: In a therapy session, patient diagnosed with cancer focuses only on rates of survival.Example: A patient with ...
- Isolation (of affect) Separating feelings from ideas and events. Example: Describing murder in graphic detail with no emotional response.
- Projection Attributing an unacceptable internal impulse to an external source (vs displacement). Example: A man who wants to cheat on his wife accuses his wife of being unfaithful.Example: A girl talks about her ...
- Rationalization Proclaiming logical reasons for actions actually performed for other reasons, usually to avoid self-blame. Example: After getting fired, claiming that the job was not important anyway.Example: A murderer ...
- Reaction formation Replacing a warded-off idea or feeling with an (unconsciously derived) emphasis on its opposite (vs sublimation). Example: A patient with lustful thoughts enters a monastery.Example: A student who wanted ...
- Regression Involuntarily turning back the maturational clock and going back to earlier modes of dealing with the world (vs fixation). Example: Seen in children under stress such as illness, punishment, or birth ...
- Repression Involuntarily withholding an idea or feeling from conscious awareness (vs suppression). Example: A 20-year-old does not remember going to counseling during his parents' divorce 10 years earlier.
- Mature defenses Sublimation: Replacing an unacceptable wish with a course of action that is similar to the wish but socially acceptable (vs reaction formation).Example: Teenager's aggressive urges toward his parents' ...
- Vulnerable child syndrome Parents perceive the child as especially susceptible to illness or injury. - Usually follows a serious illness or life-threatening event. - Can result in missed school or overuse of medical services.
- Attention-deficit hyperactivity disorder - Onset before age 12. - At least 6 months of limited attention span and/or poor impulse control. - Characterized by hyperactivity, impulsivity, and/or inattention in multiple settings (school, home, ...
- Malingering Symptoms are intentional, motivation is intentional. Patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific 2˚ (external) gain (eg, avoiding work, ...
- Factitious disorders Symptoms are intentional, motivation is unconscious. Patient consciously creates physical and/or psychological symptoms in order to assume "sick role" and to get medical attention and sympathy (1˚ [internal] ...
- Somatic symptom and related disorders Symptoms are unconscious, motivation is unconscious. Category of disorders characterized by physical symptoms causing significant distress and impairment. Symptoms not intentionally produces or feigned. ...
- Somatic symptom disorder Variety of bodily complaints (eg, pain, fatigue) lasting for months to years. - Associated with excessive, persistent thoughts and anxiety about symptoms. - May co-occur with medical illness. Treatment: ...
- Conversion disorder Also known as functional neurologic symptom disorder. - Loss of sensory or motor function (eg, paralysis, blindness, mutism), often following an acute stressor.- Patient may be aware of but indifferent ...
- Narcolepsy Disordered regulation of sleep-wake cycles characterized by excessive daytime sleepiness (despite feeling rested upon waking) and "sleep attacks" (rapid-onset, overwhelming sleepiness). Caused by ↓ ...
- Autism spectrum disorder Characterized by poor social interactions, social communication deficits, repetitive/ritualized behaviors, restricted interests. - Must present early in childhood.- More common in boys. - May be accompanied ...
- Conduct disorder Repetitive and pervasive behavior violating the basic rights of others or societal norms.- Aggression & cruelty toward people & animals- Destruction of property, settinf fires- Serious violation of rules ...
- Disruptive mood dysregulation disorder Severe and recurrent temper outbursts out of proportion to situation.- Child is constantly angry and irritable between outbursts. - Onset before age 10. Treatment: stimulants, antipsychotics, CBT.
- Oppositional defiant disorder Enduring pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social norms.- Argues with adults, defies authority figures, refuses to follow rules- Deliberately ...
- Separation anxiety disorder Overwhelming fear of separation from home or attachment figure lasting ≥4 weeks. - Can be normal behavior up to age 3-4. - Commonly experience physical symptoms (eg, headaches, stomach aches, nausea) ...
- Depersonalization/derealization disorder Dissociative disorder. Persistent feelings of detachment or estrangement from one's own body, thoughts, perceptions, and actions (depersonalization) or one's environment (derealization). Intact reality ...
- Dissociative amnesia Inability to recall important personal information, usually subsequent to severe trauma or stress.
- Dissociative identity disorder Formerly known as multiple personality disorer. Presence of 2 or more distinct identities or personality states.- More common in women. - Associated with history of sexual abuse, PTSD, depression, substance ...
- Psychosis Distorted perception of reality characterized by delusions, hallucinations, and/or disorganized thought/speech. - Can occur in patients with medical illness, psychiatric illness, or both.
- Delusions Presentation of psychosis. Unique, false, fixed, idiosyncratic beliefs that persist despite the facts and are not typical of patient's culture or religion (eg, thinking aliens are communicating with you). ...
- Disorganized thought Presentation of psychosis. Speech may be:- incoherent ("word salad")- tangential, eg, in answer to the question "Where are you from", a response "My dog is from England. They have good fish and chips ...
- Schizophrenia Chronic mental disorder with periods of psychosis, disturbed behavior and thought, and decline of functioning lasting ≥6 months (including prodrome and residual symptoms). - Associated with ↑ dopaminergic ...
- Delusional disorder Fixed, persistent, false belief system lasting >1 month. - Functioning otherwise not impaired (eg, a women who genuinely believes she is married to a celebrity when, in fact, she is not). - Can be shared ...
- Manic episode Distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently ↑ activity or energy lasting ≥1 week.- Often disturbing to patient and causes ...
- Hypomanic episode Similar to 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. - ...
- Bipolar disorder Bipolar I defined by presence of at least 1 manic episode +/- a hypomanic or depressive episode (may be separated by any length of time). Bipolar II defined by presence of a hypomanic and a depressive ...
- Major depressive disorder Episodes characterized by at least 5 of the 9 diagnostic symptoms lasting ≥2 weeks (symptoms must include patient-reported depressed mood or anhedonia). Screen for history of manic episodes to rule ...
- Depression with atypical features Characterized by mood reactivity (able to experience improved mood in response to positive events, albeit briefly), "reversed" vegetative symptoms (hypersomnia, hyperphagia), leaden paralysis (heavy feeling ...
- Postpartum mood disturbances Onset during pregnancy or within 4 weeks of delivery. Maternal (postpartum) blues: 50-85% incidence rate. Characterized by depressed affect, tearfulness, and fatigue starting 2-3 days after delivery. ...
- Grief The five stages of grief per Kubler-Ross model (may occur in any order):- Denial- Anger- Bargaining- Depression- Acceptance - Other normal grief symptoms: shock, guilt, sadness, anxiety, yearning, and ...
- Electroconvulsive therapy Rapid-acting method to treat resistant or refractory depression, depression with psychotic symptoms, and acute suicidality.- Induces grand mal seizure while patient is anesthetized. Adverse effects: disorientation, ...