Step 2 Psych 1 (1-4-16)

ruhland1's version from 2016-01-04 13:59

Section 1

Question Answer
SIG E CAPSup sleep or insomnia, dn interest, guilt worthless, dn concentration, D apetite, psychomotor retard/agitation, suicidality
MDDdepressed mood or anhedonia plus 4 of SIG E CAPS for atleast 2 weeks
adjustment d/oemo/behave sx w/in 3 mo of stressful event, not sx of breavement, and resolve w in 6 mo of stressor being eliminated
Bi polar IIrequires hx of hypomania for dx
OSAup MDD, deep over bite, small chin
OSA dxpolysomnagraphy (atleast 5 major obstructive events
OSA severepolysomn >20 events get a CPAP or mandibular repositioning splint
OSA srxuvulopalatopharyngoplasty
atypical dephypersomnai, overeating, mood reactivity, up lb, up sensitive to reject
OSAalways check TSH level
idiopathic hypersomulence>10 hr a night and take naps throughout day
Narcolepsyinduction of REM sleep at inappropriate times, up cataplexy
rationalizationcreates explanations for a situation to justify their behavior, blame someone else rather than themselfs
displacementunacceptable emotions in one situation are expresed in a different situation where they are more tolerable to the patient
projectionattribute thoughts of feels to another person who does not actually have these
suppressionperson consciously ignores unacceptable impulses or emotions

Section 2

Question Answer
TCA overdosedn BP up HR up anticholinergic
APAP odN V F pancytopenia ARF and hypoglycemic coma
Lithium Overdosevomit ataxia tremor joint pain confision sz and brady
lithium ekgflat T, ST dep, QTC prolong, must trend Li levels for 12 hours
lithium od txwhole bowel irrigation, IV fluid, hemodialysis when greater than 4 [ ] or greater than 2.5 [ ] if pt has sx
phentolaminealpha 1 blocker
countertransferancepatient causes a negative or positive reaction to the doctor due to the doctors past life
psuedocyesis"false pregnancy" pt can exp sx of preg and have actual body effects
reaction formationindividual develops an attitude that is the direct antithesis of an infantile wish. A drug dealer who takes money from a community gives back by giving turkey to homeless on thanksgiving to avoid guilt ridden impulses
sublimationunacceptable energy or impulses diverted into good ones, like a guy who likes fighting becomes a professional fighter
most important risk factor of another suicide attempt if had one priorprior suicide attempt, nearly 30% will try again of this 10% are successful

Section 3

Question Answer
neuroleptic malignant syndromem rigid, tremor, hyperthermia, dyspahgia, labile blood pressure,evidence of muscular injury (elevated CPK)
dx anticholinergic toxphysostigmine will temporarily reduce sx
halothanemalig hyperthermia
serotonin synd triadd mind, autonomic hyperreactivity, d neuromuscular
serotonin synd claasicMAOI + sertonergic agent
serotonin synd sxshivering, diaphor, tremor, hyperreflexia, myoclonus, atatixia, tremor
NMScpk > 1000, myoglobinuria, hyperkalemia, metabolic acidosis
NMS txdantolene m relax,cut off DA antag, IVF, antiarrthy, bromocriptine, LMWH, antihtn, anti coag
vasopressorsincrease bloodpressure
vadodilatordn bp
Oppositional defiant d oneed 4 of 6, loses temper, argues w adult, actively defies, deliberatley annoys ppl, blames others for misbehavior/mistake, easily annoyed by others, resentful, spiteful/vindictive
antisocial p d o dx > 18 yo, have had history prior to 15 yo of ADHD/somatization d o, substance abuse d o, lack remorse
conduct d ochildren/teen need 3 criteria of bullying, initiating fights, used weapon, physically cruel, physically cruel to animals, forced someone to sex, arson, deliberately destoryed property, borken into house, stolen items, stays out at night, run away from school atleast twice, truant in school
dysthymiachronic depressed, change in sleep apetitie > 2 years
double depressiondysthimia w episodes of superimposed MDD
bipolar T 1need 1 manic episode for dx
bipolar T 2one hypomanic episode
mania vs hypomaniahypomania duration ins 4 days and does not require hospitalization
cyclothymiachronic sx of both dep and hypomania over > two years but patients do not meet criteria of MDD or hypomanic episode
hypomanicirritable, elevated mood, dn need for sleep, distractibility, pressured speech, up goal directed activity, racing thoughts and grandiosity lasting greater than 4 days.

Section 4

Question Answer
tangentialitygives responses and never reaches goal of answering, politicians
circumstantialityextra and unnesscecary details are able and questions are eventually answered
loose associationno link between ideas, feature of mania
flight of ideaspt speaks rapid and abruptly changes topics with links between topics, seen in mania and accompanied by pressured speech
word saladextreme form of loose assoc
thought processideas, beliefs, delusions, preoccupations and obsessions
briquets syndrome=somatization d o
briquet synd "brittany synd"multiple physical complaints before age of 30 result in seeking treatment or impairs func
capgras"crabgrass" dylan is an imposter
fregoli delusiondelusion of capgrass "crabgrass" believed that a presecutor can assume the physical appeaance of a stranger
conversion d opresence of voluntary motor or sensory impairment, like Hank Hill becoming blind after seeing his mom naked
munchausen synd"hospital addcition" motivated by secondary gain not like briquet where there is no secondary gain
pain d opredominant focus is pain in one or more sites associated w psycho factors that bring about the pain

Section 5

Question Answer
panic attack mxssri
panic attack txbenzo when sx active
psychodynamic therapyfor panic do and agoraphobia, CBT is better tho
cognitive behavioral therapypanic do, agorophobia, GAD, PTSD, anorexia
regadenosonA2a adenosine rec ag that is a coronary vasodil used in stress testing that is useful in radionuclied myocardia perfusion imaging
bulimiayoung Female, normal wirght, dizzi, m weakness, cramping during exercise do to e- changes. perimolysis and enargerd parotid/tonsils
bulimia txssri and CBT/psychotherapy
perimolysiserosion of tooth enamel
adjustment dowithin 3 mo of stressor not lasting longer than 6
Klein-Levin Syndrare sleep do recurrent hypersomnia, hyperphagia and hypersex. jew males
MDDchange in previous function, 5 SIGECAPS symptoms present
biscodyllaxative bulemia
cascaralaxative bulemia
sennalaxative bulemia
hi fiberlaxative bulemia
phenylpropanolamineanorectix, stimulant, decongestant used in bulemia
anorecticsideeffect that produces not eating
abuse laxativesdamage myenteric plexus leading to constip

Section 6