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Glossary of USMLE Behavioral Sciences

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How do delusions, illusions, and hallucinations differ?
Hallucinations are sensory impressions (without a stimulus); illusions are misperceptions of real stimuli; and delusions are false beliefs that are not shared by the culture.
What syndrome is characterized by sweating, insomnia, nausea, diarrhea, cramps, delirium, and general restlessness secondary to MAOI and SSRI in combination?
Serotonin syndrome. It is also associated with high doses and MAOI and synthetic narcotic combinations (Ecstasy). Treatment consists of decreasing SSRI dosage, removing the causative agent, and giving cyproheptadine.
What is the legal age to be deemed competent to make decisions?
18 years old (except if emancipated)
With what stage of sleep is enuresis associated?
Stage 3 and 4 most commonly. It can occur at any stage in the sleep cycle and is usually associated with a major stressor being introduced into the home.
When more than one explanation can account for the end result, what form of bias occurs?
Confounding bias
Increased levels of what neurotransmitter, in the hippocampus, decrease the likelihood of learned helplessness?
Increased GABA levels decrease the likelihood of learned helplessness.
How does ceasation of barbiturate use affect sleep?
By causing rebound insomnia and decrease in REM sleep
What type of correlation compares two ordinal variables?
Spearman correlation
What syndrome is characterized by bilateral medial temporal lobe lesion, placidity, hyperorality, hypersexuality, hyperreactivity to visual stimuli, and visual agnosia?
Klüver-Bucy syndrome
What is the term for having fantasies or dressing in female clothes for sexual arousal by heterosexual men?
Transvestite fetishism
What disorder is described as having
• Unconscious symptoms with unconscious motivation?
Somatoform disorder
What disorder is described as having
• Conscious symptoms with conscious motivation?
Malingering
What disorder is described as having
• Conscious symptoms with unconscious motivation?
Factitious disorder
What is the term for the ability of a test to measure something consistently?
Reliability (think of it as "nice grouping" or "precise")
What cerebral vessel size is affected in patients with vascular dementia?
Small to medium-sized cerebral vessels
What is the name of the program that deals with codependency and enabling behaviors for family members of alcohol abusers?
Al-Anon
What level of mental retardation is characterized by
• Needing a highly structured environment with constant supervision?
Profound (I.Q. range < 20)
What level of mental retardation is characterized by
• Having the ability to communicate and learn basic habits but training is usually not helpful?
Severe (range 20–34)
What level of mental retardation is characterized by
• Being self-supportive with minimal guidance and able to be gainfully employed (includes 85% of the mentally retarded)?
Mild (50–70)
What level of mental retardation is characterized by
• Can work in sheltered workshops and learn simple tasks but need supervision?
Moderate (35–49)
Name these immature defense mechanisms:
• Taking others' beliefs, thoughts, and external stimuli and making them part of the self. (Hint: if it's done consciously, it is called imitation.)
Introjection (a sports fan is a good example)
Name these immature defense mechanisms:
• Returning to an earlier stage of development (e.g., enuresis)
Regression
Name these immature defense mechanisms:
• Inability to remember a known fact (aware of forgetting)
Blocking
Name these immature defense mechanisms:
• Psychic feelings converted to physical symptoms
Somatization
What is the term for ejaculation before or immediately after vaginal penetration on a regular basis?
Premature ejaculation
At what stage of cognitive development (according to Piaget) do children
• See death as irreversible?
Concrete operations (6–12 years)
At what stage of cognitive development (according to Piaget) do children
• Have abstract thinking?
Formal operations (> 12 years)
At what stage of cognitive development (according to Piaget) do children
• Lack law of conservation and be egocentric?
Preoperational (2–6 years)
Is it acceptable to lie, even if it protects a colleague from malpractice?
No, it is never acceptable to lie.
What happens to prevalence as duration increases?
Prevalence increases. (Note: Incidence does not change.)
With what stage of sleep are nightmares associated?
REM sleep. Nightmares are frightening dreams that we recall.
What is the statistical term for the proportion of truly nondiseased persons in the screened population who are identified as nondiseased?
Specificity (it deals with the healthy)
In the elderly, what happens to total sleep time, percentage of REM sleep, and percentage of NREM sleep?
Total and NREM sleep decrease considerably as we age, but REM sleep remains relatively constant (20%) up to age 80, then begins to decline.
What happens to dopamine levels when we awaken?
Dopamine levels rise with waking; dopamine is associated with wakefulness.
What is the primary risk factor for suicide?
Previous suicide attempt
What is defined as a general estimate of the functional capacities of a human?
IQ
What dementia is associated with dilated ventricles with diffuse cortical atrophy, decreased parietal lobe blood flow, and a decrease in choline acetyl transferase activity?
These are the gross pathologic changes associated with Alzheimer's disease.
What is the term for a deficiency or absence of sexual fantasies or desires?
Hypoactive sexual desire disorder
What phobia is described as the fear of open spaces?
Agoraphobia. It also means having a sense of humiliation or hopelessness.
What antidepressant, which recently was approved for general anxiety disorder, inhibits the reuptake of NE and 5-HT?
Venlafaxine. (It also has a mild dopaminergic effect.)
What judgment states that the decision, by rights of autonomy and privacy, belongs to the patient, but if the patient is incompetent to decide, the medical decision is based on subjective wishes?
Substituted judgment. It is made by the person who best knows the patient, not the closest relative.
What ethnic group has the highest adolescent suicide rate?
Native Americans
What are the three microscopic pathologic changes seen in Alzheimer's disease?
Senile plaques, neurofibrillary tangles, and granulovascular changes in neurons
When does most REM sleep occur, in the first or second half of sleep?
REM sleep occurs more often in the second half of sleep. The amount of REM sleep increases as the night goes on.
What is the name of the benzodiazepine antagonist used in the treatment of an overdose?
Flumazenil
What type of test asks a patient to draw a scene, attempting to find out the individual's unconscious perceptions in his or her life?
Projective drawing. The artistic form is irrelevant, but the size, placement, erasures, and distortions are relevant.
What is the biochemical trigger for REM sleep?
Increased ACh to decreased NE levels. (NE pathway begins in the pons and regulates REM sleep.)
What neuropsychologic test shows nine designs to the patient, then asks for recall of as many as possible?
Bender Visual Motor Gestalt Test
What are the three characteristics of ADHD?
1. Short attention span
2. Impulsivity
3. Hyperactivity
Is suicidal ideation a component of normal grief?
It is rare with normal grief; however, it is relatively common in depression
In what stage of sleep is it easiest to arouse a sleeping individual?
During REM sleep
What scale separates things into groups without defining the relationship between them?
Nominal scale (categorical, e.g., male or female)
What specifies how accurately the sample values and the true values of the population lie within a given range?
Confidence interval. It is a way of admitting estimation for the population.
If the family member of a patient asked you to withhold information, would you?
For the USMLE Step 1 the answer is no, but if the information would do more harm than good, withhold. This is very rare but it does occur.
What AD dementia has a defect in chromosome 4, onset between the ages of 30 and 40, choreoathetosis, and progressive deterioration to an infantile state?
Huntington's chorea. (Death in 15–20 years, often via suicide.)
What percentage of children born to HIV-positive mothers will test positive for HIV at birth?
100%, with about 20% remaining positive after 1 year
Name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 months of age, peaks around 8 months, and decreases at 12 months.)
Separation anxiety
Which drug is used to treat opioid withdrawal, ADHD, and sometimes Tourette's syndrome?
Clonidine
What chromosome is autism linked to?
Chromosome 15
What type of correlation is defined as
• Two variables that go together in the same direction?
Positive correlation
What type of correlation is defined as
• Two variables with no linear relation to one another?
Zero correlation
What type of correlation is defined as
• One variable that diminishes in the presence of the other?
Negative correlation
When the results of a test are compared to findings for a normative group, what form of reference does the objective test use?
Norm reference (i.e., 75% of the students in the class will pass)
What hypothesis states that the findings of a test are a result of chance?
Null hypothesis (what you hope to disprove)
What is the term to describe the inability to feel any pleasant emotions?
Anhedonia
What is the term for involuntary constriction of the outer third of the vagina to prevent penile penetration?
Vaginismus; it is the female counterpart of premature ejaculation.
What is the term for the same results achieved again on testing a subject a second or third time?
Test–retest reliability
At what age does a child develop
• Endogenous smile?
At birth (reflex)
At what age does a child develop
• Exogenous smile?
8 weeks (response to a face)
At what age does a child develop
• Preferential smile?
12 to 16 weeks (in response to mother's face)
Per Freud, with what part of the unconscious are sex and aggression (instincts) associated?
Id
What enzyme is inhibited by disulfiram?
Acetaldehyde dehydrogenase. When this enzyme is blocked, acetaldehyde builds up, and its presence in excess results in nausea and hypotension.
What type of questions should you begin with when a patient seeks your medical opinion?
It is best to begin with open-ended questions, allowing patients to describe in their own words what troubles them. You can then move to closed-ended questions when narrowing the diagnosis.
What type of scheduled reinforcement states that after a desired response, the reinforcement is given
• On a set time schedule?
Fixed interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given
• After a set number of responses?
Fixed ratio (rewards set behaviors)
What type of scheduled reinforcement states that after a desired response, the reinforcement is given
• Varying in time?
Variable interval
What type of scheduled reinforcement states that after a desired response, the reinforcement is given
• Varying in the number of responses?
Variable ratio

If it is based on time, it is an interval, and if it is based on the number of responses, it is a ratio.
At what stage of psychosexual development (according to Freud) do children fear castration?
Phallic stage (4–6 years)
What is the label given to an individual whose IQ is
• 130
Very superior (<2.5% of the population)
What is the label given to an individual whose IQ is
• 110 to 119
High average
What is the label given to an individual whose IQ is
• 80 to 89
Low average
What is the label given to an individual whose IQ is
70 to 79
Borderline
What is the label given to an individual whose IQ is
• 90 to 109
Average
What is the label given to an individual whose IQ is
• Below 69
Mentally disabled
What is the label given to an individual whose IQ is
• 120 to 129
Superior
At what stage of sleep is GH output elevated?
Stage 4
Can incidence, prevalence, and cause and effect be assessed in
• Case control studies?
Case control studies cannot assess incidence or prevalence, but they can determine causal relationships.
Can incidence, prevalence, and cause and effect be assessed in
• Cross-sectional studies?
Cross-sectional studies determine prevalence, not incidence or cause and effect.
Can incidence, prevalence, and cause and effect be assessed in
• Cohort studies?
Cohort studies determine incidence and causality, not prevalence.
Can a physician commit a patient?
NO!! Remember, only a judge can commit a patient. A physician can detain a patient (maximum is for 48 hours).
What are the five pieces of information considered necessary for fully informed consent?
1. Benefits of the procedure
2. Purpose of the procedure
3. Risks of the procedure
4. The nature of the procedure (what you are doing)
5. The alternative to this procedure and its availability

(Don't forget the last one; this is where physicians get in trouble.)
What is the term for the number of individuals who have an attribute or disease at a particular point in time?
Prevalence rate
What is the term for the degree to which a test measures what it is intended to measure?
Validity (remember, reliability is necessary but not the only thing needed for validity)
What Freudian psyche component is described as
• The urges, sex aggression, and "primitive" processes?
Id (pleasure principle)
What Freudian psyche component is described as
• The conscience, morals, beliefs (middle of the road)?
Superego
What Freudian psyche component is described as
• Reality, rationality, language basis?
Ego
What medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity?
Acamprosate (the number of glutamate receptors increases with chronic alcohol abuse)
What is the term for new made-up words?
Neologisms. Thomas Jefferson noted, "Necessity obliges us to neologize." (Abnormal use of neologisms is known as neolalism.)
What rate removes any difference between two populations, based on a variable, to makes groups equal?
Standardized rate
Can committed mentally ill patients refuse medical treatment?
Yes. The only civil liberty they lose is the freedom to come and go as they please.
What is the term for any stimulus that increases the probability of a response happening?
Reinforcement
Does REM deprivation interfere with performance on simple tasks?
No, but it does interfere with performing complex tasks and decreases attention to detail. (Be careful post call!)
Name the cluster C personality disorder:
• Gets others to assume responsibility, is subordinate, and is fearful of being alone and caring for self
Dependent
Name the cluster C personality disorder:
• Orderly, inflexible, perfectionist; makes rules, lists, order; doesn't like change, has a poor sense of humor, and needs to keep a routine
Obsessive-compulsive
Name the cluster C personality disorder:
• Sensitive to criticism, shy, anxious; socially isolated but yearns to be in the crowd
Avoidant
What is the term for a complete aversion to all sexual contact?
Sexual aversion disorder
What type of symptoms in schizophrenia are associated with
• Dopamine receptors?
Type I symptoms (positive); schizophrenics have them, but otherwise healthy persons do not.
What type of symptoms in schizophrenia are associated with
• Muscarinic receptors (ACh)?
Type II symptoms (negative); otherwise healthy persons have them, but schizophrenics do not.
What general pattern of sleep is described by slowing of EEG rhythms (high voltage and slower synchronization), muscle contractions, and lack of eye movement or mental activity?
NREM sleep. Remember awake body, sleeping brain
Is spousal abuse a mandatory reportable offense?
No, it is not a mandatory reportable offense (if you can believe it). Child and elderly abuse are mandatory reportable offenses.
What is the key issue surrounding teenagers' maturation?
Formation of an identity through issues of independence and rebellion; they define who they are.
What is the relationship between chance of error and
• Standard deviation?
As the standard deviation increases, the greater the chance of error.
What is the relationship between chance of error and
• Sample size?
As sample size increases, the lower the chance of error.
Name the cluster B personality disorder:
• Colorful, dramatic, extroverted, seductive, and unable to hold long-term relationships
Histrionic
Name the cluster B personality disorder:
• In a constant state of crisis, promiscuous, unable to tolerate anxiety-causing situations, afraid of being alone, and having intense but brief relationships
Borderline
Name the cluster B personality disorder:
• Criminal behavior; lacking friends, reckless, and unable to conform to social norms
Antisocial
Name the cluster B personality disorder:
• Grandiose sense of self-importance; demands constant attention; fragile self-esteem; can be charismatic
Narcissistic
In what organ system would you attempt to localize a sign for shaken baby syndrome"? What do you look for?
Look for broken blood vessels in the baby's eyes.
What case is known as "let nature take its course"?
Infant Doe. Generally, parents cannot forego lifesaving treatment, but this case states that there are exceptions to the rule.
If the P value is less than or equal to .05, what do you do to the null hypothesis?
Reject it
What disorder is characterized by an alternating pattern of depressed mood with periods of hypomania for more than 2 years?
Cyclothymia (nonpsychotic bipolar). Patients are ego syntonic.
What projective test asks the patient to tell a story about what is going on in the pictures, evaluating the conflicts, drives, and emotions of the individual?
TAT (Thematic apperception test)
What has proved to be the best way to extinguish enuresis?
Bell pad
What scale assesses a rank order classification but does not tell the difference between the two groups?
Ordinal scale (e.g., faster/slower, taller/shorter)
What is associated with prolonged lithium use?
Hypothyroidism. (TSH levels must be monitored.)
What scale has a true zero point, graded into equal increments, and also orders them?
Ratio scale
By what age should children be able to draw the following figures?
• Triangle
6 years old
By what age should children be able to draw the following figures?
• Cross
4 years old
By what age should children be able to draw the following figures?
• Diamond
7 years old
By what age should children be able to draw the following figures?
• Square
5 years old
By what age should children be able to draw the following figures?
• Circle
3 years old
By what age should children be able to draw the following figures?
• Rectangle
4.5 years old

(Alphabetic order except with a diamond last: circle, cross, rectangle, square, triangle)
What personality disorder affects 75% of the prison population?
Antisocial personality
What is the first formal IQ test used today for children aged 2 to 18?
Stanford-Binet Scale, developed in 1905, is useful in the very bright, the impaired, and children less than 6 years old.
What type of foods should patients taking MAOIs avoid? Why?
Foods rich in tyramine (e.g., cheese, dried fish, sauerkraut, chocolate, avocados, and red wine) should be avoided. Hypertensive crisis occurs when tyramine and MAOIs are mixed.
What form of anxiety, appearing at 6 months, peaking at 8 months, and disappearing by 1 year of age, is seen in the presence of unfamiliar people?
Stranger anxiety
What are the three stages that children aged 7 months to 5 years go through when they are separated from a primary caregiver for a long time?
1. Protest
2. Despair
3. Detachment
What five things are checked in the APGAR test?
1. Skin color
2. Heart rate
3. Reflexes
4. Muscle tone
5. Respiratory rate


APGAR, Appearance, Pulse, Grimace, Activity, Respiration
What are the top three causes of infant mortality?
Birth defects, low birth weight (< 1500 g) with neonatal respiratory distress syndrome (NRDS), and SIDS
Do newborns have a preference for still or moving objects?
Moving objects, along with large bright objects with curves and complex designs.
What is the name of the 12-step program believed to be the most successful for the treatment of alcohol abuse?
Alcoholics Anonymous
How can you differentiate between a medial temporal lobe and a hippocampal lesion based on memory impairment?
Long-term memory is impaired in hippocampal lesions; it is spared in medial temporal lobe lesions.
What serotonin reuptake inhibitor's major sexual side effect is priapism?
Trazodone
What is the central issue regarding the Roe vs. Wade decision (legalization of abortion)?
The patient decides about the health care she does or does not get even if it harms the fetus. This also means she can refuse blood transfusions even if it harms the fetus.
What part of the ANS is affected in the biofeedback model of operant conditioning?
The biofeedback model is based on the parasympathetic nervous system.
The proportion of truly diseased persons in the screened population who are identified as diseased refers to?
Sensitivity (it deals with the sick)
How far below ideal body weight are patients with anorexia nervosa?
At least 15%
True or false? According to social learning theory, people who believe that luck, chance, or the actions of others control their fate have an internal locus of control.
False. These beliefs are characteristic of people with an external locus of control.
What is the term for an inhibited female orgasm?
Anorgasmia. (The overall prevalence is 30%.)
What are the four exceptions to requirements for informed consent?
1. Incompetent patient (determined by the courts)
2. Therapeutic privilege (in the best interest of the patient when he or she is unable to answer)
3. Waiver signed by the patient
4. Emergency
What is the term for recurrent and persistent pain before, after, or during sexual intercourse?
Dyspareunia. It is a common complaint in women who have been raped or sexually abused.
What type of bias is it when the sample population is not a true representative of the population?
Selection bias
In what stage of sleep is it hardest to arouse a sleeping individual?
During stage 3 and 4 (remember, it is called deep sleep.)
What is the period between falling asleep and REM sleep called?
REM latency; normally it is about 90 minutes.
What case is best known for use of the "best interest standard"?
Brother Fox (Eichner vs. Dillon). The substituted standard could not apply because the patient had never been competent, so no one knew what the patient would have wanted. Therefore, the decision was based on what a "reasonable" person would have wanted.
What drug is used to prevent alcohol consumption by blocking aldehyde dehydrogenase?
Disulfiram
According to Freud, what facet of the psyche represents the internalized ideals and values of one's parents?
Superego
What pineal hormone's release is inhibited by daylight and increased dramatically during sleep?
Melatonin. It is a light-sensitive hormone that is associated with sleepiness.
What somatoform disorder is described as
• Having a F:M ratio of 20:1, onset before age 30, and having 4 pains (2 gastrointestinal, 1 sexual, 1 neurologic)?
Somatization disorder
What somatoform disorder is described as
• La belle indifférence, suggestive of true physical ailment because of alteration of function?
Conversion disorder
What somatoform disorder is described as
• Unrealistic negative opinion of personal appearance, seeing self as ugly?
Body dysmorphic disorder
What somatoform disorder is described as
• Preoccupied with illness or death, persisting despite reassurance, lasting longer than 6 months?
Hypochondriasis (they will begin with "I think I have...")
What somatoform disorder is described as
• Severe, prolonged pain that persists with no cause being found, disrupts activities of daily living?
Somatoform pain disorder
What statistical test compares the means of many groups (>2) of a single nominal variable by using an interval variable?
One-way ANOVA
What disease is described by the following characteristics: multiple motor and vocal tics, average age of onset 7, a M:F ratio of 3:1, and association with increased levels of dopamine?
Tourette's syndrome; it is usually first reported by teachers as ADHD with symptoms of obsessive-compulsive disorder and learning disabilities.
In Parkinson's disease, what area of the basal ganglia has a decreased amount of dopamine?
Substantia nigra
What naturally occurring substances mimic the effects of opioids?
Enkephalins
What disorder, experienced more than half of the time for a 6-month period, is described as being fearful, worrisome, or impatient and having sleep disturbances, poor concentration, hyperactivity, and an overall sense of autonomic hyperactivity?
Generalized anxiety disorder
What percent of sexual abuse cases are committed by family members?
50%. The uncles and older siblings are the most likely perpetrators, although stepfathers also have a high rate.
Kaiser-Fleischer rings, abnormal copper metabolism, and ceruloplasmin deficiency characterize what disease, which may include symptoms of dementia when severe?
Wilson's disease (Remember chromosome 13 and hepatolenticular degeneration)
To what does failure to resolve separation anxiety lead?
School phobia
What is the term to describe the average?
Mean
How does L-tryptophan affect sleep?
It increases REM and total sleep time.
Should information flow from the patient to the family or vice versa?
Your duty is to tell the patient, not the family. The patient decides who gets to know and who doesn't, not you.
Can parents withhold treatment from their children?
Yes, as long the illness does not threaten limb or life. If illness is critical or an emergency, treat the child.
What is the name of the hypothesis you are trying to prove?
Alternative hypothesis (what is left after the null has been defined)
What percent of unwed mothers are teenagers?
50%, with 50% of them having the child
What happens to REM, REM latency, and stage 4 sleep during major depression?
Increased REM sleep, decreased REM latency, and decreased stage 4 sleep, leading to early morning awakening
What 11–amino acid peptide is the neurotransmitter of sensory neurons that conveys pain from the periphery to the spinal cord?
Substance P. (Opioids relieve pain in part by blocking substance P.)
True or false? In a positively skewed curve the mean is greater than the mode.
True. In positively skewed distributions the mode is less than the median is less than the mean.(Remember to name a skewed distribution: the tail points in the direction of its name. positive skew tails point to the positive end of a scale.)
What is the term to describe jumping from one topic to the next without any connection?
Loose association
What is the leading cause of school dropout?
Pregnancy
Name the four components of the narcoleptic tetrad.
1. Sleep paralysis
2. Hypnagogic hallucinations (while falling asleep)
3. Sleep attacks with excessive daytime sleepiness
4. Cataplexy (pathognomonic)


Narcolepsy is a disorder of REM sleep, with REM occurring within 10 minutes of sleep.
What happens to cortisol levels in sleep-deprived individuals?
Cortisol levels increase. Lymphocyte levels decrease in sleep-deprived individuals.
What is the period between going to bed and falling asleep called?
Sleep latency
What disorder is characterized by a depressed mood and a loss of interest or pleasure for more than 2 years?
Dysthymia, which is also known as nonpsychotic depression. (Think of it as the car running but not well.)
What form of conditioning is defined as a new response to an old stimulus resulting in a consequence?
Operant conditioning (reinforcement is after a response)
What pituitary hormone is inhibited during sleep?
TSH. 5-HT and prolactin increase during sleep, and dopamine levels decrease during sleep.
Based on operant conditioning, what type of reinforcement is described when
• Adding a stimulus stops a behavior?
Punishment
Based on operant conditioning, what type of reinforcement is described when
• Removing a stimulus stops a behavior?
Extinction
Based on operant conditioning, what type of reinforcement is described when
• Adding a stimulus reinforces a behavior?
Positive reinforcement
Based on operant conditioning, what type of reinforcement is described when
• Removing a stimulus reinforces a behavior?
Negative reinforcement
What is the formula to calculate IQ?
(MA/CA) x 100 = IQ score, where MA = mental age and CA = chronological age
What happens to NE levels in
• Major depression?
Decrease (5-HT and dopamine levels do the same)
What happens to NE levels in
• Bipolar disorder?
Increase (5-HT and dopamine levels do the same)
What law was adopted to shield physicians from liability when helping at the scene of an accident?
Good Samaritan Law. (Physicians are not required to stop and help.)
What is the term for the number of new events occurring in a population divided by the population at risk?
Incidence rate
What is the term to describe inability to recall the past and possible assumption of a completely new identity?
Dissociative fugue. (Patients are unaware of memory loss.)
What classical conditioning therapy or modification is described as
• Pairing noxious stimuli to an inappropriate behavior?
Aversive conditioning
What classical conditioning therapy or modification is described as
• Forcing patients to confront their fears by being exposed to them until they are extinguished?
Exposure
What classical conditioning therapy or modification is described as
• Triage of a hierarchy of fears (from least to most), then teaching muscle relaxation techniques in the presence of those fears until the subject is not afraid anymore?
Systematic desensitization
Failure to accurately recall the past leads to what form of bias?
Recall bias. These problems arise in retrospective studies.
Regarding neuroleptics, what is the relationship between potency and anticholinergic side effects?
Inversely proportional: the higher the potency, the lower the anticholinergic side effects.
What potentially lethal side effect of clozapine should be monitored with frequent blood drawing?
Agranulocytosis; approximately 2% develop this side effect.
True or false? Being college educated increases a man's risk of having premature ejaculation.
True; also, stressful marriage, early sexual experiences in the back of a car, and sex with a prostitute all increase the risk of premature ejaculation.
What is the term for the rate measured for a subgroup of a population?
Specific rate (e.g., men aged 55–60)
In what stage of psychosexual development, according to Freud, do children resolve the Oedipus complex?
Latency stage (6–12 years)
Where is lithium metabolized and excreted?
95% in the kidneys; that's why adequate Na+ and fluid intake is essential.
At what age do children begin to understand the irreversibility of death?
At 8 to 9 years of age. Prior to this age they view death as a form of punishment.
What are the three benzodiazepines that do not undergo microsomal oxidation?
Oxazepam, temazepam, and lorazepam (OTL) (mnemonic: Outside The Liver). They undergo glucuronide conjugation, not via the cytochrome p450 system.
What neuropsychologic test has five basic scales testing for the presence and localization of brain dysfunction?
The Halsted-Reitan battery. It consists of finger oscillation, speech sound perception, rhythm, tactual, and category testing.
What subtype of schizophrenia is characterized by
• Childlike behaviors, unorganized speech and behaviors, poor grooming, incongruous smiling and laughter, and the worst prognosis?
Disorganized schizophrenia
What subtype of schizophrenia is characterized by
• Stuporous mute echopraxia and automatic obedience, waxy flexibility with rigidity of posture?
Catatonic schizophrenia
What subtype of schizophrenia is characterized by
• Delusions of persecution and/or grandeur, auditory hallucinations, late onset, and the best prognosis?
Paranoid schizophrenia
If a patient cannot pay, can you refuse services?
No, you never refuse to treat a patient simply because he or she can't pay. You are a patient advocate.
Does alcoholism increase the rate of suicide?
Yes. It increases the rate of suicide to nearly 50 times that of the general population.
What is the term for the dementia characterized by decremental or patchy deterioration in cognitive function due to a cerebrovascular accident?
Vascular dementia. It is characterized as a stepwise deterioration in cognitive function.
What is the term for the difference between the highest and the lowest score in a population?
Range
How is sleep affected in a person with alcohol intoxication?
Decreased REM sleep and REM rebound during withdrawal
How many attacks are needed over how much time before panic disorder is diagnosed?
Need 3 panic attacks over 3 weeks (remember, they come out of the blue.)
What axis I disorder is characterized by pronoun reversal, preference for inanimate objects, obliviousness to the external environment, lack of separation anxiety, and abnormalities in language development?
Autism. Head-banging, rocking, and self-injurious behaviors are also common in autism.
What major side effect of neuroleptics is characterized by pill rolling, shuffling gait, and tremors that abate during sleep?
Tardive dyskinesia. It persists even after treatment is discontinued and has no treatment. Focus is on monitoring for side effects and prevention.
If you report a suspected case of child abuse and are wrong, are you protected from legal liability?
Yes. This is done to help prevent underreporting out of fear of lawsuit. Remember that it is your duty to protect the child first, not worry about legal responsibility.
Can advance directives be oral?
Yes
Increased self-esteem, flight of ideas, decreased sleep, increased libido, weight loss, and erratic behavior are all symptoms of what disorder?
Bipolar disorder (manic-depressive disorder)
Is marital satisfaction higher for couples with or without children?
Without children (but don't think about this one for too long)
At what age does IQ stabilize?
From age 5 onward IQ stabilizes.
Name the aphasia based on these characteristics:
• Nonfluent speech, telegraphic and ungrammatical; lesion in Brodmann's area 44; unimpaired comprehension
Broca's aphasia
Name the aphasia based on these characteristics:
• Lesion in the prefrontal cortex; inability to speak spontaneously; unimpaired ability to repeat
Transcortical aphasia
Name the aphasia based on these characteristics:
• Lesion is in the parietal lobe or arcuate fibers because the connection between Broca's and Wernicke's area is severed; word comprehension preserved; inability to write or speak the statement (can
Conduction aphasia
Name the aphasia based on these characteristics:
• Both Broca's and Wernicke's areas damaged by lesion in the presylvian speech area; trouble repeating statements; poor comprehension with telegraphic speech
Global aphasia
Name the aphasia based on these characteristics:
• Lesion in Brodmann area 22; impaired comprehension; incoherent rapid, fluent speech; verbal paraphrasias; trouble repeating statements
Wernicke's aphasia
What rare form of dementia is associated with personality changes and affects the frontal and temporal lobes?
Pick's disease
Which drug is used to treat respiratory depression associated with an overdose of opioids?
Naloxone or naltrexone
What rate is indicated by 1-specificity?
False-positive rate
When does most of the NREM sleep (stage 3 and 4) occur, in the first or second half of sleep?
The deepest sleep levels (stage 3 and 4) occur mostly in the first half of sleep.
Name the stages of sleep with these EEG patterns:
• Disappearance of alpha waves, appearance of theta waves
Stage 1
Name the stages of sleep with these EEG patterns:
• Delta waves
Stage 3 and 4
Name the stages of sleep with these EEG patterns:
• Sawtooth waves, random low voltage pattern
REM
Name the stages of sleep with these EEG patterns:
• Alpha waves
Being awake
Name the stages of sleep with these EEG patterns:
• Sleep spindles, K-complexes
Stage 2
What is the drug of choice for treating ADHD?
Methylphenidate (Ritalin)
True or false? Prolactin levels can serve as a rough indicator of overall dopamine activity.
True. PIF is dopamine in the tuberoinfundibular system.
What is the term for failure to give up infantile patterns of behavior for mature ones?
Fixation (arrested development)
Is masturbation considered an abnormal sexual practice?
No. It is abnormal only if it interferes with normal sexual or occupational function.
Which benzodiazepine has the longest half-life?
Flurazepam
In the classical conditioning model, when a behavior is learned, what must occur to break the probability that a response will happen?
Stimulus generalization must stop. (Pairing of the unconditioned stimulus and the conditioned stimulus must cease.)
What is the most abundant neuron in the cerebellum?
The granule cell. Its neurotransmitter is glutamic acid, which is also the principal neurotransmitter of the visual pathways.
Name these anxiety defense mechanisms:
• Separating oneself from the experience. The facts are accepted but the form is changed for protection.
Dissociation
Name these anxiety defense mechanisms:
• Use of explanations to justify unacceptable behaviors.
Rationalization

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