Glossary of USMLE Step 2 Lesson 2 Psychic Structures Kaplan Notes
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- What are you born with?
Sex and Aggression
- What do we get from our parents, values, conscience?
little devil (Id) and little angel (Superego)
- What is the superego?
- Antisocial personality doesn't have what?
- Superego (lacunae)
holes in it...
like Swiss cheese
they lie, steal
- Question has drive, instinct is there?
- Right, wrong, conscience, morality?
- Everything else?
- Defense mechanism is related to what?
- Ego's way warding anxiety
- Object relations is what?
Developed shortly after birth
- Ego gives defense mechanism shield against attacks
- role is to decrease anxiety
- Defense mechanisms are what?
- Which defense mechanism is not unconscious?
- What is projection?
- wishes to someone else
she doesn't like me...
(really I don't like her)
You are cheating on me
(really I am cheating on you)
- What personality has projection?
- Paranoid Personality
all attacking them
- What is denial?
- use to avoid painful
I didn't have a heart attack
Woman who's husband died but she cooks for 2 and places the table for two
- Patient comes in with an MI?
Telemetry, patient takes medication with leads on himself. Patient says I didn't have a Heart Attack... What is the next step?
- DO NOT refer to psych
Interpret denial w/ dream analysis
Find out patients view about death
Answer is DO NOTHING
Patients defense mechanism is not interfering with Tx
- If patient spits out pill, takes all I.V. lines out...
Patient in denial then you need to?
- Ask the patient why
- When patient thinks all good or all bad, Splitting... Which personality uses this?
good is idealized
bad is devalued
The morning staff is the best
- What is blocking?
- Temporary when you can't remember answer
When you have anxiety
- WHat is regression?
- go back to earlier stage
acting like a baby
children go back
like 7 year old
birth of sibling (divorce)
so they will start sucking on their thumb
Wet the bed again
Curled up in fetal position
- - talk like babies
- want to be pampered
patient buzzing nurse
- adult acting like child
- What is somatization?
- Psychic converted to bodily symptoms
- What personality is associated w/ somatization?
- Physical exam normal
2) Body Dysmorphic
- Old patient w/ depression?
Just retired complains with backache, knee ache... so what is it?
- What is introjection?
- Features of external world made as one self
whatever she thinks I bring inward
Superman... girl puts cape around neck
resident acting like attending
- Displacement is what?
emotion shifted to another person
scream at nurse since Dr. is angry at patient
Learned or Psychological
Afraid of Shark
Shark represents something else
- Freud says displacement is part of phobias?
- Woman was having dreams about snake...
Afraid of Penis
Argument with boss
So scream at wife
Kick at little dog in the house
- Repression is what?
- Defense mechanism that deals with memories
not remember all of our memories
want to forget bad memories
repression are memories that we have but don't want to tap into
another word is
- Pat. 2-3 year old that had STDs?
- sexually abused as a child
but when asked if ever sexually abused says no
suppression you become aware of it
when you are in treatment
- When you have a suppresion what does it mean?
- You remember but you don't want to talk about it
- Repression is conscious or subconscious?
- Suppresion is conscious or subconscious?
- Repression vs. denial?
- denial did not happen
repression don't remember it happen
- What do we fear the most?
- Death, space, ocean
- What decreases our fear?
- when you learn about something
- Intellecualization is what?
- Pat. is told that it has cancer so patient starts reading about Cancer
-go to seminars
-talk about Cancer w/ intellecual way with no emotions
- What is isolation?
- patient will not show any emotion
- Pat. just experience something horrible like a man who sees her daughter killed by a car driving by... man doesn't cry?
Pat. doesn't cry when they see body in the morgue
- Denial vs. isolation?
- denial you say it did not happen
isolation you say parents die but you don't cry
- Rationalization is?
- rational explanations are used to explain something unacceptable
pat. says works is hard and drink 6 beers
- Reaction formation?
- Unacceptable (you personally find it)
You do the opposite
So sex(pornography) is unacceptable so you become a priest/nun
- You like killing babies so you become a pediatrician...
- Reaction formation
- You want to set fires (pyromania), you become a fire-fighter....
- Reaction formation
- If you wanna hit people... you become a police officer.
- Reaction formation example
- Where do we see reaction formation?
Obsessive Compulsion Disorder
Doctor who wants to kill people and becomes surgery
- Fear of contamination... OCD (Obsessive Compulsive Disorder)
- Patient really wants to touch everything
so must convince yourself that everything is dirty
that is a reaction formation
- What is undoing and where is it seen?
As good as it gets
not step on a crack
break your mother's back
- If you think you gotten dirty, how do you undo it?
- Wash hands
like in OCD
- Patient washes hand 100 times? Is it reaction formation or undoing?
like Preacher Jimmy Suager
- Acting out is what?
Kid starts screaming and complains
needs to be age appropiate
- if it is an adult with a temper tantrum?
- This is a regression
not ACTING OUT
- Humor is what?
- mature defense
- Standup comedy who is overweight and he talks about eating in this all you can eat and talks about in different accents (mexican, chinese, indian)?
- Humor is used as a defense mechanism
- What is sublimation?
- the most mature of all defense mechanism
getting away with murder
doing exactly what you want to do but it is done acceptably in society
- If you like porn? You become a censor...
- Want to kill people, butcher people... become a surgeon?
- You want to kill babies so you become an abortion specialist?
- Sublimation not Reaction Formation
- You want to start fires and demolish building you become a park ranger or are part of demolition teams for building?
not reaction formation
- If you like staring fires you become a movie specialist on explosives?
- sublimation example
not reactio formation?
- If you like hitting people and you want to look good in society? You become a boxer...
- Example of sublimation
- Supression involves?
- Conscious about it but
You would rather forget
- Formula for IQ = ???
- IQ= MA/CA x 100
- What is the mean IQ?
- What is the standard deviation of IQ? S1?
- SD = 15
- MA is?
- Mental Age
How you perform on test
- CA is?
- your actual Age
age in years
- Kid 10 scores 12
- MA = 12
so 12/10= 120 IQ
- What is the Adults IQ test?
Wechsler Adult Intelligence Scale Revised
- What are two test for intelligence children?
- What is good about the Stanford Binet?
- It was the first one developed
used in children who are very young
mentally retarde or high intelligence
- Standfor is good for?
- Dumn and Bright
- Objective test include?
- Simple stimuli
not much training for this
- Projective test?
- ambiguous stimuli
lots of answers
- What is the best objective test?
Minnesota Multiphasic Personality Inventory (MMPI)
It tells if you are lying
- What are the ages for WISC-R test?
- Kids with whiskers just coming out...
6-17 year old
- What are the projective tests?
- Rorschach Test
Thematic Apperception Test (TAT)
- What are Drawings used for?
- Child Abuse
- What is another name for Rorschach Test?
No right wrong answer so need someone specialized to interpret test
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