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usmle: behavioral sciences I

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how do delusions, illusions, and hallucinations differ
delusions are false beliefs that are not shared by the culture
illusions are misperceptions of real stimuli
hallucinations are sensory impressions
what syndrome is characterized by sweating, insomnia, nausea, diarrhea, cramps, delirium, and general restlessness secondary to MAOI and SSRIin combination
serotonin syndrome
what is the legal age to be deemed competent to make decisions
18
with what stage of sleep is enuresis associated
3 and 4
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 liklihood of learned helplessness
increased GABA
how do barbituates effect sleep
rebound insomnia and dec REM
what type of correlation compares two ordianl variables
spearman correlation
what syndrome is characterized by bilateral medial temporal lobe lesion, placidity, hyperorality, hypersexuality, hyperreactivity to visual stimuli, and visual agnosia
Kluver-Bucy
what is the term for having fantasies or dressing in femal clothes for sexual arousal by heterosexual men
transvestite fetishism
what disorder is caracterized by
1. unconscious sx w/ unconscious motivation
2. conscious sx w/ conscious motivation
3. conscious sx w/ unconscious motivation
1. somatoform disorder
2. malingering
3. factitious disorder
what is the term for the ability of a test to measure something consistently
reliability ("nice grouping")
what cerebral vessel size is affected in patients with vascular dementia
sm to med 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 ...
1. needing a highly structured environment w/ constant supervision
2. having the ability to communicate and learn basic habits but training is usually not helpful
3. can work in shel
1. profound (<20)
2. severe (20-35)
3. moderate (35-50)
4. mild (50-70)
name these immature defense mechanisms
1. taking others' beliefs, thoughts, and external stimuli and makign them part of the self
2. returing to an earlier stage of development
3. inability to remember a known fact (aware of forgetting)
1. introjection
2. regression
3. blocking (brain fart)
4. 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 do children
1. see death as irreversible
2. hae abstract thinking
3. lack law of conservation and be egocentric
1. concrete operations (6-12 yrs)
2. formal operations (>12 yrs)
3. preoperational (2-6 yrs)
is it acceptable to lie, even if it protects a colleague from malpractice
no
what happens to prevalence as duration increases
prevalence increases
with what stage of sleep are nightmares associated
REM
what is the statistical term for the proportion of truly nondiseased persons in the screened population who are identified as nondiseased
specificity
in the elderly, what happens to total sleep time, percentage of NREM sleep, and percentage of REM sleep
total and NREM sleep decrease considerably as we age, but REM remains constant (20%) up to age 80, then begins to decline
what happens to DA levels when we awaken
rise w/ waking
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 strophy, dec parietal lobe blood flow, and a dec in choline acetyl transferase activity
these are the gross pathologic changes associated w/ Alzheimer's
what is the term for a deficiency or absence of sexual fantasies or desires
hypoactive sexual desire disorder
what phobia is the fear of open spaces
agoraphobia
-also 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
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*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
senile plaques
neurofibrillary tangles
granulovascular chages
when does most REM sleep occur, in the first or second half of sleep
second
what is the name of the benzo antagonist used to tx 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
what is the biochemical trigger fro REM sleep
inc ACh to decreased NE levels
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
short attention span
impulsivity
hyperactivity
is suicidal ideation a component of nl grief
it is rare with nl grief; it is 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
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 info, would you
usmle- no
what AD dementia has a defect in chr 4, onset between the ages of 30 to 40, choreoathetosis, and progressive deterioration to an infantile state
huntington's chorea
what percentage of children born to HIV pos mothers will test pos for HIV at birth
100%
20% remain pos after 1 year
name the reaction that appears in babies who are temporarily deprived of their usual caretaker. (This reaction usually begins around 6 mo of age, peaks around 8 mo, and decreases at 12 mo)
separation anxiety
which drug is used to tx opiod withdrawal, ADHD, and sometimes Tourette's syndrome
Clonidine
what chr is autism linked to
15
what type of correlation is defined as...
1. two variables that go together in the same direction
2. two variables with no linear relation to one another
3. one variable that diminishes in the presence of the other
1. pos correlation
2. zero correlation
3. neg 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 (75% of students in the class will pass)
what hypothesis states that the findings of a test are a result of chance
null hypothesis
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 reliabilty
at what age does a child develop...
1. endogenous smile
2. exogenous smile
3. preferential smile
1. at birth
2. 8 wks
3. 12-16 wks
per Freud, with what part of the unconscious are sex and aggression (instincts) assoc
id
what enzyme is inhibited by disulfiram
aldehyde dehydrogenase- when the enzyme is blocked, aldehyde 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 attention
open-eneded
what typeof scheduled reinforcement states that after a desired response the reinforcement is given...
1. on a set time schedule
2. after a set number of responses
3. varying in time
4. varying in number of responses
1. fixed interval
2. fixed ratio
3. variable interval
4. variable ratio
at what stage of psychosexual development do children fear castration
phallic stage (4-6)
what is the label given when an individual whose IQ is
1. 130
2. 120-130
3. 110-120
4. 90-110
5. 80-90
6. 70-80
7. below 70
1. very superior (<2.5%)
2. superior
3. high average
4. average
5. low average
6. borderline
7. mentally retarded
at what stage of sleep is hCG output elevated
stage 4
can incidene, prevalence, and cause and effet be assessed in...
1. case control studies
2. cross-sectional studies
3. cohort studies
1. case control studies can't assess incidence or prevalence, but they can determine causal relationship
2. cross-sectional studies determine prevalence, not incidence or causal relationship
3. cohort studies determine incidence and causality, not prevalence
can a physician commit a patient
no! only a judge can
a physician can detain a patient for 48 hrs
what are the five pieces of info considered necessary for fully informed consent
1. benefits of the procedure
2. purpose of procedure
3. risks of procedure
4. nature of procedure
5. alternatives to procedure
what is the term for the number of individuals who have an attribute or disease at a particular point in time
prevalence ratio
what is the term for the degree to which a test measures what is intended to measure
validity
what freudian psyche component is descibed as
1. urges, sex, aggression, and primitive responses
2. the conscience, goals, beliefs
3. reality, rationality, language basis
1. id
2. superego
3. ego
what medication is used to help alcoholics avoid relapse by decreasing glutamate receptor activity
acamprosate
what is the term for new made-up words
neologisms
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 tx
yes
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 w/ performing complex tasks and decreases attention to detail
(be careful post call!!!)
name the cluster C personality disorder...
1. gets others to assume responsibility, is subordinate, and is fearful of being alone and caring for self
2. orderly, inflexible, perfectionist; makes rules, lists, order; doesn't like change, has a p
1. dependent
2. OC
3. avoidant
what is te term for a complete aversion to all sexual contact
sexual aversion disorder
what type of sx in schizophrenia are associated w/ ...
1. DA receptors
2. ACh receptors
1. type I sx (positive)
2. type II sx (neg)
what freudian psyche component is descibed as
1. urges, sex, aggression, and primitive responses
2. the conscience, moals, beliefs
3. reality, rationality, language basis
1. id
2. superego
3. ego
what general pattern of slepp is described by slowing of EEG rhythms (high voltage and slower synchronization), mm contractions, and lack of eye mov't or menatl activity
NREM sleep- awake body sleeping brain
is spousal abuse a mandatory reportable offense
no
what is the key issue surrounding teenagers' maturation
formation of identity through independence and rebellion; they define who they are
what is the relationship between chances of error and...
standard deviation?
sample size?
standard deviation inc
chance of error inc
sample sixe inc, chance of error dec
1. colorful, dramatic, extroverted, seductive, and unable to hold long term relationships
2. in a constant state of crisis, promiscuous, unable to tolerate anxiety-causing situations, afraid of being alone, and having intense but brief relationships
1. histrionic
2. borderline
3. antisocial
4. narcissistic
in what organ system would you attempt to localize a sign for shaken baby sysndrome?
look for broken vessels in the baby's eyes
what case is known as "let nature take its course"
infant doe
-generally, parents can't forego lifesaving tx, 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 mor than 2 yrs
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
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
faster/slower
taller/shorter
what is associated with prolonged lithium use
hypothyroidism
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...
1. circle
2. cross
3. rectangle
4. square
5. triangle
6. diamond
1. 3
2. 4
3. 4 1/2
4. 5
5. 6
6. 7
what personality disorder affects 75% of the prison population
antisocial
what is the first formal IQ test used today for children aged 2 to 18
stanford-binet
what type of foods should patients taking MAOIs avoid
foods rich in tyramine (cheese, dried fish, sauerkraut, chocolate, avocados, red wine)
hypertensive crisis occurs when tyramin and MAOIs are used
what form of anxiety, appearing at 6 mo, peaking at 8 mo, 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 mo to 5 yrs 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. appearance- color
2. pulse
3. grimace- reflexes
4. activity- mm tone
5. respiration rate
what are the top three causes of infant mortality
birth defects
low birth weight (<1500g) w/ NRDS
SIDS
do newborns have a perference for still or moving objects
moving objects- large, bright, with curves and complex designs
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 alpha-1 receptor blocker's major sexual side effect is priapism
trazodone
what is the central issue regarding roe vs. wade
the patient decides about the health care she does or does not get, even if it harms the fetus; this also means that 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 screed populations who are identified as diseased refers to
sensitivity
how far below ideal body weght are patients with anorexia nervosa
at least 15%
t or f
according to social learning theory, poeple who believe that luck, chance or the actions of other control their fate ahve an internal locus of control
f
they have an external locus of control
what is the term for an inhibited female orgasm
anorgasmia
what are the four exceptions to requirements for informed consent
incompetent patient (court)
therapeutic privlege
waiver signed by patient
emergency
what is the term for recurren and persistent pain before, after or during sexual intercourse
dyspareunia
(common w/ women who've been raped or sexually abused)
what type of bias is it when the sample population is not a true represantive of the population
selection bias
in what stage of sleep is it hardest to arouse a sleeping individual
3 and 4
what is the period between falling asleep and REM sleep called
REM latency (~90 min)
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
what somatoform disorder is described as...
1. having a F:M ratio 20:1, onset before age 30, and having 2 GI pains, 1 sexual, 1 neuro
2. la belle indifference, suggestive of true physical ailment because of alter of function
3. unrealistic
1. somatization disorder
2. conversion disorder
3. body dysmorphic disorder
4. hypchondriasis
5. somatoform pain disorder
what statistical test compares the means of many groups 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 ration of 3:1 and association with incresaed levels of DA
Tourette's syndrome
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 opiods
enkephalins
what disorder, emperienced more than half the time for a 6 mo period, is described as being fearful, worrisome, or impatient and having sleep disturbances, poor conc, hyperactivity, and an overall sense of autonomic hyperactivity
generalized anxiety disorder
what percent of sexual abuse cases are committed by family members
50%
Kaiser-Fleishcer rings, abnormal copper metabolism, and ceruloplasmin deficiency, characterize what disease?
What chr?
where is the degeneration?
Wilson's
Chr 13
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
increases REM and total sleep time
should information flow from the patient to the family or vice versa
you just tell the patient
can parents withhold tx from their children
yes, as long as the illness does no threaten life or limb
what is the name of the hypothesis you are trying to prove
alternative hypothesis
what percent of unwed mothers are teenagers
50% w/ 50% of them having the child
what happens to REM, REM latency, and stage 4 sleep during depression
inc REM
dec REM latency
dec stage 4 -> early morning awakening
what ll-aa peptide is the neurotransmitter of sensory neurons that conveys pain from theperiphery to the spinal cord
substance P
t or f
in a positivey skewed curve, the mean is greater than the mode
f
mode > median > mean
what is the term to describe junmping from one topic to the next without 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
3. sleep attacks w/ excessive daytime sleepiness
4. cataplexy (pathognomic)

REM occurs within 10 minutes of sleep
what happens to cortisol levels in sleep-deprived indivisuals
inc
lymphocyte levels dec
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
what form of conditioning is defined as a new response to an old stimulus resulting in consequence
operant
what pituitary hormone is inhibited during sleep
TSH
5-HT and prolactin inc during sleep
DA dec
base on operant conditioning, what type of reinforcement is described when...
1. adding a stimulus stops a behavior
2. removing a stimulus stops a behavior
3. adding a stimulus reinforces a behavior
4. removing a stimulus reinfores a
1. punishment
2. extinction
3. pos reinforcement
4. negative reinforcement
what is the formula to calculate IQ
Mental age/chronological age *100
what happens to NE levels in major depression?
bipolar disorder?
NE, 5-HT, and DA levels dec in major depression

NE, 5-HT, and DA levels inc in bipolar disorder
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 occuring 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
what classical conditioning therapy or modification is described as...
1. pairing noxious stimuli to an inappropriate behavior
2. forcing patients to confront their fears by being exposed to them until they are extinguished
3. triage of hi
1. aversive conditioning
2. exposure
3. systematic desensitization
failure to accurately recall the past leads to what form of bias
recall bias
-arise in a retrospective study

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