WAPCP Part I flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Nigrostriatal pathway

Dopamine tract from substantia nigra to striatum. D2 blockade here produces extrapyramidal symptoms, akathisia, and tardive dyskinesia.

Tuberoinfundibular pathway

Dopamine tract from hypothalamus to anterior pituitary. Blockade removes tonic prolactin inhibition, causing hyperprolactinemia, galactorrhea, amenorrhea, and sexual dysfunction.

Kindling model

Repeated subthreshold limbic stimulation progressively lowers seizure threshold. Used to explain bipolar illness progression and rationale for early mood stabilization.

Dexamethasone suppression test

Dexamethasone normally suppresses cortisol via negative feedback. Nonsuppression reflects HPA axis dysregulation, seen in a subset of melancholic depression.

Heritability of schizophrenia

Roughly 60 to 80 percent based on twin studies. Monozygotic concordance is about 40 to 50 percent, so environmental factors remain substantial.

Flight of ideas

Rapid, continuous speech with frequent topic shifts, often with understandable associations and punning. Characteristic of mania and sometimes mixed states.

Tangentiality

Replies drift away from the question and the original goal is never reached. Differs from circumstantiality, where the goal is eventually regained.

Overvalued idea

Understandable, ego-syntonic belief held with less conviction than a delusion and responsive to contrary evidence. Common in personality disorders and cultural contexts.

Thought broadcasting

Schneiderian first-rank symptom in which the patient believes thoughts escape and are accessible to others. Suggests psychotic illness, often schizophrenia.

Insight in mental state exam

Awareness of illness, need for treatment, and correct attribution of symptoms. Poor insight predicts nonadherence, relapse, and involuntary treatment.

Clozapine indication

Treatment-resistant schizophrenia after two adequate antipsychotic trials, or persistent suicidality in schizophrenia. Requires regular absolute neutrophil count monitoring for agranulocytosis.

Serotonin syndrome triad

Altered mental status, autonomic instability, and neuromuscular hyperactivity such as clonus and hyperreflexia. Caused by serotonergic drug combinations; stop offending agents.

Neuroleptic malignant syndrome

Severe rigidity, hyperthermia, autonomic instability, and elevated creatine kinase after dopamine blockade. Treatment is drug cessation, supportive care, dantrolene, or bromocriptine.

Lithium therapeutic range

Serum level approximately 0.6 to 1.2 mEq/L for maintenance. Toxicity risk increases with dehydration, NSAIDs, thiazides, ACE inhibitors, and renal impairment.

Valproate pregnancy risk

First-trimester exposure raises neural tube defect risk. Avoid in women of childbearing potential unless alternatives fail; supplement folate and monitor levels.

SSRI discontinuation syndrome

Dizziness, paresthesias, nausea, and flu-like symptoms after abrupt cessation. More likely with short half-life agents such as paroxetine and venlafaxine.

ECT indications

Severe melancholic depression, catatonia, life-threatening illness in pregnancy, and treatment-resistant psychosis. Cognitive effects are usually transient.

Assertive Community Treatment

Multidisciplinary team with low caseloads, frequent outreach, and 24-hour availability. Targets high service utilizers with severe mental illness to reduce hospitalization.

Individual Placement and Support

Supported employment model with rapid competitive job search, integration with treatment, and time-unlimited support. Strong evidence for competitive employment outcomes.

Housing First model

Provides unconditional housing without sobriety or treatment prerequisites. Reduces homelessness and emergency service use compared with treatment-first approaches.

Recovery model principles

Hope, person-centered care, empowerment, peer support, and community inclusion. Emphasizes functioning and meaning rather than symptom elimination alone.

Community treatment order

Statutory mechanism for involuntary outpatient treatment with defined conditions and review. Requires legal authority and periodic reassessment of criteria.

Cognitive behavioral model

Situations trigger automatic thoughts that shape emotion and behavior. Therapy targets cognitive distortions and avoidance using restructuring, exposure, and behavioral experiments.

Behavioral activation

Structured activity scheduling and monitoring to increase environmental reinforcement. Comparable efficacy to full CBT for depression and simpler to deliver.

Exposure therapy principles

Prolonged, repeated contact with feared stimuli without safety behaviors. Produces habituation and inhibitory learning; core treatment for anxiety disorders and OCD.

Dialectical behavior therapy

Skills training in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Targets self-harm and therapy-interfering behavior in borderline personality disorder.

Motivational interviewing

Person-centered counseling for ambivalence. Uses open questions, affirmations, reflections, and summaries while eliciting change talk rather than confrontation.

Informed consent capacity

Four abilities: understanding information, appreciating relevance to self, reasoning about options, and communicating a choice. Assessed per decision, not globally.

Duty to protect

Obligation to warn or protect identifiable third parties from serious threatened harm, including notifying the person or authorities. Scope varies by jurisdiction.

Dusky fitness standard

Defendant must understand proceedings and assist counsel with a reasonable degree of rational understanding. Concerns present capacity, not mental state at the offense.

Psychiatric advance directive

Document stating treatment preferences and surrogate decision-makers for future periods of incapacity. Supports autonomy and can guide involuntary treatment decisions.

Boundary violation

Exploitation of the fiduciary relationship for clinician benefit, such as sexual contact or financial involvement. Distinct from boundary crossings, which may be benign.