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First Aid USMLE Step 1: Psychiatry Questions with
Detailed Verified Answers (100% Correct Answers)
/Already Graded A+
Transference?
Ans: Patient projects feelings about formative or other important persons
onto physician.
Countertransference?
Ans: *Doctor* projects feelings about formative or other important persons
onto patient.
What is the central goal of Freudian psychoanalysis?
Ans: Make patient aware of what is hidden in his/her unconsciousness.
*Primal* urges (food, sex, aggression)
– “Drives” instinct
– Entirely subconcious
Ans: ID
*Mediator* between primal urges and behavior accepted in reality
Ans: ego
Moral values, *conscience*, can lead to self-blame and attacks on ego
Ans: super ego
Thoughts and behaviors voluntary or involuntary that are used to resolve
conflict and prevent undesirable feelings ( anxiety depression)
Ans: EGO Defenses
12 y/o girl dies her hair purple after her parents ground her
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Ans: Acting out
Ego Defense: Acting Out
Ans: Unacceptable feelings and thoughts are expressed through actions.
*Tantrums*
Temporary drastic change in personality, memory, consciousness or motor
behavior to avoid emotional stress.
Ans: Dissociation
Extreme forms of Dissociation can result in
Ans: Extreme forms *can result in dissociative identiy disorder* (multiple
personality disorder).
A patient with cancer schedules a full 40 hour work week despite her
Oncologist telling her that she is going to be very fatigued and sick during
treatment
Ans: Denial
Denial
Ans: Avoidance of awareness of some painful reality.
Process whereby *avoided ideas and feelings are transferred to some
NEUTRAL PERSON or OBJECT
Ans: Displacement
Mother places blame on child because she is angry with husband.
Ego Defense: Fixation
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Ans: Partially remaining at a more childish level of development vs.
regression.
Men fixating on sports games.
Ego Defense: Identification
Ans: Modeling behavior after another person who is more powerful
(*though not necessarily admired*).
Abused child identifies himself/herself as an abuser.
Ego Defense: Isolation of affect
Ans: *Separation of feelings* from ideas and events.
Describing murder in graphic detail with no emotional response.
Ego Defense: Projection
Ans: An unacceptable internal impulse is attributed to an external source.
A man who wants another woman thinks his wife is cheating on him.
Ego Defense: Rationalization
Ans: Proclaiming logical regions for actions actually performed for other
reasons; usually to avoid self blame.
After getting fired, claiming that the job was not important anyway.
Ego Defense: Reaction formation
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Ans: Process whereby a warded-off idea or feeling is replaced by an
unconsciously derived emphasis on its opposite.
Patient with libidinous thoughts enters a monastery.
Ego Defense: Regression
Ans: Turning back the maturational clock and going back to earlier modes
of dealing with the world.
Seen in *children under stress (bedwetting)* and in patients on dialysis
(crying)
Ego Defense: Repression
Ans: Involuntary witholding an idea or feeling from consciousness
awareness.
Not remembering a conflictual or traumatic experience.
Ego Defense: Splitting
Ans: Belief that people are either all good or all bad at different times due
to intolerance of ambiguity. *Seen in borderline personality disorder.*
Patient that says all nurses are cold and insensitive but that the doctors are
warm and friendly.
What are the mature/less primitive ego defenses?
Ans: Sublimation, Altruism, Suppression, Humor
Ego Defense: Sublimation
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Ans: Process whereby one replaces an unacceptable wish with a course of
action that is similar to the wish but does not conflict with one’s value
system.
Actress uses experience of abuse to enhance her acting.
Ego Defense: Altruism
Ans: Guilty feeling alleviated by unsolicited generosity towards others.
Mafia boss makes large donation to charity.
Ego Defense: Suppression
Ans: Voluntary withholding of an idea or feeling from conscious awareness
(vs. repression).
Choosing not to think about the USMLE until the week of the exam.
Ego Defense: Humor
Ans: Appreciating the amusing nature of an anxiety-provoking or adverse
situation.
Nervous medical student jokes about the boards.
What are effects of long-term deprivation of affection in infants?
