4TH BIMONTHLY RECALLS Flashcards
particularly which of the following amphetamine-like substances can dangerously exacerbate hypertension, precipitate a toxic psychosis, cause intestinal infarction, or result in death
ephedrine
pseudoephedrine
phenylpropanolamine (PPA)
none of the above
phenylpropanolamine (PPA)
increased risk of conversion disorder in dizygotic twin pairs has been reported
True
False
False
-MONOZYGOTIC DAPAT
The first biomarker identified in autism spectrum disorder was elevated ________ in whole blood, almost exclusively in the platelets
serotonin
dopamine
norepinephrine
none of the above
serotonin
a variant of somatic symptom disorder (hypochondriasis)
conversion disorder
illness anxiety disorder
panic disorder
functional neurological symptom disorder
illness anxiety disorder
characterized by 6 or more months of a general and non-delusional preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s misinterpretation of bodily symptoms
panic disorder
somatic symptom disorder
body dysmorphic disorder
conversion disorder
somatic symptom disorder
motor symptoms in conversion disorder
psychogenic
vomiting
opisthotonus
midline anesthesia
deafness
opisthotonus
Several studies have reported data consistent with the hypothesis that specific degeneration of cholinergic neurons is present in this area in persons with Alzheimer’s disease
locus ceruleus
nucleus basalis of Meynert
hippocampus
substancia nigra
nucleus basalis of Meynert
illness anxiety disorder is diagnosed more frequently in older rather than younger persons
True
False
True
the following symptoms are associated with poor prognosis in conversion disorder
blindness
aphonia
seizures
all of the above
seizures
principal component of cannabis is
Δ9-THC
11-hydroxy-Δ9-THC
Dronabinol
none of the above
Δ9-THC
more strongly indicate Alzheimer’s disease, although they are also seen in Down syndrome and, to some extent, in normal aging
amyloid plaques
neurofibrillary tangles
neuronal loss (particularly in the cortex and the hippocampus)
synaptic loss (perhaps as much as 50 percent in the cortex)
amyloid plaques
in conversion disorder, onset is generally from late childhood to early adulthood; rare before 10 years of age or after 35 years of age; onset as late as the ninth decade of life has been reported
True
False
True
sensory symptoms in conversion disorder
aphonia
anesthesia
paralysis
weakness
anesthesia
sensory deficits in conversion disorder
involuntary movements
midline anesthesia
blepharospasm
tics
midline anesthesia
in illness anxiety disorder, somatic symptoms are not present or, if present, are only mild in intensity
True
False
True
What is a drink?
20 g of ethanol
15 g of ethanol
12 g of ethanol
40 g of ethanol
12 g of ethanol
associated behavioral symptoms that may occur in autism spectrum disorder
disturbances in language development and usage
intellectual disability
irritability
all of the above
disturbances in language development and usage
psychiatric illness worsens cardiac morbidity and mortality in patients with a history of myocardial infarction, diminishes glycemic control in patients with diabetes, and decreases return to functioning in patients experiencing a stroke
True
Fals
True
good prognosis in somatic symptom disorder include
high socioeconomic status
treatment-responsive anxiety or depression
sudden onset of symptoms
all of the above
all of the above
Dementia refers to low
intellectual functional
mental retardation
cognitive decline from a previous level of functioning
all of the above
cognitive decline from a previous level of functioning
irritability in autism spectrum disorder includes
aggression
self-injurious behaviors
severe temper tantrums
all of the above
all of the above
most common method of using cocaine is
inhaling the finely chopped powder into the nose (“snorting” or “tooting”)
subcutaneous or intravenous injection
smoking (freebasing)
none of the above
inhaling the finely chopped powder into the nose (“snorting” or “tooting”)
in conversion disorder blindness
patients walk around without collisions or self-injury
their pupils react to light
cortical-evoked potentials are normal
all of the above
all of the above
in the general hospital, delirium occurs in 18 percent of patients
True
False
True
when symptoms suggest a conversion disorder onset in middle or old age, the probability of an occult neurological or other medical condition is high
True
False
True
psychodynamic explanation of illness anxiety disorder
A. aggressive and hostile wishes toward others are transferred into minor physical complaints or the
B. fear of physical illness
fear of illness is viewed as a request to play the sick role made by someone
C. facing seemingly insurmountable and insolvable problems
D. sick role offers an escape that allows a patient to be excused from usual duties and obligations
E. all of the above
A. aggressive and hostile wishes toward others are transferred into minor physical complaints or the
It is not uncommon for a child with autism spectrum disorder to appear deaf, at times showing little response to a normal speaking voice; on the other hand, the same child may show intent interest in the sound of a wristwatch
True
False
True
the second most common type of dementia
alzheimer’s type (alzheimer’s disease)
vascular
alcohol-related
movement disorder-related
vascular
psychiatric disorders are linked to nonadherence with antiretroviral therapy
True
False
True
a new diagnosis in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
illness anxiety disorder
somatic symptom disorder
conversion disorder
panic disorder
illness anxiety disorder
in conversion disorder, the gain is primarily social, monetary, or legal
True
False
False
PRIMARILY PSCHOLOGICAL AND NOT SOCIAL, MONETARY, LEGAL
being excused from obligations and difficult life situations, receiving support and assistance; controlling other persons’ behavior
la belle indifference
identification
secondary gain
primary gain
secondary gain
the following symptoms are associated with good prognosis in conversion disorder
tremors
seizures
paralysis
all of the above
paralysis
family members affected by or influencing the behavior of the substance abuser
Codependence
Dependence
Enabler
Addiction
Codependence
Tremulousness (commonly called the ―shakes‖ or the ―jitters‖) develops how many hours after the cessation of drinking?
6 to 8 hours
8 to 12 hours
12 to 24 hours
none of the above
6 to 8 hours
psychiatric disorders worsen the prognosis and quality of life of cancer patients
True
False
True
one of the major problems in diagnosing conversion disorder is the difficulty of definitively ruling out a medical disorder
True
False
True
repeated and increased use of a substance, the deprivation of which gives rise to symptoms of distress and an irresistible urge to use the agent again
Dependence
Addiction
Misuse
Abuse
Addiction
applies to persons who are preoccupied with being sick or with developing a disease of some kind
conversion disorder
somatic symptom disorder
generalized anxiety disorder
illness anxiety disorder
illness anxiety disorder
depressive disorders in the general hospital are more than twice as common, and substance abuse is two to three times as common
True
False
True
patients with somatic symptom disorder usually resist psychiatric treatment, some accept this treatment if it takes place in a medical setting and focuses on stress reduction and education in coping with chronic illness
True
False
True
the most common type of dementia
alcohol-related
movement disorder-related
vascular
alzheimer’s type (alzheimer’s disease)
alzheimer’s type (alzheimer’s disease)
keeping internal conflicts outside their awareness; symptoms have symbolic value; they represent an
unconscious psychological conflict
la belle indifference
primary gain
identification
secondary gain
primary gain
psychotherapy also plays an important role in psychosomatic medicine and may vary in its structure and outcomes as compared with therapy that occurs in a mental health practice
True
False
True
Autism spectrum disorders have been increasingly diagnosed over the last two decades, with the current prevalence estimated at approximately
1 percent
0.1 percent
15 percent
10 percent
1 percent
Medical and neurological disorders occur frequently in conversion disorder
True
False
True
biological factors in conversion disorder
A. classically conditioned learned behavior; symptoms of illness, learned in childhood, are called forth as a means of coping with an otherwise impossible situation
B. hypometabolism of the dominant hemisphere and hypermetabolism of the nondominant hemisphere;
impaired hemispheric communication
C. repression of unconscious intrapsychic conflict and conversion of anxiety into a physical symptom
D. all of the above
B. hypometabolism of the dominant hemisphere and hypermetabolism of the nondominant hemisphere;
impaired hemispheric communication
sensory symptoms in conversion disorder
deafness
astasia-abasia
weakness
falling
deafness
conversion disorder was originally combined with the syndrome known as somatization disorder and was referred to as
hysteria
conversion reaction
dissociative reaction
all of the above
all of the above
motor symptoms in conversion disorder
pseudocyesis
astasia-abasia
tunnel vision
blindness
astasia-abasia
6-month prevalence of illness anxiety disorder
4 to 6 percent
25 percent
50 percent
1 percent
4 to 6 percent
psychoanalytic factors in conversion disorder
A. classically conditioned learned behavior; symptoms of illness, learned in childhood, are called forth as a means of coping with an otherwise impossible situation
B. hypometabolism of the dominant hemisphere and hypermetabolism of the nondominant hemisphere;
C. impaired hemispheric communication
D. repression of unconscious intrapsychic conflict and conversion of anxiety into a physical symptom
E. all of the above
D. repression of unconscious intrapsychic conflict and conversion of anxiety into a physical symptom
regarding motor symptoms in conversion disorder
patients rarely fall; they are generally not injured
distribution of the involved muscles does not conform to the neural pathways
reflexes remain normal
all of the above
all of the above
inappropriately cavalier attitude toward serious symptoms; the patient seems to be unconcerned about what appears to be a major impairment
secondary gain
la belle indifference
primary gain
identification
la belle indifference
delirium was associated with worse outcomes after surgery, even after controlling for severity of medical illness
True
False
True
repeated use of a drug or chemical substance, with or without physical dependence
Dependence
Abuse
Misuse
Codependence
Dependence
The prevalence of moderate to severe dementia in the general population older than 65 years of age is approximately
15 to 20 percent
50 percent
20 to 40 percent
5 percent
5 percent
a frequent sleep problem among children and adolescents with autism spectrum disorder, estimated to occur in 44 to 83 percent of school-aged children
insomnia
hypersomnia
nightmares
none of the above
insomnia
somatic symptom disorder reportedly occur in about 3 percent of medical students, usually in the first 2 years and they are generally chronic
True
False
True
conversion finding when patient with severe bilateral blindness is instructed to look at his/her hand
patient flinches
patient does not look there
patient looks at hand
none of the above
patient does not look there
wildly ataxic, staggering gait accompanied by gross, irregular, jerky truncal movements and thrashing and waving arm movements
globus hystericus
pseudocyesis
opisthotonus
astasia-abasia
astasia-abasia
6-month prevalence of somatic symptom disorder
4 to 6 percent
1 percent
25 percent
50 percent
4 to 6 percent
motor symptoms in conversion disorder
tunnel vision
blindness
anesthesia
tics
tics
an illness of symptoms or deficits that affect voluntary motor or sensory functions
illness anxiety disorder
panic disorder
functional neurological symptom disorder (conversion disorder)
somatic symptom disorder
functional neurological symptom disorder (conversion disorder)
thought, judgment, and restraint are loosened and sometimes disrupted with this blood alcohol
concentration
0.2%
0.3%
0.1%
0.05%
0.05%
associated with long-term heavy use of cannabis and has been characterized by a person’s unwillingness to persist in a task—be it at school, at work, or in any setting that requires prolonged attention or tenacity
Cannabis Intoxication Delirium
Cannabis Withdrawal
amotivational syndrome
Cannabis-Induced Anxiety Disorder
amotivational syndrome
differential diagnosis of somatic symptom disorder include
medical conditions
illness anxiety disorder
panic disorder
all of the above
all of the above
motor symptoms in conversion disorder
diarrhea
torticollis
urinary retention
globus hystericus
torticollis
somatic symptom disorder most commonly appears in persons
40 to 50 years of age
20 to 30 years of age
50 to 60 years of age
60 to 70 years of age
20 to 30 years of age
personality disorders co-morbid with conversion disorder
borderline
passive-dependent
schizotypal
antisocial
passive-dependent
sensory deficits in conversion disorder
opisthotonus
blindness
abnormal gait
seizures
blindness
in the context of neurodegenerative disease such as Parkinson’s or Alzheimer’s, depression, psychosis,
and behavioral disturbances are significant predictors of functional decline, institutionalization, and caregiver burden
True
False
True
usually applies to drug prescribed by physicians that are not used properly
Misuse
Codependence
Dependence
Abuse
Misuse
Hyperactivity and inattention are both common behaviors in young children with autism spectrum
disorder
True
False
True
core symptoms of autism spectrum disorder include
a. persistent deficits in social communication and interaction
b. restricted, repetitive patterns of behavior, interests, and activities
c. both of the above
c. both of the above
conversion disorder suggests another medical condition, but is judged to be caused by psychological
factors because the illness is preceded by conflicts or other stressors
True
False
True
which of the following statements regarding treatment approach to somatic symptom disorder is false
a. frequent, regularly scheduled physical examinations help to reassure patients that their physicians are not abandoning them and that their complaints are being taken seriously
b. invasive diagnostic and therapeutic procedures should only be undertaken when objective evidence calls for them
c. the clinician should always treat equivocal or incidental physical examination findings
d. all of the above
c. the clinician should always treat equivocal or incidental physical examination findings
social learning model for illness anxiety disorder
a. sick role offers an escape that allows a patient to be excused from usual duties and obligations
b. anger of patients with illness anxiety disorder originates in past disappointments, rejections, and losses
c. fear of illness is also viewed as a defense against guilt, a sense of innate badness, an expression of low self -
esteem, and a sign of excessive self-concern
d. all of the above
d. all of the above
most common conversion disorder symptoms
paralysis, blindness, and mutism
seizures, anesthesia, diarrhea
astasia-abasia, seizures, pseudocyesis
none of the above
paralysis, blindness, and mutism
pseudoseizures in conversion disorder are difficult to differentiate from an actual seizure by clinical observation
True
False
True
in conversion disorder, ratio of women to men among adult patients is at least 2 to 1 and as much as 10 to
True
False
True
personality disorders co-morbid with conversion disorder
paranoid
schizoid
histrionic
schizotypal
histrionic
patients unconsciously model their symptoms on those of someone important to them
identification
primary gain
secondary gain
la belle indifference
identification
large group of organic molecules that have a hydroxyl group (-OH) attached to a saturated carbon atom
amphetamine
methamphetamine
alcohol
delta-9-tetrahydrocannabinol
alcohol
Some children with autism spectrum disorder vocalize noises—clicks, screeches, or nonsense syllables— in a stereotyped fashion, without a seeming intent of communication
True
False
True
1.
psychiatric disorders are also linked to nonadherence with safe sex guidelines and with use of sterile needles in HIV-infected injection drug users
True
False
True
patients in the general hospital have the highest rate of psychiatric disorders when compared with
community samples or patients in ambulatory primary care
True
False
True
1.
diagnosis may also be used for persons who do, in fact, have a medical illness but whose anxiety is out of proportion to their diagnosis and who assume the worst possible outcome imaginable
somatic symptom disorder
illness anxiety disorder
conversion disorder generalized anxiety disorder
illness anxiety disorder
1.
use of any drug in a manner that deviates from approved social or medical patterns
Dependence
Codependence
Abuse
Misuse
Abuse
most common physical effects of cannabis
dysregulation of menstrual cycles dilation of the conjunctival blood vessels (red eye) and mild tachycardia
dry mouth
depersonalization and derealization
dilation of the conjunctival blood vessels (red eye) and mild tachycardia
By about age 5 years, 15 to 20 percent of children with autism spectrum disorder developed macrocephaly
True
False
True
in conversion disorder, all sensory modalities can be involved; distribution of the disturbance is inconsistent with either central or peripheral neurological disease
True
False
True
1.
differential diagnosis for illness anxiety disorder include
conversion disorder
somatic symptom disorder generalized anxiety disorder
all of the above
all of the above
Course and prognosis of illness anxiety disorder may extrapolate from the course of somatic symptom disorder, which is usually episodic
True
False
True
1.
in somatic symptom disorder, beliefs are not sufficiently fixed to be delusions
True
False
True???
depression is both a risk factor and a poor prognostic indicator in coronary artery disease
True
False
True
learning theory in conversion disorder states that symptoms are/ results from:
a) classically conditioned learned behavior; symptoms of illness, learned in childhood, are called forth as a means of coping with an otherwise impossible situation
b) hypometabolism of the dominant hemisphere and hypermetabolism of the nondominant hemisphere; impaired hemispheric communication
c) repression of unconscious intrapsychic conflict and conversion of anxiety into a physical symptom -
d) all of the above
a) classically conditioned learned behavior; symptoms of illness, learned in childhood, are called forth as a means of coping with an otherwise impossible situation
conversion finding when examiner drops paralyzed hand onto face
hand falls next to face, not on it
hands falls on face hand stays, does not fall
none of the above
hand falls next to face, not on it
men and women are equally affected by somatic symptom disorder
True
False
True
function of entire motor area of the brain is measurably depressed and the parts of the brain that control emotional behavior are also affected
0.05%
0.1%
0.2%
2.0.3%
0.2%
at this blood alcohol concentration, voluntary motor actions usually become perceptibly clumsy
a. 0.05%
b. 0.1%
c. 0.2%
d. 0.3%
b. 0.1%
at this blood alcohol concentration, a person is commonly confused or may become stuporous
a. 0.05%
b. 0.1%
c. 0.2%
d. 0.3%
d. 0.3%
at this blood alcohol concentration, a person is falls into a coma
a. 0.4-0.5%
b.1%
c. 2%
d. 3%
a. 0.4-0.5%
late onset, more evidence of psychological than of physical dependence and the presence of guilt feelings
a. type 1, male-limited variety of alcohol dependence
b. type 2, male-limited varoety of alcohol dependece
a. type 1, male-limited variety of alcohol dependence
As a conservative approach to identify blood levels that are likely to have major effects on driving abilities, the legal definition of intoxication in most states in US requires a blood concentration of 80 or 100 mg ethanol per deciliter of blood (mg/dL) which is the same as
0.08 to 0.10 g/dL
12 g/dl
8-10 g/dl
1-2 g/dl
0.08 to 0.10 g/dL
In alcohol withdrawal, the psychotic and perceptual symptoms begin how many hours after the cessation of drinking
a. 8-12 hours
b. 12-24 hours
c. first 72 hours
d. none of the above
a. 8-12 hours
In alcohol withdrawal, seizures begin how many hours after the cessation of drinking
a. 8-12 hours
b. 12-24 hours
c. first 72 hours
d. none of the above
b. 12-24 hours
In alcohol withdrawal, delirium tremens begin how many hours after the cessation of drinking
a. anytime during the first 72 hours
b. 8-12 hours
c. 12-24 hours
d. none of the above
a. anytime during the first 72 hours
primary medication to control alcohol withdrawal symptoms are the
a. benzodiazepines
b. antipsychotic
c. mood stabilizers
d. selective serotonin reuptake inhibitors
a. benzodiazepines
psychodynamic factors in the etiology of substance abuse include
a. substance abuse is a masturbatory equivalent
b. drug use can be viewed as behavior maintained by its consequences
c. the dopaminergic neurons in the ventral tegmental area are particularly important
d. drugs can reinforce antecedent behaviors by terminating some noxious or aversive state such as paon, anxiety, or depression
a. substance abuse is a masturbatory equivalent
learning and conditioning theories of substance abuse include
a. defense against anxious impulses
b. manifestation of oral regression
c. reflection of disturbed ego function
d. drug use can be viewed as behavioral maintained by its consequences
d. drug use can be viewed as behavioral maintained by its consequences
consequences of Cannabis Use Disorder that is considered rare
a. cannabis intoxication
b. cannabis withdrawal
c. cannabis induced psychotic disorder
d. alzheimer’s disease
c. cannabis induced psychotic disorder
also called alcoholic encephalopathy, is an acute neurological disorder characterized by ataxia affecting primarily the gait, vestibular dysfunction, confusion and a variety of ocular motility abnormalities, including horizontal nystagmus, lateral orbital palsy, and gaze palsy
a. wernickes encephaloptahy
b. korsakoffs syndrome
c. delirium tremens
d. amotivational syndrome
a. wernickes encephaloptahy
