Diagnoses - OCD (and related)

Question 1

A genetic susceptibility for OCD is suggested by evidence that there is a familial link with (4x)

Answer 1

TIC DISORDERS

Question 2

Principal behavioral technique for OCD (4x)

Answer 2

EXPOSURE & RESPONSE PREVENTION

Question 3

What is the most common pattern of obsessions in pts with OCD? (x2)

Answer 3

CONTAMINATION

Question 4

25 y/o with OCD diagnosed 2 years ago is likely to benefit from what medicine (in addition to psychotherapy)? (2x)

Answer 4

CLOMIPRAMINE

Question 5

A 20 year old male pt presents to his physician for a physical examination because he is worried that he may have contracted an infectious disease. He states that his worry is interfering with his ability to complete work assignments. He states that he counts to 100 repetitively in order to distract himself from this worry. He has no prior medical or psychiatric history. He does not abuse substances and is not involved in any relationships. Which of the following regions of the pt’s brain is most likely to show increased activity on PET scan? (2x)

Answer 5

CAUDATE

Question 6

Name for tics comprised of obscene gestures (2x)

Answer 6

COPROPRAXIA

Question 7

Neurosurgical approach that treats refractor OCD targets what structure?

Answer 7

CORTICO-STRIATAL-THALAMO-CORTICO- CIRCUITRY

Question 8

Difference between childhood onset OCD and adult onset

Answer 8

PSYCHIATRIC COMORBIDITY BURDEN IS GREATER

Question 9

Pt with OCD resistant to entering treatment is a candidate for:

Answer 9

MOTIVATIONAL INTERVIEWING

Question 10

According to DSM-IV-TR, compulsive skin picking would be:

Answer 10

IMPULSE CONTROL D/O NOS

Question 11

Episodic OCD with variable severity of Sxs, independent of Tx, is more common in:

Answer 11

BIPOLAR MOOD DISORDER

Question 12

Which TCA has consistently been found to be useful in long term treatment and relapse prevention of OCD?

Answer 12

CLOMIPRAMINE

Question 13

Repetitive behaviors that the pt feels compelled to perform ritualistically, while recognizing the irrationality and absurdity of the behaviors, describes:

Answer 13

COMPULSIONS

Question 14

Persistently intrusive inappropriate idea, thought, impulse, or image that causes marked distress is

Answer 14

OBSESSION

Question 15

Pt w OCD started on 100mg sertraline, at 4 week f/u increased to 150mg b/ o no response. Week 10, pt reported no improvement. Next step?

Answer 15

INCREASE SERTRALINE TO 200MG

Question 16

Hx of OCD, Zoloft only partially effective. Next:

Answer 16

TRY ANOTHER SSRI

Question 17

What is an effective treatment for obsessive compulsive disorder?

Answer 17

ESCITALOPRAM

Question 18

Anterior capsulotomy and/or cingulotomy are indicated and demonstrated effective for pts with what severe incapacitating disorder?

Answer 18

OCD

Question 19

Pt is hoarding, home filled with filth, acknowledges she is keep a lot of things (hoarding)

Answer 19

HOARDING DISORDER

Question 20

Which condition is least likely to respond to hypnosis?

Answer 20

OCD

Question 21

40 y/o pt complains of repetitive, continuous hand-washing throughout day to the point of chafing skin. Pt denies fear of germs or any obsessive thoughts, cannot explain continuous washing. Dx?

Answer 21

OCD

Question 22

Psych MD asks a patient, “are there things you must do in a particular way or order?”which this question, psych MD is trying to elicit?

Answer 22

COMPULSIONS

Question 23

Man obsesses about killing his g/f. Instead of killing, picks his face w/ a pin. Medication:

Answer 23

FLUVOXAMINE

Question 24

Pt with contamination fears and hand washing rituals is treated with response prevention combined with:

Answer 24

EXPOSURE THERAPY

Question 25

35 M w/ severe OCD, failed multiple meds, CBT and ECT, what next?

Answer 25

CINGULOTOMY

Question 26

What condition is frequently associated with OCD?

Answer 26

TOURETTE SYNDROME

Question 27

What statement reflects current thinking about neurological procedures for intractable OCD?

Answer 27

AT PRESENT, THERE IS LITTLE EVIDENCE TO SUGGEST THAT ANY ONE PROCEDURE IS SUPERIOR TO ANOTHER.