Exam 3

Question 1

*How is avoidant personality different from social phobia?

Answer 1

Social phobia: intense fear of social situations, fear arises when individual believes that they may be judged, scrutinized or humiliated by others. (They are Aware of the anxiety/fear)

Avoidant personality: social inhibition, feelings of inadequacy and hypersensitivity to negative evaluations (wants to be left alone)

Question 2

What is the most efficacious treatment for personality disorders?

Answer 2

Therapy
SSRI & SNRI
Antidepressants, mood stabilizer, low dose of antipsychotic

Nb: avoid benzos & ECT

Question 3

*How is obsessive Compulsive Disorder different from Obsessive compulsive Personality Disorder?

Answer 3

OCD
Inherently distressing
Excessive time taken up due to compulsion
Happy for others to take over

OCPD
Distress not present as preoccupations seen as desirable
Perfectionism interfere with task completion
Reluctant to delegate
Misery/unable to discard
Over conscientious, inflexible about morality,ethics, values

Question 4

What is the most useful treatment for persons with borderline personality disorder?

Answer 4

Therapy:- DBT

NB: avoid short acting benzos

Question 5

What is dialectical behavioral therapy (DBT)? How is it managed?

Answer 5

DBT: treat border personality disorders (BPD) and those who struggle with self harm or chronic thoughts of suicide.

It is a type of talk therapy for ppl who experience emotions very intensely

Question 6

Impulsivity and self-injury is most common with _____ personality disorder?

Answer 6

Borderline

Question 7

Persons with BPD often report a history of ____ as children

Answer 7

Distractive Mood Dysregulation Disorder (DMDD)

Question 8

*What is a primary goal on the acute care unit for a person with anorexia nervosa?

Answer 8

Gain weight and nutrition

Question 9

*What antidepressant is contraindicated for persons with eating disorders and why?

Answer 9

Bupropion (Wellbutrin)
Due to increased risk of seizures

Question 10

What is the efficacy rate of stimulants for managing ADHD?

Answer 10

70-80%

Question 11

What non-stimulant medications are used for the treatment of ADHD?

Answer 11

*Bupropion
clonidine, guanfacine
*Strattera (atomoxetine)

Question 12

Important teaching point for parents of children on stimulant medications for ADHD include?

Answer 12

SE:
Insomnia
Anorexia
Weight loss
Tachy (^HR)
Decrease growth rate

NB: do not give child drug during holiday, monitor for cardiac events cause psychiatric symptoms may worsen

Question 13

*What are the signs and symptoms of ADHD, and intellectual disability?

Answer 13

ADHD:
Inattention, impulsiveness, & hyperactivity
Highly distracted, limited attention span, impulsivity

Intellectual disability or intellectual development disorder (IDD):
Onset prior to age of 18
Impairment intellectual performance and adaptive skills

Question 14

*What must be identified before a determine that a patient is malingering?

Answer 14

Secondary gain eg conscious fabrication or exaggeration of illness symptoms

Question 15

What are common secondary gains associated with malingering?

Answer 15

Insurance fraud
Meds
Avoid prison or military service

Question 16

What is the primary goal of the person who has factitious disorder (Muchausen’s Syndrome)

Answer 16

Assuming a sick role
By wanting attention, person will go into extreme lengths in harming

Question 17

What is sleep hygiene?

Answer 17

Go to bed at the same time each night, get up at same tome each morning, including weekends, quite dark bedroom

Question 18

What medications are used for the treatment of insomnia?

Answer 18

ramelteon–improves meltonia

Question 19

*What are the Z-hypnotics?

Answer 19

Recommended only after other interventions and prescribed for short amount of time
Eg zolpidem & ambien

Question 20

*What are common laboratory findings in persona with Anorexia Nervosa?

Answer 20

Severe dehydration
Low blood glucose
Hypochloremia/kalemia
Metabolic acidosis
Hyponatremia