Final exam (all quizes) Flashcards
(165 cards)
1
Q
Thinking about PTSD and Acute Stress Disorder, in what way is an individual exposed to a traumatic event? Repeated extreme exposure to the situation, for example, an EMT. (Does not include exposure via media, unless work-related.)
a. Learning (secondhand) that the event occurred to a close friend or family member.
b. Witnessing the traumatic event.
c. Directly experiencing the traumatic event.
d. All of the Above
A
All of the Above
2
Q
The following is not a mental disorder, (but often mistaken as one,) and therefore cannot be assigned a DSM-5 code. However, it may be present in any anxiety disorder, some depressive disorders, PTSD, and substance-use disorders. What am I referring to? A. Flashbacks B. Perfectionist Tendencies C. Compulsions D. Panic Attack
A
D. Panic Attack
3
Q
Fear of spiders, airplanes, clowns, hurricanes, and/or elevators are examples of specific phobias; it is common for individuals to present with more than one specific phobia, simultaneously.
a. True
b. False
A
a. True
4
Q
The cause of Hoarding Disorders is well documented. It mostly effects the worlds’ elderly population, and is a direct result of experiencing a chaotic childhood, having perfectionist tendencies, and exhibiting difficulty making decisions.
a. True
b. False
A
b. False
5
Q
It is clinically proven that Pharamcotherapy can stop dissociation, derealization, and remove the presence of multiple identities.
a. True
b. False
A
b. False
6
Q
An individual who chronically presents with one or more excessively distressing, physical symptoms or health concerns.
a. Somatic Symptom Disorder
b. Illness Anxiety Disorder
c. Factitious Disorder
d. Conversion Disorder
e. Malingering
A
a. Somatic Symptom Disorder
7
Q
The preoccupying fear and worry that one has a serious illness.
a. Somatic Symptom Disorder
b. Illness Anxiety Disorder
c. Factitious Disorder
d. Conversion Disorder
e. Malingering
A
b. Illness Anxiety Disorder
8
Q
A desire to present as ill, therefore intentionally fabricating ones’ signs and symptoms.
a. Somatic Symptom Disorder
b. Illness Anxiety Disorder
c. Factitious Disorder
d. Conversion Disorder
e. Malingering
A
c. Factitious Disorder
9
Q
One of more symptoms of altered motor or sensory function, though not intentionally or consciously altering
a. Somatic Symptom Disorder
b. Illness Anxiety Disorder
c. Factitious Disorder
d. Conversion Disorder
e. Malingering
A
d. Conversion Disorder
10
Q
Fabricating symptoms or creating a situation for a secondary gain/external incentive.
a. Somatic Symptom Disorder
b. Illness Anxiety Disorder
c. Factitious Disorder
d. Conversion Disorder
e. Malingering
A
e. Malingering
11
Q
As a PA, it is important to ask if your patient has experienced a traumatic event, as symptoms of PTSD (note, NOT full diagnostic criteria - just strains and characteristics of symptoms) are similarly depicted in ALL but the following diagnosis: (Select one answer that is not a differential diagnosis for PTSD.) A. Substance Use Disorders B. Psychotic Disorder C. Body Dysmorphic Disorder D. Anxiety and Panic Disorders E. Major Depressive Disorder F. Conversion Disorder G. Dissociative Disorders H. Adjustment Disorder I. Personality Disorders J. Traumatic Brain Injury
A
C. Body Dysmorphic Disorder
12
Q
An individual can display the following characteristics, and not have a diagnosis of Anorexia Nervosa. 1) Experiencing significant weight loss, 2) Denying oneself lack of nutrients on a consistent basis, 3) Unable to concentrate in class and marked interfere with psychosocial functioning, 4) preoccupied with the aversive consequences of eating and a general lack of interest in food.
What would be a more fitting diagnosis for this patient?
A. Rumination Disorder
B. Bulimia
C. Binge Eating Disorder
D. Avoidant/Restrictive Food Intake Disorder
A
D. Avoidant/Restrictive Food Intake Disorder
13
Q
Select the clinical disorder below in which an individual presents with excessive fear or anxiety that is developmentally inappropriate, and which concerns the separation from those whom the individual is attached. A. Separation Anxiety Disorder B. Agoraphobia C.Specific Phobia D. Social Anxiety Disorder
A
A. Separation Anxiety Disorder
14
Q
Dissociative Identity Disorder used to be known as Multiple Personality Disorder.
a. True
b. False
A
a. True
15
Q
Please make one selection that is true about Dissociative Identity Disorders (DID).
A. DID may be caused by significant physical or sexual trauma, often during childhood .
B. The core personality in DID typically lacks awareness of the altar personalities, but the other personalities maintain awareness of each other.
C.Identity switches within DID may be triggered by the trauma itself, subsequent microtraumas, removal from the abuse of environment, or death of an abuser.
D. DID involves subjectively experiencing fragmentations of the self into distinct identities.
E. All of the above.
A
E. All of the above.
16
Q
Fragmentation of identity and derealization are Positive Dissociative Symptoms, whereas amnesia, inability to access information, and inability to control mental functions that normally are readily amenable to access and control, are considered Negative Dissociative Symptoms.
a. True
b. False
A
a. True
17
Q
2 weeks after a natural disaster hits a community, one individual begins to experience clinically significant emotional and behavioral symptoms, causing significant functional limitations in work, school, and in areas of daily living, not accounted for by another mental disorder. These symptoms persist for 5 months, before the individual begins to experience some relief through working with a therapist. What is the most likely diagnosis for this individual? A. Adjustment Disorder B. Reactive Attachment Disorder C.Posttraumatic Stress Disorder D. Acute Stress Disorder
A
A. Adjustment Disorder
18
Q
Trichotillomania, the recurrent pulling out of one's hair resulting in hair loss and clinical distress, and with repeated attempts to stop the hair pulling, is classified as a: A. Anxiety Disorder B. Trauma and Stressor-Related Disorder C.Elimination Disorder D. Obsessive-Compulsive and Related Disorder E. Dissociative Disorder F. Eating and Feeding Disorder G.Somatic Symptom and Related Disorder
A
D. Obsessive-Compulsive and Related Disorder
19
Q
It is a cold March day in Boston. Zoe reports that she started a graduate program this past Fall that is accelerated and very intense. She reports she sleeps very little (due to staying up late studying for exams, and worrying about her performance in her program.) Zoe adds that she experiences near constant tension/muscle pain in her upper body and back, and states the pain and lack of sleep make it hard for her to pay attention in class. Zoe reports that on her last few exams, her mind has gone blank and she "freezes". She reports she then begins to cry in class, as she knows she is wasting precious time and fears she will fail the exam and get kicked out of the program. Zoe stated that her mother, a non-native speaker, is disabled and Zoe is in charge of caring for her two adolescent brothers at home and communicating with their school. Zoe begins to tear up in front of you, as she mentions the cost of her program and the failure she perceives she will bring upon her family if she were to "flunk out". Zoe adds that she barely passed her Fall classes, and spent the winter break worried about getting her Spring schedule set up so she can be a successful student. Zoe adds she is exhausted all the time, as she commutes 40 min to and from home, has to cook for her family, tend to the household, AND do school. What is the most accurate diagnosis you would give Zoe, given the information you have at this time? A. Panic Disorder B. Major Depressive Disorder (MDD) C.Persistent Depressive Disorder D. Generalized Anxiety Disorder (GAD)
A
D. Generalized Anxiety Disorder (GAD)
20
Q
Hypnosis is a recommended treatment for which disorder? (Please select the best answer, based on what you learned during class, and not based on what you might find from outside research.) A. Narcolepsy B. Anorexia Nervosa C.Obsessive Compulsion Disorder D. Dissociative Identity Disorder
A
D. Dissociative Identity Disorder
21
Q
An often irritable child who rarely seeks or responds to comfort when distressed, as the child has bounced from one foster home to another - never able to form a stable, securely attached relationship with a caregiver, may be exhibiting characteristics of which disorder? A. Reactive Attachment Disorder B. Intermittent Explosive Disorder C.Adjustment Disorder D. Autism Spectrum Disorder
A
A. Reactive Attachment Disorder
22
Q
Recently, Allie has begun to engage in self-induced vomiting as she can not stand the way she looks in the mirror. Though quite thin, Allie strives to “fit in” and tries to eat dinner with her friends each evening. Directly after eating, Allie fears if she does not immediately rid herself of “dinner” she will become overweight. What is the most likely diagnosis Allie is experiencing?
A. Other Specified Feeding or Eating Disorder - Atypical anorexia nervosa
B. Unspecified Feeding or Eating Disorder
C.Anorexia Nervosa - Binge Eating/Purging Type
D. Anorexia Nervosa - severe
E. Anorexia Nervosa - Restrictive Type
F. Bulimia Nervosa - moderate
G.Binge-Eating Disorder - mild
A
C.Anorexia Nervosa - Binge Eating/Purging Type
23
Q
Treating Bulimia Nervosa is often quite challenging. For severe cases and best results, it is recommended an individual use the support of:
A. Dietician/Nutricianist
B. Doctor/PCP/Psychiatrist for medication management
C.Hypnotherapist
D. Psychotherapy
E. Full-time hospital placement
F. Rehab Center or some partial inpatient hospitalization
G.All of the Above
H.B, C, D, & E
I.A, B, D, & F
A
I. A, B, D, and F
24
Q
What are the primary features letting you know you are looking at an individual experiencing Sleep Apnea? A. Nocturnal urination B. Frequent waking to void C.Waking up to vomit D. Snoring/breathing disturbances E. Daytime fatigue F. A, B, C G.D and E H.All of the Above
A
G. D and E
25
```
As you are conducting a physical exam, you immediately notice your youthful female patient is experiencing significant thinning of her hair. You palpitate her abdomen and the patient winces. As she clutches her stomach you notice scarring on her knuckles. Out of curiosity, you ask the patient to open her mouth and say "ahh" to which you note the patient has swollen parotid glands. What is the most likely activity the patient is engaging in, and what diagnosis might you immediately consider?
A. Laxatives; Binge-Eating Diosrder
B. Laxatives; Rumination Disorder
C.Vomiting; Binge-Eating Disorder
D. Vomiting; Bulimia
E. Vomiting; Avoidant/Restrictive Food Intake Disorder
F. Diuretics; Bulimia
G.Diuretics; Anorexia
H.Laxitives; Anorexia
```
D. Vomiting; Bulimia
26
Alcohol, barbiturates, benzodiazepines, and tobacco exacerbate the signs and symptoms of Obstructive Sleep Apnea. An individual with persistent signs and symptoms of Sleep Apnea, even while on substance/medication should NOT receive a ddiagnosis of Sleep Apnea. Instead, they should be considered for a Substance-Induced Sleep Disorder diagnosis.
a. True
b. False
a. False
27
A marked incongruence between the adolescent/adult’s experienced/expressed gender and assigned gender, often associated with distress.
Gender Dysphoria
28
The initial "sex" assignment as "male" or "female".
Gender Assignment/"natal gender"
29
Features or behaviors that are not "typical" of individuals with the same assigned gender.
Gender non-conforming/gender atypical
30
Transiently or persistently identify with a gender different from ones' natal gender.
Transgender
31
An individual who seeks, or has undergone, a social transition from male to female, or female to male, which may involve hormone treatments and/or sex-reassignment therapy.
Transexual
32
A category of social identity - refers to an individuals' identification as male, female, or some category other than male or female.
Gender Identity
33
A behavior where cross-dressing generates sexual excitement and causes stress or impairment, without drawing the individual's primary gender into quesiton.
Transvestic Disorder
34
Steve lacks daily caloric consumption, leading to a significantly low body weight (110 lbs) for his age (27), height (6'1"). Steve expresses an Intense fear of gaining weight and consistently uses laxatives which prevents potential weight gain. Steve expresses disturbed thoughts about his body weight and states he must lose more weight for his upcoming race. Steve contacts his PCP, who informs him he has Avoidance/Restrictive Food-Intake Disorder.
a. True
b. False
a. False
| The above mention clinical characteristics of Anorexia Nervosa, not Avoidant/Restrictive Food-Intake Disorder.
35
In a U.S. survey of 570 individuals with Insomnia, approximately 75% consulted with their physician about their sleep disorder. This survey supports the notion that asking patients about their sleep is an unnecessary time-consumer of the mental status examination, as most individuals tend to not get enough sleep in general.
a. True
b. False
b. False
36
Recurrent episodes of eating large amounts within a 2-hour time frame and lack of self control over eating, then purging the food, occurs at least once a week, for three months. What disorder is this describing?
A. Bulimia Nervosa
B. Body Dysmorphic Disorder
C.Binge-Eating Disorder
D. Avoidant/Restrictive Food-Intake Disorder
E. Anorexia Nervosa
A. Bulimia Nervosa
37
Soft, downy hair on face, arms, and chest
Lanugo
38
Going to bed and getting up at the same time every day, drinking a glass of warm milk, and avoiding alcohol are what?
Sleep Hygiene Techniques
39
Loss of tooth enamel is a symptom of:
Bulimia
40
Most common Eating Disorder in U.S.
Binge Eating Disorder
41
Complaint of unusual behavior or events during sleep that may lead to intermittent awakenings and difficult resuming sleep
Parasomnias
42
Sudden, bilateral, loss of muscle tone, spontaneous grimaces, or slack-jaw:
Cataplexy
43
Jaundice-like skin color is a symptom of:
Anorexia
44
Neurodevelopmental Disorders tend to be diagnosed in the beginning stages of life, where as Schizophrenia and Other Psychotic Disorders tend to develop toward the later stages of life.
True
False
False
45
```
What types of pharmacotherapy might you consider when treating a patient who presents with ADHD? Check all that apply:
A. Guanfacine
B. Atomoxetine
C.Clonidine
D. Stimulants
```
```
All of the above.
A. Guanfacine
B. Atomoxetine
C.Clonidine
D. Stimulants
```
46
```
Psychotic episodes occur during presenting mood episodes; however, mood episodes do not always occur during presenting psychotic episodes. What disorder is described here?
A. Catatonia
B. Schizophrenia
C.Schizoaffective Disorder
D. Schizophreniform Disorder
E. Delusional Disorder
F. Brief Psychotic Disorder
```
C.Schizoaffective Disorder
47
What is a half life of a drug?
A. a half life is the peak of a drug's activity, (i.e. if a drug is taken at 8am and wears off at 4pm, it's half life is 12pm.)
B. The half life of a drug is half of the drug's shelf life (expiration date). It is recommended that drug's not be used after they've reachedd their half life.
C.The amount of time it takes for a drug (i.e. Adderol) to activate (i.e. allow individual to focus).
D. The amount of time it takes before half of the active drug elements are either eliminated or broken down by the body.
D. The amount of time it takes before half of the active drug elements are either eliminated or broken down by the body.
48
```
What is the first stage of psychiatric treatment?
A. Assessment
B. Medication
C.Diagnosis
D. Therapy
```
A. Assessment
49
```
A patient has been shuffling for hours from side to side. His movements indicate an ever-present restlessness. He states "this is worse than having a mental illness". What side effect to an anti-psychotic medication is the patient describing?
A. Dystonia
B. Tardive Dyskinisia
C.Nihlistic Delusions
D. Neuroleptic Malignant Syndrome
E. Akathisia
```
E. Akathisia
50
When individuals are diagnosed with more than one mental disorder at a given time.
A. The individual's likelihood of mortality increases 50%
B. They are at greater risk to experience severe mental health symptoms.
C.They are less likely to have a social support system in place.
D. They are experiencing what is referred to as comormidity.
D. They are experiencing what is referred to as comormidity.
51
What is the concept when an individual's mental condition is no longer viewed as the primary, defining, characteristic of an individual, but one of several aspects of the whole person? Using this conceptual framework, what is the primary emphasis?
A. Gestalt therapy; the individual's whole picture
B. Psychology; therapy as a form of treatment
C.Person-first language; the person
D. Psychiatry; medication as a form of treatment
C.Person-first language; the person
52
```
What three entities relate to racism, discrimination, and economic inequities that may result in heath disparities?
A. Gender
B. Race
C.Ethnicity
D. Culture
```
B. Race
C.Ethnicity
D. Culture
53
```
A woman walks into the clinic whispering and darting glances around her. She sits down and lowers her gaze to her lap as stringy, dirty hair falls forward, shielding her face. You notice her shoelaces are untied and she is wearing different colored socks on each foot. You approach her and she looks up at you - wide-eyed. Her whispers become faster and louder. You ask "Are you speaking to me?" The women continues to whisper: "No. No. Stop. Go away. I can't. No. Please. Help. Stop. Go away." What are you experiencing in this moment?
A. Comorbidity
B. Symptoms of a Mental Disorder
C.Differential Diagnosis
D. Signs of a Mental Disorder
```
D. Signs of a Mental Disorder
54
Which of the following is not a clinical diagnostic characteristic of ADHD?
A. Several symptoms are present in two or more setting, (such as at home, school or work; with friends or relatives; in other activities).
B. The symptoms are not better explained by another mental disorder (such as a mood disorder, anxiety disorder, dissociative disorder, or a personality disorder). The symptoms do not happen only during the course of schizophrenia or another psychotic disorder.
C.There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
D. Several inattentive or hyperactive-impulsive symptoms were present before the individual was four years old.
D. Several inattentive or hyperactive-impulsive symptoms were present before the individual was four years old.
55
Every individual on the autism spectrum is exactly the same as another individual on the sprectrum.
a. True
b. False
b. False
56
An expectable or culturally approved response to a common stressor or loss (such as death of a loved one) is not in itself, defined as a mental disorder.
a. True
b. False
a. True
57
In order to meet diagnostic criteria for Social Pragmatic Communication Disorder, an individual must exhibit persistent difficulties in the social use of verbal and nonverbal communication as manifested by the following: (Choose all that apply.)
A. Difficulties following rules for conversation, such as knowing how to use verbal and nonverbal signals to regulate interaction.
B. Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior.
C.Fixated interests that are abnormal in intensity or focus.
D. Using communication for social purposes, such as greeting and sharing information.
E. Difficulties understanding what is not explicitly stated (e.g., making inferences) and ambiguous meanings of language (e.g.humor, metaphors).
F. Changing communication to match context or the needs of the listener.
G.Hyper/hyporeactivity or sensitivity to sensory aspects of the environment (e.g. smell, tactile feel, visual brightness, sound).
A. Difficulties following rules for conversation, such as knowing how to use verbal and nonverbal signals to regulate interaction.
D. Using communication for social purposes, such as greeting and sharing information.
E. Difficulties understanding what is not explicitly stated (e.g., making inferences) and ambiguous meanings of language (e.g.humor, metaphors).
F. Changing communication to match context or the needs of the listener.
58
Asking about suicide will increase the risk a patient with Depression will kill themself.
a. True
b. False
b. False
59
What contributing factors may lead to the onset of ADHD in an individual? (Check all that apply.)
A. overdose of aspirin as a child
B. genetics
C.chemical, structural, and connectivity differences in the brain
D. iron deficiency
B. genetics
| C.chemical, structural, and connectivity differences in the brain
60
____________________ is a type of "therapy" sometimes used to alleviate uncomfortable/harmful hallucinations. This type of therapy can also be used to treat Major Depressive Disorder, and it considered a "safe" form of therapy.
Electroconvulsive therapy
61
In Obsessive Compulsive Disorder (OCD), rituals are considered to be:
a. Compulsions
b. Checking
c. Obsessions
d. Contamination
e. A characteristic of Autism Spectrum Disorders
a. Compulsions
62
```
To meet criteria for ADHD, symptoms must be presented in _____ # of settings:
A. 3+
B. 2+
C.1+
D. 4+
```
B. 2+
63
A skin-picking disorder characterized by recurrent picking of one’s skin, and repeated attempts to decrease or stop the behavior.
Excoriation
64
A hair-pulling disorder characterized by recurrent pulling out of one’s hair and repeated attempts to decrease or stop the behavior.
Trichotillimania
65
The inability to discard useless or worn out possessions.
Hoarding
66
The need to constantly clean and wash; the belief that to not clean and wash may result in death.
Contamination
67
What are recurrent, intrusive, unwanted thoughts that often lead to anxiety?
a. Obsessions
b. Compulsions
c. Auditory hallucinations
d. Suicidal ideation
a. Obsessions
68
Lack of energy
Anergia
69
Lack of Interest in typical pleasure-seeking activities/hobbies
Anhedonia
70
Reduced drive to pursue goal-directed behavior
Avolition
71
A state of disordered thought or impairments in reality testing, as manifested by perceptual disturbances, disorganized speech, and behavior
Psychosis
72
Decreased expressed emotion, withdrawal, anhedonia, amotivation, flat affect, feeling of emptiness
Negative psychotic symptoms
73
Outward manifestations of a thought disorder
Positive psychotic symptoms
74
Caused by general medical conditions, side effects from meds, severe mood disorder with psychotic features, & substance use.
Secondary Psychotic Symptoms
75
"Hypo" mania means what:
A. The term when mania is combined with depressive symptoms.
B. "Half" the amount of mania or more accurately, "reduced" symptoms of mania
C.When an individual with psychotic hallucinations sees pink hippopotamuses instead of pink elephants.
D. Twice the amount of mania or more accurately, "increased" symptoms of mania.
B. "Half" the amount of mania or more accurately, "reduced" symptoms of mania
76
```
What is the best treatment for OCD?
A. Exposure Therapy
B. Cognitive Behavioral Therapy
C.SSRI
D. All of the Above
```
D. All of the Above
77
__________ is a lack of insight/awareness of one’s disorder and the most common predictor of non-adherence to treatment.
Anosognosia
78
True or False? Individuals with Schizophrenia do not pose a danger to others and do not have multiple personalities?
a. True
b. False
a. True
79
Sam presents "Aspergers-like" tendencies as he is fixated on trains and building his own Underground Railroad. Sam demonstrated evidence of a repetitive movement (kicking). However, Sam makes eye contact with the clinician, initiates conversation and answers the clinician's questions without rigidity or akwardness.
Rule Out Autism Spectrum Disorder
80
Over the past 18-24 months Sam has progressively payed less and less attention in school, expressed interest in school, or completed his homework for school. He often avoids mental tasks such as homework, and fails to give notices from school to his mother. In times of stress he tends to become distracted (eyes darting around office,) fidget (repetitive kicking,) blurt out stories (underground railroad). However, he is attentive, organized, and productive toward tasks he chooses to engage in. He does not act out in class or at home.
Rule Out ADHD
81
Sam exhibits a consistent pattern of being emotionally withdrawn, blunted affect, lack of emotions, minimal social responsiveness, and a history of familial strife. Additional interviews will need to access for a presence of fear, or undisplayed sadness or irritability, and information about the level of care (or lack thereof) from primary caregivers which may include basic emotional needs, repeated changes in caregivers, or rearing in unusual settings. Additional interviewing/therapy will need to help understand reasons for Sam's disturbed behavior, and if it was evident prior to age 5.
Differential Diagnosis for Reactive Attachment Disorder
82
Sam experiences persistent and reoccurring thoughts while at school, where he draws his train and tunnel plans, possibly suppressing other potentially disturbing thoughts. Upon arrival at home, Sam immediately and compulsively runs to his tunnel. Perhaps his notion of building an underground railroad is grandiose, unrealistic, or obsessive? Perhaps the anxiety displayed at the doctors office is alleviated by Sam's notions of grandeur? Certainly Sam's "activity" is time-consuming and is something that is impacting his performance at school.
Additional interview questions and/or therapy will help determine whether Sam's persistent thoughts at school involve truly obsessing about trains, or is the railroad masking something more serious and traumatic that Sam doesn't want to think about? If the latter is the case, perhaps Sam is not responding to an obsessive interest, perhaps he is repressing a bad memory and replacing it with a compulsion?
Differential Diagnosis for Childhood Onset Obsessive Compulsive Disorder, with delusional beliefs
83
Consistently, for the past 18-24 months, when Sam comes home from school his behavior changes from withdrawn and having diminished interest in school to often exhibiting a flight of ideas, becoming more talkative than usual (though typically talking to himself), and has an increase in goal-directed activity. He often experiences a decreased need for sleep. Sam appears to meet diagnostic criteria for hypomania, but not for depression.
Rule Out Childhood Onset Bipolar Disorder II
84
Sam displays signs of a depressed mood while at school (which is significantly affected). Symptoms have been ongoing for 18-24 months, AND Sam is exhibiting problems eating and sleeping. Additional interviewing will need to access for low self-esteem, fatigue/low energy, and feelings of hopelessness. However, Sam meets criteria for a hypomanic episode. Sam displays signs of a depressed mood while at school (which is significantly affected). Symptoms have been ongoing for 18-24 months, AND Sam is exhibiting problems eating and sleeping. Additional interviewing will need to access for low self-esteem, fatigue/low energy, and feelings of hopelessness. However, Sam meets criteria for a hypomanic episode.
Rule Out Persistent Depressive Disorder (Dysthymia)
85
Sam has exhibited a chronic, fluctuating mood disturbance, involving numerous periods of hypomanic symptoms and periods of depressive symptoms - both insufficient in number, severity, pervasiveness, and duration to meet full diagnostic criteria. Symptoms have been persistent for 18-24 months.
Differential Diagnosis of Childhood Onset Cyclothymic Disorder
86
Which two diagnosis would you consider when presented with an individual who displays the following characteristics in a classroom setting (Select only one response):
Answers a question before it is finished being asked
Difficulty waiting one’s turn
Frequent interrupting others
A. ASD and ADHD
B. ADHD and Conduct Disorder
C.ASD and Oppositional Defiant Disorder
D. Conduct Disorder and Oppositional Defiant Disorder
A. ASD and ADHD
87
In ADHD, we have discussed how stimulants are known to be the more common treatment. Atomoxetine (Straterra) is an alternative to stimulants, and produces the following effects - (Select all that apply):
A. Gradual effects/ takes longer than a stimulant to reach full potential.
B. Less potential for abuse
C.24-hour length of action
D. Does not promote tics.
```
All of the above.
A. Gradual effects/ takes longer than a stimulant to reach full potential.
B. Less potential for abuse
C.24-hour length of action
D. Does not promote tics.
```
88
An individual can experience all the criteria to meet a diagnosis of schizophrenia, but they have a full recovery and proceed with their life, often times without the onset of another mental illness or diagnosis. What is this called?
Brief psychotic disorder
89
What are three types of Delusions not included in Delusional Disorder? (Hint, look at specifiers.)
A. Referential: believe certain gestures/environmental cues are directed at self
B. Erotomanic: believe falsely that another is in love with them
C.Mixed/Unspecified
D. Persecutory: belief one will be harmed
E. Grandiose: believe in having exceptional abilities
F. Nihilistic: convinced a major catastrophe will occur
G.Jealous
H.Somatic: preoccupations regarding health and organ function
I.Fixed beliefs: not amenable to change
A. Referential: believe certain gestures/environmental cues are directed at self
F. Nihilistic: convinced a major catastrophe will occur
I.Fixed beliefs: not amenable to change
90
To meet the criteria for Major Depressive Disorder, Five or more symptoms must be present during the same 2-week period. These symptoms represent a change from previous functioning. At least one of the symptoms must be either:
A. Daily change in appetite or almost daily fatigue.
B. Significant weight fluxuation or sleep changes (insomnia or hypersomnia).
C.Recurrent thoughts of death or psychomotor agitation.
D. Feelings of worthlessness or inability to concentrate nearly every day.
E. Depressed mood or loss of interest or pleasure.
E. Depressed mood or loss of interest or pleasure.
91
```
Name the Disorder: Marked fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others, and in which the fear is out of proportion to the reality.
A. Separation Anxiety
B. Reactive Attachment
C.Social Phobia
D. Agoraphobia
```
C.Social Phobia
92
Check all that apply in relation to First Generation Anti-Psychotics:
A. 1st generation antipsychotics work as antagonists by blocking central dopamine receptors, reducing hallucinations and delusions in individuals with schizophrenia.
B. 1st generation antipsychotics may cause unwanted side effects such as dystonia, Parkinsonian symptoms, akathisia, tardive dyskinesia, neuleptic malignant syndrome, and sometimes impotency.
C.1st generation antipsychotics often cause sedation.
D. 1st generation antipsychotics consist of Risperdol, Abilify, Zyprexa, and Clozaril.
C.1st generation antipsychotics often cause sedation.
93
Odd caricature of normal activities (catatonia)
Mannerism (catatonia)
94
Repetitive, abnormally frequent, non-goal directed movements (catatonia)
Steryotypy (catatonia)
95
Passive induction of a posture held against gravity (catatonia)
Catalepsy (catatonia)
96
Not influenced by external stimuli (catatonia)
Agitation (catatonia)
97
Very little verbal response (catatonia)
Mutism (catatonia)
98
Mimicking another's movements (catatonia)
Echopraxia (catatonia)
99
Mimicking another's’ speech (catatonia)
Echolalia (catatonia)
100
Resistance to examiner (catatonia)
Waxy flexibility (catatonia)
101
Opposition or no response to instructions or external stimuli (catatonia)
Negativism (catatonia)
102
No psychomotor activity; not actively relating to environment (catatonia)
Stupor (catatonia)
103
Benzodiazapines potential side effects of medications?
Addiction
104
Stimulants potential side effects of medications?
Tics, decreased appetite, trouble sleeping
105
Lithium potential side effects of medications?
Toxicity - need for liver screenings
106
Haldol, 1st generation antipsychotic potential side effects of medications?
Akasthasia, Dystonia, Tardive Dyskinesia, Neuroleptic Malignant Syndrome
107
Lithium potential side effects of medications?
Significant weight gain
108
What is not a symptom of panic?
A. Fear of dying.
B. Nausea or abdominal distress.
C.Sensations of shortness of breath or smothering
D. Rapid eye movement/blinking (i.e. tardive dyskinesia)
E. Numbness or tingling sensations
F. Palpitations, pounding heart, or accelerated heart rate.
G.Sweating
H.Chills or heat sensations.
D. Rapid eye movement/blinking (i.e. tardive dyskinesia)
109
Many patients with ____________ (Approx. 10%) seek care from their primary care provider before presenting to a mental health provider.
However, when a patient is having a ___________ episode, their family/friends are more likely to bring the individual in to consult with a medical provider, due to concern regarding the significant change in the individual's behavior, a behavior that is often alarming.
depression;
| manic
110
Treatment of Personality Disorders is a long term process, as behaviors developed early on if life and as such, are hard to change. Treatment goals include the elimination of maladaptive coping behaviors, and replacing these behavior with healthy coping skills.
True
False
True
111
Schizotypal Personality Disorder is a pattern of acute discomfort in close relationships, cognitive and perceptual distortions, and eccentricities of behavior. What do I mean by "cognitive and perceptual distortions"?
Magical thinking
Ideas of reference
Hallucinations
A and B
A, B, and C
A and B
Magical thinking
Ideas of reference
112
Individuals who show the personality features associated with Antisocial Personality Disorder often violate the basic rights of others or violate major age-appropriate societal norms, and as a result their pattern of behavior often meets criteria for Conduct Disorder.
True
False
True
113
According to the Lippincott text, 1% of patients who completed a suicide attempt visited their primary care provider within one (1) month of the patient's death.
True
False
False
114
Disruptive Mood Dysregulation Disorder (DMDD) was added to DSM-5 to address the considerable concern about the appropriate classification and treatment of children who present with chronic, persistent irritability compared to children who present with classic, episodic Bipolar Disorder (pediatric Bipolar Disorder).
True
False
True
115
Which Personality Disorder is a synonym (different word, same meaning) for Sociopath and Psychopath?
Borderline PD
Avoidant PD
Narcissistic PD
Antisocial PD
Antisocial PD
116
```
Select the item(s) below that are associated specifically with Borderline Personalty Disorder:
A.
Harm to Animals
B.
Inability to control one's impulsivity
C.
Dialectical Behavioral Therapy (DBT)
D.
Self-harm
E.
Importance of setting up rules and limits when working with patient
F.
Breaking the Law
G.
Sense of Grandiosity
H.
A, E, & F
I.
B,C,D,E
J.
All of the Above - A,B,C,D,E,F,G
```
```
I.
B,C,D,E
Inability to control one's impulsivity
Dialectical Behavioral Therapy (DBT)
Self-harm
Importance of setting up rules and limits when working with patient
```
117
```
Irritable mood, defiant behavior, or vindictiveness, lasting at least 6 months. The child often justifies their behavior as a response to unreasonable demands or circumstances. Does not include aggression toward people or animals. The presence of mood symptoms (angry/irritable) conveys risk for development of anxiety disorders and Major Depressive Disorder.
A.
Conduct Disorder
B.
Intermittent Explosive Disorder
C.
Disruptive Mood Dysregulation Disorder
D.
Oppositional Defiant Disorder
```
D. Oppositional Defiant Disorder
118
```
Recurrent behavioral outbursts. Failure to control aggressive impulse as manifested through verbal or physical aggression toward property, animals, or other individuals. Outbursts occur on average twice weekly for 3 months, (or 3 times within 1 year for more severe behavioral outbursts). This disorder is most common in late childhood/adolescence and rarely begins after age 40.
A.
Conduct Disorder
B.
Intermittent Explosive Disorder
C.
Disruptive Mood Dysregulation Disorder
D.
Oppositional Defiant Disorder
```
B. Intermittent Explosive Disorder
119
```
Regularly violates rules and the basic rights of others. May be physically cruel toward people and animals, destroy property, lie, or steal. Early onset-type predicts a worse prognosis and increased risk of criminal behavior and substance-related disorders in adulthood.
A.
Conduct Disorder
B.
Intermittent Explosive Disorder
C.
Disruptive Mood Dysregulation Disorder
D.
Oppositional Defiant Disorder
```
A. Conduct Disorder
120
```
Chronic, severe, persistent irritability. Recurrent temper outbursts occurring on average 3+ times per week, as manifested by verbal rages and/or physical aggression toward people or property. Age of onset is prior to age 10. This diagnosis should not be made (for the first time) prior to age 6 or after age 18.
A.
Conduct Disorder
B.
Intermittent Explosive Disorder
C.
Disruptive Mood Dysregulation Disorder
D.
Oppositional Defiant Disorder
```
C.
| Disruptive Mood Dysregulation Disorder
121
The personality disorders Schizoid and Schizotypal both exhibit positive symptoms of Schizophrenia, such as hallucinations and delusions.
True
False
False
122
Suicidal ideation may accompany mild, moderate, or severe depression.
True
False
True
123
Suicidal intent only comes up during the initial phase of a patient's treatment.
True
False
False
124
In the movie "Mean Girls" (showed in class) the character Regina George displays a classic case of Borderline Personality Disorder.
True
False
False
125
The difference between Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder is that OCPD is ego-syntonic and shows inflexibility in one's thinking, vs. OCD which exhibits intrusive, repetitive thoughts (obsessions) and ritualistic behavior (compulsions).
True
False
True
126
Disregard to and violation of the rights of others.
```
A.
Dependent PD
B.
Avoidant PD
C.
Histrionic PD
D.
Antisocial PD
E.
Obsessive Compulsive PD
```
D. Antisocial PD
127
Excessive emotionality and attention seeking.
```
A.
Dependent PD
B.
Avoidant PD
C.
Histrionic PD
D.
Antisocial PD
E.
Obsessive Compulsive PD
```
C.Histrionic PD
128
```
Feelings of inadequacy; hypersensitive to negative evaluation.
A.
Dependent PD
B.
Avoidant PD
C.
Histrionic PD
D.
Antisocial PD
E.
Obsessive Compulsive PD
```
B.
| Avoidant PD
129
```
An excessive need to be taken care of.
A.
Dependent PD
B.
Avoidant PD
C.
Histrionic PD
D.
Antisocial PD
E.
Obsessive Compulsive PD
```
A.
| Dependent PD
130
```
Preoccupation with orderliness, perfectionism, and control.
A.
Dependent PD
B.
Avoidant PD
C.
Histrionic PD
D.
Antisocial PD
E.
Obsessive Compulsive PD
```
E.
| Obsessive Compulsive PD
131
When working with patients who have personality disorders, providers need to be careful of feelings of countertransference that may arise. Please match the following feeling (potentially experienced by a clinician) to a patient's personality disorder:
```
Fear - an emotional or physical over-response
A.
Antisocial PD, Borderline PD, and/or Narcissistic PD
B.
Antisocial PD
C.
Borderline PD
D.
Narcissistic PD
```
B.
| Antisocial PD
132
When working with patients who have personality disorders, providers need to be careful of feelings of countertransference that may arise. Please match the following feeling (potentially experienced by a clinician) to a patient's personality disorder:
```
Self-doubt - questioning one's own abilities
A.
Antisocial PD, Borderline PD, and/or Narcissistic PD
B.
Antisocial PD
C.
Borderline PD
D.
Narcissistic PD
```
D.
| Narcissistic PD
133
When working with patients who have personality disorders, providers need to be careful of feelings of countertransference that may arise. Please match the following feeling (potentially experienced by a clinician) to a patient's personality disorder:
```
Frustration, as patient may not follow through on completing their treatment plan
A.
Antisocial PD, Borderline PD, and/or Narcissistic PD
B.
Antisocial PD
C.
Borderline PD
D.
Narcissistic PD
```
C.
| Borderline PD
134
When working with patients who have personality disorders, providers need to be careful of feelings of countertransference that may arise. Please match the following feeling (potentially experienced by a clinician) to a patient's personality disorder:
```
Anger - as displayed through verbal retaliation, inappropriate comments (about patient) in charting and providing the patient substandard care.
A.
Antisocial PD, Borderline PD, and/or Narcissistic PD
B.
Antisocial PD
C.
Borderline PD
D.
Narcissistic PD
```
A.
| Antisocial PD, Borderline PD, and/or Narcissistic PD
135
```
What is NOT a characteristic related to Delirium?
A.
Ego-syntonic
B.
Acute Onset
C.
Hypoactive - Sluggishness and Lethargy
D.
Impaired/Wandering Attention
E.
Hyperactive - agitation; refusal to cooperate with medical care
F.
Altered Level of Consciousness
```
A.
| Ego-syntonic
136
```
Dementia is referring to which clinical, DSM-5 diagnosis?
A.
Mild Neurocognitive Disorder
B.
Major Neurocognitive Disorder
C.
Parkinson's disease
D.
Alzheimer's disease
E.
Delirium
```
B.
| Major Neurocognitive Disorder
137
How long do drugs stay in an individual's system? Match the drug name to the duration:
Heroin and Cocaine
3 to 6 weeks
138
How long do drugs stay in an individual's system? Match the drug name to the duration:
Morphine
3 to 4 days
139
How long do drugs stay in an individual's system? Match the drug name to the duration:
Marijuana
7 to 30 days
140
```
What is the core factor that constitutes Neurocognitive Disorders?
A.
Auditory hallucinations and tremors.
B.
Being an older individual (65+)
C.
Becoming non-ambulatory.
D.
A decline in cognitive function.
```
D.
| A decline in cognitive function.
141
Once we accurately diagnose a patient with Alzheimer's Disease, we can then begin the first treatment phase. There are 7 treatment phases that will ultimately result in curing the patient.
True
False
False
142
```
At what stage do individual's with Alzheimer's Disease begin to have a hard time paying their bills?
A.
Stage 3: Mild Cognitive Decline
B.
Stage 7: Very Severe Cognitive Decline
C.
Stage 4: Moderate Cognitive Decline
D.
Stage 2: Very Mild Cognitive Decline
```
A.
| Stage 3: Mild Cognitive Decline
143
```
At what stage do individual's with Alzheimer's Disease begin to have a hard time paying their bills?
A.
Stage 3: Mild Cognitive Decline
B.
Stage 7: Very Severe Cognitive Decline
C.
Stage 4: Moderate Cognitive Decline
D.
Stage 2: Very Mild Cognitive Decline
```
A.
Stage 3: Mild Cognitive Decline (WRONG)
C.
Stage 4: Moderate Cognitive Decline
144
Which of the following statements is not a myth about Alzheimer's?
A.
Repeated head trauma doubles the risk of developing Alzheimer’s.
B.
Memory loss is a natural part of aging.
C.
Silver dental fillings can increase the risk of developing Alzheimer’s disease
D.
Flu shots increase the risk of developing Alzheimer’s disease.
A.
Repeated head trauma doubles the risk of developing Alzheimer’s. (WRONG)
B.
Memory loss is a natural part of aging.
145
Do you ever think about cutting back Do you get annoyed if someone criticizes your drinking?Do you ever feel guilty about drinking or events which happened while you have been drinking? Do you ever have a drink when you awaken (eyeopener) to calm your nerves?
A.
CAGE, a screening tool for Alcohol Use Disorder
B.
Opium
```
C.
Relapse - explanation for why it occurs
D.
Relapse Risk Factors
E.
Prescription drug monitoring program
```
A.
| CAGE, a screening tool for Alcohol Use Disorder
146
Heroin, Morphone, Tramadol, Fentanyl, and Oxycodone
A.
CAGE, a screening tool for Alcohol Use Disorder
B.
Opium
```
C.
Relapse - explanation for why it occurs
D.
Relapse Risk Factors
E.
Prescription drug monitoring program
```
B.
| Opium
147
Opiates triggers the brain to release dopamine and activate the mesolimbic system (aka the reward-pleasure pathway). These pleasurable feelings become reinforcing triggers for addiction. Chronic use of opiates changes the brain itself to develop an opioid dependence
A.
CAGE, a screening tool for Alcohol Use Disorder
B.
Opium
```
C.
Relapse - explanation for why it occurs
D.
Relapse Risk Factors
E.
Prescription drug monitoring program
```
C.
| Relapse - explanation for why it occurs
148
Stress, lack of support system, reverting back to old habits, and not having an "aftercare plan" are characteristics of:
A.
CAGE, a screening tool for Alcohol Use Disorder
B.
Opium
```
C.
Relapse - explanation for why it occurs
D.
Relapse Risk Factors
E.
Prescription drug monitoring program
```
D.
| Relapse Risk Factors
149
An electronic database that tracks controlled substance prescriptions in a state and provides health authorities timely information about prescribing and patient behaviors.
A.
CAGE, a screening tool for Alcohol Use Disorder
B.
Opium
```
C.
Relapse - explanation for why it occurs
D.
Relapse Risk Factors
E.
Prescription drug monitoring program
```
E.
| Prescription drug monitoring program
150
Identify the difference between Major and Mild Neurocognitive Disorder.
A.
Evidence of cognitive decline.
B.
All of the above.
C.
Cognitive deficits do not occur exclusively in the context of a delirim.
D.
Cognitive deficits interfere with independence in everyday activities.
D.
| Cognitive deficits interfere with independence in everyday activities.
151
Identify the difference between Major and Mild Neurocognitive Disorder.
A.
Evidence of cognitive decline.
B.
All of the above.
C.
Cognitive deficits do not occur exclusively in the context of a delirim.
D.
Cognitive deficits interfere with independence in everyday activities.
D.
| Cognitive deficits interfere with independence in everyday activities.
152
```
Chemically “sticky” proteins called beta amyloids found in Alzheimers’ patients brain tissues after death.
A.
Plaques
B.
Tangles
C.
Probable Alzheimer's
D.
Possible Alzheimer's
E.
NCD with Lewy Bodies
F.
Frontotemporal NCD
```
A.
Plaques
Refer to Group 9's PP (slides 5 & 8) and Instructor's PP (slides 13, 16, 17).
153
```
Abnormal collections of proteins called tau which prevent neurons from carrying out their primary function.
A.
Plaques
B.
Tangles
C.
Probable Alzheimer's
D.
Possible Alzheimer's
E.
NCD with Lewy Bodies
F.
Frontotemporal NCD
```
B.
Tangles
Refer to Group 9's PP (slides 5 & 8) and Instructor's PP (slides 13, 16, 17).
154
```
A causative mutation for Alzheimer's was detected in family history or through genetic testing.
A.
Plaques
B.
Tangles
C.
Probable Alzheimer's
D.
Possible Alzheimer's
E.
NCD with Lewy Bodies
F.
Frontotemporal NCD
```
C.
Probable Alzheimer's
Refer to Group 9's PP (slides 5 & 8) and Instructor's PP (slides 13, 16, 17).
155
```
There is no evidence of a causative mutation or mixed etiology, however there is evidence of decline in memory and learning, and a steady, progressive decline in cognition.
A.
Plaques
B.
Tangles
C.
Probable Alzheimer's
D.
Possible Alzheimer's
E.
NCD with Lewy Bodies
F.
Frontotemporal NCD
```
D.
Possible Alzheimer's
Refer to Group 9's PP (slides 5 & 8) and Instructor's PP (slides 13, 16, 17).
156
```
Visual Hallucinations, tremors and shaking, frequent falls and fainting, and eventual memoryimpairment are characteristics of:
A.
Plaques
B.
Tangles
C.
Probable Alzheimer's
D.
Possible Alzheimer's
E.
NCD with Lewy Bodies
F.
Frontotemporal NCD
```
E.
NCD with Lewy Bodies
Refer to Group 9's PP (slides 5 & 8) and Instructor's PP (slides 13, 16, 17).
157
```
Difficulties seen in ability to use language, judgment, regulate behavior, empathize with others, and a lack of organization and planning.
A.
Plaques
B.
Tangles
C.
Probable Alzheimer's
D.
Possible Alzheimer's
E.
NCD with Lewy Bodies
F.
Frontotemporal NCD
```
F.
Frontotemporal NCD
Refer to Group 9's PP (slides 5 & 8) and Instructor's PP (slides 13, 16, 17).
158
```
A psychologist is someone who:
A.
Often spends 15 min with each patient.
B.
Prescribes and manages medication.
C.
A medical doctor.
D.
Studies the mind and human behavior; diagnoses and treats patient using various forms of therapy; has a PsyD, PhD, or Ed.D
```
D.
Studies the mind and human behavior; diagnoses and treats patient using various forms of therapy; has a PsyD, PhD, or Ed.D
159
Due to abnormal substances amyloid plaques (an insoluble protein deposit) and neurofibrillary tangles, Alzheimer's Diseases causes the progressive deterioration of brain cells.
True
False
True
160
```
Easily distracted by competing events in the environment, (such as TV, radio, conversation). Difficulty recalling new information, such as an address that was just given to them.
A.
Complex Attention
B.
Executive Functioning
C.
Learning and Memory
D.
Language
E.
Perceptual-motor
F.
Social Cognition
```
A.
Complex Attention
Please refer to NCD neurocognitive domains in DSM-5 (p. 593). The list of 6 is in Instructor PP on NCD (slide 11) but the DSM-5 has a chart which gives concrete examples in each of the 6 domains.
161
```
Needs to focus on one task at a time and relies on others to plan activities of daily living and make decisions.
A.
Complex Attention
B.
Executive Functioning
C.
Learning and Memory
D.
Language
E.
Perceptual-motor
F.
Social Cognition
```
B.
Executive Functioning
Please refer to NCD neurocognitive domains in DSM-5 (p. 593). The list of 6 is in Instructor PP on NCD (slide 11) but the DSM-5 has a chart which gives concrete examples in each of the 6 domains.
162
```
Cannot keep track of a list of short items, such as a shopping list. Repeats self, often within the same conversation.
A.
Complex Attention
B.
Executive Functioning
C.
Learning and Memory
D.
Language
E.
Perceptual-motor
F.
Social Cognition
```
C.
Learning and Memory
Please refer to NCD neurocognitive domains in DSM-5 (p. 593). The list of 6 is in Instructor PP on NCD (slide 11) but the DSM-5 has a chart which gives concrete examples in each of the 6 domains.
163
```
May not verbally recall names of close friends or family and may use more general phrases such as "you know what I mean" to describe something the individual could once speak at length about.
A.
Complex Attention
B.
Executive Functioning
C.
Learning and Memory
D.
Language
E.
Perceptual-motor
F.
Social Cognition
```
D.
Language
Please refer to NCD neurocognitive domains in DSM-5 (p. 593). The list of 6 is in Instructor PP on NCD (slide 11) but the DSM-5 has a chart which gives concrete examples in each of the 6 domains.
164
```
Experiences difficulty driving a motor vehicle and navigating familiar environments.
A.
Complex Attention
B.
Executive Functioning
C.
Learning and Memory
D.
Language
E.
Perceptual-motor
F.
Social Cognition
```
E.
Perceptual-motor
Please refer to NCD neurocognitive domains in DSM-5 (p. 593). The list of 6 is in Instructor PP on NCD (slide 11) but the DSM-5 has a chart which gives concrete examples in each of the 6 domains.
165
```
Dresses in a T-shirt and shorts to go outside, when it is a February day in New England. Behavior is not socially acceptable, and regard to one's safety is lacking.
A.
Complex Attention
B.
Executive Functioning
C.
Learning and Memory
D.
Language
E.
Perceptual-motor
F.
Social Cognition
```
F.
Social Cognition
Please refer to NCD neurocognitive domains in DSM-5 (p. 593). The list of 6 is in Instructor PP on NCD (slide 11) but the DSM-5 has a chart which gives concrete examples in each of the 6 domains.
