MIDTERMS: ABPSYCH Flashcards
TRAUMA AND STRRESSOR RELATED DISORDER:
A 25-year-old woman, new to your practice, tells you that a little more than 3 months ago she was accosted on her way home. The attacker told her he had a gun, was going to rape her, and would shoot her if she resisted. He walked her toward an alley. She was sure he would kill her afterward no matter what she did, and therefore she pushed away from him, aware that she might be shot. She was able to escape unharmed. She describes not being able to fall asleep for the first 2 nights after the attack and of avoiding that particular street in her neighborhood for 2 days following the event. She thinks that the attacker might have touched her breasts but cannot remember for sure. She has recently started feeling anxious all of the time and is tearful, and she has stopped going to work. She fears that something about her makes her “look like a victim.” What is the most likely diagnosis?
Adjustment Disorder
TRAUMA AND STRRESSEOR RELATED DISORDER:
After a routine chest X ray, a 53-year-old man with a history of heavy cigarette use is told that he has a suspicious lesion in his lung. A bronchoscopy confirms the diagnosis of adenocarcinoma. The man delays scheduling a follow-up appointment with the oncologist for more than 2 weeks, describes feeling as if “all
of this is not real,” is having nightly dreams of seeing his own tombstone, and is experiencing intrusive flashbacks to the moment when he heard the physician saying, “The tests strongly suggest that you have cancer of the lung.” He
is tearful and is convinced he will die. He also feels intense guilt that his smoking caused the cancer and expresses the thought that he “deserves” to have cancer. What diagnosis best fits this clinical picture?
Adjustment Disorder
A woman complains of sad mood and feeling hopeless 3 months after her husband files for divorce. She finds it difficult to take care of her home or make meals for her family but has continued to fulfill her responsibilities. She denies suicidal ideation, feels she was a good wife who “has nothing to feel guilty about,” and wishes she could “forget about the whole thing.” She cannot stop thinking about her situation. Which diagnosis best fits this symptom picture?
Adjustment Disorder
SEXUAL DYSFUNCTIONS:
In all of the sexual dysfunctions except substance/medication-induced sexual
dysfunction, symptoms must be present for what minimum duration to qualify for the diagnosis?
Approximately 6 months
SEXUAL DYSFUNCTIONS:
A 65-year-old man who presented with difficulty in obtaining an erection due to diabetes and severe vascular disease had received a DSM-IV diagnosis of Sexual Dysfunction Due to…[Indicate the General Medical Condition] (coded
as 607.84 male erectile disorder due to diabetes mellitus). What DSM-5 diagnosis would be given to a person with this presentation?
No diagnosis
SEXUAL DYSFUNCTIONS:
A 35-year-old man with new-onset diabetes presents with a 6-month history of inability to maintain an erection. His erectile dysfunction had a sudden onset: he was fired from his job a month before the symptoms began. His serum glucose is well controlled with oral hypoglycemic medication. What is the appropriate DSM-5 diagnosis?
Erectile disorder
SEXUAL DYSFUNCTIONS:
What are the factors considered during assessment and diagnosis of a sexual dysfunction?
Partner
Relationship
Cultural or religious
Individual vulnerability factors, psychiatric comorbidity, or stressors
SEXUAL DYSFUNCTIONS:
A 30-year-old woman comes to your office and reports that she is there only because her mother pleaded with her to see you. She tells you that although she has a good social network with friends of both sexes, she has never had any feelings of sexual arousal in response to men or women, does not have any erotic fantasies, and has little interest in sexual activity. She has found other like-minded individuals, and she and her friends accept themselves as asexual. What is the appropriate diagnosis, if any?
No diagnosis, because she does not have clinically significant distress or impairment
SEXUAL DYSFUNCTIONS:
Which of the following symptoms or conditions would rule out a diagnosis of erectile disorder?
A. Presence of diabetes mellitus.
B. Marked decrease in erectile rigidity.
C. Age over 60 years.
D. Presence of alcohol use disorder.
E. Presence of symptom for less than 3 months
E. Presence of symptoms for less than 3 months
GENDER DYSPHORIA:
In order for a child to meet criteria for a diagnosis of gender dysphoria, which
of the following must be present?
A. A co-occurring disorder of sex development.
B. A strong desire to be of the other gender or an insistence that one is the other gender.
C. A strong dislike of one’s sexual anatomy.
D. A stated wish to change gender.
E. A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender.
B. A strong desire to be the other gender or an insistence that one is the other gender.
GENDER DYSPHORIA:
Which of the following statements about gender is true?
A. An individual’s gender cannot always be predicted from his or her biological indicators.
B. An individual’s gender is determined by cultural factors.
C. An individual’s gender is determined by assignment at birth (natal gender).
D. An individual’s gender is determined by psychological factors.
E. An individual’s gender cannot be determined when there is a concurrent disorder of sexual development.
A. An individual’s gender cannot always be predicted from his or her biological indicators.
PERSONALITY DISORDERS:
While collaborating on a presentation to their customers, the members of a sales team become increasingly frustrated with their team leader. The leader insists that the members of the team adhere to his strict rules for developing
the project. This involves approaching the task in sequential manner such that no new task can be begun until the prior one is perfected. When other members suggest alternative approaches, the leader becomes frustrated and insists that
the team stick to his approach. Although the results are inarguably of high quality, the team is convinced that they will not finish in time for the scheduled presentation. When voicing these concerns to the leader, he suggests that the
real problem is that the other members of the team simply don’t share his high standards. Which of the following disorders would best explain the behavior of this team leader?
Obsessive-compulsive disorder (OCD)
PERSONALITY DISORDERS:
Individuals with obsessive-compulsive personality disorder are primarily motivated by a need for which of the following?
A. Efficiency.
B. Admiration.
C. Control.
D. Intimacy.
E. Autonomy.
C. Control
PERSONALITY DISORDERS:
A 36-year-old woman is approached by her new boss, who has noticed that despite working for her employer for many years, she has not advanced beyond an entry level position. The boss hears that she is a good employee who works long hours. The woman explains that she has not asked for a promotion because she knows she’s not as good as other employees and doesn’t think she deserves it. She explains her long hours by saying that she is not very smart and has to check over all her work, because she’s afraid that people will laugh
at her if she makes any mistakes. On reviewing her past evaluations, her boss notes that there are only minor critiques and her overall evaluations have been very positive. Which of the following personality disorders would best explain this woman’s lack of job advancement?
Avoidant personality disorder
PERSONALITY DISORDERS:
A cardiologist requests a psychiatric consultation for her patient, a 46-year-old man, because even though he is adherent to treatment, she is concerned that he “seems crazy.” On evaluation, the patient makes poor eye contact, tends to
ramble, and makes unusual word choices. He is modestly disheveled and wears clothes with mismatched colors. He expresses odd beliefs about supernatural phenomena, but these beliefs do not seem to be of delusional intensity.
Collateral information from his sister elicits the observation that “He’s always been like this—weird. He keeps to himself, and likes it that way.” Which of the following conditions best explains this man’s odd behaviors and beliefs?
Schizotypal personality disorder
PERSONALITY DISORDERS:
A 43-year-old warehouse security guard comes to your office complaining of vague feelings of depression for the last few months. He denies any particular sense of fear or anxiety. As he gets older, he wonders if he should try harder to
form relationships with other people. He feels little desire for this but notes that his coworkers seem happier than he, and they have many relationships. He has never felt comfortable with other people, not even with his own family. He has lived alone since early adulthood and has been self-sufficient. He almost always works night shifts to avoid interactions with others. He tries to remain low-key and undistinguished to discourage others from striking up conversations with him, as he does not understand what they want when they talk to him. Which personality disorder would best fit with this presentation?
Schizoid
PERSONALITY DISORDERS:
A 25-year-old man has a childhood history of repeated instances of torturing animals, setting fires, stealing, running away from home, and school truancy, beginning at the age of 9 years. As an adult he has a history of repeatedly lying
to others; engaging in petty thefts, con games, and frequent fights (including episodes in which he used objects at hand—pipe wrenches, chairs, steak knives—to injure others); and using aliases to avoid paying child support. There is no history of manic, depressive, or psychotic symptoms. He is dressed in expensive clothing and displays an expensive wristwatch for which he demands admiration; he expresses feelings of specialness and entitlement; the belief that he deserves exemption from ordinary rules; feelings of anger that his special talents have not been adequately recognized by others; devaluation, contempt, and lack of empathy for others; and lack of remorse for his behavior. There is no sign of psychosis. What is the appropriate diagnosis?
Antisocial personality disorder and narcissistic personality disorder
PERSONALITY DISORDERS:
A pattern of excessive emotionality and attention seeking.
Histrionic PD
PERSONALITY DISORDERS:
A pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity.
Borderline PD
PERSONALITY DISORDERS:
A pattern of submission and clinging behavior related to an excessive need to be taken care of.
Dependent PD
