Psych Flashcards
How long does a panic attack usually last?
10-20 minutes
What type of hallucinations are the most common in schizophrenia: Auditory, visual, or olfactory?
Auditory - hearing voices
What cause anorexic patients to have osteopenia?
A decrease in estrogen
When treating psychiatric patients, are benzodiazepines more commonly for acute or chronic treatment?
Acute
What is the most common precipitating event for post traumatic stress disorder in women?
Rape
A patient’s wife complains that he is hyper-vigilant and has a hyperstartle response, what is the most likely diagnosis?
PTSD
Are patients with specific phobias aware they are strange?
Yes
A patient complains of having suddenly developed stage fright. It is very important to his career
that he be able to speak in front of groups. What medication might you treat him with?
Beta blocker - propranolol
A doughnut shaped burn should make you think of what issue?
Abuse (child or elder)
What is the generic name for prozac?
Fluoxetine
How long must symptoms last before diagnosing ADD?
6 months
A patient’s mother has recommended that he
see you. He lives on his own and is a computer programmer. He works from home. He has no friends and seldom leaves the house. She is concerned that clearly he would like to meet people, but he is terri ed of doing so. What is the most likely diagnosis?
Avoidant personality disorder
A 6 year old boy seems to have all of the
symptoms of ADD while at school, but at home he has no problems. Does he have ADD?
No, symptoms must occur in both settings for diagnosis
An 18 month old is not yet speaking. He does not point to objects. He does not make eye contact with others. What is the most likely diagnosis?
Autism
List 3 positive symptoms of schizophrenia
Hallucinations, delusions, movement disorders
What is the typical onset of Tourette’s syndrome?
3-8 years old
Is anorexia egosyntonic or ego-dystonic? What about bulimia?
Anorexia is egosyntonic. Bulimia is ego-dystonic.
List the three cluster A personality disorders
“Mad” schizoid, schizotypal and paranoid
How long does menstruation need to be absent before secondary amenorrhea can be diagnosed?
If cycles have been previously normal: 3 months. If cycles have been previously irregular: 6 months.
A 16 year old has just moved schools. He is quiet, moody and not like himself at all. Within six months he seems to have completely changed back to his previous personality. What is the most likely diagnosis?
Adjustment disorder
You have a patient with major depressive disorder. Once his symptoms have completely resolved how long should you continue with treatment?
A six month minimum is recommended due to very high relapse rates
What medication is often used to treat postpartum depression in a woman who is breast feeding?
Sertraline (Zoloft)
A patient has very strange magical thinking. What is the most likely diagnosis?
Schizotypal personality disorder
Four symptoms of serotonin syndrome
Hyperthermia!!, seizure, mental status change, tremor
What is the term for a chronic mild depression which has lasted greater than two years?
Dysthymia
What is necessary to diagnose a patient with bipolar 1?
One manic episode. They do not have to have the depressive episode for the diagnosis.
What is the major concern with lithium?
It has a very narrow therapeutic window. Blood tests are needed every four weeks.
A patient believes that her 15 year old daughter is sleeping with the mailman. She has no evidence of this. She has confronted her daughter who denies it. It is not interfering with her daily activities, but she does spend time thinking about it. What is the most likely diagnosis?
Delusional disorder
At what BMI should a patient be hospitalized for anorexia?
BMI of less than 17.5 or 20% below appropriate body weight
What is the term for being afraid of being out in a terrible situation with no help available?
Agoraphobia
Borderline personality disorder is on the border of what two psychological disorders?
Neurosis and psychosis
Waxy flexibility should make you think of what diagnosis?
Catatonic schizophrenia
How long before normal grief resolves?
About one year
A patient of yours always craves attention, often
using sex as a tool to gain it. She often acts like a child when she does not get her way? What is the most likely diagnosis?
Histrionic personality disorder
To be diagnosed with ADD patients must exhibit symptoms before what age?
7
What is Russell’s sign?
Abraded knuckles from forcing oneself to vomit
How long must symptoms occur before diagnosing schizophrenia?
At least 6 months
Posturing should make you think of what disorder?
Catatonic depression
A patient complains of acute paralysis in his left arm. This does not seem to bother him, but his wife made him come in. There was no traumatic event. A complete neurologic workup is negative. What is the most likely diagnosis?
Conversion disorder
A psychiatric patient presents with confusion, fever and lead pipe rigidity. What is the most likely diagnosis?
Neuroleptic malignant syndrome, this can occur with high dose antipsychotics
A patient is very concerned that she has breast cancer. In order to reassure her you perform a full workup which is negative. She is still unsatis ed and convinced that she has breast cancer. What is the most likely diagnosis?
Hypochondriasis
What is the time frame for the rst symptoms of withdrawal from alcohol?
Tremor in 8-18 hours
How do you treat alcohol withdrawal?
Benzos
List the 4 cluster B personality disorders?
“Bad” Antisocial, Borderline, histrionic and narcissistic
List the two cluster C personality disorders
“Sad” avoidant and obsessive compulsive
What medication is clearly contraindicated in anorexia and bulimia?
Wellbutrin because it can increase risk of seizures (lowers seizure threshold)
What two psychiatric disorders are more common in males than females?
Autism and ADD
A patient’s mother has recommended that he see you. He lives on his own and is a computer programmer. He works from home. He has
no friends and seldom leaves the house. She
is concerned that he expresses no interest in meeting people and seems perfectly happy to be home alone all the time. What is the most likely diagnosis?
Schizoid personality disorder
A patient expresses concern that he can’t trust anyone. That everyone is out to get him, and his problems are all the faults of others. He has held very long grudges due to perceived past wrongs. What is the most likely diagnosis?
Paranoid personality disorder
A patient is very charming during his interview. You note during your interview that he has no concern for hurting or using other people. He seems to show no remorse for any of his actions. What is the most likely diagnosis?
Antisocial personality disorder
Antisocial personality disorder may not be diagnosed until what age?
18
A patient exhibits all of the characteristics of
antisocial personality disorder, but he is only 14 years old. What is the most likely diagnosis?
Conduct disorder
A patient exhibits splitting, seeing others as all good or all bad. What is the most likely diagnosis?
Borderline personality disorder
What type of behavioral therapy works best for borderline patients?
Dialectical behavioral therapy
A patient is arrogant with an inflated self-image. He feels he is special and should be treated that way. What is the most likely diagnosis?
Narcissistic personality disorder
Is obsessive compulsive disorder egosyntonic or ego-dystonic? What about obsessive compulsive personality disorder?
OCD is ego-dystonic, OCPD is egosyntonic
What two things are needed to make a diagnosis of bipolar 2?
One major depressive episode and one hypomanic apisode
What medication is a good place to start treating bipolar 1 or 2?
Lithium
How is acute stress disorder different from PTSD?
Acute stress disorder occurs within 1 month of event and resolves within about a month. PTSD begins at about 1 month after event and can last inde nitely.
A serial fracture should make your think of what issue?
Abuse (child or elder)
During an interview a patient states “I have been anxious for as long as I can remember.” This statement should make you think of what diagnosis?
Generalized anxiety disorder
Are hallucinations normal during grieving period?
Yes, as long as they are not persistent or intrusive
