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PANCE 2.0 > Psych/Behavioral Health #3 > Flashcards

Psych/Behavioral Health #3 Flashcards

1
Q

What is dissociative identity disorder?

A

2 or more distinct identities or states of personalities

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2
Q

Dissociative identity disorder is MC in ______, those with a history of ______, _____, or ______.

A

Women

-PTSD, substance abuse, sexual abuse

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3
Q

What is depersonalization?

A

Persistent feelings of detachment or estrangement from oneself (out of body feeling)

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4
Q

What is derealization?

A

-Persistent feelings of detachment or estrangement from surrounding environment

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5
Q

What is dissociative amnesia?

A

Inability to recall personal/autobiographical information (often due to sexual abuse, stress, or trauma)

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6
Q

Abrupt change in geographic location with loss of identity or inability to recall the past

A

Dissociative fugue

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7
Q

Treatment for dissociative disorders

A

Psychotherapy

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8
Q

Obesity is defined as a BMI > _____ or body weight _____% or more over the ideal weight

A

BMI > 30

body weight 20% or greater over ideal weight

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9
Q

At what age should a patient be screened for obesity?

A

All adults and children age 6 years or older

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10
Q

Orlistat is an anti-obesity medication that works how?

A

Decreases GI fast digestion

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11
Q

Another anti-obesity medication, Lorcaserin, works…

A

as a serotonin agonist

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12
Q

Unlike bulimia nervosa, binge-eating episodes are NOT associated with

A

compensatory behaviors (purging or restrictive behaviors) and they are not as fixated on their body shape or weight

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13
Q

Treatment for binge-eating disorders

A
  • Psychotherapy
  • Strict diet and exercise plan
  • Topiramate (anti epileptic associated with weight loss)
  • Stimulants: appetite suppression (Amphetamine)
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14
Q

What exactly is binge-eating disorder?

A

Recurrent episodes of binge eating: eating within a 2 hour period more than people would in a similar period with lack of an overeating episode (occurs at least weekly for 3 months)

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15
Q

How does Bulimia Nervosa differ from Anorexia Nervosa?

A

Patients with bulimia usually maintain a normal weight (or may be overweight) and their compensatory behaviors are ego-dystonic (troublesome to the patient)

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16
Q

Physical exam findings of a patient with bulimia nervosa

A
  • Teeth pitting or enamel erosion (from vomiting)
  • Russell’s Sign: calluses on the dorsal of the hand
  • Parotid gland hypertrophy
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17
Q

Lab findings of a patient with bulimia nervosa

A
  • Hypokalemia
  • Hypomagnesemia
  • Increased amylase

-Metabolic alkalosis from vomiting

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18
Q

Diagnostic criteria for bulimia

A
  • Recurrent episodes of binge eating (at least weekly for 3 months)
  • Compensatory behaviors: purging and non-purging
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19
Q

Treatment for bulimia

A
  • Psychotherapy

- Pharmacotherapy: Fluoxetine

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20
Q

Anorexia nervosa is _______

A

Failure to maintain normal weight, fear and preoccupation with body weight, body image, and being thin

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21
Q

True or False: Anorexia nervosa has the highest mortality of all psychiatric conditions?

A

True

22
Q

With anorexia nervosa, their behaviors are _____, which means

A

Ego-syntonic, their behaviors are acceptable to them and are in harmony with their self-image goals

23
Q

Name and describe the two types of Anorexia Nervosa

A

Restrictive type: strict, reduced calorie intake, dieting, fasting, excessive exercise, and diet pills

Binge eating/Purging: primarily engages in self-induced vomiting and diuretic, laxative, and enema use

24
Q

Symptoms of anorexia nervosa

A
  • Amenorrhea
  • Lanugo
  • Bradycardia
  • Dry skin
  • Salivary gland hypertrophy
  • Osteopenia
  • Russell’s Sign
25
Q

What is the BMI and body weight of a patient with anorexia nervosa?

A

BMI: 17.5 or less
Weight: < 85% of ideal weight

26
Q

What labs are present in a patient with anorexia nervosa?

A
  • Hypokalemia
  • Metabolic alkalosis
  • Increased BUN (dehydration)
  • Hypothyroidism
27
Q

Treatment for anorexia: When should a patient be hospitalized?

A

< 75% expected body weight or those with medical complications (dehydration)

28
Q

Most common complication of management of anorexia nervosa?

A

Refeeding syndrome: increased insulin leads to hypophosphatemia and cardiac complications

29
Q

What is the recommended pharmacotherapy for anorexia nervosa?

A

SSRI’s (may help with weight gain)

30
Q

True or False: Obsessive compulsive disorder: the obsessions are usually ego-dystonic and inconsistent with one’s own personal beliefs?

A

True

31
Q

What is the theorized pathophysiology of OCD?

A

Abnormal communication between the basal ganglia

32
Q

What is the primary neurotransmitter involved in OCD?

A

Serotonin

33
Q

What are the four major patterns of OCD?

A

1) Contamination: cleaning or hand washing
2) Pathologic doubt: forgetting to unplug iron to avoid danger
3) Symmetry/Precision: ordering or counting
4) Intrusive thoughts

34
Q

What is the first-line therapy for OCD?

A

Cognitive behavioral therapy: exposure and response prevention

35
Q

Pharmacotherapy for OCD

A
  • SSRI in higher doses than with depressive disorders

- TCA: Clomipramine used because it is most serotonin specific

36
Q

What is body dysmorphic disorder?

A

Excessive preoccupation with at least 1 perceived flaw or defect in physical appearance not observable by others

37
Q

What actions will the patient commit with body dysmorphic disorder and what is the average age of onset?

A
  • Repetitive acts related to preoccupation: mirror checking, skin picking, seeing reassurance
  • Average age of onset: 15 years old
38
Q

Treatment for body dysmorphic disorder

A

-SSRI’s and/or CBT

39
Q

What is trichotillomania?

A

Hair-pulling disorder

40
Q

Risk factors for trichotillomania

A
  • Female gender

- Increased incidence with OCD, excoriation, and depressive disorders

41
Q

Treatment for trichotillomania

A

CBT and habit reversal therapy

-SSRI can be used as well

42
Q

Hoarding disorder is most prevalent in ______ and 20% have ______

A

Older population

OCD

43
Q

What is the treatment for hoarding disorder?

A

CBT specific for hoarding, but very difficult to treat

-SSRI’s can be used as well

44
Q

67% of patients with ADHD also have _____ and _____

A

Conduct and oppositional defiant disorders

45
Q

Diagnostic criteria for ADHD must have three things. Name them.

A
  • Symptom onset before age 12
  • Present for at least 6 months
  • Must occur in at least 2 settings
46
Q

What are the three symptoms that are present with ADHD?

A
  • problems paying attention
  • Impulsivity
  • Hyperactivity
47
Q

Name some symptoms of ADHD

A
  • Easily distracted; misses details, easily distracted
  • Forgets things or loses things easily
  • Difficulty in completing assignments
  • Fidgets and squirms in seat
  • Impatience
  • Talks nonstop or excessively
  • Restlessness
  • Interrupts conversation
48
Q

The treatment for ADHD is a multimodal approach; explain this

A
  • Behavior modification
  • Stimulants (Methylphenidate, Amphetamine/Dextroamphetamine)
  • Nonstimulants (Atomoxetine)
49
Q

Adverse effects of stimulants (Amphetamine, Methylphenidate, Dextroamphetamine)

A
  • Abdominal pain
  • Insomnia
  • Weight loss
  • Hypertension
  • Tachycardia
  • Growth delays
  • Addiction
50
Q

Mechanism of action of stimulants

A

Blocks reuptake and increases the release of norepinephrine and dopamine in extraneuronal space

51
Q

Symptoms of autism are usually recognized between what ages?

A

12-24 months

52
Q

Symptoms of autism spectrum disorder

A
  • Social interaction difficulties
  • Impaired communication
  • Restricted, repetitive stereotyped behaviors
  • Savantism (unusual talents)
  • Unusual attachments to ordinary objects

PANCE 2.0 (62 decks)

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