Psychiatric/Behavioral & Substance Abuse

Question 1

not thinking about behavior modification =

thinking about it =

planning behavior modification =

putting plan into action =

maintaining new behavior

Answer 1

Precontemplation

contemplation

preparation

action

maintenance

Question 2

recurrent episodes of binge eating, followed by compensatory behavior, excessive preoccupation with body weight and shape, normal weight weight or above normal =

treatment with nutritional rehab, CBT, and ________

Answer 2

bulimia nervosa

SSRI fluoxetine

Question 3

_______ blocks the ________ receptor and blocks the rewarding and reinforcing effects of alcohol to reduce CRAVING

Answer 3

naltrexone

mu opioid

Question 4

evaluation of a patients access to _____ is a key part of suicide risk assessment

Answer 4

guns

Question 5

depressed mood, low energy, loss of interest, insomina, weight loss, poor concentration almost every day for >2 weeks =

even if hypothyroidism diagnosed, TSH is _______, so not a consequence of this

Answer 5

Major Depressive Disorder

normal

Question 6

_______ is a pure opioid Receptor antagonist and used to treat opioid intox and OD. It has the greatest affinity for ____ receptor

Answer 6

Naloxone

Mu

Question 7

acute onset of tremulousness, agitation, elevated pulse and BP 48hrs following admission is suggestive of _______. FIrst line therapy is _______ such ________ in order to prevent progression to seizure and delrium. Long acting agents are preferred unless the patient has liver disease, then shorter acting agents like lorazepam and oxazepam are preferred

Answer 7

alcohol withdrawal

benzos

chlordiazepoxide or diazepam

Question 8

based on the principle of _____ the prescription of medications likely to do more harm than good should be avoided, even if requested by patients (stimulants for ADHD in patient with many risk factors)

Answer 8

nonmaleficence

Question 9

_______ for Bipolar Disorder has a very narrow therapuetic index and presents toxicity as gradual worsening confusion, agitation, ataxia, tremors/fasciculations. This toxicity can be precipitaed by volume depletion and drug interactions with _______, ACEI, and NSAIDs

Answer 9

Lithium

thiazide diuretics

Question 10

_____________ in college student preparing for finals can present with paranoid ideation and must be differentiated from primary psychiatric disorders. Physical signs of stimulant intoxication include tachycardia, HTN, hyperthermia, diaphoresis, and mydriasis

Answer 10

Stimulant intoxication

Question 11

_______ medications are the first line treatment for ADHD. They work by increasing the availability of _______ and _____ in the PFC

Answer 11

Stimulant

NE and DA

Question 12

Key defense mechanisms:

expressing unacceptable feelings through actions =

behaving as if an aspect of reality does not exist =

transferring feelings to a more acceptable object =

using intellect to avoid uncomfortable feelings =

avoiding conflict by expressing hositility convertly =

attributing ones own feelings to others =

justifying behavior to avoid difficult truths =

responding to a manner opposite to one’s actual feelings

reverting to earlier developmental stage =

seeing others as all good or all bad =

channeling impulses into socially acceptable behaviors =

putting unwanted feelings aside to cope with reality =

Answer 12

acting out

denial

displacement

intellectualization

passive aggression

projection

rationalization

reaction formation

regression

splitting

sublimation

suppression

Question 13

depression, suicidal ideation, impulsivity in women in the setting of feeling rejected; persistent pattern of unstable and intense relationships, substance abuse, unsafe sex, recurrent suicidal behaviors or threats, inappropriate or intense anger, chronic feelings of emptiness =

Answer 13

Borderline personality disorder

Question 14

pervasive pattern of distrust and suspiciousness beginning in early adulthood and occurring in a variety of settings

Answer 14

paranoid personality disorder

Question 15

intentional falsification or inducement of symptoms (induction of infection in the absence of obvious rewards)

Answer 15

Factitious disorder

Question 16

_________ involves a neutral stimulus being repeatedly paired with non neutral stimulus that elicits an unconditioned response. Over time the neutral stimulus (stethoscope) is able to evoke a conditioned response (sweating, anxiety) in absence of non neutral stimulus (physician girl is scared of)

Answer 16

Classical conditioning

Question 17

the new onset of anxiety in a patient with no prior psychiatric history and prominent physical findings on examination suggest that the anxiety is more likely due to a _______ such as ________

Answer 17

medical condition

hyperthyroidism

Question 18

patient initially presents with depression and insomnia, given a medication, then comes back 3 weeks later in a full blown manic episode, with a family history of bipolar disorder. Disorder?

induced by __________ such as ________

Answer 18

Bipolar disorder

antidepressants, sertraline

Question 19

buspirone is a _________ used in the treatment of GAD. It is not useful in the treatment of acute anxiety due to its ________, lacks muscle relaxant or anticonvulsant properties, and carries no risk of dependence

Answer 19

nonbenzodiazepine anxiolytic

slow onset of action

Question 20

treatment resistant schizophrenia or schizophrenia assoicatied with suicidality =

adverse effects =

Answer 20

clozapine

agranulocytosis (monitor neutrophil count)

Question 21

_______ is characterized by psychotic symptoms (delusions, hallucinations, disorganized speech, behavior, negative symptoms) lasting greater than 1 month and less than 6 months

greater than 6 months =

less than 1 month =

Answer 21

Schizophreniform disorder

Schizophrenia

Brief Psychotic disorder

Question 22

recurrent, unexpected panic attacks and avoidance of potential triggers =

Answer 22

Panic disorder

Question 23

in order to manage somatic symptom disorder, physicians should __________, limit unnecessary workout and referrals, reassure the patient that a serious illness has been ruled out, legitimize symptoms, decrease stress, improve coping strategies, and only refer to mental health once a physician/patient relationship is well established

Answer 23

schedule regular visits with the same provider

Question 24

smoked drug, uncoordinated, jerky movements, assaults bouncer, fights off 4 officers, immune to pain, visual hallucinations, agitation and sedation altering states, HTN, tachycardic, vertical nystagmus =

works primarily as a n

Answer 24

PCP induced psychosis

NMDA receptor antagonist

Question 25

acute treatment of agitation, psychosis in the presence of delirium in an elderly patient with UTI =

Answer 25

haloperidol

Question 26

sexual dysfunction is seen in up to 50% of patients treated with ______. Bupropion, a _____________ is a first line treatment for MDD that does not cause this side effect

Answer 26

SSRIs NDRI

Question 27

mature defense mechanism involving the conscious choice not to dwell on a particular thought or feeling =

Answer 27

suppression

Question 28

___________ are the most common adverse effects of psychostimulate medications used to treat ADHD such as methylphenidate

Answer 28

decreased appetite and insomnia

Question 29

acute panic disorder treatment = acts by positive allosteric modulation of the ____ receptor

Answer 29

Benzodiazepine GABAa

Question 30

multiple persistent deficits in social communication and interactions currently or history involving lack of social engagement, repetitive play, insistence on sameness =

Answer 30

Autism spectrum disorder

Question 31

reversible, acute confusional state in the presence of a likely bacterial infection = gradual progressive irreversible confused state with remote memory sparing =

Answer 31

delirium dementia

Question 32

recurrent episodes of chest pain, tachycardia, SOB, sweating, and tremulousness in a young, otherwise healthy patient with normal ECG are consistent with _______ administration of _______ results in rapid relief

Answer 32

panic disorder benzos

Question 33

_________ consists of anxiety >4 weeks in children and >6months in adults due to separation from those to whom the patient is attached. Physical symptoms and nightmares may accompany anxiety

Answer 33

Separation anxiety disorder

Question 34

in the US, the majority of OD deaths are caused by

Answer 34

opioids

Question 35

distracted, impulsive, grandiosity, flight of ideas, increased activity, decreased need for sleep, talkativeness (DIGFAST) is most likely _______ and can occur with or without psychotic features. _______ involves hypomanic episodes and major depressive episodes

Answer 35

BPDI BPDII

Question 36

replacing unacceptable feelings and impulses with their extreme opoosites =

Answer 36

reaction formation

Question 37

______ acts by inhibiting the presynaptic reuptake of NE, DA, and 5HTP. Intoxicated patients develop agitation, tachycardia, HTN, and light responsive mydriasis due to increase ______ activity. It is also a potent vasoconstrictor and can cause myocardial ischemia and atrophy of nasal mucosa and septum

Answer 37

Cocaine sympathetic

Question 38

chlorpromazie and thioridazine are ______ first generation anti-psychotics, while haloperidol and fluphenazine are _______ first generation anti-psychotics. Fluphenazine will have a higher chance of ________ symptoms as an adverse effect

Answer 38

low potency high potency extrapyramidal

Question 39

______ is typically the first symptom of alcohol withdrawal

Answer 39

tremulousness

Question 40

treatment for _______ includes scheduled daytime naps and psychostimulants such as ________ for daytime sleepiness

Answer 40

nacrolepsy modafinil

Question 41

at age 2, a child should have a vocabulary of ______ and be using 2 word phrases. Parents concerns about delayed milestones should be validated, and that further assessment and regular monitoring are essential

Answer 41

50-200 words

Question 42

all patients experiencing a major depressive episode should be carefully screened for __________ to rule out bipolar disorder

Answer 42

past manic episodes

Question 43

nausea, vomiting, abdominal pain, muscle aches, dilated pupils, yawning, lacrimation are _______ withdrawal symptoms

Answer 43

heroin

Question 44

PTSD (symptoms longer than 1 month) =

Answer 44

SSRI, SNRI

Question 45

__________ is characterized by recurrent intrusive thoughts (obsessions) and repetitive time consuming rituals (compulsions) that the individual feels driven to perform

Answer 45

Obsessive-compulsive disorder

Question 46

______ is a sedating antidepressant often used as a hypnotic to treat insomnia associated with depression. It has been associated with the rare but serious side effect of priapism

Answer 46

Trazodone

Question 47

long term panic disorder treatment = immediate

Answer 47

SSRI/SNRI and CBT Benzo

Question 48

subjective restlessness with inability to sit still in a patient being treated for schizophrenia successfully is due to = called

Answer 48

antipsychotic treatments akathisia

Question 49

Clozapine and olanzabine can cause ________ syndrome, so fasting glucose and lipids should be measured regularly

Answer 49

metabolic

Question 50

the most common causes of death with TCA OD are ______ and refractory hypotension due to the ______ of fast sodium channels in cardiac myocytes

Answer 50

cardiac arrhythmias inhibition

Question 51

___________ side effects include DI, hypothyroidism, tremor, ebstein anomaly

Answer 51

Lithium

Question 52

preoccupation with >1 perceived physical defects, appear slight to others, repetitive behavior or mental acts performed in response, significant distress or impairment, specific insight

Answer 52

body dysmorphic disorder

Question 53

peer behavior has a strong influence on adherence in ______ due to desire to fit in

Answer 53

teens

Question 54

not excessive or out of proportion to severity of stressor, no significant functional impairment, just sad =

Answer 54

normal stress response

Question 55

drug induced parkinsonism is a type of extrapyramidal symptom caused by medications that block _______ such as ________

Answer 55

D2 receptors Benztropine

Question 56

patients who experience major depressive and hypomanic episodes are diagnosed with _________

Answer 56

BPD2

Question 57

young kid, new friends, inappropriate laughter, increased appetitie, slowed reaction time, tachycardia and conjunctival injection =

Answer 57

marijuana

Question 58

methadone is a drug of choice for maintenance treatment of opioid use because it is potent and

Answer 58

long acting

Question 59

involuntary movments after chronic use of antipsychotics such as lip smacking, choreoathetoid movements =

Answer 59

tardive dyskinesia

Question 60

hallucinations of recently deceased relatives in children are part of the -________

Answer 60

normal grief reaction

Question 61

Risperidone and other antipsychotics cause _________ by blocking D2 receptors on lactotrophs leading to elevated prolactin levels, amenorrhea, galactorrhea, and breast soreness

Answer 61

hyperprolactinemia

Question 62

________ is characterized by loss of speech and motor skills, deceleration of head growth, sterotypic hand movements after a period of normal development. It mainly affects girls and is associated with mutations in _______

Answer 62

Rett syndrome MECP2

Question 63

the anticonvulsant ______ also has mood stabilizing properties and is an effective maintenance therapy for Bipolar disorder

Answer 63

valproate

Question 64

by age ____ a child is expected to play imaginateively in parallel, speak in simple sentences, copy a circle, use utensils, and ride a tricycle

Answer 64

3

Question 65

short term acting benzos or intermediate term acting benzos such as _____ or _______ are preferred as a temporary treatment during the initiation period for SSRIs in anxiety treatment

Answer 65

triazolam lorazepam

Question 66

patient develops hyperthermia, HTN, tachycardia, agitation, confusion, tremor, hyperreflexia, myoclonus, GI symptoms, diaphoresis after a round of antibiotics in the hospital = due to _______ which has some MAOI activity combined with patients current SSRI/SNRI/TCA

Answer 66

serotonin syndrome linezolid

Question 67

to avoid serotonin syndrome, patients must wait at least 2 weeks after discontinuing an MAOI (phenyelzine) before initiating SSRI therapy (Sertraline) allowing time for ______

Answer 67

MAO regeneration

Question 68

patients showing drug seeking behavior should, physician should obtain ________

Answer 68

confirmation of the patients prescription history

Question 69

patient experiencing a manic episode, receives multiple doses of antipsychotic medication to control him, develops hyperthermia, muscle rigidity, and confusion = contrast to serotonin syndrome, these patients do not exhibit ______ and clonus

Answer 69

Neuroleptic malignant syndrome hyperreflexia

Question 70

a ________ is characterized by difficulties with learning key academic skills like reading, writing, or mathematics. Kids will display symptoms of anxiety, inattention, or hyperactivity when under stress

Answer 70

learning disorder

Question 71

specific phobias are best treated with

Answer 71

behavioral therapy

Question 72

child aggressive toward people and animals, destruction of property, serious violation of rules, deceitfulness or theft = if adult =

Answer 72

conduct disorder antisocial disorder

Question 73

eccentric, odd thoughts, perceptions and behavior = preferes to be a loner, detached, unemotional =

Answer 73

Schizotypal Schizoid

Question 74

patient overdose with cutaneous flushing, dry oral mucosa, dilated poorly reactive pupils, confusion, which drug? why?

Answer 74

TCAs (amitriptyline) strong anticholinergic adverse effects)

Question 75

____________ is the strongest single risk factor for suicide

Answer 75

previous suicide attempt

Question 76

mania, delusions, hallucinations in the absence of any other mood episode over lifetime =

Answer 76

schizoaffective

Question 77

_________ is characterized one more more delusions in the absence of other psychotic symptoms. Behavior is not obviously bizarre and functioning is not significantly impaired apart from the direct impact of the delusions

Answer 77

delusional disorder

Question 78

misattribution of one's unacceptable feelings or thoughts to another person who does not actually have them

Answer 78

projection

Question 79

multiple motor and vocal tics for >1 year with no obvious cause = treatment with antipsychotics, alpha 2 adrenergic agonists, and behavioral therapy

Answer 79

Tourette disorder

Question 80

persistent or recurrent feelings of detachment from or being outside ones self, derealization, but intact reality testing

Answer 80

depersonalization/derealization disorder

Question 81

_______ is an eating disorder characterized by low body weight, intense fear of becoming fat, and distorted body image, bradycardia, hypotension, osteoporosis, amenorrhea, and cardiac atrophy as a result of malnutriton and starvation

Answer 81

anorexia nervosa

Question 82

GAD should be treated long term with SSRIS or SNRIs like

Answer 82

citalopram

Question 83

patients with _________ often experience executive dysfunction and personality changes secondary to impairment of the organizational, restraint, and motivational symptoms. Changes in social behavior can manifest in variable ways. _______ lesions more often associated with apathy and ________ lesions with disinhibition

Answer 83

front lobe injury left sided right sided

Question 84

increased appetite and sleep, leaden paralysis, rejection sensitivity, and mood reactivity are hallmarks of _________ can respond well to MAOI like ________

Answer 84

atypical depression phenelzine

Question 85

depression, fatigue, hypersomnia, hyperphagia, vivid dreams, history of drug use, due to withdrawla of

Answer 85

cocaine

Question 86

______ is the unconscious shifting of emotions associated with signfiicant from ones past to a person in the present

Answer 86

Transference

Question 87

bilateral parotid gland enlargement, erosion of tooth enamel, irregular menses, abnormal electrolytes

Answer 87

bulimia nervosa

Question 88

____________ is a severe subtype of unipolar major depression characterized by symptoms meeting criteria for a major depressive episode and the presence of delusions or hallucinations

Answer 88

major depressive disorder with psychotic features

Question 89

_______ involves excessive fears of scrutiny or embarrassment in social or performance situations, resulting in significant distress and functional impairment

Answer 89

social anxiety disorder

Question 90

nonpharmacologi treatments for insomnia include sleep hygiene, stimulus control, relaxation, sleep restriction, and cognitive behavioral therapy. stimulus control focuses on eliminating stimulating bedroom activities and ____________

Answer 90

getting into bed only when sleepy

Question 91

MDD treatment

Answer 91

SSRIs or TCAs

Question 92

_______ is characterized by chronic depressed mood and at least 2 other depressive symptoms lasting for at least 2 years

Answer 92

persistent depressive disorder (dysthymia)

Question 93

________ is maladaptive pattern of behavior characterized by social inhibition, feelings of inadequacy and fear of embarrassment and rejection. Patients have the desire for social interaction unlike _____

Answer 93

Avoidant personality disorder Schizoid

Question 94

___________ are the treatment of choice for OCD

Answer 94

SSRIs

Question 95

______ is the compulsive consumption of a nonfood or nonstaple food source for >1month common in

Answer 95

pica (ice eating) pregnancy

Question 96

recurrent episodes of early ejaculation accompanied by a sense of lack of control

Answer 96

premature ejaculation

Question 97

________ is a behavioral disorder of childhood characterized by argumentative and defiant behavior toward authority figures. It does not involve the more severe violations of the basic rights of others seen in conduct disorder

Answer 97

Oppositional defiant disorder

Question 98

________ is a first line antidepressant with amphetamine like properties, it is not associated with sexual side effects or weight gain, however, it is associated with an increased _____ risk at high doses.

Answer 98

Bupropion Seizure