Psychiatry Flashcards
1
Q
What is considered mild mental retardation?
A
IQ btw 50-70
6th grade level functioning, can work & live independently but need help in stressful imes
2
Q
What is considered moderate mental retardation?
A
IQ btw 30-50
2nd grade level functioning, require supervision & support
3
Q
What is considered severe mental retardation?
A
IQ 20-40
little/no speech, limited self care
4
Q
What is considered profound severe mental retardation?
A
IQ < 20
needs continuous care & supervision
5
Q
What is treatment for mental retardation? (4)
A
- preventation: genetic counseling, prenatal care, safe environment
- treat underlying disorder (PKU, etc)
- special education to improve functioning
- behavioral therapy to reduce negative behaviors
6
Q
What are the childhood developmental disorders that involve social, behavioral, and language problems that occurs before 3 years old? (4)
A
- Autism
- Rett disorder
- Childhood disintegrative disorder
- Asperger disorder
7
Q
A boy who lacks peer relationships (w/ peers and parents), poor eye contact, lack social smile, absent/ bizarre speech, repetitive behaviors (spinning, banging head, stacking), easily agitated resulting in injury of self and others presenting before 3 years old most likely suffers from …
A
Autism Disorder
8
Q
What is the treatment for the aggressive behavior of Autistic children?
A
Antipsychotic medications
9
Q
A girl presents with microcephaly, hand wringing, loss of speech, ataxia, progressive loss of muscle function, progressive encephalopathy and psychomotor retardation most likely suffers from ….
A
Rett Syndrome
10
Q
A boy presents with normal development for 2 years followed by marked functional regression (loss of language, motor function, bladder function) and repetitive/ stereotyped behavior most likely suffers from ….
A
Childhood disintegrative disorder
need to rule out infectious causes
11
Q
A boy presents with social and behavioral problems (lack peer relationships, poor eye contact, repetitive behaviors) and preoccupied with rules without language or intellectual deficits most likely suffers from ….
A
Asperger Disorder
12
Q
A child presents with history of interrupting others, fidgeting in chair, running/ climbing excessively, and unable to engage in leisure activities at home while at school, inattentive, make careless mistakes in work, doesnt follow thru with instructions, has difficulties organizing tasks and easily distracted; these symptoms have been present for at least 6 months with onset before 7 years old most likely suffers from …
A
ADHD (attention deficit hyperactivity disorder)
13
Q
What is the best initial treatment for ADHD (attention deficit hyperactivity disorder)?
A
Methylphenidate or dextroamphetamine
14
Q
What are common side effects associated with stimulant medication used for ADHD (methylphenidate, dextroamphetamine)?
A
- insomnia
- decreased appetite
- headache
15
Q
what is second line treatment for ADHD (attention deficit hyperactivity disorder)?
A
atomoxetine (NE reuptake inhibitor)
usually chosen over stimulant medication b/c low side effect profile
16
Q
A child presents around age 8 years old and argues often, loses temper easily, easily annoyed, blames others for their mistakes, have problems with authority figures (teachers, parents), justifies behavior as response to other’s actions that interrupts with functioning in school/ home/ work most likely suffers from …
A
Oppositional Defiant Disorder
17
Q
What is treatment for oppositional defiant disorder?
A
teach parents appropriate child management skills
18
Q
A boy presents with persistent behavior that breaks rules, aggressive to others, bullying, cruelty to animals, fighting, use weapons, vandalize and destroy property, set fires, steal items from others, and lie to obtain good from others, and get in trouble with law (truancy, running away, breaking curfew) most likely suffers from ….
A
Conduct disorder
19
Q
What is the treatment for aggressive behavior of children with Conduct disorder?
A
antipsychotic medication
20
Q
A pt presents with multiple tics that have lasted for longer than 1 year with onset before 18 y/o, tics can be motor (facial, neck muscle twitching like head shaking or blinking) or vocal (grunting, coughin, throat clearing) that is uncontrollable most likely suffers from …
A
Tourette Disorder
21
Q
What is the treatment for Tourette Disorder?
A
Dopamine antagonist (risperidone)
22
Q
A pt presents with at least 2 weeks of having at least 4 of the SMIGECAPS symptoms without a medical or neuological and causing impairment of functioning most likely suffers from …
A
Major depression
23
Q
What are the SMIGECAPS symptoms associated with depression?
A
- sleep changes
- mood (depressed)
- interest loss (anhedonia)
- guilty
- energy loss (fatigue)
- concentration poor
- appetite changes
- psychomotor agitation/ depression
- suicidal ideation
24
Q
What is the most common medical cause of depressed mood?
A
Hypothyroidism
25
What is the first line treatment for depression?
SSRIs (fluoxetine, paroxetine, sertraline, citalopram, escitalopram)
26
How long does it take for SSRIs to become effective?
4-6 weeks
27
What is the next best step in management if a pt with depression has some improvement but not a full response to an SSRI?
1. increase dose of SSRI
| 2. add psychotherapy (cognitive therapy to identify negative thoughts and develop positive ways of thinking)
28
What disorder is associated with SSRIs being used with MAO inhibitors?
Serotonin syndrome
29
What is the best treatment for a pt with depression and neuropathic pain?
Desvenlafaxine
30
What is the best treatment for a pt with depression who is fearful of weight gain or sexual side effects?
Bupropion
| used as adjunct treatment for SSRI induced sexual side effects
31
A pt presents with elevated mood along with at least 3 DIGFAST symptoms that last at least 1 week that causes significant distress in level of functioning and may have associated depression episodes most likely suffers from ....
Bipolar 1 Disorder
32
What are the DIGFAST symptoms associated with maniac disorder?
```
D: distractibilty
I: insomnia (decreased need for sleep)
G: grandiosity
F: flight of ideas
A: activities (increased goal directed and pleasurable)
S: pressured speech
T: thoughtlessness
```
33
What is a common medical cause of manic episodes?
Cocaine/ amphetamine use
| obtain urine drug screen
34
What is the difference between mania and hypomania?
mania: severe impairment of functioning, last 1 week
hypomania: mild impairment, lasts less than 1 week
35
A pt presenting with hypomania and major depression most likely suffers from ...
Bipolar 2 disorder
36
What is the treatment for acute manic episode?
1. lithium
2. valproic acid
3. atypical antipsychotics (olanzapine, especially if severe)
37
What is the treatment for bipolar depression?
1. lithium
| 2. lamotrigine
38
What patients should not be given lithium for bipolar disorder? (2)
1. kidney dysfunction
| 2. pregnant
39
A pt presents with depressed mood that lasts most of the day and is present almost continuously for at least 2 years with minimal impairment of functioning most likely suffers from....
Dysthymia
40
A pt presents with hypomanic episodes and mild depression for at least 2 years with minimal impairment of functioning most likely suffers from ...
Cyclothymia
| tx: lithium, valproic acid, carbamazepine, and psychotherapy
41
A pt presents with depressed mood, increased sleep, increased weight and increased appetite with mood worse in the evening and complain of extremities feeling heavy most likely suffers from ...
Atypical depression
42
What is the treatment atypical depression?
1. SSRIs
| 2. MAO inhibitors
43
A pt presents with depressed mood that usually occurs in fall and winter yearly with associated weight gain, increased sleep, and fatigue most likely suffers from ...
Seasonal Affective Disorder
44
What is the treatment for seasonal affective disorder?
1. phototherapy
| 2. bupropion
45
A post-partum women develops sadness, mood lability, tearfulness that starts immediately after birth lasting up to 2 weeks and lack negative feelings toward their baby most likely suffers from ....
Postpartum blues ("baby blues")
46
What is the treatment for postpartum blues (baby blues)?
Supportive (usually self limited)
47
A post-partum women presents with depressed mood, weight changes, sleep disturbances and excessive anxiety that started withing 1-3 months after giving birth and may have negative feelings toward baby and feels guilty about the feelings most likely suffers from ...
Post-partum depression
48
A post-partum women presents with depression, delusions, and thoughts of harming the baby that starts within 2-3 weeks after birth most likely suffers from ...
Postpartum psychosis
49
What is the treatment for postpartum psychosis?
1. antipsychotic medication
2. lithium
(with antidepressants)
50
What is the treatment for postpartum depression?
antidepressant medication
51
A pt presents with feelings of sadness, worrying, irritability, sleep difficulties, poor concentration and tearfulness after the death of a loved one that usually last less than 6 months most likely suffers from ...
Bereavement (Grief)
52
What is the treatment for bereavement (grief)?
supportive therapy
53
What are red flags that a pt has depression instead of bereavement? (6)
1. weight loss
2. feeling of worthlessness
3. symptoms last longer than 2 months
4. prolonged functional impairment
5. suicidal ideation
6. psychosis
54
What are the side effects of TCAs (amitriptyline, notriptyline, imipramine)? (9)
1. hypotension
2. dry mouth
3. constipation
4. confusion
5. arrhythmias
6. sexual side effects
7. weight gain
8. GI distress
9. toxic
55
What are the major side effects of MAO inhibitors (phenelzine, isocarboxazid, tranylcypromine)?
```
Hypertensive crisis (w/ aged cheese, red wine, chocolate)
2. Serotonin syndrome (if given with SSRIs)
```
56
What are the side effects of SSRIs (fluoxetine, paroxetine, sertraline, citalopram, escitalopram, fluoxamine)? (5)
1. headaches
2. weight changes
3. sexual side effects
4. GI distress
5. Serotonin syndrome (if given w/ MAO inhibitor)
57
What are the side effects of SNRIs (venlafaxine, duloxetine, desvenlafaxine)?
1. hypertension
2. blurry vision
3. weight changes
4. sexual side effects
5. GI distress
58
What are the side effects of buproprion?
increased risk of seizures (lowers threshold for seizures)
| avoid in anorexic
59
What is the side effect of trazadone?
Priapism
60
What are the side effects of mirtazapine? (2)
1. weight gain
| 2. sedation
61
What antidepressant medication can be helpful in smoking cesstion?
Bupropion
62
What are the side effects associated with lithium? (7)
1. tremors
2. weight gain
3. GI distress
4. nephrotoxic (diabetes insipidus)
5. teratogenic (Ebstein's anomaly)
6. leukocytosis
7. toxicity (confusions, ataxia, lethargy, abnormal reflexes)
63
What are the side effects associated with valproic acid? (7)
1. tremors
2. weight gain
3. Gi distress
4. alopecia
5. teratogenis
6. hepatotoxic
7. toxicity (coma, hyponatremia, death)
64
What is the side effect associated with lamotrigine?
Stevens- Johnson syndrome
65
What are the side effects associated with ECT (electroconvulsive therapy)?
1. headache
| 2. transient memory loss
66
What is the most effective treatment for depression?
ECT (electroconvulsive therapy)
67
When should ECT be used for depression?
1. no response to medical treatment
| 2. suicidal patient
68
A pt presents with agitation, confusion, hallucinations, hypomania, sweating, fever, tachycardia, tremors and myoclonus while on antidepressant medication most likely suffers from ...
Serotonin Syndrome
69
What is treatment for Serotonin syndrome?
1. stop SSRI (offending medication)
2. symptomatic treatment of fever, diarrhea, HTN
3. cyproheptadine (serotonin antagonist)
70
A pt presents with with delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior that has been going on for more than 1 day but less than 1 month most likely suffers from...
Brief Psychotic Disorder
71
A pt presents with with delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior and negative symptoms (flat affect, poor grooming, social withdrawal) that has been going for at least 1 month but less than 6 months most likely suffers from ...
Schizophreniform
72
A pt presents with with delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior and negative symptoms (flat affect, poor grooming, social withdrawal) that severely affects level of functioning that has been going for longer than 6 months most likely suffers from ...
Schizophrenia
73
A pt presenting with signs and symptoms of schizophrenia, what test should be performed to rule out other causes of similar symptoms?
Urine drug screen (rule out LSD, mushrooms, cocaine, amphetamine, etc)
74
What type of schizophrenia is characterized by delusions or hallucinations mostly of persecutory or grandiose type?
Paranoid Schizophrenia
75
What type of schizophrenia is characterized by psychomotor disturbances (retardation or excitation) that include stupor, rigidity, posturing and mutism?
Catatonic Schizophrenia
76
What type of schizophrenia is characterized by marked regression to disinhibited behavior with little contact with reality, appear disheveled and have bizarre emotional responses, and wearing something weird on head?
Disorganized Schizophrenia
| worse prognosis and earliest onset
77
What type of Schizophrenia is characterized by lack of positive symptoms (hallucinations, delusions) but the presence of negative symptoms (flat affect, poor grooming, social withdrawal)?
Residual Schizophrenia
78
What is the treatment for brief psychotic disorder, schizophreniform, and schizophrenia?
1. hospitalize if acutely psychotic
| 2. atypical antipsychotic (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole, paliperidone)
79
What is the treatment for a psychotic patient in the emergency situation where intramuscular medication is needed?
1. Olanzapine
2. Ziprasidone
(haloperidol has more side effects)
80
When treating a psychotic pt who is noncompliant, what medication is used?
Risperidone (long acting)
| haloperidol has more side effects
81
What is the last line anti-psychotic medication for a pt who does not respond to an adequate trial of typical and atypical antipsychotics?
Clozapine
| side effect of agranulocytosis
82
What is the most common side effects for olanzipine?
1. diabetes
2. weight gain
(avoid in diabetics and obese)
83
What is the most common side effects for risperidone?
1. movement disorders
| 2. gynecomastia
84
What is the most common side effects for quetiapine?
Less incidence of movement disorders
85
What is the msot common side effect for ziprasidone?
```
QT prolongation
(avoid in pts with conduction defects)
```
86
What is the most common side effect for clozapine?
agranulocytosis
| monitor CBC
87
What are the two atypical antipsychotics that are less likely to cause weight gain, diabetes and metabolic syndrome?
1. aripiprazole
| 2. ziprasidone
88
....is muscle spasms such as torticollis, laryngeal spasms and occulogyric crisis that occurs hours to days after initiating an antipsychotic medication
Acute dystonia
89
What is the treatment for acute dystonia?
1. benzotropine
2. trihexyphenidyl
3. diphenhydramine
(stop offending medication)
90
.... is generalized restlessness, pacing, rocking, and inability to relax that occurs weeks after initiating an antipsychotic medication
Akathisia
91
What is the treatment for Akathisia?
1. reduce dose of antipsychotic
2. beta blockers
3. switch to atypical antipsychotic
92
....is characterized by abnormal involuntary movements of head, limb and trunk with perioral movements being common, occurs after 6 months of use of antipsychotic medication
Tardive dyskinesia
93
What is the treatment for tardive dyskinesia?
1. switch to atypical
| once occurs, it is irreversible
94
What antipsychotic medication has the least likelihood of tardive dyskinesia developing?
Clozapine
95
A pt presents with muscular rigidity, fever, autonomic changes, agitation and altered mental status while being treated with anantipsychotic most likely suffers from ...
Neuroleptic Malignant Syndrome
96
What is the treatment for Neuroleptic Malignant Syndrome?
1. dantrolene
| 2. bromocriptine
97
A pt presents with prominent non-bizarre delusions (neighbor stealing from them, etc) for greater than 1 month and without impairment in functioning most likely suffers from ....
Delusional Disorder
| tx: atypical antipsychotic and psychotherapy
98
A pt presents with sudden episodes of feeling intense anxiety and feelings of dread and doom with at least 4 associated symptoms (diaphoresis, trembling, chest pain, fear of dying, chills, palpitations, SOB, nausea, dizziness, paresthesias, dissociative symptoms) that last less 30 minutes most likely suffers from ....
Panic Disorders
| rule out thryoid, hypoglycemia and cardiac
99
What is agoraphobia?
fear of places that escape is felt to be difficult
100
What is the treatment for panic disorder?
SSRIs (fluoxetine, paroxetine, sertraline)
| can start with benzo that is tapered down once SSRI is therapeutic
101
What is the treatment for a single panic attack?
Benzo
102
.... is the fear of an object or situation and the need to avoid it
Phobias
103
What type of phobia is characterized by fear of an object such as animals, heights or cars?
Specific Phobia
104
What type of phobia is fear of a situation where something potentially embarassing may happen such as public restrooms, eating in public, or public speaking?
Social Phobia
105
What is the treatment for specific phobia?
1. behavioral modification (systematic desesitization)
| 2. relaxation techniques (breathing, guided imagery)
106
What is systematic desensitization?
expose individuals to their feared objects, moving from the least anxiety provoking to the most anxiety-provoking
107
What is the treatment for performance anxiety?
beta blockers
108
A pt presents with thoughts that are intrusive, senseless, and distressing to the pt that increases anxiety (ie fear of contamination) and rituals that are done to neutralize thoughts (ie counting, checking) that consume time and lower anxiety, these thoughts and rituals affect the pt's level of functioning most likely suffers from ...
Obsessive Compulsive Disorder
109
What is the treatment for obsessive compulsive disorder? (20
1. SSRI (fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine)
2. exposure and response prevention
110
What disease can co-exist with compulsive disorder?
Tourette's syndrome
111
A pt who has been exposed to a stressor that was a near death experience that continually relive the event, avoid anything that reminds them of the event and these symptoms (increased startle response, hypervigilance, sleep disturbances, anger outbursts, poor concentration) affect their functioning and have been going on for at least 1 month most likely suffers from ...
Post Traumatic Stress Disorder
112
A pt who has been exposed to a stressor that was a near death experience that occurred that continually relive the event, avoid anything that reminds them of the event and these symptoms (increased startle response, hypervigilance, sleep disturbances, anger outbursts, poor concentration) affect their functioning and started within 1 month of event and have been going on for less than 1 month most likely suffers from ...
Acute Stress Disorder
113
What is the treatment for PTSD and acute stress disorder?
1. SSRIs (paroxetine, sertraline)
2. relaxation techniques
3. Psychotherapy
114
A pt presenting with excessive anxiety and worries about most things for at least 6 months, the anxiety is out of proportion of the event, and has associated symptoms (fatigue, poor concentration, sleep problems, muscle tension, restlessness) most likely suffers from ...
Generalized Anxiety Disorder
115
What is the treatment for Generalized Anxiety Disorder?
1. SSRIs (fluoxetine, paroxetine,sertraline, citalopram)
2. Venlafaxine and buspirone
3. psychotherapy and behavioral therapy
116
What are the side effects associated with benzos (diazepam, lorazepam, clonazepam, alprazolam, oxazepam, chlordiazepoxide, temazepam, flurazepam)?
1. sedation
2. confusion
3. memory deficits
4. respiratory depression
5. addiction
117
What are the side effects associated with buspirone?
1. headache
2. nausea
3. dizziness
118
When is lorazepam used?
emergency situations (b/c can be given IM)
119
When is clonazepam used?
if addiction is concerned (has longer half-life)
120
What benzo's are used for alcohol withdrawal?
1. chlordiazepoxide
2. oxazepam
3. lorazepam
121
When is alprazolam used?
panic disorder
122
When is flumazenil (benzo antagonist) used?
acute benzo overdose in which pt is not chronically dependent
123
What are side effects associated with flumazenil use?
1. seizures (in benzo dependent pt)
| 2. withdrawal (tremor, seizures)
124
... is maladaptive pattern of use of a substance that leads to engaging in hazardous situations, legal problems, inability to fulfill obligations and continued use despite adverse consequences
Substance Abuse
125
... is maladaptive pattern of use of substances that leads to tolerance, withdrawal when trying to cut down, great deal of time engaging in drug use, continued use despite adverse consequence
Substance Dependence
126
A pt presenting with talkativeness, sullen/ remorseful, sociable, moody and disinhibited most likely suffers from ...
Alcohol intoxication
127
A pt presenting with tremors, hallucinations (tactile), seizures, and delirium tremens most likely suffers from ..
Alcohol withdrawal
128
What is the treatment for alcohol withdrawal?
1. benzos
| 2. thiamine, multivitamins, folic acid
129
A pt presenting with euphoria, hypervigilence, autonomic hyperactivity, weight loss, pupillary dilation and perceptual disturbances most likely suffers from ...
Amphetamine/ Cocaine intoxication
130
A pt presents with anxiety, tremulousness, headache, increased appetite, depression, and suicidal risk most likely suffers from ...
Amphetamine/ Cocaine Withdrawal
131
What is the treatment for amphetamine/ cocaine withdrawal?
1. bupropion
| 2. bromocriptine
132
A pt presents with impaired motor coordination, slowed sense of time, social withdrawal, increases appetite, and conjunctival injection most likely suffers from ...
Cannabis/ Marijuana intoxication
133
A pt presents with ideas of reference, perceptual disturbances, impaired judgment, tremors, incoordination, and dissociative symptoms most likely suffers from ...
Hallucinogen Intoxication
134
What is the treatment for hallucinogen intoxication?
1. antipsychotics
2. benzos
3. talk down
135
A pt presents with belligerence, apathy, aggression, impaired judgement, stupor, or coma most likely suffers from ...
Inhalants Intoxication
136
What is the treatment for inhalant intoxication?
Antipsychotics
137
A pt presents with apathy, dysphora, pupillary constriction, drowsiness, slurred speech, respiratory depression and coma/death most likely suffers from ..
Opioid Intoxication
138
What is the treatment for opioid intoxication?
Naloxone
139
A pt presents with fever, chills, lacrimation, abdominal cramps, muscle spasms, and diarrhea most likely suffers from ...
Opiate Withdrawal
140
What is treatment for opiate withdrawal?
1. clonidine
| 2. metadone or burprenorphine
141
A pt presents with belligerence, psychomotor agitation, violence, nystagmus, hypertension and seizures most likely suffers from ...
```
PCP intoxication
(phencyclidine)
```
142
What is the treatment for PCP (phencyclidine) intoxication?
1. antipsychotics
2. benzo
3. talking down
143
An athlete who is large for his age who presents with irritability, aggression, mania and psychosis most likely suffers from ...
Anabolic Steroid Intoxication
144
What is the treatment for anabolic steroid intoxication?
Antipsychotics
145
An athlete who presents with depression, headaches, anxiety, and increased concern over their body's physical state most likely suffers from ...
Anabolic steroid withdrawal
146
What is the treatment for anabolic steroid withdrawal?
SSRIs
147
What are the CAGE questions used to assess for alcohol abuse/ dependence?
C: cut down
A: annoyed by criticism
G: guilty about drinking
E: eye opener (need drink first thing in morning)
(2 or more is positive test)
148
What are pharmacologic agents used for substance dependence treatment?
1. disulfram (aversion therapy for alcohol)
2. naltrexone (opioid antagonist)
3. acamprosate
149
A pt presents with 4 pain symptoms, 2 GI symptoms, 1 sexual symptom and 1 pseudoneurological symptoms that has no medical explanation most likely suffers from...
Somatization disorder
150
A pt presents with belief that they have some specific disease despite constant reassurance with no medical explanation most likely suffers from ...
Hypochondriasis
151
A pt presents with a voluntary motor or sensory functions that are indicative of a medical condition but are not concerned about his/her impairment (la belle indifference) most likely suffers from ...
Conversion Disorder
152
A pt presents with belief that some part of the body is abnormal, misshapen and defective, usually wants cosmetic surgery constantly most likely suffers from ...
Body Dysmorphic Disorder
153
A pt presents with the presence of pain as the main complaint and have psychological factors associated with pain most likely suffers from ...
Pain disorder
154
What is the treatment for somatoform disorders (somatization, hypochondriasis, conversion, body dysmorphic, pain disorders)?
Psychotherapy
155
... is characterized by a pt (usually women in healthcare profession) faking a illness (hallucinations, delusions, depression, abdominal pain, etc) in order to get attention and emotional support by assuming the pt role
Factitious Disorder
156
.... is characterized by a caretaker faking signs and symptoms in another person (usually kid) in order to have kid admitted so parent can be in hospital.
Munchausen by proxy
157
What is the next best step in management for Munchausen by proxy?
child protection services
158
.... is characterized by conscious production of signs and symptoms for an obvious gain, such as avoiding work/ evading criminal prosecution/ achieve financial gain; best diagnosed when there is discrepancy between the pt's complaints and the actual physcial or lab findings and pt will usually not cooperate
Malingering
| common in prisoners and military
159
What is the next best step in management if patient is found to be malingering?
confront patient with outcome
160
A pt presents with maladaptive reaction (anxiety, depression, conduct disturbances) to a non-life threatening stressor (loss of job, divorce, failed school) within 3 months of stressor and remits within 6 months of removing stressor, and symptoms cause functional impairment most likely suffers from ...
Adjustment Disorder
161
What is the treatment for Adjustment Disorder?
Psychotherapy
162
A pt is constantly suspicious, mistrustful, secretive, isolated, and questioning the loyalty of family and friends most likely suffers from...
Paranoid personality disorder
| cluster A
163
A pt constantly chooses solitary activities, lack close friends, emotional cold and has no desire for close relationship most likely suffers from ...
Schizoid personality disorder
| cluster A
164
A pt that constantly have ideas of reference, magical thinking, odd thinking, eccentric behavior, increased social anxiety and brief psychotic episodes most likely suffers from ...
Schizotypal personality disorder
| cluster A
165
A pt who constantly must be center of attention, have inappropriate sexual behavior, self dramatization, and use physical appearance to draw attention to themself most likely suffers from ...
Histrionic personality disorder
| cluster B
166
A pt (older than 18 y/o) who constantly fails to conform to social rules, deceitful, lack remorse, impulsive, aggressive towards others, irresponsible and usually have history of conduct disorder most likely suffers from ...
Antisocial Personality Disorder
| cluster B
167
A pt who is constantly in unstable relationships, impulsive, has recurrent suicidal behaviors (cutting, etc), have chronic feelings of emptiness, inappropriate anger, and can occasionally have dissociative symptoms and brief psychotic episodes when severely stressed most likely suffers from ...
Borderline Personality Disorder
| cluster B
168
What is the most common defense mechanism used by pts with borderline personality disorder?
Splitting
169
A pt who constantly has grandiose sense of self, belief that they are special, lack empathy, have sense of entitlement, and require excessive admiration most likely suffers from ...
Narcissistic Personality Disorder
| cluster B
170
A pt that is constantly unwilling to get involved with people, views self as socially inept, reluctant to take risks, have feeling of inadequacy, and dont have friends but want friends most likely suffers from ...
Avoidant Personality Disorder
| Cluster C
171
A pt who is constantly has difficulty making day-to day decisions, unable to assume responsibility, unable to express disagreement, fear of being alone, and seeks relationship as a source of care most likely suffers from ...
Dependent Personality Disorder
| Cluster C
172
A pt who is constantly preoccupied with details, rigid, orderly, perfectionistic, excessively devoted to work and inflexible most likely suffers from ...
Obsessive compulsive personality disorder
| Cluster C
173
What is treatment for personality disorders?
Individual Psychotherapy
174
A pt who fails to maintain normal body weight (BMI
Anorexia Nervosa
175
What are associated signs and symptoms associated with anorexia nervosa?
1. calluses on hand
2. cavities
3. arrhythmias
4. lanugo hair
5. amenorrhea
6. electrolyte disturbances
176
What is the treatment for anorexia nervosa?
1. hospitalization (tx dehydration, starvation, electrolyte imbalance)
2. psychotherapy and behavioral therapy
3. SSRIs (to promote weight gain)
177
A pt presents with frequenct binge eating (large amounts of food in discrete time) and lack of control overeating episodes with associated compensatory behavior (purging, miuse of laxatives/ diuretics, fasting, excessive exercise) to prevent weight gain, have poor body image but have normal BMI/ weight most likely suffers from ...
Bulimia Nervosa
178
What is treatment for bulimia nervosa?
1. Psychotherapy
| 2. SSRIs
179
A pt presents with excessive daytime sleepiness, abnormal REM sleep, have sleep attacks (episodes of irresistible sleepiness and feel refreshed upon awakening), cataplexy, hypnogogic/ hypnopompic hallucinations, and sleep paralysis most likely suffers from ...
Narcolepsy
180
What is cataplexy?
sudden loss of muscle tone usually precipitated by loud noise or emotions
(pathognomonic for narcolepsy)
181
What is hypnogogic hallucinations and what disorder is it associated with?
hallucinations as the pt is going to sleep; Narcolepsy
182
What is hypnopompic hallucinations and what disorder is it associated with?
hallucinations as the pt awakens from sleep; Narcolepsy
183
What is sleep paralysis and what disorder is it associated with?
patient awakens but is unable to move; Narcolepsy
184
What is the treatment for Narcolepsy?
1. forced naps during fay
2. Modafinil (maintain alertness)
3. methylphenidate, dextroamphetamine GHB
185
What is the diagnostic test of choice for narcolepsy?
Sleep study
186
A pt presents with inability to initiate or maintain sleep and it adversely affects level functioning, may have associated fatigue, increased yawning and increased appetite most likely suffers from ..
Insomnia
187
What is the treatment for insomnia?
1. sleep hygiene (go to bed and wake up at same time each day, avoid caffeine, avoid daytime naps)
2. behavioral modification (only use bed for sleep)
3. Zolpidem, eszopiclone, zaleplon
188
.... is a person's secondary sexual characteristics
Sexual identity
189
... is one's sense of maleness or femaleness that is established by 3 years old
Gender Identity
190
.... is external patterns of behavior that reflect inner sense of gender identity
Gender Role
191
... is person's choice of love object; may be heterosexual, homosexual, bisexual, asexual
Sexual orientation
192
.... is the persistent or recurrent inability to attain/ maintain an erection until completion of the sexual act
Impotence
193
... is ejaculation before penetration or just after penetration usually due to anxiety
Premature Ejaculation
194
What is treatment for premature ejaculation?
1. psychotherapy
2. behaviroal modification (stop, go, squeeze)
3. SSRI
195
... is pain associated with sexual intercourse
Dyspareunia
196
what is treatment of dyspareunia not due to medical condition?
Psychotherapy
197
... is involuntary constriction of the outer third of the vagina preventing penile insertion
Vaginismus
198
What is the treatment for vaginismus?
1. psychotherapy
| 2. dilator therapy
199
A pt who has recurrent urge to expose oneself to strangers for more than 6 months and causes significant distress and impairment of functioning most likely suffers from ..
Exhibitionism
200
A pt who suffers from recurrent use of nonliving objects to achieve sexual pleasure for more than 6 months and causes significant distress and impairment of functioning most likely suffers from ...
Fetishism
201
A pt who suffers from recurrent urges or arousal toward prepubescent children for more than 6 months and causes significant distress and impairment of functioning most likely suffers from ...
Pedophila
202
A pt who suffers from recurrent urges or behavior involving the act of humiliation for more than 6 months and causes significant distress and impairment of functioning most likely suffers from ...
Masochism
203
A pt who suffers from recurrent urges or behaviors involving acts in which physical or psychological suffering of a victim is exciting for more than 6 months and causes significant distress and impairment of functioning most likely suffers from ...
Sadism
| want to be the dominator with clamps, whips, etc
204
A pt who suffers from recurrent urge or behavior involving cross dressing for sexual gratification (usually found in heterosexual men) for more than 6 months and causes significant distress and impairment of functioning most likely suffers from ...
Transvestic fetishism
205
A pt who suffers from rubbing their pelvis or erect penis against a nonconsenting person for sexual gratification for more than 6 months and causes significant distress and impairment of functioning most likely suffers from ...
Frotteurism
206
What is the treatment for paraphilias (exhibitionism, fetishism, pedophilia, masochism, sadism, transvestic fetishism, frotteurism)?
1. individual psychotherapy
2. behavioral modification (aversive conditioning)
3. antiandrogens or SSRIs (to control sexual drive)
207
... is characterized by the persistent discomfort and sense of inappropriateness regarding their assigned sex, usually associated with wearing opposite gender's clothes, use toys of opposite sex, play with opposite sex kids, taking hormones to deepen/ soften voice, breast binding, or hiding of penis/ testicles
Gender Identity Disorder
208
What is the treament for Gender Identity Disorder?
1. sexaul reassignment surgery (need approval)
| 2. individual psychotherapy
209
What are the risk factors for suicide in a pt with suicidal ideation? (7)
1. men
2. elderly
3. social isolation
4. presence of psychiatric illness/ drug abuse
5. perceived hopelessness
6. previous attempts
7. suicidal behaviros (buying weapons, giving away possessions, writing wills)
210
What is the treatment for suspected suicide?
admit (to psychiatric unit)
