Psychiatry II Flashcards

1
Q

Delusional disorder is a fixed, persistent, false belief system lasting > […] (duration) with otherwise normal functioning.

A

Delusional disorder is a fixed, persistent, false belief system lasting > 1 month (duration) with otherwise normal functioning.

e.g. a woman who genuinely believes she is married to a celebrity when, in fact, she is not

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2
Q

Delusional disorder typically presents with […] delusions. (bizarre or non-bizarre)

A

Delusional disorder typically presents with non-bizarre delusions. (bizarre or non-bizarre)

i.e. theoretically possible, but not plausible; delusion disorder can still be diagnosed with bizarre delusions

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3
Q

Delusions can be shared by individuals in close relationships; termed […].

A

Delusions can be shared by individuals in close relationships; termed folie a deux.

it is important to separate the individuals to determine the degree of impairment in each

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4
Q

Depression and normal aging are associated with […] REM latency.

A

Depression and normal aging are associated with decreased REM latency.

however, depressed patients experience increased REM sleep, while normal aging results in decreased REM sleep

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5
Q

Depression is associated with […] total REM sleep.

A

Depression is associated with increased total REM sleep.

thus, these patients have decreased slow-wave sleep

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6
Q

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: […]

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

A

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

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7
Q

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: […]

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

A

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

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8
Q

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: […]

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

A

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

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9
Q

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: […]

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

A

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

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10
Q

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: […]

S: Sleeplessness

T: Talkativeness or pressured speech

A

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

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11
Q

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: […]

T: Talkativeness or pressured speech

A

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

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12
Q

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: […]

A

Diagnosis of a manic episode requires an elevated and/or irritable mood plus at least three “DIG FAST” criteria:

D: Distractibility

I: Impulsivity (high-risk behaviors)

G: Grandiosity (inflated self-esteem)

F: Flight of ideas/racing thoughts

A: Agitation/increased Activity

S: Sleeplessness

T: Talkativeness or pressured speech

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13
Q

Diagnosis of acute intermittent porphyria may be aided by the presence of elevated urinary […].

A

Diagnosis of acute intermittent porphyria may be aided by the presence of elevated urinary porphobilinogen.

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14
Q

Diagnosis of panic disorder requires recurrent & unexpected panic attacks with at least […] (duration) of preoccupations with the attack.

A

Diagnosis of panic disorder requires recurrent & unexpected panic attacks with at least one month (duration) of preoccupations with the attack.

e.g. persistent concern of additional attacks, worrying about consequences of the attack, behavioral change related to the attack

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15
Q

Dissociative […] is a subtype of dissociative amnesia characterized by an abrupt traveling or wandering.

A

Dissociative fugue is a subtype of dissociative amnesia characterized by an abrupt traveling or wandering.

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16
Q

Do patients with erectile dysfunction due to medical etiologies have nocturnal penile tumescence?

A

No

e.g. depression, diabetes, STIs or drugs (antipsychotics, SSRIs, ethanol, antihypertensives)

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17
Q

Do patients with erectile dysfunction due to psychological etiologies have nocturnal penile tumescence?

A

Yes

e.g. performance anxiety; common cause of ED following a myocardial infarction

18
Q

Do patients with manic episodes need to be hospitalized?

A

Yes (psychiatric emergency)

50% are psychotic; prone to extremely dangerous behavior

19
Q

Do patients with nightmare disorder have any memory of the scary dream?

A

Yes

occurs during REM sleep; important distinguishing feature from night terrors

20
Q

Do patients with sleep terror disorder have any memory of the arousal episode?

A

No

occurs during non-REM sleep (stage N3); important distinguishing feature from nightmares

21
Q

Does a patient with bipolar disorder typically return to normal mood and functioning between episodes?

A

Yes

22
Q

Does a patient with cyclothymia typically return to normal mood and functioning between episodes?

A

No

minimal return to baseline (< 2 months per 2 years)

23
Q

Dronabinol (medical marijuana) is used clinically as an […] for AIDS patients.

A

Dronabinol (medical marijuana) is used clinically as an appetite stimulant for AIDS patients.

24
Q

Evidence of shaken baby syndrome includes […] hematomas, retinal hemorrhages, cervical spine injury, and posterior rib fractures.

A

Evidence of shaken baby syndrome includes subdural hematomas, retinal hemorrhages, cervical spine injury, and posterior rib fractures

damage occurs due to repetitive acceleration-deceleration forces, which cause shearing of dural veins and vitreoretinal traction

25
Q

Evidence of shaken baby syndrome includes subdural hematomas, […] hemorrhages, cervical spine injury, and posterior rib fractures.

A

Evidence of shaken baby syndrome includes subdural hematomas, retinal hemorrhages, cervical spine injury, and posterior rib fractures.

damage occurs due to repetitive acceleration-deceleration forces, which cause shearing of dural veins and vitreoretinal traction

26
Q

Evidence of […] syndrome includes subdural hematomas, retinal hemorrhages, cervical spine injury, and posterior rib fractures.

A

Evidence of shaken baby syndrome includes subdural hematomas, retinal hemorrhages, cervical spine injury, and posterior rib fractures.

damage occurs due to repetitive acceleration-deceleration forces, which cause shearing of dural veins and vitreoretinal traction

27
Q

First-line treatment for social anxiety disorder includes CBT and […].

A

First-line treatment for social anxiety disorder includes CBT and SSRIs.

beta-blockers and benzodiazepines are used for the performance-only subtype

28
Q

Gender […] is persistent cross-gender identification that leads to persistent distress with sex assigned at birth.

A

Gender dysphoria is persistent cross-gender identification that leads to persistent distress with sex assigned at birth.

29
Q

Gustatory hallucinations are rare, but may be seen in […].

A

Gustatory hallucinations are rare, but may be seen in epilepsy.

30
Q

HIV-associated dementia is associated with […] symptoms (brain area) early in the course of illness.

A

HIV-associated dementia is associated with subcortical symptoms (brain area) early in the course of illness.

e.g. basal ganglia or nigrostrial dysfunction (slowed movement, difficult with smooth limb movements)

31
Q

If episodes of psychosis only occur during a major mood episode, the diagnosis is either […] or […].

A

If episodes of psychosis only occur during a major mood episode, the diagnosis is either major depressive disorder or bipolar disorder with psychotic features.

32
Q

In addition to lithium and valproate, first-line maintenance treatments for bipolar disorder include […] and […].

A

In addition to lithium and valproate, first-line maintenance treatments for bipolar disorder include lamotrigine and quetiapine.

33
Q

In elderly patients with suspected dementia, screening for […] should be performed to rule out other possible causes.

A

In elderly patients with suspected dementia, screening for depression should be performed to rule out other possible causes.

34
Q

In elderly patients with suspected dementia, […] and B12 levels should be measured to rule out other possible causes.

A

In elderly patients with suspected dementia, TSH and B12 levels should be measured to rule out other possible causes.

35
Q

In elderly patients with suspected dementia, TSH and […] levels should be measured to rule out other possible causes.

A

In elderly patients with suspected dementia, TSH and B12 levels should be measured to rule out other possible causes.

cobalamin

36
Q

n older patients, REM sleep behavior disorder may be a sign of […].

A

In older patients, REM sleep behavior disorder may be a sign of neurodegeneration (e.g. Parkinson’s).

often occurs with other subtle prodromal symptoms (e.g. constipation, subtle changes in gait)

37
Q

In patients with TCA overdose, a QRS duration > […] is associated with increased risk of arrhythmias and/or seizures and is an indication for treatment with sodium bicarbonate.

A

In patients with TCA overdose, a QRS duration > 100 msec is associated with increased risk of arrhythmias and/or seizures and is an indication for treatment with sodium bicarbonate.

38
Q

In patients with TCA overdose, a QRS duration > 100 msec is associated with increased risk of […] and/or […] and is an indication for treatment with sodium bicarbonate.

A

In patients with TCA overdose, a QRS duration > 100 msec is associated with increased risk of arrhythmias and/or seizures and is an indication for treatment with sodium bicarbonate.

39
Q

Increased sensitivity to lactate infusion is associated with […].

A

Increased sensitivity to lactate infusion is associated with panic attacks.

40
Q

Indications for involuntary psychiatric hospitalization including being a […] and/or grave disability (inability to care for self).

A

Indications for involuntary psychiatric hospitalization including being a danger to self or others and/or grave disability (inability to care for self).

hospitalization is indicated for patients with suicidal ideation with intent or a plan; those with suicidal ideation without intent/plan may be managed with aggressive outpatient therapy

41
Q

Is electroconvulsive therapy safe to use during pregnancy?

A

Yes

42
Q

Life-threatening effects of MDMA (ecstasy) include hyperthermia and […] (Na+ levels).

A

Life-threatening effects of MDMA (ecstasy) include hyperthermia and hyponatremia (Na+ levels).

also may cause life-threatening hypertension and tachycardia; treat with normal saline and cooling