Psychology Flashcards
How long does a panic attack typically last?
10-20 minutes
What type of hallucinations are most common in schizophrenia: auditory, visual or olfactory?
Auditory: hearing voices
What causes anorexic pts to have osteopenia?
A decrease in estrogen
When tx’ing psych pts, are benzodiazepines used more commonly for acute or chronic tx?
acute
What is the most common precipitating event for PTSD in women?
rape
A pt’s wife c/o that he is hypervigiliant and has a hyper startle response. What is the most likely dx?
PTSD
Are pts c specific phobias aware they are strange?
Yes
A pt c/o having suddenly developed stage fright. It is very important to his career that he be able to speak in front of groups. What med might you tx him with?
Beta blocker–propanolol
A doughnut shaped burn should make you think of what issue?
Abuse–either elder or child
What is the generic name for Prozac?
Fluoxetine
How long must symptoms last before dx’ing ADD?
6 mos
A pt’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 terrified of doing so. What is the most likely dx?
Avoidant personality disorder
A 6yo 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 dx.
An 18 mo is not yet speaking. He does not point to objects. He does not make eye contact with others. What is the most likely dx?
Autism
List 3 positive symptoms of schizophrenia.
Hallucinations, delusions, movement d/o
When is the typical onset of Tourette’s syndrome?
3-8 yo
Is anorexic egosyntonic or egodystonic? What about bulimia?
Anorexia is egosyntonic
bulimia is egodystonic
Def: egosyntonic: of or relating to aspect’s of one’s behavior or attitudes viewed as acceptable and consistent with one’s fundamental personality and beliefs
egodystonic: of or relating to aspects of one’s behavior or attitudes viewed as inconsistent with one’s fundamental beliefs and personality
List 3 cluster A personality d/o
“Mad” schizoid
schizotypal
paranoid
A 16yo has just moved schools. He is quiet, moody and not like himself at all. Within 6 mos, he seems to have completely changed back to his previous personality. What is the most likely dx?
Adjustment d/o
You have a pt c major depressive d/o. Once his symptoms have completely resolved, how long should you continue the tx?
A six month minimum is recommended due to very high relapse rates
What med is often used to tx postpartum depression in a woman who is breastfeeding?
Sertraline (Zoloft)
A pt has very strange magical thinking. What is the most likely dx?
Schizotypal personality d/o
List 4 symptoms of serotonin syndrome.
Hyperthermia
seizure
mental status change
tremor
What is the term for a chronic mild depression that has lasted for greater than 2 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 dx.
What is the major concern with using lithium?
It has a very narrow therapeutic window. Blood tests are needed q 4 wks.
A pt believes that her 15 yo 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 dx?
Delusional disorder
At what BMI should a pt be hospitalized for anorexia?
BMI of <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 in on the border of what two psychological disorders?
Neurosis and psychosis
Waxy flexibility should make you think of what dx?
Catatonic schizophrenia
How long before normal grief resolves?
About one year
A pt 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 dx?
Histrionic personality disorder
To be diagnosed with ADD patients must exhibit symptoms before what age?
7 yo
What is Russell’s sign?
Abraded knuckles from forcing oneself to vomit
How long must symptoms occur before diagnosing schizophrenia?
at least 6 mos
Posturing should make you think of what dx?
Catatonic depression
A pt c/o 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 w/u was negative. What is the most likely dx?
Conversion d/o
A psychiatric pt presents with confusion, fever and lead pipe rigidity. What is the most likely dx?
Neuroleptic malignant syndrome, this can occur with high dose antipsychotics
A pt is very concerned that she has breast cancer. In order to reassure her, you perform a full workup which is negative. She is still unsatisfied and convinced that she has breast cancer. What is the most likely dx?
Hypochondriasis
What is the time frame for the first symptoms of withdrawal from alcohol?
Tremor in 8-18 hours
How do you treat ETOH withdrawal?
Benzodiazepines
List the 4 cluster B personality d/o
“Bad” antisocial
borderline
histrionic
narcissistic
List the 2 cluster C personality d/o
“Sad” avoidant
obsessive compulsive
What medication is clearly contraindicated in anorexia and bulimia?
Buproprion (wellbutrin) because it can increase risk of seizures.
What 2 psychiatric issues are more common in males than females?
Autism and ADD: the rest are either equal or more common in females
Name 3 SSRIs
Fluoxetine paroxetine sertraline citalopram escitalopram dapoxetine zimelidine mesembrine seproxetine
A pt expresses concern that he can’t trust anyone. That everyone is out to get him, and his problems are all the faults of other. he has held very long grudges due to perceived past wrongs. What is the most likely dx?
Paranoid personality d/o
A pt 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 dx?
Antisocial personality disorder
Antisocial personality d/o may not be dx’ed until what age?
18yo
A pt exhibits all of the characteristics of antisocial personality d/o but he is only 14 yo. What is the most likely dx?
conduct d/o
A pt exhibits splitting: seeing others as all good or all bad. What is the most likely dx?
Borderline personality d/o
What type of behavior therapy works best for borderline patients?
Dialectical behavior therapy
A pt is arrogant with an inflated self image. He feels he is special and should be treated that way. What is the most likely dx?
Narcissistic personality d/o
Is obsessive compulsive disorder egosyntonic or egodystonic? What about obsessive compulsive personality disorder?
OCD is ego-dystonic
OCPD is egosyntonic
What 2 things are needed to make a dx of bipolar 2?
One major depressive episode and one hypomanic episode
What medication is a good place to start treating bipolar 1 or 2?
Lithium
How is acute stress d/o different from PTSD?
Acute stress disorder occurs within 1 month of the event and resolves within about a month. PTSD begins about 1 month after the event and can last indefinitely.
A spiral fracture should make you think of what issue?
Abuse: either 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 dx?
Generalized anxiety disorder
Are hallucinations normal during a normal grieving period?
Yes, as long as they are not persistent or intrusive.
