Somatic Symptoms & Related

Question 1

a patient has increased health anxiety, frequent office visits, unnecessary labs or imaging tests. what could they be experiencing?

Answer 1

somatic symptoms & factitious disorders

Question 2

diagnosis that is made on the basis of positive symptoms and signs (distressing feeling about the symptom), rather than the absence of a medical explanation for somatic symptom

Answer 2

somatic symptom disorder

Question 3

how long should a patient be in the state of being persistently symptomatic to be diagnosed with somatic symptom disorder?

Answer 3

more than 6 months

Question 4

what diagnostic can be used for somatic symptoms disorder?

Answer 4

patient health questionnaire

Question 5

what must be excluded to diagnose a patient with somatic symptom disorder? (2)

Answer 5

factious disorder
malingering

Question 6

what is the general management for somatic symptom disorder?

Answer 6

review criteria with patient explaining the disorder as a medical condition

Question 7

how often should visits be scheduled for somatic symptom disorder?

Answer 7

4-8 weeks

Question 8

what is the treatment/medication used for somatic symptoms disorder?

Answer 8

SSRI, SNRI, TCA
CBT

Question 9

abnormal nervous system functioning in the absence of structural pathology; symptoms are genuine and cause distress

Answer 9

conversion disorder

Question 10

a patient presents with weakness, abnormal movements, nonepileptic seizures, and blindness - without structural pathology. what are they likely experiencing?

Answer 10

conversion disorder

Question 11

what is the first line treatment for conversion disorder?

Answer 11

patient education about the syndrome

Question 12

what is the second line treatment for conversion disorder? (2)

Answer 12

CBT
physical therapy

Question 13

what are nonepileptic seizures?

Answer 13

trance-like state with rhythmic movements

Question 14

what is the 3rd line treatment for conversion disorder? (3)

Answer 14

antidepressants
hypnosis
family/group therapy

Question 15

preoccupation for 3-8 hrs/day with nonexistent or slight defects in physical appearance; patients believe they look abnormal, unattractive, ugly, or deformed, when they look normal

Answer 15

body dysmorphic disorder

Question 16

what kind of procedures do patients with body dysmorphic disorder seek?

Answer 16

dermatologic
surgical procedures

Question 17

a patient presents with preoccupations, compulsions to fix/hide appearance, poor insight and delusions, social avoidance, emotional distress, and somatic symptoms. what are they likely experiencing?

Answer 17

body dysmorphic disorder

Question 18

what is the treatment for body dysmorphic disorder? (3)

Answer 18

SSRI
CBT
education - patient and family

Question 19

what is important to remember in patients with body dysmorphic disorder?

Answer 19

relapses can occur

Question 20

what are the 3 most common comorbidities associated with body dysmorphic disorder?

Answer 20

depression
personality disorders
substance use disorders

Question 21

creating symptoms or signs in yourself or in somebody else for the purpose of self-worthiness; actual medical abnormalities are created

Answer 21

factitious disorder

Question 22

for a patient with possible factitious disorder imposed on another, what should the medical provider do?

Answer 22

review all medical records

obtain comprehensive H&P

confirm hx with other clinicians

identify whether symptoms
depend upon perpetrator’s presence

Question 23

what is the management for factitious disorder imposed on another? (3)

Answer 23

contact child/adult protective services

stop medications

try to correct iatrogenic damage