Somatization Conversion And Factitious Disorder’s

Question 1

Somatization disorder

Answer 1

Prominence of somatic, (bodily) symptoms associated with significant distress and impairment

Commonly encountered in primary care

Question 2

Somatic symptom disorder

Answer 2

At least one but often multiple physical symptoms

Excessive anxiety about these symptoms, despite reassurance that the concerns are unfounded

These patients often get repeated evaluation from multiple providers, but extensive lab tests and studies that often come up negative

Question 3

Diagnosis of somatic symptom disorder, depends on…

Answer 3

The extent to which the thoughts feelings and behaviors related to the symptoms are excessive or out of proportion

Question 4

Treatment for somatic symptom disorder

Answer 4

Regularly scheduled visit with single primary care physician

Patients almost always resist referral to mental health professionals

Question 5

Key to managing somatic symptom disorder

Answer 5

To balance the need for a prudent medical evaluation with the very real risk of over diagnosis or over treatment

Reassure the patient that, although the test perform have been normal, that does not mean that but they’re experiencing is not happening

Question 6

Conversion disorder

Answer 6

A patient complains of a neurological symptom(numbness blindness or paralysis) despite the absence of evidence of physical cause

Question 7

“Conversion” suggests that…

Answer 7

The patients are subconsciously, converting their psych distresses into Neuro symptoms

Question 8

For conversion disorder to be present, the patient must have what?

Answer 8

At least one or a logical symptom, either sensory or motor, which cannot be explained by neurological condition

Question 9

What symptoms may have patient with conversion disorder describe?

Answer 9

Blindness
paralysis
Seizures
Mutism
Paresthesias

Question 10

Conversion disorders are most common in what population?

Answer 10

Women

Question 11

Prognosis for conversion disorder

Answer 11

Poor

Question 12

Illness, anxiety disorder

Answer 12

Patient is preoccupied with having or acquiring a serious illness in the absence of any significant or concerning symptoms

Last six months

Question 13

A 45-year-old woman admits to a lifelong fear of colon cancer; she reports that both her parents, as well as her sisters, died of this disease.

She does not have any worrisome symptoms, such as blood in the stool, weight, loss, or a domino pain, but she still request frequent valuations by her family physician, and often wonders whether or not she should be having another colonoscopy - even though she has been advised with a past normal exam, repeat screening before 5 to 10 years is not medically indicated

Because of her concern about this diagnosis, she will not equal food, and takes great pans to eat fiber, rich diet. She also recently made an appointment with a gastroenterologist, just to get a second opinion.

This woman is likely suffering from what disorder?

Answer 13

Illness, anxiety disorder

Question 14

Factitious disorder

Answer 14

A patient produces or fakes, physical or mental illness when they’re really not sick, or intentionally makes a minor illness worse

May also create illnesses or injury, and a third party

Patient fakes symptoms and illness by fabricating them

Question 15

People with factitious disorder’s seem to be seeking what?

Answer 15

Unconscious, emotional gain

Key= absence of material reward (malingering would have material reward)

Question 16

Infection, hypoglycemia, abdominal pain, seizures, hematuria, or psychological issues are the commonly faked symptoms of what disorder?

Answer 16

Factitious disorder

Question 17

What is the old name for factitious disorder’s?

Answer 17

Munchhausen syndrome

Question 18

Munchhausen syndrome by proxy

Answer 18

Refers to the intentional production of signs or symptoms of illness, and someone else who is in your care (think gypsy rose)

Question 19

Patience with factitious disorder is eventually require ________________

Answer 19

Confrontation

Question 20

Malingering disorder

Answer 20

Illness falsification to obtain an external benefit

Not a mental illness because they’re doing it for secondary gain

Question 21

How is factitious disorder, separated from malingering?

Answer 21

Factitious disorders are better explained by a deep-seated need for attention and love, and are willing to undergo expensive and painful diagnostic procedures

Question 22

A 37-year-old man who shows up at your hospitals, epilepsy support group claims to have disabling seizures; he is a self proclaimed “expert“ on epilepsy, and yet cannot tell you what medication he is taking. When confronted, he collapses on the ground, thrashing wildly, and then rules and moans dramatically. Despite your reservations about this behavior, you call 911. It is later determined that the patient has lost his job and is looking for Social Security disability benefits. What is the diagnosis?

Answer 22

Malingering

Question 23

A 52-year-old female patient is hospitalized multiple times for repeated episodes of unexplained sepsis. She finally worked as a nurse, but then lost her job after a car, accident left her disabled, depressed, and dependent on “painkillers“ apart from chronic low back pain, she is otherwise healthy and has no risk factors for infection, such as diabetes, HIV, or other immunosuppression. her blood cultures consistently grow out multiple fecal, micro organisms. After being confronted, the patient admits that they have been injecting themselves with fecal material. What is the likely diagnosis?

Answer 23

Factitious disorder

Question 24

A conversion disorder must require what

Answer 24

A nervous system symptom

Question 25

Hysteria

Answer 25

Completely replaced by a more precise Termanology today-conversion and somatization

Question 26

Malingering involves…

Answer 26

Conscious manipulation or fabrication of symptoms for secondary gain

Not mental illness