Test Flashcards
67 yr old woman makes aptment to see PCP. For 6 months, she has experienced fatigue, worry regarding health, waking up at 3:30 am every morning. a ten pound weight loss, difficulty concnetrating and a sense of depression and not being interested in her usual activities. The most significant change in the patients life is that her husband of 40 yrs retired approximately a year earlier, what is the diagnosis
Major depressive disorder - primary symptoms are mood symptoms and she meets criteria. Her symptoms exceed those for adjustment disroder and therefore a more serious illness is diagnosed. Additionally symptoms have not been present for 2 years henche she does not meet criteria for dysthymia
Why does exercise decrease major depressive disorder symptoms
It increases neurogenesis (running in particular)
75 yr old feels sadness inadequacy and helplessness. Her medical histroy is signifcant for bout of major depressive disorder when she was in her late forties.
At that time she was successfully treated with a drug that managed her depression (X) but she recalls during treatment she felt light headed and occassionally felt faint when rising from a chair. given her age she is concerned. To avoid hypotension, physician prescribes a different drug (Y). What are X and Y possibly?
X: MAOI
Y. SSRI
postural hypotension is side effect of TCA, MAOI, and trazadone (5HT2 antagonist).
Drug Y should be either an SSRI or SNRI to avoid this side effect.
Girl asks Dan of their plans how theyre going to spend the day. When he dismisses her, alex experiences an abrupt mood swing and confronts DAn about his callousness. Dan then berates her and decides to leave. Alex’s anger is turned inward and she cuts her wrists
mood lability and suicidal gesture are what two defense mechanisms
Splitting and passive aggression.
Splitting is black and white thinking which can lead to all or nothing feelings and behavior such as that which is labeled mood lability.
Passive aggression is an ego defense that turns an aggressive impulse inward and is hypothesized to underlie the suicidal gestures charactersitic of BPD.
Dissociation while a defining element of BPD (and histrionic) is defined as a drastic shift to a MORE PLEASANT affect. Expression of dissociation leads others to believe shallow and dramatic.
“Acting out” is acting on an observable impulse so to avoid being consciously aware of it. Assaults in Antisocial personality.
A young child starts looking under a blanket where he last found the toy rather than the place where the examiner placed it. What age and piaget level is the child showing
Sensori motor age 12 months - object permanence.
What quality infers the greatest risk of suicide
Expressing hopelessness.
Which learning theory suggests that thoughts play a very important role in the development of new behavior
Social learning theory - posits learning and behavior change is not simply based on a stimulus-response association but that thoughts play a major role in behaviors that are learned and performed. This forms foundation of CBT.
What type of operational learning is this
Prescribed Zoloft for depression
-negative reinforcement - reducing and or eliminating depression. DESIRABLE
Patient A: limps into office, requesting pain management for previously diagnosed osteoarthritis
Patient B: has a history of CAD asks for tums for heartburn
Patient C: seeing a counselor for mild depression, would like to take disability leave.
Patient D: acute unilateral stocking-glove numness in left arm
Patient E: convinced he has fatal illness would like you to figure out what it is. He checks body for skin lesions multiple times a day.
Which is NORMAL ILLNESS BEHAVIOR
Patient A: limping
Somatization is someone’s behavior in response to physical symptoms , these are usually adaptive signs of disease and facilitate patients seekign appropriate medical attention.
Patient B: denial of illness may be maladaptive
Patient C: distress or disability induced symptoms is disproportionate with known pathology.
Patient D: or inconsistent with known pathology
Patient E: illness anxiety disorder - chronic and excessive anxiety about one’s health with excessive health related behaviors but with minimal or no associated symptoms
Negative symptoms of schizo
5A’s, Plant
aPathy aLogia (poverty of speech, thought) Affective flattening aNhedonia (withdrawal) aTtention deficit
All substances in intoxication can cause psychosis except for 3?
2 substances that cause psychosis in withdrawal phase
Caffeine (induces two disorders: anxiety and insomnia)
Nicotine (zero syndromes resulting from intoxication and withdrawal - some anxiety is different from full disorder)
Opioids - (intoxication doesn’t lead to psychosis)
____________________________
Alcohol - delerium tremors - delerium is psychotic symptom
Sedatives do the same
EPS (standard of typical antipsychotics)
Parkinson - like syndrome with bradykinesia, rigidity, and tremor
Akathisia
Dystonias
Que son los CAGA preguntas?
C: ever felt like you should CUT down on drinking
A: have people ANNOYED you by criticizing drinking
G: have you ever felt GUILTY for drinking
E: have you ever had a drink in the morning to steady your nerves or to get rid of hangover.
Two positive responses are considered a positive test, one is suspicious so ddo an assessment
Clarisa is an 8 year old who was admitted to the pediatric hospital with severe abdominal pain of 3 days duration. The workup has been entirely negative beyound moderate constipation that responded to a course of laxatives. Her nurse suggested that the child is anxious and suggested that she be evaluated. You learn from mom that Clarisa has always worried and is irritable for things in the past 9 months about things and sometimes worries about unfamiliar situations. For the past 2 weeks she has been reluctant to attend school and fearful of taking part in a school play. She did have problems with separation from her mom in preschool but non since then. Which one of the following additional pieces of information about Clarisa.
Fear of dark and a history of separation anxiety would point to separation anxiety disorder but the 4 week duration of school avoidance and other symptoms to meet the criteria are not present. Children with anxiety disorders are often eager to please and often have the temperament or risk factor of being shy or have behavioral inhibition that predisposes them to differing anxiety disorders that alternate over time. No specific social situation seems to be the precipitating event suggesting that social phobia is not a likely diagnosis even with her long standing social inhibition.
Generalized anxiety disorder with the duration criteria and with the chronic worry, criteria are met.
What is one of the most commonly associated feature of ASD?
Hyperaccusis - over sensitive hearing
