1. |
Use of clozapine is associated with what blood abnormality? |
Agranulocytosis; patients on clozapine should have serial CBCs. |
2. |
What condition is associated with recurrent episodes of quickly eating large quantities of food, often to the point of discomfort, a loss of control during the eating, shame or guilt afterward, and not purging, or abusing laxatives called? |
Binge eating disorder |
3. |
For mania, what antiseizure medication can be used? |
Valproate |
4. |
In patients with anorexia nervosa, what cardiac related finding is induced? |
Bradycardia |
5. |
What psychiatric medications can cause serotonin syndrome? |
Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), bupropion, tricyclic antidepressants (TCAs), lithium, herbal supplements (including St. John’s Wort), and some illicit drugs |
6. |
How is binge eating disorder different from anorexia nervosa? |
Binge eating disorder is similar to an addiction, where self-image is intact but control over eating is not. Anorexia is considered distortion of self-image. Cognitive behavioral therapy (CBT) and psychotherapy are used for both, although binge eating disorder may respond to some medications (topiramate, stimulants). |
7. |
What does the psychiatric axis 1 define? |
Axis 1: High-level diagnosis; acute symptoms that need treatment (e.g., major depressive episode, schizophrenic episode, panic attack) |
8. |
What is the most common eating disorder in the United States? |
Binge eating disorder |
9. |
What does the psychiatric Axis 2 define? |
Axis 2: Personality disorders
A: Paranoid, schizoid, schizotypal
B: Antisocial, borderline, histrionic, narcissistic
C: Avoidant, dependent, obsessive, compulsive |
10. |
For patients on SSRIs who develop serotonin syndrome, what medications can be used to treat the symptoms? |
Benzodiazepines and cyproheptadine (Periactin) |
11. |
What does the Psychiatric Axis 3 define? |
Axis 3: Medical diagnosis (e.g., diabetes, asthma, etc.) |
12. |
What does the Psychiatric Axis 4 define? |
Axis 4: Recent psychosocial stressors |
13. |
What does the Psychiatric Axis 5 define? |
Axis 5: Global assessment of functioning (GAF) scaled 0-100 (where 100 is ideal) on ability to function in daily life |
14. |
A 22-year-old woman presents with a body mass index (BMI) of < 15 and has secondary amenorrhea for 3 months; urine hCG is negative. What is the likely cause of her amenorrhea? |
Patients with anorexia nervosa can induce secondary amenorrhea (loss of menstrual bleeding); patients with bulimia do not routinely develop amenorrhea. |
15. |
What are the components of the Patient Health Questionnaire 9 (PHQ-9)? |
In the last 2 weeks, how often have you felt
Sleep (trouble falling or staying asleep, or sleeping too much)
Interest (little interest or pleasure)
Guilt (feeling badly about yourself; let others down)
Energy (tired, little energy)
Concentration (trouble watching TV or reading)
Appetite changes (poor appetite or overeating)
Psychomotor changes (lethargic, moving slowly, or manic)
Suicidal/Homicidal thoughts (better off dead or gone)
Depressed feeling (hopeless)
|
16. |
What are the components of a gambling disorder? |
Gambling disorder is persistent and recurrent maladaptive gambling behavior that disrupts personal, family, and/or vocational pursuits. It has high rates of comorbidity with other mental disorders (substance use, depression, anxiety, and personality disorders). |
17. |
What the classic behaviors of someone with histrionic personality disorder? |
Histrionic personality disorder is often expressed as excessive emotions and attention seeking. People with this disorder have attractive, flamboyant personalities. |
18. |
What is dysthymia? |
A chronic depressive disorder (lasting more than 2 years) associated with an early and insidious onset (i.e., in childhood, adolescence, or early adulthood) |
19. |
How does depression differ from dysthymia? |
Depression requires a majority of the PHQ 9 responses to be positive, has a more acute onset, and when treated, depression goes into remission. Dysthymia requires a minority of PHQ 9 positive responses, and rarely goes into remission. |
20. |
A 22-year-old veteran is seen in follow-up from an Emergency Department visit for a boxer’s fracture of his hand; he seems distant and admits to frequently getting into fights. What condition should he be evaluated for? |
Posttraumatic stress disorder (PTSD); this is an anxiety disorder defined as a reaction that can occur after exposure to an extreme traumatic event involving death, threat of death, serious physical injury, or a threat to physical integrity. This reaction has three cardinal characteristics: reexperiencing the trauma, avoidance of anything related to the traumatic event and/or numbing of general responsiveness, and an increased arousal. |
21. |
What are the common traits of somatization disorder? |
Onset before 30 years of age
Rarely affects males
Physical and/or sexual abuse
Multiple symptoms affecting multiple organ systems
Not logical history given, jumping to multiple symptoms during interview
Anxious and depressed
Suicide attempts are common. |
22. |
What are the common behaviors of someone with borderline personality disorder? |
Impulsivity
Unstable relationships
Difficulty regulating behavior
Unstable mood
Self-damaging acts
Boredom, feelings of emptiness, depression
Paranoia
Extreme dependency
Alternating idealization and devaluation of the physician |
23. |
What characteristics and populations are at high risk for suicide? |
Age over 45
Male gender
Caucasian race
Living alone
Poor health |
24. |
What sexual side effect is associated with trazodone? |
Priapism |
25. |
What sexual side effects are associated with SSRIs? |
Decreased libido
Delayed ejaculation
Anorgasmia |
26. |
What are the treatments of choice for posttraumatic stress disorder? |
CBT, relaxation techniques including meditation and when medication is needed, SSRIs. |
27. |
What metabolic disorder is associated atypical antipsychotic medications? |
Type 2 diabetes mellitus |
28. |
What condition is associated with symptoms of illness in a child that are exaggerated, fabricated, or induced by a caretaker when there is usually no underlying health disorder in the child? |
Munchausen syndrome by proxy or factitious disorder by proxy; results in harm to the child victim through repeated interactions with the medical care system, including unnecessary tests, medications, and surgeries. |
29. |
For panic disorder, what medication class is the treatment of choice? |
SSRIs |
30. |
For obsessive-compulsive disorder, what class of drugs should be used as first line of treatment? |
SSRIs |
31. |
For bipolar disease, what agents are commonly used as first line of treatment? |
Lithium, antiseizure medication, atypical antipsychotics |
32. |
What endocrinologic disorder can lithium induce? |
Hypothyroidism; in women up to 15% will develop hypothyroidism; in men ˜5% |
33. |
What are the common criteria to commit someone for mental illness against his/her will? |
Commitment criteria: (1) Individual is mentally ill (many states exclude mental retardation, antisocial behavior, medical illness, and substance abuse); (2) High likelihood of serious harm (substantial risk of physical harm to self OR substantial risk of physical harm to other persons OR “Gravely disabled”: inability to care for basic needs, including food, clothing, shelter, medical care, and safety; (3) No less-restrictive alternative to hospitalization would attenuate risk. There are two stages of commitment: (a) Emergency detention and admission (sometimes called emergency hold)—an emergency admission with minimum of legal process, usually 72 hr and (b) Longer-term commitment—requires judicial approval of continued confinement in an adversarial proceeding where patient may have legal representation. |
34. |
How do you determine the difference between delirium and dementia? |
To determine the difference, look at the onset of symptoms. Delirium develops acutely with rapid deterioration over hours to days whereas dementia develops over months to years. |
35. |
In treating mania, what mood stabilizer drugs are commonly used? |
Lithium carbonate
Valproic acid
Carbamazepine
Lamotrigine |
36. |
Describe the signs and symptoms associated with mania. |
Increased psychomotor activity
Euphoria
Impaired judgment
Impulsivity
Grandiose ideas
Irritability |
37. |
As a child with attention deficit hyperactivity disorder ages, what symptoms may persist into adulthood? |
Inattention
Hyperactivity and impulsivity tend to decrease with advancing age. |
38. |
What is the common side effect of electroconvulsive therapy (ECT) on mental status? |
Reversible short-term memory loss |
39. |
What are the six stages of change? |
Precontemplation
Contemplation
Determination
Action
Maintenance
Termination
|
40. |
What psychiatric diagnosis is associated with thought disorders such as hallucinations, delusions, and loose associations, disorganized speech, catatonic behavior, and apathy or flat affect resulting in social/occupational impairment? |
Schizophrenia |
41. |
What test is helpful in detecting polypharmacy? |
Urine toxicology screen |
42. |
Long-term use of which anticonvulsive agent is associated with osteoporosis? |
Phenytoin |
43. |
What is the risk when an SSRI is used in the treatment of bipolar disorder? |
SSRIs may induce mania in patients with bipolar disorder. |
44. |
Define hypochondriasis. |
Hypochondriasis is a preoccupation with bodily functions and fears of acquiring a serious disease. |
45. |
Define the clinical signs and symptoms of a conversion disorder. |
Conversion disorder is a set of physical symptoms related to a psychological conflict that are unconsciously converted to a neurologic disorder (lack of coordination or balance, weakness, paralysis, loss of sensation, simulated convulsions, or loss of major senses). |
46. |
What is the likely diagnosis in a patient with daily excessive anxiety and worry that has continued for more than 6 months? |
Generalized anxiety disorder |
47. |
In diagnosing a primary mood disorder, what is the most important predisposing factor? |
Family history |
48. |
Which antidepressant medication can be used in smoking cessation and is associated with seizures but does not cause significant sexual dysfunction? |
Bupropion (Wellbutrin) |
49. |
What class of antidepressant drugs can induce a hypertensive crisis if mixed with tyramine-containing products such as aged cheese? |
MAOIs. |
50. |
In the evaluation of primary erectile dysfunction (ED), what is the most common cause? |
Psychogenic causes (guilt, fear, depression, anxiety) can be distinguished from a physiologic cause as people with psychogenic ED continue to get nocturnal and morning erections, while those with physiologic ED do not. |
51. |
What nonpharmacologic treatment can be used for circadian sleep disorders? |
Bright light therapy |
52. |
What condition is characterized by two or more identities or personalities? |
Dissociative identity disorder |
53. |
Which SSRI is most likely to induce loose stools? |
Sertraline (Zoloft) |
54. |
Which antidepressant is useful in the treatment of weight loss in the elderly? |
Mirtazapine (Remeron) |
55. |
Which antidepressive medication can induce an elevation in diastolic blood pressure? |
Venlafaxine (Effexor) |
56. |
What class of medication is likely to causing yawning as a side effect? |
SSRIs |
57. |
Which antidepressant medications are highly sedative and can be used to treat insomnia? |
Trazodone, doxepin, most TCAs (amitriptyline) |
58. |
What is the first mode of treatment for bulimia? |
Cognitive behavioral therapy |
59. |
What drugs are approved for lowering the risk of alcohol abuse relapse? |
Naltrexone, acamprosate (Campral), topiramate |
60. |
What drugs are used to lower the risk of seizures and delirium in alcohol withdrawal? |
Long-acting benzodiazepines (BZDs) (diazepam, chlordiazepoxide) are more effective at preventing breakthrough seizures and delirium management. |
61. |
In the United States, what medication is approved for the treatment of bulimia? |
Fluoxetine (Prozac) |
62. |
What neurotransmitter is affected by the use of acamprosate (Campral)? |
γ-Aminobutyric acid (GABA) |
63. |
What type of interpersonal therapy is recommended in obsessive compulsive disorder? |
Cognitive behavioral therapy |
64. |
What medications can be used for the treatment of chronic opioid dependence? |
Methadone, Suboxone (buprenorphine/naloxone) |
65. |
Chronic use of methadone maintenance therapy decreases the risk of what other diseases? |
HIV, hepatitis B and C |
66. |
Does the use of β blockers increase the risk of depression? |
There is no data that supports a significant increased risk of reported depressive symptoms when taking β blockers. |
67. |
What are the five stages of sleep? |
Stages 1, 2, 3, 4, and rapid eye movement (REM) sleep. They cycle from stage 1 to REM sleep, and then repeat.
Approximately 50% of sleep is in stage 2, 20% in REM sleep, and the rest in the other stages. |
68. |
In which stage of sleep does dreaming occur? |
REM sleep |
69. |
What happens to a patient’s REM sleep as they age? |
REM sleep does not change, but, there are significant decreases in stage 3 and 4 sleep. |
70. |
On an EEG, how is wakefulness characterized? |
Alpha Waves |
71. |
In patients on lithium for bipolar disorder, what blood testing should be done on a regular basis? |
Renal and thyroid functions |
72. |
What is the goal of cognitive therapy? |
To help the patient change a thought that leads to a change of mood, behavior, or reaction |
73. |
What side effect is most common with St. John’s wort? |
Transient photosensitivity rash |
74. |
In a patient with anorexia nervosa, what clinical findings are common? |
Bradycardia, low blood pressure, pubertal delay, loss of tooth enamel |
75. |
At a local middle school, an outbreak of nonspecific symptoms (headache, dizziness, lightheadedness, abdominal discomfort, chest discomfort, and inability to concentrate) occurs but no identifiable source is found. What is the term for this psychosomatic situation? |
Mass psychogenic illness |
76. |
What drug is used to prevent alcohol withdrawal in a patient with cirrhosis? |
Short-acting benzodiazepine such as lorazepam (Ativan) |
77. |
What neurotransmitter is altered by alcohol consumption? |
γ-Aminobutyric acid (GABA) |
78. |
What are the clinical characteristics of baby blues? |
Baby blues consist of mild depressive symptoms, crying without a cause, anxiety, irritability, and fatigue that can start within a few days of delivery and usually resolve within 10-14 days of birth. |
79. |
Patients use SAMe (adenosylmethionine) as it is believed to alter what neurotransmitter? |
Serotonin |
80. |
If a patient on an SSRI or SNRI develops a decreased libido, what antidepressant medications can be used because they have little effect on libido? |
Bupropion (Wellbutrin) |
81. |
What condition is hoped to be prevented by taking ginko biloba? |
Dementia |
82. |
What conditions may be improved by the use of valerian root? |
Insomnia and anxiety |
83. |
What medication can induce a paradoxical reaction in patients with mental retardation? |
Benzodiazepines |
84. |
What is the worrisome side effect associated ginkgo biloba? |
Bleeding complications |
85. |
Kava has been used by eastern cultures to treat what condition? |
Anxiety |
86. |
What herb used for depression may reduce the effectiveness of oral contraceptives? |
St. John’s wort |
87. |
What is the development of emotional or physical maladaptive symptoms that occur within 3 months following an identifiable stressor called? |
Adjustment disorder |
88. |
What older class of antidepressant medications can precipitate hypotension and arrhythmias? |
TCAs |
89. |
What antiepileptic drug is commonly used to treat chronic neuropathic pain? |
Gabapentin (Neurontin). |
90. |
What antiseizure medication is associated with rare but potentially life-threatening rashes? |
Lamotrigine (Lamictal) |
91. |
What method is used by males for suicide completion? |
Gunshot (firearms) |
92. |
What method of suicide is most commonly used by females? |
Drug overdose |
93. |
What cardiac condition abnormality does haloperidol potentially induce? |
Prolongation of the Q-T interval |
94. |
Who is most commonly the abuser in elder abuse? |
A relative (usually the spouse) |
95. |
What is the primary treatment for seasonal affective disorder? |
Light therapy for 30 min/day |
96. |
Smoking affects what gynecological conditions? |
Infertility, spontaneous abortion, ectopic pregnancy, and premature menopause |
97. |
What are persistent thoughts, ideas, and images that invade conscious awareness called? |
Obsessions |
98. |
What term is used for urges or impulses for repetitive intentional behavior performed in a stereotyped manner? |
Compulsions |
99. |
What risk factors are associated with suicide? |
Prior history of admission to a psychiatric facility
Other risk factors include living in an urban area, being unemployed, single, and poor. |
100. |
What metabolic condition does bulimia induce? |
Metabolic alkalosis |
101. |
Which TCA has the potential to induce the most anticholinergic properties (dry mouth, blurred vision, constipation, and urinary retention)? |
Amitriptyline |
102. |
Venlafaxine alters which neurotransmitters? |
Serotonin and norepinephrine |
103. |
Sleep disturbance, decreased interest or pleasure, feelings of worthlessness or guilt, fatigue, difficulty with concentration, altered appetite, weight change, psychomotor agitation or depression, and active suicidal thoughts that exist for at least 2 weeks are consistent with what diagnosis? |
Depression |
104. |
When anorexia is successfully treated, in what percent of women does menstruation usually resume? |
90% |
105. |
What condition is likely when a patient taking haloperidol develops a high fever, tachycardia, tachypnea, diaphoresis, and mental status changes? |
Neuroleptic malignant syndrome |
106. |
What eye-related condition has been associated with quetiapine (Seroquel) use? |
Cataract formation
Screening for cataracts is recommended at the initiation of therapy and at 6-month intervals thereafter. |
107. |
Disulfiram (Antabuse) can continue to react with alcohol for how many days after the drug is discontinued? |
Up to 14 days |
108. |
How soon after starting an antidepressant should the patient be followed up? |
2-3 weeks |
109. |
What condition would upper dental erosions in a 22-year-old female college student suggest? |
Bulimia nervosa |
110. |
A patient presents with mildly depressed mood, fatigue, low self-esteem, difficulty with concentration, and persistent hopelessness for at least 2 years. What is the likely diagnosis? |
Dysthymia |
111. |
What condition involves episodes of dysthymia followed by episodes of mild mania? |
Cyclothymia |
112. |
What disorder is likely if a female patient has issues of impulsivity, victimization, dependency, limited insight, and alternating episodes of idolization and disgust with her physician? |
Borderline personality disorder |
113. |
What is the likely diagnosis for someone with a pattern of one or more somatic symptoms recurring or persisting for > 6 months that are distressing or result in significant disruption of daily life, with no identifiable cause, is not being faked, and is true suffering by the patient? |
Somatization disorder |
114. |
What antianxiety medication does not induce dependence or cause abuse, cause drowsiness, or other functional limitations and is safe for senior citizens? |
Buspirone (Buspar) |
115. |
Abrupt cessation of what class of psychiatric medication can cause headaches, anxiety, diarrhea, dizziness, fatigue, insomnia, and visual disturbances? |
SSRIs |
116. |
What is the neurosis in which the patient fakes signs or symptoms without tangible personal benefit other than to experience the sick role, is more common in men, and a chronic childhood illness? |
Munchausen syndrome |
117. |
What common past medical/social history is found in a patient with Munchausen syndrome? |
Parental emotional or physical abuse |
118. |
How does Munchausen syndrome differ from factitious disorder? |
Factitious disorder patients tend to simulate only one disease and they do this during times of major psychosocial stress. They do not doctor shop (as those with Munchausen syndrome) and they usually can be treated successfully. |
119. |
What treatment is commonly used for Munchausen disorder? |
Confronting the patient with the diagnosis without suggesting guilt or reproach |
120. |
How is somatization disorder treated? |
Treatment consists of arranging a regular visit on an agreed-upon interval to help limit emergency department (ED) exposure and unnecessary testing and a long-term physician relationship that offers reassurance and symptomatic relief when necessary but discourages unnecessary diagnostic or therapeutic procedures. Medications and psychotherapy may be beneficial. |
121. |
What is the most common cause of death in adults below age 50 years? |
Prescription drug accidental overdose (opioids are the class with the greatest risk) |
122. |
In motivational interviewing, what two aspects should a practitioner assess with a patient? |
Patient’s level of importance about the issues and his or her confidence about achieving it |
123. |
What is the likely diagnosis when a patient describes excessive/irrational fear and avoidance of situations that may be difficult to escape, including fear of crowds, enclosed spaces (e.g., elevators, automobiles, or airplanes), or simply being alone (at home or away from home) and is often associated with panic disorder? |
Agoraphobia |
124. |
How is agoraphobia treated? |
Agoraphobia is treated by exposure therapy where the patient confronts and remains within the environment they fear until anxiety resolves (this is called habituation). |
125. |
In the general adult population, what are the most common anxiety disorders? |
Phobias (fear of snakes, dark, flying, heights, needles, etc.) present in up to 7% of individuals. |
126. |
How long must buspirone be taken to begin to show anxiolytic effects? |
About 2 weeks |
127. |
What is the condition associated with a stressful event inducing a memory lapse that can range from a few minutes to years? |
Dissociative amnesia |
128. |
What is the term when a patient has the inability to form new memories after an event? |
Antegrade amnesia |
129. |
What condition is characterized by the assumption of a new name and identity following a major stressful event (i.e., major accidents, and natural disasters)? |
Dissociative fugue |
130. |
What is the condition called when previously stored memories are unavailable? |
Retrograde amnesia, most often temporary |
131. |
In geriatric depression, how common is suicide among depressed men? |
Suicide rates are highest for males aged > 75 years (rate 38.5/100,000). |
132. |
What conditions are included on the differential diagnosis for senior citizens with new onset depression? |
Hypothyroidism, vitamin B12 deficiency, liver or renal failure, cancers, stroke, new onset dementia, some medications |
133. |
What diagnosis has the highest risk for suicide? |
Dissociative identity disorder (multiple personality disorder) |
134. |
What is the clinical state when a patient feels removed from himself or herself, and detached from his or her physical and mental processes? |
Depersonalization |
135. |
Overdose of TCAs may cause what fatal condition? |
Cardiac arrhythmia |
136. |
At higher dosages, what SSRI is associated with weight loss and is effective for binge eating disorder? |
Fluoxetine (Prozac) |
137. |
How does trazodone effect blood pressure? |
Trazodone is a α1-noradrenergic antagonist and is associated with postural hypotension. |
138. |
Because of its adverse effects, which patients should not be prescribed bupropion? |
Patients with seizure disorders |
139. |
In patients with severe depression refractory to medication, what intervention may be considered? |
Electroconvulsive therapy |
140. |
What clinical condition can chronic lithium use induce? |
Hypothyroidism
This can be ruled out by obtaining a thyroid stimulating hormone (TSH) level. |
141. |
Which class of antihypertensives can induce lithium toxicity in patients using lithium for bipolar disorder? |
Diuretics |
142. |
Why should lithium not be used in women who may become pregnant? |
Lithium use in the first trimester may induce Ebstein anomaly, a cardiac defect. |
143. |
Carbamazepine and divalproex use in the first trimester are associated with what birth defect? |
Neural tube defects |
144. |
What personality disorder is associated with distrust of others’ motives resulting in avoidance of intimate relationships, grudges, and the sense that they are being exploited by others? |
Paranoid personality disorder |
145. |
What personality disorder is most commonly seen by healthcare providers? |
Borderline personality disorder |
146. |
What personality disorder is associated with grandiosity, exaggerated sense of superiority, and often seen in individuals who are high achievers? |
Narcissistic personality disorder |
147. |
A person who demonstrates a habitual pattern of passive resistance to expected work requirements, expresses opposition, and has negative attitudes in response to requirements for normal performance is what personality type? |
Passive aggressive personality |
148. |
What childhood exposure can result in chronic hypoactive sexual desire? |
Abuse or traumatic events in childhood |
149. |
A side effect of what class of medication can be used to treat premature ejaculation? |
SSRIs |
150. |
What is the term for patients who obtain sexual satisfaction by observing unsuspecting persons who are naked, disrobing, or engaging in sexual activity? |
Voyeurs |
151. |
What factor has the greatest impact on the prognosis for patients with schizophrenia? |
Adherence to prescribed psychoactive medications |
152. |
Antipsychotic medication can induce what condition which presents with involuntary movement such as puckering of the lips and tongue and/or writhing of the arms or legs? |
Tardive dyskinesia |
153. |
What potentially fatal adverse event may result from the use of antipsychotic medication associated with rigidity, fever, autonomic instability, and elevated creatinine phosphokinase? |
Neuroleptic malignant syndrome |
154. |
What vitamin can prevent the cerebellar degeneration seen in alcoholics? |
B1 (Thiamine) |
155. |
For mild to moderate depression, what treatment is as effective as medication? |
Cognitive behavioral therapy |
156. |
What should be administered to unconscious patients before IV glucose? |
Thiamine should be given IV to prevent Wernicke encephalopathy and Korsakoff psychosis. |
157. |
What is included in the differential diagnosis of adult attention deficit disorder (ADD)? |
Hearing impairment, thyroid dysfunction, sleep deprivation, sleep apnea, phenylketonuria, obsessive-compulsive disorder (OCD), lead toxicity, substance abuse |
158. |
What is the single greatest risk factor of adult ADD? |
Having attention deficit hyperactivity disorder (ADHD) symptoms before age 12 years |
159. |
What diagnosis is present in patients with pervasive subjective feelings of ugliness about one or more aspects of their appearance despite a normal or near-normal appearance? |
Body dysmorphic disorder
DSM V criteria (all must be included):
Preoccupation with a perceived defect in appearance. If there is a minor physical anomaly, the concern is excessive.
At some point during the course of the disorder, the individual has performed repetitive behaviors or mental acts in response to the appearance concerns.
The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of function.
The preoccupation is not accounted for by another mental disorder or meet criteria for an eating disorder.
|
160. |
What is the drug class of choice for body dysmorphic disorder? |
SSRIs |
161. |
What condition occurs in children when provoked by strong emotion to seem to stop breathing, become limp, and possibly become unresponsive, but are not having a seizure? |
Breath holding attacks characterized by the following:
|
162. |
What percent of teenagers experience cyberbullying? |
Estimated to be at 15%, cyberbullying is behavior via electronic or digital media that communicates hostile or aggressive messages intended to harm or cause discomfort to others. Threefourths of victims report knowing their bully implying that one-fourth of those bullied report NOT knowing their victim. |
163. |
What is the likely diagnosis of a 27-year-old with history of recurrent depression episodes who now presents agitated, speech is pressured, has flight of ideas, and is having grandiose or paranoid thoughts? |
Bipolar I (BP-I) is a mood disorder characterized by at least one manic or mixed episode, often alternating with episodes of major depression. Exam finds the following:
General appearance: bright clothing, excessive makeup, disorganized or discombobulated, psychomotor agitation
Speech: pressured, difficult to interrupt
Mood/Affect: euphoria, irritability/expansive, labile
Thought process: flight of ideas (streams of thought occur to patient at rapid rate), easily distracted
Thought content: grandiosity, paranoia, hyperreligious
Perceptual abnormalities: three-fourths of manic patients experience delusions, grandiose or paranoid
Suicidal/homicidal ideation: Irritability or delusions may lead to aggression toward self or others; suicidal ideation is common with mixed episode.
Insight/judgment: poor/impaired
|
164. |
How does bipolar II differ from bipolar I? |
Bipolar II consists of at least one episode of major depression and at least one episode of hypomania, a milder form of mania. Bipolar I has mania, which includes flight of ideas and grandiose or paranoid thoughts. |
165. |
Hallucinations are sensory perceptions (auditory, olfactory, visual, tactile, gustatory) that occur without external stimulation of the relevant sensory organ but are experienced as a sensation through that organ. What medications can induce hallucinations? |
Anticholinergic agents
Steroids
Methylphenidate
|
166. |
What percent of homeless individuals suffer from chronic mental illness? |
25% |
167. |
What percent of homeless individuals are veterans? |
8% |
168. |
For patients with chronic insomnia, what are the components of good sleep hygiene? |
Fixed wake-up times and bedtimes regardless of amount of sleep obtained (weekdays and weekends)
Go to bed only when sleepy.
Avoid naps.
Sleep in cool, dark, quiet environment.
No activities or stimuli in bedroom associated with anything but sleep or sex
30-minute wind-down time before sleep
If unable to sleep within 20 minutes, move to another environment and engage in quiet activity until sleepy. |
169. |
What interventions should be first-line treatment for all patients with chronic insomnia? |
Proper sleep hygiene and cognitive behavioral therapy |
170. |
What percentage of patients with binge eating disorder and bulimia abuse laxatives? |
Up to 70% of patients with binging/purging anorexia and bulimia nervosa abuse laxatives but rarely as the sole method of purging. |
171. |
What is the most commonly used illicit substance in the United States? |
Cannabis is the most widely used illicit psychoactive substance in the United States.
Approximately 42% of teens will have tried marijuana by the time they graduate from high school and approximately 30% of students report having used marijuana at college entry.
In the United States, 10% of those who ever used marijuana become daily users, and 20%-30% become weekly users. |
172. |
What skin disorder is due to a habit or anxiety induced that results in skin lichenification (thickening)? |
Lichen simplex chronicus is dermatitis resulting from chronic, repeated rubbing or scratching of the skin, resulting in thickening with accentuated lines (“lichenification”); the scratching may be secondary to habit or a conditioned response to anxiety. |
173. |
What disorder causes at least two individuals to both hold the same delusional belief? |
Shared delusional disorder occurs when a delusional belief held by one person (the “primary”) becomes shared by one other (the “secondary”) or several other people associated with that person. It is also known as shared psychotic disorder and folie a deux (if two people are involved). |
