Day 3 Flashcards

What are the two most common causes of dementia in the elderly?

_____ disease (most common)
_____ dementia

What is the likely diagnosis for an adult with a history of chronic alcohol consumption who is exhibiting anterograde amnesia and confabulation in the emergency department?

What type of amnesia is present in a patient who sustained a head injury and is unable to recall anything that occurred from the time that the injury occurred?

What type of amnesia is present in a patient who cannot recall anything that occurred before they sustained a head injury but can still make new memories?

Korsakoff syndrome is a late neuropsychiatric manifestation of what disease?

What is the definition of an anxiety disorder?

When a patient experiences inappropriate ____ and ____

Which three other conditions must be ruled out to make a diagnosis of anxiety disorder?

Another ____ disorder
____ use
____ condition

In a person with bipolar disorder, what mood can you expect between episodes of mania/hypomania and depression?

Mood generally returns to ______

What disorder is present in a patient who has mild dysthymia and has been experiencing hypomanic episodes for 3 years?

What class of drugs are used most commonly to treat bipolar disorder?

____ ____

____ ____

How does bipolar I disorder differ from bipolar II disorder?

Bipolar I disorder includes _____ episodes with or without a _____ or _____ episode
Bipolar II disoder includes a _____ episode and a _____ episode, but no _____ episodes

What class of drugs can cause mania and increase suicide risk in patients with bipolar disorder?

______

How long are symptoms required to be present for a diagnosis of cyclothymic disorder?

____ or more years with symptoms present at least ____% of the time, with any remission lasting for ____ months or less

What additional disorder do patients with selective mutism usually have?

How do you treat selective mutism?

____, ____, and ____ therapies with or without ____

What is selective mutism?

____ disorder that involves refraining from ____ in specific situations for less than or equal to ____ month in a child older than ____ years who has no impairment in speech/language development

Selective mutism interferes with performance of what kinds of tasks?

____ tasks
____ tasks
____ tasks

In _____ disorder, the basic rights of others or social norms are violated
In _____ _____ disorder, the basic rights of others or social norms are not violated

What is the treatment for conduct disorder?

How do you treat a child with oppositional defiant disorder?

Up to what age is separation anxiety considered a normal phenomenon?

___ to ___ years

An episode of separation anxiety in older children must last how long for it to be considered a disorder?

____ weeks or more

What can be used to treat a child with separation anxiety disorder?

____ ____ therapy
____ therapy
____ therapy

What modalities are used to treat intractable tics in a patient with Tourette syndrome?

High-potency____, ____-agonists, ________

Tourette syndrome presents with what symptoms and at what age?

Sudden, rapid, recurrent, [rhythmic/nonrhythmic] stereotyped vocal and motor ____ that are present > ____ year(s) before the age of ____ years

What is the first-line therapy for Tourette syndrome?

_____ therapy
_____education

What features and associated disorders may be seen in a patient with Tourette syndrome?

Vocal and motor ____
C____
____-____ ____
____-____ ____ ____

____ is the medical term for the involuntary outburst of obscene words, slurs, or socially inappropriate remarks.

How long do symptoms need to be present for Tourette syndrome to be diagnosed?

More than __ year(s)

ADHD symptoms must last for how long before diagnosis?

What three traits characterize attention-deficit hyperactivity disorder?

I____
I____
H____

ADHD symptoms must be found in ____ or more settings

What are the treatment options for attention-deficit hyperactivity disorder?

______ with or without ______ ______ therapy
______ alternatives

You suspect that a child who does poorly in school has attention-deficit hyperactivity disorder. Does this disorder affect intelligence?

What classes of drugs are used to treat disruptive mood dysregulation disorder?

_____

_____

How does disruptive mood dysregulation disorder present?

Severe, recurrent _____ outbursts incongruent to situation

How long must symptoms be present before a diagnosis of disruptive mood dysregulation can be made?

Autism must present in [early/late] childhood and is more common in [boys/girls]

At what age would you diagnose a patient with conduct disorder?

Before the age of ____ years

After age 18, conduct disorder is reclassified as _____ _____ disorder.

A child with autism may have an intellectual _______ or _______ abilities or specific skills. Size of head and/or brain may be _______.

Which childhood disorder is characterized by poor social interactions, communication deficits, ritualized or repetitive behavior, and restricted interests?

_____ _____ disorder

What is intellectual disability?

______ cognitive deficits that affect memory, reasoning, judgment, abstract thinking, language, and learning

Why do patients with intellectual disability have difficulties in socialization, education, employment, and independence?

_____ functioning is impaired due to _____ cognitive deficits

How do you treat a patient with intellectual disability?

By providing ______ support to improve global functioning

A child is unable to read near the level of proficiency for his or her age even after working with a tutor 7 months. What is the most likely diagnosis?

_____ _____ disorder

What happens to general functioning and intelligence in an individual with specific learning disorder?

How long must symptoms persist for a diagnosis of specific learning childhood disorder?

> ___ months

How do you treat a patient with specific learning disorder?

_____ support
C_____
_____ activities

How do you treat delirium?

Treatment of delirium is aimed at identifying and addressing the _____ _____

_____ may be used as needed for acute episodes of delirium

What classes of medication should be avoided in the treatment of delirium?

_____
_____
_____

What could be the cause of sudden waning of consciousness in hospitalized older patients?

You suspect that your patient with altered mental status has delirium. What test may help to confirm the diagnosis?

_____

EEG may reveal _____ _____ _____ slowing, a finding associated with delirium.

Define delirium.

Acute, [reversible/irreversible], onset of waxing/waning _____ with rapidly decreasing _____ span and level of _____

How do you begin management of delirium before considering medication?

Identifying/treating underlying _____
Providing cognitive _____
Keeping a clock or calendar nearby for _____ purposes
Reducing _____ disturbances

What is the treatment for atypical depression?
_____
_____ _____ therapy
_____ (not first-line)

What symptoms differentiate atypical depression from classical depression?

_____ reactivity
[Hypersomnia/Hyposomnia]
[Overeating/Undereating]
_____ paralysis
_____ to rejection

Heavy feeling in legs and arms is called what?

Transient improvement in mood in response to a positive event is called what?

What is the most common subtype of depression?

How long must symptoms be present for a diagnosis of delusional disorder to be made?

> [...] month(s)

How long must symptoms persist for a diagnosis of brief psychotic disorder?

< [...] month(s)

Symptoms of major depressive disorder last ≥ [...] weeks
Dysthymia and cyclothymia are diagnosed in adults after symptoms last > [...] years

After how many months of anxiety-related symptoms can the diagnosis of generalized anxiety disorder be made?

> [...] months

After how many months of symptoms can the diagnosis of panic disorder be made?

> [...] month(s)

How many months of symptoms are necessary for a narcolepsy diagnosis?

> [...] month(s)

How long must symptoms be present in a child for a diagnosis of oppositional defiant disorder to be made?

> [...] months

How long must symptoms be present for the diagnosis of tic disorder be made?

> [...] year(s)

How long must symptoms be present for the diagnosis of a phobia be made?

> [...] months

Symptoms persisting ____ than ____ months indicate adjustment disorder

Symptoms persisting ____ than ____ months indicate generalized anxiety disorder

Compare the duration of symptoms in acute stress disorder versus post-traumatic stress disorder.

Acute stress disorder → Symptoms persist ____ than ____ month(s)
Post-traumatic stress disorder → Symptoms persist ____ than ____ month(s)

How long must symptoms be present for a diagnosis of schizophreniform disorder to be made?

Symptoms must be present for [...] to [...] months

How long must symptoms be present for a diagnosis of schizophrenia to be made?

Name six psychiatric conditions associated with dissociative identity disorder.

____-____ ____ disorder
______
______ personality disorder
______ use disorder
______ disorders
History of ______ abuse

Dissociative identity disorder is more common in which sex?

Depersonalization → Feelings of detachment/estrangement from one's ____
Derealization → Feelings of detachment/estrangement from one's ____

A man often feels estranged from his surroundings and from himself, almost as if he is merely an observer. What could this condition be?

________/________ disorder

If a patient has two or more distinct personality states or identities, what is the diagnosis?

Due to the severe trauma of child abuse, a woman is unable to recall her date of birth. What type of amnesia is this?

_____ amnesia

A man abruptly travels to the other side of the country and is found wandering on the streets there. What is the most likely diagnosis?

Dissociative _____

Dissociative fugue occurs during a period of dissociative amnesia, which is often associated with _____ circumstances.

Which eating disorder involves dieting, fasting, and/or exercising excessively without purging or binge eating for ≥ 3 months?

Which eating disorder involves recurrent purging behaviors or binge eating for ≥ 3 months?

What three treatment options are available for patients with anorexia nervosa?

_____
_____ rehabilitation
_____

What is the definition of anorexia nervosa?

Intense fear of [gaining/losing] weight, distortion of body image, and overvaluation of ____ → Calorie ____, extreme weight [gain/loss], and inappropriately [high/low] BMI

Name three electrolyte disturbances that occur in refeeding syndrome in patients with anorexia.

[Hyperkalemia/Hypokalemia]
[Hyperphosphatemia/Hypophosphatemia]
[Hypermagnesemia/Hypomagnesemia]

In anorexia nervosa, what three symptoms or diseases may present due to disruption of the endocrine symptom?

[Hyperthyroidism/Hypothyroidism]
_____
_____

How may body hair be altered in anorexia nervosa?

Development of ____ hair on the arms and legs

Compare the body weight profiles of patients with anorexia nervosa and bulimia nervosa.

Anorexia nervosa → _____ BMI
Bulimia nervosa → _____ or _____ BMI

What four findings may be seen in a patient with bulimia nervosa?

____ of enamel on teeth
Metabolic [acidosis/alkalosis]
____ disturbances
[Ventral/Dorsal] hand ____ caused by induction of vomiting

What is the definition of pica?

Recurring consumption of _____ items, not considered normal for an individual's culture or developmental stage, for _____ month(s) or longer

What is the treatment for pica?

First-line treatment → _____ rehabilitation and _____
Second-line treatment → _____

What population of patients does pica typically affect?

_____
_____ women

What four comorbidities is pica associated with?

______ deficiency anemia
______ disabilities
______
______ trauma

Describe the mechanism of refeeding syndrome and three potential complications in a patient with anorexia.

Sudden increase in calorie intake → Increase in ____ → [Hyperphosphatemia/Hypophosphatemia], [hyperkalemia/hypokalemia], and [hypermagnesemia/hypomagnesemia] → Rhabdomyolysis, seizures, and cardiac complications

What treatment options are available for binge-eating disorder?

_____ (first-line treatment)
_____
_____

Why is bupropion contraindicated for patients with bulimia nervosa?

Elevated risk of ______

Why might a doctor order an endoscopy for a patient with bulimia nervosa?

To check for _____ in the [upper/lower] part of the esophagus

Which enzyme would increase as a result of parotid gland hypertrophy in patients with bulimia nervosa?

Serum _____

What is the treatment for bulimia nervosa?

_____
_____ rehabilitation
_____

Is electroconvulsive therapy safe for pregnant patients and elderly patients?

Name four clinical indications for electroconvulsive therapy.

Acute _____
_____ with psychosis
_____ depression
C_____

What is the mechanism of electroconvulsive therapy?

Electroconvulsive therapy induces ____-____ seizures in patients under anesthesia and neuromuscular blockade

What are the adverse effects of electroconvulsive therapy?

_____
_____
_____/_____ amnesia that usually resolves within _____ months

What is the first-line treatment for someone diagnosed with enuresis?

______ modifications
[Positive/Negative] reinforcement

For nocturnal urinary incontinence refractory to behavioral modifications, what are two treatment options?

Bedwetting ______
Oral ______

How long must symptoms of nighttime incontinence last for a diagnosis of enuresis to be made?

≥ [...] times per week for ≥ [...] months

How old does a person have to be for a diagnosis of enuresis to be made?

> [...] years

A caregiver—usually a parent—intentionally fabricates, exaggerates, or induces physical or psychological symptoms in a dependent (often a child) to deceive others and gain attention or sympathy.

_____ disorder imposed on [self/another]

Patients with factitious disorder imposed on self are _____ to undergo tests and procedures

Patients with malingering often _____ treatment

What is the primary goal of a patient with a factitious disorder?

To get _____ and medical _____ by means of the sick role

In which two population groups is factitous disorder imposed on self more common?

_____ workers
[Men/Women]

What is the definition of gambling disorder?

Persistent, recurrent, problematic gambling that cannot be better explained as a _____ episode

What is the treatment of gambling disorder?

______

What is the definition of transgender?

When a patient lives their life as a [similar/different] gender than what was assigned at _____

What is definition of gender dysphoria?

A difference between the way an individual ______ gender and the gender assigned at ______

gender dysphoria lasts for over ______ months and causes persistent ______.

Is gender nonconformity a mental disorder?

At what age does gender identity develop?

What are seven of the most common symptoms associated with generalized anxiety disorder?

Excessive _____
_____ problems
_____
_____
Difficulty _____
_____
Muscle _____

By definition, the symptoms of generalized anxiety disorder must be present for how long to be clinically significant?

On most days for [...] months or longer

What are three first-line treatment options available for generalized anxiety disorder?

____ ____ therapy
____
____

What are three second-line treatment options for generalized anxiety disorder?

____
____
____

How do the criteria for a diagnosis of generalized anxiety disorder in adults compare with the criteria for a diagnosis of generalized anxiety disorder in children?

Adults → ≥ [...] symptoms of generalized anxiety
Children → ≥ [...] symptoms of generalized anxiety

Compare hypomanic and manic episodes in terms of severity.

Hypomanic episodes are [more/less] intense
Hypomanic episodes do not impair ____ or feature ____
Hypomanic episodes do not require ____
Hypomanic episodes last for ≥ ____ consecutive days

What treatment options are first line for major depressive disorder?

_____ _____ _____
_____

What are the features of major depressive disorder?

_____ disturbance
Decreased interest in _____ activities
_____
[Increased/Decreased] energy
[Increased/Decreased] concentration
_____ /_____ changes
_____ agitation
_____ ideation

For major depressive episode: Symptoms must have been present for most days for a period of ____ ____ or longer

Which disorder is often milder than major depressive disorder with at least 2 depressive symptoms lasting at least 2 years and with remission of 2 months or less?

_____ _____ disorder AKA _____

In which depressive disorder do episodes occur only during a particular season in 2 or more consecutive years?

_____ _____ disorder with _____ _____

What are the treatment options for major depressive disorder with seasonal pattern?

______ ______ therapy
______
______ therapy

Psychotic features occur only ______ the major depressive episode in a patient with major depressive disorder with psychotic features

A patient with schizoaffective disorder will have psychotic symptoms [dependent/independent] of a depressive episode

What is the treatment for major depressive disorder with psychotic features?

A(n) ______ combined with a(n) ______ ______ or ______ therapy

Define major depressive disorder with psychotic features.

Major depressive disorder accompanied by _____ or _____

In major depressive disorder with psychotic features, hallucinations and delusions typically have what overlying theme?

They are typically mood ______ with depressed mood

Which disorder is intentional and the patient's complaints stop after something is gained?

Which disorder occurs when a patient consciously fakes, exaggerates, or reports a disorder with goal of attaining a secondary gain?

How does malingering affect a patient's compliance with treatment and follow-up?

Compliance with treatment or follow-up is often _____

What are the seven symptoms of a manic episode?

_____
_____/_____
_____
Flight of _____
[Increased/Decreased] activity/agitation
[Increased/Decreased] sleep needs
_____

For diagnosis of a manic episode, how many manic symptoms must be present and for how long?

At least ___ symptoms for at least ___ ___

Define mood disorders: disorders in which an abnormal range of internal emotions/moods and loss of ____ over them cause distress and impairment in ____ function

Give four examples of disorders that are classified as mood disorders.

____ ____ disorder
____ disorder
____ disorder
____ disorder

Can a patient with a mood disorder experience symptoms of psychosis, such as hallucinations or delusions?

List the order in which a person loses his or her components of orientation.

First → ______
Second → ______
Third → ______

What is orientation in the context of the psychiatric exam?

An individual’s ability to know ____ he/she is, ____ he/she is, and the ____ and ____

What are the common causes of loss of orientation?

____ injury
Fluid/electrolyte ____
____
____
Hypo_____
Hypo_____
_____
_____ deficiencies

What are the criteria for a diagnosis of panic disorder?

____ ____ followed by history of ≥ ____ month of ____ or more of the following criteria:

____ of new attacks
____ about consequences of attacks
Changed ____ due to attacks

What is the treatment for panic disorder?

_____ _____ therapy
_____
_____

For panic disorder, what drug class may be used for acute episodes?

Is panic disorder genetic?

What disorder causes recurrent episodes of intense fear, nausea, paresthesias, and depersonalization for short periods?

How does panic disorder affect the risk for suicide?

What are risk factors for postpartum psychosis?

_____ disorder
_____ disorder
[First/Second] pregnancy
_____ history
Recent discontinuation of _____ medication

Which of the peripartum mood disturbances is the only one that does not usually warrant pharmacologic therapy?

_____ _____

What postpartum mental disorder could cause a woman to have delusions and threaten to kill herself and the baby?

_____ _____

What is the treatment for major depressive disorder with peripartum onset?

____
____ ____ therapy

When will the symptoms of postpartum blues likely resolve?

Within ____ ____

What are three peripartum mood disturbances that new mothers may experience in order from highest to lowest incidence rate?

____ ____ (50% to 85%)
____ ____ disorder with ____ ____ (10% to 15%)
____ ____ (0.1% to 0.2%)

What is the treatment for postpartum psychosis?

Admission to inpatient _____ unit

Administration of _____ _____ or _____ therapy if drug therapy is ineffective

What is the definition of personality disorder?

[Flexible/Inflexible] and ______ pattern of behavior that is pervasive in their life → Distress and/or impaired function

What is the definition of personality trait?

A personality trait is an enduring pattern in which a person processes and relates to his/her _____ and his/her _____ in it

In what age group do personality disorders usually present?

Before or during early ______

What are the three clusters of personality disorders?

Cluster A → "____"
Cluster B → "____"
Cluster C → "____"

What are the three cluster A personality disorders?

____ personality disorder
____ personality disorder
____ personality disorder

Cluster A personality disorders have a genetic association with which other psychiatric disorder?

_______

What common characteristics could be observed in an individual with paranoid personality disorder?

Pervasive _____
[Hypervigilance/Hypovigilance]
_____
Very _____ view of the world

What are four common characteristics of schizotypal personality disorder?

_____ beliefs
Interpersonal _____
_____ thinking
_____ appearance

What three characteristics are common with schizoid personality disorder?

Limited _____ expression
Indifferent to the _____ of others
Prefers _____ activities

What are the four cluster B personality disorders?

____ personality disorder
____ personality disorder
____ personality disorder
____ personality disorder

What three characteristics do cluster B personality disorders share?

D_____ behavior
E_____ behavior
E_____ behavior

Cluster B personality disorders are genetically associated with what two other disorders?

____ abuse
____ disorders

What personality disorder could cause a person who has fragile self-esteem to demonstrate entitlement, grandiosity, and defensiveness and lack empathy?

______ personality disorder

What personality disorder could cause a person to engage in impulsive and self-mutilating behavior, express emotional emptiness, and have unstable moods and relationships?

______ personality disorder

What is the treatment for borderline personality disorder?

_____ _____ therapy

What is a major defense mechanism for a patient with borderline personality disorder?

What personality disorder could cause a person to be shallow and sexually provocative, seek attention, and use dramatic speech and emotional expression?

______ personality disorder

What personality disorder could cause individuals to be hostile, impulsive, manipulative, and unremorseful when they disregard the rights of others?

______ personality disorder

Is antisocial personality disorder more common in males or females?

What are the three cluster C personality disorders?

____ personality disorder
____-____ personality disorder
____ personality disorder

What category of disorders is cluster C personality disorders associated with?

_____ disorders

What personality disorder could cause an individual to have low self-confidence, often remain in abusive relationships, and constantly seek support from others?

_____ personality disorder

What personality disorder could cause a person to be preoccupied with perfectionism, order, and control and experience pleasure in doing so?

_____-_____ personality disorder

What personality disorder could cause a person to be hypersensitive to rejection, timid, and socially inhibited and express feelings of inadequacy yet desire relationships?

[...] personality disorder

What are the three hallmarks of serotonin syndrome?

[Increased/Decreased] activity
____ instability
Altered ____ status

Which medication can be used in the treatment of serotonin syndrome, and what is its mechanism?

_____ , which is a _____ receptor antagonist

What condition can develop in a patient on a MAOI who consumes tyramine-rich foods?

______ ______

What is the treatment for a patient prescribed MAOIs undergoing a hypertensive crisis?

______

How does eating tyramine-rich foods while taking MAOIs result in hypertensive crisis?

Tyramine displaces ______ in the synaptic cleft → Increased ______ → Stimulation of the ______ nervous system

What are six manifestations of neuroleptic malignant syndrome?

M________
F________
E________
________ unstable
[Increased/Decreased] enzyme levels
Muscle ________

What class of drugs should not be prescribed for a patient with a known family history of neuroleptic malignant syndrome?

What drugs can be used to treat neuroleptic malignant syndrome?
_____
_____
_____ agonists

In a patient experiencing alcohol withdrawal, when does delirium tremens typically arise?

____ to ____ days after the last drink

What is the treatment for a patient undergoing alcohol withdrawal with seizures?

Longer-acting _______

What is the likely cause of laryngospasm requiring intubation in a patient who has started taking an antipsychotic medication?

Acute _____

What three symptoms may be present in a patient with acute dystonia?

Muscle _____
Muscle _____
_____ crisis

acute dystonia symptoms can begin hours to days after use of a _____ _____.

An oculogyric crisis is an acute, involuntary neurological condition characterized by a sustained, ______ deviation of the eyeballs.

What is the treatment for lithium toxicity?

______ of lithium

Hydrating aggressively with ______ ______ solution

______ can be considered

What is the treatment for a TCA overdose?

_____ treatment

Activated _____

_____

_____ monitoring