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Day 3

front 1

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

_____ disease (most common)
_____ dementia

back 1

Alzheimer disease (most common)
Vascular dementia

front 2

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?

back 2

Korsakoff syndrome

front 3

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?

back 3

Anterograde amnesia

front 4

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?

back 4

Retrograde amnesia

front 5

Korsakoff syndrome is a late neuropsychiatric manifestation of what disease?

back 5

Wernicke encephalopathy

front 6

What is the definition of an anxiety disorder?

When a patient experiences inappropriate ____ and ____

back 6

When a patient experiences inappropriate fear and worry

front 7

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

Another ____ disorder
____ use
____ condition

back 7

Another psychiatric disorder
Substance use
Medical condition

front 8

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

Mood generally returns to ______

back 8

Mood generally returns to normal

front 9

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

back 9

Cyclothymic disorder

front 10

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

____ ____

____ ____

back 10

Mood stabilizers
Atypical antipsychotics

front 11

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

back 11

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

front 12

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

______

back 12

Antidepressant

front 13

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

back 13

2 or more years with symptoms present at least 50% of the time, with any remission lasting for 2 months or less

front 14

What additional disorder do patients with selective mutism usually have?

back 14

Social anxiety disorder

front 15

How do you treat selective mutism?

____, ____, and ____ therapies with or without ____

back 15

Behavioral, family, and play therapies with or without SSRIs

front 16

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

back 16

Anxiety disorder that involves refraining from speech in specific situations for less than or equal to 1 month in a child older than 5 years who has no impairment in speech/language development

front 17

Selective mutism interferes with performance of what kinds of tasks?

____ tasks
____ tasks
____ tasks

back 17

Academic tasks
Social tasks
Occupational tasks

front 18

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

back 18

In conduct disorder, the basic rights of others or social norms are violated
In oppositional defiant disorder, the basic rights of others or social norms are not violated

front 19

What is the treatment for conduct disorder?

back 19

Psychotherapy

front 20

How do you treat a child with oppositional defiant disorder?

back 20

Psychotherapy

front 21

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

___ to ___ years

back 21

3 to 4 years

front 22

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

____ weeks or more

back 22

4 weeks or more

front 23

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

____ ____ therapy
____ therapy
____ therapy

back 23

Cognitive Behavioral Therapy

Family therapy

Play therapy

front 24

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

High-potency____, ____-agonists, ________

back 24

High-potency antipsychotics
α2-agonists
Tetrabenazine

front 25

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

back 25

Sudden, rapid, recurrent, nonrhythmic stereotyped vocal and motor tics that are present > 1 year(s) before the age of 18 years

front 26

What is the first-line therapy for Tourette syndrome?

_____ therapy
_____education

back 26

Behavioral therapy
Psychoeducation

front 27

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

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

back 27

Vocal and motor tics
Coprolalia
Obsessive-compulsive disorder
Attention-deficit hyperactivity disorder

front 28

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

back 28

Coprolalia

front 29

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

More than __ year(s)

back 29

More than 1 year(s)

front 30

ADHD symptoms must last for how long before diagnosis?

back 30

6 months

front 31

What three traits characterize attention-deficit hyperactivity disorder?

I____
I____
H____

back 31

Inattention
Impulsivity
Hyperactivity

front 32

ADHD symptoms must be found in ____ or more settings

back 32

2

front 33

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

______ with or without ______ ______ therapy
______ alternatives

back 33

Stimulants with or without cognitive behavioral therapy
Stimulant alternatives

front 34

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

back 34

No

front 35

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

_____

_____

back 35

Stimulants
Antipsychotics

front 36

How does disruptive mood dysregulation disorder present?

Severe, recurrent _____ outbursts incongruent to situation

back 36

Severe, recurrent temper outbursts incongruent to situation

front 37

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

back 37

1 year

front 38

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

back 38

Autism must present in early childhood and is more common in boys

front 39

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

Before the age of ____ years

back 39

Before the age of 18 years

front 40

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

back 40

After age 18, it is reclassified as antisocial personality disorder.

front 41

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

back 41

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

front 42

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

_____ _____ disorder

back 42

Autism spectrum disorder

front 43

What is intellectual disability?

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

back 43

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

front 44

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

_____ functioning is impaired due to _____ cognitive deficits

back 44

Adaptive functioning is impaired due to global cognitive deficits

front 45

How do you treat a patient with intellectual disability?

By providing ______ support to improve global functioning

back 45

By providing multidisciplinary support to improve global functioning

front 46

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

back 46

Specific learning disorder

front 47

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

back 47

They are usually normal

front 48

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

> ___ months

back 48

> 6 months

front 49

How do you treat a patient with specific learning disorder?

_____ support
C_____
_____ activities

back 49

Academic support
Counseling
Extracurricular activities

front 50

How do you treat delirium?

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

back 50

Treatment of delirium is aimed at identifying and addressing the underlying condition

front 51

_____ may be used as needed for acute episodes of delirium

back 51

Antipsychotics may be used as needed for acute episodes.

front 52

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

_____
_____
_____

back 52

Benzodiazepines
Anticholinergics
Opioids

front 53

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

back 53

delirium

front 54

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

_____

back 54

EEG

front 55

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

back 55

diffuse background rhythm

front 56

Define delirium.

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

back 56

Acute, reversible, onset of waxing/waning consciousness with rapidly decreasing attention span and level of arousal

front 57

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

back 57

Identifying/treating underlying condition
Providing cognitive stimulation
Keeping a clock or calendar nearby for orientation purposes
Reducing sleep disturbances

front 58

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

back 58

SSRIs
Cognitive behavioral therapy
MAOIs (not first-line)

front 59

What symptoms differentiate atypical depression from classical depression?

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

back 59

Mood reactivity
Hypersomnia
Overeating
Leaden paralysis
Hypersensitivity to rejection

front 60

Heavy feeling in legs and arms is called what?

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

back 60

Leaden paralysis

Mood reactivity

front 61

What is the most common subtype of depression?

back 61

Depression with atypical features

front 62

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

> [...] month(s)

back 62

> 1 month(s)

front 63

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

< [...] month(s)

back 63

< 1 month(s)

front 64

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

back 64

Symptoms of major depressive disorder last ≥ 2 weeks
Dysthymia and cyclothymia are diagnosed in adults after symptoms last > 2 years

front 65

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

> [...] months

back 65

> 6 months

front 66

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

> [...] month(s)

back 66

> 1 month(s)

front 67

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

> [...] month(s)

back 67

> 3 months

front 68

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

> [...] months

back 68

> 6 months

front 69

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

> [...] year(s)

back 69

> 1 year(s)

front 70

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

> [...] months

back 70

> 6 months

front 71

Symptoms persisting ____ than ____ months indicate adjustment disorder

Symptoms persisting ____ than ____ months indicate generalized anxiety disorder

back 71

Symptoms persisting less than 6 months indicate adjustment disorder

Symptoms persisting more than 6 months indicate generalized anxiety disorder

front 72

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)

back 72

Acute stress disorder → Symptoms persist less than 1 month(s)
Post-traumatic stress disorder → Symptoms persist more than 1 month(s)

front 73

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

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

back 73

Symptoms must be present for 1 to 6 months

front 74

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

back 74

> 6 months

front 75

Name six psychiatric conditions associated with dissociative identity disorder.

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

back 75

Post-traumatic stress disorder
Depression
Borderline personality disorder
Substance use disorder
Somatoform disorders
History of sexual abuse

front 76

Dissociative identity disorder is more common in which sex?

back 76

female

front 77

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

back 77

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

front 78

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

back 78

Depersonalization/derealization disorder

front 79

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

back 79

Dissociative identity disorder

front 80

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

back 80

Dissociative amnesia

front 81

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 _____

back 81

Dissociative fugue

front 82

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

back 82

traumatic

front 83

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

back 83

Anorexia nervosa, restricting type

front 84

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

back 84

Anorexia nervosa, binge-eating/purging type

front 85

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

_____
_____ rehabilitation
_____

back 85

Psychotherapy
Nutritional rehabilitation
Olanzapine

front 86

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

back 86

Intense fear of gaining weight, distortion of body image, and overvaluation of thinness → Calorie restriction, extreme weight loss, and inappropriately low BMI

front 87

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

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

back 87

Hypokalemia
Hypophosphatemia
Hypomagnesemia

front 88

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

[Hyperthyroidism/Hypothyroidism]
_____
_____

back 88

Hypothyroidism
Amenorrhea
Osteoporosis

front 89

How may body hair be altered in anorexia nervosa?

Development of ____ hair on the arms and legs

back 89

Development of soft hair on the arms and legs

front 90

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

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

back 90

Anorexia nervosa → Low BMI
Bulimia nervosa → Normal BMI or overweight

front 91

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

back 91

Erosion of enamel on teeth
Metabolic alkalosis
Electrolyte disturbances
Dorsal hand calluses caused by induction of vomiting

front 92

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

back 92

Recurring consumption of nonfood items, not considered normal for an individual's culture or developmental stage, for 1 month(s) or longer

front 93

What is the treatment for pica?

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

back 93

First-line treatment → Nutritional rehabilitation and psychotherapy
Second-line treatment → SSRIs

front 94

What population of patients does pica typically affect?

_____
_____ women

back 94

Children
Pregnant women

front 95

What four comorbidities is pica associated with?

______ deficiency anemia
______ disabilities
______
______ trauma

back 95

Iron deficiency anemia
Developmental disabilities
Malnutrition
Emotional trauma

front 96

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

back 96

Sudden increase in calorie intake → Increase in insulin → Hypophosphatemia, hypokalemia, and hypomagnesemia → Rhabdomyolysis, seizures, and cardiac complications

front 97

What treatment options are available for binge-eating disorder?

_____ (first-line treatment)
_____
_____

back 97

Psychotherapy (first-line treatment)
SSRIs
Lisdexamfetamine

front 98

Why is bupropion contraindicated for patients with bulimia nervosa?

Elevated risk of ______

back 98

Elevated risk of seizures

front 99

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

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

back 99

To check for tears in the lower part of the esophagus.

This is Malory-Weiss syndrome.

front 100

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

Serum _____

back 100

Serum amylase

front 101

What is the treatment for bulimia nervosa?

_____
_____ rehabilitation
_____

back 101

Antidepressants
Nutritional rehabilitation
Psychotherapy

front 102

Is electroconvulsive therapy safe for pregnant patients and elderly patients?

back 102

Yes. There are no absolute contraindications to electroconvulsive therapy.

front 103

Name four clinical indications for electroconvulsive therapy.

Acute _____
_____ with psychosis
_____ depression
C_____

back 103

Acute suicidality
Depression with psychosis
Refractory depression
Catatonia

front 104

What is the mechanism of electroconvulsive therapy?

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

back 104

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

front 105

What are the adverse effects of electroconvulsive therapy?

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

back 105

Headache
Disorientation
Anterograde/retrograde amnesia that usually resolves within 6 months

front 106

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

______ modifications
[Positive/Negative] reinforcement

back 106

Behavioral modifications
Positive reinforcement

front 107

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

Bedwetting ______
Oral ______

back 107

Bedwetting alarm
Oral desmopressin

front 108

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

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

back 108

≥ 2 times per week for ≥ 3 months

front 109

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

> [...] years

back 109

> 5 years

front 110

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]

back 110

Factitious disorder imposed on another

front 111

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

Patients with malingering often _____ treatment

back 111

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

Patients with malingering often avoid treatment

front 112

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

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

back 112

To get sympathy and medical attention by means of the sick role

front 113

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

_____ workers
[Men/Women]

back 113

Healthcare workers
Women

front 114

What is the definition of gambling disorder?

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

back 114

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

front 115

What is the treatment of gambling disorder?

______

back 115

Psychotherapy

front 116

What is the definition of transgender?

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

back 116

When a patient lives their life as a different gender than what was assigned at birth

front 117

What is definition of gender dysphoria?

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

back 117

A difference between the way an individual experiences gender and the gender assigned at birth

front 118

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

back 118

gender dysphoria lasts for over 6 months and causes persistent distress.

front 119

Is gender nonconformity a mental disorder?

back 119

No

front 120

At what age does gender identity develop?

back 120

3 yo

front 121

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

Excessive _____
_____ problems
_____
_____
Difficulty _____
_____
Muscle _____

back 121

Excessive anxiety
Sleep problems
Restlessness
Fatigue
Difficulty concentrating
Irritability
Muscle tension

front 122

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

back 122

On most days for 6 months or longer

front 123

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

____ ____ therapy
____
____

back 123

Cognitive behavioral therapy
SSRIs
SNRIs

front 124

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

____
____
____

back 124

Buspirone
TCAs
Benzodiazepines

front 125

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

back 125

Adults → ≥ 3 symptoms of generalized anxiety
Children → ≥ 1 symptoms of generalized anxiety

front 126

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

back 126

Hypomanic episodes are less intense
Hypomanic episodes do not impair function or feature psychosis
Hypomanic episodes do not require hospitalization
Hypomanic episodes last for ≥ 4 consecutive days

front 127

What treatment options are first line for major depressive disorder?

_____ _____ _____
_____

back 127

Cognitive behavioral therapy
SSRIs

front 128

What are the features of major depressive disorder?

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

back 128

Sleep disturbance
Decreased interest in pleasurable activities
Guilt
Decreased energy
Decreased concentration
Appetite/weight changes
Psychomotor agitation
Suicidal ideation

front 129

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

back 129

2 weeks

front 130

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 _____

back 130

Persistent depressive disorder AKA dysthymia

front 131

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

_____ _____ disorder with _____ _____

back 131

Major depressive disorder with seasonal pattern

front 132

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

______ ______ therapy
______
______ therapy

back 132

Cognitive behavior therapy
SSRIs
Light therapy

front 133

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

back 133

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

A patient with schizoaffective disorder will have psychotic symptoms independent of a depressive episode

front 134

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

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

back 134

A(n) antidepressant combined with a(n) atypical antipsychotic or electroconvulsive therapy

front 135

Define major depressive disorder with psychotic features.

Major depressive disorder accompanied by _____ or _____

back 135

Major depressive disorder accompanied by delusions or hallucinations

front 136

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

They are typically mood ______ with depressed mood

back 136

They are typically mood congruent with depressed mood

front 137

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

back 137

Malingering

front 138

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

back 138

Malingering

front 139

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

Compliance with treatment or follow-up is often _____

back 139

Compliance with treatment or follow-up is often poor

front 140

What are the seven symptoms of a manic episode?

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

back 140

Distractibility
Impulsivity/indiscretion
Grandiosity
Flight of ideas
Increased activity/agitation
Decreased sleep needs
Talkativeness

front 141

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

At least ___ symptoms for at least ___ ___

back 141

At least 3 symptoms for at least 1 week

front 142

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

back 142

Disorders in which an abnormal range of internal emotions/moods and loss of control over them cause distress and impairment in daily function

front 143

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

____ ____ disorder
____ disorder
____ disorder
____ disorder

back 143

Major depressive disorder
Bipolar disorder
Dysthymic disorder
Cyclothymic disorder

front 144

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

back 144

Yes

front 145

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

First → ______
Second → ______
Third → ______

back 145

First → Time
Second → Place
Third → Person

front 146

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 ____

back 146

An individual’s ability to know who he/she is, where he/she is, and the date and time

front 147

What are the common causes of loss of orientation?

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

back 147

Head injury
Fluid/electrolyte imbalance
Drugs
Alcohol
Hypoglycemia
Hypoxia
Infection
Nutritional deficiencies

front 148

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

back 148

Panic attack followed by history of ≥ 1 month of 1 or more of the following criteria:

Fear of new attacks
Worry about consequences of attacks
Changed behavior due to attacks

front 149

What is the treatment for panic disorder?

_____ _____ therapy
_____
_____

back 149

Cognitive behavioral therapy
SSRIs
Venlafaxine

front 150

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

back 150

Benzodiazepines may be used for acute episodes.

front 151

Is panic disorder genetic?

back 151

Yes

front 152

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

back 152

Panic Disorder

front 153

How does panic disorder affect the risk for suicide?

back 153

Increases sucide risk

front 154

What are risk factors for postpartum psychosis?

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

back 154

Bipolar disorder
Psychotic disorder
First pregnancy
Family history
Recent discontinuation of psychotropic medication

front 155

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

_____ _____

back 155

Postpartum blues

front 156

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

_____ _____

back 156

Postpartum psychosis

front 157

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

____
____ ____ therapy

back 157

SSRIs
Cognitive behavioral therapy

front 158

When will the symptoms of postpartum blues likely resolve?

Within ____ ____

back 158

Within 2 weeks

front 159

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%)

back 159

Postpartum blues (50% to 85%)
Major depressive disorder with peripartum onset (10% to 15%)
Postpartum psychosis (0.1% to 0.2%)

front 160

What is the treatment for postpartum psychosis?

Admission to inpatient _____ unit

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

back 160

Admission to inpatient psychiatric unit

Administration of atypical antipsychotics or electroconvulsive therapy if drug therapy is ineffective

front 161

What is the definition of personality disorder?

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

back 161

Inflexible and maladaptive pattern of behavior that is pervasive in their life → Distress and/or impaired function

front 162

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

back 162

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

front 163

In what age group do personality disorders usually present?

Before or during early ______

back 163

Before or during early adulthood

front 164

What are the three clusters of personality disorders?

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

back 164

Cluster A → "Weird"
Cluster B → "Wild"
Cluster C → "Worried"

front 165

What are the three cluster A personality disorders?

____ personality disorder
____ personality disorder
____ personality disorder

back 165

Paranoid personality disorder
Schizoid personality disorder
Schizotypal personality disorder

front 166

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

_______

back 166

Schizophrenia

front 167

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

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

back 167

Pervasive distrust
Hypervigilance
Suspiciousness
Very cynical view of the world

front 168

What are four common characteristics of schizotypal personality disorder?

_____ beliefs
Interpersonal _____
_____ thinking
_____ appearance

back 168

Odd beliefs
Interpersonal awkwardness
Magical thinking
Eccentric appearance

front 169

What three characteristics are common with schizoid personality disorder?

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

back 169

Limited emotional expression
Indifferent to the opinion of others
Prefers solitary activities

front 170

What are the four cluster B personality disorders?

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

back 170

Antisocial personality disorder
Borderline personality disorder
Histrionic personality disorder
Narcissistic personality disorder

front 171

What three characteristics do cluster B personality disorders share?

D_____ behavior
E_____ behavior
E_____ behavior

back 171

Dramatic behavior
Emotional behavior
Erratic behavior

front 172

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

____ abuse
____ disorders

back 172

Substance abuse
Mood disorders

front 173

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

______ personality disorder

back 173

Narcissistic personality disorder

front 174

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

back 174

Borderline personality disorder

front 175

What is the treatment for borderline personality disorder?

_____ _____ therapy

back 175

Dialectical behavioral

front 176

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

back 176

Splitting

front 177

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

______ personality disorder

back 177

Histrionic personality disorder

front 178

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

______ personality disorder

back 178

Antisocial personality disorder

front 179

Is antisocial personality disorder more common in males or females?

back 179

Males

front 180

What are the three cluster C personality disorders?

____ personality disorder
____-____ personality disorder
____ personality disorder

back 180

Avoidant personality disorder
Obsessive-compulsive personality disorder
Dependent personality disorder

front 181

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

_____ disorders

back 181

Anxiety disorders

front 182

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

back 182

Dependent personality disorder

front 183

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

_____-_____ personality disorder

back 183

Obsessive-compulsive personality disorder

front 184

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

back 184

Avoidant personality disorder

front 185

What are the three hallmarks of serotonin syndrome?

[Increased/Decreased] activity
____ instability
Altered ____ status

back 185

Increased activity
Autonomic instability
Altered mental status

front 186

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

_____ , which is a _____ receptor antagonist

back 186

Cyproheptadine, which is a 5-HT2 receptor antagonist

front 187

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

______ ______

back 187

Hypertensive crisis

front 188

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

______

back 188

Phentolamine

front 189

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

back 189

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

front 190

What are six manifestations of neuroleptic malignant syndrome?

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

back 190

Myoglobinuria
Fever
Encephalopathy
Vitals unstable
Increased enzyme levels
Muscle rigidity

front 191

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

back 191

Antipsychotics

front 192

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

back 192

Dantrolene
Benzodiazepines
Dopamine agonists

front 193

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

____ to ____ days after the last drink

back 193

2 to 4 days after the last drink

front 194

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

Longer-acting _______

back 194

Longer-acting benzodiazepines

front 195

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

Acute _____

back 195

Acute dystonia

front 196

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

Muscle _____
Muscle _____
_____ crisis

back 196

Muscle spasms
Muscle stiffness
Oculogyric crisis

front 197

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

back 197

typical antipsychotic

front 198

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

back 198

upward

front 199

What is the treatment for lithium toxicity?

______ of lithium

Hydrating aggressively with ______ ______ solution

______ can be considered

back 199

Discontinuation of lithium

Hydrating aggressively with isotonic saline solution

Hemodialysis can be considered

front 200

What is the treatment for a TCA overdose?

_____ treatment

Activated _____

_____

_____ monitoring

back 200

Supportive treatment

Activated charcoal

Bicarbonate

ECG monitoring