Diagnoses

Question 1

Manic Episode

Answer 1

Elevated, expansive or irritable mood for at least a week, plus at least 3 symptoms:
• inflated self-esteem or grandiosity
• decreased need for sleep
• more talkative than usual or pressure to keep talking
• flight of ideas or feeling that thoughts are racing
• Distractibility
• starting multiple projects, not finishing any of them
• excessive involvement in pleasurable activities that have a high potential for painful consequences (e.g. unrestrained buying sprees, sexual indiscretions)

Question 2

Orbitofrontal Syndrome

Answer 2

(Lesion = Anterior, Medial)

Child-like euphoria (“moria”)
■Facetious humor
■Shallow, labile affect
■Social disinhibition
■Impaired judgment, tact, foresight
■Impulsive, distractible
■Difficulty maintaining set

Question 3

Dorsolateral Prefrontal Syndrome

Answer 3

Abulic, unmotivated
■Apathetic (occasional outbursts)
■Psychomotor slowing
■Concrete, stimulus bound
■Perseverative, poor problem solving, disorganized

Question 4

Delusional Disorder

Answer 4

• Delusions are the major symptom; no marked
impairment of functioning or behavior other than 2° to delusion (“encapsulated delusions”)
• Delusions are not bizarre (ie are events which could occur such as being followed, poisoned, infected, loved at a distance, infidelity)
• Other criteria for schizophrenia or mood disorder have not been met
• 6 symptom types: erotomania (another person is in love with them), grandiose, jealous (infidelity), persecutory, somatic, mixed

Question 5

Major Depression

Answer 5

5 or more symptoms within at least a 2 week period

• One symptom is either depressed mood or loss of interest/pleasure
• Causes clinically significant distress and marked functional impairment
• Rule out due to general medical condition, bereavement, adjustment reaction, substance related depression

Question 6

Adjustment disorder, depressed

Answer 6

Symptoms start within 3 months of identifiable
stressor
• Distress in excess of what would be expected but doesn’t reach criteria for major depressive disorder
• Significant impairment in social/ occupational
functioning
• Not normal bereavement
• Once sressor stops, symptoms stop w/in 6 mos

Question 7

Persistent Depressive Disorder

Dysthymic Disorder

Answer 7

Depressed mood most of the time for at least 2 years, hasn’t gone away for more than 2 months at a time

While depressed has 2 or more:
• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy/ fatigue
• Low self-esteem
• Poor concentration/ difficulty making decisions
• Hopelessness

Question 8

Central Serotonin Syndrome

Answer 8

excess stimulation of 5HT1A and possibly 5HT2A
receptors in the CNS
• most frequently results when two or more drugs
with serotonergic activity are combined
• potentially fatal

Symptoms:
– Mental status changes (confusion, hypomania)
– Autonomic instability (hypertension, hyperthermia)
– Neuromuscular (rigidity, hyperreflexia, myoclonus)

Question 9

Burnout (definition)

Answer 9

Triad of:

• Emotional exhaustion
• Feeling detached, impersonal
• Low personal accomplishment

Question 10

Delirium/Acute Confusion (definition)

Answer 10

Transient disorder of cognition and attention accompanied by disturbances of the sleep-wake cycle and psychomotor behavior

4 Core Features:

1. Disturbance of consciousness
   - Inability to maintain focus, attention, and awareness of environment
2. Cognitive and perceptual disturbances
   - Memory and language deficits, disorganized speech and thought process not explained by existing dementia
3. Sudden onset over hours to days
   - Distinguishes from dementia
4. Direct physiological causes identified

Question 11

Confusion

Answer 11

Disruption in some or all of the following cognitive functions
– Alertness
– Orientation
– Perception

Also:
Emotion, Behavior, Memory, Language, Praxis, Problem solving, Judgment, Psychomotor activity