Autism and Somatic Disorders

Question 1

DSM 5 criteria for autism diagnosis

Answer 1

1. Persistent deficits in social communication and interaction
2. Restricted, repetitive patterns of behavior, interests of activities

Question 2

At what point to autism symptoms tend to manifest

Answer 2

Six months-two years old.

Symptoms present in early development, often when social demands exceed limited capacities.

Question 3

Describe the language of an autistic patient

Answer 3

Delays in expressive and/or receptive (following commands) language

Question 4

Describe the social communication and interaction of an autistic patient

Answer 4

Lack of reciprocity (play alone)
Deficit in joint attention (parallel play)
Impaired nonverbal communication
Impaired social relationships

Question 5

Restricted, repetitive behaviors of autistic patients often include (6)…

Answer 5

Repetitive behaviors (hand flapping)
Insistence on sameness (difficulty with schedule changes)
Restricted interests
Sensory perception issues
Motor delays
Savant Skills

Question 6

How do you scan for autism?

Answer 6

M-CHAT questionnaire

Question 7

Name of the mercury containing preservative associated with vaccines

Answer 7

Thimerosal

Question 8

Physical diagnosis findings associated with Autism

Answer 8

Growth Parameters (Head circumference)
Skin exam (Woods Lamp)
Neurological Exam (Focal neuro signs)

Question 9

Treatment for autism

Answer 9

Psychosocial therapy

Behavioral Training

Question 10

Difference between illness and disease

Answer 10

Illness – response of individual/family to symptoms

Disease – Pathophysiologic process associated with documentable physical lesions

Question 11

What is Somatization?

Answer 11

Tendency to experience and communicate psychological or emotional distress as somatic (physical) symptoms

Question 12

What is a Somatoform illness?

Answer 12

Somatization that produces significant dysfunction in a patient’s life

Question 13

What is a factitious disorder?

Answer 13

Symptoms are produced or feigned in order to appear ill, with no perceivable benefit to the patient

Question 14

What is malingering?

Answer 14

Symptoms are produced or feigned in response to an external incentive

Question 15

Somatic Symptom and Related Disorders include

Answer 15

Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder
Factitious Disorder
Psychological Factors affecting other medical Conditions

Question 16

The fancy name for conversion disorder

Answer 16

Functional Neurological Symptom Disorder

Question 17

What are somatic disorder patients a difficult patient population to treat?

Answer 17

Chronic, difficult to treat

High utilizers of the medical systems

Question 18

Three common risks of somatic system disorder diagnosis

Answer 18

Repetitive, unnecessary testing
Invasive medical and surgical workups
Medically induced illness

Question 19

Gender most commonly afflicted with somatic disorders

Answer 19

Female

Question 20

Criteria for somatic symptom disorder (4)?

Answer 20

• Chronic somatic symptom(s) about which people are excessively concerned, preoccupied, or fearful
• Significant distress and dysfunction
• Patients are rarely reassured and often find care inadequate
• Lasts for more than 6 months

Question 21

Important tenant of management or somatic symptom disorder

Answer 21

Set realistic goals for reduced (not absent) pain

Increase function

Question 22

Two diseases commonly comorbid with somatic symptom disorder?

Answer 22

Anxiety and Depression

Question 23

Illness anxiety disorder was previously referred to as…

Answer 23

hypochondriasis

Question 24

Symptoms seen in Illness Anxiety Disorder

Answer 24

4 Ds (Disease Fear, Disease Preoccupation, Disease Conviction, Disability)

Question 25

What gender tends to get Illness Anxiety Disorder

Answer 25

Equal Prevalence

Question 26

Major risk in Illness Anxiety Disorder patients...

Answer 26

Missing medical diagnoses due to symptoms being assumed to be IAD related Iatrogenic complications

Question 27

Treatment for illness anxiety disorder

Answer 27

Cognitive Behavioral Therapy Relaxation and Supportive Psychotherapy SSRIs

Question 28

Functional neurological symptom disorder criteria...

Answer 28

Symptom(s) of altered voluntary motor or sensory fxn Incompatibility of symptoms with recognized syndromes Not better explained by another disorder Distress and Impairment

Question 29

Examples of motor symptoms seen in functional neurological symptom disorder

Answer 29

Weakness, Paralysis Tremors Dystonic Movements Pseudoseizures

Question 30

Examples of sensory symptoms seen in functional neurological symptom disorder

Answer 30

Distractibility Sensory symptoms split at midline Gap between tested strength and fxn La belle indifference

Question 31

What does la belle indifference refer to

Answer 31

When patients are very chill about symptoms they should be freaking out about

Question 32

What gender is more prone to functional neurological symptom disorder?

Answer 32

Females

Question 33

At what age do conversion disorder symptoms tend to develop?

Answer 33

Adolescence and early adulthood

Question 34

How is functional neurological symptom disorder treated?

Answer 34

Treat anxiety/depression Hypnosis Frame to patient as "stress related"

Question 35

Key criteria for psychological factors affecting other medical conditions?

Answer 35

Factors have influenced course of medical condition Factors interfere with treatment of condition (adherance) Factors constitute well-established health risks for the individual

Question 36

Give two examples of psychological factors affecting other medical conditions

Answer 36

``` Obesity and diabetes Smoking and COPD Alcohol Abuse and Liver Disease Anxiety and Asthma Chronic Occupational Stress and Hypertension ```

Question 37

Factitious disorder has what two types

Answer 37

Imposed on self and imposed on another (by proxy)

Question 38

Key criteria of factitious disorder

Answer 38

Individual presents as ill, impaired, or injured | The behavior is deceptive with absence of obvious external rewards

Question 39

What does Factitious Disorder by proxy tend to look like

Answer 39

Women age 20-40, often connected to health care acting on children

Question 40

Somatic Symptom Disorder. Voluntary or Involuntary Symptoms? Conscious or unconscious motivation?

Answer 40

Involuntary | Unconscious

Question 41

Factitious Disorder Voluntary or Involuntary Symptoms? Conscious or unconscious motivation?

Answer 41

Voluntary | Unconscious

Question 42

Malingering Voluntary or Involuntary Symptoms? Conscious or unconscious motivation?

Answer 42

Voluntary | Conscious