First Aid pg 511- 515 Psych

Question 1

of Days to qualify as hypomanic episode?

Answer 1

Last at least 4 consecutive days

Question 2

What makes a hypomanic episode diff from a manic episode?

Answer 2

Hypomanic is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization. No psychotic features.

Question 3

Diff between Bipolar I and II

Answer 3

Bipolar I defined by presence of at least 1 manic episode +/− a hypomanic or depressive episode.
Bipolar II defined by presence of a hypomanic and a depressive episode.

Question 4

Drugs that can ppt mania?

Answer 4

TCAs

Question 5

Tx for Bipolar disorder?

Answer 5

Treatment: mood stabilizers (eg, lithium, valproic acid,

carbamazepine), atypical antipsychotics.

Question 6

Minimal duration of cyclothymic disorder?

Answer 6

lasting at least 2 years

Question 7

How long do major depressive episodes last?

Answer 7

major depressive episodes usually last 6–12

months.

Question 8

What symptoms are included to Dx Major Depressive disorders?

Answer 8

SIG E CAPS:
ƒƒDepressed mood
ƒƒ Sleep disturbance
ƒƒ Loss of Interest (anhedonia)
ƒƒGuilt or feelings of worthlessness
ƒƒ Energy loss and fatigue
ƒƒConcentration problems
ƒƒ Appetite/weight changes
ƒƒ Psychomotor retardation or agitation
ƒƒ Suicidal ideations

Question 9

__#__ Sx out of __#__ ttl Sx for ____ (length of time) for diagnose Major Depressive Disorder?

Answer 9

Episodes characterized by at least
5 of the following 9 symptoms for 2 or more
weeks

Question 10

1st line Tx for Major Depressive Disorder?

Answer 10

CBT and SSRIs

Question 11

2nd line Tx for Major Depressive Disorder?

Answer 11

SNRIs, mirtazapine, bupropion can also be

considered.

Question 12

Persistent depressive disorder

Answer 12

depression, often milder, lasting at least

2 years.

Question 13

Changes in sleep in patients with Depression?

Answer 13

ƒƒ  slow-wave sleep
ƒƒ  REM latency
ƒƒ  REM early in sleep cycle
ƒƒ  total REM sleep
ƒƒ Repeated nighttime awakenings
ƒƒ Early-morning wakening (terminal
insomnia)

Question 14

What makes depression atypical?

Answer 14

Characterized by mood reactivity (being able to
experience improved mood in response to positive events, albeit briefly), “reversed” vegetative
symptoms (hypersomnia, hyperphagia), leaden paralysis (heavy feeling in arms and legs),
long-standing interpersonal rejection sensitivity

Question 15

Sx of postpartum psychosis?

Answer 15

Characterized by mood-congruent delusions, hallucinations, and thoughts of harming the baby or self.

Question 16

Most common method to commit suicide? Are men or women more likely to commit suicide?

Answer 16

Most common method in US is firearms, Women attempt suicide more often, men tend to succeed with it.

Question 17

Symptoms of Panic attack?

Answer 17

PANICS
P = Palpitations, Paresthesias, dePersonalization or
derealization
A = Abdominal distress or Nausea,
I = Intense fear of dying, Intense fear of losing
control or “going crazy,” lIght-headedness,
C = Chest pain, Chills, Choking, Sweating,
S = Shaking, Shortness of breath

Question 18

How to treat a specific phobia?

Answer 18

Can be treated with systematic desensitization.

** NOTE - Patient does recognize that fear is excessive

Question 19

Define Gen anxiety disorder

Answer 19

Anxiety lasting > 6 months unrelated to a specific person, situation, or event

Question 20

How is adjustment disorder different from Gen anxiety disorder?

Answer 20

emotional symptoms (anxiety, depression) causing impairment following an identifiable psychosocial stressor (eg, divorce, illness) and lasting  6 months in
presence of chronic stressor).

Key Points - Look for known stresser, and time duration

Question 21

How is OCD different from OC personality disorder?

Answer 21

Ego-dystonic: behavior inconsistent with one’s own beliefs and attitudes (vs obsessive-compulsive personality disorder

Question 22

Acute stress disorder v Post traumatic stress disorder?

Answer 22

Acute - lasts between 3 days and 1 month.

PTSD - lasts longer >1 mo

Question 23

Malingering

Answer 23

Patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific 2° (external) gain (eg, avoiding work, obtaining compensation). Poor compliance with treatment or follow-up of diagnostic tests.

Question 24

Difference between factitious disorder and malingering?

Answer 24

Complaints in malingering cease after gain obtained (vs factitious disorder).

Question 25

Patient consciously creates physical and/or psychological symptoms in order to assume “sick role” and to get medical attention

Answer 25

Factitious disorder

Question 26

Difference between malingering and somatic symptoms?

Answer 26

Malingering may be unconcious, but it is fabricated or exagerrated symptoms. Somatic illness and motivation are entirely unconscious, but not intentionally produced or feigned

Question 27

Loss of sensory or motor function (eg, paralysis, blindness, mutism), often following an acute stressor; patient is aware of but sometimes indifferent toward symptoms

Answer 27

Conversion disorder

Question 28

Excessive preoccupation with acquiring or having a serious illness, often despite medical evaluation and reassurance;

Answer 28

Illness anxiety disorder

Question 29

False, nondelusional belief of being pregnant. May have signs and symptoms of pregnancy but is not pregnant.

Answer 29

Pseudocyesis

Question 30

Inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning

Answer 30

Personality disorder

Question 31

Difference between Schizoid vs Schizotypal?

Answer 31

SchizOiD - alOne and Distant - likes to be alone and is fine with it. Schizotypal - look for eccentric appearence or odd/magical thinking.

Question 32

Major defense mech in Paranoid type personality disorder ? And define it

Answer 32

Projection

Question 33

T or F - There are symptoms of psychosis with Paranoid personality disorder?

Answer 33

F - None of the personality disorders show signs of psychosis, but there is a general association with schizophrenia

Question 34

Which B cluster personality disorder is associated with males?

Answer 34

Antisocial

Question 35

What differentiates antisocial personality disorder from conduct disorder?

Answer 35

Age - Antisocial personality disorder must be ≥ 18 years old and have history of conduct disorder before age 15. Conduct disorder if

Question 36

Which cluster B disorder is associated with females?

Answer 36

Borderline

Question 37

self-mutilation, suicidality, sense | of emptiness; females > males

Answer 37

Borderline

Question 38

Most common defense mech of borderline? and define it

Answer 38

Splitting

Question 39

sexually provocative, overly | concerned with appearance.

Answer 39

Histrionic

Question 40

Grandiosity, sense of entitlement; lacks empathy and requires excessive admiration; often demands the “best” and reacts to criticism with rage

Answer 40

Narcissistic

Question 41

Difference between avoidant and shizoid?

Answer 41

Avoidant desires relationships with others but is alone, Schizoid perfectly happy with being alone

Question 42

People of this personality type tend to get involved in abusive relationships?

Answer 42

Dependent - Submissive and clingy, excessive need to be taken care of, low self-confidence