Lange3

Question 1

What type of therapy is effective in Bulimia Nervosa?

Answer 1

CBT

Question 2

What is the comorbidity of childhood anxiety disorders (overanxious disorder, separation anxiety disorder, panic disorder) and MDD?

Answer 2

50%

Question 3

What is the rate of Rett disorder in the monozygotic twin of a girl with Rett disorder?

Answer 3

100%

Question 4

Approximately ___% of children with learning disorders have a comorbid psychiatric disorder.

Answer 4

50%! This includes, most commonly, ADHD, anxiety, and depressive disorders

Question 5

___% of children with enuresis have a comorbid mental disorder.

Do more boys or more girls have enuresis?

Answer 5

20% Boy > girls

Question 6

A child should be able to count to 50 at what age?

Answer 6

5

Question 7

What is a frequent adverse effect of clonidine?

Answer 7

sedation

Question 8

People with BPD showcase which defense mechanisms?

Answer 8

splitting, projective identification, denial

Question 9

What is the mainstay of treatment for catatonia?

Answer 9

1) benzodiazepenes or

2) ECT, if unsuccessful

Question 10

What is Mobius Syndrome?

Answer 10

congenital absence of the facial nerves and nuclei with resulting bilateral facial paralysis

Question 11

Punchdrunk syndrome is an acquired movemetn disorder associated with traumatic damage to which part of hte brain?

Answer 11

substantia nigra

Question 12

Frontal release signs (primitive reflexes) and perseveration are nonspecific findings common in

Answer 12

demented patients

Question 13

Cerebellar atrophy is seen in

Answer 13

alcoholic patients, congenital disorders

Question 14

In GAD, symptoms of anxiety last at least ___ months.

Answer 14

6

Question 15

In borderline patients, DBT should be used in conjunction with (group/individual) therapy.

Answer 15

Individual. Though group therapy is a component of DBT, it should be used in conjunction, not as a replacement to individual therapy.

Question 16

How do you differentiate impulse control disorder fro OCD?

Answer 16

impulses not as ego-dystonic (distressing); no obsessional, non-enacted (thinking) component

Question 17

The 3-month mortality rate of patients with one episode of delirium is _____%. The 1-year mortality may be as high as _____%

Answer 17

3 month: 23 to 33%

1 year: 50%

Question 18

What percentage of depressed patients eventually commit suicide? What percentage will attempt?

Answer 18

30% will attempt, 15% will be successful

Question 19

How long does an untreated MDE last?

Answer 19

between 6 and 13 months; with treatment, that can decrease to 3 months

Question 20

The best psychotherapy for panic disorder is

Answer 20

CBT

Question 21

What percentage of cases of impotence in the age group 30 to 50 has a psychological etiology?

Answer 21

90%!!! After 50, it becomes increasingly medically-related

Question 22

What class of antidepressants has the highest potential to induce a manic switch?

Answer 22

TCAs!

Question 23

What is the difference between localized amnesia and selective amnesia?

Answer 23

localized = memory loss surrounding a discrete period of time
selective = inability to recall certain aspects of an event, though other memories of the event may be intact

Question 24

What is the difference between catalepsy and cataplexy?

Answer 24

cataLEPSY = immobility seen in catatonic states
cataPLEXY = transient loss of motor tone assoc. with strong emotions

Question 25

List the following benzodiazepines in order from least to most potent: oxazepam, alprazolam, clonazepam, diazepam, chlordiazepoxide, lorazepam

Answer 25

chlordiazepoxide --> oxazepam --> diazepam --> lorazepam --> alprazolam --> clonazepam

Question 26

Acute renal failure requiring dialysis is caused by lithium levels greater than

Answer 26

2

Question 27

Though clonidine is firstline in treating mild Tourette's, more severe Tourette's might be better treated with

Answer 27

D2 antagonsits through antipsychotic medication

Question 28

The only medication that may improve the symptoms of tardive dyskinesia is

Answer 28

clozapine

Question 29

What provides the most IMMEDIATE relief of symptoms of GAD?

Answer 29

benzodiazepines (e.g. lorazepam)!! (SSRIs and buspirone take a few weeks for effect).

Question 30

What is the most common ECG change inflicted by lithium use?

Answer 30

T wave depression or inversion. The changes are usually not clinically significant. Can cause SA block or AB block, but these are usually due to underlying cardiac disease.

Question 31

In refractory OCD, what can be used to augment SSRIs?

Answer 31

2nd gen antipsychotics like risperidone!

Question 32

Which receptor is most likely responsible for clozapine's efficacy?

Answer 32

D4

Question 33

Compare imipramine and nortryptiline in terms of their effects on alpha1-receptors (and orthostatic hypotension, as a result).

Answer 33

Imipramine (3* amine) blocks multiple receptors and has many side effects Nortryptiline (2* amine) has less alpha1-blocking potency and tends to be better tolerated

Question 34

Compare NALOXONE and NALTREXONE.

Answer 34

``` naloxone = opiate antagonist to reverse opiate intoxication naltrexone = opioid antagonist that can decrease the number of days a person with alcohol dependence drinks and can increase the time before relapse of heavy drinking ```

Question 35

What is the usual dose range for lorazepam?

Answer 35

2 to 6 mg/day for anxiety, divided over 2-3 doses

Question 36

Why isn't flumazenil given to a patient that has severely altered consciousness when dextrose, thiamine, and naloxone are?

Answer 36

flumazenil can lower the seizure threshold, so it should not be used before obtaining more history

Question 37

What is buprenorphine?

Answer 37

A mixed opioid agonist-antagonist which suppresses opioid withdrawal and blocks the effects of other opioids

Question 38

T/F: Risperidone can cause orthostatic hypotension, weight loss, and anticholinergic effects.

Answer 38

FALSE! While it can cause orthostatic hypotension, it does not cause appreciable anticholinergic effects and it causes weight GAIN.

Question 39

What is topiramate and what is it used for? Side effects?

Answer 39

An anticonvulsant used in the treatment of bulimia and binge eating; decreases frequency of binge episodes and leads to weight loss. Can also be used in bipolar. Can result in renal stones (1.5% risk_ and cognitive impairment

Question 40

Which drug, when used in combination with citalopram, can lead to a prolongation of the QTc?

Answer 40

pimozide, first generation antipsychotic

Question 41

What can be used to help with the sialorrhea resulting from clozapine? (30% of patients)

Answer 41

clonidine!

Question 42

How does clozapine affect the heart?

Answer 42

Causes a persistent sinus tachycardia; can be treated with propanolol. NOTE: clozapine can cause orthostatic hypotension via alpha receptor blockade, so labetalol (mixed a and b antagonist) would not be a good treatment choice!

Question 43

Which of the atypical antipsychotics are least likely to cause metabolic syndrome, including weight gain, hyperlipidemia, hypercholesterolemia, and insulin resistance? Which are the most likely?

Answer 43

least likely: ziprasidone, aripiprazole medium: risperidone and quetiapine most likely: clozapine and olanzapine

Question 44

Which medication can be used to treat middle insomnia (frequent awakening during the night)?

Answer 44

Zaleplon, a non-benzo hypnotic

Question 45

Why should you use olanzapine, and not haldol, in a delirious patient with a prolonged QTc?

Answer 45

haldol can also lengthen the QTc (should be less than 440)

Question 46

How do buspirone and citalopram affect warfarin?

Answer 46

can lead to decreased efficacy of warfarin! watch PT/PTT and INR

Question 47

What is the difference between nymphomania and satyriasis?

Answer 47

insatiable sexual desire in women (nymph) vs men (satyr)

Question 48

Obstructive jaundice, including fever, nausea, malaise, and pruritus, can result from use of which drug?

Answer 48

chlorpromazine

Question 49

alpha1-receptor blockade resulting in orthostatic hypotension is particularly troublesome in which antipsychotics?

Answer 49

chlorpromazine and clozapine

Question 50

While alcohol withdrawal with focal seizures can occur within ___ hours of cessation of drinking, DTs occur starting ___ hours after cessation of drinking.

Answer 50

withdrawal = 48; DTs = 72

Question 51

Oxcarbazepine can result in

Answer 51

hyponatremia! (2.5% of cases)

Question 52

Technique in which group members are used as the audience adn the cast in reenactments of scenarios and conflict in order to explore individual problems in a group setting:

Answer 52

psychodrama

Question 53

Common technique where each group member is asked to introduce themselves, state how they are feeling, or otherwise specifically respond:

Answer 53

go-around

Question 54

When a patient relives an emotional or traumatic experience to get rid of or purge negative emotions and move forward:

Answer 54

abreaction

Question 55

What is the difference between the techniques of "reframing" and "clarification"?

Answer 55

reframing: examining how patient's thoughts or beliefs about themselves may be skewed clarification: further details about a patient's experience or situation they are describing

Question 56

Are reflexes reduced or increased during a trance state like hypnosis?

Answer 56

Reduced

Question 57

In which type of therapy is a single, focal area of conflict identified?

Answer 57

brief psychodynamic therapy

Question 58

____________ is one's tendency to relate events to oneself without any reason for doing so

Answer 58

personalization

Question 59

What is "selective abstraction"?

Answer 59

A term from cognitive therapy where the details of a scenario are taken out of context and believed while everything else contrary about the scenario is ignored

Question 60

In paradoxical therapy the therapist suggests that the patietn engage in the behavior with negative connotations (phobia or compulsion). Who was it developed by?

Answer 60

Bateson

Question 61

When expression of emotion elicits emotional response in other members of the group:

Answer 61

contagion

Question 62

When the group recreates a family of origin or the original dynamics of a conflict which helps a patietn work through their original conflict:

Answer 62

corrective experience

Question 63

When group emmbers test norms and compete with each otehr to establish autonomy:

Answer 63

differentiation

Question 64

What is the "real relationship" in psychodynamic therapy?

Answer 64

the relationship between a psychoanalyst and patient which is not influenced by transference

Question 65

Made many contributions to psychiatry and neurology with a special interest in describing hysteria:

Answer 65

Jean-Martin Charcot

Question 66

Known as the inventor of the "cathartic" treatment or talking therapy:

Answer 66

Josef Breuer

Question 67

Known as the developer of self-psychology:

Answer 67

Heinz Kohut (helped direct approaches to treatment of narcissism, selfobject transferences' of mirroring and idealization, need self-esteem mirrored back, identify with larger whole)

Question 68

Father of modern hypnosis:

Answer 68

Anton Mesmer