Psych Week 3

Question 1

Which of the following is FALSE about EtOH withdrawal?

1. Hallucinosis is more likely to occur within 48 hours after the last drink.
2. Delirium tremens is more likely to occur within 3-5 days after the last drink.
3. Seizures and ANS instability can overlap.
4. Hallucinosis is associated with disorientation.

Answer 1

D. Hallucinosis is NOT associated with disorientation. While patients may experience visual hallucinations, they usually have a clear sensorium (ie. are not disoriented).

Lecture: Substance Intoxication and Withdrawal

Objective 3: Describe the timeline for the alcohol withdrawal syndrome

Question 2

A patient must have symptoms most days for how long to be diagnosed with Generalized Anxiety Disorder?

1. 1 month
2. 3 months
3. 6 months
4. 1 year

Answer 2

C. 6 months. A patient must have symptoms for 6 months to be diagnosed with Generalized Anxiety Disorder (GAD).

Lecture: Anxiety Disorders

Objective 3: List different anxiety disorders and be able to explain how they present clinically.

Question 3

You are evaluating a patient who has Major Depressive Disorder who has a history of an attempted suicide 3 months prior. The patient has a cousin who passed from suicide a year ago. What is this patient’s single biggest risk factor for completed suicide?

Answer 3

A recent suicide attempt.

Lecture: Suicide

Objective 1: Assess a patient’s near-term risk for completed suicide by listing known risk factors present in that patient at the time of evaluation.

Question 4

You see a patient in the Emergency Room who is complaining of stomach pain. Physical exam is nonspecific, and labs are within normal limits. An abdominal CT is ordered, but the patient asks several members of the medical team to order more tests or take them to surgery. You are looking through Care Everywhere and notice that this patient has presented to multiple emergency rooms for nonspecific abdominal pain in the past months and begin to suspect a somatoform disorder.

Which disorder are you most suspicious for? What type of gain is this disorder associated with?

Answer 4

Factitious disorder and primary gain. This patient is willing to undergo medical exams and procedures which is more consistent with factitious disorder than malingering. Primary gain is an unconscious desire to be in the sick role while secondary gain (associated with malingering) is a conscious desire for financial/legal benefit.

Lecture: Somatoform Disorders

Objective 2: Define factitious disorder and contrast it with malingering behavior.

Question 5

What are the four categories of sexual dysfunctions in DSM-5?

Answer 5

1. Sexual Desire Disorders
2. Sexual Arousal Disorders
3. Orgasmic Disorders
4. Sexual Pain Disorders

Lecture: Sexual Disorders

Objective 3: Identify core physical and psychological causes of sexual dysfunction.

Question 6

State whether the following drugs are used to treat alcohol or opiate addiction.

1. Buprenorphine
2. Disulfiram
3. Acamprosate
4. Naltrexone

Answer 6

1. Buprenorphine is used for opiate addiction
2. Disulfiram – Alcohol addiction
3. Acamprosate – Alcohol addiction
4. Naltrexone – Both alcohol and opiate addiction

Lecture: Substance Use Disorders

Objective 4: Describe basic aspects of pharmacological treatment for substance use disorders.

Question 7

Which of the following patients would be appropriate for neuropsychological assessment? More than one may apply.

1. 45M undergoing alcohol withdrawal who is disoriented and hallucinating.
2. 69F w/ PMH of HTN who is having difficulty remembering her appointments to meet with friends
3. 70M who has gotten lost in his neighborhood five times in the past few months
4. 23F who began to behave erratically at a party 2 hours ago and is confused about her surroundings

Answer 7

B and C. These are both cases of suspected dementia and would be appropriate for neuropsychological assessment.

A is a case of frank delirium and would NOT be appropriate for neuropsychological assessment.

D is a case where a reversible cause of AMS (ex. Substance use) has not been ruled out or corrected yet. Neuropsychological assessment would not be appropriate.

Lecture: Neuropsychological Assessment

Objective 6: Identify conditions for which a neuropsychology consult is appropriate

Question 8

A patient presents with MDD and severe suicidality. She is also 2 months pregnant. Would Electroconvulsive Therapy (ECT) be appropriate for her?

Answer 8

Yes, ECT is safe during pregnancy, and this patient’s severe suicidality would make ECT a good first therapeutic option.

Lecture: Neuromodulation

Objective 1: List and appraise two psychiatric and one neurological indication for electroconvulsive therapy.

Question 9

A man is dating someone who owns a dog that he dislikes strongly. The man begins to buy many treats for the dog and overreacts when the dog is upset. What type of defense mechanism is this and what is it called?

Answer 9

Reaction formation. The man is adopting the opposite attitude toward the dog since his dislike of the dog is unacceptable.

Lecture: Psychotherapy

Objective 2: List three immature defense mechanisms and one mature defense mechanism and give one example for each.