Psychiatry IV Flashcards

1
Q

Persistent depressive disorder (dysthymia) is characterized by persistent depressive symptoms for […] (duration) with no lapses in depressive symptoms for > 2 months at a time.

A

Persistent depressive disorder (dysthymia) is characterized by persistent depressive symptoms for > 2 years (duration) with no lapses in depressive symptoms for > 2 months at a time.

it includes patients with pure dysthymia and those with intermittent or persistent major depressive episodes

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2
Q

Persistent depressive disorder (dysthymia) is characterized by persistent depressive symptoms for > 2 years (duration) with no lapses in depressive symptoms for […] at a time.

A

Persistent depressive disorder (dysthymia) is characterized by persistent depressive symptoms for > 2 years (duration) with no lapses in depressive symptoms for > 2 months at a time.

it includes patients with pure dysthymia and those with intermittent or persistent major depressive episodes

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3
Q

Postpartum blues is characterized by depressed affect, tearfulness, and fatigue starting 2-3 days after delivery and lasting […]. (duration)

A

Postpartum blues is characterized by depressed affect, tearfulness, and fatigue starting 2-3 days after delivery and lasting < 2 weeks. (duration)

50 - 85% incidence rate; usually resolves within 10 days

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4
Q

Postpartum depression is characterized by depressed affect, anxiety, and poor concentration for […]. (duration)

A

Postpartum depression is characterized by depressed affect, anxiety, and poor concentration for > 2 weeks. (duration)

8 - 15% incidence rate

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5
Q

Postpartum […] is characterized by mood-congruent delusions, hallucinations, and thoughts of harming the baby or self.

A

Postpartum psychosis is characterized by mood-congruent delusions, hallucinations, and thoughts of harming the baby or self.

0.1 - 0.2% incidence rate

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6
Q

Prior to beginning lithium therapy, patients should be screened to ensure adequate […] and […] function.

A

Prior to beginning lithium therapy, patients should be screened to ensure adequate thyroid and renal function.

Ca2+ levels should be checked as well (due to risk of hyperparathyroidism) and patients with coronary risk factors should have an EKG; long-term side effects include nephrogenic DI, hyperparathyrodiism, and thyroid dysfunction

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7
Q

PTSD is diagnosed if the disturbance lasts […] (duration) with significant distress or impaired social-occupational functioning.

A

PTSD is diagnosed if the disturbance lasts > 1 month (duration) with significant distress or impaired social-occupational functioning.

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8
Q

Refeeding syndrome is characterized by hypo-phosphatemia, secondary to increased insulin, which may cause […] complications.

A

Refeeding syndrome is characterized by hypo-phosphatemia, secondary to increased insulin, which may cause cardiac complications.

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9
Q

Refeeding syndrome is characterized by […]-phosphatemia, secondary to increased insulin, which may cause cardiac complications.

A

Refeeding syndrome is characterized by hypo-phosphatemia, secondary to increased insulin, which may cause cardiac complications.

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10
Q

Rett syndrome presents with […], including loss of development and verbal abilities.

A

Rett syndrome presents with regression, including loss of development and verbal abilities.

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11
Q

Rett syndrome symptoms usually become apparent between ages […] to […].

A

Rett syndrome symptoms usually become apparent between ages 1 to 4.

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12
Q

Risk of prescription opioid misuse may be reduced by regular patient follow-up (every 3 months), random […], and by reviewing the state’s prescription drug-monitoring program data.

A

Risk of prescription opioid misuse may be reduced by regular patient follow-up (every 3 months), random urine drug screens, and by reviewing the state’s prescription drug-monitoring program data.

risk factors for misuse include age < 45, psychiatric disorder, and history of substance abuse or legal history; long-acting opiates are associated with higher rates of morbidity/mortality than short-acting formulations

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13
Q

Risks factors for postpartum psychosis include […] pregnancy, history of bipolar or psychotic disorder, family history, and recent discontinuation of psychotropic medication.

A

Risks factors for postpartum psychosis include first pregnancy, history of bipolar or psychotic disorder, family history, and recent discontinuation of psychotropic medication.

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14
Q

Schizophrenia presents earlier in […]. (gender)

A

Schizophrenia presents earlier in men. (gender)

late teens to early 20s vs late 20s to early 30s in women

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15
Q

Second-line treatment for generalized anxiety disorder includes […], TCAs, and benzodiazepines.

A

Second-line treatment for generalized anxiety disorder includes buspirone, TCAs, and benzodiazepines.

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16
Q

Separation anxiety is normal in children age […] - […] months and again during times of transition (e.g. beginning preschool).

A

Separation anxiety is normal in children age 9 - 18 months and again during times of transition (e.g. beginning preschool).

separation anxiety disorder is abnormal and characterized by persistent anxiety with separation and excessive worry about losing major attachment figures for at least 4 weeks

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17
Q

Serum […] is a sensitive indicator of alcohol use.

A

Serum γ-glutamyltransferase (GGT) is a sensitive indicator of alcohol use.

18
Q

Sleep in the elderly is associated with […] REM sleep.

A

Sleep in the elderly is associated with decreased REM sleep.

versus increased REM sleep in depressed patients

19
Q

Splitting is a major defense mechanism seen in patients with […] personality disorder.

A

Splitting is a major defense mechanism seen in patients with borderline personality disorder.

20
Q

The DSM-5 criteria for adjustment disorder include:

A. Emotional or behavioral symptoms in response to an identifiable stressor occurring within […] (time) of the onset of the stressor

B. Marked distress out of proportion to the stressor or significant impairment in social or occupational functioning

C/D. Symptoms do not meet the criteria for another mental disorder or represent normal bereavement

E. Once the stressor ceases, the symptoms do not persist for more than an additional 6 months (time)

A

The DSM-5 criteria for adjustment disorder include:

A. Emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months (time) of the onset of the stressor

B. Marked distress out of proportion to the stressor or significant impairment in social or occupational functioning

C/D. Symptoms do not meet the criteria for another mental disorder or represent normal bereavement

E. Once the stressor ceases, the symptoms do not persist for more than an additional 6 months (time)

21
Q

The DSM-5 criteria for adjustment disorder include:

A. Emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months (time) of the onset of the stressor

B. Marked distress out of proportion to the stressor or significant impairment in social or occupational functioning

C/D. Symptoms do not meet the criteria for another mental disorder or represent normal bereavement

E. Once the stressor ceases, the symptoms do not persist for more than an additional […] (time)

A

The DSM-5 criteria for adjustment disorder include:

A. Emotional or behavioral symptoms in response to an identifiable stressor occurring within 3 months (time) of the onset of the stressor

B. Marked distress out of proportion to the stressor or significant impairment in social or occupational functioning

C/D. Symptoms do not meet the criteria for another mental disorder or represent normal bereavement

E. Once the stressor ceases, the symptoms do not persist for more than an additional 6 months (time)

22
Q

The DSM-5 criteria for generalized anxiety disorder include:

A. Excessive anxiety and worry for at least […] (time)

B. Difficult to control

C. At least three of the following symptoms:

  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbance

D. Clinically significant distress or impairment

E./F. Not better explained by another medical condition, mental disorder, or substance

A

The DSM-5 criteria for generalized anxiety disorder include:

A. Excessive anxiety and worry for at least 6 months (time)

B. Difficult to control

C. At least three of the following symptoms:

  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Irritability
  • Muscle tension
  • Sleep disturbance

D. Clinically significant distress or impairment

E./F. Not better explained by another medical condition, mental disorder, or substance

23
Q

The DSM-5 criteria for major depressive disorder include:

A. At least five SIG E CAPS symptoms for > […] (time); one symptom must be depressed mood or anhedonia

B. The symptoms cause social/occupational distress or impairment

C/D. Not better explained by another medical condition, mental disorder, or substance

E. No history of manic or hypomanic episodes

A

The DSM-5 criteria for major depressive disorder include:

A. At least five SIG E CAPS symptoms for > 2 weeks (time); one symptom must be depressed mood or anhedonia

B. The symptoms cause social/occupational distress or impairment

C/D. Not better explained by another medical condition, mental disorder, or substance

E. No history of manic or hypomanic episodes

24
Q

The DSM-5 criteria for schizophrenia include:

A. At least two of the following symptoms (at least one must be 1, 2, or 3), each present for a significant portion of time during a one-month period:

  1. […]
  2. […]
  3. […]
  4. […]
  5. […]

B. Significant impairment in social or occupational functioning

C. Continuous signs of the disturbance persist for > 6 months (duration)

*May include periods of prodromal or residual symptoms

D./E. Not better explained by another mental disorder, medical condition, or substance

F. If there is a history of autism spectrum disorder, diagnosis of schizophrenia is made only if prominent delusions or hallucinations

A

The DSM-5 criteria for schizophrenia include:

A. At least two of the following symptoms (at least one must be 1, 2, or 3), each present for a significant portion of time during a one-month period:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Disorganized or catatonic behavior
  5. Negative symptoms

B. Significant impairment in social or occupational functioning

C. Continuous signs of the disturbance persist for > 6 months (duration)

*May include periods of prodromal or residual symptoms

D./E. Not better explained by another mental disorder, medical condition, or substance

F. If there is a history of autism spectrum disorder, diagnosis of schizophrenia is made only if prominent delusions or hallucinations

25
Q

The DSM-5 criteria for schizophrenia include:

A. At least two of the following symptoms (at least one must be 1, 2, or 3), each present for a significant portion of time during a one-month period:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Disorganized or catatonic behavior
  5. Negative symptoms

B. Significant impairment in social or occupational functioning

C. Continuous signs of the disturbance persist for > […] (duration)

*May include periods of prodromal or residual symptoms

D./E. Not better explained by another mental disorder, medical condition, or substance

F. If there is a history of autism spectrum disorder, diagnosis of schizophrenia is made only if prominent delusions or hallucinations

A

The DSM-5 criteria for schizophrenia include:

A. At least two of the following symptoms (at least one must be 1, 2, or 3), each present for a significant portion of time during a one-month period:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Disorganized or catatonic behavior
  5. Negative symptoms

B. Significant impairment in social or occupational functioning

C. Continuous signs of the disturbance persist for > 6 months (duration)

*May include periods of prodromal or residual symptoms

D./E. Not better explained by another mental disorder, medical condition, or substance

F. If there is a history of autism spectrum disorder, diagnosis of schizophrenia is made only if prominent delusions or hallucinations

26
Q

The DSM-5 criteria for somatic symptom disorder include:

A. One or more somatic symptoms that are distressing or result in significant disruption of daily life

B. Excessive thoughts or behaviors related to the somatic symptoms

C. Duration > […] (time)

A

The DSM-5 criteria for somatic symptom disorder include:

A. One or more somatic symptoms that are distressing or result in significant disruption of daily life

B. Excessive thoughts or behaviors related to the somatic symptoms

C. Duration > 6 months (time)

management often focuses on stress reduction and regularly scheduled visits with the same provider

27
Q

The DSM-5 criteria for […] disorder include:

A. Criteria have been met for at least one major depressive episode

B. Criteria have been met for at least one hypomanic episode

C. No history of manic or mixed episodes

D. Not better explained by another medical condition, mental disorder, or substance

E. The symptoms cause social/occupational distress or impairment

A

The DSM-5 criteria for bipolar II disorder include:

A. Criteria have been met for at least one major depressive episode

B. Criteria have been met for at least one hypomanic episode

C. No history of manic or mixed episodes

D. Not better explained by another medical condition, mental disorder, or substance

E. The symptoms cause social/occupational distress or impairment

28
Q

The DSM-5 criteria for […] disorder include:

A. Criteria have been met for at least one manic episode

B. The symptoms cause social/occupational distress or impairment

C. Not better explained by another medical condition, mental disorder, or substance

A

The DSM-5 criteria for bipolar I disorder include:

A. Criteria have been met for at least one manic episode

B. The symptoms cause social/occupational distress or impairment

C. Not better explained by another medical condition, mental disorder, or substance

29
Q

The DSM-5 criteria for schizoaffective disorder include:

A. Presence of a major depressive, manic, or mixed episode concurrent with symptoms of schizophrenia

B. Lifetime history of delusions or hallucinations for > […] (duration) in the absence of prominent mood symptoms

C. Mood symptoms are present for the majority of the illness

D. Not due to substances or another medical condition

A

The DSM-5 criteria for schizoaffective disorder include:

A. Presence of a major depressive, manic, or mixed episode concurrent with symptoms of schizophrenia

B. Lifetime history of delusions or hallucinations for > 2 weeks (duration) in the absence of prominent mood symptoms

C. Mood symptoms are present for the majority of the illness

D. Not due to substances or another medical condition

versus bipolar or major depression with psychotic features, where psychotic symptoms occur exclusively during the mood episode

30
Q

The DSM-5 criteria for […] disorder include:

A. Presence of a major depressive, manic, or mixed episode concurrent with symptoms of schizophrenia

B. Lifetime history of delusions or hallucinations for > 2 weeks (duration) in the absence of prominent mood symptoms

C. Mood symptoms are present for the majority of the illness

D. Not due to substances or another medical condition

A

The DSM-5 criteria for schizoaffective disorder include:

A. Presence of a major depressive, manic, or mixed episode concurrent with symptoms of schizophrenia

B. Lifetime history of delusions or hallucinations for > 2 weeks (duration) in the absence of prominent mood symptoms

C. Mood symptoms are present for the majority of the illness

D. Not due to substances or another medical condition

versus bipolar or major depression with psychotic features, where psychotic symptoms occur exclusively during the mood episode

31
Q

The illness production and motivation in somatic symptom disorder are […] drives (conscious or unconscious).

A

The illness production and motivation in somatic symptom disorder are unconscious drives (conscious or unconscious).

symptoms are not intentionally produced or feigned; important distinguishing feature from malingering and factitious disorders

32
Q

The majority of cases of Rett syndrome are caused by de novo mutations in […].

A

The majority of cases of Rett syndrome are caused by de novo mutations in MECP2.

33
Q

The majority of cases of […] syndrome are caused by de novo mutations in MECP2.

A

The majority of cases of Rett syndrome are caused by de novo mutations in MECP2.

34
Q

The mature mechanisms of ego defense may be remembered with the mnemonic “SASH”:

S: […]

A: […]

S: […]

H: […]

A

The mature mechanisms of ego defense may be remembered with the mnemonic “SASH”:

S: sublimation

A: altruism

S: suppression

H: humor

35
Q

The onset of disruptive mood dysregulation disorder symptoms is before age […].

A

The onset of disruptive mood dysregulation disorder symptoms is before age 10.

36
Q

The onset of postpartum mood disturbances is typically within […] weeks of delivery.

A

The onset of postpartum mood disturbances is typically within 4 weeks of delivery.

37
Q

The onset of Tourette syndrome symptoms is before age […].

A

The onset of Tourette syndrome symptoms is before age 18.

38
Q

The primary cause of neuroleptic malignant syndrome is antagonism of […] receptors.

A

The primary cause of neuroleptic malignant syndrome is antagonism of dopamine (D2) receptors.

secondary to antipsychotic use

39
Q

The primary symptom of narcolepsy is excessive daytime […].

A

The primary symptom of narcolepsy is excessive daytime sleepiness.

other symptoms include sleep paralysis, cataplexy, and hypnagogic/hypnopompic hallucinations

40
Q

The risk factors for suicide completion may be remembered with the mnemonic “SAD PERSONS”:

S: […]

A: Age (teenage or elderly)

D: Depression

P: Previous attempt (highest risk factor)

E: Ethanol or drug use

R: Rational thinking impaired (psychosis)

S: Sickness (medical illness)

O: Organized plan

N: No spouse or other social support

S: Stated future intent

A

The risk factors for suicide completion may be remembered with the mnemonic “SAD PERSONS”:

S: Sex (male)

A: Age (teenage or elderly)

D: Depression

P: Previous attempt (highest risk factor)

E: Ethanol or drug use

R: Rational thinking impaired (psychosis)

S: Sickness (medical illness)

O: Organized plan

N: No spouse or other social support

S: Stated future intent

41
Q

The risk factors for suicide completion may be remembered with the mnemonic “SAD PERSONS”:

S: Sex (male)

A: […]

D: Depression

P: Previous attempt (highest risk factor)

E: Ethanol or drug use

R: Rational thinking impaired (psychosis)

S: Sickness (medical illness)

O: Organized plan

N: No spouse or other social support

S: Stated future intent

A

S: Sex (male)

A: Age (teenage or elderly)

D: Depression

P: Previous attempt (highest risk factor)

E: Ethanol or drug use

R: Rational thinking impaired (psychosis)

S: Sickness (medical illness)

O: Organized plan

N: No spouse or other social support

S: Stated future intent

42
Q

The risk factors for suicide completion may be remembered with the mnemonic “SAD PERSONS”:

S: Sex (male)

A: Age (teenage or elderly)

D: […]

P: Previous attempt (highest risk factor)

E: Ethanol or drug use

R: Rational thinking impaired (psychosis)

S: Sickness (medical illness)

O: Organized plan

N: No spouse or other social support

S: Stated future intent

A

The risk factors for suicide completion may be remembered with the mnemonic “SAD PERSONS”:

S: Sex (male)

A: Age (teenage or elderly)

D: Depression

P: Previous attempt (highest risk factor)

E: Ethanol or drug use

R: Rational thinking impaired (psychosis)

S: Sickness (medical illness)

O: Organized plan

N: No spouse or other social support

S: Stated future intent