Psychology #2

Question 1

What is the time frame for PTSD in which the event could have occurred?

Answer 1

Any time in the past!

Question 2

Treatment for PTSD

Answer 2

SSRI + CBT

Question 3

In PTSD, what drug can be used for insomnia? Which drug for nightmares?

Answer 3

Trazodone

Prazosin

Question 4

What is the time frame in which the event occurs in acute stress disorder?

Answer 4

Less than 1 month ago and symptoms last less than 1 month

Question 5

Treatment for acute stress disorder

Answer 5

Counseling and psychotherapy

Question 6

If the symptoms of acute stress disorder last longer than 1 month, what should you do?

Answer 6

Treat as PTSD = SSRI + CBT

Question 7

What psych condition has the highest mortality rate?

Answer 7

Anorexia Nervosa

Question 8

Explain anorexia nervosa and a patient that has the condition

Answer 8

-Failure to maintain normal weight
-Behaviors to keep low weight
-Ego-Syntonic
-Restrictive and Binge-Eating/Purging Types

Question 9

What are some common exam findings in a patient with anorexia nervosa?

Answer 9

Lanugo (fine, downy hair)
Dry Skin
Salivary gland hypertrophy
Amenorrhea
Osteopenia
Hypotension
Bradycardia
Russel’s Sign: callouses on hand
BMI 17.5 or less
Body weight: <85% ideal

Question 10

In anorexia nervosa, what is the weight of the patient?

Answer 10

BMI 17.5 or less

weight < 85% ideal

Question 11

What do labs show in anorexia nervosa?

Answer 11

Hypokalemia
Metabolic alkalosis

From Vomiting

Question 12

Treatment for anorexia nervosa

Answer 12

Admit if weight < 75%

Psychotherapy

SSRI’s (they help with weight gain)

Question 13

What is the difference between anorexia and bulimia

Answer 13

Bulimia nervosa patients are able to maintain an normal weight or are overweight

Ego-dystonic

Question 14

Exam findings of a patient with bulimia?

Answer 14

Teeth pitting or enamel erosion

Russell’s Sign

parotid gland hypertrophy

Question 15

Lab findings of bulimia nervosa

Answer 15

Hypokalemia
Metabolic alkalosis
Increased amylase (parotid gland hypetrophy)

Question 16

What are the two criteria for bulimia nervosa?

Answer 16

Recurrent episodes of binge eating followed by compensatory behaviors

Question 17

Treatment for bulimia nervosa

Answer 17

Psychotherapy + Fluoxetine (only medication used in treating this)

Question 18

What is refeeding syndrome?

Answer 18

Result of fluid and electrolyte shifts during aggressive nutritional rehabilitation

Question 19

What is the HALLMARK symptom of refeeding syndrome?

Answer 19

Hypophosphatemia

Question 20

Binge eating disorder is not associated with _______, but a treatment option, besides psychotherapy is ______

Answer 20

Compensatory behaviors

Topiramate, or appetite suppressants such as stimulants like Adderall

Question 21

Schizophrenia is a disorder of abnormal thinking, emotion, and behavior. What is the difference in presentation (age wise) between men and women?

Answer 21

Men - early 20’s
Women - late 20’s

Question 22

What are some things that show a better prognosis in schizophrenia?

Answer 22

Late onset, acute onset, positive symptoms, no family history, good support system

Question 23

What are some things that show a worse prognosis in schizophrenia?

Answer 23

early onset, gradual onset, negative symptoms, male gender, family history, bad support system

Question 24

What is the pathophysiology to explain the positive symptoms in schizophrenia?

Answer 24

Due to excess dopamine in the mesolimbic pathway

Question 25

In schizophrenia, what is seen on a CT scan? Although not frequently done

Answer 25

Ventricular enlargement (lateral and third) and decreased grey matter and cortical volume

Question 26

What are the diagnostic criteria for schizophrenia?

Answer 26

2 or more symptoms for at least 6 months. One must be positive (hallucinations, delusions, disorganized speech) and one negative (flat affect, alogia, avolition, anhedonia, asociality, absence of normal cognition)

Question 27

First line treatment for schizophrenia

Answer 27

2nd gen (atypical) antipsychotics --Risperidone --Olanzipine --Quetiapine --Aripiprazole --Ziprasidone

Question 28

What is the MOA of 2nd gen antipsychotics and how long should you try them before determining efficacy?

Answer 28

Dopamine and serotonin antagonists 4 weeks

Question 28

What is the MOA of 2nd gen antipsychotics and how long should you try them before determining efficacy?

Answer 28

Dopamine and serotonin antagonists 4 weeks