MDT 15.11 Psychiatry Test 2
Terms
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- A disturbance of consciousness with reduced ability to focus, sustain or shift attention and can be caused by the consequences of substance or general medical conditions is?
- Delirium
- A maladaptive pattern of substance use leading to clinically significant impairment or distress is?
- Substance Abuse
- The development of a substance-specific syndrome due to the cessation of (or reduction in) substance use that has been heavy and prolonged is?
- Substance withdrawal
- Presence of persistent core psychotic, prodromal or residual symptoms associated with significant deterioration social and occupational function w/o evidence of mood disorder or organic etiology is?
- Schizophrenia
- A distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood that last at least 4 days (<7 days)is?
- Hypomanic Episode
- The common feature of this disorder is the presence of physical symptoms that suggest a general medical condition (GMC); but are not fully explained by GMC, direct effects of a substance or another mental disorder is?
- Somatoform Disorder
- This disorder is characterized by the presence of two or more distinct identities of personality states that recurrently take control of the individual's behavior accompanied by an inability to recall important personal information that is too extensive
- Dissociative identity disorder
- What type of disorder is presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors?
- Primary Sleep Disorders
- This disorder is characterized by the development of multiple cognitive deficits (including memory impairment) that are due to the direct physiological effects of a GMC, to the persisting effects of a substance, or to multiple eitiologies.
- Dementia
- The essential feature of this disorder is the development of a reversible substance-specific syndrome due to the recent ingestion of (or exposure to) a substance.
- Substance intoxication
- What disorder has an essential feature of at least 2 weeks during which there is either depressed mood or the loss of interest or pleasure in nearly all activities?
- Major depressive episode
- The essential feature of this disorder is a discrete period of intense fear or discomfort that is accompanied by at least 4 of 13 somatic or cognitive symptoms?
- Panic attack
- What somatic or cognitive symptoms can be seen in a PANIC ATTACK?
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-Palpitations, pounding heart, or accelerated heart rate.
-Sweating
-Trembling or shaking
-Sensations of SOB or smothering
-Feeling of choking
-CP or discomfort - How long must symptoms be present to diagnose an anxiety disorder?
- More days than not for the past 6 months
- This disorder is characterized by physical or psychological symptoms that are intentionally produced or feigned in order to assume the sick role?
- Factitious disorder
- The essential feature of this disorder are persistent or recurrent episodes of feeling of detachment or estrangement from one's self.
- Depersonalization disorder
- This disorder is characterized by severe disturbances in eating behavior.
- Eating disorders
- The essential feature of this disorder is the failure to resist an impulse, drive, or temptation to perform an act that is harmful to the person or to others.
- Impulse control
- An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adultood, is stable over time, and leads to distress or impai
- Personality disorder
- A disturbance of consciousness (i.e. reduced clarity of awareness of the environment) with reduced ability to focus, sustain, or shift attention and is caused by the direct physiological consequences of a GMC is?
- Delirium
- What is the first aim of tx when dealing with delirium?
- Identify and correct the etiologic medical problem
- The essential feature of this disorder is the development of multiple cognitive deficits that include memory impairment.
- Dementia
- What cognitive disturbances can be seen in dementia?
- Aphasia, Agnosia and disturbance in executive functioning
- What is a persistent personality disturbance that represents a change from the individuals previous characteristic personality pattern?
- Personality Change
- What signs can be seen or developed during or shortly after alcohol use? (Can also be used as a diagnostic criteria)
- Slurred speech; incoordination; unsteady gait; nystagmus; impairment in attention or memory; stupor or coma.
- What signs can develop due to the cessation of (or reduction in) alcohol use that has been heavy and prolonged?
-
-Autonomic hyperactivity (sweating or pulse rate >100)
-N/V
-Psychomotor agitation
-Transient visual, tactile, or auditory hallucinations or illusions - What signs can develop within 2 hrs of cannabis use? (2 or more to dx cannabis)
-
-Conjunctival injection
-Increased appetite
-Dry mouth
-Tachycardia - What signs can develop during or shortly after cocaine use? (2 or > to dx cocaine intoxication)
-
-Tachycardia or Bradycardia
-Pupillary dilation
-Hypertension/Hypotension
-Perspiration/Chills
-N/V
-Evidence of weight loss
-Psychomotor agitation or retardation
-Muscular weakness, resp. depression, CP, Cardiac arrhytmias
-Confusion, seizures, dyskinesias, dystonias, or coma - What unknown substance can sometimes produce an initial sense of enhanced well-being which is replaced after repeated use by lack of energy, irritability, and other forms of dysphoria?
- Anabolic Steroids
- What unknown substance produces an intoxication that is characterized by a feeling of fullness in the head, mild euphoria, a change in the perception of time, relaxation of smooth muscles and a possible increase in sexual feelings?
- Nitrite Inhalants
- This unknown substance causes rapid onset of intoxication that is characterized by light-headedness and a floating sensation that clears in a matter of minutes after administration is stopped.
- Nitrous Oxide
- Two of what physiological changes would constitute amphetamine withdrawal?
-
1.Fatigue
2.vivid, unpleasant dreams
3.insomnia or hypersomnia
4.increased appetite
5.psychomotor retardation or agitation - What amount of consumption would constitute a caffine substance disorder?
- >250mg
- Clinically significant maladaptive behavioral changes such as belligerence, asultiveness, impulsiveness, unpredictability, psychomotor agitation, impaired judgement, or impaired social or occupational functioning occur in use of what?
- Phencyclidine
- What disorder is a period of illness during which, at some time, there is either a major depressive episode, a manic episode, or a mixed episode concurrent with SX that meet Criterion A for Shcizophrenia
- Schizoaffective disorder
- Disorganized speech, disorganized behavior, flat inappropriate affect are all prominent in what disorder?
- Schizophrenia, disorganized type
- This disorder is characterized by the occurrence of one or more Manic Episodes or Mixed Episodes
- Bipolar I disorder
- This disorder is a depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years
- Dysthymic disorder
- The motivation for this disorder is to assume the sick role?
- Factitious Disorders
- This phobia is a marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he/she will act in a way that will be humiliating
- Social phobia
- This disorder is excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities such as work or school performance.
- Generalized anxiety
- This is a marked and persistent fear that is excessive or unreasonable, cued by the presence or anticipation of a specific object or situation.
- Specific Phobia
- What would be the DX of a person with the preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily Sx? (THIS BELIEF IS NOT OF DELUSIONAL INTENSITY)
- Hypocondriasis
- What is the time span required to meet the criteria for a DX of Hypocondriasis?
- at least 6 months
- This disorder is a persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity that triggers orgasm?
- Female orgasmic disorder
- What is a persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it?
- Premature ejaculation
- What disorder is a recurrent intense sexually arousing fantasies, sexual urges, or behaviors involving the exposure of ones genitals to an unsuspecting stranger?
- Exhibtionism
- This disorder is a aversion to, and avoidence of, all genital sexual contact with a sexual partner.
- Sexual Aversion Disorder
- What is pain associated with sexual intercourse in either a male or a female?
- Dysparaeunia
- What can be DX in a person with recurrent intense sexually arousing fantasies, sexual urges or behaviors involving the act of observing an unsuspecing person who is naked, in the process of disrobing, or engaging in sexual activity?
- Voyeurism
- The predominant complaint of this disorder is difficulty initiating or maintaining sleep, or nonrestorative sleep for at least 1 month?
- Primary Insomnia
- This is a sleep disruption leading to excessive sleepiness or insomnia that is due to the mismatch between the sleep-wake schedule required by a person's enviroment?
- Circadian Rhythm Sleep Disorder
- What is the Dx of a pt. with excessive sleepiness for at least a month?
- Primary Hypersomnia
- What disorder is deliberate and purposeful fire setting on more than one occasion
- Pyromania
- A pt. with recurrent pulling out of ones hair can be DX with?
- Trichotillomania
- Failure to resist impulses to steal objects that are not needed for personal use or their monetary value can be a DX of what?
- Kleptomania
- In a Chronic Adjustment disorder what is the length of time required to make a DX
- Sx must occur within 3 months and last 6 months or longer.
- The development of marked distress greater than expected and significant social or occupational impairment, occuring within 3 months and lasting 6 months and lasting no longer than 6 months after termination of stressor can be a DX of what?
- Chronic Adjustment Disorder
- What disorder is a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent , beginning by early adulthood and present with a variety of contexts?
- Paranoid Personality Disorder
- What disorder is a pervasive and excessive need to be taken care of that leads to a submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts.
- Dependent Personality Disorder
- This is a pervasive pattern preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts.
- Obsessive- Compulsive Personality Disorder
- What Axis is for reporting all the various disorders or conditions in the classification except for the personality disorders and mental retardation.
- Axis I Clinical Disorders
- Which axis is used for reporting personality disorders and mental retardation can also be used for reporting maladaptive personality features and defense mechanisms?
- Axis II Personality disorders and Mental retardation.
- What should be emphasized to reduce stress while interviewing a pt. for suicidal ideations
- Physical fitness
- What refernce gives guidelines for evaluations of personnel exhibiting suicidal ideation or behavior.
- NAVMEDCOMINST 6520.1a
- What Axis is used for reporting General Medical Conditions that are potentially relevant to the understanding or mangement of the individuals mental disorder.
- Axis III
- What is an anxiety disorder about being in places or situations from which escape might be difficult or which help may not be available in the event of having an unexpected or situationally predisposed Panic attack like SX.
- Agoraphobia
- A pt with a HX of many complaints beginning before age 30 and occuring over a period of several year and results in TX being sought after or significant impairment in social, occupational, or other important areas of functioning can be DX with what?
- Somatization Disorder
- What disorder is a refusal to maintain body weight at or above a minimally normal weight for age and height?
- Anorexia Nervosa
- Which type of Anorexia Nervosa does the pt. engage in self induced vomiting or the misuse of laxatives, diuretics or enemas?
- Anorexia Nervosa Binge-eating/Purging type
- A pt. with recurrent episodes of binge eating in a discrete period of time, with larger than expected amounts of food and lack of control can be DX with what?
- Bulimia Nervosa
- This is a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood.
- Manic episode
- This is characterized by sudden, unexpected travel away from home or one's customary place of work, accompanied by an inability to recall one's past and confusion about personal identity or the assumption of a new identity.
- Dissociative fugue
- What are the 2 indications for meds in a delirious states?
-
Behavioral Control (pulling out lines)
Subjective distress (pronounced fear due to hallucinations) <--test question - What is manifested by motoric immobility, excessive motor activity extreme negativism or mutism, peculiarites of voluntary movement or echolalia or echopraxia
- Catatonic Disorder
- What is the DX if it has been established that the disturbance is caused by the direct physiological effects of a general medical condition, but the criteria are not met for a specific mental disorder due to a GMC
- Mental Disorder NOS
- What can be defined as a need for markedly increased amounts of the substance to achieve intoxication or desired effect, or a diminished effect with continued use of the same amount of the substance
- Tolerance
- What type of Schizophrenia has a preoccupation with one or more delusions or frequent auditory hallucinations?
- Schizophrenia paranoid type
- What is a delusion that develops in an individual in the context of a close relationship with another person, who has an already established delusion?
- Shared psychotic disorder
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A person with the presence of 1 or more the following SX that last at least 1 day but less than 1 month can be DX with what?
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or Catatonic behavior - Brief Psychotic disorder
- A person with the presence or HX of one or more Major Depressive episodes, at least 1 Hypomanic episode, and no manic or mixed episode can be DX with what?
- Bipolar II disorder
- What is the length of time to DX a Acute Adjustment Disorder?
- Less than 6 months <---On test
- What to types of Bulimia Nervosa are there?
-
Purging type (self induced vomitting)
Non-purging type (other compensatory behaviors) - What is a impairment of memory in the ability to learn new info or the inability to recall previously learned information?
- Amnesic