Psychology 6

A 16-year-old overweight male is noted by his parents to frequently sneak out of the house in order to buy large amounts of snacks several times a week. Of note, he eats everything in one sitting. What underlying condition do you suspect?

What is the key difference between binge eating and bulimia nervosa patients?

Which of the following disorders has the highest suicide rate?

Which of the following disorders is commonly associated with cardiac abnormalities such as mitral valve prolapse pericardial effusions and myocardial atrophy?

What is the treatment of choice for binge eating?

A child is referred to your office for unusual animal cruelty and bullying at school, what underlying condition do you suspect?

A wife brings her husband into the office because he is constantly worried about everything that’s going on in his life. She reports that he thinks the worst will happen despite it being a very unlikely occurrence. What underlying condition do you suspect?

Lithium therapy is initiated in a 24-year-old woman in treatment of bipolar disorder. Which of the following is proper counseling for the patient?

A patient with generalized anxiety disorder is having difficulty sleeping, what medication do you recommend?

A patient with post-traumatic stress disorder has been having frequent nightmares and comes to your office for treatment. What medication could you add to his regimen to help with the nightmares?

The 27-year-old female presents to the emergency room actively seizing. While she is seizing, she tells you this is the first time she has had seizures. You also note that she is eating a lunch tray and drinking without difficulty during the seizure. What underlying disorder do you suspect?

What is the treatment for cocaine overdose?

What is the treatment for a diazepam overdose?

How do you treat pyrexia due to an MDMA (ecstasy) overdose?

A 22-year-old woman has anorexia nervosa. She is most likely to have which of the following clinical disorders?

Which of the following is a diagnostic criterion for attention-deficit hyperactivity disorder?

A 35-year-old woman diagnosed with Crohn’s disease when she was 30 years old is prescribed high doses of prednisone (60–80 mg/daily for 1 week and thereafter decreasing doses for the next month) to arrest a recent exacerbation of the disease. Her spouse seeks out emergency medical evaluation, despite her resistance and objections that she is “fine,” after her demonstration of increasingly agitated moods, and patterns of decreased sleep (although she has historically only slept 4–6 hours nightly, she now sleeps less than 3 hours nightly), alternation between engaging in multiple projects at home and then quickly abandoning such projects, uncharacteristic provocative behavior at recent social engagements (e.g., inappropriate dress and language), and a recent surge in purchases from QVC. The likely diagnosis would be:

A 40-year-old National Guard reservist has been deployed to Iraq twice over the last 24 months. During his first tour, which lasted 9 months, he was in charge of assuring that adequate general supplies were maintained at his primary command post. During his second tour, which lasted 6 months, he was assigned to assist a Mobile Army Surgical Hospital (MASH) with the management of medical supplies and occasionally transporting wounded soldiers. He reports that just prior to his redeployment to the United States 3 weeks ago, he was assigned to transport deceased soldiers, some with severe bodily dismemberments. Upon his return to civilian life, he reports persistent and increasingly frequent outbursts of anger, sleep disturbances that are often accompanied by images of the wounded and deceased soldiers he transported, vague sensations of emotional numbness and detachment from others, difficulty actually recalling the details of the events that have most bothered him in his dreams, and an avoidance of any discussion of his military experiences. He becomes very angry when questioned about these experiences. Given this scenario, what is the most likely diagnosis?

Which of the following would not be considered an appropriate treatment action for a patient diagnosed with a major depressive disorder?

Which of the following is typically not true concerning young children with attention-deficit hyperactivity disorder?

A 35-year-old male patient working as a postal employee on the night shift at the local postal warehouse comes in for treatment of an acquired skin rash. Interaction with this patient is challenging, and information gathering, even for purposes of providing basic medical treatment, is difficult because the patient exhibits a blunt, if not constricted, affect, does not seem to respond to “small talk,” appears indifferent to levity and efforts to engage, etc. In addition to concerns about the skin rash, he indirectly alludes to being upset over the news that his supervisor plans to move him to the day shift at the warehouse or possibly assign him to a postal route in the community. The patient reports that he feels best when left alone and has felt that way since he was a child. He indicates that he has been a bachelor all of his life and rarely engages in or takes particular pleasure in social events or relationships. He denies any delusional or aberrant thought processes and demonstrates a solid capacity for reality testing and normal cognition. He reports a successful and satisfying employment history (15 years) in his current job and position with no adverse performance actions. What is the most likely diagnosis for the patient in this scenario?

A 65-year-old man with a history of episodic alcohol abuse is brought to the hospital by his family at 1:00 am in the morning in a hyperglycemic state (blood sugar = 450); the man also demonstrates erratic cognitive and behavioral symptoms. His family reports that he has exhibited agitated behavior, has been verbally threatening, has been making inappropriate sexual comments to his 16-year-old niece, and has demonstrated difficulty maintaining attention. He alternates between remorse and intense anger. His family reports that such patterns have been most prominent over the last 4 to 5 days. The family reported that, in the week prior to his hospital admission, the patient had been drinking an average of eight 12-ounce cans of beer daily, typically in the evening hours prior to going to bed. On the night before his admission, the patient is believed to have consumed 10 cans of beer. The diagnosis that would most likely account for his presented psychiatric and behavioral symptoms would be:

A 28-year-old man with schizophrenia arrives at the emergency department complaining of open sores in his mouth, fever, chills, and shakes. A STAT CBC discloses a WBC of 2000. This patient has most likely been taking which of the following antipsychotics?

Your 26-year-old patient with Bipolar disorder continues on Depakote which the patient has been taking for more than 12 months. The patient was intolerant to other medications but has been having good efficacy with Depakote. Which of the following is most essential to monitor in this patient?

A 25-year-old female patient complains of 4 years of persistent headaches, nausea, diarrhea, stomach pain, back pain, pain in her legs, intermittent tingling in her arms, and pain with sexual intercourse. All of her symptoms have failed to respond to treatments and, thus far, her physical examination and laboratory work-up has been unremarkable. The most likely diagnosis for this patient is:

Which of the following diagnostic studies is indicated in the initial evaluation of a patient with psychosis?

Which of the following is the central theme of Delusional Disorder, the Grandiose Type?

An 89-year-old female has become increasingly irritable and reclusive over the last five years. She has recently become forgetful and twice she called 911 after having lost her automobile in the parking lot. She believes friends and relatives are speaking ill of her and refuses to allow them to visit. She has neither known serious medical conditions, a history of alcohol or drug abuse nor past emotional difficulties. Physical examination is unremarkable. Which of the following is the most likely cause of this patient’s symptoms?

A 17-year-old high school student is brought to your office by her mother. Her mother states that for three months she has been withdrawn and has been missing classes and “hanging with the wrong crowd”. The mother suspects that she has been smoking marijuana. Without her mother’s presence, she becomes animated and acknowledges all of the above. She says that she has been “really unhappy” since her parents decided to divorce four months ago. She admits to trouble sleeping, frequent nightmares, and crying “almost every day”. Her appetite is good, her grades have not declined much and she denies suicidal/homicidal ideation and hallucinations. What is the most likely diagnosis?

A 65-year-old woman with a 30-year history of Bipolar I disorder is currently ready for discharge after a recent admission for mania. She has been managed on Lithium but is often non-compliant. During this admission, she was also diagnosed with essential hypertension and started on hydrochlorothiazide (HCTZ). Which of the following medications is the most appropriate for the patient at this time?