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Primary Care Psychiatry
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Primary Care Psychiatry, 2nd Edition TEST BANK byRobert McCarron, Glen Xiong
Define mental illness - ANSWER:-a condition that affects a person's cognition,
perception, behavior or mood.
-usually associated with significant distress or disability in social, occupational, or
other important activities
Identify the major societal and medical consequences of mental illness - ANSWER:-
Depression is the leading cause of disability worldwide
-Serious mental illness costs $193. 2 billion in lost earnings every year
-Suicide is the 10th leading cause of death in US. 90% of those who die by suicide
have an underlying mental illness
-26% of homeless adults living in shelters have a serious mental illness
-10.2 million adults have co-occurring mental health and addiction disorders
What are the 2 most important anatomical structures in the brain responsible for
emotional and behavioral regulation ? - ANSWER:-limbic system, amygdala,
hippocampus
-prefrontal cortex
-It is the connections between the limbic system and the prefrontal cortex that leads
to our emotions and our subsequent behavioral responses
limbic system - ANSWER:-a group of structures linked to the processing of emotions
amygdala - ANSWER:-Previously known to be the "fear detector" that initiates fight
or flight but also studies have shown that the amygdala also responds to positive
stimuli. It may also be linked to consolidating emotional memories, both positive or
negative
hippocampus - ANSWER:known to assist in regulating learning, memory encoding,
memory consolidation, and spatial navigation
frontal lobe - ANSWER:-Goal oriented behavior
-Reward system/Addiction (nucleus accumbens)
-Recall memory
-Elaboration of thought, abstraction
-Inhibition of limbic system
What is the clinical relevance of the major neurotransmitters related to emotional
and behavioral processes ? - ANSWER:-acetylcholine,
-norepinephrine
,-serotonin
-dopamine
-histamine
-GABA (inhibitory)
-glutamate (excitatory)
acetylcholine - ANSWER:-Involved in memory, wakefulness, sexuality, and thirst.
Alzeimer Dz=decreased ACTH.
Norepinephrine - ANSWER:-CNS: Attention, Concentration, Energy
-Peripheral nervous System: HR, BP, blood sugar
-Excitatory effects of Cocaine and amphetamines caused by blocked reuptake of NE
and thus overstimulation of post-syn neurons
serotonin - ANSWER:-Mood, anxiety, Sleep, Impulsivity, GI motility/upset. Migraines
-Increased in psychotic states
-Serotonin Syndrome: precipitated by the use of serotonergic drugs and
overactivation of both the peripheral and central postsynaptic 5HT-1A (too much
serotonin
dopamine - ANSWER:-attention, "feel good hormone" - seen w/ antipycotic
medications
-Parkinson Disease (destruction of DA-secreting neurons)
histamine - ANSWER:-Arousal, thermoregulation, Vasodilation, Inflammation
(allergies), Digestion (reflux)
GABA(inhibitory) - ANSWER:-Calming, relaxation
glutamate (excitatory) - ANSWER:-Excitement
-Actions in memory and learning
What does the term "differential diagnosis" mean - ANSWER:-"What are all the
conditions that could be causing this presentation?"
-It is how we go from 100 possibilities to the 1 correct diagnosis
What is the most important consideration while assessing a psychiatric patient? -
ANSWER:is the patient safe??
What is the Difference between transference and counter-transference - ANSWER:-
TRANSFERENCE : is a phenomenon in which one seems to direct feelings or desires
related to an important figure in one's life—such as a parent—toward someone who
is not that person. (Ex. Patient to therapist)
-COUNTER- TRANSFERENCE: occurs when the therapist projects their own
unresolved conflicts onto the client.
, What are the 11 items assessed in the mental status examination and what does
each item represent - ANSWER:-Appearance
-Behavior/Attitude
-Movement
-Speech
-Mood
-Affect
-Thought Content
-Thought Process
-Cognition
-Insight
-Judgment
11 items assessed in mental status examination: APPEARANCE - ANSWER:Grooming,
clothing, weight, deformities
11 items assessed in mental status examination: BEHAVIOR/ATTITUDE - ANSWER:Eye
contact, engagement, hostility
11 items assessed in mental status examination: MOVEMENT - ANSWER:Gait,
strength, psychomotor agitation or retardation, abnormal movements (lip smacking,
torticollis), posture
11 items assessed in mental status examination: SPEECH - ANSWER:Rate, rhythm,
volume, articulation, tone, latency, prosody
11 items assessed in mental status examination: MOOD - ANSWER:Stated by patient.
Can be given as 1-10
11 items assessed in mental status examination: AFFECT - ANSWER:Quality, range,
intensity, appropriateness, congruence
11 items assessed in mental status examination: THOUGHT CONTENT -
ANSWER:Hallucinations, delusions, perceptual disturbance, SI/HI, self harm,
violence, obsessions
11 items assessed in mental status examination: THOUGHT PROCESS - ANSWER:Rate,
coherency, associations, abstraction
11 items assessed in mental status examination: COGNITION - ANSWER:Memory,
Language, Orientation, Attention, Concentration, Intelligence, current events
11 items assessed in mental status examination: INSIGHT - ANSWER:patient's
understanding of how he or she is feeling, presenting, and functioning as well as the
potential causes.
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