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Exam (elaborations)

Primary Care Psychiatry

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Primary Care Psychiatry

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  • September 3, 2024
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  • 2024/2025
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Test Bank For Primary Care Psychiatry 2nd Edition By Robert
McCarron 9781496349217 Chapter 1-26 Complete Guide .

Define mental illness. - ANSWER: A condition that affects a person's cognition,
perception, behavior, or mood.
A disorder that provides stress and impairment of daily life not as a side effect to a
separate condition or medication.

What is Psychiatry? - ANSWER: Psychiatry is the medical specialty devoted to the
diagnosis, prevention, and treatment of mental illness, emotional disturbance, and
abnormal behavior.

Identify the major societal and medical consequences of mental illness. - ANSWER:
Mental disorders are usually associated with significant distress or disability in social,
occupational, or other important activities.
These conditions may also affect the ability the relate to others.
Medically, these patients do not take care of themselves, which leads to a decrease
in overall health.

Identify the 2 most important anatomical structures in the brain responsible for
emotional and behavioral regulation. - ANSWER: Limbic System: contains the
amygdala and hippocampus - responsible for impulsivity

Frontal Lobe: thoughtful processing

It is the connection between the limbic system and the prefrontal cortex that leads
to our emotions and our subsequent behavioral response.

Identify the clinical relevance of the major neurotransmitters related to emotional
and behavioral processes. (ACh, NE, 5-HT, DA, Histamine, GABA, Glutamate) -
ANSWER: Medication Targets:
Acetylcholine (ACh): involved in memory, wakefulness, sexuality, and thirst;
Alzheimer's is a result of decreased ACh

Norepinephrine (NE): attention, concentration, energy; plays a role in the peripheral
nervous system (HR, BP, blood sugar)

Serotonin (5-HT): mood, anxiety, sleep, impulsivity, GI motility/upset, migraines;
increased in psychotic states

Dopamine (DA): attention, hyperprolactinemia; antipsychotics are DA antagonists;
Parkinson Disease is the destruction of DA secreting neurons

Histamine: arousal, thermoregulation, vasodilation, inflammation, digestion (reflux)

, GABA: calming, relaxation; benzos are agonist - anxiety, sleep, hyperarousal

Glutamate: excitement, actions in memory and learning

Recognize what is meant by the term differential diagnosis in the psychiatric
evaluation. - 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.

Identify the most important consideration while assessing a psychiatric patient. -
ANSWER: Safety

Differentiate between transference and counter-transference. - ANSWER:
Transference: done by the patient onto the psychiatrist; how the patient views the
psychiatrist

Counter-Transference: done by the psychiatrist on the patient; are you treating the
patient differently because they remind you of someone?

Recognize a patient centered approach given a clinical scenario. - ANSWER:
Introduce your self

Observe the patient: clothing, grooming, affect, etc.

Set a goal for the interview: what are the patient's expectations (why are they there)

Detect any barriers to communication: language, physical impediments, cultural
differences; physiological - paranoia, delusions, distractions

When the person is telling you their problem keeping asking more questions until
you understand: "Tell me more" What does that look like for you?"

Time management: negotiate priorities by establishing mutual interests and agree
on what you will tackle this visit; set a time for follow-up

Define the 11 items assessed in the mental status examination (a.k.a psychiatric
exam). - ANSWER: Appearance: what you see and smell (example - grooming,
clothing, weight, deformities)

Behavior/Attitude: eye contact, engagement, hostility

Movement: gait, strength, psychomotor agitation or retardation, abnormal
movements, posture

Speech: rate, rhythm, volume, articulation, tone, latency, prosody

Mood: stated by the patient (scale of 1-10)

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