Psychiatry PA EOR Exam Questions And Answers 100% Verified

Psychiatry PA EOR Exam Questions And Answers 100% Verified MDD Criteria - answerMust have at least five of the following symptoms (must include either number I or number 2) for at least a 2-week period: 1. Depressed mood 2. Anhedonia (loss of interest in pleasurable activities) 3. Change in appetite or body weight (f or J,) 4. Feelings of worthlessness or excessive guilt 5. Insomnia or hypersomnia 6. Diminished concentration 7. Psychomotor agitation or retardation (ie, restlessness or slowness) 8. Fatigue or loss of energy 9. Recurrent thoughts of death or suicide Manic episode criteria - answerA period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary) and including at least three of the following (four if mood is irritable): I. Distractibility 2. Inflated self-esteem or grandiosity 3. tin goal-directed activity (socially, at work, or sexually) 4. J, need for sleep 5. Flight of ideas or racing thoughts 6. More talkative or pressured speech (rapid and uninterruptible) 7. Excessive involvement in pleasurable activities that have a high risk of negative consequences (eg, shopping sprees, sexual indiscretions) These symptoms cannot be due to substance use or medical conditions, and they must cause social or occupational impairment. Seventy-five percent of manic patients have psychotic symptoms. Mania vs hypomania - answerMania: Lasts at least 7 days, Causes severe impairment in social or occupational functioning, May necessitate hospitalization to prevent harm to self or others, May have psychotic feature Hypomania: Lasts at least 4 days, No marked impairment in social or occupational functioning, Does not require hospitalization, No psychotic features Bipolar 1 disorder criteria - answerThe only requirement for this diagnosis is the occurrence of one manic or mixed episode - depression, dysthymia, and hypomania can happen between episodes, but are not required for diagnosis Bipolar 1 and 2 treatment - answerLithium Anticonvulsants (carbamazepine or valproic acid) are also mood stabilizers. They are especially useful for rapid cycling bipolar disorder and mixed episodes, although associated with T risk of suicide. Atypical antipsychotics (olanzapine, quetiapine, ziprasidone) are effective as both monotherapy and adjunct therapy Psychotherapy: Supportive psychotherapy, family therapy, group therapy (prolongs remission once the acute manic episode has been controlled). • ECT: Works well in treatment of manic episodes Lithium Side Effects - answerWeight gain • Tremor • Gastrointestinal disturbances • Fatigue • Cardiac arrhythmias • Seizures • Goiter/hypothyroidism • Leukocytosis (benign) • Como • Polyuria (nephrogenic diabetes insipidus) • Polydipsia • Alopecia • Metallic taste Bipolar 2 Criteria - answerHistory of one or more major depressive episodes and at least one hypomanic episode. Remember: If there has been a full manic episode even in the past, then the diagnosis is not bipolar II disorder, but bipolar I. Cyclothymic disorder - answerAlternating periods of hypomania and periods with mild to moderate depressive symptoms. Chronic disorder - 1/3 of patients are eventually diagnosed with bipolar disorder Cyclothymic disorder criteria - answer• Numerous periods with hypomanic symptoms and periods with depressive symptoms for at least 2 years. • The person must never have been symptom free for > 2 months during those 2 years. • No history of major depressive episode or manic episode. Cyclothymic disorder treatment - answerSame as bipolar disorder Persistent depressive disorder (dysthymia) - answerChronic mild depression Dysthymic disorder (DD) = 2 D's 2 years of depression 2 listed criteria Never asymptomatic for > 2 months Dysthymia Criteria - answerl. Depressed mood for the majority of time most days for at least 2 years (in children or adolescents for at least I year) 2. At least two of the following: • Poor concentration or difficulty making decisions • Feelings of hopelessness • Poor appetite or overeating • Insomnia or hypersomnia • Low energy or fatigue • Low self-esteem 3. During the 2-year period: • The person has not been without the above symptoms for > 2 months at a time. • No major depressive episode. • The patient must never have had a manic or hypomanic episode (this would make the diagnosis bipolar disorder or cyclothymic disorder, respectively) Cannot have psychotic features Dysthymia treatment - answerCognitive therapy and insight-oriented psychotherapy are most effective. Antidepressant medications (SSRis, TCAs, or MAOis) are useful when used concurrently with psychotherapy Exhibitionistic disorder - answerExposure of one's genitalia to an unsuspecting individual, with the additional requirement that the person has acted on these sexual urges with a nonconsenting person or the sexual urges or fantasies have resulted in clinically significant distress or functional impairment Exhibitionistic disorder criteria - answerA. Over a period of at least 6 months, recurrent and intense sexual arousal from the exposure of one's genitals to an unsuspecting person, as manifested by fantasies, urges, or behaviors. B. The individual has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. Exhibitionistic disorder treatment - answerPsychotherapy, support groups, and SSRIs - First line Sometimes antiandrogen drugs - in order to lower testosterone and lower sexual desire Fetishistic disorder - answerSexual preference for inanimate objects (eg, shoes or pantyhose). Example: Men being aroused by women's shoes