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16 Cards in this Set
- Front
- Back
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A 53 yo Asian man is brought to the clinic believing that his penis is shrinking into his body. He now has no energy. He thinks that he may eventually die from this problem. Which one of the following dg is most approp?
A)conversion disorder B) major depression C) psychotic disorder not otherwise specified D) Somatization disorder E) Diagnosis deferred on Axis I |
E) Diagnosis deferred on Axis I
there was a crazy explanation about finding a traditional healer |
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A 54 yo mechanic has been unable to work for 2 years because of chrnoic back pain caused by lifting a heavy toolbox. Repeated neuro and neuroradiologic exams reveal muscle spasm and pain in the L4-5 area, which occasionally is referred in the expected distribution. No herniations, tears, or fractures have been found. Which of the following would be a single best intervention for the pt
a) antidepressants b) antiinflammatory agents c) benzos d) family therapy E) narcotic analgesics |
a) antidepressants
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a 55 yo woman is seen on a medical service for complaints of abdominal pain. The physician notes a hx of lifelong poor health and multiple past somatic complaints. Which of the following is the best tx strategy?
A) trial of MAOi B) Placement on long term benzo meds C) immediate transfer to psychiatry service D) Appointments in the outpt medicine clinic for periodic evaluations of the pts symptoms by the same attending physician E) A trial of neuroleptic medication to control the delusional aspects of the illness |
D) Appointments in the outpt medicine clinic for periodic evaluations of the pts symptoms by the same attending physician
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A 63 yo man presents with a preoccupation with his bowel movements. He is convinced that this irregularity, which did not begin until during the past year, represents an occult cancer. Repeated exmas and lower GI series reveal no abnormalities. No occult blood is present in the stool. Which of the following is the dg?
A) conversion disorder B) hypochondriasis C) Major depression D) Panic disorder E) Somatization disorder |
C) Major depression
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A 38 yo woman sees her internist to be checked for colon cancer. She reports recent constipation and a family hx of colon cancer. She denies other sx and her organic workup is negative. She becomes irritated when she is reassured about her physical health and believes the evaluation was not complete. Which of the following statements about the pt is most likely correct?
A) her disorder affects women more often than men B) she perceives her bodily functions more acutely than others C) medicatoin will cure her disorder D) Narcotic analgesics are the tx of choice E) It is unlikely that she will seek another medical opinion |
B) she perceives her bodily functions more acutely than others
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A 35 yo woman presents with a 10 year hx of numerous physical complaints with negative organic workups. given her most likely diagnosis:
A) there is a high incidence of family hx of alcoholism in male relatives in this disorder B) there is a high incidence of somatization disorder in female relatives in this disorder C) there is an increased rate of this disorder in persons raised in chaotic settings D) all the above E) none of the above |
D) all the above
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What should tx of body dysmorphic disorder include?
A)Surgery B) SSRIs C) Long-ternm psychotherapy D) all the above E) none of the above |
B) SSRIs
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Pts with somatization disorder
A) are often underevaluated medically B) Commonly experience anxiety and depressive sx C) have no need for evaluation of medical sx D) often require use of benzos E) are rarely frustrating to tx |
B) Commonly experience anxiety and depressive sx
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Many pts with conversion disorder
A) have comorbid body dysmorphic disorder B) with an obvious stressful precipitant have a poor prognosis C) respond to benzos D) are later diagnosed with a physical illness that explains their sx E) intentionally produce their sx |
D) are later diagnosed with a physical illness that explains their sx
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Conversion disorder sx:
A) are culturally sanctioned B) Affect voluntary motor or sensory function C) are not assoc with stressors D) are intenionally produced E) are rarely comorbid with another psychiatric diagnosis |
B) Affect voluntary motor or sensory function
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The following diagnoses occur more frequently in women than men
A) Conversion B) Pain disorder C) Somatization disorder D) All of the above E) none of the above |
D) All of the above
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In factitious disorder
A) sx are not under the pts voluntary controll B) the primary goal of the sx is secondary gain C) the physician may become the perpetual object of transference D) substance addiction is rare E) none of the above |
C) the physician may become the perpetual object of transference
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What does malingering involve?
A) consciously faking an illness B) The intent to deceive others C) No medial or psychiatric tx D) All the above E) None of the above |
D) All the above
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The placebo response
A) helps to differentiate "real" from "psychological" sx in pts B) to pain is a physiologic phenomenon C) is more likely to occur in a histrionic pt D) is a minimal part of most medical tx |
B) to pain is a physiologic phenomenon
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15-20, match the sx to the disorder
A) Conversion disorder B) Dissociative Fugue C) Dissociative identity disorder D) General medical condition E) Major depression F) Panic disorder G) Somatization disorder 15. Unilateral temporal headache, parietal headache, or both 16. Sudden loss of sensation and flaccid paralysis of the entire left arm in a 20 yo woman 17. General malaise in a 50 yo man with a negative workup 18. Complaintes of episodic chest tightness and breathing difficulty in a 28 yo woman with a negative workup 19. Chrnoic multiple system physical complaints in a 40 year old woman wiht a negative organic eval 20. 32 yo woman who disappeared 5 years ago after the accidental death of her child shows up in a town 100 miles away with a new identity and no memory of her previous life |
15. Unilateral temporal headache, parietal headache, or both; D) General medical condition
16. Sudden loss of sensation and flaccid paralysis of the entire left arm in a 20 yo woman; A) Conversion disorder 17. General malaise in a 50 yo man with a negative workup; E) Major depression 18. Complaints of episodic chest tightness and breathing difficulty in a 28 yo woman with a negative workup; F) Panic disorder 19. Chronic multiple system physical complaints in a 40 year old woman with a negative organic eval; G) Somatization disorder 20. 32 yo woman who disappeared 5 years ago after the accidental death of her child shows up in a town 100 miles away with a new identity and no memory of her previous life; B) Dissociative Fugue |
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Match
A) Depressive sx B) Schizophreniform disorder sx C) Panic disorder sx 21. Paroxysmal atrial tachy 22. Toxic delirium 23. Hypothyroidism |
21. Paroxysmal atrial tachy; C) Panic disorder sx
22. Toxic delirium; B) Schizophreniform disorder sx 23. Hypothyroidism; A) Depressive sx |
