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30 Cards in this Set
- Front
- Back
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34yo F wants a bilateral tubal ligation (BTL). She has had a live-in boyfriend for 10 years. No kids. What do you do?
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Review risks/benefits and ask pt if she has discussed this with her S.O.
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14yo F, + preg test (5wks). Pt doesn't want you to tell her mother. What is the best response?
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I will treat you without parental consent.
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29yo F w c/o fatigue and unhappiness for 4 years, No enjoyable activites. "I'm worthless". No suicide, loss of appetite, or sleep chenages. Work up neg. Dx?
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Dyshymic disorder, a chronic low intensity mood disorder characterized by low energy, low selfesteem for more than 2 years.
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27yo M acting crazy for 2 wks. No sleep in 4 days. Speech is pressured and says he "feels spectacular". Dx and Tx
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Acute Mania.
Valproate (mood stabilizer), lithium, carbamazepine also work |
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48yo M w c/o dry hands. Says he keeps clean, washes hands 3-4 hours per day. Recently fired from job for refusing to touch keyboards shared by others. Dx?
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OCD
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48yo M tells therapist, "stop treating me like a child! My father did that!" This is an example of...
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Transference
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Medical resident is belittled by his attending. Resident turns around and belittles his medical student. Example of?
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Displacement
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Patient accuses therapis of having sexual interest in him, when it's the patient who has an interest in the therapist. Example of
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Projection
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24yo F gave birth 2 days ago, is sad now. No suicide or anything weird. What should you say?
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This is normal, please come back and see me in 2 wks.
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36yo F thinks "god is punishing her" after her fetus is dx w Downs. What do you say?
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This is a difficult situation. Let me explain the condition in greater detail.
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20yo F sweats when she sees her doctor and pharmacist. Example of?
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Classical Conditioning
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3yo M. Speaks in sentences.
Can ride a tricycle, but not a bike. Scribbles, but cannot copy a line. Knows his name and gender. Does not play cooperatively. What aspect of development is delayed? |
Fine Motor
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18yo F admitted to psych ward after suicide attempt. ID's a medical student as "the only person who understands me" and all other staff as "horrible and mean". What defense mech?
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Splitting
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Dying pt's wife says he didn't want machines. No DNR on file. What do you do?
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Attend to pt's comfort and ensure family is present.
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42yo M, daytime sleepiness. Falls asleep during meetings, TV, driving. Does not feel refreshed after daytime naps. No vivid hallucinations when falling asleep. Wife complains he keeps her up at night. BMI = 31.3 Dx?
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Obstructive sleep apnea
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23yo M, constantly tired, falls asleep an inappropriate times. Falls to ground. No confusion or LOC. Dx?
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Narcolepsy
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38yo M, hx psych illness. Malodorous, dishelveled. Incoherent speech, laughs inappropirately. Urinates himself Dx?
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Disorganized Schizo
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19yo M, thinks radio is sending him messages. Locked in room for 2 days so devil would not find him. Hx since 17yo. Neg drug screen. Tx?
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Acute Paranod Schizo
Risperidone (atypical antipsychotic) |
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45yo M seek protection from people trying to harm him. Hx for 10 years. No real threat. Dx?
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Delusional disorder
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30yo F, MVA after drunk driving. Later, starts volunteering and donating. Behavior?
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Altruism
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17yo student failing in school. EtOH, pot. Docs teenage daughter also uses drugs. Doc asks pt's mom if she feels like slapping her son. What defense mech?
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Projection
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31yo F, does not socialize with people at work. low self esteem. no hx of long term romantic partner. normal affect. Dx
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Avoidant
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23yo F w severe L leg weakness for 3 days. Fiance' broke off engagement 3 days ago. Normal exam, tests. Dx?
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Somatoform disorder (conversion disorder)
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32yo F w GAD and panic attacks. Pt wants help immediately. Which benzo has the shortest half life?
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Alprazolam
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22yo student worries about exams. worries if friends like him Irritable, difficulty sleeping, dec energy. Worse over last 7 mos. Dx?
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GAD
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35yo WM. Feels the need to break things when he gets in arguments with wife. punches holes in walls
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Displacement
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Med student just finished Step 1. Decides to not think about results. What defense mech?
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Suppression
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10yo M touches doorway with foot 5 times before leaving home. Washes hands 3 times. Checks doors and windows. Dx?
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OCD
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43yo drug abuser volunteers with narcotics anon. What defense mech
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Reaction Formation
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54yo M, IDDM, high Hgb A1c. Doc increases insulin and diet control. Pt cancels appts at last minute or arrives late for several months. What defense?
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Passive Aggresive
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