Pay Attention!
The ADHD symptom that is most likely to persist into adulthood is...
Inattention
32 yo with no psych hx brought to ER with 2 days of memory loss, insomnia, poor appetite, difficulty performing daily routines. Subjective sense of numbing, detachment, anxiety. One week earlier pt witnessed her child fatally injured in an MVA. Labs, imaging normal. DSM-5 Diagnosis?
Acute stress disorder
The DSM diagnosis for a patient with complaints of skin infection with insects, negative medical work-up.
Delusional disorder, somatic type
Suspected medical diagnosis in a patient presenting with weight loss, 3 mo hx of anxiety, mild depression, insomnia. Physical exam reveals elevated HR, low BP, mild tremor, thin body habitus.
Hyperthyroidism
Post-partum psychosis is most associated with this disorder.
Bipolar I disorder
The most common comorbid psychiatric disorder with ADHD is...
Depression
14 yo F with long-standing history of perfectionism has developed a fear of talking in class after forgetting her line in a school play. Pt says, "I don't like talking to other kids," and practices reading aloud over and over so "I can remember what I'm saying." DSM diagnosis?
Social phobia
Patients with this syndrome complain of having lost not only their possessions, status, and strength, but also their heart, blood, and intestines.
Cotard's Syndrome, the "delusion of negations"
(Famously known as delusion that person is dead, but can also be that they do not have organs, do not exist, or even that they are immortal)
Group A Beta-hemolytic Streptococcus
Episodic OCD-like symptoms, with variable severity of symptoms independent of treatment, can occur for patients with this diagnosis.
Bipolar disorder
Which comorbid diagnosis with childhood ADHD worsens prognosis into adolescence and adulthood to the greatest degree?
Conduct disorder
Pt presents with chapped and reddened hands. Upon questioning, patient admits to washing hands many times per day because "I work in a hospital cafeteria and am intensely afraid of contracting a flesh-eating bacterial infection." No other ritualistic behavior noted. Denies excessive worrying in other situations.
Specific phobia
The most important risk factor for developing post-partum psychosis
Previous post-partum psychosis
Patients with a phobia of blood have a two-stage response when exposed to stimulus. First stage is increased anxiety and elevated BP. What occurs in the second stage?
Hypotension (can lead to presyncope, syncope)
A psychiatrist is treating a patient with relatively stable bipolar disorder who reports feeling depressed recently. The psychiatrist is considering adjunct lamotrigine, but it concerned it may interact with the patient's current medication for bipolar disorder. What is the patient's current medication for bipolar disorder?
Valproate
Which side effect from stimulant medications warrants immediate discontinuation and re-assessment of the treatment plan?
Hallucinations
Pt with leukemia underwent bone marrow transplant. Psych consulted because pt has been more anxious and fearful about leaving the hospital. Difficulty sleeping. Unremarkable MSE. DSM Diagnosis?
Adjustment disorder with anxiety
Psychosis
(also acceptable, symptoms of psychosis: hallucinations, delusions, disorganization, etc)
Patients with rapid cycling bipolar II disorder have higher prevalence of this endocrinologic dysfunction.
Hypothyroidism
Which TCA has consistently been found to be useful in long-term treatment and relapse prevention of OCD?
Clomipramine
Which medication used to treat ADHD has been associated with liver damage?
Atomoxetine (Strattera)
Child persistently refuses to attend school or sleep in bed alone. Complains of somatic symptoms with no physiological origin. DSM Diagnosis?
Separation Anxiety
Capgras Syndrome
35 yo M presents with severe depression and episodes of anxiety for 9 months, so severe he can no longer leave the house. ROS +cold intolerance, unexpected weight loss. Physical exam shows hyperpigmentation of exposed skin. Which medical diagnosis is most likely?
Addison's Disease
In Addiction Psychiatry, what does CAGE stand for?
Cut down (Have you ever felt the need to cut down on your drinking?)
Annoyed (Have people annoyed you by criticizing your drinking?)
Guilty (Have you ever felt guilty about drinking?)
Eye opener (Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?)