Diagnostics
Psychopharmacology
Crisis and safety
Name that disorder
MIsc
100
  • A score of 13 on PHQ 9 is: minimal, mild, moderate, or severe
  • Moderate
100
  • Black box warning for SSRIs

Suicidality for people under 25 years old.

100
  • Patient scores ‘2’ for question 9 on the PHQ9, what screening test is appropriate to do next?
  • Columbia-Suicide severity rating scale
100
  • Person has PHQ9 indicating depression with a GAD7 showing comorbid anxiety; they are started on an SSRI and return saying now they feel invincible, on top of the world, they don’t need any doctors anymore because they have discovered the cure to all ailments, they have not slept in days. What do they have.
  • Bipolar
100
  • What does SMART goal stand for
  • Specific, measurable, attainable, realistic/reasonable/relevant, timely
200
  • How much time needs to pass before acute stress disorder becomes PTSD

1 month

200
  • Good SNRI for co existing pain (e.g. fibromyalgia, neuropathy)
  • Duloxetine (Cymbalta)
200
  • Your patient makes you promise your conversation will remain confidential, then reports a desire to harm another specific individual, are you obligated to warn that person?
  • Yes, Tarasoff duty.
200
  • Lamotrigine is a first line agent to treat bipolar disorder; what key aspect of this disease does it not help with.
  • Mania
200
  • Patient smokes 4 packs of cigarettes per day, they have a small child at home, and care for their elderly mother who has severe COPD and allergies. When you ask about their smoking, they have no intention of changing their behavior. What stage of change is this.
  • Precontemplation
300
  • What is the DSM-5 criteria for the dx of depression using the PHQ9 (when is the PHQ9 “positive”).
  • Q’s 1-2: must score a 2 or 3 on one of them
  • Must score a 2 or 3 on 5 or more of the remaining 9 questions
  • Must experience some difficulty
300
  • A patient is started on an SSRI and reports worsening of her sleep. She tosses and turns all night, and has an uncomfortable sensation to move which seems to make her feel better. What is this?
  • Restless legs syndrome (Willis–Ekbom disease)
300
  • Your patient is actively suicidal but is low risk, what next step or plan is needed before allowing them to leave the office
  • Safety plan
300
  • This patient avoids public speaking, they avoid interactions with others, in particular they fear scrutiny, and have significant anxiety anticipating these situations for >6m
  • Social anxiety disorder
300
  • Patient is looking for a therapist in town, they are looking for some specific qualifications and want to be able to filter out psychologists by these qualifications. What website would you suggest
400
  • A major depressive episode requires depressive symptoms to be present for at least ‘x’ weeks

2 weeks

400
  • Patient’s caretaker reports patient has hx of bipolar disorder and recently started a new medicine. Now reports tinnitus, blurred vision, tremors, confusion, and ataxia. Did recently have GI illness with reduced PO intake and increased GI losses, labs reveal AKI. What medicine did he start?
  • Lithium
400
  • Your patient is suicidal, they score high risk on the Columbia. You aren’t sure what to do next. Your attending for the day stepped out for a coffee break. What should you do? Send them home? Send yourself home? Sign a petition?
  • Contact BHC, Amy/Emalie, Dr Odom for help.
400

The host of Jeffardy is stuck on inpatient. This makes him sad. But why? He has...

Fear of missing out (FoMO). But this is not in the DSM-5. What does DSM-5 stand for?

Diagnostic and Statistical Manual of Mental Disorders (5th edition)

400
  • You promise you pay attention during didactics but cant remember the a certain behavioral health office flow. Where should you look?
  • Google classroom or the old google site.
500
  • Your very complex patient is not getting much better on your current treatment plan for their depression. You feel they need diagnostic clarification and would benefit from some model that combines psychiatry and behavioral health. Aha! You have the perfect answer: open evidence, unfortunately the patient has an extreme phobia of AI, and they WILL know if you use it. What referral should you make instead
  • CoCM (Collaborative Care Model)
500
  • Patient presents on an abandoned island, he swallowed some island meat and it got stuck in his esophagus. Luckily, Dr Pearson is there and wants you to administer 10cc of meat tenderizer PO. He tells you to find a certain fruit that can make meat tenderizer. What fruit?
  • Papaya
500
  • A black box in aviation is a flight recorder that is used for investigations in the event of an accident. It is neither black nor does it have any relation to the FDAs black box warning for serious or life-threatening medication risks. Why is the FDAs black box warning called this?
  • The box surrounding the warning is black.
500
  • Your clinic patient had a great visit with you today, you discussed their HTN, HLD, depression (on a monoamine oxidase inhibitor), diabetes, they got a DME order for a new wheelchair, you removed their ingrown toenail, sent two referrals, and got in a session of OMT. Time to celebrate with a bottle of wine and some imported cheeses… What abnormality will you find on their same day visit tomorrow?
  • Hypertensive crisis
500
  • The Great Lakes surrounding Michigan hold about 21% of the Earth’s total supply of fresh water. Conveniently, the same percentage of oxygen in our atmosphere. However, your patient is in a severe panic attack, and they don’t care about your fun facts. They are hyperventilating and ask to breathe into a paper bag. What acid base disorder are they trying to fix? AND… why is this practice no longer recommended?
  • Respiratory alkalosis. Hyperventilation can be caused by MI, PE, pneumothorax, asthma… all disorders causing hypoxemia- breathing in air with less oxygen will worsen the condition and several deaths have been attributed to this.
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