Anxiety
A diagnostic feature of panic attacks: (2x)
Derealization
What cognitive response do pts w/ anxiety have compared to pts with depression? (2x)
ATTENTIONAL BIAS TOWARD POTENTIALLY THREATENING STIMULI
Pt w/ h/o bipolar presents w/ immobility, posturing, echopraxia. First-line tx? (5x)
LORAZEPAM
Respiratory illness is most clearly a risk factor for developing which anxiety disorder? (2x)
Panic disorder
62 yo requests antidepressant. Spouse died 6 weeks ago. Crying spells, decreased appetite, poor sleep. Continues to see friends, no SI. Fam hx of depression, no prior depressive episodes. Dx? (4x)
Bereavement. Assure patient of no pathology
What predicts bipolarity in adolescents w/ depression? (2x)
Psychotic symptoms
Differential dx of a pt presenting to ED w/ panic d/o: (2x)
Pulmonary embolism
Factor with the most evidence to support its protective effect in bereavement following the loss of a spouse: (2x)
Quality of social support of the bereaved
40 yo w/ 6 kids, has insomnia, poor appetite, dizziness/nausea, thinks husband is poisoning her. Despite all classes of meds marked fluctuations from sadness to euphoria five times during the year. Dx? (2x)
Bipolar with rapid cycling
28 yo presents w/ 1 year h/o agoraphobia. Pt able to drive to local drug store but only with considerable pre-travel apprehension. Pt will venture alone no further than within approximately 5 miles of home. Personal hx of panic attacks or depression is denied, although family hx is positive for depression and alcoholism. Pt has had no previous hx. Best initial tx and one that offers the best long-term prognosis is? (2x)
CBT INCLUDING EXPOSURE & SSRI AND BENZO
8 yo w/ no hx of emotional disturbance presents w/ separation anxiety & over-concern for health of surviving parent: (2x)
Age-typical presentation of normal bereavement
This is a risk factor for the rapid cycling form of bipolar d/o (2x)
female
Pt w/ leukemia underwent marrow transplant. Psych consulted. Pt more anxious and tearful about leaving hospital. Having trouble sleeping. MSE is unremarkable. Dx? (2x)
Adjustment disorder with anxiety
Most likely to increase risk of impairment after bereavement in 80 yo: (2x)
Significant depressive symptoms shortly after loss
What medication strategies are most effective and rapid in the tx of severe bipolar illness, manic phase? (2x)
Antipsychotic meds + Lithium or Valproate