Neuropsych
What type of memory deficits are associated with left hemispheric lesions?
Verbal memory deficits
At around what age do children become able to recognize themselves in a mirror?
Beginning at around 18 months, toddlers tend to smile and attempt to remove the marks from their own noses rather than merely pointing toward their reflections (Lewis and Brooks-Gunn 1979).
In the landmark case Rennie v. Klein (1978), the court recognized the right of psychiatric patients to refuse treatment but concluded that this right could be overridden in which of the following circumstances?
The patient is a danger to self or others.
According to DSM-5, by what age must symptoms be present for a child to be diagnosed with attention-deficit/hyperactivity disorder (ADHD)?
12
A 19-year-old patient begins treatment following his first episode of psychosis. His parents ask about their son’s long-term prognosis. What percentage of patients achieve sustained recovery after first-episode psychosis?
One in five patients (20%)
A 65-year-old man presents with memory problems after a recent stroke in the right hemisphere. What type of deficit would be most expected with a right hemispheric lesion?
Visuospatial memory deficits
At what age do most children begin to develop a gendered sense of self?
By around the age of 2 years, most children begin to acquire a gendered sense of self. They accurately label themselves as boy or girl.
If a patient commits suicide, what circumstances renders the psychiatrist most vulnerable to a wrongful death claim?
A failure either to (1) reasonably assess a patient’s suicide risk or to (2) implement an appropriate precautionary plan after the suicide potential becomes foreseeable.
What is considered the “gold standard” diagnostic tool for direct assessment of symptoms of autism spectrum disorders (ASD)?
Autism Diagnostic Observation Scale
According to historical evidence from before the antipsychotic era, which positive symptom is most common among individuals with schizophrenia?
91% of hospitalized patients had delusions (47% marked/severe),
87% had bizarre behavior (40% marked/severe),
66% had hallucinations (28% marked/severe),
and 66% had thought disorder (8% marked/severe) (Fenton and McGlashan 1991).
A 48-year-old British man is admitted to the inpatient unit for progressive cognitive decline and abnormal jerky movements in his left leg over the last 2 months. The clinician suspects Creutzfeldt-Jakob disease (CJD). Which laboratory study could be helpful in confirming the diagnosis?
cerebrospinal fluid 14-3-3 protein
At what age do children typically develop a theory of mind?
Understanding of mental states, is a transformational process in development, usually demonstrable by the age of 4 years.
A psychiatrist is most likely to be sued successfully when a patient commits suicide in which clinical setting?
Psychiatrists are more likely to be sued successfully when a psychiatric inpatient commits suicide. The law permits the fact finder to conclude that the opportunities to foresee (i.e., anticipate) and control (i.e., treat and manage) suicidal patients are greater in the hospital (Hofflander v. St. Catherine’s Hospital 2003).
What fraction of children with ADHD can be expected to no longer exhibit symptoms in adulthood?
Roughly one-third of individuals appear to no longer exhibit symptoms of ADHD during adulthood.
What nongenetic risk factor for developing schizophrenia has the highest OR?
Chronic psychostimulant use (OR=10) (MacDonald and Schulz 2009).
What are the PET and SPECT findings for Alzheimer's disease?
bilateral, symmetric, posterior temporal, and parietal lobe perfusion defects
In the “still-face” experiment, the sudden loss of an affectively reciprocal interaction with the parent would likely cause a healthily attached infant to exhibit what?
Acute distress, crying, and averting the gaze.
A managed care company refuses to authorize payment for an extended hospital stay for a patient who is deemed violent by the hospital’s doctors. Which entity is most likely to carry the burden of liability if this patient commits a violent act soon after discharge?
The inpatient psychiatrist.
A 6-year-old girl is noted to have poor motor coordination for her age. She often bumps into objects and is unable to catch a ball. Although her mother works with her, practicing skills, her play is significantly impacted. These symptoms seemed to have started before the age of 3. What is the most likely diagnosis?
Developmental coordination disorder.
What are some risk factors for suicide among patients with schizophrenia?
(1) younger age,
(2) younger age at symptom onset,
(3) high premorbid functioning,
(4) high personal expectations,
(5) awareness that life’s expectations are unlikely to be met,
(6) awareness of symptoms (especially if aware of delusions, anhedonia, asociality, blunted affect),
(7) and a negative attitude toward or noncompliance with treatment
What aging-related change in the brain increases the risk of delirium induction from anticholinergic drugs?
Loss of neurons in the nucleus basalis of Meynert and septal nuclei.
At around what age do children begin to look at and attempt to “read” the facial expressions of others to obtain emotional clues to guide their own behavior?
Between 8 and 10 months.
Serious boundary violations such as sexual contact with patients are associated with which physician risk factors?
(1) Inadequate training, (2) isolation from colleagues, and (3) narcissistic pathology.
When considering the diagnosis of speech sound disorder, it is important to know that the speech of a young child should be fully intelligible by the age of ___, and full mastery of speech sounds of one’s native language should occur by the age of ___.
The speech of a young child should be fully intelligible by age 4 years.
Full mastery of the speech sounds of one’s native language should occur by age 8 years.
A patient with chronic schizophrenia has had five hospitalizations and three additional emergency room visits over the past year, mostly in the context of treatment nonadherence. She has a history of multiple medical problems requiring treatment by various specialty providers and has experienced difficulty in maintaining housing. What treatment modality is most appropriately suited to this patient?
Assertive community treatment (ACT Team)