History and Law
In forensic psychiatry, the term “standard of care” refers to the use of treatments that are:
USED BY AVERAGE REASONABLE PRACTITIONERS
The factor most consistently associated with outcome of therapy
Strength of therapeutic alliance
OCD is most commonly co-morbid with what type of disorder?
Anxiety disorders
This medication reduces the suicide rate in adults with Schizophrenia
Clozapine
Image of a clock, with all the numbers drawn only on the right hand side, where is the lesion?
PARIETAL LOBE
What are the 4 D's of malpractice
Duty
Dereliction of Duty (or Deviation from Standard of Care)
Damages
Direct Causation
Treatment with best long term outcome for insomnia
CBT
Respiratory illness is most clearly a risk factor for developing which anxiety disorder?
Panic Disorder
Pt with Schizophrenia stable on Haldol 20mg for over 10 years but suddenly develops significant acute EPS symptoms. Cause?
Cessation of Smoking
80yo patient unable to demonstrate how to blow out a match. This is an example of:
Apraxia
The development of what prompted the beginning of the deinstitutionalization movement?
Antipsychotic medications (Chlorpromazine)
Pt with multiple social fears is terrified of public speaking. As the next step in treatment, the therapist arranges for the pt to give a 15 minute talk to clinical staff. This is an example of:
Flooding
Depression increases risk of mortality from what disease?
ISCHEMIC HEART DISEASE
How do antipsychotic meds elevate prolactin?
Prolactin is under tonic inhibitory control by dopamine
The primary purpose of a CT scan in in the evaluation of a patient suspected of having an acute ischemic stroke is:
To exclude the presence of hemorrhage
What are the three primary standards of proof?
Preponderance of the Evidence
Clear and Convincing Evidence
Beyond a Reasonable Doubt
Which type of therapy has individual sessions to analyze self-destructive cognitions/feelings/actions, and group sessions with skills training to improve relationships and decrease impulsivity?
DIALECTICAL BEHAVIORAL THERAPY
What disorder carries the greatest global burden of disease according to the WHO's estimates of years lived with disability?
Major Depressive Disorder
What drug is useful in the Rx of urinary retention secondary to TCA therapy
BETHANECHOL
Wernicke-Korsakoff syndrome
First edition of the DSM to exclude homosexuality as a diagnosis (bonus 100pts for year)
DSM-III-R (1987)
This treatment goal is most specific to psychoanalytic
psychotherapy:
Bringing unconscious conflict into awareness
29yo pt is admitted to the hospital with a 1 week history of euphoria, insomnia, pressured speech, and grandiosity. Has delusions of being monitored by the FBI, and the staff observes pt
responding to unseen others. In addition to these symptoms, what is required for diagnosis of Schizoaffective disorder?
PRESENCE OF PSYCHOTIC SYMPTOMS FOR AT LEAST 2 WEEKS IN THE ABSENCE OF MOOD SYMPTOMS
In the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, which medication was the most effective due to its low rate of discontinuation, high reduction in psychopathology, and longest time to discontinuation of treatment
OLANZAPINE
2 years after MVA with rear-end collision, pt develops BUE weakness with some muscle wasting, loss of DTRs in arms, loss of sensation to pain and temp in neck/arms/shoulders, intact sensation to touch.
Most likely cause?
SYRINGOMYELIA