Child Psychiatry
An 8 year old child is referred for an intake evaluation, at the suggestion of his teacher. Parents describe the child as "having lots of energy," "acting without thinking about consequences," and "having a short fuse." He has difficulty paying attention and makes careless errors on homework. Yet, the child is able to play video games at home without difficulty. This category of drugs is most commonly used to treat the child's condition.
What are stimulants?
A 47 year old patient develops new onset vertigo, diplopia, gait imbalance, and severe occipital pain during chiropractic manipulation of the neck. This is the most likely diagnosis.
What is vertebral artery dissection?
This racial/ethnic group has the highest rate of suicide in the United States.
What is native American?
This treatment for alcohol dependence blocks the enzyme aldehyde dehydrogenase.
What is disulfiram?
This is the first step in management of restless legs syndrome.
What is to evaluate for iron deficiency?
A 13 year old boy is evaluated, due to concerns by his parents that he is "sleepy" during the day and frequently appears dazed and "out of it." He is frequently not hungry, complains of nausea, and has red eyes, a runny nose, and red sores around his mouth. You suspect that the teenager is likely using this substance.
What are aerosols?
A 37 year old truck driver presents with numbness of the left hand. He reports episodes of numbness, increasing in frequency and severity over the past 2 years. His grip has weakened, he has reduced pinprick sensation of the left little and ring finger, and his left hypothenar muscles seem small. You suspect a lesion of this nerve.
What is the (left) ulnar nerve?
A student presents after barely escaping an assailant who attacked and tried to rob him one month ago. The student reports nervousness, being easily startled, having disturbingly vivid dreams of the event, and "not wanting to see anybody." Such symptoms are expected to last no longer than this time period.
What is 4 weeks?
This psychotherapy for addiction utilizes a disease-model approach and emphasizes concepts, such as acceptance of the disease and surrender to help beyond oneself.
What is 12-step facilitation (or a 12-step program)?
A 26 year old patient is concerned that his brow ridge is too prominent and reports that, "it makes me look like a Neanderthal." The patient consults a physician who finds the brow ridge to be prominent, but within the normal range. Despite this, the patient insists on a referral to a plastic surgeon. The patient's belief is best described as this.
What is a delusion?
A 10 year old boy with primary nocturnal enuresis is going away to overnight camp. He is dry during the day with no urgency, frequency, or dysuria. His father reports that he had the same problem until he was age 12. This treatment would be considered the most appropriate in this situation.
What is desmopressin (DDAVP)?
A 62 year old patient has a several year history of progressive personality changes, characterized by dull emotions, lack of initiative, and apathy. Autopsy reveals atrophy of this region of the brain.
What is the frontal lobe?
Myoclonus, hyperreflexia, diaphoresis, shivering, tremor, and confusion are compatible with this psychiatric diagnosis.
What is serotonin syndrome?
A 21 year old patient is dropped off at an ED. He is agitated, but not aggressive towards staff, and states that computers in the ED are flashing messages at him. He says, "I need my knife to protect myself." This substance is found on urine toxicology.
What is amphetamine?
This defense is best characterized by a self or object representation that is disavowed by placing it into someone else and inducing the latter to unconsciously identify with the self/object representation.
What is projective identification?
A 3 year old child and his parents present for an evaluation. The child is playing alone in the corner of the room, stacking and unstacking blocks. The child is oblivious to the presence of the parents and physician. Parents report that the child has not yet begun to speak, and an audiology evaluation was negative for hearing loss. This is the most useful instrument to use for assessment of this patient.
What is the Autism Diagnostic Observation Schedule (ADOS)?
A 19 year old patient is evaluated for episodes of getting out of bed during the night and moving about the bedroom in a frenzied manner while asleep. She is frightened during the episodes and has, on occasion, self-injured. Her disturbance is most likely happening during this sleep phase.
What is Non-REM (Stage 3) sleep?
A 65 year old bipolar patient comes to the ER following a lithium overdose. He is hypotensive, stuporous, agitated, and having severe diarrhea. His plasma lithium level is 4.5, creatinine is 3.0. Following gastric lavage and bowel irrigation with polyethylene glycol, this would be considered the most appropriate next step.
What is emergent hemodialysis?
This symptom is considered to be the hallmark of amphetamine-induced psychosis.
What is paranoia?
This personality disorder may be associated with transient psychotic symptoms.
What is borderline?
According to the Child-Adolescent Multimodal Study (CAMS), combination therapy of CBT and this medication, was superior to monotherapy alone for children with moderate to severe GAD, separation anxiety, and social phobia.
What is sertraline?
This is the principal mechanism of termination of the synaptic activity of dopamine in the prefrontal cortex.
What is diffusion away from the synaptic cleft?
A 65 year old man with a history of urinary incontinence is brought to the ED after having 2 days of unusual behavior. He has accused family members of stealing his belongings and is seeing animals and children that are not present. He had been taking oxybutynin and increasing amounts of diphenhydramine for sleep. During exam, he is restless and trying to get off of the hospital stretcher. Physical examination shows dry skin and mucous membranes, mydriasis, tachycardia, and a temperature of 101F. CBC, BMP, U/A, and EKG are unremarkable. Serum toxicology is positive for diphenhydramine only. This is the treatment of choice for his condition.
What is physostigmine?
This is considered to be the best treatment recommendation for a pregnant woman who is dependent on heroin.
What is methodone maintenance?
A patient with a history of arrest for possession of cocaine. Due to this intervention, the patient is required to spend 2 nights in jail after missing 2 appointments with the substance abuse counselor.
What is drug court?