Clinical Psych Final

How many drinks are metabolized by the liver in an hour on average? 1 3 5 7

1

Substance use disorder is defined as a problematic pattern of behavior leading to distress or impairment, manifested by the development of______ or more of the 11 criteria over a ____ period of time? 2 criteria over 12 months 2 criteria over 1 month 2 criteria over 36 months 3 criteria over 6 months

2 criteria over 12 months

What is the mortality rate for delirium at 6 months? 80% 1% 5% 22%

22%

Patients with anorexia are about ____ more likely to die by suicide than the general population: 30-60% 1% 5-10% 80-100%

30-60%

At what age are most children in the US bowel and bladder trained (aka potty trained)?

4y

Lawrence Kohlberg (1927-1987) is an american psychologist who is attributed for the creation of which of the following developmental theories?

6 STAGES OF MORAL DEVELOPMENT

How long would someone need to have anxiety symptoms such as feeling "worried most days" to meet criteria for Generalized Anxiety Disorder? 6 months 1 month 1 week 1 day

6 months

Which of the following are NOT possible causes of poor food intake in patients with Avoidant Restrictive Food Intake Disorder? A concern about weight gain A fear of choking on food somatic complaints that their stomach hurts after eating or that they feel nauseas Sensory issues regarding the taste, smell, color, or texture of food

A concern about weight gain

A 43-year-old woman is brought to the clinic by her mother because she has refused to leave the house over the past 6 months. She has started working online to avoid going to her place of employment, and no longer goes to the shopping mall or theater with friends where it might be crowded; otherwise, she describes a sense of feeling trapped. She has stopped using public transportation for the same reason. Which of the following is the most likely diagnosis? Agoraphobia Panic disorder Social anxiety disorder Specific phobia

Agoraphobia

What phobia results in fear regarding public spaces and avoidance of places, situations in which the patient may feel trapped, helpless or embarrassed? Agoraphobia Arachnophobia Xenophobia Photophobia

Agoraphobia

What movement disorder (sometimes a side effect of antipsychotic medication) causes a patient to appear restless and to pace or move constantly? Akathisia Dystonia Parkinsonism Tardive Dyskinesia

Akathisia

Aspects of the cognitive assessment include: Orientation Memory Level of consciousness Attention and concentration All of the above

All of the above

What contributes to personality disorders?

All of the above: Early life events, genetics, cultural factors

What is the most common cause of dementia? Alzheimer's Vascular Dementia Lewy Body Dementia Parkinson's

Alzheimer's

Which class of medications are considered first line treatment for PTSD? Antidepressants Antipsychotics Mood stabilizers Alpha 2 antagonists

Antidepressants

What personality disorder is characterized by lack of remorse and indifference towards others? Antisocial personality disorder Paranoid personality disorder Avoidant personality disorder Schizoid Personality Disorder

Antisocial personality disorder

How long must a patient's symptoms last for in order to meet the criteria for PTSD? At least 4 weeks At least 2 days At least 6 months 3 days to 4 weeks

At least 4 weeks

Which of the following factors does NOT contribute to mental illness? A. Genetics B. An individual's willpower C. Family History of mental illness D. Trauma

B. An individual's willpower

Which class of medication mentioned in the lectures should be avoided in patients with PTSD? Benzodiazepines NSAIDs Antidepressants Antiepileptics

Benzodiazepines

What is the most common form of eating disorder? Binge Eating Disorder Avoidant Restrictive Food Intake Disorder Bulimia Nervosa Anorexia Nervosa

Binge Eating Disorder

Acronym to screen for alcohol use disorder? CAGE MORE CAPE MADISON

CAGE

What type of therapy links thoughts, behavior, and feelings? CBT psychodynamic exposure supportive

CBT

Which of the following is a proper description of "pacing" as outlined in the lecture? A. Pacing involves moving for a set period of time despite pain so you realize overtime that you don't really need rest breaks B. Pacing involves working as hard as you can on some days and then taking days off to rest and recover C. Pacing involves selecting an activity, evaluating how long you can comfortably engage in the activity daily, setting a baseline starting point, and slowly increasing your goal on a regular basis D. The concept of pacing has not been defined and is up to the patient's interpretation

CORRECT! Pacing involves selecting an activity, evaluating how long you can comfortably engage in the activity daily, setting a baseline starting point, and slowly increasing your goal on a regular basis

Which of the following is FALSE about Gate Control Theory of Pain? Certain behaviors facilitate gate opening such as meditation and exercise Positive states of mind mitigate signals Negative states of mind amplify signals Certain behaviors facilitate gate opening such as smoking, poor diet and no exercise.

Certain behaviors facilitate gate opening such as meditation and exercise

What percent of the population will die by suicide? A. 1% B. 2% C. 5% D. 20%

Correct! 1%

Which of the following statements are true regarding exercise and depression? A. Despite exercise increasing feelings of achievement and mastery, this has no impact on positive self beliefs B. Some studies have shown similar antidepressant treatment efficacy with exercise comparable to medication and psychotherapy C. Exercise should not be recommended as a depression treatment adjunct as those with depression have symptoms of low motivation D. Recommending exercise increases a depressed individual's sense of obligation which overtime often worsens their depression

Correct! Some studies have shown similar antidepressant treatment efficacy with exercise comparable to medication and psychotherapy

Which of the following statements regarding exercise and anxiety are true? A. Even with long-term exercise training and PT exercise will continue to trigger a fear response in those with anxiety B. Exercise is not recommended for those with panic attacks as the bodily response between anxiety and panic often feels similar C. Those with anxiety may initially interpret the natural bodily response of exercise as a sign that a catastrophe is about to ensue D. Exercise is not recommended for anxiety management as it might make symptoms worse

Correct! Those with anxiety may initially interpret the natural bodily response of exercise as a sign that a catastrophe is about to ensue

Which of the following statements is FALSE regarding breathing exercises? - During anxiety our breathing often increases - Timed breathing often involves slowing down ones breath - Timed breathing can slow heart rate and lower blood pressure - Timed breathing activates the sympathetic nervous system and thus is good for use in melancholic depression

Correct! Timed breathing activates the sympathetic nervous system and thus is good for use in melancholic depression

How long does an average untreated manic episode last for bipolar I? - 6 months - 1 week - 1 month - 1 year

Correct! 6 months

Which of the following statements are true regarding progressive muscle relaxation? - The skill involves using the 5 senses of sight, touch, hearing, smell, and taste - This should only be taught by a licensed therapist or psychiatrist - The skill is incredibly difficult to master and takes a lot of practice - Among other potential uses, Progressive Muscle Relaxation can be used to help an individual suffering from anxiety and chronic pain

Correct! Among other potential uses, Progressive Muscle Relaxation can be used to help an individual suffering from anxiety and chronic pain

What type of hallucination do patients that suffer from schizophrenia usually experience? Auditory Visual Tactile

Correct! Auditory

The nurses are upset at doctors over patients' complaints at terrible treatment; the doctors cannot fathom how nurses are siding with the patient as the patient has been angry, resistant, and manipulative with treatment team. What diagnosis are you worried about? Borderline personality disorder Schizoid personality disorder Antisocial personality disorder Histrionic personality disorder

Correct! Borderline personality

Autism spectrum disorder can be conceptualized as deficits in what primary domain[s]? A. social communication and interactions B. restricted or repetitive behaviors/interests/activities C. sustained concentration and attention Both A & B Both A&C

Correct! Both A & B

What makes us depressed? A. Nature B. Nurture Neither Both A & B

Correct! Both A & B

Which of the following is characteristic of delirium, and NOT dementia? Can acutely happen in the ICU Patients usually have normally alertness Patients usually have normal awareness Slow in duration and onset (months to years)

Correct! Can acutely happen in the ICU

What mnemonic helps us diagnose mania? - DIGFAST - SIGECAPS - SIGCPS - PCL-5

Correct! DIGFAST

Which of the following is an appropriate way to react to an agitated elderly patient? Deescalate the situation and remain calm Shout your frustration at them Get angry Push them

Correct! Deescalate the situation and remain calm

What is the monoamine hypothesis for depression? - Disorganized firing of neurons causes depression - Patients with low monoamines are depressed - Patients with high monoamines are depressed

Correct! Disorganized firing of neurons causes depression

What is the gold standard for treatment resistant depression? - Electroconvulsive therapy (ECT) - Medications - Exercise - transmagnetic therapy

Correct! Electroconvulsive therapy (ECT)

Individuals that have a combination of traits from various personality types likely have a personality disorder. True False

Correct! False

True or False: Asking depressed patients whether or not they have had thoughts of wanting to kill themselves plants the seed of suicide, increasing risk. - True - False

Correct! False

True or False: Dementia is normal when someone ages.

Correct! False

Which of the following is NOT a risk factor for first episode depression occurring later in life? Higher socio-economic status Widowed Female sex Pain

Correct! Higher socio-economic status

Which of the following is FALSE about major depressive disorder (MDD) in the pediatric population? - Kids are too young to experience depression, anxiety or other mental illnesses - Tend to see more somatic complaints and irritability compared to adults - More common in females during adolescence - Common to have other psychiatric comorbidity

Correct! Kids are too young to experience depression, anxiety or other mental illnesses

What personality disorder is characterized by exploiting others, lack of empathy, and excessive need for admiration? Narcissistic personality disorder Schizoid personality disorder Antisocial personality disorder Histrionic personality disorder

Correct! Narcissistic personality disorder

Which of the following diagnoses' hallmark feature is 'Recurrent patterns of negativistic, hostile, or defiant behavior directed at authority figures'? - Oppositional Defiant Disorder (ODD) - Selective Mutism - ADHD - Intermittent Explosive Disorder (IED)

Correct! Oppositional Defiant Disorder (ODD)

What term best fits the following description of a child's play behavior; 'Child plays beside other children without interacting with them. He usually watches and tries to copy their play but is not ready to interact with them directly.' - Parallel play - Cooperative play - Self-stimulatory play - Onlooker play

Correct! Parallel play

Select the correct definition of 'proactive aggression' as discussed in the lecture. - Premeditated Aggression: manipulative, intentional, goal directed, cold-blooded; requires no provocation; directed toward possessing objects or dominating - Impulsive Aggression. emotional, hot-blooded, impulsive; a response to provocation - Based on frustrative non-reward which is increased drive in the absence of expected reward

Correct! Premeditated Aggression: manipulative, intentional, goal directed, cold-blooded; requires no provocation; directed toward possessing objects or dominating

Which of the following is the best indicator that a patient is at increased risk of suicide? - Prior suicide attempt - Diagnosed with a substance use disorder - Recent divorce - Parasuicidal behavior (cutting)

Correct! Prior suicide attempt

What mnemonic helps us diagnose depression? - SIGECAPS - DIGFAST - GOAT - PCL-5

Correct! SIGECAPS

Which of the following is something that happens with normal aging? Slower at learning new information Not being able to recognize their children Confusion Forgetting how to use a remote

Correct! Slower at learning new information

How impaired is someone in a manic phase with Bipolar I? - They end up in jail or in the hospital - They can still take care of all aspects of their life

Correct! They end up in jail or in the hospital

Which of the following is NOT a primary domain of developmental milestones recommended to be followed by the CDC? - biological - physical - language - cognitive

Correct! biological

Select which of the following ways exercise may improve mood A. Better Sleep B. Less Stress, Anxiety, & Depression C. Improved Energy & Decreased Fatigue D. All of the above

D. All of the above

Which of the following statements regarding mental illness and violence is true? A. Those with mental illness are more likely to be victims of violent crime compared to the general population B. Most violence is attributable to severe mental illness C. The general population is just as likely to commit violent acts as those with mental illness D. Both A and C

D. Both A and C

What are two symptoms of psychosis? Disorganized speech and hallucinations Delusions and insomnia Irritability and disorganized behavior Mutism and delayed movements

Disorganized speech and hallucinations

Which neurotransmitter is most directly responsible for the reinforcing/pleasure signals in the brain? Dopamine Serotonin Norepinephrine GABA

Dopamine

What movement disorder (sometimes a side effect of antipsychotic medication) causes painful cramping often in the jaw? Dystonia Akathisia Tardive dyskinesia Parkinsonism

Dystonia

Which of the following should be incorporated into chronic pain treatment? Early dialogue that analgesic medications are unlikely to fully treat their pain Requiring that patient only see one type of provider (such as a pain specialist) rather than referrals to interdisciplinary team members such as PT, Accupuncturist, Psychotherapist etc. Avoidance of any kind of discussion of comorbid mental health conditions as this will make the patient feel their pain isn't being taken seriously Liberal use of opioid pain medication at least initially to help the patient feel better before starting physical therapy

Early dialogue that analgesic medications are unlikely to fully treat their pain

All the following are important in caring the patients with PTSD, except: Explore each patient's past trauma in extraordinary depth Displaying empathy toward the patient Keeping in mind that every individual was given their own "deck of cards" in life

Explore each patient's past trauma in extraordinary depth

What type of therapy focuses on familiarizing the source of distress to the patient? exposure CBT Psychodynamic supportive

Exposure

What are the 5 main principles when interviewing someone using the skill of motivational interviewing? - Express empathy, avoid arguing with the patient, roll with resistance, develop discrepancy, support the patient's self-efficacy - Empathize with the patient, always agree with them so as not to make them feel judged, if you sense resistance change the topic, do not point out any discrepancies in their thinking, encourage whatever the patient wants - Point out what they're doing wrong, educate them on what you recommend, debate if needed, make an action plan, as the clinician be unwavering in what you know is right - None of the above

Express empathy, avoid arguing with the patient, roll with resistance, develop discrepancy, support the patient's self-efficacy

If a patient is exaggerating their symptoms and inducing harm to themselves to be admitted to a hospital, but there is no motive for a secondary gain, the patient likely has/is: Factitious disorder Malingering Conversion disorder Illness anxiety disorder

Factitious disorder

Delerium Tremens typically occur in the first 24 hours of detoxification from alcohol. True False

False

Nocioceptive disorders are those that occur due to damage of PNS or CNS nerves. True False

False

Patients with bulimia are usually underweight True False

False

Schizophrenia is the only cause of psychosis. True False

False

The diagnosis of PTSD requires the individual to have been physically injured? True False

False

To diagnose anorexia, a patient must either have amenorrhea or be <85% of normal body weight True False

False

What are delusions? False thoughts that conflict with reality. Paranoid thoughts Auditory hallucinations False beliefs about their body

False thoughts that conflict with reality.

CNS depressants such as benzodiazepines, primarily effect which neurotransmitter pathway? GABA Norepinephrine Serotonin Dopamine

GABA

The actions of rolling, sitting up, crawling, walking are examples of milestones from which category?

Gross motor development

A medical student makes frequent appointments with his PCP as he is concerned he has the various illnesses he learns about in lectures. He is reassured by normal test results only to learn of a new disease which he is very concerned he may have. The medical student most likely has which of the following conditions: Illness Anxiety Disorder Hypochondriasis Somatic Symptom Disorder Conversion Disorder

Illness Anxiety Disorder

Which of the following is the most important overall goal when addressing chronic pain? Improving Functional Capacity Decreasing Pain levels Getting Pain level down to zero

Improving Functional Capacity

What is the most important symptom to screen for in order to not miss a diagnosis of depression? - Irritability - sadness - High energy - Low energy

Irritability

Which of the following statements regarding mental health in children is FALSE? a) The majority of mental health conditions present before age 24 b) Mental Health in children is impacted by both biological and psychological factors c) Many children with mental health conditions go untreated d) It is best to avoid officially diagnosing mental health conditions until the individual reaches age 18

It is best to avoid officially diagnosing mental health conditions until the individual reaches age 18

What is psychosis? Loss of contact with reality Progressive cognitive impairment including memory loss A period of unbridled energy, often resulting in insomnia and hyperactivity

Loss of contact w/ reality

Which of the following is NOT a risk factor for suicide? Married Caucasian or Native American Sexual minority male

Married

45% of Chronic Pain Patients have Mood Disorder Borderline Personality Disorder Substance Use Disorder Dependent Personality Disorder

Mood Disorder

The 30-year old project supervisor's editing team works until 2am every night because they are not up to her standards, and she constant gives feedback daily about things that need to be addressed. When met with suggestions, she is rigid and has to do things her way, believes that as supervisor, she needs to "control everything and make sure it's all perfect." What personality disorder diagnosis would be most aligned with this description? Obsessive compulsive personality disorder Avoidant personality disorder Obsessive compulsive disorder Antisocial disorder

Obsessive compulsive personality disorder

Dysphoric mood, muscles aches, lacrimation, pupillary dilation, diarrhea and yawning are constellation of symptoms from which type of withdrawal? Opiates Tobacco Marijuana Benzodiazepines

Opiates

What disorder results in anxiety attacks and at least a month of worrying about an anticipated attack? Panic disorder Phobia Obsessive compulsive disorder Generalized anxiety disorder

Panic disorder

What disorder results in a persistent, excessive, unreasonable fear of a particular object or situation? Phobia panic disorder generalized anxiety disorder Panic disorder

Phobia

How do you tell your patient / client that they may need to see a mental health professional/psychiatrist / therapist? Reassurance, normalize, empathize Reassurance, criticize, normalize Empathize, normalize, infantilize

Reassurance, normalize, empathize

What most commonly is the first line of treatment in terms of medications? Seretonin Selective Reuptake Inhibitors (SSRIs ) Benzodiazepines Antipsychotics Beta blockers

Seretonin Selective Reuptake Inhibitors (SSRIs )

A 30-year-old woman presents to the clinic with fear of getting trapped in the elevator. She works at an insurance company which is located on the 10th floor, and she climbs stairs every day to reach her office. She has never had any accidents in an elevator but says that she has had this fear since childhood. She denies this type of anxiety in any other situation. What is the most likely diagnosis? Specific phobia Social anxiety Agoraphobia Generalized anxiety disorder

Specific phobia

Which of the following statements regarding Somatic Symptom Disorder is FALSE: Symptoms are consciously produced or feigned by the patient for attention Patients endorse physical symptoms that are not explained by a medical condition Symptoms often worsen in the setting of increased psychological distress Normal physiological functions are often misinterpreted

Symptoms are consciously produced or feigned by the patient for attention

Which movement disorder causes uncontrollable movements of the tongue or mouth? Tardive dyskinesia Dystonia Akathisia Parkinsonism

Tardive dyskinesia

In a patient with sudden onset left lower extremity paralysis following news that her husband was tragically killed, which of the factors is indicative of Conversion Disorder: The paralysis is NOT intentionally produced or feigned The patient is faking the paralysis in order to assume the role of the injured and be cared for The patient needs money and hopes the paralysis will help her get disability The patient has a history of hemiplegic migraines and stress often causes flair ups

The paralysis is NOT intentionally produced or feigned

What is the biggest risk factor for premature labor? Tobacco Alcohol Benzodiazepines Opiates

Tobacco

Depression is a more common cause of a patient presenting with somatic symptoms than somatic symptom disorder True False

True

Drugs that are the most addictive have Low potency and cross the blood brain barrier (BBB) quickly? True False

True

Sensitization is where nociceptors have increasing sensitivity with repeated exposure. True False

True

When I enter the room of an aggressive patient I should try to stand closer to the door than my patient. True False

True

Which group has the HIGHEST rate of suicide? White men over 85 Young people 20-24 years of age Adolescents

White men over 85

Which movement disorder (sometimes a side effect of antipsychotic medication) causes a tremor, cogwheel rigidity? parkinsonism dystonia akathisia tardive dyskinesi

parkinsonism

In 2022 the CDC recommended what change in standardized developmental surveillance of childhood milestones?

using the 75th percentile for developmental surveillance