Quiz 3 PPT Questions

In addition to memory impairment, each of the following may provide evidence of dementia EXCEPT A. Aphasia B. Apraxia C. Agnostic D. Executive dysfunction E. Anhedonia

E. Anhedonia

All of the following are TRUE about HIV infection EXCEPT A. Dementia is often a late manifestation of HIV infection because the retrovirus does not infect the CNS until late in the course B. When HIV does infect the CNS, subcortical structures are more damaged than cortical areas C. Care for many patients with HIV/AIDS may be hampered by clinicians' discomfort with the lifestyles they do not share or understand D. Viruses similar to HIV also cause progressive immunologic and neurological decline E. Both CD4 count and presence of complication determine a diagnosis of AIDS

A. Dementia is often a late manifestation of HIV infection because the retrovirus does not infect the CNS until late in the course

Each of the following blood tests is recommended when screening for dementia EXCEPT A. ESR B. Vitamins B12 level C. CBC D. Thyroid function E. syphilis serology

A. ESR

Characteristic features of dementia with Lewy bodies include each of the following EXCEPT A. Incontinence B. Well-formed visual hallucinations C. Parkinsonism D. Fluctuating cognitive impairment E. memory impairment

A. Incontinence

From the time she was a child, a 24-year-old woman has always had a problem with her peers. She has never had a friend in whom she felt she could confide because she suspects the motives of everyone. When any remark is made as a joke, she takes it personally and has a tendency to carry a grudge. She feels that she is the constant butt of attacks on her reputation and this has caused a great deal of difficulty in any on-going relationship she has had with a man. She is always questioning their fidelity without grounds to do so. It has resulted in most of the relationships breaking up rather quickly, and she feels she's been cheated by life. There is no history of psychotic illness, no mood disorder, no familial history of psychosis, or serious medical illness. She is in good physical health for her age. What is this woman's diagnosis? A. Paranoid Personality Disorder B. Dependent Personality Disorder C. Borderline Personality Disorder D. Brief Reactive Psychosis E. Narcissistic Personality Disorder

A. Paranoid Personality Disorder

Risk factors for child abuse include all of the following EXCEPT A. Poverty B. Low birth weight C. Being a handicapped child D. Having a behavioral disorder E. Having a parent who was abused

A. Poverty

A 28-year-old woman begs to make the voices in her head stop arguing. She is very soft-spoken, polite, and well-groomed. She explains that she often becomes confused and finds herself in unfamiliar places. She believes that 1 of the voices might be trying to kill her. She has a history of alcohol abuse, but no drug abuse. She has an extensive medical history of unexplained injuries, stomach problems, and unusual bruising beginning in early childhood. The woman denies being physically or sexually abused as a child, but states that she has weird nightmares about a strange dark figure standing over the bed of a small child; she does not recognize the child or the man. The following week the patient's behavior is very different; she is speaking loudly, acts as if she never has seen you before, refuses to answer most questions, and is very uncooperative. According to the post-traumatic model, what is the most likely etiologic cause for this client's symptoms? A. Severe child abuse B. Genetics C. Witnessing a traumatic event D. The therapist planting dissociative suggestions E. High score on hypnotizability scales

A. Severe child abuse

Individuals with Down's syndrome have a high incidence which of the following? A. Multi-infarct dementia B. Alzheimer's dementia C. Dementia pugilistica D. NPH E. All of the above

B. Alzheimer's dementia

An 18-year old high school dropout recently set a fire in his old school classroom because he was dared to do so by other students. He has been sent to you for evaluation. You interview him and find that he had a number of problems related to truancy and fighting in school; he has been found with liquor in his locker at school, and he always seems to feel that someone else is responsible for his having done something. When he was 10, the patient burned down a barn; last year, he and some friends threw rocks at passing cars on the expressway. What is the provisional diagnosis? A. Conduct disorder B. Antisocial personality disorder C. Impulse control disorder D. Oppositional defiant disorder E. Substance abuse NOS

B. Antisocial personality disorder

A 26-year-old woman presents asking for a new employment physical. She is a new patient to your office, having recently moved to the area. On taking her social history, she reveals that she is quite sad because she feels isolated and lonely. You ask whether she has attended any local places of worship or tried any other things to foster new relationships, but she has not, saying that she is afraid no one will like her. She admits that she has always been shy and never had many friends, which has been painful for her. In addition, she is afraid to begin her new job because she fears that she will perform poorly and is afraid that others will reject her.What type of personality disorder does this patient have? A. Schizoid B. Avoidant C. Borderline D. Antisocial E. Paranoid

B. Avoidant

Mrs. A is a 70 y/o female admitted to the surgical service after she fell and fractured her right hip. Three days after surgery, she is confused, disoriented, and inattentive. All of the following are appropriate functions of the medical team in this case EXCEPT A. Diagnosis of post-operative delirium and recommendation of appropriate work-up and pharmacotherapy B. Criticize the surgical team for failure to recognize and treat the delirium earlier C. Education of the surgical staff about the delirium and its possible etiologies D. Suggestion it the nursing staff that they provide orienting cues for Mrs. A E. Availability should the patient become acutely agitated

B. Criticize the surgical team for failure to recognize and treat the delirium earlier

In distinguishing delirium from dementia, each of the following characteristics of delirium may be useful EXCEPT A. An acute or subacute onset B. Hallucinations C. A fluctuating course D. Impaired attention E. an impaired level of consciousness

B. Hallucinations

A 40-year-old man is referred by his primary physician for an evaluation of possible mental health problems. He was seen by the physician a month ago and presented with some bizarre behavior, such as recurring thoughts that his wife is having an affair. He is preoccupied with the idea that his friends are following him. His wife claims that he never confides in others and carries a grudge regarding his peers. He has no medical condition that would explain his behavior, and he does not use alcohol or drugs. His wife describes his behavior as longstanding; she has noticed it ever since they were married 5 years ago What personality disorder is present in this case? A. Schizoid personality disorder B. Paranoid personality disorder C. Schizotypal personality disorder D. Antisocial personality disorder E. Borderline personality disorder

B. Paranoid personality disorder

A 48-year-old woman has a history of poor interpersonal relationships, chronic headaches, and previous suicide attempts. She has an extremely demanding attitude and often directs her anger towards others. What personality disorder is the most likely diagnosis? A. Narcissistic B. Avoidant C. Borderline D. Histrionic E. Antisocial

C. Borderline

A 26-year-old woman is having marital difficulties with her husband; she is a flight attendant, and he is a pilot for another airline. The woman dropped out of college during her senior year, occasionally smokes marijuana, and has had breast implants. Frequently, she and her husband get into violent fights over little things at home, primarily his not being attentive enough to her. At these times, she engages in self-mutilating activities. The next morning, she awakens in an amorous mood and wants to make love, feeling that he is the most wonderful man on this earth. More than once, she has made a suicidal gesture when she thought her husband would leave her. She constantly fears that her husband is going to abandon her someday. When stressed, she becomes paranoid and has a feeling of being able to step outside her body and watch herself. She also has a terrible sense of emptiness and a tendency for binge eating. She is very impulsive and often goes off on shopping sprees.What is the most likely diagnosis? A. Histrionic Personality Disorder B. Dependent Personality Disorder C. Borderline Personality Disorder D. Avoidant Personality Disorder E. Narcissistic Personality Disorder

C. Borderline Personality Disorder

A 40-year-old woman who has been referred by a psychiatrist presents for a general medical evaluation. While lying down on the examination table, she states that she is feeling light-headed. She is wearing a low-cut blouse and spandex pants. She notes that she has had a difficult year and was very depressed after her lover left her without warning; she begins crying and states that she has autoimmune problems from breast implants she received to please her lover. When asked if the referring psychiatrist treated her for depression, she smiles and states that he saved her life and she does not know what she will do if he ever retires. The patient also presents with fatigue, recurrent ear infections with bleeding, irritable bowel, and fibromyalgia. She has a diagnosis of recurrent major depression, in remission. From what personality disorder does this patient also suffer? A. Narcissistic personality disorder B. Antisocial personality disorder C. Histrionic personality disorder D. Paranoid personality disorder E. Borderline personality disorder

C. Histrionic personality disorder

A woman in her early 50's is being seen at a behavioral health clinic. She has been encouraged by her family and her employer to attend. The primary reason is that "she has serious problems relating to other people." Most people describe her as especially solitary, indifferent, and emotionally cold. They feel that her quality of life suffers from this lack of social inclination, and that problems with loneliness may worsen as she gets older. She has always been single and has never had any friends to speak of, even as a child. What is the most likely provisional diagnosis from the DSM-IV based in this information? A. Schizophrenia B. Paranoid personality disorder C. Schizoid personality disorder D. Schizotypal personality disorder E. Antisocial personality disorder

C. Schizoid personality disorder

Activities of daily (ADL's) include each of the following EXCEPT A. Bathing B. Dressing C. Using the telephone D. Toileting E. Feeding

C. Using the telephone

Each of the following drugs is commonly associated with impaired cognitive function EXCEPT A. Antihypertensives B. Narcotics C. Benzodiazepines D. SSRIs E. Anticholinergics

D. SSRIs

A 20-year-old man is referred by his college for behaviors that they feel are about to cause him to be expelled from school. He has been in trouble with the law for theft, bringing a weapon to school and his mother reports that he hangs around with a gang of boys that have been stealing cars and damaging property belonging to others.What is the most likely diagnosis? A. Avoidant personality disorder B. Histrionic personality disorder C. Narcissistic personality disorder D. Antisocial personality disorder E. Borderline personality disorder

D. Antisocial personality disorder

The afternoon clinic is almost finished. A 22 year old white female comes in for her scheduled appointment. The chart says she is here for an URI. As she explains her symptoms, you notice 4 small round bruises in a row on her bicep. While vital signs are: T: 99.6 HR: 78 BP: 120/60 RR: 16 You proceed to ask her how she got the bruises. She states that she fell down the front steps at home. You ask gently, "Has your partner hit you?" She starts to cry and says "yes." She goes on to state that she has tried to leave before but he has always been so nice afterwards and felt so sorry. Listening to her lungs you notice a number of bruises around the kidneys. They range in color from dark blue to yellow. The rest of the exam is normal. What might you tell this patient? A. Ask if her partner is under stress B. Ask if her partner was drinking C. Discuss her symptoms of the URI D. Her partner will not give up control E. Tell her she needs to give him one more chance

D. Her partner will not give up control

Drugs which have been shown to have some benefit in Alzheimer's disease include each of these EXCEPT A. Tacrine B. Donepezil C. Vitamins E D. L-dopa E. Selegiline

D. L-dopa

A 40-year-old man comes to see you at the insistence of his wife. He states that there is nothing wrong with him, but if seeing a psychiatrist will satisfy his wife, then he is willing to do it. The client states that he is a very successful businessman, and tells you that his wife recommended he see a therapist. He states that, if he was going to receive counseling, then he wanted to see a psychiatrist because they have more education. The patient then states that his wife is frustrated because they have no friends and he is too picky about people. Upon further elaboration, the client says that he is not going to spend time with just anyone, and he adds that spending time with people less educated and less intelligent than himself is a waste of time. When asked about his job, the client states that it is okay, but he is under appreciated. He tells you that, without him, the company would never make any money; however, he feels that nobody ever recognizes how important he is to the company. What is the most likely diagnosis? A. Borderline personality disorder B. Histrionic personality disorder C. Antisocial personality disorder D. Narcissistic personality disorder E. Obsessive-compulsive personality disorder

D. Narcissistic personality disorder

A 25-year-old man rarely goes out, and his mother is pressuring him to get a girlfriend. He reveals that he has never felt comfortable around other people because he feels too much pressure to "perform". He fears rejection. What type of personality disorder does he exhibit? A. Obsessive-compulsive B. Narcissistic C. Borderline D. Dependent E. Avoidant

E. Avoidant

Infectious etiologies associated with dementia include each of the following EXCEPT A. Neurosyphilis B. HIV infection C. Creutzfeldt-Jakob disease D. Military tuberculosis E. Escherichia coli in the urinary tract

E. Escherichia coli in the urinary tract

A 3-month-old boy presents with a 12-hour history of lethargy. Physical exam reveals a child who cries and becomes irritable when examined. There is edema noted over the left side of the head. There is no papilledema, and his mother denies a history of the child vomiting. There is a single faint bruise on the upper lip. A CT of the head reveals a linear skull fracture of the left parietal bone; there is no evidence of intracranial injury. On further questioning, the mother states, "My baby rolled over the sofa onto a carpeted floor 2 days ago." What is the best management in this case? A. Give 80cc of 0.9% normal saline (i.e 20mL/Kg) B. Give intravenous mannitol to lower intracranial pressure C. Discharge the child after a 4 hour observation period if the infant is asymptomatic D. Discharge the child immediately with instructions about precautions following head injury E. Obtain a skeletal survey to rule out child abuse

E. Obtain a skeletal survey to rule out child abuse

REGARDING SPOUSAL ABUSE ALL OF THE FOLLOWING STATEMENTS ARE CORRECT EXCEPT A.THE ABUSING SPOUSE IS LIKELY TO HAVE BEEN ABUSED AS A CHILD B.THE ABUSED SPOUSE IS LIKELY TO HAVE BEEN ABUSED AS A CHILD C.SPOUSAL ABUSE IS OFTEN CARRIED OUT BY MEN WHO ARE DEPENDENT AND NON-ASSERTIVE D.ABUSED HUSBANDS HIDE THE PROBLEM FOR FEAR OF RIDUCULE E.PREGNANCY USUALLY RESULTS IN A REDUCTION OF ABUSE

E.PREGNANCY USUALLY RESULTS IN A REDUCTION OF ABUSE