Psychiatry/Behavior Blueprint

1. Psychiatry/Behavior Blueprint Questions, Answers, and Explanations

2. Question 1 1. Your patient is a 85 year old male that presents with depression with suicide ideation. He has attempted suicide in the past by overdose but was not successful. He has never married. He is a retired factory worker and lives in apartment by himself. Which of the following is the most accurate statement regarding the above patient. A. Females are much more likely to successful at suicide than males. B. There is a less likelihood of suicide in an older patient. C. Patients that have never married have an increased risk of suicide. D. Unskilled laborers have a lower risk of suicide.

3. Answer 1 1. Choice C is the correct answer. Patients that have never married have an increased risk of suicide. Females attempt suicide more often but males are much likely to succeed. Unskilled laborers have a higher risk of suicide. There are many young people that attempt suicide, but as a rule of thumb suicide risk increases with age.

4. Question 2 2. Your patient is a 24 year old male that presents with excessive worrying for 6 months. This is accompanied by sleep disturbance and irritability. There is no specific focus that seems to exacerbate his symptoms. The patient states he has difficulty concentrating. Which of the following is the most likely diagnosis? • Phobia • Panic Disorder • Generalized anxiety disorder • Post Traumatic Stress Disorder

5. Answer 2 2. Choice C is the correct answer. Patients with generalized anxiety disorder present with excessive worrying on most days for at least 6 months. The patient finds it difficulty to control their worrying. The patient may have sleep disturbance or difficulty concentrating.

6. Question 3 3. Which of the following are considered first line in treating Generalized Anxiety Disorder (GAD). • Paxil • Elavil • Depakote • Ativan

7. Answer 3 3. Choice A is the correct answer. First-line treatment for generalized anxiety disorder include SSRIs and SNRIs. Anticonvulsants, benzodiazepines, and tricyclic antidepressants are considered second line medications or adjunctive medications.

8. Question 4 4. Your patient is a 18 year old female presents with low body weight, in an intense fear of gaining weight. She also feels that she's overweight. Which of the following is the most likely diagnosis? • Anorexia nervosa • Bulimia Nervosa • Hypothyroidism • Methamphetamine Abuse

9. Answer 4 4. Choice A is the correct answer. Patients with anorexia nervosa present with the restriction of energy intake and leads to low body weight. These patients have an intense fear of becoming overweight. They also have a distorted perception of their body. Patients with bulimia have episodes of binge eating and use compensatory mechanisms to prevent weight gain such as vomiting and/or laxative abuse. Patient hypothyroidism typically do not lose weight and gain weight.

10. Question 5 5. Your patient is a 45-year-old male that presents with episodes of depression and episodes of hypomania. He's also been suffering with sleep disturbance difficulty concentrating. There has been no episodes of true mania. He has no active homicidal or suicidal ideation. Which of the following is the most likely diagnosis? • Bipolar I Disorder • Bipolar II Disorder • Adjustment Disorder • Dysthymia

11. Answer 5 5. Choice B is the correct answer. Bipolar II disorder is defined as at least one hypomanic episode, and at least one depressive episode without mania. Bipolar I disorder has manic episode and nearly always experienced major depressive episode and hypomanic episodes.

12. Question 6 6. Your patient is a 45-year-old male he presents with fantasies of unlimited success and power. This patient lacks empathy in shows arrogant haughty behavior. He has a sense of entitlement and favorable treatment. Which of the following is most likely diagnosis? • Borderline Personality Disorder • Narcissistic Personality Disorder C. Antisocial Personality Disorder D. Conduct Disorder

13. Answer 6 6. Choice B is the correct answer. Patients with narcissistic personality disorder have grandiose and self importance. Are preoccupied with fantasies of unlimited power and success. The patients lack empathy. Antisocial personality disorder and conduct disorder feel that the rules of society do not apply to them. Patient with borderline personality disorder are often histrionic and have impaired relationships, and are impulsive.

14. Question 7 7. Your patient is a 25 year old male that was brought in by his parents because he believes he is the next prophet. He is reciting from the bible and is not making sense. This has been persistent for about two months. He has had no history of mental disorder or medical problems. His medical workup is normal. Which of the following is the most likely diagnosis? • Delirium • Schizophrenia • Delusional Disorder • Schizoaffective Disorder.

15. Answer 7 7. Choice C is the correct answer. Delusional disorder it Is characterized by one or more delusions for at least a month. There's also exclusion criteria for meeting any criteria for schizophrenia. Schizophrenic patients typically have a disturbance for at least six months in the absence of any medical condition. Delirium is a false belief unusual thought secondary to a medical condition.

16. Question 8 8. All of the following are considered negative symptoms of schizophrenia except: • Cognitive Impairment • Anxiety • Hallucinations • Flat Affect

17. Answer 8 8. Choice C is the correct answer. Positive symptoms of schizophrenia include distortion of symptoms, hallucination, and delusions. Negative symptoms of schizophrenia include the decrease expressiveness, apathy, flat affect, cognitive impairment, mood symptoms, and anxiety.

18. Question 9 9. Your patient is a 31 year old male with schizophrenia that has been exhibiting hallucinations and delusions. Which of the following is the most effective medication for controlling these type of symptoms in schizophrenic patients? • Benzodiazepines • Anticonvulsants • SSRI’s • Antipsychotics

19. Answer 9 9. Choice D is the correct answer. Antipsychotic medications are considered first-line treatment of schizophrenic patients positive symptoms. Patient shall be observed for at least 2-6 weeks before concluding these medications are ineffective. These medications should be continue indefinitely.

20. Question 10 10. Your patient is a 45-year-old female he Presents with headaches that tended to severe. She seemed multiple specialist and had MRIs of her head in spinal taps that have been negative. The does not seem to be a reasonable medical etiology of her symptoms. She tends to be dramatic and demanding when she gets these headaches. Her urine drug screen and alcohol screen is negative. She is also going through a divorce. Which of the following is the most logical diagnosis? • Brain Tumor • Meningitis • Somatoform Disorder • Hypochondriasis

21. Answer 10 10. Choice C is the correct answer. Somatoform disorder is characterized by physical symptoms that are distressing not explained by a medical condition after a thorough workup. Brain tumor and meningitis are not likely because of the negative MRI negative spinal tap.