Identify the following personality disorders with the symptoms listed below. Preoccupied with feelings of superstitiousness; has a sixth sense; seems odd
A. antisocial
B. avoidant
C. borderline
D. dependent
E. histrionic
F. narcissistic
G. obsessive-compulsive
H. paranoid
I. schizoid
J. schizotypal
Correct Answer: J
Persons with personality disorders are rigidly bound to the use of patterns of defense and various traits that distinguish the disorders. All have problems with interpersonal relationships
Question 212:
A7-year-old boy presents with his mother who reports he cannot pay attention and is having severe problems at school because of this and his hyperactivity. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.
A. buspirone
B. sertraline
C. risperidone
D. lithium carbonate
E. acamprosate
F. dextroamphetamine
Correct Answer: F
Lithium carbonate is an effective treatment for manic and depressive episodes due to bipolar I disorder, as well as for the prophylaxis of manic and depressive episodes in patients with bipolar I disorder. It can impede the release of thyroid hormone from the thyroid, and it can reduce the ability of the kidneys to concentrate urine; its use requires regular blood levels to ensure the avoidance of toxic blood levels that could cause tremor, dysarthria, ataxia, or death. Acamprosate (Campral) is gabanergic and decreases the craving for alcohol in patients with alcohol dependence. Sertraline (Zoloft) is a SSRI which is effective in the treatment of major depressive disorder, as well as in the treatment of panic disorder, obsessive-compulsive disorder, and PTSD. Risperidone is an atypical antipsychotic that is effective in the treatment of psychotic conditions, including schizophrenia, and is associated with fewer serious longterm side effects, such as tardive dyskinesia, than traditional neuroleptics. Risperidone is a potent blocker of both 5-HT2 serotonin receptors and D2 dopamine receptors. Buspirone, a nonaddictive azapirone, acts as an agonist or partial agonist of 5-HT1 serotonin receptors, and is effective in the treatment of generalized anxiety disorder. Dextroamphetamine is a stimulant and is an effective treatment for ADHD.
Question 213:
A 45-year-old woman reports a 6-month history of free-floating anxiety, which makes her feel tense most of the time on most days. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.
A. buspirone
B. sertraline
C. risperidone
D. lithium carbonate
E. acamprosate
F. dextroamphetamine
Correct Answer: A
Lithium carbonate is an effective treatment for manic and depressive episodes due to bipolar I disorder, as well as for the prophylaxis of manic and depressive episodes in patients with bipolar I disorder. It can impede the release of thyroid hormone from the thyroid, and it can reduce the ability of the kidneys to concentrate urine; its use requires regular blood levels to ensure the avoidance of toxic blood levels that could cause tremor, dysarthria, ataxia, or death. Acamprosate (Campral) is gabanergic and decreases the craving for alcohol in patients with alcohol dependence. Sertraline (Zoloft) is a SSRI which is effective in the treatment of major depressive disorder, as well as in the treatment of panic disorder, obsessive-compulsive disorder, and PTSD. Risperidone is an atypical antipsychotic that is effective in the treatment of psychotic conditions, including schizophrenia, and is associated with fewer serious longterm side effects, such as tardive dyskinesia, than traditional neuroleptics. Risperidone is a potent blocker of both 5-HT2 serotonin receptors and D2 dopamine receptors. Buspirone, a nonaddictive azapirone, acts as an agonist or partial agonist of 5-HT1 serotonin receptors, and is effective in the treatment of generalized anxiety disorder. Dextroamphetamine is a stimulant and is an effective treatment for ADHD.
Question 214:
A 41-year-old woman has a long history of chronic paranoid schizophrenia. She experiences auditory and visual hallucinations and has had difficulty maintaining a job. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.
A. buspirone
B. sertraline
C. risperidone
D. lithium carbonate
E. acamprosate
F. dextroamphetamine
Correct Answer: C
Lithium carbonate is an effective treatment for manic and depressive episodes due to bipolar I disorder, as well as for the prophylaxis of manic and depressive episodes in patients with bipolar I disorder. It can impede the release of thyroid hormone from the thyroid, and it can reduce the ability of the kidneys to concentrate urine; its use requires regular blood levels to ensure the avoidance of toxic blood levels that could cause tremor, dysarthria, ataxia, or death. Acamprosate (Campral) is gabanergic and decreases the craving for alcohol in patients with alcohol dependence. Sertraline (Zoloft) is a SSRI which is effective in the treatment of major depressive disorder, as well as in the treatment of panic disorder, obsessive-compulsive disorder, and PTSD. Risperidone is an atypical antipsychotic that is effective in the treatment of psychotic conditions, including schizophrenia, and is associated with fewer serious longterm side effects, such as tardive dyskinesia, than traditional neuroleptics. Risperidone is a potent blocker of both 5-HT2 serotonin receptors and D2 dopamine receptors. Buspirone, a nonaddictive azapirone, acts as an agonist or partial agonist of 5-HT1 serotonin receptors, and is effective in the treatment of generalized anxiety disorder. Dextroamphetamine is a stimulant and is an effective treatment for ADHD.
Question 215:
A21-year-old male college student reports a 1- month period of intensely depressed mood, with marked anxiety, sleep disturbance, and weight loss. He has never before experienced an episode of a mood disorder.
According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.
A. buspirone
B. sertraline
C. risperidone
D. lithium carbonate
E. acamprosate
F. dextroamphetamine
Correct Answer: B
Lithium carbonate is an effective treatment for manic and depressive episodes due to bipolar I disorder, as well as for the prophylaxis of manic and depressive episodes in patients with bipolar I disorder. It can impede the release of thyroid hormone from the thyroid, and it can reduce the ability of the kidneys to concentrate urine; its use requires regular blood levels to ensure the avoidance of toxic blood levels that could cause tremor, dysarthria, ataxia, or death. Acamprosate (Campral) is gabanergic and decreases the craving for alcohol in patients with alcohol dependence. Sertraline (Zoloft) is a SSRI which is effective in the treatment of major depressive disorder, as well as in the treatment of panic disorder, obsessive-compulsive disorder, and PTSD. Risperidone is an atypical antipsychotic that is effective in the treatment of psychotic conditions, including schizophrenia, and is associated with fewer serious longterm side effects, such as tardive dyskinesia, than traditional neuroleptics. Risperidone is a potent blocker of both 5-HT2 serotonin receptors and D2 dopamine receptors. Buspirone, a nonaddictive azapirone, acts as an agonist or partial agonist of 5-HT1 serotonin receptors, and is effective in the treatment of generalized anxiety disorder. Dextroamphetamine is a stimulant and is an effective treatment for ADHD.
Question 216:
A23-year-old university student has lost interest in his master's degree program. His two friends who bring him to the psychiatrist say he has been isolating himself in his room and has covered all electrical appliances and outlets with duct tape claiming that "electromagnetic waves are disturbing the microchip in my brain." He acknowledges that he once took a medication for the same problem with the "microchip," but then he became unbearably restless, could not sit still, and felt that he was "crawling" inside. According to the patient's psychiatric symptoms, select the most appropriate medication. Presume no medical problems other than those mentioned.
A. amitriptyline
B. clozapine
C. divalproex
D. fluoxetine
E. hypericum perforatum
F. olanzapine
G. lorazepam
H. propranolol
I. temazepam
J. thiothixene
Correct Answer: F
This man's symptoms are psychotic in nature and somewhat bizarre. In addition, the information strongly suggests that he is very sensitive to the extrapyramidal effects of the traditional antipsychotics. Olanzapine, an atypical antipsychotic with very few extrapyramidal effects, would be a good choice here.
Question 217:
A40-year-old man has a history of severe alcohol dependence and is very interested in whatever help he can get to avoid relapsing in his alcohol use. According to the clinical vignette, select the pharmacotherapeutic agent which is most likely to be helpful to the patient.
A. buspirone
B. sertraline
C. risperidone
D. lithium carbonate
E. acamprosate
F. dextroamphetamine
Correct Answer: E
Lithium carbonate is an effective treatment for manic and depressive episodes due to bipolar I disorder, as well as for the prophylaxis of manic and depressive episodes in patients with bipolar I disorder. It can impede the release of thyroid hormone from the thyroid, and it can reduce the ability of the kidneys to concentrate urine; its use requires regular blood levels to ensure the avoidance of toxic blood levels that could cause tremor, dysarthria, ataxia, or death. Acamprosate (Campral) is gabanergic and decreases the craving for alcohol in patients with alcohol dependence. Sertraline (Zoloft) is a SSRI which is effective in the treatment of major depressive disorder, as well as in the treatment of panic disorder, obsessive-compulsive disorder, and PTSD. Risperidone is an atypical antipsychotic that is effective in the treatment of psychotic conditions, including schizophrenia, and is associated with fewer serious longterm side effects, such as tardive dyskinesia, than traditional neuroleptics. Risperidone is a potent blocker of both 5-HT2 serotonin receptors and D2 dopamine receptors. Buspirone, a nonaddictive azapirone, acts as an agonist or partial agonist of 5-HT1 serotonin receptors, and is effective in the treatment of generalized anxiety disorder. Dextroamphetamine is a stimulant and is an effective treatment for ADHD.
Question 218:
A 53-year-old man reports that he is currently in one of his "up" periods. He states that he feels very good, and he is quite talkative, but he reports that he is having no trouble keeping his job, and he is sleeping well. He has never had any periods of elevated mood that have substantially interfered with his working, and he has never needed hospitalization for his "up" periods. However, he has suffered two periods of severe depression, each requiring hospitalization for suicidal thoughts, the most recent having occurred 3 years ago. Identify the diagnosis below that best describes the situation.
A. major depressive disorder, recurrent
B. bipolar I disorder
C. bipolar II disorder
D. cyclothymia
E. dysthymic disorder
F. mood disorder due to a general medical condition
G. substance-induced mood disorder
Correct Answer: C
The criteria for mood disorders depend on the presence or absence and duration of depressive and hypomanic or manic symptoms as well as on their severity, and also on the presence or absence of a causative general medical condition or the ingestion of substances. Major depressive disorder, recurrent, is marked by the lifetime occurrence of two or more major depressive episodes without intervening hypomanic or manic episodes. A major depressive episode is a severe depression which has lasted at least 2 weeks. Bipolar I disorder is characterized by a history of at least one full-blown manic episode, during which the patient's mood has been abnormally and persistently elevated, expansive or irritable for at least 1 week with marked impairment in occupational functioning. Bipolar II disorder, on the other hand, is marked by a history of at least one major depressive episode and at least one hypomanic episode, during which a patient's mood has been elevated, but not to the extent of causing marked impairment in social or occupational functioning. Apatient with bipolar II disorder may not, by definition, have had a full-blown manic episode.
Cyclothymia is marked by periods of hypomanic symptoms alternating with depressive symptoms that do not meet the criteria for a major depressive episode. Dysthymic disorder is marked by a persistent, low-grade depression occurring more days than not for at least 2 years. Amood disorder due to a general medical condition is a prominent and persistent disturbance in mood that is judged to be the direct physiologic effect of a general medical condition, such as hyperthyroidism. A substance-induced mood disorder is a prominent and persistent disturbance in mood that is judged to be due to the direct effects of a substance, but which continues beyond the usual period of intoxication or withdrawal from a substance.
Question 219:
A32-year-old woman reports that she has been in a low-grade, chronically depressed mood for more days than not for the past 3 years. She reports that she has never had a period of severely depressed mood, but the low-grade feeling of sadness has not gone away for more than 2 or 3 days at a time over the past 3 years. Identify the diagnosis below that best describes the situation.
A. major depressive disorder, recurrent
B. bipolar I disorder
C. bipolar II disorder
D. cyclothymia
E. dysthymic disorder
F. mood disorder due to a general medical condition
G. substance-induced mood disorder
Correct Answer: E
The criteria for mood disorders depend on the presence or absence and duration of depressive and hypomanic or manic symptoms as well as on their severity, and also on the presence or absence of a causative general medical condition or the ingestion of substances. Major depressive disorder, recurrent, is marked by the lifetime occurrence of two or more major depressive episodes without intervening hypomanic or manic episodes. A major depressive episode is a severe depression which has lasted at least 2 weeks. Bipolar I disorder is characterized by a history of at least one full-blown manic episode, during which the patient's mood has been abnormally and persistently elevated, expansive or irritable for at least 1 week with marked impairment in occupational functioning. Bipolar II disorder, on the other hand, is marked by a history of at least one major depressive episode and at least one hypomanic episode, during which a patient's mood has been elevated, but not to the extent of causing marked impairment in social or occupational functioning. Apatient with bipolar II disorder may not, by definition, have had a full-blown manic episode.
Cyclothymia is marked by periods of hypomanic symptoms alternating with depressive symptoms that do not meet the criteria for a major depressive episode. Dysthymic disorder is marked by a persistent, low-grade depression occurring more days than not for at least 2 years. Amood disorder due to a general medical condition is a prominent and persistent disturbance in mood that is judged to be the direct physiologic effect of a general medical condition, such as hyperthyroidism. A substance-induced mood disorder is a prominent and persistent disturbance in mood that is judged to be due to the direct effects of a substance, but which continues beyond the usual period of intoxication or withdrawal from a substance.
Question 220:
A24-year-old cocaine addict with no previous psychiatric history, reports that he had been bingeing on cocaine for 2 months earlier in the year. He stopped using cocaine 2 months ago, and he has been very sad and tearful for the entire period since he stopped his cocaine use. Identify the diagnosis below that best describes the situation.
A. major depressive disorder, recurrent
B. bipolar I disorder
C. bipolar II disorder
D. cyclothymia
E. dysthymic disorder
F. mood disorder due to a general medical condition
G. substance-induced mood disorder
Correct Answer: G
The criteria for mood disorders depend on the presence or absence and duration of depressive and hypomanic or manic symptoms as well as on their severity, and also on the presence or absence of a causative general medical condition or the ingestion of substances. Major depressive disorder, recurrent, is marked by the lifetime occurrence of two or more major depressive episodes without intervening hypomanic or manic episodes. A major depressive episode is a severe depression which has lasted at least 2 weeks. Bipolar I disorder is characterized by a history of at least one full-blown manic episode, during which the patient's mood has been abnormally and persistently elevated, expansive or irritable for at least 1 week with marked impairment in occupational functioning. Bipolar II disorder, on the other hand, is marked by a history of at least one major depressive episode and at least one hypomanic episode, during which a patient's mood has been elevated, but not to the extent of causing marked impairment in social or occupational functioning. Apatient with bipolar II disorder may not, by definition, have had a full-blown manic episode.
Cyclothymia is marked by periods of hypomanic symptoms alternating with depressive symptoms that do not meet the criteria for a major depressive episode. Dysthymic disorder is marked by a persistent, low-grade depression occurring more days than not for at least 2 years. Amood disorder due to a general medical condition is a prominent and persistent disturbance in mood that is judged to be the direct physiologic effect of a general medical condition, such as hyperthyroidism. A substance-induced mood disorder is a prominent and persistent disturbance in mood that is judged to be due to the direct effects of a substance, but which continues beyond the usual period of intoxication or withdrawal from a substance.
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