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Psychiatry PA EOR Exam Questions and Correct Answer
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ELSCORES: Tuesday, 20 August 2024Psychiatry PA EOR Exam Questions
and Correct Answer
MDD Criteria
✓ :- Must have at least five of the following symptoms (must include either number I
or number 2) for at least a 2-week period:
✓ 1. Depressed mood
✓ 2. Anhedonia (loss of interest in pleasurable activities)
✓ 3. Change in appetite or body weight (f or J,)
✓ 4. Feelings of worthlessness or excessive guilt
✓ 5. Insomnia or hypersomnia
✓ 6. Diminished concentration
✓ 7. Psychomotor agitation or retardation (ie, restlessness or slowness)
✓ 8. Fatigue or loss of energy
✓ 9. Recurrent thoughts of death or suicide
Manic episode criteria
✓ :- A period of abnormally and persistently elevated, expansive, or irritable mood,
lasting at least 1 week (or any duration if hospitalization is necessary) and including
at least three of the following (four if mood is irritable):
✓ I. Distractibility
✓ 2. Inflated self-esteem or grandiosity
✓ 3. tin goal-directed activity (socially, at work, or sexually)
✓ 4. J, need for sleep
✓ 5. Flight of ideas or racing thoughts
✓ 6. More talkative or pressured speech (rapid and uninterruptible)
✓ 7. Excessive involvement in pleasurable activities that have a high risk of negative
consequences (eg, shopping sprees, sexual indiscretions)
These symptoms cannot be due to substance use or medical conditions, and they must cause
social or occupational impairment. Seventy-five percent of manic patients have psychotic
symptoms.
Mania vs hypomania
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✓ :- Mania: Lasts at least 7 days, Causes severe impairment in social or occupational
functioning, May necessitate hospitalization to prevent harm to self or others, May
have psychotic feature
✓ Hypomania: Lasts at least 4 days, No marked impairment in social or occupational
functioning, Does not require hospitalization, No psychotic features
Bipolar 1 disorder criteria
✓ :- The only requirement for this diagnosis is the occurrence of one manic or mixed
episode - depression, dysthymia, and hypomania can happen between episodes, but
are not required for diagnosis
Bipolar 1 and 2 treatment
✓ :- Lithium
Anticonvulsants (carbamazepine or valproic acid) are also mood stabilizers. They are
especially useful for rapid cycling bipolar disorder and mixed episodes, although associated
with T risk of suicide.
Atypical antipsychotics (olanzapine, quetiapine, ziprasidone) are effective as both
monotherapy and adjunct therapy
Psychotherapy: Supportive psychotherapy, family therapy, group therapy (prolongs remission
once the acute manic episode has been controlled). • ECT: Works well in treatment of manic
episodes
Lithium Side Effects
✓ :- Weight gain • Tremor • Gastrointestinal disturbances • Fatigue • Cardiac
arrhythmias • Seizures • Goiter/hypothyroidism • Leukocytosis (benign) • Como •
Polyuria (nephrogenic diabetes insipidus) • Polydipsia • Alopecia • Metallic taste
Bipolar 2 Criteria
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✓ :- History of one or more major depressive episodes and at least one hypomanic
episode. Remember: If there has been a full manic episode even in the past, then the
diagnosis is not bipolar II disorder, but bipolar I.
Cyclothymic disorder
✓ :- Alternating periods of hypomania and periods with mild to moderate depressive
symptoms.
Chronic disorder - 1/3 of patients are eventually diagnosed with bipolar disorder
Cyclothymic disorder criteria
✓ :- • Numerous periods with hypomanic symptoms and periods with depressive
symptoms for at least 2 years.
• The person must never have been symptom free for > 2 months during those 2 years.
• No history of major depressive episode or manic episode.
Cyclothymic disorder treatment
✓ :- Same as bipolar disorder
Persistent depressive disorder (dysthymia)
✓ :- Chronic mild depression
Dysthymic disorder (DD) =
2 D's
2 years of depression
2 listed criteria
Never asymptomatic for > 2 months
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Dysthymia Criteria
✓ :- l. Depressed mood for the majority of time most days for at least 2 years (in
children or adolescents for at least I year)
2. At least two of the following: • Poor concentration or difficulty making decisions •
Feelings of hopelessness • Poor appetite or overeating • Insomnia or hypersomnia • Low
energy or fatigue • Low self-esteem
3. During the 2-year period: • The person has not been without the above symptoms for > 2
months at a time. • No major depressive episode. • The patient must never have had a manic
or hypomanic episode (this would make the diagnosis bipolar disorder or cyclothymic
disorder, respectively)
Cannot have psychotic features
Dysthymia treatment
✓ :- Cognitive therapy and insight-oriented psychotherapy are most effective.
Antidepressant medications (SSRis, TCAs, or MAOis) are useful when used concurrently
with psychotherapy
Exhibitionistic disorder
✓ :- Exposure of one's genitalia to an unsuspecting individual, with the additional
requirement that the person has acted on these sexual urges with a nonconsenting
person or the sexual urges or fantasies have resulted in clinically significant distress
or functional impairment
Exhibitionistic disorder criteria
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