MH709 Final Exam Guide With
Complete Solution
Why don't providers usually diagnose personality disorders in patients under
the age of 18? - ANSWER Appreciating development and the necessary
developmental phases and struggles in "becoming self".
Cluster A - ANSWER Odd or eccentric- Paranoid, Schizoid and Schizotypal
Cluster B - ANSWER Dramatic and erratic- Histrionic, Narcissistic, Borderline,
Antisocial
Cluster C - ANSWER Fearful and Anxious- Obsessive Compulsive PD,
Aviodant, Dependent
How would describe the general diagnostic differences between Schizoid and
Schizotypal Personality Disorder? - ANSWER People with Schizoid PD prefer
to work alone and do not desire the company of others. Those with
Schizotypal PD might talk about strange, magical or mystical phenomenon
and might appear suspicious of others. In Schizotypal PD, care must be taken
to not pathologize cultural norms (ie talking to the dead or communicating
with natural spirits)
How would describe the key differences between Avoidant Personality
disorder and Social Phobia? - ANSWER In Avoidant PD, the concern is about
criticism and rejection from others. In social phobia, concerns are more
specific about doing something that the person thinks is embarrassing out of
the proportion than what others think (i.e. Someone will never eat at parties
because they are so worried about getting something stuck in their teeth).
,How might cultural aspects impact of making or not making the diagnosis of
Dependent Personality Disorder? - ANSWER The cultural roles in decision
making and information sharing could be misinterpreted as a Dependent
Personality Disorder.
Describe 3 key aspects of interacting with a patient in an outpatient setting
who demonstrates manipulative behavior? - ANSWER a. Establishing specific
parameters about frequency of non-appointment communication
b. Define and enforce professional boundaries
c. Clear and detailed communication in the EHR for covering/call staff
How are OCD and OCP the same? How are they different? - ANSWER Other
than the names, OCD and OCP share obsessional thinking but themes are
different:
OCPD- Rigid, unyielding, obsessed with perfection, process, demands others
follow their strict and rigid guidelines
OCD- Defined Obsessions and compulsions that are internalized, more
significant anxiety, if rigidity is present, it is more internalized than projected
on others.
Review the different psychotic disorders, what are some key differential
diagnoses? Why? - ANSWER Delusional Disorder, Brief Psychotic Disorder,
Schizophreniform Disorder, Schizoaffective Disorder, Substance/Medication
Induced Psychotic Disorder, Psychotic Disorder
Possible differentials: Bipolar Disorder- The disorganization of thought in
mania can resemble psychosis, Major Depression, Substance Use Disorder-
Possible detox, Obsessive-
, Compulsive Disorder- Extreme obsessions can present like psychosis
What are some non-pharmacologic interventions for psychotic disorders? -
ANSWER Social skills training, CBT, art therapy
What are important lab values to monitor for people taking SGAs? - ANSWER
Blood glucose, triglycerides, lipid panel, CBC
Review the dopamine pathways and how they relate to symptoms. - ANSWER
Mesocortical pathway- projects to dorsolateral prefrontal cortex- Negative
symptoms, cognitive symptoms
Mesolimbic- Positive symptoms
Nigrostriatal- regulates movements (is thought to be "normal" in
schizophrenia but during treatment with dopamine medications, can result in
DA excess can result in movements
Tuberoinfundibular Pathway- Projects from hypothalamus to anterior
pituitary. Thought to be normal in schizophrenia but when stimulated with
treatment of DA medications and can cause hyperprolactinemia.
What is an AIMS scale and who should be assessed with an AIMS? - ANSWER
The Abnormal Involuntary Movement Scale should be performed before
beginning treatment with first and second generation antipsychotics and
performed every 3 months during treatment.
Explain the similarities and differences between Bipolar I and Bipolar II as you
would if talking with a client or family. - ANSWER The key difference is with
the history of depression. People who have Bipolar I will have symptoms of
mania but not necessarily a major depression and those with Bipolar II will
have a history of Major Depression but not necessarily a manic episode. Both
Complete Solution
Why don't providers usually diagnose personality disorders in patients under
the age of 18? - ANSWER Appreciating development and the necessary
developmental phases and struggles in "becoming self".
Cluster A - ANSWER Odd or eccentric- Paranoid, Schizoid and Schizotypal
Cluster B - ANSWER Dramatic and erratic- Histrionic, Narcissistic, Borderline,
Antisocial
Cluster C - ANSWER Fearful and Anxious- Obsessive Compulsive PD,
Aviodant, Dependent
How would describe the general diagnostic differences between Schizoid and
Schizotypal Personality Disorder? - ANSWER People with Schizoid PD prefer
to work alone and do not desire the company of others. Those with
Schizotypal PD might talk about strange, magical or mystical phenomenon
and might appear suspicious of others. In Schizotypal PD, care must be taken
to not pathologize cultural norms (ie talking to the dead or communicating
with natural spirits)
How would describe the key differences between Avoidant Personality
disorder and Social Phobia? - ANSWER In Avoidant PD, the concern is about
criticism and rejection from others. In social phobia, concerns are more
specific about doing something that the person thinks is embarrassing out of
the proportion than what others think (i.e. Someone will never eat at parties
because they are so worried about getting something stuck in their teeth).
,How might cultural aspects impact of making or not making the diagnosis of
Dependent Personality Disorder? - ANSWER The cultural roles in decision
making and information sharing could be misinterpreted as a Dependent
Personality Disorder.
Describe 3 key aspects of interacting with a patient in an outpatient setting
who demonstrates manipulative behavior? - ANSWER a. Establishing specific
parameters about frequency of non-appointment communication
b. Define and enforce professional boundaries
c. Clear and detailed communication in the EHR for covering/call staff
How are OCD and OCP the same? How are they different? - ANSWER Other
than the names, OCD and OCP share obsessional thinking but themes are
different:
OCPD- Rigid, unyielding, obsessed with perfection, process, demands others
follow their strict and rigid guidelines
OCD- Defined Obsessions and compulsions that are internalized, more
significant anxiety, if rigidity is present, it is more internalized than projected
on others.
Review the different psychotic disorders, what are some key differential
diagnoses? Why? - ANSWER Delusional Disorder, Brief Psychotic Disorder,
Schizophreniform Disorder, Schizoaffective Disorder, Substance/Medication
Induced Psychotic Disorder, Psychotic Disorder
Possible differentials: Bipolar Disorder- The disorganization of thought in
mania can resemble psychosis, Major Depression, Substance Use Disorder-
Possible detox, Obsessive-
, Compulsive Disorder- Extreme obsessions can present like psychosis
What are some non-pharmacologic interventions for psychotic disorders? -
ANSWER Social skills training, CBT, art therapy
What are important lab values to monitor for people taking SGAs? - ANSWER
Blood glucose, triglycerides, lipid panel, CBC
Review the dopamine pathways and how they relate to symptoms. - ANSWER
Mesocortical pathway- projects to dorsolateral prefrontal cortex- Negative
symptoms, cognitive symptoms
Mesolimbic- Positive symptoms
Nigrostriatal- regulates movements (is thought to be "normal" in
schizophrenia but during treatment with dopamine medications, can result in
DA excess can result in movements
Tuberoinfundibular Pathway- Projects from hypothalamus to anterior
pituitary. Thought to be normal in schizophrenia but when stimulated with
treatment of DA medications and can cause hyperprolactinemia.
What is an AIMS scale and who should be assessed with an AIMS? - ANSWER
The Abnormal Involuntary Movement Scale should be performed before
beginning treatment with first and second generation antipsychotics and
performed every 3 months during treatment.
Explain the similarities and differences between Bipolar I and Bipolar II as you
would if talking with a client or family. - ANSWER The key difference is with
the history of depression. People who have Bipolar I will have symptoms of
mania but not necessarily a major depression and those with Bipolar II will
have a history of Major Depression but not necessarily a manic episode. Both
