PAEA Behavioral Health Questions and
Answers| Latest Update
What are the diagnostic criteria for dysthymia Depressed mood and at least 2 CHASES sx
for 2 years (and patient must not be without sx for >2 months during that time)
What are the diagnostic criteria for cyclothymia Numerous periods with hypomanic sx
(but not meeting hypomanic episode criteria) and depressive sx (but not meeting depressive
episode criteria) for at least 2 years, no period symptom free for more than 2 months
What is a commonly shared feature of bipolar disorder and ADHD in pediatric patients?
Behavioral problems
A patient presented to your office with multiple somatic complaints. During the mental status
exam, you notice that the patient loses the thread of conversation and discusses irrelevant topics
based on an external stimulus. The patient never gets back to the main point he or she was trying
to express. What is this thought process called? Tangentiality
A 15-year-old boy presents with a diagnosis within the autism spectrum disorder. He is
considered high-functioning: he attends a public school, goes to daily cognitive/behavioral
sessions, and he attends weekly counseling sessions with a provider who specializes in treating
adolescent patients with a diagnosis within the autism spectrum disorder. His mother has noted a
significant increase in episodes of what she can only describe as temper tantrums; severe
irritability and quickly changing moods are also present. These occurrences have become so
severe that they have begun to disrupt the patient's daily activities.
,Best treatment for irritability in children and adolescents with autism spectrum disorder?
Risperidone
Most appropriate test in evaluation of ASD? DNA test for fragile X syndrome
There is no laboratory or imaging test to confirm autistic disorder, but the patient should be
evaluated for other similar disorders, especially with a family history of intellectual disabilitites.
A DNA test for fragile X syndrome would be appropriate, as about 1/4 of those with fragile X
have autistic disorder.
A 20-year-old man presents because he is feeling nervous, cannot sleep at night, has a loss of
appetite, a low-grade fever, a runny nose, and stomach cramps. On physical exam, the hair on his
arms is standing on end, he is sweating, and his pupils are dilated. He states that he is
accustomed to taking a certain drug, but he has not been able to obtain it for the last 72 hours.
From what type of drug is this patient most likely withdrawing Opiates
Withdrawal symptoms of an opiate include flu-like symptoms, nausea and/or vomiting, runny
nose, yawning, diarrhea, piloerection, fever, insomnia, goose bumps, sweating, and pupilary
dilation (a clear, late withdrawal symptom).
Most commonly used medication for treatment of opiate withdrawal Clonidine
A 31-year-old woman presents with recurrent episodes of palpitations, tachycardia, dyspnea, and
impending dread that began shortly after the birth of her first child.
,Based on her most likely diagnosis, what is best for the sustained treatment of her condition?
(SSRIs) are the first-line treatment options for chronic, sustained treatment of panic
disorder.
A middle-aged man is angry, frustrated, disillusioned, and disappointed with his wife's
involvement with his best friend. He enrolls himself in a men's tennis club to relieve his negative
emotions. What defense mechanism is he using? Sublimation
Sublimation is a defense process by which an unacceptable feeling is unconsciously replaced
with a course of action that is constructive and personally and socially acceptable. The conscious
use of work, sports, art or hobbies to divert one's thoughts from a problem or from a rejected
wish, is an analog of this.
What defense mechanism is characterized by the conscious or unconscious separating off of
mental contents (i.e.: thoughts, feelings, and fantasies) from the individual's awareness, which is
disowned and separated from one's personality? Dissociation
What defense mechanism is characterized by attributing an unacceptable impulse or idea to
others or the external world? Projection
What defense mechanism is characterized by the disclaiming and rejecting of any aspects of
internal or external reality that, if acknowledged, would cause anxiety? Denial
, What defense mechanism is characterized by transforming unacceptable feelings, ideas, or
impulses into their exact opposites? Reaction formation
What defense mechanism is characterized by redirecting pent-up emotions away from the
primary object of that emotion toward other persons, ideas, or objects. Displacement
What defense mechanism involves daydreaming about events that have not occurred; although
this occurs in creative processes, it may also be a sign of mental illness Fantasizing
What has been identified as the primary neurotransmitter responsible for ADHD?
Dopamine
What pharmaceutical therapy would be most beneficial for a patient with a personality disorder
who has trouble controlling his anger? Mood stabilizers such as *lamotrigine and
topiramate* are extremely useful in anger management and mood stability in these patients.
What is the best way to manage a patient with somatic sx d/o? Schedule frequent visits
and involve her in deciding what should be accomplished at each appointment
Group therapy is also helpful because it provides a social support and may make them less reliant
on medical assistance.
In which patients is psychoanalysis contraindicated Patients who have problems with
reality testing (actively psychotic or manic patients)
Answers| Latest Update
What are the diagnostic criteria for dysthymia Depressed mood and at least 2 CHASES sx
for 2 years (and patient must not be without sx for >2 months during that time)
What are the diagnostic criteria for cyclothymia Numerous periods with hypomanic sx
(but not meeting hypomanic episode criteria) and depressive sx (but not meeting depressive
episode criteria) for at least 2 years, no period symptom free for more than 2 months
What is a commonly shared feature of bipolar disorder and ADHD in pediatric patients?
Behavioral problems
A patient presented to your office with multiple somatic complaints. During the mental status
exam, you notice that the patient loses the thread of conversation and discusses irrelevant topics
based on an external stimulus. The patient never gets back to the main point he or she was trying
to express. What is this thought process called? Tangentiality
A 15-year-old boy presents with a diagnosis within the autism spectrum disorder. He is
considered high-functioning: he attends a public school, goes to daily cognitive/behavioral
sessions, and he attends weekly counseling sessions with a provider who specializes in treating
adolescent patients with a diagnosis within the autism spectrum disorder. His mother has noted a
significant increase in episodes of what she can only describe as temper tantrums; severe
irritability and quickly changing moods are also present. These occurrences have become so
severe that they have begun to disrupt the patient's daily activities.
,Best treatment for irritability in children and adolescents with autism spectrum disorder?
Risperidone
Most appropriate test in evaluation of ASD? DNA test for fragile X syndrome
There is no laboratory or imaging test to confirm autistic disorder, but the patient should be
evaluated for other similar disorders, especially with a family history of intellectual disabilitites.
A DNA test for fragile X syndrome would be appropriate, as about 1/4 of those with fragile X
have autistic disorder.
A 20-year-old man presents because he is feeling nervous, cannot sleep at night, has a loss of
appetite, a low-grade fever, a runny nose, and stomach cramps. On physical exam, the hair on his
arms is standing on end, he is sweating, and his pupils are dilated. He states that he is
accustomed to taking a certain drug, but he has not been able to obtain it for the last 72 hours.
From what type of drug is this patient most likely withdrawing Opiates
Withdrawal symptoms of an opiate include flu-like symptoms, nausea and/or vomiting, runny
nose, yawning, diarrhea, piloerection, fever, insomnia, goose bumps, sweating, and pupilary
dilation (a clear, late withdrawal symptom).
Most commonly used medication for treatment of opiate withdrawal Clonidine
A 31-year-old woman presents with recurrent episodes of palpitations, tachycardia, dyspnea, and
impending dread that began shortly after the birth of her first child.
,Based on her most likely diagnosis, what is best for the sustained treatment of her condition?
(SSRIs) are the first-line treatment options for chronic, sustained treatment of panic
disorder.
A middle-aged man is angry, frustrated, disillusioned, and disappointed with his wife's
involvement with his best friend. He enrolls himself in a men's tennis club to relieve his negative
emotions. What defense mechanism is he using? Sublimation
Sublimation is a defense process by which an unacceptable feeling is unconsciously replaced
with a course of action that is constructive and personally and socially acceptable. The conscious
use of work, sports, art or hobbies to divert one's thoughts from a problem or from a rejected
wish, is an analog of this.
What defense mechanism is characterized by the conscious or unconscious separating off of
mental contents (i.e.: thoughts, feelings, and fantasies) from the individual's awareness, which is
disowned and separated from one's personality? Dissociation
What defense mechanism is characterized by attributing an unacceptable impulse or idea to
others or the external world? Projection
What defense mechanism is characterized by the disclaiming and rejecting of any aspects of
internal or external reality that, if acknowledged, would cause anxiety? Denial
, What defense mechanism is characterized by transforming unacceptable feelings, ideas, or
impulses into their exact opposites? Reaction formation
What defense mechanism is characterized by redirecting pent-up emotions away from the
primary object of that emotion toward other persons, ideas, or objects. Displacement
What defense mechanism involves daydreaming about events that have not occurred; although
this occurs in creative processes, it may also be a sign of mental illness Fantasizing
What has been identified as the primary neurotransmitter responsible for ADHD?
Dopamine
What pharmaceutical therapy would be most beneficial for a patient with a personality disorder
who has trouble controlling his anger? Mood stabilizers such as *lamotrigine and
topiramate* are extremely useful in anger management and mood stability in these patients.
What is the best way to manage a patient with somatic sx d/o? Schedule frequent visits
and involve her in deciding what should be accomplished at each appointment
Group therapy is also helpful because it provides a social support and may make them less reliant
on medical assistance.
In which patients is psychoanalysis contraindicated Patients who have problems with
reality testing (actively psychotic or manic patients)
