Behavioral Med Exam 2 Latest 2025 (100% Correct Answers & Explanations with Complete Solutions

1. What are some other names used by society to describe PTSD? - battle fatigue - shell shock - soldier's heart 2. What is PTSD? - when a pt has increased stress or anxiety following exposure to a traumatic or stressful event 3. Who is most likely to suffer from PTSD? - young children and elderly pts 4. What type of event is typically the root cause of a male developing PTSD? - combat 5. What type of event is typically the root cause of a female developing PTSD? - sexual assault 6. T or F: Most people, when faced w/ a trauma, will experience PTSD symptoms? - false 7. What is the most important risk factor for PTSD? - the severity, duration, and proximity of a person's exposure to the actual trauma 8. What are some risk factors for PTSD? - childhood trauma, personality disorder, poor support system, genetic predisposition to psych illness, recent stressor, recent excessive alcohol intake, etc. 9. How common is it for a pt w/ PTSD to also suffer from comorbid psych disorders? - very likely - 2/3 will have at least 2 other disorders 10. What comorbid disorders are most commonly seen in pts w/ PTSD? - depressive disorder, substance-related disorder, anxiety disorder, and bipolar disorder 11. What is the causative factor in the development of PTSD? - the stressor which leads to a response of intense horror or fear Behavioral Med Exam 2 Latest 2025 (100% Correct Answers & Explanations with Complete Solutions) 12. T or F: In order to develop PTSD a pt only needs an exposure to a stressor? - false - there must also be an intense fear or horror related 13. What are some factors that play a role in the etiology of PTSD? - stressor, psychodynamics, cognitive behavioral, biological 14. PTSD dx includes symptoms in which 3 domains? - intrusion symptoms, avoiding symptoms, and symptoms of increased arousal 15. What is the common cycle of symptoms associated w/ PTSD? - ...arousal - avoidance - intrusive - arousal - avoidance - intrusive...etc. worse during stressful periods 16. What types of symptoms would be considered intrusion symptoms in PTSD? - flashbacks, dreams, stress reactions, etc. 17. How many intrusion symptoms must a pt have in order to be dx w/ PTSD? - at least 1 18. What types of symptoms would be considered avoiding symptoms in PTSD? - anhedonia, reduced memory of events related to trauma, avoidance of thoughts/activities related to the trauma, etc. 19. What types of symptoms would be considered symptoms of increased arousal in PTSD? - insomnia, irritability, hypervigilance, etc. 20. What is considered Gulf War Syndrome? - a condition which was found to occur in pts who were a part of the Gulf War 21. What types of symptoms may be seen w/ Gulf War Syndrome? - irritability, chronic fatigue, SOB, myalgias, arthralgias, HA, difficulty concentrating, rash, hair loss 22. What are some good prognostic indicators for PTSD? - rapid onset of symptoms, < 6 months, good premorbid functioning, strong support, absence of other psych illnesses 23. How soon after a traumatic event must the symptoms of PTSD present in order to be considered a dx of PTSD? - any time after (could be days to weeks to years) 24. How do you tx a pt w/ PTSD? - destigmatize the dx, find support groups for pt and family, have discussions at pt's pace, educate about coping mechanisms, psych referral for CBT or hypnosis, and meds 25. What should psychotherapy focus on in pts w/ PTSD? - exposure therapy and stress management 26. What medications are used to tx PTSD? - SSRIs = 1st line, buspirone (buspar), TCAs, anticonvulsants 27. Which SSRIs are best to tx PTSD? - sertraline (zoloft) and paroxetine (paxil) 28. Which TCAs can be used to tx PTSD? - imipramine (tofranil) and amitryptyline (elavil) 29. Who is more likely to be prescribed a TCA for PTSD? - elderly pts or those who have been on them for a while 30. Which anticonvulsants can be used to tx PTSD? - carbamazepine (tegretol) and valproate (depakote) 31. What is adjustment disorder? - emotional or behavioral sx that develops w/in 3 m of an exposure to a stressor 32. How long does adjustment disorder typically last? - rarely lasts more than 6 m after the stressor has ended 33. Who is most likely to suffer from adjustment disorder? - F > M, children (more behavioral sx), hospitalized pts 34. What are some common stressors in adults leading to adjustment disorder? - finances, medical illness, relationships, work, etc. 35. What are some common stressors in children leading to adjustment disorder? - school, parental rejection, divorce, substance abuse at home, etc. 36. What are the subtypes of adjustment disorder? - AD + depressed mood, mixed anxiety/depression, conduct disturbance, mixed emotional/conduct disturbance, features of acute stress disorder or PTSD, bereavement 37. What are some emotional s/s of adjustment disorder? - sad, hopeless, crying spells, nervous, anxious, worried, desperate, insomnia, difficulty concentrating, overwhelmed, suicidal thoughts, anhedonia, etc. 38. What are some behavioral s/s of adjustment disorder? - fighting, reckless driving, seeking approval, cheating, lying, avoiding family/friends, poor school performance, skipping school, vandalizing, ignoring important tasks, etc. 39. What is the prognosis for adjustment disorder? - typically, good - should return to normal function w/in 3 m 40. What is the prognosis for adjustment disorder in kids, specifically? - take longer to recover and will have higher risk of substance abuse or mood disorder - increased risk of suicide 41. How do you tx a pt w/ adjustment disorder? - psychotherapy = 1st line can use SSRIs if significantly depressed/anxious 42. What is the baby blues? - a common transient mood disturbance that occurs w/in 1st 6 wks after delivery 43. What are some s/s of the baby blues? - mood liability, sad, dysphoria, fearful, etc. 44. How do you tx the baby blues? - you don't! just educate mom that as time goes on the sx will resolve (short duration) 45. What is thought to cause the baby blues? - fluctuating hormones, stress from childbirth and increased responsibilities, etc. 46. What is postpartum depression? - a subtype of MDD which lasts > 2 wks and begin w/in the 1st 4 wks post delivery 47. What is the strongest risk factor for postpartum depression? - hx of depression 48. T or F: having the baby blues doesn't put you at a higher risk for developing post partum depression? - true 49. Which psych illness do pts w/ postpartum depression have an increased LIFETIME risk of developing? - MDD 50. What is the dx criteria for postpartum depression? - 5+ sx during a 2 wk period w/in the 1st 4 weeks of delivery w/ at least one being: depressed mood or anhedonia others can be: anxiety, wt change, fatigue, energy loss, thoughts of harm to baby or self, guilt, inadequacy, etc. 51. How do you tx postpartum depression? - combo of psychotherapy and SSRIs for at least 6 m 52. What are some s/s that a pt w/ postpartum depression is getting worse instead of better? - difficulty breastfeeding, difficulty attaching to baby, can't return to work, etc. 53. What are some major complications of postpartum depression? - postpartum psychosis and suicide 54. Which psychotherapy techniques should be used for pts w/ postpartum depression? - interpersonal therapy and CBT 55. What meds should you use to tx a pt w/ postpartum depression? - SSRIs - paroxetine (paxil), sertraline (zoloft), escitalopram (lexapro) 56. Are SSRIs found in breast milk? - yes - a small amount is 57. How long should you tx a pt w/ post partum depression? - 6+ m 58. What is postpartum psychosis? - a psychotic disorder which typically occurs days after delivery and is associated w/ a rapid onset of sx 59. What are the s/s of postpartum psychosis? - early: fatigue, insomnia, tearful, emotional lability, depression, late: suspiciousness, confusion, incoherence, obsessive concerns, denial of birth, delusions, hallucinations, thoughts of harming baby or self 60. How do you tx postpartum psychosis? - possible admission, mood stabilizers, and psychotherapy 61. Which mood stabilizers should you use to tx postpartum psychosis? - lithium, valproate (depakote), or carbamazepine (tegretol) 62. What is substance use disorder? - maladaptive pattern of substance use that causes impairment or distress and 2+ criteria for > 12 m pts may have genetic predisposition to this 63. Who is most likely to suffer from substance use disorder? - M > F whites > blacks unemployed > full/part-time 64. What are the s/s criteria for substance use disorder? - inability to fulfill required roles, physiologically hazardous use of the substance, repeated use even after having issues socially, tolerance of the substance, withdrawal of the substance, a lot of time spent acquiring the substance, craving the substance, giving up things because of the substance 65. What are the 3 categories of substance use disorders? substance intoxication substance withdrawal substance induced mental disorder (psychotic or depressive) 66. What is the dx criteria for substance induced mental disorder? clinically significant mental disorder which developed during or w/in 1 m of substance intoxication or withdrawal from a substance that is capable of producing the disorder cannot only occur during the course of a delirium 67. What are the characteristics of substance induced mental disorder? - mental disorder must not have been present prior to the substance use mental disorder must go away w/in 1 m of stopping the substance 68. What is substance intoxication? - a reversible syndrome occurring after ingestion or exposure to a substance which causes maladaptive behavior or psych changes during or shortly after usage 69. T or F: substance intoxication applies to tobacco also. - false - there is only a category for nicotine withdrawal 70. What is substance withdrawal? - a syndrome resulting from abrupt cessation of heavy and prolonged use of a substance which causes significant distress or impairment in functional areas 71. What are the 3 components used to characterize dependence? - having behavioral, physical, and psychological features which are associated with a certain substance/activity 72. What is dependence? - repeated use of a substance which can lead to a physical dependence and a resultant syndrome that develops after cessation 73. What is drug abuse? - use of a drug (self-administration) in a manner that deviates from the approved social or medical use 74. What is drug misuse? - when a physician uses a drug in a way that isn't what it was intended for 75. What is addiction? - repeated and increased use of a substance which leads to deprivation, distress, and an urge to have it when the substance is stopped causes mental/physical deterioration when stopped 76. What is intoxication? - reversible syndrome from a substance affecting one or more mental functions 77. What is withdrawal? - substance-specific syndrome after stopping or reducing a drug amount after regular/prolonged use that causes physiologic s/s and psychological changes 78. What is tolerance? - when a drug produces less effects after repeated administration or requires increasingly larger doses to obtain the same effects 79. What is behavioral tolerance? - ability of a person to perform tasks despite the expected effect of the drug 80. What is cross-tolerance? - ability of one drug to be substituted for another and produce the same physiologic/psychologic effect 81. What is neuroadaptation? - changes in the body from repeated exposure to a drug which leads to tolerance 82. Who is more likely to have alcohol use disorder? - M > F 83. What is the dx criteria for alcohol use disorder? - a problematic pattern of alcohol use which causes clinically significant impairment/distress must meet 2+ criteria w/in 12 m 84. What is the name of a survey that can be used to screen for alcohol use disorder? - CAGE (2+ yes's suggests a problem) 85. What are the categories of alcohol use disorder? - mild: 2-3 sx moderate: 4-5 sx severe: 6+ sx 86. What is the most common cause of chronic pancreatitis? - alcoholism 87. What are some contributing factors to alcohol use disorder? - environmental - easy access and it's legal - psychological - positive reinforcement (friends, euphoria), self-medication (for - sleep), personality disorders (anti-social) - biological - genetics 88. What are some effects of alcohol? - CNS depressant, decreased REM, fatty liver, gastritis, ulcers, varices, HTN, dyslipidemia, risk of MI, increased MCV (foliate deficiency from poor nutrition), drug interactions that are fatal 89. What size drinks all contain 18 mL of EtOH? – 12 oz beer (5% ABV) 5 oz wine (12% ABV) 1.5 oz liquor (40% ABV) 90. At what blood EtOH concentration does a pt begin to experience decreased ability to think clearly? - 0.02 - 0.03% 91. What is the legal limit of blood EtOH for driving? - 0.08%+ 92. At what blood EtOH concentration does a pt begin to have impaired speech, balance, or gait? - 0.06 - 0.15% 93. At what blood EtOH concentration does a pt begin to experience decreased breathing (poisoning)? - > 0.3% 94. What are some s/s of alcohol withdrawal? - delirium tremens, irritability, tachycardia, HTN, anxiety, diaphoresis, flushing, insomnia, GI upset, depression, dilated pupils, etc. 95. What is delirium tremens (DTs)? - a severe alcohol withdrawal sx which includes tremors, confusion, high fever, and hallucinations maybe seizures, hyperthermia, or death 96. Why do pts experiencing alcohol withdrawal get tachycardia and HTN? - the body is preparing for the CNS depressant effect of alcohol 97. How do you tx a pt w/ alcohol use disorder? - drunk tank if acute, inpatient rehab, AA, CBT, meds 98. What is done for pts in the drunk tank? - give IV fluids and monitor to prevent aspiration 99. What is in a coma cocktail? - narcan, thiamine, and D50 100. What meds can be used to tx alcohol use disorder? - benzodiazepines (valium, librium), naltrexone, disulfiram (antabuse), acamprosate 101. How do benzodiazepines help pts w/ alcohol use disorder? - they control withdrawal sx like seizures, delirium, anxiety, tachycardia, HTN, diaphoresis 102. How does disulfiram (antabuse) help pts w/ alcohol use disorder? - produces an acute sensitivity to alcohol and results in vomiting if pt drinks while on the medication 103. Why is disulfiram (Antabuse) not 1st line for alcohol use disorder? - pts can plan their drinking around the medication - just won't take it if they want to drink 104. How does naltrexone help pts w/ alcohol use disorder? - it is an opioid receptor antagonist, blocks the intoxication feeling/euphoric effect, and prevents relapse in previously opioid dependent pts 105. What are the CI for naltrexone? - liver failure, acute hepatitis, current opioid dependence 106. How long must pts be off of opioids in order to start taking naltrexone? - 7- 10 days 107. What is alcohol induced persisting amnestic disorder? - a disturbance in short term memory due to a thiamine deficiency caused by prolonged heavy use of alcohol 108. What are the 2 classic names for alcohol induced persisting amnestic disorder? - wernicke's encephalopathy and korsakoff's syndrome 109. What is wernicke's enchephalopathy? - triad of abnormal eye movements, ataxia, and mental confusion caused by prolonged heavy alcohol use 110. usually reversible in days - wks if tx'd but may progress to korsakoff's syndrome 111. Do pts w/ wernicke's encephalopathy have to present w/ the classic triad of sx's? - no - that is why it is highly missed 112. What is another name for korsakoff's syndrome? - alcohol induced dementia 113. What is korsakoff's syndrome? - an irreversible impaired mental syndrome w/ anterograde amnesia in an alert and responsive pt 114. How do you tx both wernicke's encephalopathy and korsakoff's syndrome? - high dose thiamine and nutritional support 115. How do you tx a pt w/ acute alcohol intoxication? - IV fluids and monitor (drunk tank) 116. How do you tx a pt w/ alcohol withdrawal? - benzo taper 117. How do you tx a pt who OD'd on benzodiazepines? - flumazenil - a GABA receptor antagonist only give if you KNOW it was a benzo OD 118. How do you tx a pt w/ benzodiazepine withdrawal? - benzo taper 119. How do you tx a pt who OD'd on opiates? - naloxone (narcan) to reverse opioid effects 120. How do you tx a pt w/ opioid withdrawal? - methadone to take the edge off and kill the cravings (may be on this long term) 121. What can happen if you mix benzos w/ alcohol? - can go into a coma or die from respiratory depression 122. How do you tx a pt w/ acute cocaine intoxication? - alpha blockers then BBs 123. How do you tx a pt w/ amphetamine intoxication? - supportive care 124. What do pts often complain of during cocaine withdrawal? - bugs crawling of their skin 125. How do you tx a pt w/ acute PCP intoxication? - haldol and/or physical restraints (very aggressive and strong)