PA PSYCHIATRY EOR 2026/2027 COMPREHENSIVE EXAM
QUESTIONS AND SOLUTIONS RATED A+
✔✔Anorexia nervosa - Egosyntonic - ✔✔Avoidance of food and meals
*Low body weight* - 15% below expected
Intense fear of wt gain
Distorted body perception
Excessive exercise regimen
Denial of illness
Amenorrhea
Tx: Psychotherapy + SSRIs > Li+
✔✔Diagnostic labs & imaging to evaluate pt w/ Anorexia nervosa - ✔✔EKG: *SVT* or
*Long QT-Syndrome* or *Sinus Bradycardia*
Labs: *↑ BUN* Hypokalemia, Hypochloremia, Hyperaldosterone, *↑ GnRH*
Acidosis w/ dehydration
✔✔Osteopenia seen in anorexic patients - ✔✔Due to a decrease in estrogen
✔✔Bulimia nervosa - Egodystonic - ✔✔Recurrent binge eating
Self-induced vomiting or laxative abuse = *alkalosis*
Dental enamel erosion
Salivary gland enlargement
Calluses over dorsal aspect of fingers (Russell's Sign)
*Normal or above normal body wt*
Tx:
1st line: *CBT* > SSRIs > TCAs
✔✔The female athlete triad - ✔✔Low bone density
Menstrual dysfunction
Low energy availability
✔✔Obesity - ✔✔BMI 20-25: Little to no risk
BMI 25-29.9 w/ no CAD risk factors: prevent wt gain
BMI 25-29.9 w/ CAD risk factors or BMI 30-34.9: diet & exercise
BMI 35-40+ High risk: lifestyle mod + pharmacotherapy > bariatric
✔✔Dissociative identity disorder - ✔✔Dx: 2 or more distinct personality states and
recurrent gaps in recall of personal information or events
, Alterations in: affect, behavior, consciousness, perception, cognition, senory-motor
funciton
Amnesia
Depersonalization
Derealization
Self-alteration
Trance state
✔✔Depersonalization - ✔✔Feeling of detachment or estrangement from one's self
"out of body experience"
✔✔Derealization - ✔✔Feeling the external world is strange or unreal
✔✔Self-alteration - ✔✔Sense that one part of one's self is markedly different from
another part of one's self
✔✔Dissociative amnesia with *fugue* - ✔✔Sudden, unexpected *travel or wandering* in
a dissociated state w/ autobiographical memory loss for the duration of the episode
✔✔Gambling disorder (Pathologic gambling)
4 or more: - ✔✔Preoccupied w/ gambling
Need to gamble w/ increasing amounts of money for excited state
Restless or irritable when trying to cut down/stop gambling
Gambles as a way to escape life's responsibilities
Lies to family, friends, therapist to conceal extent of gambling
Jeopardizes or has lost significant relationship, job, or opportunity
Relies on others to provide money since their $ is gone
✔✔Intermittent explosive disorder - ✔✔Periodically unable to restrain impulses of
physical or verbal aggression
Behavior is out of proportion to any precipitating factor
Outbursts are impulsive, unplanned, and or a response to anger
Marked distress or psychosocial impairment
Aggression is not accounted for by another disorder
Tx: *SSRIs* (fluoxetine) + *CBT*
✔✔Mania to steal
Mania to burn
Mania to scratch/itch - ✔✔Kleptomania
Pyromania
Trichtillomania
✔✔Primary Insomnia
QUESTIONS AND SOLUTIONS RATED A+
✔✔Anorexia nervosa - Egosyntonic - ✔✔Avoidance of food and meals
*Low body weight* - 15% below expected
Intense fear of wt gain
Distorted body perception
Excessive exercise regimen
Denial of illness
Amenorrhea
Tx: Psychotherapy + SSRIs > Li+
✔✔Diagnostic labs & imaging to evaluate pt w/ Anorexia nervosa - ✔✔EKG: *SVT* or
*Long QT-Syndrome* or *Sinus Bradycardia*
Labs: *↑ BUN* Hypokalemia, Hypochloremia, Hyperaldosterone, *↑ GnRH*
Acidosis w/ dehydration
✔✔Osteopenia seen in anorexic patients - ✔✔Due to a decrease in estrogen
✔✔Bulimia nervosa - Egodystonic - ✔✔Recurrent binge eating
Self-induced vomiting or laxative abuse = *alkalosis*
Dental enamel erosion
Salivary gland enlargement
Calluses over dorsal aspect of fingers (Russell's Sign)
*Normal or above normal body wt*
Tx:
1st line: *CBT* > SSRIs > TCAs
✔✔The female athlete triad - ✔✔Low bone density
Menstrual dysfunction
Low energy availability
✔✔Obesity - ✔✔BMI 20-25: Little to no risk
BMI 25-29.9 w/ no CAD risk factors: prevent wt gain
BMI 25-29.9 w/ CAD risk factors or BMI 30-34.9: diet & exercise
BMI 35-40+ High risk: lifestyle mod + pharmacotherapy > bariatric
✔✔Dissociative identity disorder - ✔✔Dx: 2 or more distinct personality states and
recurrent gaps in recall of personal information or events
, Alterations in: affect, behavior, consciousness, perception, cognition, senory-motor
funciton
Amnesia
Depersonalization
Derealization
Self-alteration
Trance state
✔✔Depersonalization - ✔✔Feeling of detachment or estrangement from one's self
"out of body experience"
✔✔Derealization - ✔✔Feeling the external world is strange or unreal
✔✔Self-alteration - ✔✔Sense that one part of one's self is markedly different from
another part of one's self
✔✔Dissociative amnesia with *fugue* - ✔✔Sudden, unexpected *travel or wandering* in
a dissociated state w/ autobiographical memory loss for the duration of the episode
✔✔Gambling disorder (Pathologic gambling)
4 or more: - ✔✔Preoccupied w/ gambling
Need to gamble w/ increasing amounts of money for excited state
Restless or irritable when trying to cut down/stop gambling
Gambles as a way to escape life's responsibilities
Lies to family, friends, therapist to conceal extent of gambling
Jeopardizes or has lost significant relationship, job, or opportunity
Relies on others to provide money since their $ is gone
✔✔Intermittent explosive disorder - ✔✔Periodically unable to restrain impulses of
physical or verbal aggression
Behavior is out of proportion to any precipitating factor
Outbursts are impulsive, unplanned, and or a response to anger
Marked distress or psychosocial impairment
Aggression is not accounted for by another disorder
Tx: *SSRIs* (fluoxetine) + *CBT*
✔✔Mania to steal
Mania to burn
Mania to scratch/itch - ✔✔Kleptomania
Pyromania
Trichtillomania
✔✔Primary Insomnia
