Psychiatry High-Yield Comprehensive Study Guide

Comprehensive practice flashcards covering psychiatric evaluation, disorders, treatments, and legal issues based on the High-Yield Study Guide.

What is the difference between mood and affect in a Mental Status Exam (MSE)?

Mood is the patient’s internal state, while affect is the observed expression.

According to the guide, what are the high-yield contents of the 'Cognition' domain in the MSE?

Alertness, orientation, attention, memory, language, and abstraction/executive function.

In cases of Amitriptyline toxicity, what is used to treat $QRS$ widening or ventricular dysrhythmia?

Sodium bicarbonate.

What is the key discriminator for diagnosing Dementia with Lewy bodies versus Parkinson disease dementia?

Dementia with Lewy bodies occurs before or within approximately $1$ year of parkinsonism, while Parkinson disease dementia occurs years after established PD.

Which medications are indicated for moderate to severe Alzheimer disease?

NMDA antagonists such as memantine.

What are the common precipitants of delirium in older adults?

Anticholinergics (e.g., diphenhydramine, oxybutynin) and benzodiazepines.

What are the components of the CAGE screening tool for alcohol use?

$C$ut down, $A$nnoyed, $G$uilty, $E$ye-opener.

What is the first-line treatment for opioid overdose?

Naloxone.

What duration of continuous disturbance is required for a diagnosis of Schizophrenia?

$\ge 6$ months, including at least $1$ month of active-phase symptoms.

Which medication is reserved for treatment-resistant schizophrenia and recurrent suicidal behavior?

Clozapine.

What are the classic mood-congruent psychotic features in severe depression?

Nihilistic or somatic delusions (e.g., 'I am dead' or organs are gone).

What is the diagnostic duration requirement for Agoraphobia?

Typically persists $\ge 6$ months.

What is the clinical threshold for diagnosing OCD?

$> 1$ hour per day or clinically significant distress/impairment.

What is the first-line psychotherapy for OCD?

CBT with exposure and response prevention (ERP).

How long must symptoms last to transition from a diagnosis of Acute Stress Disorder to PTSD?

Symptoms must last $> 1$ month; Acute Stress Disorder covers $3$ days to $1$ month.

Which medication is specifically considered for trauma-related nightmares in PTSD?

Prazosin.

What is the defining characteristic of Functional Neurologic Symptom Disorder?

Motor or sensory symptoms with positive evidence of incompatibility with recognized neurologic disease, where symptoms are not consciously produced.

How does Factitious Disorder differ from Malingering?

Factitious Disorder involve intentional deception to assume the sick role with no external reward; Malingering is symptom production for external gain and is not a mental disorder.

What is the core discriminator between Anorexia Nervosa and Bulimia Nervosa?

Anorexia Nervosa involves significantly low weight; in Bulimia Nervosa, weight is usually not significantly low.

What are the potential ECG findings associated with vomiting in Anorexia?

Bradycardia, hypokalemia/hypomagnesemia, and $QT$ changes.

What is the first-line evidence-based psychotherapy for Borderline Personality Disorder?

Dialectical Behavior Therapy (DBT).

What are the diagnostic requirements for ADHD?

Symptoms must appear before age $12$, persist for $\ge 6$ months, occur in $\ge 2$ settings, and impair function.

What is the core difference between Oppositional Defiant Disorder (ODD) and Conduct Disorder?

ODD involves angry/irritable or defiant behavior without major rights violations; Conduct Disorder involves aggression, destruction, and serious rule violations.

What are the '4 D's' required to prove Malpractice?

$Duty$, $Deviation$ from standard, $Damage$, and $Direct$ causation.

What is the legal precedent for competency to stand trial in the United States?

Dusky v. United States, which requires the ability to consult counsel and a rational/factual understanding of the proceedings.

Which atypical antipsychotic is associated with marked weight gain and metabolic syndrome?

Olanzapine (Zyprexa).

What are the potential toxicities and monitoring requirements for Lithium?

Tremor, GI issues, nephrogenic DI, hypothyroid, and renal toxicity; monitoring should include drug levels, renal function, and thyroid function.

What is the Tarasoff duty?

The duty to protect related to serious threats toward identifiable persons.