Manual Psychiatry : 1200 questions to help you pass the boards

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Alexithymia is an inability to describe or recognize ones emo- tions. Patients also have a limited fantasy life, constriction of affective life, reduced symbolic thinking, and an inability to empathize with others. Difficulty reading is not a feature of alexithymia. Visual hallucinations are common in delirium. In fact, they are extremely uncommon in functional psychiatric illnesses.

They are not a common feature of late-onset schizophrenia, which is more likely to be characterized by delusions and auditory hallucinations, though visual hallu- cinations may be present. Frontotemporal dementia presents with disorgan- ized behavior, change in personality, poor insight, emotional blunting, and stereotyped and perseverative behavior. Untreated depression can result in hallucinations, but they are more often auditory. This is the definition of mannerism. Stereotypy is the constant repetition of meaningless and purposeless gestures or movements.

In au- tomatism, the individual is consciously or unconsciously, but involuntarily, compelled to perform certain motor or verbal acts. Diminution of emotional response is called blunting of affect. Flattening of affect is strictly speaking the absence of an emotional response. Auditory hallucinations are the most commonly seen symptom in schizophrenia from among the five listed answers. Perseveration is the inability to shift from one theme to an- other. A thought is retained long after it has become inappropriate in the given context.

It is seen in organic brain disorders. Autoscopy is the experience of seeing ones own body in exter- nal space. Extracampine hallucination is the experience of a hallucination outside the field of that particular sense. Reflex hallucination is the pres- ence of hallucinations in one modality when the stimulus is in another modality. Gedankenlautwerden is also called echo de la pense or thought echo. In Capgras syndrome, a person believes that someone known to him has been replaced by an exact double. In Fregoli syndrome, the patient believes that one or more individuals have altered their appearance to resemble familiar people, usually to persecute the patient.

In de Cleram- bault syndrome, the patient believes that another person, usually of higher social standing, is in love with him. Othello syndrome is also called patho- logical or morbid jealousy. Diogenes syndrome is also called senile squalor, characterized by hoarding and self-neglect. In obsession, patients realize that the obsessive thoughts are their own and illogical, perceive the thoughts as distressing and unpleasant, and usually try to resist them, though with long-standing illness resistance may be absent.

Psychiatry Questions to Help You Pass the Boards | Hallucination | Schizophrenia

Echopraxia is the imitation of movements or actions. Echolalia is the repetition of words. Ambivalence or ambitendence is an inability to make decisions. In waxy flexibility, an awkward posture is held by the patient without distress for longer than would be possible for a normal individual. In anosognosia, patients are unaware of their illness or condi- tion. Anton syndrome is a form of cortical blindness in which the patient denies the visual impairment. It is caused by occipital lobe damage that ex- tends from the primary visual cortex into the visual association cortex.

Agreement with all that the doctor says does not necessarily demonstrate good insight. The criteria that may be used to judge insight are a the patient realizes that he has an illness; b the patient recognizes the illness to be of a psychological nature; c the patient thinks he needs help with the illness; or d the patient is willing to accept help.

All the others are clinician-rated or observer-rated scales. The New Word Learning test is a test to detect organic brain damage. Rorschach test is a projective test and Stanford-Binet is a test for intelligence. Tactile hallucination is classically seen in cocaine use. Alcoholic polyneuropathy does not cause hallucinations. Obsessive- compulsive disorder or panic disorder is not associated with hallucina- tions.

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Dermatitis artefacta is a self-inflicted dermatological injury produced for secondary gain. It is not associated with hallucinations. In Cotard syndrome, the patient has nihilistic delusions, that is, beliefs about the nonexistence of some person or thing. The thoughts are associated with extreme degrees of depressed mood. Comparable ideas con- cerning failures of bodily function often accompany nihilistic delusions. A year-old Caucasian male with a history of chronic paranoid schizo- phrenia is hospitalized for a relapse of symptoms.

He is given parenteral haloperidol because he is very agitated and threatening. The patient contin- ues to be belligerent and has to be put in physical restraints.

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The next day the patient is less agitated and belligerent, but he reports feeling nauseated and tired and toward evening is found to be disoriented to time and place. His laboratory work-up shows an increase in BUN and creatinine.

Psychiatry 1,200 Questions to Help You Pass the Boards

He is di- agnosed with acute renal failure and transferred to the medical floor. What could be the cause of his acute presentation? Intramuscular injection B. Myoglobinuria due to muscle breakdown secondary to struggling when restrained C.

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Dystonia secondary to multiple doses of pareneteral antipsychotic D. All of the above. A year-old patient has been under treatment for chronic paranoid schiz- ophrenia. He presents to the ER with a relapse of symptoms and is admitted to the hospital because he is very agitated. He had missed an appointment with his psychiatrist a few days before, although he had his WBC count done the day before that. He is started back on clozapine at the same dosage he was receiving before admission: mg.

The next morning he is found unconscious near his bed with a bump on the head. Which of the following could have led to this clinical situation? Starting the patient on clozapine B. Starting the patient on the same dosage of clozapine as previously C. Not starting the patient on benztropine D.

Approximately 6 months later, he is brought to the ER by his girlfriend. According to the girlfriend, the patient has been reporting seeing burglars breaking into their house.


The patient is well oriented to time and place, and he reports that although he realizes what he is seeing is untrue, the experience is very unsettling for him. What is this phenomenon called? Doppelganger B. Reflex hallucinations C.

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Charles Bonnet syndrome D. Functional hallucinations. Which of the following is one of the four As identified by Eugene Bleuler as the primary symptoms of schizophrenia? Abnormal association B. Autistic behavior C. Ambivalence D. All the above. What is the total direct and indirect cost of schizophrenia to the U. What is the concordance rate for schizophrenia in monozygotic twins? Which of the following cognitive impairments is found in persons with schizophrenia? Deficits in information processing B.