1. The only serotonin-releasing neurons in the CNS are found in the raphe nuclei.

These neurons disseminate widely to synapse on numerous structures in the CNS. 2. POP or phencyclidine is a hallucinogen that works y stimulating the e!citatory N"#$ receptor. "oderate amounts of PCP cause feelings of detachment and distance. $dditionally PCP can produce slurred speech% loss of coordination &ata!ia'% in(oluntary mo(ements% e!aggerated gait% and nystagmus. )t can induce paranoia and hallucinations and most users will ecome (ery hostile and aggressi(e. *. +hen an ill patient re,uests your prayers in an acute selling it is appropriate to offer your personal support without inter-ecting your personal eliefs into the interaction. The o(erriding goal in these situations is to .do no harm./ This can e achie(ed y not disagreeing with the patient not entering into a religious de ate with them and not displacing responsi ility for the care of the patient onto others. 0. The first step in addressing noncompliant patients is to educate them a out the disease eing treated% the risks of not treating this disease% and how inter(entions can help them a(oid or lessen these risks. 1. )n situations where patients are una le to make decisions for themsel(es responsi ility for those decisions falls on the ne!t of kin if the patient has no written directi(es clearly stating their intentions. The ne!t of kin for a married person is their spouse followed y their adult children. The ne!t of kin is to make decisions ased on how they elie(e the patient would ha(e wanted things. 2. Typical and atypical antipsychotics are the mainstay of treatment for schi3ophrenia. They ha(e e,ual efficacy in treating schi3ophrenia and are selected y clinicians ased upon side-effect profiles. 4. Physicians are re,uired y law to report o (ious child% spousal or elder a use to law enforcement authorities. $dditionally% reporting of threats of physical harm made y patients who are capa le of carrying out such threats imminently is allowa le and ad(isa le under the Tarasoff decision and similar laws in many states in the 5nited States. 6. $lpra3olam has a half-life less than twel(e hours and is useful for acute an!iety. 7. There are three categories of postpartum mood distur ances. The most common is the maternity lues% a enign% self-limited change in affect that lasts up to 18 days postpartum. )t is treated with watchful waiting and the knowledge that up to 289 of these women will de(elop postpartum depression. 18. The .female athlete triad/ consists of an eating disorder% amenorrhea% and osteoporosis. 11. #isplacement is one of the less mature defense mechanisms. )n displacement% a patient will redirect emotions from the person or o -ect that is causing the negati(e emotions to a more accepta le% ut still inappropriate% person or o -ect. 12. :eaction formation is the replacement of an unpleasant or unaccepta le thought or desire with an emphasis on its opposite. 1*. ;+hite coat syndrome< &patient an!iety e(oked y healthcare workers dressed in white coats' is an e!ample of classical conditioning% wherein the white coat ser(es as a conditioned stimulus for an!iety. 10. No matter how serious or tri(ial a medical error a physician is ethically o ligated to inform a patient that a mistake has een made. =thics committees and risk management personnel can assist if a patient wishes to speak with someone or threatens a lawsuit. 11. Contact Child Protecti(e Ser(ices immediately if child a use is suspected. 12. >ust as competent patients ha(e the right to refuse medical care% they also ha(e the right to refuse knowledge of their own medical information and diagnoses. )n cases such as these it is essential to ensure that the patient is well informed efore they make their decision and find out from the patient who their surrogate decision-maker should e. 14. ?ulimia ner(osa is an eating disorder characteri3ed y alternating inging and weight reduction eha(iors. Patients can de(elop ilateral parotid gland enlargement% erosion of tooth enamel% and irregular menses. 16. "ari-uana contains T@C which stimulates canna inoid receptors to produce effects on mood% perception% and memory. "ari-uana produces a mild euphoria with laughing

uacy% timidity and fear of re-ection. 21.g. )t remains in tissues for a significant amount of time and can e detected up to *8 days after use. +hen a patient threatens to kill or physically harm someone else during their interaction with the physician and has a reasona le a ility to carry out this threat in the near future. This practice contri utes to the societal pro lem of anti iotic resistance and it places the patient at unreasona le risks due to ad(erse reactions to anti iotic therapy #isa ility is a form of assistance pro(ided to workers who can no longer work due to their general medical conditionA it re. 22. )f as part of a medical team you ha(e een asked to perform an action that you feel will cause harm to the patient% it is your ethical o ligation to discuss that order with your super(ising or colleague physician who has made the . =thical principles as well as the @ealth )nsurance Porta ility and $ccounta ility $ct of 1772 &@)P$$) Title ))' dictate that patient information can not e disclosed to others% including lo(ed ones and family mem ers% with out the e!plicit consent of the patient. olan3apine'.uences of decisions made in that situation. ?ody dysmorphic disorder is one in which a patient elie(es his or her ody is pathologically flawed when in fact it is not. $ patient who is competent and not incapacitated has the right to refuse treatment y a physician at anytime e(en if that treatment is life-sa(ing. 27.uires certification of disa ility y a physician. 21. )tis ethical to accept gifts from patients if those gifts are not eyond the means of the physician or patient% if the gift is not made with the intention to secure preferential treatment% if the gift does not place the patient or their family in financial hardship% and if the patient is not demented.17. +hen interacting with difficult patients% it is est to try to calm them% e!plain your position and in. Prescription of anti iotics for diseases that are not acterial in origin is not proper procedure. . :apid heart rate and con-uncti(al in-ection are the two most immediate physical symptoms of mari-uana use. $ competent patient understands their situation as well as the possi le conse. #ocumentation that the patient has granted consent for disclosure of their health information should e placed in the patient<s chart. *1. *8. Suppression is a conscious% mature defense mechanism in(ol(ing withholding trou lesome thoughts or impulses. There is a high rate of comor id ma-or depressi(e disorder and suicide attempts among patients with ?##. 2*. 28.uestions. 20. There are numerous somatoform disorders. 26. +hen a patient is diagnosed with a reporta le communica le disease and 0. $(oidant personality disorder is a maladapti(e pattern of eha(ior characteri3ed y feelings of inade.g. $ccording to guidelines released y the $merican Psychiatric $ssociation &2882' the mainstay of therapy for acute mania is a mood sta ili3ing agent &e. )n situations where a patient is una le to make their wishes known and they do not ha(e written documentation of their wishes the responsi ility for medical decision making falls on the ne!t of kin. +hen a patient has sustained gunshot or sta ing in-uries% *. )n the case of a married person the ne!t of kin is the spouse There are only four situations where disclosure of patient information without the consent of the patient is allowa leB 1.uire more a out what trou les them y using open-ended . 22. 24. lithium% (alproate% or car ama3epine' plus an atypical psychotic &e.uestiona le suggestion in order to reach a consensus without in(ol(ing the patient or ancillary staff $d(ance care planning for end of life issues such as desire for intu ation% mechanical (entilation% tu e feedings% parenteral feedings CP: and cardio(ersion are est initially discussed during out patient (isits with primary care pro(iders. +hen child% elder or spousal a use is suspected% 2. Cifts can contri ute to a positi(e doctor-patient relationshipA shunning all patients with gifts may make patients feel awkward as gift-gi(ing is a normal practice in many cultures. eha(ior% slowed refle!es% di33iness% impaired coordination% and short term memory loss. These decisions must also e readdressed during the admission process for acute admissions so that medical staff can adhere to the specific wishes of patients.

01. )t is necessary to counsel the patient of the risks% enefits alternati(es and contraindications of any procedure or treatment% and the physician should additionally counsel the patient that she may want to discuss her decision with her significant other to a(oid social difficulties later. )t is an immature defense mechanism. )t can occur in patients taking narcotics legally or illegally. FThe religious eliefs of patients should always e respected. The responsi ility of the physician who ser(es in a medical capacity at a sporting e(ent is to protect the health and safety of the players.uestions is the most effecti(e way to start clinical histories.uestions the patient may ha(e *0. Con(ersion disorder refers to the unconscious manifestation of neurologic symptoms when pathophysiological e!planations for the symptoms cannot e found. )t occurs more commonly in women and often occurs after a significant life stress. *1. $mong drugs of a use% into!ication with hallucinogens &psychotomimetic drugs'% amphetamines% and cocaine is most commonly associated with (iolent eha(ior. )f a parent<s decisions are not in the est interests of the child or place the child in imminent danger% then a court order should e sought y medical practitioners. ?elligerence and psychomotor agitation tend to e more common with PCP than with ES# into!ication.uently e!plaining what the news means and what their options are. 0*. #ysthymia is a low-intensity mood distur ance lasting at least two years. *2. 02. Narcolepsy is a disorder characteri3ed y e!cessi(e day time sleepiness and :=" sleeprelated phenomena such as cataple!y% sleep paralysis% and hypnagogic hallucinations. )t occurs due to poor oropharyngeal tone and results in daytime sleepiness morning headaches and depression. )t differs from ma-or depressi(e disorder in length and se(erity of symptoms. *4. 01.*2. .uestions to clarify certain points. This is also important when discussing drugs alcohol to acco and se!ual acti(ity with teenagers. The physician<s -udgment should e guided only y medical considerations. Consent of a married or unmarried significant other is not re.uired for a patient to undergo any type of procedure electi(e or nonselecti(e. O structi(e sleep apnea is the most common medical cause of e!cessi(e daytime sleepiness in the 5S. lack and white/ and is common amongst patients with orderline personality disorder. Dou should always end y answering any . @allucinogens include ES# and phencyclidine &PCP% angel dust'. Once the patient has started his history% one can use closed-ended follow-up . 02. 00. )n situations where a parent is complicating an inter(iew or where you feel you will not e a le to get honest answers from the adolescent patient with the parent present it is appropriate to politely ask the parent to wait outside while you inter(iew the patient. Splitting refers to seeing the world in .uality of care rendered y that practitioner. +hen treating patients that are referred to you for specialty care or second opinions% it is imperati(e to not undermine or otherwise ad(ersely affect the patient<s relationship with their primary pro(ider y making negati(e comments a out the . There are numerous defense mechanisms &all of which the 5S"E= lo(es'. **. $t three years of age a child is e!pected to e a le to play in parallel% speak in simple sentences% copy a simple shape% and ride a tricycle. *7. *6. 5sing open-ended . $ parent has the authority to make all health care decisions for their minor child unless that child is emancipated. 04. Opiate withdrawal is marked y a dominal pain% nausea% (omiting% diarrhea% piloerection% pupillary dilation% diaphoresis and fe(er. Pro-ection refers to transplanting one<s unaccepta le impulses or affect onto another person or situation. )n situations where you need to relay difficult information to a patient% you should take the approach of immediately informing the patient of the news% gi(ing them a moment to think a out the news% and su se. 08. The desire of spectators% coaches% or e(en the athlete that he or she not e remo(ed from the game should not affect the physician<s decision.