1 28 yeacoi man presents tothe psychic ward, complaring taut pace hacoperstat have flowed ror he pact year He pasened eater nthe woskto te emargoncy depart the compa ot 2 lan spetm ert He sates athe has buns on his stomach anda low spem count ma este laver tate polos use la uaskrim He says he has cntated Sergeant ical an tetalaars fice, who snow mvesigainghis charge of pic bay. The papet appears anaous and Fequeray Tooks cute window. Ate ting his sry, he asks you lowe him. What she best respons oS ‘weston? (© A °5é,elave your cancers are syngas f= psychi ness” © B: Yourimagnatonis geting he best of you. What you as taking abouts notpossble, so pease stop werina™ (© © Vhnow your xpenence na pean stcutforyou. Lats ae whats ean ate nlp! © D.'Winy dontwe cal Sersartvicraels io ngute abou te prozess a is investipton?* "ts a goostring yeu camets the hesptal. Te ple lsers cant etto yours2 s2.yeacoli man presents this fly physician camplring of erctle dtuncton and decreased bia forthe post mann. He dunce ary pan orloee of eraaton nie genial, and Maemo proveme ith Uunaton Heas never expeninced tse symptoms before ad find them very upsetting. The pert has ‘instar of scrizupnrena and waa discarged Wom he paytatc nesta tae morn 92, He dees {ny curen halucnatons or delisans, and his ug are vl arganes. Raven ef symptom negative exceptforaracen 3 (@ 8b) wright gan. Physical amination reves lel breast nargerent. Yhich othe alow accounts fr tess hangs? (© A nateased dopamine sataty ne ngtasatalpatway © B Increases soparine acy he mesoieric para © C nreabe9 dopamine scikty nthe uterorunauarcatway © D Decreased dopamine acty nthe rizostist pathy (© E Decreased dopamine activin the messi patway (© F Decreased dopamine acti nthe iberoinkndoulr pathway.‘98 year od woman strougtta the emergency department tr beng inven a mina cat acest ‘She sustaned 3 ema acrato shat Nand and hae amg headache But eparinc dno ss of Consciousness dung cafe the accident Wie protdng her medialhision shetels you hat she has hha cancer armarethan tv years she dora nna what ype ot eancersheaa an aaye she ‘rusbatea ih ner dctr because hehas repeted tld her hat she has na egence ef cancer she raparts hau seen mull physicians over the pact ve years, and hadng undergone muple magna Ses and bod tests atl toreves canoe, Yvan yu ask iw she Wns seas cacer she ess, “Beinye me, henyauhave cance you kan" Phystea! etarinaions unemarable except fx 3 minor laceration onherighthand. Wikis hs patents diagnosis? (© A Bia psychotic dior © B.Detrum © © Delusional ésorder © 0 Schicoypal personality order © E Samuteatondisarder Poot‘Tha paterts ofa Syearld gt rng het cn for evasion, They ae ight because ter daughter has Stared oak afarse, especialy when che sone infer roam. Whan the paras ask shals, talongta she says “Noood* and refuses odncuss he mater, She becomes angry hey nersat. FRecoiy ster sping mi rng breaifst the gt dnd having sane sing at ng a2 ‘spans The parents srt ay nave na des anon i= The grins sometaublessusnng [nde atthe sar of te sl oar bute now ong wel. She am ony chil, Pe names fries, ano as feacne alo er milestones on be. What SrauD ie pants be save” (© A "Your saugrers teraver is rarmal far he age, ans ete is rating a wary about” eB: Yourdaugter should str taking rsprdona to decrease th knead a her symptoms, (© 6-"Yourdavatar may te expereneng misreatment and stuse her kindergarten las" © Your daughsr shoud bein weekly counssing session wt the scheal pychalogist” E "Vaurdaupier nas oppaitona fant acer and needs more ating bore worsen Block aioe‘.47.yeacold woman i traugtta the hospital by pole ae bing faund wandering inthe sbeet She is Gienoveles, msodorove, and appeae mehourene, Aihough she emiee pacar and sarees wth bala Intereved tis dfcutts hod Re tenon On a number af oxcasons, she gets up Fam het cha ana (aka tounge racm, nen seed abawrherbehavor se sates, ungle angie det ge ange* inch ene faloning iste mos: appropri mecicatn to neal presenter fhe pate? ‘Lang s:tna nape neton B Londo tum Propanokt © D.Rsperidone E Semaine “This patert has sns an symetoms of dso ganized schzoptren, a supe of scizopreria chaacteizes by are afest su pomnertastganzatchofhaiht Pabers ith Ps contin have ‘Several pale fuicond capactes andar rarely ble ta malta employment parsoralelaiohps. ‘The progress or dsarganzed sophia ery post [Because this pate cooperative, teatmant ih an atl artipychoticmaciaion s apprariae. Abpea lmapovehote (on, repancons) ar sandra rat ne teapybecauos ort lover kt Dsaraml Se eects im companson topical ntpsychatcs, (Chotew A) Athoushypicl antipsychotics the hapetil can be usedin he beakment af dsarasized enzootrana usualy se n-ne therapy) the ang acong econ maton shausnerbe gen wth an tara for haope assess lerbily {hotee 5) The moos stanza itu she gos andacseamertor polar Sso18er. Linum nat erste stoning sete payehona mower {Choice 6) Propraol ates tock used ntreatng alata, cmon se eect of ntpsychote Imescatons, Propranll net esive neatng ace psvences, Mane! (Cholee€) Serrsine ca eles serctonn reuptake bear (SS) uses inte meat ot moodB Londose tum (Propanotl 6D Rspendane E senvalne ‘This pterthas sigs and symptoms of dsorgarizad schizoptrnia, a subtype of schizapreria cheractezed ty tizare sect ad gomnentdeoeganzaton of hah. Paters wth Us conton Nave Seve mpatedfunctona capacties and at aly ale a mattan employment or petsoral lalonshes ‘The progross for earganzed schizophrenia Very poo. [Because his paterts cooperate, testment ih an otal artipsychatic mediation apprenate. Apical lntpoychates (9, pena) ar considera frat ine tetapy because ofthe lane ak fara Soe eterts mn cortmanean tonics antpayenates {Ghoice A) Athounh tical anbpsychatcs tke halperdol ca te used inthe beatent of disrganized ‘Scnsogrrana usualy as acon e eran) Delong acing econ tamatonshauaneebe hen thet an ivi rao orhalopeia assess erty {Choice B) The mood statizr thurs the gol tandadtrearerefor polar dsorder. Lithium sna ‘ens n eating acute psychosis, nawever (Gholee 6) Propranala a beta tocker used ntretng aati, canmon side efecto antpsychate Ieseatons. Propranolol nat fecive nesting ase psychos Hane? (choice ) Secvaneis 2 selzcive sero eugate ibo (SS sesh ne eatment of oad Cisurders, ncidng depression and amy. ‘Seralne isnot eflecave neat arte psychosis, RoWever Eéucatona objective _Aypical apsystate mescators suoh a ispergoe are consoered rst wesimert for patents wah payehute decor because char mare avrale nde elec pofe, secple answered questoncoect Lastundoted (9212008| 2a. year ot man presets tote psychic ward, comparing stout polo helcopes that have flowed Fi for the past year He posed arar nthe nsekto te smargency department wi the coma low sperm count He stats tha has burs an his stomach andalon sperm curt a 2 ecu he lasers that he polce use to tack. He says tes crtacted Sergeant Wichaels, an eral afars tificer ho show evesbgainghs chage of pole bulalty ‘The part appears aiscus ar reqirty Tacks cure window. Ate tng is soy he asks youlevelim. What she best response ih question? 15 °Sr believe your concer are sya fa pacha hess” 5. "Yourimagiaion geting he bes of you. What you as taking abet cnet possible, so pate stoe werina © C.'inon your exariance hasbeen ficult for yu, Late eae whats can do tol 1 “Wry dont ne cal Sergeartichalstoinqure abet he progress ois investiatan? E 'ts.ag00d ingyou comet ie hospal_The pace lasers cart gett Youre When psjchoc paints ack yu sare or blew intr delusions ar hacia ts irapprepit ta nsw int fabs However esatching appa i of considerable importance nth eaten opulaton andan outight acuta che patents beats may damage be pyscen gate reaboneip "The eat approach s anon comma and nan udgmantl stance n which you acimawedge De patents isress vatouondo'sing spac deusonsoralucnabons. Aer amore sabe physcier-pabert. Faltorshe rasbeen ounded, may be appropriate to assist me part dstngushing paynctc Movants tremely (Choice A) This bunt buthores statement maybe tees eceved aera stronger eons estab whe patent (Cholee 8) The cencescensingtane chs statement minmizes the patents canceme which uncermines ‘appar. Mroover tis Fig unusual forthe course of a paler’ psychossto be sgnfcandy mpacted by ‘Satemeres such asthe one holees‘ASF, lve your concerns are eyes af = psychiati hess.” 5 "Yourimagnaton geting thebestof yu. Whatyau taking abeutis not possibe, so pease sop reming” 1.6 Cin your epaianc hasbeen dificult for you, Lats ae vate can dato la 1D "Wy dont ne calSegsartivchaels io nqute abou te prozes ois estiaton?* E its agaod thing youcamete he hosptal_The pce lasers cart gett youhere wont 7 nen psychate pits sek you share aleve inte delusions arhalcinatons inappropriate ta nsw int afrabv. However osabcing appa i of consiertle portance inihis patent Bopuaton andon oxtgit resulta cthe patents bles may damage he prs patent reabonshi {The astapproachs anon coma an nan uagertl stance n which you aimawledge De patents ines uma oncoring spare dusiansoraluenatone Aer omer ste pryseten patent Feltinshp tas been founded, tay be appropriate fo assist the pert dstngushing psyched houghts from reaty (holes A) Tis bu burhonest statement maybe beer eceva ater a srongerelatonshi is ‘Seublehed th the pater, {holes 8 The consescenang ane otis statement inmizes he patents concem which undermines ‘appar Mereover, fs righ unusual forthe course a paler’ psyehoss ta be sgnacandy mpactea by ‘Satsmeres such aot one (Ghotees D and e) These resoonss suggest you conser the patents concems to be easonate Physicians should aad rerforcng psychatc beefs, he simutanecuslywrshng io esas apport and pen communication. Eeuestona sectve Physica saul be nan-commva andinanugmertal hen weatna psjchtc pateres. tis impartanta {einoafesze tne patents cetene wena endoreng apes delusions haluantn. NORLDLLC. aber ver 2000.09| 32.year oi man presents tos famly physician comparing of erectedtuncton ana decreased bio forthe past mart. He ones any pan orloss cf seraaton nie gens ad Meena poten na Uuinatizn. Heras never eperincod these symtoms before ad finds tha vary upseing, The pert has ‘hstow of schizephrena and was discharged Wom he psychabic Hostal tree morhs 9. He denies, Snycureat halucnatons ar deisans,andhs hogs acvel ganized. Raven of Simp egatweexceptoraracem 3g (6 SE) welt gan. Physical xamnaon reveds leeral react Cnirgement. hich othe falyng aecaunt hese nang? 1 heteaseddoparine acta nthe gros pabway. 8 ncteaseddopatne acy inthe mesolimbic pty. CInereased dopamine atntyin the etorfundar patsy 1 Decreased dopamine acta inte nizosiatal paw E Decreased dopamine acy nthe mesolmbi pabwoy v0 F Decreased dopamine acoviy inthe uberartinsuir pathy ‘This patert has sons ang symetoms of epralsctneria, 3 condi associé ih sexual dstunson ang gmecorasta nmalesNarmaly neurons nthe uberanfunacul patty scree soparnne, when inhbts prolactin lear rm heart ptay lar. Copan recopiorartaperise such 35 “ntessoranes meer It sopanie's Sly to eB proastnrleae eaugh vs Bawa, AS 8 Consequanee,ploac elesre'esbmulsted, Causing hypatpracnaria (Chotes A) The rigratatlpatway extends fram he substantia nigato te baeal gandia, ndieinvehadin thecoordnaton afmoverert. creased dopamine acbiy nbs pathway isthoughete te rahedn ‘movement rae sich a chorea anaes {Cholee 8) The mescimtic patwray ends fom tne vanaltegmantl areata the lnc system. Increase saparne acy hs palemy accounts forte eunhora seeoraryng Gre, as We asthe eure arahatuenatans expenened by paris wih sonzoprvena (Gholee 6 increased dopamine activy nthe uberanfundbulrpatway inhibits rather nan simulates prolactn releaseC.Inereabed dopamine atktyin th uterorfindeuar pay. 1. Decreased dopamine acti inthe izastital pathy. Decreased doparine acttynthe esolmbicpatway. Decreased doparine acy nthe mbertunsbul pathy ‘This patertas sigs and synetams of yperprlactnaria, a condo asccitad wth sesual ytunction and gmecomastamnmales. Narmaly, neurons nthe ubetomfunaeulz pattway secrets ooparane, whch Inhbts proa-tn release ram the artaor puta lar. Copan recepioratapeits Such 95 “mupsjenance Deretore int sopame's sly ta fbr proctn alee roushius patay AS 2 Consequence rast releare ve somes eausing hyprpraacanemia {Choice ) The rigrstatl panyay extents fram the substantia tothe bass gandia. mdisineokedin the coordnavon ofmovemet. noresed dopamine aco nbs patwayisthoughe tote nyaleEdn Imaverenteraers sich chose anaes {hotee B) The messimtic pabwiay ete om te vena tegmental areato he nbc system Incresee copamne acy is patway accounts othe evra sccorearyng Grup use, aswel 36 Be Aetsirs andhalucnatans expenenced by patents wth sczoprvena {holes ¢) increased doparineacvy the tuberinfundbuarpatwry inhibits ator han simulates proactn else {hotee 0) Decreased dopamine acttyinthengrostiata pathway causes the atrapyramital side tects sssaciated ih antpeychats ue, ae wells the sins and symploms of Parkncon's deaase {holes €) Decreases sopamine acy n he meson pamay accounts ore hetapeute ees ot antpsychotes éucational objective: Artpaychutcs cause ypsprolacinemia by blocking dparine att loathe iteroiunduiar pany th too etupdtes (021200 JORLD.LLC. Oberk ver 2009.02 F‘3 38.year ot woman trougtta he emergenay depsrment ater ting inolvedina mina cat acon ‘She austaned 3 sma aceraton a her hand aaa‘ mig headache but expanencid na los ot Consciousness dung ose the acid. Whe proidng her madicalhisioy shotele yout she has Fad eacer formate han ive years. She does rot kno what ype of emicer sh Fas on says shes frasated wth het doctor because he has repeat tae that she Rasa eden of cancer “She ‘apart haung seen mull pysicias verte pst ve year, and haang uncergone mule raga ‘Ses andood tests at fl foreve cancer Whenyau ak hw she Wins Shas cme she eps, “Beieve me, wnenyounave caer, you kaw” Prysea examinations umemarable except or aminor lacersin onher nguthand. Vinzisthe patents dagrsis? ' Bt psychote sarder B Delnum © © Detisona ssorder D. Schizotypal personaity dorder Somsneaton clearer ites 7 [Deisonal disorders an uncommon consiton characterised alse noneare delusions n= thenusehigt-tunctoangingwdua Halucnauns, dsofeanzed hae. and funciona deteoratun donot ‘manfestin pabarts win dslusional dard when prsort. hey are supgerive ofa mars panaie Boychoss. Anipsychotc medcatons are en usedte eat paberts wth dluseral disorder, buthave not Drover veryetacthe ‘The patent dasenbed above has he nan-tzare delusion that she has cancer Her delision ceumscnbed and does net thenise fect her hnctering, I adébon, she has re other psychotic ‘Simgioms, maing delusional sara he mast apres daprass (holes A) Ei psychotic sorters chaacterzed by delusions halsintions, and darganzes ought that lst fa na mre fran one mon. This paler hawever, ha a romial uncial status and no her Teaure of payahoss 208 ram her snl non-bizae geste, (Chole) Osu carcass abrupt eae carts Sareea ng cease ot1. Scnzotral personaly Border Somicaton dearer ‘Deisional isarderis an uncorman coniton characterized lated nonbizare delusions n an ihomisehigt-functonngindsidud. Haluinains,dsorganized haus and funcional deteroratn da not ‘mantastin pavers win desional dsr wen prsent ey ate suagesv oa mar xpansie PSyehasis.Antpsychote medcatons ar afer uredia Wea pater wh aausnal dsarderbuthave ct provenvery face ‘The pabntdeeenbedatove has the non-core delusion hat she has cancer Het deison ceumscnbed and sees nat ese fect he unctaning In addban, shehas neater psyehatc ‘Simpare ming elution] seardr he most aoqreenascagnase {Choice A) Eri psychotic dsorderscharacerzed by delusions halicintins, a organized taught thats far na mae fan one ron Ths pater hawsver has #homalfunciana sts and no her feaures at peyenons aes om mersingls non izane geusen, {hoice 8) Dsrium'scharacteized by abrupt onset corusien,soenstion and decreased eve ot onsalouness. Ths pare however has a namal mea staus andhas martanes We spe delusion fertveyears. (Choice 0) Pavers schictypal personaly sorder have muti odd mapcal eles strange tous processes, and poor nierprsonlesanonsnins rit feiss D=usions,Nowever af sual not a Fisture ofthe conan, (Choice ) Somstantion disorders an unconscious sxeeson of emotional ress trough vscal signs, een leading a rule nagave dagnostc evaluations TMepalent Nas no Sans of cance, homover Educational objective: [Detsoal disorder nies one of more nn-izare deusinsin an ahensse hi unctinng in oot tase etupdates (021200 JORLD.LLC. Oberk ver 2009.02 F‘The paterts ofa Syearld gt tng her ta cn far evauson, They ae ight because er daughter has stared oak afree, especialy when chee soe nr rom. Whan he paras ask ho shes falongta she says “Nooody" and refuses to dscuss the mater. She beoomes angry fey pest. FRecey ster sping mi cng breaifst, the gt dnd having ane song at Wn” as ‘espana The parents srt ay nave na des anos '2 The gras sometaublesSusnng to IGnderar athe ear fe sol oar ut ena ing wel. She mony el, Pena mee rots, ano as eae alo er milestones on be. What Shao ean be ave” ‘© Aur daughter's behav i name arher age, and nee fe nting te wary bout 5 “Your daughter should start thing risperidone to decrease he hethoa of er syrtoms ‘rors (“Your dougher maybe experienc misteament and abuse n her kndergarten class 1."Your daughter hous begin woe couneing sasione ih the echoa paychaoget| “Your daughter has oppostond deat cistern nts mere li etna before twrsens “This Syed git hasan imaghary end, whichis quite corman or her age. Parents fen become Conese and fuses vente chten segue magia mend tut Pi phenomenon eneray Consdefed an ndeaton athe chihas found creanve ways a ceal wih bing alae Chisen beeen the ages of oo and sicyears are most bey develop magnary fends ycayf respase tees ch ‘change sess. Mast roan abandon ms banavar thin te Ms fe Years of manta Son Explanation: (Cholees 8, andD)imagnarytrence ar caneeres = completely namalphsnomenan in cieren. They [sonotincatve of psjchose,atuse or the ned fr caunsang (hotee & smovan hare wen osgostional dean: osarde may ame aners Tor ter mistakes rmisdeeds, thy alo tnd tahave a pattem of angry, rgumertatve, snd nepaive behav fovars thelr parents and teachers Eeueatonal asectve: Imagnaty enas ae 2 ramal camponentt development fr mary youn cise, and ae usualy cura byte ery elamentary ecool yearnas Sarsas ek toners eopeily nen ane @ lone her oom When he paren ask se — takngta, she says, Nod” and refsesto dacs the mater. She tecomes angi hey persst FRecetyate sping mk dung breaMas. hep danedrauing nef. nsetng at ny" was L ‘eapanatle The pares ste ay ave roles arabs The gr has some wale susing Findegaten lth star ea school year tts now dong vol. She's anon child, has ro med protlems, ands reached a a her miesonesonbme. "What haul he tents be ase? ' © A"You oaugrer's bear i armel arRer ae, andere etna we wary adoX B “Yur dour should tart tng nspendoe to decrease the ikethond at her STAM vroering” (“Yur daunhiermaybeexerienngmiseament an sbuse mer kndegaten class ("Your douse houston wey eouneing ezsion win te echoa payehsoaet| "Yaw saugrer has oppestand dant oder andneads more lit sting belo terse “This yeaa git hasan imaghary rend, whichis quite common orher age. Parents fen become anesned and puztes wen er charensequre magia mend, tut phnomenan s oeneray Conadered an ndeaton tat the chihos found creanve ways ceal wih being sane. Chisen beeen the agos of bv and sicyears are most kyo develop imaginary fends, ycaly response to bes oF Change sess. Mast ren aandon is banavar wth te Me Years of manta Sen (Cholees 8, and D)imagnarytrence sr caneeres = complet namnalphsnamenan in cidren They ‘notincatve of psjchose,atuse or he ned fr coursing, (hotee € movan chisren wen ogeostional dea: osarde may kame aners or ter minke Isteess they iso ten toay aati of angry, afgumariaive and negaive bea ava thee parents and teachers éuestona jective Imagay fends ae 2 ramalcamponentt development for mary youn cise, and ae usualy curr Dye ear elementary szvoal years ver soap Fe1 S.yeacol Caucasian man presets complaing of eeingovernelmed by fe" He has ft depressed forthe past socmort, and sats tata has dficuty focusng on daly acwues. Hi eps poor adhe toes reqemdy at rah Further nqary revels athe 9 Var War vetren and that he enpenences fasheacis anunarimares cout comeatepaiences Heats tat he hateacks beea er Me {ealngs of depression Ne ads atchng warmades arrefises ta ciscuss wen anjane iste spat 9 \ietam This his fst ist to a peyhiatst and he asks tobe said on some medcaton Which of Be Tolorin shouldbe avoded mms patent” © A Lerazepam © 8 Nompsine © © Paroxetine © 0 Bipesuetneray © E Copitve merapy Poot| Sb.yearold woman has ais of mir depressive dard hat nas been in remission forth pat en ‘years, Sha tales paneline daly and sees he pychatat every chet mann. Whe on vacation the ater and er hushongnalge na gourmet meal. tera the patent becomes concamed 9 She Eeleves one che ashes may ave cortaned aged ciezse heh her pay Na wate Me oot featng. Se comes tote emergency deparmert of elaca hosp te express Re cancers. Which othe faloring is mst appropri to ment? © A Bod pressure (© 8 Bld wes riragen creatine © © Cresine pasphatinase © D Lier tunctantests © E Tempertire PootWink arin sth atendng peatician the neanatlICU, yu re cli y uring ta examine twe-da-ldmate chia who Ras recent tegunvorntng The chighas fled o pass mecanium since bth Physical eramaton demonstes sacar’ atdommaldteréon rectal eammaton reves 1091 trata au svangy suspect Hschsprung disease ans farm te chs maha alan skaorea ‘adagrag andtarum enema srenecessary The mater orice yeu tam proceed win any futher tesing or procedures because she doesnot tle heres arjhing wrong” What se most appropiate reste? (© A Age atta part a ests © & Catan a cour eer to aumarze testing © C Proceea win ete © D Contact the hosts ethics commits for udarce {© E Wiaitun the mathe proves consent © F Callgendparens of chido cbtan consent Poot| a. yearo feral trary assistant rater a psych forthe presumptive agnosis of Gystyia. She repos having ates. yer Riso of aw energy vals and radu wereening nr sity tofocus onherwark. Sheteels "sad hopeless” and experiences pleasure. ‘She denies ayy suc) tmaugitsShemae never been an ay payehatope medozions tla and dens ary fam ton of psyche ness Shs nas gateseaphages etx aaenesforvinch she takes ameorara ‘She Naso noon args, and does nat rk Accel or smoke eigaretss. The poychatitcecdes to teat er syria win bupronion. When a he follonng a canranscston‘a the use of burepa? © A Nacalepay © B Atenton efit hyperacty order © ©-Smekingcessaton © 0 Anorena nenosa © E Spot dserder Block aioe2 35. yeacoldwoman has craic austey hlucatons which she hears he fathers vice Hes vice ‘sai encouraging ngs tor the pas, butt has recor boen szaldng her and saying derogatory tings hauther The woman's stared on rspersone, and she reums to weeks er fo afaloneap st $inaugh ae sates hat he ralucinaans ate much baer you nae Mat se a wang much tower than Usual andie ner swngig her arms. Also te pabers aca expressions ae rer tang unchanging, an ‘he ait that her wring hae become emallr sce staring the mescaton, Winch ths flowing phammacsoge changes woud be mos parame? (© A Statuenavopine © 8 Statderecene © C Stat proprarstl © 0 Sua servaine © E Discontinue ispendone and start haere! Poot2 2b yeacol sda, para 0 Caucasian female uth ahistary of bipalar isarder presents tight meeks of gostton for prenatal coursing, She hs been aig ttl ase of rium forthe pat yer. Herat. Aepressnve epsode was 15 months age Her famly history's sigicat for bpoar dsoroern her mater, (hich wna success coratag wt iu he does hor amas fgaata or cenaume aan She {sks whee er baby wll have ay congentalaznarales, Which eftefolaningcomplcabans is er fet moreso re fo? ‘© A Catdac anoraies © 8 Craniofacial detects © Neral be ceects (© 0 Weta retardation © E Genital anomalies Pootoe 2 18yeacoli itis bought ta cic by hermahar, wh complains thatthe gis “ficult ta at alan mth a | lately" The mater says her daughs can no lorger concsnate er prlond peas ands easy ftaved + ‘She fos fungher tering mer sles snight She says tat er daughter genes consere ty ends ans amy tc2"Tigh stung" Upan ingary e a asm seeing atemayaprenenave whe ng {ests arschac Sa feals is sts fam er nanralycompetoveranre rahe desta be class “aledctarian. She wories abou boing accepted to 3 good uriversy and than bushes schoo She ays that ‘hei urate carol er nous ana amatmes fakes 0 day af Fam scrgalt “escape athe Sess, that canes wih" Whch of he flowing the mast ely agrasis? © A Pani dearer (© B Generalzes ant isarser © C Obsessive-campulsve disorder © 0 usin personality dcr © & Simple prous © F Sonzaa personaly aster © 6 Schoo personaly asoraer 5 PootYou are the nteist caring for a2. yea. mal who's srckan wth alcahole gastiss. The man has Famaned ateet from hi work a a water for several days due tans ness. His employer cals yu for ‘ote featon about re iness andthe prognsis He says thet he jst spoke wih his employes on he fhe answas gates prmissan a aiken you Wat the mast sppopral fesporse ths request? ‘© Aim soy, tut leanne share such inarmatn wth you ats poet ce BThedagnsis is acohoic gat, and expect tl lear up spontaneous at sme pontin ‘he near" 9 © “lean assure you thatthe ness does not pose a heath iskto ay of yur empnyees or _D"ilneedto hae a lease of tformaion dcumant signed by my part before we can > Socusstis mater” Lo "lll ped to have a verbal waver of cane grate tome byelephane before me can ‘Ssiusstmemater Let cl youtack™ Pootoe A S0yeaold man resets pay ae physi ad descbes a sense ol geeae fm. He on ‘eps haa ee ery arene aa heay aug clege deeb saya‘ See . tke ps wong or aon ost Byers Pe eas poor ahs on pounds rte lat ee yes “etiipn shows pana ana sys sine seu comeaang nostaie yt medica ety a omennaetmsmurane adne doe ot sninedrgsoraesnl The eter =n bare rt {en an semper bscbal wnt fan. Baeedon te above pseanoy a he iostey oan? a © A Aden dour =n © 8 Dystymis a © C Map dees dsrder =n (© 8 Ganeraze nt aioe ea © Suber nies ans ote rs srt a2 shale mather tings her 10. yea. santa see the pedatician. The mater says that she is abs feduo" wah ner eons behavor ane unable a coon. Te by feaueey get i fate he ‘bing, neighbors, and classmates at schel When asked helpwth hausehot chores, fe esos. Hes “eaysarterpered and argos equery wits patents ans teacher Atew days ago he goin an [argument win te elder waran na nes nest doo, andi aft anger heated 2 marker and wre 29 ecanty on har font door" What iste mos ely diagnos? © A Conduct dsrder (© B stertion defi yperactty disorder © C-Touete'sasorder © 0 Oppostoral defatdiscer © E Arisacial personaly disorder Poot‘22. year os woman trout ta he emergency department yes father because he is demon “srange, dsorganzeabshavo* Esler tht day shi had ssi tal he leven nen anchorman Was tang diecty fer abet the rsks of patsonrays" om the moon Se was asa appweriy aterpng o "erganae her baroam cose nen he fer eundhermuaning ineeterty an ceuntng te aera pal bfenais over an aver She's agesesunen examines nine emergency separmereanatne denon = ‘macs ta sorither tothe payshatc wars Ther, sora dead raw, ts gros of ctaophama ‘ace, Se stabized wh anpsysnotes and then dschargeg name Her fer asi wat can be doe ‘ase her etn to everyday ie ato decraae the ano ft haspealaaion Wich the along ‘eseures veld te most ph ini ears? ‘© A Restictthe patento home as much 5 posse (© B Eneerage te para ret tower (© C.Miize the patents social ineractnwth others © 0 Keep famiy stresses and confit 2 a minimum © E Stengly encourage he patent ta make new ends Poot‘mide age Asian Amescan maria couple comes adn fora routine exerinatin Bath he hustand nde have been knorm part of yours or many sar. The husband i tsing ested ft cornaty atey Gisease and tension headches. Today he mentions tat he "cant get an erecta even when he els ‘eau este He adse mane sla vate pysicaly atte sat ey are mua campstle © ‘very respect Ths recere deveopmert has zen causing Rm signficar ane ana hasbeen a sauce of Concer or fis wife Ater rung ou medal nd psychological causes for Ns tect ysrcton by ting 3 Setied istry ana pursuing 2 orough workup, you ayee to hs request Mate te stated on sens One ‘eek ater hie af laces an uget calla your oes, repatng tat her husband developed severe chest ai tar iang tha naw medication you prescrbed" An EKG doe inte emergency dgatimertreveals Few nfenor walischemia You mimes reaize hat you shoul rethave wen Ren the prescrip For ‘Sloe because re was akeaayusng 2 vogycein patch for Ns coranaty ater ecabe has De ‘ost apeapie ne step? (© A.Withald is irtrmatn a i could est iva leit © & Admitothe patent and nswte mat you mase a ste © ©. Tele pater and his fe that you ware not sare of tis ross reactonbetnoen the to drugs (© 0 Telihe pater and is wife thats chest pain was probably precited by ansty E Remar yousef athe pater’ physician immediatly e PootA idle age dvrced woman bigs ar Bye daattar tothe physcian wh the complaint that her {augntr soem sonoma: Shee concemed bacavta her auger hae na cla rence, doesnot 3, land shows na erst nthe actvtes that are popular ith young aduts. The il prefers saude and keeps {Dhar oom fr mast of te day When she dos ga aut she hues nthe woods tne for hous at anme, She ‘tends alocaunveraty were she stusiesengnecrg and pavers wel scademicaly Cunng ie fice “is he daughter avis ee cortactInrespone to questringaboutherreasoe fer tng oo, she ‘eples “ius oor enoy eng nthe combany o aes. Peonedonatineest me much woud rater keeps myset” Her oud pacers appears deal of deine. halucraions Which of te fallnng personaly corde ie demon ated by her bear? (© A Schizelypa personaly dsorer (© B Dependent percaalty eorder © ©. Schizoid personaly disorder © 0 Assit personality dscrder (© E Sardetinepersanatydisarder © F Sehzophrenfom dserder PootBlock 2 38. yeacoi male wth achranic sary of schizophrenia is admits to he hospital for deteriraton inhi Condon He 3 ken patent nd was stable an risperidone forte pastfew years. Toy, hs patent Joss Ratrespend when spoken sand he sts matciessy He moves a eye contact an his fac reais ‘Sipresnoness Val sgn: ncuse emperaurec137 OC (998) loo pressure ISZEO mm Hg, pulse ct fm, an respisiens af mn. Physical ecminain semonstates aftuse muscle ngity bis cshornse uverartatle Which of he fllovng woud be the most sporepat nx 07 (© A etease risperidone dase © B init harap with datlene sod (© © Replace nsperidone with quetirine (© D Continue same dose of isperione and 23 clozapine © E Adninterrezepam aioe2 7yeaalboyis baught th peatician by hs mater for aout chec-up. Physical examinabonis ‘normal, tt durng ths seam th mater reves hate son's behavior hasbeen poor She eaye rate ‘nays running around (even suing dinner) oes ister andeepshis room a mess ‘She Mapes he wh ‘jw autoftne saon. Upan ater uesienng the peda ears ate patents second gate {eachr has reponed hat le answers questa impulsively and auf tum, and tat he cannc sats dese for 3 varying te without higetng_ He als tequety forges toting nhs homer The mater tates that ner Son Mas hagthese synocame for about year and that hs grades ave een fling ovr he past ‘orth. The daghosis of atertonsefckhypetacvty sodas mage andthe boy © sated an ‘thant. Which othe foloving sie cts mest kayo occur in pairs who take retybhemaae? © A Decreased aprile © B Donte © © Hypersomna © 0 Secures © E Weigr gain Pootmide age, divorced mater ngs her 18-year-old dauahter infor a evaluation She say thather Gaugnternae a ero rola. Ths momma concemed because har daugtar aay heey Mesa Goes rot te has no cose ends and refuses parkipate in atvtes popular wrth wren of he age ‘The dau eiemalyassatetoy wtencra, sper caurdess aus inher foam garg i 2 Crystal ana muterng undernerere am Wnen canard south cena ane 20} have some Supernara powers that ar nating to deus” She aonds college eguaty and ears ood ade. ion one ane fofowing te most hey agnosis? ‘© A vldant personaly seorcer (© 8 Dependent persanaiyssorder © ©. Schold personaly disorder (© © Scrizoypal personality sore © € Sehraphreni Poot‘Hispanic marie cauple rings inthe 1-year san because is bahavar hasbeen sharma forthe past twa weeks Noraly, he by pate and ot spakan uth has event become erate andre, MS parents dsmssed hs behavior a5 2 phase" nh the expectation tat he woul fo out of ut they came vty cancemes upon tava et neha bean spending age aura mena tom Ni age ‘und wahaut ar consent When questaneaty his far abast hs sang Cenava the boy espense “Im fn secret ion Tsling of Naw hae eet me hers to spy onthe US qovemmert" Hs tl Sg loud temperature o 9 2 (9) oad pressure a 12214 mm Hg. pulse TOs, and espratans ot {Wan On psc examnatan the bay appears tabeinna dts Hs pups are dated Wh a he folening ie fre mee ely daneie? © A Bri psychotic episcde (© B.Mricepeods © C Herdn ination © 0 Schizophrena © E Arphetarin intistion © F Herinwentrava © 6 Aemphatine wthstanal Poot2 s2yeacold woman trout int inc by her husband af fou years because she hasbeen rests and hyperct’for re pact bve vedi, Ths huccand esses tae unueualy tala, and eave ere epeake So quchiy that ahers hove dey unserstandng her She has spent iarge sms of money on nw chat, ‘aleip ans pes, when asked abou het purchases, she say at she noes los elegance ‘She "a member ofthe rojl aml" She stays up veya each nghtt areughy clean te hause, on ‘leering only an hour or wo, The husband nab never observed hase symptoms before in is wile Physical ‘rammaton other uvemarkable nh oe along Ns woman mast key Gung am? © A Mane episode © & Hysomane enone © © Bios asorder © D Dysthymic disorder © E Bie psychotic ésorder © F Opioid ehirana © 8. Trtnscosis Poot2 Tyeacold woman trautta the clinic byherdauht naw The woman sa requlr patent and has Slonghieary cf hypetenson and cham heat deeare. he ee Yat gon and dugtetin an na ‘re concerned that she has bacome increas feget ul ovr fe past yea ial, they abd er Fergetuness te normal agg et er memary mpatoet has prtessve warsened aa he past s=vtal ‘mort, Of ste shehss sso develope some dfcuy win speech and no's no onger able to perform ne [rhs of dy ng Wich one ots folowing is the mat aly disgrace? © A Prk dsease © 8 Pseuiodementa © C.Mutinfarct omens © D.Azheimers dementia (© E Norm pressure hyrocephals © F Gictastoma mutfame © G Age-related changes aioe9-year li cose foal brouht othe emasgency deparientcomplaning of seer at upper {qusdrant abdominal pan at began cudéoryearir bis muing.Sheis accompanied by het husband. An Utrasound evaaton fs performed ante woman fs dagnosed wih acute colcyates Bees her Syrploms worsen win conserve wearmar e dzcsion ade Co cpetate The pars wscharges ome ve days ster nr successtlehaecytecomy Upon ascarge, te patent and er husband request llmedcal recor associate wih her stay What the mest appropri responce onthe behalf of ho pivseian? (g ® Prowde a copy tine eran vecorés co B Rete to provi the ecards 9 ©-Potely inert coupe htt unanoprov patents wth ter medial records oO Gere them the mel chartintsenrety Go E imaure asta wry ne recor are needs Poot2.yeal boys baught his pediatrician by his mathe for‘mutile fang spl *Athoughpsicl ‘sarinaton reves no abnaraltes, he boy fe aarited to tha hospalfor an eens agnosie Wotan Uatortry evaluation reveals no abrrmaves except fr aw serum lose high serum insulin, a oe loves seran C ppt The tea suns are evedadta ebay maher whovwars aaa seh he hospital Wich othe folong the mast ely cagnosis? (© A Factiousdsorasr © B Nalngering © Child atuse © D.Hpoatycomia (© E Murchausen syndrome by pmy © F insulnoma Poot1 1e.yearolstoy presents ta is pcan th scaerad patechiae ad steed hit of fetaue Lateratry evasion ad a bane maraw biopsy corm ie agnosis facts Wrmphelasic leukemia. The boys parents ate dkorced and have rt custody afr Hs mater corsets tote proposee himatrapy an tloosvanstusion and equesc Paris eatmert ee sated mediate The ae, howsver rene to apse tthe weamert because ci eis bales Vihas the most Soprepeat ans ending ts stuaion? (© A Withol te proposedteaere (© 8 Proceed wah he proposed reatmert © C Aske ptt ns wishes © 0 Obtan a cout oder to procees © Consutthe hosptats thes commites Poot2 1. yea. college reshnan is rough athe emaroency department by his ends. They say hat hes normalyhappy and gaod-naurea but bacame unusual waharan ad aot afer urs ater fatal gare He complans af ary moun Physia| examination reveas injected conuncbvae a tachycad, iron ere along is most content win ns patents presenta? ‘© A Opaid overdose © B Adenal criss © © Alcohol intvcaton © 0 Cacanewihrawal © E-Comabisstuse © F Opes werarava! 5 Poot le2 st-yeacod male presets tothe emergency depatmentcomplaring of severe loner back pan He rates theparvae 110m svar and deezrbes tae nonradaina,euadon monoct and agg by ‘moverent He eluses tbe examines, nssbng hat any exarnan il worsens pa He denies ay Isto of trauma ar ing teary wets He tay “Doe, he ony hing that ean rleve my pans ‘margin. yauVe gat ta have metcy on me The paterthasalarg Misty ef epaic depencence and has oun sito the hoepl ub trse whe irsisted Ai at afreson wae ban weeks 290 and he as refered to 3 dg enabitatonprozam upon Bscharge GWen te cca pesertston, what ee ‘os! hey diagnos? (© A Factiousasraer © 8 Hypachandiasis © © Mangting © 0 Camversiancsorer © & Disc nematon © F Cay equinasyrome © 6 Dependent gersonatyasoer Poot‘young Caucasian mater bingsher5yea-l daughter to he peiatcian woah ater he oi ist began tencing hndergaren. She says at ata isk het Saupe teacher clea say tat te gf persistent refuses a anserquestons oro speakto thers nclass.The teacher aed atthe pr [Bes soos notaries play wa, a thers cigs ne tall stems The aha NN ery Surpaing paceuns ner augrtsr very vere! anstalatve strom '3y2Mepoly winner sings ena @ 39 sMfectonato chid Futter questing reveals atthe gis alte shy’ asocl gaherngs. Which ofthe alongs te mosey Gaanosis? i ‘© A Separation any aor © 8 Sacipnot 7 © C Selective mutsm © Dats » © E Sanger aniety 5 PootA idle aged maria couple beng hs Dysart dave tothe asian bacause she sti oo twadto ply nowadays and sleep al the neha ates say ha thar auger sanded itt mina creron Further ngury reveals hat or the patio meek the has had leedng gus ihe she Srusnes heist Pryical examination semonseates pal arahepasplenmegay an ocensve warp indeats athe gis suterng rom ace ymphabast leukemia, an her pareres ae formes at Chemotherapy ile necessay. The paerts frm refuse o comply wt this teen pan hoeevr, ‘ecavee mey are conunces atthe sue eects wllbe too severe Daspte a engy dseusson about ne eras often andthe lal conssquances fo tor daughter fthrapy stil te spares int upan ing he hora. What i ems apposite? © A Proceed wi the chemotherapy © B Comply wi parents wishes © ©. Obiin a court oder fr chemotherapy © 0 Prove suppartve wesmant ory co Eltfam te pareres hatte refuse treatment for her daughter, hey wll needa fd anew © pedinrcantsassimener ce Poot2 T2yeacoi man presents for afolomupvistregarng hs depressed mood ais wle's death seven ‘months ag. The pater camolan of thay ad epsodes af earluUness. He has atendedbvoe sessions UF supportive psychaterapy sar and expresses aporeiabn forthe referral because he tes the eros However ne coranues oot cepeased an is naw penance ncurna He's asa Tesi vey uy Shsuthswte's dea ana fees tharhe shaulshave somenay dans mare farmer nerf manta He ‘rat tnt during 3 party dark momere at marth he brs conempsed comming sis 2 that Fe 2049 jn ner” atnough Mets aoamor tat he Go nt el SuCdal atts tine and ead carat fer safety Physical examination reveals he pate has lst 13 bs (59 hg) saceTns mes dea. What ste st apap nes a6? ‘© A Presciteamitipvine and alprazolam © 8 Prestite snag © C-rcrase payhotherapy sessions nice woshy © 0 Recommend eecracanmisve nerapy (© & Prowse essouraes and conn paychoherapy regen Poot‘year od Caucasan man presets to family physician comparing of wight loss and fatigue A eve of eystsms i pose xa change bowl habs. He sys thar inte past several eke he has {evenped pencihn sons Futher evaluation reveals he presence afcaon carcama, The pate se ‘Me dagnans, ands veamentoptans and pags are oscussed He uses any eabmant ane says Me ants ce peaceful at Rome wher any saccaliaverson. What woul be the mas appropriate Means handing testator? (© A Treat the pabetaganst hs wishes ‘© 8 Coreacths tamly and ash them to camince ito receivetreatmert (© C Askin patent why eis reluctantta be tested (© D Respect te patent's decison © E Provide the pat th sre rue stout he banat of chamatneray PootBlock 2 12yeacolidtay ic sccused of setng hs neatbar's use on fre Hs parents describ him a5 hyperacts, tava chi, He eas excellant grades schoo but requ ost no fits wth schoolmates and sings. Two years ago, he was caught seting he err of fers caron fre He hos ‘abu eon to several suspccus resin the nlghzoaad hag no cel chatoes were Beught laganst im Eases on is iformatan,wheriste rast kay aghast? ‘© A.Aterton dofcthyperacty cscrder © B Promenia (© © Oppositoral defantdisader (© D Antisocial persantty dsorder © E Contuctdserder aioeBlock 2 38 yea gated feral wth an aninaan medical histayisboupht the emergency department by poice ar he was found zssautng an macertpedestan on beset. Shea te aterm pryeician that she has unusual pavers and hasbeen seroma spec mission by God She s proud freuen Communcaun wih Gad tath parca andverbaly and sys tare asi ern -purshing al tthe wicked paple nthe ward" Whh fe falling is ast emonetaed her ugh career’? (© A.Magealtnring © B ideas aretererce © C.Grandase deusin © D tusion © E Halucinatin (© F Flgnctideas © © Perseveraton aioe2.28 yeacoli femal presets oe family doar wh her mathe, who complnsthat er douse has oan behaving eecentcaly ands boen social aren fr he pat year. The Matha ys that ht Saugttr used ne very load rena. tthe she stp ut hea 9 a tn ana one year 290 “indnow pefrstaaay hams ner becom moat tne ume The pater storaughyevauseaey 2 PsychahstDunng fat ere, she revels tothe poychisnstnat she canstay hear so many aces" Ine head. The vless tl her varios things fa crtal and suspicious nature She ako as hat she els “ty sad and has Padrumefaus severe crn spas ater eet do's deat our months ago. She rete tobe dane and des not enpy meracng wth ers. She haspaor sles an ee apps Wich ee faloning is he most ely dagnesis inthis waman? © A Schizophrenia © B Schizaatectve dort © C.Msjor depression wih psychotic features © D.Dysiyma © E Cyelatnymia Poot. | ayearol feral cole student i braught tothe emergancy department pace 290 am arene 7 was caugt atamptng ta eter the White House. Shes hgh aptated and is pacng aeundths @arinaton . ‘Bom. Upanfurther questioning, she states hal she ste fom Texostomeet wi fe presere + [ecause she has 2 Youproa plan or elma trem lance nist sen ay” She ae at she 0 has br siepor me pet ten ngs tecause she nes bean ang mens ontmspan She epese 4 ‘ery ky, tt period aly stops to angry shout“ going to sue a of yautorrterfeng wh my ee 2 mest wah te ptesnt he ealatan nas ote stoped because she demands Mat she be stoned to leave. Famiy isos signficartfox maor depression in her maine al sigs are temperate 570°C (80°), blood posture 1494 mma pulse Semin, and espa ats 23 rin, Which of he flavirg rmedcatons sul be admnsteredin tis pabere mimes? © A Mitazapne © B Desiprmine © C Flutie © D Haloperdt (© E Ubu carbonate 5 Poot oaFor each patient itn any sees te most hey diagnosis ‘An 1. year-ol feral has st started calege ands tng by hese fore fst ume. Forth pastmach, ‘he has ben iereasingarious hat sarteoe is going to break rt ar house despis ing a uct eihborhood. She festense al the te ad isha diculy slepngtiraugh be mah AS 2resut Sheen ed al dayne staging att her eden © A Acie sess dsarder (© 8 Adusiment dsr th anoety © © Avaiant personality dscrder © 0 Genersizes asety disorder © € Obsessive compute disorder (© F ObseseNe-compusve personaly Border © G Paranoipersanaity dsorer © H Postraumti sess aor © | Social photia ce 4 Seeere phobia Block aioeFer cach patient ith arty, select he mos hey agnosis. ASB year-old female recent retured to wark ar having hr second child. Sha shaving a cut me Concervaing because she keeps enema Pe childs okay ad whether cr net fs using velo (daca She seas hora makng mertal ite che tinge she sto a preparsfr spay shee havegatherhame ned ran. Bye te she gets ame, se eels etausted ana oan snaps at her Chien and husband. Dug be rig, she has 3 oicut me faling asleep andcarstanty worries about ‘800g rering done ata © A Ace sess dsorder © B Adusimert disrder with andy © C Busia personally disorder © 0 Genersizes asety disorder © E Cesessive.compubivecsarer (© F Obsessivecompuste personality disorder © G Pranoipersonaiy dsorer (© H Posttraumatic sress disorder © | Seca pista © 4. Specie pobia aioe28 yeroi woman troughtta he emeigensy dears by her sire she penne 2 (genefazadtonc- onc seizure. The pate appears confused ad unable to ance ary questo. The [Sse ays te paert has never hada sezurebeore The patent's msicl storys uerkabe except far lang story ot pant daorder for nc ane aa bean ang ih doves afsome maseston® The ter ‘stat the patntmisse afew soses recent because may wee staying at afend’s house, ou se is Sure atthe patent as oherwise regularn taking her mediation Wich of he falening medications Was thepatertmost kay tara? i ‘© & Clonazepam ' © 8 cherie an © ¢ sumnene t © 0 Aaston a © € Poweie : © F Raper ou © 8 vee So es oe2 S2yeacoi bese mal presets with comslats of episodes af daytme sleepiness hat prove tesisitle He report fing very reteshed and enarazed upon awalaning ram hese "aps Adsaled isn reveals he aia Feqieny expenences a compl os f mace one, expec en he ugh suse orfcis ‘eurge cimanse ematon OF parca concn ahs patent that he occasnaly ngs hensetunace ta ‘ove upan wai, and ays ees temporal ‘razen is prevaus dagrasesncute gout and xem hemanhods Hs family fst snoncortrbutory He does ot smeke cartes or ink lsh and eres ‘ecteatonal sug use Prysica eamiratan feeds no atnormaltes, Yc of eolonng ise most ‘pyropiae beainertfartus pz? © A Banzosazepines © 8 Melanin © Creamer of is undying neuralgia canton © D Matndoendate (© Walgrreaicton (© F Nasal eortruous postive aimay pressure Block aioe rr| 27-yearolisman brought a his pray car physician by his re because ne hasnt ean hms fr thapastten day. He wf sas thathar foray reserved, uct rusbarahas bee sang up lng ey gartbing ther songs anay whl paying poker wrth ends hate recent met Hets aso nt conceried Sbuthaing missed woncarine past eck When asad abou Di rece change m berate an les and replies praudy at he na lager neees a ark because ne as ives alae sum of maneyin {company tht wl soon aes fm ich He epsake vy Quy nd ie dei fri to forum fe atonton times. nich one of folonng medcatone would be most appropiate nthe vealment fs patent? ‘© A Bupropen © 8 Clomipraine © © Cozepine (© 0 Halper © Varo ait Poot carBlock 2 1nyearald itis rougeto he oficeby her mother forthe evaluation ofracert changes in behav. She has been sleeping panty at gr has stanza warn hr bea. Her schaa gases have reppes Signficarty, ad she has become rable and crany. She retusest slp at ght uni he father returs ome ond Joes ates Her famer wars ov aoe diver, ans on anole. Ho Mater ea ose Mend oF "ous, and appears ery cancemed. Prot ois ffce vist you have known hs gto be chee ana Way Fomover, a you stare tak tthe young gine oles, he sudden bursts tears. Wich fe falorng sould you consider abs pont” (© A Mar depression wen malancnol estes © & Adusimert order © C.Ariety sore © 0 Pant dseter © E Specie proba © F Physical abuse © © Acute sbese disorder aioe car2 1Byeacold woman makes an appinmenta see her primary care physician ataut 2 "persona concern” Uimen she comes for her et ane eave tat she ae bean Jee depressed’ for ne pat sera mons because of her ‘nomous nose” She proceeds to descrbein dela he numerous case aspects o er oss tet rove wauting She ays tat sha ana ao smttrated tetas uaingta goa th ‘ands because "everane jst stares army nose" She fnds facut conceate one studies because eh = preocsupied vn thats Seau undergoing corecive surgery. Cn svarinaton et NOES ‘ppeats crreletey normal She leads fr aretaloa gobs pase surgeon Viren othe flowing se ‘ost hey dos? © A Mypochonsinis © B Baty dysmarpic dsarder © CMa depression © 0 Somatzaton dorder (© E Detisonal disorder, somatic ype (© F Facts asorser © 6 Matngetng Poot‘A lng.tme patent cals your fice to speak wih yau dec She voices tustration with yaur eceptnit ‘haha rapeately refused a alow hao sched an appaertto as ou. The pat says at at her lasts, she hada heated argumere wth tie receptonst abet amino etal regan er surance {overage Wan she has calea ance hen, eoepanistavays responds by saying," sy, tere sre taa mary pateres wating aead af you" Wh af falonng seence mechanams ist receptrist eating? © A Distorbon © B Displacement © C.Aatng ot © D trjcton © E Passive-apgessie behavior © F Suppression © 6 en © H Dissociation Poot| 27-year lisman presets this primary care physicin camplang of fingsofinaseauscy and hopsossness. na quaerng4ace, he repats hate ges ‘oaremel) amoaus" When ees 9 speak blo ‘3 grup opel al tusiness meetings of aber socal events He's unable to justel "ever ats Panes wn eras orfamy andhe waste mga a. osu He fas hs caval secs tng Ne Earer atvancemert wich beter him great. Whin af folonng earners comeinanans would ee rst aprons chuce er this ater? ‘© A Flietne and cHordazepnee © B Assarivnass traning and parang {© © Peyenadyeamic psychotherapy and clonazepam © 0 Supporivepsychatherapy and phenetne © E Supportive psychotherapy and propane Poot"Yau are an internist mang your rau at ocal nursing home Wha you are evening a mesial chat ne oftne nurses aperoacee yauta complah abot» £2 year-old male pat wna equerty macturbatez Infrortal the sf and ater uring home resierts, He hasbeen tng oanzapne or years Senzopirnia. Upon terscrng im, you nate patents aught processes tobe vad Pluss a delusions. Thre are several mes nnen he [nigh apprepratay dug he eter Hs Speech ‘ameing and unpedctaby shift fem onetopic to another Based on Hs clic peseraon how shoul Figlines be assed? ‘© A Sanzoprrena,calatonle pe © 8 Schizophrenia, unaerereted ype © ©. Schzophrena, dsorgerized ype (© 0 Scnzopiena, panos ype © & Senzapneei resisualtpe aioe2 38. yeacoitusinessman wih an unremarkable past madalhictor presents to you complain of faique Sn uma weigh ee vet he patras marth, He aakere 4 0/am each mornng ane unl tf back step. He also meron hate uselto egy playing go bce per Weck, iknow haste wrest Dinaugh he usedio excel at war he nau ne nat oengneest and "spacing ct ates. He denies consderng susde. 1 TSHis normal Hee dagnosed wan maar depression snd presenbeatusctne, Sn seta tort or flowin aposnimert meno reekeAtthe ernest he tate teat he Simotome nave nat worsened tut ave nat proved etx. He sys," do eel he he mediation is dong amoung What ste most aproprate nest sepinthe management ofthe patents condom? (© A Cantnue nih funezbe athe same dose © B Increase the dose of tuoeine © © Discentnue uot and beg sarang © D Discentnue uote and beg amine (© E Corenue uowene an aa¢ amerpyine Pooteee Whe marking as the medical resident on cll ya ae paged to see 2 72-yeald woman wha compan of ‘thaadache, Upon ssingyou she saps, You ok young a foots, nape youre mre efcerthan you Seem "Wine you ar performrg a base tysical examaton one, she says," gong to complan the Fosptaadretsatare abot you because yau Pave na ides Nowa papel geal aha pant” Which oe {alning isthe bes espanse a her treat? ‘@ ® Feelfes do 3 oulease” @ 8: Plese alowma to complete he physical ecaminaion est" ce ©: Nouseemto be any, and dant kno @ D- outs hating me wih your commerts: cE aux mfr fms an nt ce Fe"Illnoed your caopratn in order top adagosi* @ 8: Tamreaialy newpeenced but can as gH Letus stl his ssue basen, Poot| S7.yeacold Caucasian man presents complaining of eeing oven fe" He has ft depressed forte past socmort, and sats tthe has duty focusn on daly aces. Hi sep poor and he ‘nies regent at righ Further nqary reveals athe 9 Via War vetren and that he expenences fasheacia annapimarce auth comeatexpaiences Heats that he taheacks beea ae tne feaings af epressan He avaids watering war maves and reses ta lsu wen anyones bmespert \isnar This sis frst vist toa psychanrt and he asks tobe stared on some medzaton, Wich of ho folorin shouldbe avoded mms pater” © A.Larazepam B Norpiine C.Paratne 1 Exposure tony E come erapy ‘Tha diagnate errs eau for pot raumabs arets dude (PTSO)ncude he folening exposure ta 2 traumatic evert, ecurentfastoacks ae nightares about te event, prise avidance of srl ssacate wih he auma, ana ejrpums of herearedafausal Ris comon for ese pees De Geprassed, unntaresteain acts, and sacily detached om ches Siezp and cencereraon may suet ‘Spon must be pesert fone mortar oner Because posttraumatic sess dsooer is tong _sSedoita wh sutstanoe use, We peso ot aaicive mescanos Ike kenzodazepies shou ‘aged when possbleTheelre,lrazepam shuld ot be used wi hs patent {Gholee Bp Noptin is 2 wieyicanidepressant hati bnefalin he treatment of PTSD, (holes 6) Parsee sa selecve serotonin euler Mats Lene ne ester at PTSD. (holee 0) Exposure nerapy's form cFpeychaherapy used ret patents wh PTED, The pats ‘peated rgoved to th toumatngroiuslyincteosng doses. Everly the Faure evant canoe Fememoered Mino assent anes {holee ) Copntve therapy canoer ot paynsteranyntinaiesseparting the curealong saulsbe voces nis pert v6 Alarazepam 5 Norepohine Cc Parostne D Exposure erapy opie therapy L ‘Te diagnostic errs enue for post-araunabs sess dsarde (TSO) nude He allowing exposuteta 3 traumate ever, recut fashoachs a nighhmres about a event, prise avidance of stl seaciated with he aura, and syrpams of hetearedarusal is common for tess pateis tobe Gepresse, unnleesiedn actives, nd socily detached om ches Sleep and concetraten may sue ‘Snpams must be poser fr ane marth ongr Because postvaumate sess dsoer senay sluzcited wth substance abuse i peserbr af asdctve medcabers ke Eenzadiazepines shale {aged when possble Therefore, brazepam should ot be used wih ts patent {hotea 8) Nonprin is 2 ete anadepressant mati wenencalin he treatment a PTSD, (Gholee 6) Parnes sa selective serotonin euptstemitr hats benefeialin he treatment of PTSD. (Choice 0) Expose herapy's form eFpaychaherapy used reat pabentsvthPTSO. The patie ‘pated exposed oth trauma graiulyinceasng doses Evetunly the Waurate evant ean be remembered mot assets oa {Choice &) Cogntve therapy is aot ye of psychotherapy thats separating the recuent aaneact ran ne swat hy price Th term of herapy sparc heft ase patets who {po shmul nt ae remiss a ne taumane srt Educational Objective: vad wenzodazepine use h pales wn posttraumatic sess sor Treatment of PTSD best {ccomplahed ths combnaton of Ste and exposure cognitive tera.A S.yearold woman has ait of mir depressive dead hat nas been in remission forth pat en yeas. She tates phanelane daly and sees hr poy every cher month Wl on vacaton the pater and her rusband indulge ina gourmet meal. tera the patent becomes conzzred 2s She Eeleves one che gshes may fave cortaned aged cheese neh er peje had veneer at featng. She comes tote emergency dparmert of elacal hosp Te express he cancers. Which othe foloring is mest appropri to mentor? © A Boos pressure Blood wes niragen and creatine © Cresine phosphokinase 1. Lwertunenon ets E Temperature Pherelsines. 3 mencarine oxidase rior (MAO). The ADIs are an cider cass of aniepressart tugs Imostyused nthe Yeamen of aclorydepession AOS ae pial nol used 3¢ fist ne herapyn parseause othe cists restore aceasta use. patenting an WAC) consumes ones Figh n rarine clung aped meats an cheeses, Pypertersive cis can result (choices 8, €,D, and E) Te ngesian at pranezine an ages cnzese oes not cause renal astuctan, ‘usele red, Merny, or bos temperature action Eéucatona objective Pater hn morearnecxidose mbar he perez should avi foods high in tram, 36Ne Ccomeinatan canresut nhypernsve ons Lastundotes (29/2008 RLD.LLC. Bark ver 00902 14% ot pense answer mis auesion corech (Copyrart USMA S.yearold woman has ait of mir depressive dead hat nas been in remission forth pat en yeas. She tates phanelane daly and sees hr poy every cher month Wl on vacaton the pater and her rusband indulge ina gourmet meal. tera the patent becomes conzzred 2s She Eeleves one che gshes may fave cortaned aged cheese neh er peje had veneer at featng. She comes tote emergency dparmert of elacal hosp Te express he cancers. Which othe foloring is mest appropri to mentor? © A Boos pressure Blood wes niragen and creatine © Cresine phosphokinase 1. Lwertunenon ets E Temperature Pherelsines. 3 mencarine oxidase rior (MAO). The ADIs are an cider cass of aniepressart tugs Imostyused nthe Yeamen of aclorydepession AOS ae pial nol used 3¢ fist ne herapyn parseause othe cists restore aceasta use. patenting an WAC) consumes ones Figh n rarine clung aped meats an cheeses, Pypertersive cis can result (choices 8, €,D, and E) Te ngesian at pranezine an ages cnzese oes not cause renal astuctan, ‘usele red, Merny, or bos temperature action Eéucatona objective Pater hn morearnecxidose mbar he perez should avi foods high in tram, 36Ne Ccomeinatan canresut nhypernsve ons Lastundotes (29/2008 RLD.LLC. Bark ver 00902 14% ot pense answer mis auesion corech (Copyrart USMWearing a the atendngpeatician the neanatlICU, yu are cli y uring ta examine = twe-dy-ld make chlo Ras recenty egunvorntng The chighas flea o pass meconium snc bith Physical examaton demonstaes syiieatatdommaldteréon rectal exammaton reves 031 tnevaut au svangy suspect vschsprung disease ans ifarm he chs raat hat an staan ‘adagrag and tarum enema srenecessary The mater orcs yeu tam proceed win ay futher testing or procedures bacaurs she dove no tale hae snting wong” What the mot appropriate resto? ‘Ages atta part a ets Onion a curtarertsauhorze testing 6 C.Procenswtntaste 1 Cantactthe hosp ethics commites for guidance 4 Watunl he mate rows consent F Cal grandparents of chit btn conn comutn | ‘Becaisethe chi inthis case has suspected Hrscheprng disease fling acon the dianosis auld rest inpetertly ifeshrestenngcorlicatns (eg, petfraon) Thepyscan should hereore rity to ‘inn tn he rest parent the consemiences of wtnhalang diagnostic tests and eniment te patent ortruesta ruse peas cases [such a Ps oe] where delay cou have isstcus Consequences, aphyscian legal auonzeie pre he emergency wesert fre Cis (Choice )Faing ts otan the rsig ph and eneme could resin senaus muy or death fortis ch, She merfore sv unacoepabeepten (Gholee 8) Cetsning a cau erders he prefered avenue nnon-amergert stations. However in cases ‘here ely matting legal consent cot resin seus harm, a pysantscxpete to pre te emergency vearnere (Cholee 0) Cont:tng te hospta’senies commse wausbe the caret aperaacn nen an ena Semmes exis tat ques furher eporaon Inte caes however ths physician ae claret mors obigaton a proto ha chs eres and shoul proceed whe ernon .1. Cantactihe hosp tics commits for guidance Waturl he mater proies consent Fall erandperents af cid ta atan consent Because the chil inthis case has suspected Hrecheprng tease fling econ the dlagosis could ‘esutnpuertaly e-tretenng corelicatons ep getoraion)Mepiysianshaus Meteor et Uy to ‘isan tothe estan pant he consequences ofwtthalang agnosis and estar the paren Cortmues ta rtusepermssien fcates [sich a Bis oe] whee say cou Pave isascus Consequences, aphystian legal aurzed pron the emerge Weert ft Che {hotew A) Faint cts the ato ph and ename could esutin Sefaus uy o death fr this chi, Snavetmeretore an unacsopabeeoton (Choice 8) ostoning » court eters he prefered menue nnonemergentststons. However n cases ‘hor alyn aban nal snsart cout sun seus harm, a physisaneorpeced a provde he emergency earmere {Choice 0) Contactngthe hospitals ethics commie wauldbe he covet apprach nen a thal Gemma ects at equ urher exploration nts case, Noweve te pnysroan tas 3 cearcut mors Ghiganon to pratuct ie ens terse anata procera venom {Choice )sthoush a cncered efor musttbe made o ean the seriousness of the stuabont the cits Barents wat (pty n van fr te moe og consent unnecessary dleys Me mate and cout ‘esdt te che death threfore not an advsatechace, {holes Uness ts grandparents ar the egal guanans ofthe chil, hey do nota the authority to rove or sey consent ueatonal objective: Ifparant reve te ave concetforthe reatmant of tr chigin a ifs hreatning sua, the physician haul proces wi te eater espte he prertl wishes 289 of paola ancwared (sigA 2-year ols fomale eterna assistant refered to a psychi forthe presumptive agnosis ot Gystymia. She repos havng aves Year hisuy/of ow energy keels and acu warsenng nr ily tofocus onfar werk. She feck "sad hopeless," and eparoncss ik plassure. She denies ay suc thoughts She has never been on any asehatone micas before ard denies afi So oF Psychic ness Sho has gastostophaged ef zeae or ohich she takes amaprands che has 2 Fann alergs, and does nat rk acolo smoke cyaretes. The psychatstseciges Beat her Srstymis ath tpresion. ‘heh of he following canacatontathe ie of tunrepon? 78 Narcolepsy B.Atenon deft hypractviy dearer ©. Saking cessation © D.Rearea renee E Bipolrdsoer ‘upropan isan antdepressart at reduces its efecspimanlytraugh he inition ofthe re-uptake of norepephine, dopamine and sertonn. tis partculy nated for improving he imped corcertraio and Grichedeneray tet many depeseed patents experience. Edoes rat zause he soa astuton Corman associated nan mast anbderessat esis, aang ka gia chace fa yuna patents oF those wna are sare concemes out amusl ete eects. ihe ndestons tor he wee oeupocion Incide smaing cessaton seosonel ecvecerdersyshya posttraumatic ress sete stron fatgue smarone, atenon Geet nyperacivy rae, nxcleny.newopatnc gan, anaperodk: ‘movement rset ‘An moran side effec fbupropon is decreased secure resol, wtchis usualy seen seer doses ‘Ths medcavon shuld Meteors be avadedm paves va secure srdes condos that preasoose tosetute (eg, concur alccal or berzadazepne use eatng dsardes)Indacuots wih arena nowoss of bulimia navosa Woauenty develo dlc abr that can precipitate seizures, therfore 9 tsi of naresa enasa's a conransestonto bupropion sane (Choice A) Recent sides have shorn that bupropion is helflin decreasing he catapow and daytime Sleepnesscbeered wah naralepsyevn 7 [Bupropion isan antepressart at roduces its eflecspimanilytraugh he inion othe re-uptake of ofepeptune dopamine and sorlann is patulynutea Yor grown De npates careers and Cimished energy tet many depessed patents emenence. doesnot cause the seal ystncton Conmny associated nih asl anidepreseant medians, malngita goad chace fr youn pts {hase who are prtedary concemes au sual ede eens Uher gears ar De usec CUBAN Incude srakng cessaten seasonal #ecvedsarde, ysiyenia,post-vaumatic sess dsoderhvoNe faague sncrome,atonon dee yparaciiy asset nacelepy,neuopatic pan, andperoa: Im ‘movement dsder ‘An mparantsde sac f bupropion is dacrested seizure thal wtchis usualy seen sigh doses ‘This medcaton shaul erefore be avadedm patents wah secure dsardes cr candnans that preaspose tosezures (eg, concurertaleoelrberzadazepne use eatng Jsordes)Incacuais wt) ares netvosa of bulma nrvosa teauenty devon HectoN anores that con pecptte Sees, therfore 9 amy anerava envasa a canangestonts bupropion 299° {Ghotee A) Recent stuses have shorn that bupropion is helflin decreasing the catapixy ad dyte Slesnesscboered wah narcoensy (Gholee 8 The increases dopaminergic actity of tupropcnisrespansile forts eficacy in tesing stanton deft hypractity tarde. {Choice c) Eusreen's en aan smauing cessation ands mares under te eran name Zan tS purpose (Chotes ) Patents sutsng ram the depressed phase of pole dsordar canons rom the use of utroion Eaueatonal objective: CConrandeatone ts tuprsion us include stu disorders estng deeds, a ether aren predsposngto sures (2g, concurere acohelorberzadazenne use)2 35. yeacoldwoman has craic austey halucatons which she hears he fathers vice He vace Sai encouraging ngs tor the pas, butt has reco boen saldng het and saying deragay ngs bauther. The woran stared onrspersane, and she eturstwo weer ter fr aflonesp st Snaugh ae sates hat he ralucinans te muon baer yu nae Mat Se a wang much tower than Usual andis ner swnging her arms. Also te patents facia expressions ae ramer ft ang unchanging, an ‘he art that her wring hae Hocome emllx sce sarong te mescaon, Winch ofthe flowing pharmacsoge changes woud ue mos puro? © A Slatuensvopne Stet drealene stat ponranoo| 1. Stat eetraine Discontinue risperidone ad trthalopeo Risperidone isan atpicalanipsychat that acts a a dopamine receptor atagonist. though itis es ely tantra arpa to cause pasnson erapyamisal side eects (Er) rparsne the most. lke abies anpaycnotc to cause CPS, especialy atgher doses. EPS symreams ncude ity, tracyknesis, tremor and akahisn Were common se elects of eperdoneneuge mid secon Icienson otztn etevaien, ana ela gan Explanation: ‘This ptertshavingbracneia,mackes aces and mcrograria al amps ct excess dopamine Hockade. "The anizhalregi mediation benzzpine is inde att ho reduce his pants raya simotoms, (Choice 8) Osrtilne aul elacantthatis somes uss cases of naualec malignant syndrome, which canbe cauredby peal amipsychotce. tis metus forthe weaoment of tanya Sie ofocis (Choice ¢)Propranal s sometimes used to teat artpsychaticinduced aba, batts at ut for Parknsanan symptoms.Stat eoprancio 1 St eanaine| E Discornuerspentae and starthaopenol Fispendoneisanstyicalanpsychate that acts a a dopamine receptor arsgoistAthaughitis ess kay than pal anioeyics to cause parkinsonian etapjramial side elects (EPS), riperidane is the mest. hel aca ansychote to cause EPS. especaly at haher doses. EPS eympnms nctude ny, trathkinesis, tomar and akaivea Mave common ade lcs of nspendane Include mid sen hypolonson,proictn elevation, and neigh gan ‘This patertishavrgbraditinesia, masked faces, and microarahia, al smptoms eFexcess dopamine oskade “The aichalnegie median benstopine is indeaedt he fel is pats tanta symptoms (Choice 8) Omtrtne is 2 muscle elaxant thts somebmes used cases of netle: malgart Synatame, when cane cauredby pal aripsjchacs. Tis he Use ote West pyramidal sie erases {hoice 6) ropraal s sometimes used treat artpsycheticanduced alah, tutti at ust for parknsanan symptoms. (Cholee 0) The pstntin tis vane has extapyrarialsyrptoms, nat symetoms af worsening SopressionTheefore, the selective serotonin euptave Ritter srtane nel nt be appropriate. {hotee € smougn same canefesion canbe mad a decrease or dacartnua taprdone, hope ‘ld natbe a good siesta a Eeariesahigherrkthanrependane m causing parnsanisn se eects Eéueatona sbjective ‘The earanjramial side eects of artesycotics can be Westd wth arcchalnerge medcatons We eration 18% of peo answe rza20051 2Byeacoi asda ara d Caucasian female uth 2 histary of bipalar isarder presents tight meek of (gostton for prorat courselg, She hs been aig a stable dase of rum forthe pat yer. Her art ogress epsode nas 16 months age Her farlyhsory's sigicat fer bpolar sore ner mae, (hteh was Success coratag wth ium Sha does nor amaue goats r censure azana She {sls wnsher nea wl nave any songentl sara. ich ote faningcompkeabane eh fet mcrae ek fo? © A Cardiac roraies 5. Cranofacia gafecte Nawal be defects 1 mental etaaen E Genta aromas — 7 Lubium exposure nthe fst tims of pregnancy is associated th an crated ska catac ‘maforratone ann paula, betas anomaly. This condo haracrzedby 2 maformed and Ineraryeactedtrcuspi wa ha-eaunes iratcabon othe upper goer and a decrease he {She crtefunctonalgntvere -Athaugh he ek af Ebstein's arama increases tenon pares taking thum dunn thirst temestero pregnancy the nadence nevertheless remans very on apprasatay 100) erase ts ‘angen mafarmain s gute rarein he genet papuaton Leium exposure dung te ater nesters may stuss goer ana onsen anata heuremuseusr yehineten (Choices 8, €, and €) Eniconulste medications suchas carbamazepine an wlpoate are mond Saozes known to cause cranofasal deers nour ie sets. and pena anoaies mie unto ‘hd Lem ent associate wth such comgieatans (Cholee ) Nis longterm neurotshavaral trarmalts have bosn reported aes canseauance om ‘emosure muster