MH 709 FINAL EXAM QUESTIONS WITH
ACCURATE ANSWERS
Why don't providers usually diagnose personality disorders in patients under the age of
18? - ANSWER Appreciating development and the necessary developmental phases and
struggles in "becoming self".
Cluster A - ANSWER Odd or eccentric- Paranoid, Schizoid and Schizotypal
Cluster B - ANSWER Dramatic and erratic- Histrionic, Narcissistic, Borderline,
Antisocial
Cluster C - ANSWER Fearful and Anxious- Obsessive Compulsive PD, Aviodant,
Dependent
How would describe the general diagnostic differences between Schizoid and
Schizotypal Personality Disorder? - ANSWER People with Schizoid PD prefer to work
alone and do not desire the company of others. Those with Schizotypal PD might talk
about strange, magical or mystical phenomenon and might appear suspicious of others.
In Schizotypal PD, care must be taken to not pathologize cultural norms (ie talking to the
dead or communicating with natural spirits)
How would describe the key differences between Avoidant Personality disorder and
Social Phobia? - ANSWER In Avoidant PD, the concern is about criticism and rejection
from others. In social phobia, concerns are more specific about doing something that
the person thinks is embarrassing out of the proportion than what others think (i.e.
Someone will never eat at parties because they are so worried about getting something
stuck in their teeth).
How might cultural aspects impact of making or not making the diagnosis of Dependent
Personality Disorder? - ANSWER The cultural roles in decision making and information
sharing could be misinterpreted as a Dependent Personality Disorder.
Describe 3 key aspects of interacting with a patient in an outpatient setting who
demonstrates manipulative behavior? - ANSWER a. Establishing specific parameters
about frequency of non-appointment communication
b. Define and enforce professional boundaries
c. Clear and detailed communication in the EHR for covering/call staff
How are OCD and OCP the same? How are they different? - ANSWER Other than the
names, OCD and OCP share obsessional thinking but themes are different:
OCPD- Rigid, unyielding, obsessed with perfection, process, demands others follow
, their strict and rigid guidelines
OCD- Defined Obsessions and compulsions that are internalized, more significant
anxiety, if rigidity is present, it is more internalized than projected on others.
Review the different psychotic disorders, what are some key differential diagnoses?
Why? - ANSWER Delusional Disorder, Brief Psychotic Disorder, Schizophreniform
Disorder, Schizoaffective Disorder, Substance/Medication Induced Psychotic Disorder,
Psychotic Disorder
Possible differentials: Bipolar Disorder- The disorganization of thought in mania can
resemble psychosis, Major Depression, Substance Use Disorder- Possible detox,
Obsessive-
Compulsive Disorder- Extreme obsessions can present like psychosis
What are some non-pharmacologic interventions for psychotic disorders? - ANSWER
Social skills training, CBT, art therapy
What are important lab values to monitor for people taking SGAs? - ANSWER Blood
glucose, triglycerides, lipid panel, CBC
Review the dopamine pathways and how they relate to symptoms. - ANSWER
Mesocortical pathway- projects to dorsolateral prefrontal cortex- Negative symptoms,
cognitive symptoms
Mesolimbic- Positive symptoms
Nigrostriatal- regulates movements (is thought to be "normal" in schizophrenia but
during treatment with dopamine medications, can result in DA excess can result in
movements
Tuberoinfundibular Pathway- Projects from hypothalamus to anterior pituitary. Thought
to be normal in schizophrenia but when stimulated with treatment of DA medications
and can cause hyperprolactinemia.
What is an AIMS scale and who should be assessed with an AIMS? - ANSWER The
Abnormal Involuntary Movement Scale should be performed before beginning treatment
with first and second generation antipsychotics and performed every 3 months during
treatment.
Explain the similarities and differences between Bipolar I and Bipolar II as you would if
talking with a client or family. - ANSWER The key difference is with the history of
depression. People who have Bipolar I will have symptoms of mania but not necessarily
a major depression and those with Bipolar II will have a history of Major Depression but
not necessarily a manic episode. Both conditions will usually require taking medication
and following a treatment plan that supports overall health.
What types of patients are at risk to develop mania induced by antidepressant therapy?
ACCURATE ANSWERS
Why don't providers usually diagnose personality disorders in patients under the age of
18? - ANSWER Appreciating development and the necessary developmental phases and
struggles in "becoming self".
Cluster A - ANSWER Odd or eccentric- Paranoid, Schizoid and Schizotypal
Cluster B - ANSWER Dramatic and erratic- Histrionic, Narcissistic, Borderline,
Antisocial
Cluster C - ANSWER Fearful and Anxious- Obsessive Compulsive PD, Aviodant,
Dependent
How would describe the general diagnostic differences between Schizoid and
Schizotypal Personality Disorder? - ANSWER People with Schizoid PD prefer to work
alone and do not desire the company of others. Those with Schizotypal PD might talk
about strange, magical or mystical phenomenon and might appear suspicious of others.
In Schizotypal PD, care must be taken to not pathologize cultural norms (ie talking to the
dead or communicating with natural spirits)
How would describe the key differences between Avoidant Personality disorder and
Social Phobia? - ANSWER In Avoidant PD, the concern is about criticism and rejection
from others. In social phobia, concerns are more specific about doing something that
the person thinks is embarrassing out of the proportion than what others think (i.e.
Someone will never eat at parties because they are so worried about getting something
stuck in their teeth).
How might cultural aspects impact of making or not making the diagnosis of Dependent
Personality Disorder? - ANSWER The cultural roles in decision making and information
sharing could be misinterpreted as a Dependent Personality Disorder.
Describe 3 key aspects of interacting with a patient in an outpatient setting who
demonstrates manipulative behavior? - ANSWER a. Establishing specific parameters
about frequency of non-appointment communication
b. Define and enforce professional boundaries
c. Clear and detailed communication in the EHR for covering/call staff
How are OCD and OCP the same? How are they different? - ANSWER Other than the
names, OCD and OCP share obsessional thinking but themes are different:
OCPD- Rigid, unyielding, obsessed with perfection, process, demands others follow
, their strict and rigid guidelines
OCD- Defined Obsessions and compulsions that are internalized, more significant
anxiety, if rigidity is present, it is more internalized than projected on others.
Review the different psychotic disorders, what are some key differential diagnoses?
Why? - ANSWER Delusional Disorder, Brief Psychotic Disorder, Schizophreniform
Disorder, Schizoaffective Disorder, Substance/Medication Induced Psychotic Disorder,
Psychotic Disorder
Possible differentials: Bipolar Disorder- The disorganization of thought in mania can
resemble psychosis, Major Depression, Substance Use Disorder- Possible detox,
Obsessive-
Compulsive Disorder- Extreme obsessions can present like psychosis
What are some non-pharmacologic interventions for psychotic disorders? - ANSWER
Social skills training, CBT, art therapy
What are important lab values to monitor for people taking SGAs? - ANSWER Blood
glucose, triglycerides, lipid panel, CBC
Review the dopamine pathways and how they relate to symptoms. - ANSWER
Mesocortical pathway- projects to dorsolateral prefrontal cortex- Negative symptoms,
cognitive symptoms
Mesolimbic- Positive symptoms
Nigrostriatal- regulates movements (is thought to be "normal" in schizophrenia but
during treatment with dopamine medications, can result in DA excess can result in
movements
Tuberoinfundibular Pathway- Projects from hypothalamus to anterior pituitary. Thought
to be normal in schizophrenia but when stimulated with treatment of DA medications
and can cause hyperprolactinemia.
What is an AIMS scale and who should be assessed with an AIMS? - ANSWER The
Abnormal Involuntary Movement Scale should be performed before beginning treatment
with first and second generation antipsychotics and performed every 3 months during
treatment.
Explain the similarities and differences between Bipolar I and Bipolar II as you would if
talking with a client or family. - ANSWER The key difference is with the history of
depression. People who have Bipolar I will have symptoms of mania but not necessarily
a major depression and those with Bipolar II will have a history of Major Depression but
not necessarily a manic episode. Both conditions will usually require taking medication
and following a treatment plan that supports overall health.
What types of patients are at risk to develop mania induced by antidepressant therapy?
