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Overview of EDs - IAEDP CEDS exam 1 NR 326 Abnormal psych pt2
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, ANSWER: A
Eating disorders include anorexia nervosa, bulimia nervosa, and
binge eating disorder, and the DSM-5 added avoidant/restrictive
food intake disorder, rumination disorder, and pica to this group
A 24-year-old graduate student
in 2014. Mood disorders, anxiety, substance use, and personality
comes to your office to be
or somatic disorders are common in these patients. Screening
tested for sexually transmitted
can include regularly asking questions about mood, body image
infections. The medical assistant
concerns, and eating behaviors. Before establishing the
tells you that the patient was
diagnosis based on history, it is important to perform a physical
upset when she saw how much
examination that includes measurement of orthostatic vital signs
she weighed. On questioning,
and obtain a metabolic panel that includes magnesium and
the patient says that for the past
phosphate levels.
year she has experienced
episodes of uncontrollable
This patient appears to have bulimia nervosa, which consists of
eating followed by self-induced
eating an excessive amount of food in a short period of time
vomiting. Her weight is 82 kg (181
(often >2000 calories in one sitting), with a concomitant feeling of
lb) and her BMI is 32 kg/m2.
loss of control. Because patients with bulimia base their self-
Which one of the following is
worth on their body shape and weight, they follow this binge
true regarding treatment for this
eating with compensatory behaviors to prevent weight gain, such
condition?
as vomiting, laxative use, food restriction, excessive exercise, or
taking diuretics. Episodes occur, on average, one or more times a
A. Cognitive behavioral therapy
week for 3 months or longer, and the disorder is associated with
has the best evidence for
a two- to sixfold increase in age-adjusted mortality.
treatment
B. SSRI monotherapy is a first-
After the diagnosis is established and a goal weight has been
line treatment option
accepted, the patient is best served with treatment delivered by
C. Anemia is an indication for
a team that includes a therapist, a nutritionist, and a clinician,
hospitalization
preferably with each having prior experience in caring for
D. More than half of patients will
patients with eating disorders. Cognitive behavioral therapy
relapse after treatment
(CBT) has the best evidence for treatment of adults with bulimia,
while family-based therapy is the first-line treatment for
adolescents with this condition. Early behavioral response, with
rapidly declining episodes of binge eating, is associat
, ANSWER: A
Sexual assault affects 43.6% of women in the United States
during their lifetimes, with increased risks seen in adolescents,
college students, LGBTQ persons, and active-duty military
personnel. The risk is also increased by physical or mental
A 35-year-old female presents disabilities, poverty, homelessness, incarceration, and substance
to your office for treatment of use disorders. The majority of assaults are committed by
insomnia. You ask if she has someone known to the victim, and assaults are often unreported.
experienced any trauma in her It has been estimated that only 16%-38% of victims seek help
life and she discloses that she from law enforcement or obtain a medical evaluation.Both short-
was sexually assaulted 6 weeks and long-term consequences can occur after sexual assault.
ago. She has not sought Short-term consequences include physical injuries, unintended
medical, legal, or psychological pregnancy, and sexually transmitted infections (most commonly
counseling since the assault. Chlamydia, gonorrhea, and trichomoniasis). Over time, additional
During today's visit, you should sequelae may include chronic pelvic pain, headaches,
do which one of the following? fibromyalgia and other chronic pain syndromes, and irritable
bowel syndrome. The most common long-term consequence is
A. Assess for symptoms of posttraumatic stress disorder (PTSD), while other psychological
posttraumatic stress disorder sequelae include insomnia, depression, anxiety, substance use
B. Prescribe levonorgestrel (Plan disorder, eating disorders, and suicidality.
B One-Step), 1.5 mg
C. Prescribe HIV postexposure The American College of Obstetrics and Gynecology
prophylaxis recommends screening all women for sexual violence, while the
D. Perform a forensic U.S. Preventive Services Task Force recommends intimate partner
examination to collect evidence, violence (IPV) screening for women of reproductive age. Most
such as a rape kit evaluation women will not disclose IPV or sexual violence unless asked, and
E. Refer her for cognitive a validated two-question screening tool can be most easily
behavioral therapy incorporated into a primary care practice: "Have you ever been
hit, slapped, kicked, or otherwise hurt by your partner? Have you
ever been forced to participate in sexual activities?"This patient
should have a urine pregnancy test and be tested for Chlamydia,
gonorrhea, bacterial vaginosis, syphilis, and trichomoniasis.
Blood shoul
, You are developing a practice ANSWER: A
improvement activity in your Substance use disorder (SUD) in women is often associated with
office centered on substance more severe adverse medical, psychiatric, and functional
use disorder (SUD). As part of consequences than in men, often related to the interacting
the training for your clinical staff, contributions of biological and environmental factors.
you plan to review a variety of Physiologically, women with SUD have variation in cravings and
clinical vignettes of patients with drug consumption at different times of the menstrual cycle. There
SUD. One of your goals is to is also evidence that women metabolize nicotine more rapidly
illustrate how SUD has different than men, making it harder for them to quit using nicotine-
clinical presentations in women containing products. This differential metabolism is a possible
and men. Which one of the reason that nicotine replacement therapies are less efficacious in
following statements is accurate women.
regarding these differences?
Environmentally, women often attribute their substance use to
A. Compared to men, women different reasons than men, including self-treatment of mental
have a quicker progression from health problems, management of chronic pain, and controlling
first using a substance to weight. Use of smaller quantities of drugs and a shorter time
developing dependence progression from initial use to dependence are both more likely
B. Compared to men, women among women with SUD. Treatment outcomes are not
with SUD have less severe substantially different by sex, but women are more likely to
adverse consequences relapse after treatment.
C. Smaller quantities of drug
consumption are associated
with development of SUD
among men compared to
women
D. Women are less likely to
relapse after treatment than men