DHA Mental Health & Psychiatry Flashcards

A 45-year-old male with no psychiatric history develops sudden-onset confusion, agitation, and visual hallucinations 48 hours after his last drink following a 10-year history of heavy alcohol use. What is the most likely diagnosis?

Answer: Alcohol withdrawal delirium (delirium tremens)

Delirium tremens typically presents 48–72 hours after cessation with autonomic instability, confusion, and hallucinations, and carries significant mortality.

Which of the following is the primary neurotransmitter implicated in the reward pathway dysregulation seen in substance use disorders?

Answer: Dopamine

Dopamine in the mesolimbic pathway (nucleus accumbens) is central to the reinforcement and craving mechanisms in substance use disorders.

A patient undergoing clozapine therapy develops a fever, sore throat, and absolute neutrophil count of 400 cells/mm³. What is the immediate action?

Answer: Discontinue clozapine immediately and initiate G-CSF

An ANC below 500 cells/mm³ indicates severe neutropenia (agranulocytosis), requiring immediate clozapine discontinuation; G-CSF may be used to accelerate neutrophil recovery.

According to DSM-5, persistent depressive disorder (dysthymia) requires a depressed mood lasting at least:

Answer: 2 years

DSM-5 requires at least 2 years of persistent depressed mood (1 year in children/adolescents) for a diagnosis of persistent depressive disorder.

A psychiatrist learns that a patient with paranoid schizophrenia has made specific threats to kill a named coworker. According to the Tarasoff principle, the psychiatrist's duty includes:

Answer: Warning the identified potential victim and notifying authorities

The Tarasoff duty-to-protect doctrine obligates clinicians to warn identifiable potential victims and take reasonable protective steps when a credible, specific threat exists.

Which cognitive distortion is exhibited when a patient concludes they are 'a complete failure' after making one mistake at work?

Answer: Overgeneralization

Overgeneralization involves drawing a sweeping negative conclusion from a single event, such as labeling oneself a total failure after one error.

A 30-year-old presents with episodes of intense fear, palpitations, shortness of breath, and fear of dying, peaking within 10 minutes and resolving spontaneously. Medical workup is negative. What is the most likely diagnosis?

Answer: Panic disorder

Recurrent unexpected panic attacks peaking within minutes, with physical symptoms and fear of dying, are the hallmark of panic disorder after medical causes are excluded.