Psychiatry Flashcards

A 68-year-old with new-onset psychosis, no psychiatric history, and recent urinary incontinence and gait disturbance is most likely experiencing which condition?

Answer: Lewy body dementia

Lewy body dementia classically presents with parkinsonism, visual hallucinations, and fluctuating cognition in an older adult.

Which psychotherapy has the strongest evidence base for borderline personality disorder?

Answer: Dialectical behavior therapy

Dialectical behavior therapy (DBT) is the gold-standard psychotherapy for borderline personality disorder.

A patient on lithium for 10 years presents with coarse tremor, ataxia, and confusion. His lithium level is 2.4 mEq/L. What is the priority intervention?

Answer: Hemodialysis

Lithium levels above 2.0 mEq/L with neurological symptoms warrant hemodialysis for rapid elimination.

Which of the following is a core feature used to diagnose ADHD in adults per DSM-5?

Answer: Symptoms present before age 12

DSM-5 requires that several inattentive or hyperactive-impulsive symptoms were present before age 12.

A veteran with PTSD asks about the most evidence-based non-pharmacological treatment. What should you recommend?

Answer: EMDR or prolonged exposure therapy

Trauma-focused CBT (including prolonged exposure) and EMDR have the strongest evidence for PTSD.

A 30-year-old presents with 6 months of grandiosity, decreased need for sleep, pressured speech, and impulsive spending, but continues to work. Which diagnosis best fits?

Answer: Bipolar II disorder, hypomanic episode

Hypomania lasts ≥4 days, does not cause marked impairment, and does not require hospitalization, distinguishing it from mania.

Which of the following is the safest antidepressant choice during pregnancy when treatment is necessary?

Answer: Sertraline

Sertraline has the most pregnancy safety data among SSRIs; paroxetine carries cardiac malformation risk.