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Final Exam: NU 664C / NU664C (Latest Update 2025 / 2026)
Family Psychiatric Mental Health I/ UPDATE/PRACTICE
QUESTIONS AND CORRECT VERIFIED ANSWERS /GRADED A+
Piaget Perioperations Subperiod - CORRECT ANSWER- Deferred Imitation,
symbolic play, Graphic imagery, mental imagery, and language.
Piaget Concrete Operations - CORRECT ANSWER- 7 - 11 years old
Begin abstract thought Plays games with rules Cause and effect relationship Conservation of quantity, weight, volume, inclusion/seriation
Piaget Formal Operations - CORRECT ANSWER- 12 - adult; ability to think
abstractly; thinking operates in a formal, logical manner
Piaget: Sensorimotor Stage - CORRECT ANSWER- Ages: birth to age 2
The stage during which children learn through senses and motor activities. Coordination of sensory input and motor responses Development of object permanence
Kohlberg's Theory of Moral Development - CORRECT ANSWER- Moral
development takes place in stages and awareness of other people increases at each stage Preconventional: Punishment/obedience Conventional: Act in ways to maintain good relationships with others. Postconventional: Develop ethical principles that are self-accepted.
Erikson's Psychosocial Theory - CORRECT ANSWER- stage theory of psychosocial
development, lifespan consists of eight dilemmas that must be solved correctly in order to solve the next dilemma
Trust vs. Mistrust (Erikson) - CORRECT ANSWER- 0 - 1 years. Erikson's first stage
during the first year of life, infants learn to trust when they are cared for in a consistent warm manner. Can be associated with psychosis, addiction, and depression when negative.
affect world in the way that the child desires bad: inadequacy, low self esteem. Can be associated with creative inhibition, Intertion.
Identity vs. Role Confusion (Erikson) - CORRECT ANSWER- 13 - 19 yr, **most
crucial** teens struggle with identity crisis, if healthy experimentation is fostered they attain identity achievement; if not, they face insecurity and low self-worth. Can be associated with delinquency, BPD, gender confusion.
Confidentiality - CORRECT ANSWER- The act of holding information in
confidence, not to be released to unauthorized individuals. Subpoena duces tecum can require docs to give relevant documents to the court. Permission should be gotten for each piece of info from the same individual.
informed consent - CORRECT ANSWER- An ethical principle requiring that
research participants be told enough to enable them to choose whether they wish to participate. Parent must be give IC for minors unless for VD, pregnancy, substance/etoh, and contagious disease. IC includes procedure, experimental, pain/risks, benefits, alternatives, questions, freedom to refuse/withdraw.
Tarasoff 1 and 2 - CORRECT ANSWER- 1:Provider must warn an individual if their
patient informs them that they plan to kill or injure them. Also, notify police. 2: Provider must take action to protect the target individual by nonconsensual hospitalization or arrest of the patient.
Acetylcholine - CORRECT ANSWER- A neurotransmitter that enables learning
and memory and also triggers muscle contraction. Increased: Parkinsonism Decreased: Dementia
Norepinephrine - CORRECT ANSWER- A neurotransmitter involved in arousal, as
well as in learning and mood regulation. Increased: Anxiety. Decreased: Depression.
Dopamine - CORRECT ANSWER- A neurotransmitter associated with movement,
attention and learning and the brain's pleasure and reward system. Increased: Psychosis Decreased: Anhedonia, Parkinsons, Addiction.
Serotonin (5-HT) - CORRECT ANSWER- Excitatory or inhibitory; involved in sleep,
mood, anxiety, and appetite. Increased: Serotonin Syndrome Decreased: Depression, OCD, Anxiety
Glutamate - CORRECT ANSWER- The most common neurotransmitter in the
brain. Excitatory. Increased: Psychosis, lability, SZ.
Associated with weight gain and sensitivity to rejection. Most common subtype of depression. Treatment: MAOIs/ SSRI
Depression with psychotic features - CORRECT ANSWER- Mood disturbances w/
delusions or hallucinations. Varied sleep patterns. Fluctuation in appetite Severely impaired energy Auditory/visual hallucinations or delusions. Tx: SSRI/atypicals eg Sertraline with olanzapine.
Dexamethasone suppression test - CORRECT ANSWER- blood analysis for
cortisol levels after administration of synthetic glucocorticoid. Used to evaluate cortisol levels in Cushings disease which is highly comorbid with psych disorders.
Generalized Anxiety Disorder (GAD) - CORRECT ANSWER- A disorder
characterized by chronic excessive worry accompanied by three or more of the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and sleep disturbance.
Onset: Gradual Triggers: None
Panic Disorder - CORRECT ANSWER- An anxiety disorder marked by
unpredictable minutes-long (15-30min) episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations, sweating, shaking, SOB. Fear of death. Onset: Sudden Triggers: May be without trigger/or triggers that caused previous attacks.
Social Anxiety Disorder - CORRECT ANSWER- an anxiety disorder involving the
extreme and irrational fear of being embarrassed, judged, or scrutinized by others in social situations
Tx for anxiety disorders - CORRECT ANSWER- SSRI First line
SNRI (Venlafaxine) Buspirone TCA Benzos fro short course Remeron
Schizophrenia - CORRECT ANSWER- A group of severe disorders characterized by
disorganized and delusional thinking, disturbed perceptions, and inappropriate emotions and actions. Onset: Late teens to early 30's Persistant psychosis that lasts at least 6 months.
Prognosis of Schizophrenia - CORRECT ANSWER- - 20 - 30% lead fairly normal lives
- 20 - 30% continue to experience moderate symptoms
- 40 - 60% remain significantly impaired for the rest of their lives; much poorer outcome than mood disorders 20% Life reduction expectancy.
Neurobiology of Schizophrenia - CORRECT ANSWER- Enlarged lateral and 3rd
ventricle Reduced brain symmetry Reduced size of limbic system (Amygdala, hippocampus, parahippocampal gyrus) Prefrontal cortex similar to lobotomized pts Reduced thalamic size Basal Ganglia/cerebellum-Gait/movement disorders. Secondary to antipyschotics?
Neurotransmitters associated with schizophrenia - CORRECT ANSWER-
dopamine and glutamate increased GABA decreased NMDA receptors non-functioning d/t dopamine and glutamate excess.
Capgras syndrome - CORRECT ANSWER- The delusional belief that an
acquaintance has been replaced by an identical-looking imposter. It is more commonly seen in schizophrenia, dementia, and brain trauma.
Treatment of Schizophrenia - CORRECT ANSWER- Cognitive Behavior Therapy,
medication, and training in life and social skills. Antipsychotics
schizophreniform disorder - CORRECT ANSWER- Psychotic disorder involving the
symptoms of schizophrenia but lasting less than 6 months.
schizoid personality disorder - CORRECT ANSWER- A psychological disorder
characterized by little interest or involvement in close relationships, even those with family members
brief psychotic disorder - CORRECT ANSWER- Psychotic disturbance involving
delusions, hallucinations, or disorganized speech or behavior but lasting less than 1 month; often occurs in reaction to a stressor.
Bipolar Treatment - CORRECT ANSWER- Full mania needs hospitalization
Tx for acute mania First line: Lithium, depakote, olanzapine, risperidone, seroquel, abilify, ziprasidone, asenapine, paliperidonem, cariprazine. Second line: Carbamazepine, haldol monotherapy Combined lithium and depakote CBT/family therapy Lamictal superior depressive tx ECT, TMS, Magnetic SZ therapy
kindling hypothesis - CORRECT ANSWER- episode of depression/mania is
neurotoxic; over time, episodes get more severe, last longer, more easily triggered. Initial episodes may be triggered by events "kindling" but subsequent episodes may not need them.
Neurobiology of BD - CORRECT ANSWER- Variations in gray matter volume in
striatum, thalamus amygdala, hippocampus, and pituitary with functional defects.
Etiology of BD - CORRECT ANSWER- HPA (Hypothalamix-pituitary-adrenal)
disruptions. Calcium Channeling- Genetic abnormalities in voltage-gated calcium channels leading to increased intracellular calcium signaling. (e.g. Ca channel affecting drugs like AED's help BD).
obsessive-compulsive disorder (OCD) - CORRECT ANSWER- a disorder in which
repetitive, intrusive thoughts (obsessions) and ritualistic behaviors (compulsions) designed to fend off those thoughts interfere significantly with an individual's functioning Onset 19 more in males
Contamination OCD - CORRECT ANSWER- Most common. cleaning or hand-
washing compulsions. Fear of germs
Pathologic Doubt/Checking OCD - CORRECT ANSWER- Second most common.
Doubt that you have completed a crucial task. (eg turn stove off, lock door)
Intrusive/forbidden thoughts OCD - CORRECT ANSWER- Third most common.
Obsessive thoughts without compulsions. Usually sexual or violent and morally reprehensible in some way.
Excoriation Disorder - CORRECT ANSWER- Recurrent skin picking resulting in skin
lesions Leads to distress or impairment. Mostly on face followed by hands, fingers, arms, and legs. 15% report SI, 12% Attempts More females age of 12
olfactory reference syndrome - CORRECT ANSWER- psychological
disorder which causes the patient to imagine he or she has strong body odor Mean age 25 Male single.
Tourette's Disorder - CORRECT ANSWER- developmental disorder featuring
multiple dysfunctional motor and vocal tics
OCD treatment Meds - CORRECT ANSWER- SRI: Clomipramine (Anafranil) 12
weeks High dose SSRI eg 80mg fluoxetine or 200 of sertraline Risperidone/aripiprazole after SSRI failure memantine, riluzole, ketamine, lamictal, NAC others
OCD therapy - CORRECT ANSWER- Exposure and response prevention: Expose to
stressful concepts and do not allow compulsive behaviors. CBT
ADHD (Attention-Deficit Hyperactivity Disorder) - CORRECT ANSWER- A
psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity Hyperactivity is the first symptom to remit in 40% of cases. Medications are first line (stimulants)
Methylphenidate (Ritalin)/Ampetamine salts/Desmphetamine - CORRECT
ANSWER- a stimulant used in treating ADHD
SE
Headache, insomnia, somnolence, dry mouth, nausea, abdominal pain, decrease in appetite, nausea, etc. Priapism NOTE
- do not open capsule * - irritant CYPD 2D6 substrate watch out for *LIVER PROBLEMS *
Alpha Agonists ADHD - CORRECT ANSWER- Guanfacine (Intuniv) - ER- Should not
be taken with hight fat meal. Side effects- Hypotension, fatigue, sedation Taken at bedtime 6 - 17 years old Taper dose Clonidine- Monitor for hypotension during initial dose and titrations. ER is not interchangeable with IR formulations. Side effects- Headache, fatigue, upper abdominal pain.
major depressive disorder - CORRECT ANSWER- A mood disorder in which a
person experiences, in the absence of drugs or a medical condition, two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities.
Treatments SSRI fluoxetine and esciralopram FDA approved for children. Lower dose for children prepubescent.
delusions of persecution - CORRECT ANSWER- A false belief that some person or
agency is trying in some way to harm one.
Religious delusions - CORRECT ANSWER- the belief that one is an agent of or
specially favoured by a greater being
thought broadcasting - CORRECT ANSWER- A delusion that one's thoughts are
being broadcast out loud so that they can be perceived by others.
Modafinil/Armodafinil (Provigil, Nuvigil) - CORRECT ANSWER- CNS Stimulant tx
narcolepsy and ADHD Not FDA approved due to Steven Johsnon's Syndrome.
Neuroanatomy of ADHD - CORRECT ANSWER- reduced brain volume in frontal
lobe, hippocampus, basal ganglia, amygdala, cerebellum Prefrontal cortex
