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Lecture Notes 2018,Psychiatry Epidemiology,Ethics Patient Safety. USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 1 6 13 17 3 30 PM. USMLE is a joint program of the Federation of State Medical Boards FSMB and the National. Board of Medical Examiners NBME neither of which sponsors or endorses this product. This publication is designed to provide accurate information in regard to the subject matter covered. as of its publication date with the understanding that knowledge and best practice constantly evolve. The publisher is not engaged in rendering medical legal accounting or other professional service. If medical or legal advice or other expert assistance is required the services of a competent profes. sional should be sought This publication is not intended for use in clinical practice or the delivery. of medical care To the fullest extent of the law neither the Publisher nor the Editors assume any. liability for any injury and or damage to persons or property arising out of or related to any use of. the material contained in this book,2017 by Kaplan Inc. Published by Kaplan Medical a division of Kaplan Inc. 750 Third Avenue,New York NY 10017, All rights reserved The text of this publication or any part thereof may not be reproduced in any. manner whatsoever without written permission from the publisher. 10 9 8 7 6 5 4 3 2 1,Course ISBN 978 1 5062 2821 1.
Retail Kit ISBN 978 1 5062 2086 4, This item comes as a set and should not be broken out and sold separately. Kaplan Publishing print books are available at special quantity discounts to use for sales promotions. employee premiums or educational purposes For more information or to purchase books please. call theUSMLE,Simon isSchuster,a joint program,specialofsales. The department,Federation ofat,State Medical Boards of the United States Inc. 866 506 1949,and the National Board of Medical Examiners. USMLE Step 2 CK Psychiatry indb 2 6 13 17 3 30 PM,Psychiatry.
Alina Gonzalez Mayo MD,Psychiatrist,Dept of Veteran s Administration. Bay Pines FL,Patient Safety and Quality Improvement. Ted A James MD MS FACS,Chief Breast Surgical Oncology. Vice Chair Academic Affairs,Department of Surgery,Beth Israel Deaconess Medical Center. Harvard Medical School, USMLE is a joint program of The Federation of State Medical Boards of the United States Inc.
and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 3 6 13 17 3 30 PM. We want to hear what you think What do you like or not like about the Notes. Please email us at medfeedback kaplan com, USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 4 6 13 17 3 30 PM. Table of Contents,Part I Psychiatry,Chapter 1 Mental Status Examination 3. Chapter 2 Defense Mechanisms 7,Chapter 3 Childhood Disorders 11.
Chapter 4 Depressive Bipolar and Related Disorders 19. Chapter 5 Schizophrenia and Other Psychotic Disorders 25. Chapter 6 Anxiety Disorders 31, Chapter 7 Somatic Symptom and Related Disorders 35. Chapter 8 Neurocognitive Disorders 41,Chapter 9 Dissociative Disorders 49. Chapter 10 Adjustment Disorders 53, Chapter 11 Substance Related and Addictive Disorders 55. Chapter 12 Impulse Control Disorders 59,Chapter 13 Eating Disorders 63. Chapter 14 Personality Disorders 67,Chapter 15 Normal Sleep and Sleep Disorders 71.
Chapter 16 Human Sexuality 79,Chapter 17 Psychopharmacology 83. Chapter 18 Suicide 89,Chapter 19 Psychotherapies 91. USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 5 6 13 17 3 30 PM. Part II Epidemiology Ethics,Chapter 20 Epidemiology 95. Chapter 21 Biostatistics 127,Chapter 22 Ethics 143.
Chapter 23 Interpretation of Medical Literature 151. Part III Patient Safety and Quality Improvement, Chapter 24 Clinical Applications of Patient Safety and. Quality Improvement 185,Chapter 25 Population Health Management 213. Additional resources available at,www kaptest com usmlebookresources. USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. vi and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 6 6 13 17 3 30 PM. Psychiatry, USMLE is a joint program of The Federation of State Medical Boards of the United States Inc.
and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 1 6 13 17 3 30 PM. USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 2 6 13 17 3 30 PM. Mental Status,Examination,Learning Objectives, List the steps required to perform a mental status examination. The mental status examination is used to describe the clinician s observations and. impressions of the patient during the interview In conjunction with the history of the. patient it is the best way to make an accurate diagnosis. General Description, Appearance grooming poise clothes body type disheveled neat childlike etc. Behavior quantitative and qualitative aspects of the patient s motor behavior restless. Attitude toward the examiner cooperative frank and seductive. Mood and Affect, Mood emotions perceived by the patient depressed anxious angry etc.
Affect patient s present emotional responsiveness blunted flat labile etc. Appropriateness in reference to the context of the subject appropriate or inappropriate. Speech physical characteristics of speech relevant coherent fluent etc. Perceptual disturbances experienced in reference to self or the environment hallucinations. Hallucinations false sensory perceptions without a stimulus auditory psychotic. disorders visual drugs organic diseases tactile cocaine intoxication alcohol. withdrawal olfactory seizures,Illusions sensory misperception with a stimulus. Form of thought way in which a person thinks flight of ideas loose associations. tangentiality circumstantiality etc, Content of thought what the person is actually thinking about delusions paranoia. and suicidal ideas, USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 3 6 13 17 3 30 PM. Part I Psychiatry,Sensorium and Cognition, Alertness and level of consciousness awake clouding of consciousness etc.
Orientation time place and person, Memory recent remote recent past and immediate retention and recall. Concentration and attention serial sevens ability to spell backwards. Capacity to read and write Ask patient to read a sentence and perform what it says. Visuospatial ability copy a figure, Abstract thinking similarities and proverb interpretation. Fund of information and knowledge calculating ability name past presidents. Impulse Control Estimated from history or behavior during the interview. Judgment and Insight Ability to act appropriately and self reflect. Reliability Physician s impressions of the patient s ability to accurately assess his situation. Interviewing Techniques, Open Ended Questions Allow the patient to speak in his own words as much as possible. Can you describe your pain, Closed Ended Questions Ask for specific information without allowing options in answering. Are you hearing voices, Facilitation Help the patient continue by providing verbal and nonverbal cues.
Yes please continue,Confrontation Point something out to the patient. You seem very upset today,Leading Provide the answer in the question. Are the voices telling you to hurt yourself, USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 4 6 13 17 3 30 PM. Chapter 1 Mental Status Examination,Practice Questions.
1 A 20 year old man presents to your office complaining of auditory hallucinations for. approximately 7 months in duration He reports hearing his father s voice and at times his. mother s voice as well The patient appears distressed by the hallucinations and wants your help. Which of the following would be the most appropriate statement at this time. A What do the voices say,B Have you taken medication. C Why do you think you hear voices,D How is your relationship with your parents. E Tell me about the voices, 2 A 30 year old woman comes to see you after her mother s death approximately 3 weeks ago. Since then she has complained of depressed mood and feelings of helplessness While in your. office she begins to cry Which of the following would be the next step in the management of. this patient,A Say I will come back when you stop crying. B Say Do you feel guilty about your mother s death. C Offer tissue and remain silent,D Say Go ahead it is normal to cry.
E Refer to a psychiatrist for further evaluation, Answer E The ideal interviewing technique is to begin with an open ended question and. conclude with closed ended questions Choices A C D and E are all open ended questions. However the best open ended question for this patient and the reason he came to see you is. Answer C One should always express empathy and then give the patient control By staying. silent and offering a tissue you are doing just that Choice E is always incorrect. USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 5 6 13 17 3 30 PM. USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 6 6 13 17 3 30 PM. Defense Mechanisms,Learning Objectives, List the types of defense mechanisms and the situations in which they are most likely. Describe the most common psychological and intelligence tests and their purpose. Id Drives instincts present at birth The 2 most important drives are sex and aggression. Ego Defense mechanisms judgment relationship to reality object relationships developed. shortly after birth, Superego Conscience empathy and morality are formed during latency period right vs.
DEFENSE MECHANISMS, Defense mechanisms are the way and means that the ego wards off anxiety and controls. instinctive urges and unpleasant emotions They are unconscious except suppression dis. crete dynamic and irreversible and may be adaptive or maladaptive. Types of Defense Mechanisms, Projection Attributing your own wishes thoughts or feelings onto someone else. I m sure my wife is cheating on me, Denial Used to avoid becoming aware of some painful aspect of reality. I know I do not have cancer, Splitting External objects are divided into all good or all bad. The morning staff is perfect the evening staff is terrible. Blocking Temporary block in thinking, I have known him for years but can never seem to remember his name.
USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. and the National Board of Medical Examiners,USMLE Step 2 CK Psychiatry indb 7 6 13 17 3 30 PM. Part I Psychiatry, Regression Return to an earlier stage of development most immature. Ever since my divorce my 5 year old has begun to wet the bed. Somatization Psychic derivatives are converted into bodily symptoms. Just thinking of the exam I get butterflies in my stomach. Introjection Features of the external world are taken and made part of the self. The resident physician dresses like the attending whom he admires. Displacement An emotion or drive is shifted to another that resembles the original in some. I had to get rid of the dog since my husband kicked it every time we had an argu. Repression An idea or feeling is withheld from consciousness unconscious forgetting. I do not remember having had a dog, Intellectualization Excessive use of intellectual processes to avoid affective expression or. experience, It is interesting to note the specific skin lesions which seem to arise as a conse. quence of my end stage disease, Isolation Separation of an idea from the affect that accompanies it.
As she arrived at the station to identify the body she appeared to show no emotion. Rationalization Rational explanations are used to justify unacceptable attitudes beliefs or. I did not pass the test because it was harder this year than ever before. Reaction formation An unacceptable impulse is transformed into its opposite results in the. formation of character traits, Listen to him tell his family he was not afraid when I saw him crying. Undoing Acting out the reverse of an unacceptable behavior consists of an act. I need to wash my hands whenever I have these thoughts. Acting out Behavioral or emotional outburst, My 10 year old started getting into trouble right after his mother and I got. Humor Permits the expression of feelings and thoughts without personal discomfort. So said the 300 pound man they expected me to place my head between my legs in the. event of a plane crash when the best I could manage was placing my chin on my chest. USMLE is a joint program of The Federation of State Medical Boards of the United States Inc. USMLE STEP 2 CK Lecture Notes 2018 UP TO DATE Updated annually by Kaplan s all star faculty INTEGRATED Packed with bridges between specialties and basic science TRUSTED Used by thousands of students each year to ace the exam USMLE is a joint program of the Federation of State Medical Boards FSMB and the National Board of Medical Examiners NBME neither of which sponsors

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