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[h] Hematology & Oncology System Flashcards

[i] Master this session in just 5 minutes.

[q] What is the most likely diagnosis?

– ≥ 1 somatic symptoms (pain, fatigue) causing distress and functional impairment for ≥ 6 months duration.

– It involves excessive preoccupation and overestimation of the seriousness of ≥ 1 somatic complaints and is associated with high levels of medical care utilization.

– Associated with excessive, persistent thoughts and anxiety about symptoms.

– Because symptoms often worsen during periods of stress, patients should be asked about their current emotional stressors and counseled regarding stress reduction.

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[q] What is the most likely diagnosis?

– Characterized by sudden onset of neurological symptoms (paralysis, blindness, mutism) and clinical findings that are incompatible with recognized neurological conditions.

– Often precipitated by stress (relationship conflicts), and patients can present as hysterical or strangely indifferent (“la belle indifference”) to their symptoms.

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[q] ………. is Excessive preoccupation with acquiring or having a serious illness, often despite medical evaluation and reassurance; minimal somatic symptoms.

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[q]……….. is a rare psychiatric condition in which a woman presents with nearly all signs and symptoms of pregnancy (amenorrhea, enlargement of the breasts and abdomen, morning sickness, weight gain, sensation of fetal movement and reported positive urine pregnancy test per the patient); however, ultrasound reveals a normal endometrial stripe and negative pregnancy test.

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[q] What is the most likely diagnosis?

– Patient consciously creates physical and/or psychological symptoms in order to obtain attention and receive protracted care (to assume the sick role).

– They lack conscious awareness of why they do it.

– Behaviors may include deceptive reporting of symptoms, manipulating laboratory samples, ingesting a substance (insulin), altering medical records, or inducing illness (injecting fecal matter to produce an abscess).

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[q] Factitious disorder imposed on self is called …………?

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[q] Factitious disorder imposed on another is called ……..?

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[q] What is the most likely diagnosis?

– Patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific 2° (external) gain (avoiding work, narcotics, obtaining financial compensation).

– Poor compliance with treatment or follow-up of diagnostic tests.

– Complaints cease after gain.

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[q]………… is characterized by a feeling of detachment or estrangement from the self or a sense of being an outside observer of the self.

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[q]……… is a subjective sense of detachment or unreality regarding surroundings.

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[q] …………. is inability to recall important personal information, usually subsequent to severe trauma or stress.

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[q] What is the most likely diagnosis?

– Presence of 2 or more distinct identities or personality states.

– More common in women.

– Associated with history of sexual abuse, PTSD, depression, substance abuse, borderline personality, somatoform conditions.

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[q] What is the most likely diagnosis?

19 years old female athlete presenting with tibial stress fracture,  parotid gland hypertrophy, dental caries, halitosis, and calluses on the dorsum of their hands, amenorrhea, fine, downy body hair + lab findings include hypokalemia, hypochloremia, metabolic alkalosis + BMI= 18.1 and body weight= 58 KG.

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[q] Aggressive initiation of nutrition in patient with anorexia nervosa without adequate electrolyte repletion can quickly precipitate arrhythmias and cardiopulmonary failure. This is called …….?

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[q] What is the most likely diagnosis?

19 years old female athlete presenting with tibial stress fracture,  parotid gland hypertrophy, dental caries, halitosis, and calluses on the dorsum of their hands, amenorrhea, fine, downy body hair + lab findings include hypokalemia, hypochloremia, metabolic alkalosis + BMI= 19 and body weight= 78 KG.

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[q] ………. is regular episodes of excessive, uncontrollable eating without inappropriate compensatory behaviors. ↑ risk of diabetes.

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[q] What is the most likely diagnosis?

– Recurring episodes of eating non-food substances (dirt, hair, paint chips) over ≥ 1 month that are not culturally or developmentally recognized as normal.

– May provide temporary emotional relief.

– Common in children; also common during pregnancy.

– Associated with malnutrition, anemia, developmental disabilities, emotional trauma.

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[q] ……. is inability to remember things that occurred before a CNS insult.

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[q] ……… is inability to remember things that occurred after a CNS insult (↓ acquisition of new memory).

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[q]………. is a reversible, acute-onset confusional state characterized by a fluctuating level of consciousness with deficits in attention, memory, and executive function. In contrast, ………. is of gradual onset, is irreversible, and does not involve fluctuations in consciousness.

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[q] Which type of personality disorder?

– Pervasive distrust and suspiciousness; projection is the major defense mechanism.

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[q] Which type of personality disorder?

– Voluntary social withdrawal, limited emotional expression, content with social isolation. Socially detached and prefer to be alone.

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[q] Which type of personality disorder?

– Eccentric appearance, odd beliefs or magical thinking, idea of reference, interpersonal awkwardness.

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[q] Cluster A personality disorders are genetically associated with ………….?

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[q] Which type of personality disorder?

– Disregard for and violation of rights of others, criminality, impulsivity; males > females; must be ≥ 18 years old and have history of conduct disorder before age 15.

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[q] Which type of personality disorder?

– Unstable mood and interpersonal relationships, impulsivity, self-mutilation (cutting, burning), suicidality, sense of emptiness; females > males; splitting is a major defense mechanism.

– They experience extreme mood reactivity to interpersonal stresses and frequently alternate between extremes of idealizing and devaluing others (defense mechanism of splitting).

– A history of childhood trauma (physical and sexual abuse, neglect) is common in patients with BPD. Insecure attachment to the primary caregiver may underlie the unstable relationships and fears of abandonment commonly seen in the disorder.

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[q] Which type of personality disorder?

– Excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance.

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[q] Which type of personality disorder?

– Grandiosity, sense of entitlement; lacks empathy and requires excessive admiration; often demands the “best” and reacts to criticism with rage.

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[q] Cluster B personality disorders are genetically associated with ………….?

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[q] Which type of personality disorder?

– Hypersensitive to rejection, socially inhibited, timid, feelings of inadequacy, desires relationships with others.

–  Have very limited social relationships due to fears of being judged, embarrassed, or rejected. They struggle with feelings of inadequacy and pursue relationships only when they feel assured of uncritical acceptance. Occupational dysfunction due to difficulties interacting with coworkers or turning down promotions due to fear of criticism is common.

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[q] Which type of personality disorder?

– Preoccupation with order, perfectionism, and control; ego-syntonic: behavior consistent with one’s own beliefs and attitudes.

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[q] Which type of personality disorder?

– Submissive and clingy, excessive need to be taken care of, low self-confidence.

– Patients often get stuck in abusive relationships.

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[q] Cluster C personality disorders are genetically associated with ………….?

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[q] What is the most likely diagnosis?

–  Impulse control disorder. These individuals experience impulses to steal objects that are of low monetary value or not needed for personal use.

– Overwhelming feelings of tension or anxiety precede impulses and are relieved with the act of theft.

– Feelings of guilt and shame typically follow these acts, and these individuals may return or give away stolen items.

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