psychotherapy for usmle - djyoti

[ArchivalUser]

--a middle aged man with depression request help for his symptoms of low self steem all the time feeling that -life is bad no matter what you do? doesnot want to get medication

--psychoanalysis

behavioural therapy

--cognitive psychotherapy


supportive psycotherapy

group psychotherapy

[ArchivalUser]

----a 35 has abrother with bipolar what is true thing to say to the twin brother

1. you have passed 35 so chanc is less

2. no clear evidence of genetics influence in bipolar

3. the concordence rate is 79%

4. concordence rate is 19%

5. prophylactic lithium is started


3. 42 was raped in a elevator and was fractured arm which healed well bu t she keeps visiting doctor for that fracture / she remembers the rape every othrday and avoids elevatorshe is hypervigilant and irritable and husband is encoyuraging her for claiming disability
is claiming for disability

1. major depression

2. adjusment disorder with depressed mood

3. acute stres disorder

4. malingering

post traumatic disorder

5 specific phobia concerning elevator

6 hypochondriac

[ArchivalUser]

to djyoti Have done ur internship from RML delhi?

[ArchivalUser]

2
5

[ArchivalUser]

ANSWER TO ABOVE QUESTIONS

This middle aged man has low self esteem and depressed does not want to take medication

so cognitive behavioural therapy will be good for him since he will see and understand how cognitive distortion about himself and others and the future brings about hi sdepressive feeling


psycho an lysis need lot of session and conflicts of childhood are explored

behavioural therapy has its goal the disruption of inappropriate behavious with substitute of more appropriatebehaviours. it is intened for phobias and various psychosomatic disorder
eg migraine htn

supportive psychothearpy is in addition to medication. family support system is vital

group therapy may be valuble in this patient after he has some insight into his problem and one to one communicatication habit is developed--means first know you then know others
proper preparation is necessaray before you enter group therapy



2.

concordence rate for bipolar is 19%


3

--hypervigilant rape/irritability are so much strong factor that we shouldnot be distracted by other answer--post traumatic disorder is the answer- here -iritability hypervigilant avoiding the elevator because rape happened in the elevator other features will be flashback-nightmare pt relieve those memory in dream or flashback though she wants to forget it.