University of Texas-Rio Grande Valley Physician Assistant Department Medical Psychiatry PHAS 5132 Summer II 2016

Transcription

1 University of Texas-Rio Grande Valley Physician Assistant Department Medical Psychiatry PHAS 5132 Summer II 2016 Course Number: PHAS 5132 Credit Hours: 2 Course Title: Course Location: Class Time(s): Medical Psychiatry HSHE On Monday and Wednesday but TBA Friday Class Times May Vary Due to Schedule conflicts Monday, Wednesday & Friday 8-11:10 We may utilize afternoon time 2:40-4:10 on Monday and Wednesday if Needed in order to allow for attendance of Board Review the week August 15 th. Required Texts & Materials: Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/clinical Psychiatry. Benjamin J. Sadock, Virginia A. Sadock, Pedro Ruiz, Philadelphia : Wolter Kluwer/Lippincott Williams & Wilkins, Suggested Text: DSM-IV or DSM-V supplement Instructor & Contact Information: Wilma J. Mealer, MPAS, PA-C/Dr. Charles Strong Wilma.mealer@utrgv.edu HHSE (cell) 1

2 Course Description: PHAS 5132 Medical Psychiatry explores psychiatric illnesses and provides an overview of psychiatric concepts. This course expands on the medical interview, history taking and examination of a patient with an emotional or psychiatric problem. Emotional growth and development for all age groups will be addressed. Course material identifies normal and abnormal physical, social and psychological processes in order to prepare the PA student for clinical rotations. Prerequisite: PHAS 5325 Course Grading: The course grade will be based on the following point scale. There will be no curving of the grades at the end of the semester. Examination Examination Weekly Quizzes 100 Reflection Papers/Blog 100 Final Exam 100 The course grades will be assigned as follows: A = C = 70 <80 F =<70 B = 80 - <90 Refer to the FYI policy handbook for further information regarding grades below <70. Reflection Paper: Once a week a movie will be assigned for you to watch. You will have to find it on You tube, rent it or ask a friend for the movie. The assignment will be complete once you have written and turned in a reflection paper about the movie. Please review the rubric before submitting the paper. Psycho Babble Blog: Post one entry per week in the Psyco Babble Blog. Please see the grading rubric prior to posting. The Blog is a platform for you to discuss lectures you have had in class, reflection papers, case studies, and questions you may have about a disorder and or how to recognize a disease. 2

3 Examination Policies Each examination will consist of at least 50 but no more than 100 questions that will cover all subject material discussed, reading assignments, and information that, in general, students will be familiar with during the course. Physician Assistant Core Competencies: This course will prepare the student to meet certain PA competencies. The Medical Psychiatry course outcomes and learning objectives relate to the Competencies for the Physician Assistant Profession (2012) as follows: Core Competencies for the PA Profession Specific Competencies Addressed in Medical Psychiatry Medical Knowledge Medical knowledge includes the synthesis of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion, and disease prevention. Physician assistants must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, physician assistants are expected to demonstrate an investigative and analytic thinking approach to clinical situations. Physician assistants are expected to understand, evaluate, and apply the following to clinical scenarios 1. evidence-based medicine 2. scientific principles related to patient care 3. etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions 4. signs and symptoms of medical and surgical conditions 5. appropriate diagnostic studies 6. management of general medical and surgical conditions to include pharmacologic and other treatment modalities 7. interventions for prevention of disease and health promotion/maintenance 8. screening methods to detect conditions in an asymptomatic individual 9. history and physical findings and diagnostic studies to formulate differential diagnoses Interpersonal & Communication Skills encompass the verbal, nonverbal, written, and electronic exchange of information. Physician assistants must demonstrate interpersonal and communication skills that result in effective information exchange with patients, patients families, physicians, professional associates, and other individuals within the health care system. 1. create and sustain a therapeutic and ethically sound relationship with patients 2. use effective communication skills to elicit and provide information 3. adapt communication style and messages to the context of the interaction 4. work effectively with physicians and other health care professionals as a member or leader of a health care team or other professional group 3

4 Physician assistants are expected to: demonstrate emotional resilience and stability, adaptability, flexibility, and tolerance of ambiguity and anxiety 6. accurately and adequately document information regarding care for medical, legal, quality, and financial purposes Patient Care Patient care includes patient- and setting-specific assessment, evaluation, and management. Physician assistants must demonstrate care that is effective, safe, high quality, and equitable. Physician assistants are expected to: 1. work effectively with physicians and other health care professionals to provide patient-centered care 2. demonstrate compassionate and respectful behaviors when interacting with patients and their families 3. obtain essential and accurate information about their patients 4. make decisions about diagnostic and therapeutic interventions based on patient information and preferences, current scientific evidence, and informed clinical judgment 5. develop and implement patient management plans 6. counsel and educate patients and their families 7. perform medical and surgical procedures essential to their area of practice 8. provide health care services and education aimed at disease prevention and health maintenance 9. use information technology to support patient care decisions and patient education Professionalism Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it involves prioritizing the interests of those being served above one s own. Physician assistants must acknowledge their professional and personal limitations. Professionalism also requires that PAs practice without impairment from substance abuse, cognitive deficiency or mental illness. Physician assistants must demonstrate a high level of responsibility, ethical practice, sensitivity to a diverse patient population, and adherence to legal and regulatory requirements. Physician 1. understanding of legal and regulatory requirements, as well as the appropriate role of the physician assistant 2. professional relationships with physician supervisors and other health care providers respect, compassion, and integrity 3. accountability to patients, society, and the profession 4. commitment to excellence and on-going professional development 5. commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices 4

5 assistants are expected to demonstrate: 6. sensitivity and responsiveness to patients culture, age, gender, and abilities Practice-Based Learning & Improvement Practice-based learning and improvement includes the processes through which physician assistants engage in critical analysis of their own practice experience, the medical literature, and other information resources for the purposes of self- and practice-improvement. Physician assistants must be able to assess, evaluate, and improve their patient care practices. Physician assistants are expected to: 1. analyze practice experience and perform practice-based improvement activities using a systematic methodology in concert with other members of the health care delivery team 2. locate, appraise, and integrate evidence from scientific studies related to their patients health 3. apply knowledge of study designs and statistical methods to the appraisal of clinical literature and other information on diagnostic and therapeutic effectiveness 4. utilize information technology to manage information, access medical information, and support their own education 5. recognize and appropriately address personal biases, gaps in medical knowledge, and physical limitations in themselves and others Systems-Based Practice Systems-based practice encompasses the societal, organizational, and economic environments in which health care is delivered. Physician assistants must demonstrate an awareness of and responsiveness to the larger system of health care to provide patient care that balances quality and cost, while maintaining the primacy of the individual patient. PAs should work to improve the health care system of which their practices are a part. Physician assistants are expected to: 1. effectively interact with different types of medical practice and delivery systems 2. understand the funding sources and payment systems that provide coverage for patient care and use the systems effectively 3. practice cost-effective health care and resource allocation that does not compromise quality of care 4. advocate for quality patient care and assist patients in dealing with system complexities 5. partner with supervising physicians, health care managers, and other health care providers to assess, coordinate, and improve the delivery and effectiveness of health care and patient outcomes 6. accept responsibility for promoting a safe environment for patient care and recognizing and correcting systems-based factors that negatively impact patient care 7. apply medical information and clinical data systems to provide effective, efficient patient care 8. recognize and appropriately address system biases that contribute to health care disparities 5

6 9. apply the concepts of population health to patient care Students with Disabilities: If you have a documented disability (physical, psychological, learning, or other disability which affects your academic performance) and would like to receive academic accommodations, please inform your instructor and contact Student Accessibility Services to schedule an appointment to initiate services. It is recommended that you schedule an appointment with Student Accessibility Services before classes start. However, accommodations can be provided at any time. Brownsville Campus: Student Accessibility Services is located in Cortez Hall Room 129 and can be contacted by phone at (956) (Voice) or via at accessibility@utrgv.edu. Edinburg Campus: Student Accessibility Services is located in 108 University Center and can be contacted by phone at (956) (Voice), (956) (Fax), or via at accessibility@utrgv.edu. Learning and Assessment Activities: Cognitive 1. Understand psychiatric nomenclature. 2. Recognize the major psychopathological categories and produce a differential diagnosis for each category. 3. Critique the role of psychological testing and its influence on psychiatric evaluation. 4. Differentiate the various aspects of psychiatric treatment including psychotherapeutic, social, and pharmacological modalities. 5. Explain the incidence, etiology, assessment, prevention, and proper handling of violence in psychiatric populations. 6. Discuss the purpose and utilization of the DSM-IV, DSM V and identify the basic components of psychiatric assessment based on DSM-V criteria. 7. Summarize the following mood disorders: anxiety, psychosis, personality disorder, somatoform disorder, cognitive impairment, sleep disturbances and disorders, and dissociative disorders. 8. Analyze the common psychiatric disorders of childhood, adolescent and geriatric populations. 9. Integrate the basic principles of death and dying as related to psychiatry. 10. Recall the evaluation and basic management of psychiatric emergencies. 6

7 Psychomotor 1. Perform a psychiatric interview and mental status exam in order to obtain a medical psychiatric history. 2. Write a concise psychiatric evaluation consisting of history, mental status exam, physical examination, and diagnosis and treatment plan. 3. Recognize patients who are having significant mental difficulties. 4. Identify and evaluate your own feelings and attitudes and how they affect your ability to evaluate and treat people in distress. 5. To be willing to learn ways in which such attitudes and feelings can be dealt with and be utilized to help you provide better patient care. Behavioral 1. To develop comfort in professional encounters with as many different types of individuals as possible. 2. To be able to keep emotional and physical issues in perspective when evaluating and treating any patient. 3. To appreciate the significance of emotional factors in the practice of medicine. 4. To respect the dignity and innate value of each patient regardless of their difficulties. Course Outline (Dates Subject to Change due to Conflicts ) Introduction to Psychiatry 07/20/16 Introduction/Diagnosis and Classification/The BATHE Technique Setting the Stage Approaching the Psychiatric Patient Eliciting the Psychiatric History; Psychiatric Assessment: The interview and Mental Status exam Chapter 5 By the end of this section, the student will demonstrate the ability to obtain a complete psychiatric history, recognize relevant physical findings, and perform a complete mental status examination. Specific Objectives The student will be able to: 1. Elicit and clearly record a complete psychiatric history, including the identifying data, chief complaint, history of the present illness, past psychiatric history; medications (psychiatric and non psychiatric), general medical history, review of systems, substance abuse history, family history, and personal and social history 7

8 8 2. Recognize the importance of, and be able to obtain and evaluate, historical data from multiple sources (family members, community mental health resources, old records, etc.) 3. Discuss the effect of developmental issues on the assessment of patients 4. Elicit, describe, and precisely record the components of the mental status examination, including general appearance and behavior, motor activity speech, affect, mood, thought processes, thought content, perception, sensorium and cognition (e.g., state of consciousness, orientation, registration, recent and remote memory, calculations, capacity to read and write, abstraction), judgment, and insight 5. Use appropriate terms associated with the mental status examination 6. For each category of the mental status exam, list common abnormalities and their common causes 7. Assess and record mental status changes, and alter hypotheses and management in response to these changes 8. Recognize physical signs and symptoms that accompany classic psychiatric disorders (e.g., tachycardia and hyperventilation in panic disorder) 9. Appreciate the implications of the high rates of general medical illness in psychiatric patients, and state reasons why it is important to diagnose and treat these illnesses 10. Assess for the presence of general medical illness in psychiatric patients, and determine the extent to which a general medical illness contributes to a patient's psychiatric problem 11. Recognize and identify the effects of psychotropic medication in the physical examination 12. Explain the value of skillful interviewing for patient and clinician satisfaction and for obtaining optimal clinical outcomes 13. Demonstrate respect, empathy, responsiveness, and concern regardless of the patient's problems or personal characteristics 14. Identify verbal and nonverbal expressions of affect in a patient's responses, and apply this information in assessing and treating the patient 15. Demonstrate the following interviewing skills: appropriate initiation of the interview; establishing rapport; the appropriate use of open-ended and closed questions; techniques for asking "difficult" questions; the appropriate use of facilitation, empathy, clarification, confrontation, reassurance, silence, summary statements; soliciting and acknowledging expression of the patient's ideas, concerns, questions, and feelings about the illness and its treatment; communicating information to patients in a clear fashion; appropriate closure of the interview 16. State and avoid the following common mistakes in interviewing technique: interrupting the patient unnecessarily; asking long, complex questions; using jargon; asking questions in a manner suggesting the desired answer; asking questions in an interrogatory manner; ignoring patient verbal or nonverbal cues; making sudden inappropriate changes in topic; indicating patronizing or judgmental attitudes by verbal or nonverbal cues (e.g., calling an adult patient by

9 his or her first name, questioning in an oversimplified manner, etc.); incomplete questioning about important topics 17. Demonstrate sensitivity to student-patient similarities and differences in gender, ethnic background, sexual orientation, socioeconomic status, educational level, political views, and personality traits Anxiety Disorders 07/20/16 Generalized Anxiety Disorder (GAD) Chapter 9 Panic Disorder (PD) Social Phobia (Social Anxiety Disorder SAD) Obsessive-Compulsive Disorder (OCD) Chapter 10 Post-traumatic Stress Disorder (PTSD) Chapter Summarize neurobiological, psychological, environmental, and genetic etiologic hypotheses for the anxiety disorders 2. Discuss the epidemiology, clinical features, course, and psychiatric comorbidity of panic disorder, agoraphobia, social phobia, specific phobias, generalized anxiety disorder, posttraumatic stress disorder, acute stress disorder, and obsessive-compulsive disorder 3. Distinguish panic attack from panic disorder 4. List the common general medical and substance-induced causes of anxiety, and assess for these causes in evaluating a person with an anxiety disorder 5. Outline psychotherapeutic and pharmacologic treatments for each of the anxiety disorders 6. Compare and contrast clinical presentations of anxiety disorders in children and adults Pharmacology and ECT/Review 7/20/16 2:40-4:10 Dr. Charles Strong Dr. Strong will provide material and objectives in his lectures and handouts. Chapter 21 in the book has information on the drugs but the test questions come directly from Dr. Charles Strong and his lectures. Eating Disorders 9

10 07/22/16 Anorexia nervosa Chapter 15 Bulemia Instructor: 1. Summarize the etiologic hypotheses, clinical features, epidemiology, course, comorbid disorders, complications, and treatment for anorexia nervosa 2. Summarize the etiologic hypotheses, clinical features, epidemiology, course, comorbid disorders, complications, and treatment for bulimia 3. Discuss the role of the primary care physician assistant in the prevention and early identification of eating disorders List the medical complications and indications for hospitalization in patients with eating disorders Depressive and Mood Disorders 07/22/16 Depressive Disorders Chapter 8 Bipolar Disorders 1. Discuss evidence for neurobiological, genetic, psychological, and environmental etiologies of mood disorders 2. State the epidemiologic features, prevalence rates, and lifetime risks of mood disorders in clinical and non-clinical populations 3. Compare and contrast the epidemiologic and clinical features of unipolar depression and bipolar disorders 4. State the common signs and symptoms, differential diagnosis (including general medical and substance-induced disorders), course of illness, comorbidity, prognosis, and complications of mood disorders 5. Contrast normal mood variations, states of demoralization, and bereavement with the pathological mood changes that constitute depressive illness 6. Identify the difference in the presentation, treatment, and prognosis of major depression with and without melancholic features, psychotic features, atypical features, catatonic features, seasonal pattern, and postpartum onset 7. Compare and contrast the clinical presentations of mood disorders in children, adults, and the elderly 8. Describe some common presentations of depressive disorders in non-psychiatric settings, define the term "masked depression," and develop an approach to evaluating and treating mood disorders in a general medical practice 10

11 9. Discuss the increased prevalence of major depression in patients with general medical-surgical illness (e.g., myocardial infarction, diabetes, cardiovascular or cerebrovascular accidents, hip fractures) and the impact of depression on morbidity and mortality from their illnesses 10. Discuss the identification and management of suicide risk in general medical settings 11. Outline the recommended acute and maintenance treatments for dysthymia, major depression, and bipolar disorders (manic and depressive phases) 12. State the characteristics and techniques of the non-pharmacological treatments for depression, including psychotherapy, cognitive therapy, couples therapy, and 13. phototherapy Sleep Wake Disorders 07/25/16 Sleep Wake Disorders Chapter 16 1:00 3:30 pm Instructor: 1. Describe normal sleep physiology, including sleep architecture, throughout the life cycle 2. Obtain a complete sleep history 3. Discuss the manifestations, differential diagnosis, evaluation, and treatment of primary sleep disorders, including dyssomnias and parasomnias 4. Describe the typical sleep disturbances that accompany psychiatric and substance use disorders 5. Summarize the effect(s) of psychotropic medications on sleep 6. Describe sleep hygiene treatment Addictive Disorders 07/25/16 Addiction Chapter Obtain a thorough history of a patient's substance use through empathic, nonjudgmental and systematic interviewing 2. List and compare the characteristic clinical features (including denial) of substance abuse and dependence 11

12 3. Discuss the epidemiology (including the effects of gender), clinical features, patterns of usage, course of illness, and treatment of substance use disorders 4. Identify typical presentations of substance abuse in general medical practice; 5. List the psychiatric disorders that share significant comorbidity with substancerelated disorders and discuss some criteria for determining whether the comorbid disorder should be treated independently 6. Discuss the role of the family, support groups, and rehabilitation programs in the recovery of patients with substance use disorders 7. List the questions that compose the CAGE (test for alcoholism) questionnaire and discuss its use as a screening instrument 8. Discuss the genetic, neurobiological, and psychosocial explanations of the etiology of alcoholism 9. List the psychiatric and psychosocial complications of alcoholism; 10. Know the clinical features of intoxication with, and withdrawal from: cocaine, amphetamines, hallucinogens, cannabis, phencyclidine, barbiturates, opiates, caffeine, nicotine, benzodiazepines, and alcohol 11. State the treatments of intoxication and withdrawal induced by the substances listed in # List patient characteristics associated with benzodiazepine abuse 13. State guidelines for prescribing benzodiazepines 14. Discuss the difficulties experienced by health care personnel in providing empathic, nonjudgmental care to substance abusers Sexual Dysfunction 07/27/16 Sexual Dysfunctions Chapter 17 Gender Identity Disorders Paraphilias 1. Discuss the anatomy and physiology of the male and female sexual response cycles 2. Obtain a patient's sexual history, including an assessment of risk for sexually transmitted diseases, especially HIV 3. State the implications of the high prevalence of sexual dysfunctions in the general population, particularly in the medically ill 4. List the common causes of sexual dysfunctions, including general medical and substance-related etiologies 5. Summarize the manifestations, differential diagnosis, and treatment of hypoactive sexual desire disorder and sexual aversion disorder; male erectile disorder and female sexual arousal disorder; female and male orgasmic disorders and premature ejaculation; and dyspareunia and vaginismus 6. Define the term paraphilia 12

13 7. List and define each of the common paraphilias 8. Review the management of the paraphilias 9. Discuss the prevalence, manifestations, diagnosis, and treatment of gender identity disorder Test 1 Friday July 29, 2016 Tested Material: Introduction to Psychiatry Mood Disorders Sleep Disorders Anxiety Disorders Eating Disorders Addiction Disorders Sexual Dysfunctions Pharmacology After test lecture will continue with Psychotic Disorders Psychotic Disorders 08/01/2016 Schizophrenia Chapter 7 Schizophreniform Disorder Schizoaffective Disorder Delusional Disorder 1. Define the term psychosis 2. Develop a differential diagnosis for a person presenting with psychosis, including identifying historical and clinical features that assist in the differentiation of general medical, substance induced, affective, schizophrenic, and other causes 3. State the neurobiologic, genetic, and environmental theories of etiology and pathophysiology of schizophrenia 4. Summarize the epidemiology, clinical features, course, and complications of schizophrenia 5. Name the clinical features of schizophrenia that are associated with good and poor outcome, and explain the significance of negative symptoms 6. Summarize the treatment of schizophrenia, including both pharmacologic and psychosocial interventions 13

14 7. List the features that differentiate delusional disorder, schizophreniform disorder, schizoaffective disorder, and brief psychotic disorder from each other and from Schizophrenia Dissociative Disorders 08/01/2016 Dissociative Amnesia Chapter 12 Dissociative Fugue Dissociative Identity Disorder Depersonalization Disorder 1. List a differential diagnosis of psychiatric, substance-induced, and general medical conditions that may present with amnesia and discuss the evaluation and treatment of persons with amnesia 2. State the clinical features of dissociative amnesia, dissociative fugue, depersonalization disorder, and dissociative identity disorder 3. Discuss the hypothesized role of psychological trauma, including sexual, physical, and emotional abuse, in the development of dissociative disorders (and posttraumatic stress disorders) 4. Discuss the etiologic hypotheses, epidemiology, clinical features, course, and treatment of dissociative identity disorder Psychosomatic Disorders 08/03/16 Somatic Symptom Disorder Chapter 13 Illness Anxiety Disorder Functional Neurological Symptom Disorder (Conversion Disorder) Factitious Disorder Pain Disorder 1. State the clinical characteristics of somatization disorder, conversion disorder, pain disorder, body dysmorphic disorder, and hypochondriasis 2. List the psychiatric disorders that have high comorbidity with somatoform disorders 3. Discuss the implications of the high rate of underlying general medical/neurologic illness in patients diagnosed with pain disorder and conversion disorder 4. List the characteristic features of factitious disorder and malingering, and compare these with the somatoform disorders 5. Discuss the frequency and importance of physical symptoms as manifestations of psychological distress 6. Summarize the principles of management of patients with somatoform disorders 14

15 7. Discuss difficulties physicians may have with patients with these diagnoses. Personality Disorders 08/03/16 Personality Disorders Chapter 22 Handouts 1. Explain how the DSM-IV defines personality traits and disorders, and identify features common to all personality disorders 2. Review the DSM-5 organization of Personality Disorders 3. List the three descriptive groupings (clusters) of personality disorders in the DSM-IV and DSM-5 and describe the typical traits of each personality disorder 4. Summarize the neurobiological, genetic, developmental, behavioral, and sociological theories of the etiology of personality disorders, including the association of childhood abuse and trauma 5. Discuss the biogenetic relationships that exist between certain Axis I and Axis II disorders (e.g., schizotypal personality disorder and schizophrenia) Understand that the Multiaxial system has been discontinued 6. Discuss the epidemiology, differential diagnosis, course of illness, prognosis, and co morbid psychiatric disorders in patients with personality disorders 7. List the general medical and Axis I psychiatric disorders that may present with personality changes 8. Identify difficulties in diagnosing personality disorders in the presence of stress, substance abuse, and other Axis I disorders 9. Discuss the concepts of hierarchical levels of defense and regression under stress, and list typical defense mechanisms used in various personality disorders 10. List the psychotherapeutic and pharmacologic treatment strategies for patients with personality disorders 11. Discuss the management of patients with personality disorders in the general medical setting 12. Summarize principles of management of patients with personality disorders, including being aware of one's own response to the patient, soliciting consultations from colleagues when indicated, and using both support and non-punitive limit setting 15

16 Friday August 5, 2016 Test 2 Test 2 Topics Include: Psychotic Disorders Dissociative Disorders Psychosomatic Disorders Personality Disorders Emergency Psychiatric Medicine 08/08/16 Chapter 23 and Handouts Suicide Psychiatric Emergencies in Adults 1. Demonstrate knowledge of common suicidal symptoms and precipitants/stressors. 2. Investigate how family history plays a role in the suicidal patient? 3. Identify warning signs of the potentially suicidal individual. 4. Identify the high risk factors leading to suicidal attempts. 5. Identify the professionals legal responsibilities when responding to the suicidal individual. 6. Explain the areas of focus during the initial interview. 7. Develop a better understanding of how suicide is related to mental illness, substance abuse, trauma, and violence. 8. Compare interventions that are available and assess the most effective for the prevention of suicidal behavior. 16

17 Child and Adolescent Psychiatry 8/10/2016 Psychiatric Disorders of Children Chapter 31 Psychiatric Disorders of Adolescents 1. Compare and contrast the process of psychiatric evaluation of children and adolescents at different developmental stages with that of adults 2. State the value of obtaining data from families and teachers in the evaluation and treatment of children and adolescents 3. State the indications for psychological assessment in children and list some of the common tests in a psychometric evaluation 4. List a differential diagnosis and outline the evaluation of academic performance and behavioral problems in children 5. Summarize the etiologic hypotheses, clinical features, epidemiology, pathophysiology, course, comorbid disorders, complications, and treatment for attention-deficit hyperactivity disorder and conduct disorder 6. Name the major clinical features of autism 7. Differentiate developmentally based anxiety (e.g., stranger, separation anxiety) from pathological anxiety disorders in childhood 8. Describe typical clinical features of anxiety disorders at different developmental stages 9. Compare and contrast the clinical features of mood disorders in children with that of adults 10. Discuss the epidemiology and clinical features of suicide risk in adolescents 11. State when and how a physician assistant must protect the safety of a child who may be the victim of physical or sexual abuse or neglect 12. Identify signs and symptoms of child sexual and physical abuse, and discuss its short and long-term psychiatric sequelae Friday FINAL EXAM 100 QUESTIONS Topics Include: 50% Child and Adolescent Psychiatry Emergency Psychiatric Medicine Suicide and Violence Risk Assessment Psychopharmacologic Emergencies 50% Comprehensive 17

18 18