Psych Shelf Exam

Took the Psych. Shelf today and I must say that I'm not sure how I did. I studied fairly hard for it and used Blueprints, A&L's question book, and PreTest. That's it.

All in all, it was, I suppose, a fair test, that really forced you to know your differential diagnoses. Quite a bit of "real" pathology on it (seizures, drug OD, IBD, FAS) that forced you to oftentimes work-up the patient with an EKG as opposed to prescribing a SSRI for a panic disorder.

Some suggestions/observations...

1. Know your Bereavement vs. MDD vs. Adjustment Disorder COLD. Literally, these three were in the options for "what is the diagnosis" questions many times. Like 7-8 times on my shelf.

2. 2-3 developmental questions, like "is it normal for a 3 yowm to still poop in his diaper?"

3. The treatment questions were my favorites. I had...treatment of Mania, EPS treatments in patients on Haldol (2), treating delirium in the elderly, patient w/ priapism caused by ____, treating Li-induced tremor, treatment of GAD, treatment of Trichotillomania, treatment of severe anxiety in a businessman before flying, treat school phobia, treatment of dementia, etc..

4. Don't be afraid to go with ECT if the patient is old, has PD, is actively suicidal, and had CABG a few years ago.

5. I had 2 questions where I believe the answer was MDD. One in a kid and the other in a teenager. The kid had somatic complaints and appeared sad. The distractor was IBD. The teen had extreme irritability with occasional thoughts of death. The distractor was ODD, adjustment d/o.

6. I had to treat acute ASA OD and recognize Methanol poisoning (AG metabolic acidosis). I had to recognize a TIA -- question had nothing to do with psychiatry.

7. Know MRI findings in Tourette's. I didn't know the answer but put down decreased frontal lobe mass. Up-to-Date supports this, so I think it's correct. Basal Ganglia changes weren't an option.

8. Know presentation of FAS vs. Trisomy 21 -- based on facial description.

9. Know epidemiology of BP d/o. MZ twins have >50% risk, even if raised apart.

10. I had a very tricky questioning where I had it narrowed down to Pain d/o and Factitious d/o by proxy. Put Pain d/o but no clue which one's correct.

11. Be familiar with drugs that can cause delirium (i.e., thioridazine).

I had a good smattering of questions. Best of luck to all.....

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Psych Shelf Exam