ABPN C-L Psychiatry study guide
ABPN C-L Psychiatry · Work through your exam, one topic at a time.
This page is an independent study guide for the ABPN Consultation-Liaison Psychiatry subspecialty certification examination. C-L psychiatry-formerly called psychosomatic medicine-focuses on psychiatric care of people with medical, surgical, neurologic, obstetric, and critical illness. The ABPN C-L Psychiatry study guide has 6 sections and about 1,935 words.
01Foundations and Psychiatric Assessment in the Medically Ill
In the medically ill, the first task is to distinguish primary psychiatric illness from a medical or substance-induced syndrome, and to separate delirium from dementia and depression. Any acute change in attention or arousal is delirium until proven otherwise; the hypoactive form is commonly mistaken for depression.
340 words, about 2 min02Consultation and Liaison Practice
Effective C-L work begins before the patient is seen: read the chart, identify the requesting team, and clarify the actual question. Many requests (rule out depression) mask a different need: capacity, disposition, agitation management, family conflict or staff distress.
332 words, about 2 min03Psychiatric-Medical Comorbidity and Psychopharmacology in the Medically Ill
Start low and go slow, but titrate to effect. In renal impairment, avoid or dose-adjust drugs with active metabolites: venlafaxine (desvenlafaxine accumulates), lithium (nephrotoxic and renally cleared), gabapentin and pregabalin; consider dialyzability in overdose.
322 words, about 2 min04Emergency, Critical Care, and Acute Hospital Psychiatry
The emergency psychiatric differential in the hospital is delirium, and the bedside tool is attention: digit span, months backward, and the CAM algorithm (acute onset, fluctuating course, inattention, plus disorganized thinking or altered awareness). Hypoactive delirium is missed when labeled depression or poor motivation.
327 words, about 2 min05Substance Use, Pain, and Palliative/End-of-Life Care
Alcohol withdrawal is the lethal one: tremor, diaphoresis, tachycardia, hallucinations, seizures and delirium tremens. Use symptom-triggered benzodiazepines (CIWA-Ar), give thiamine before glucose, and expect kindling in repeat episodes.
295 words, about 1 min06Special Populations, Reproductive Psychiatry, and Psychosocial/Adjustment Issues
Depression in cancer is underrecognized; somatic criteria overlap with illness, so emphasize anhedonia, hopelessness, guilt and worthlessness. Corticosteroids cause mood lability, insomnia and psychosis; treat with dose reduction and antipsychotics rather than antidepressants alone.
319 words, about 2 min