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79 Cards in this Set
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In addition, he also believes that his whole house is infested by bugs. The patient's daughter then describes an incident where he was found climbing on the roof of his "A" frame house looking for bugs. This vignette illustrates impairment in:
A. Affect B. Fund of knowledge C. Judgement D. Motivation E. Orientation |
C
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Which is an example of abnormal thought content?
A. Circumstantiality B. Flight of ideas C. Looseness of associations D. Tangentiality E. Thought broadcasting |
E
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The multiaxial evaluation in Psychiatry reflects the biopsychosocial approach to
diagnosis. Psychosocial stressors are reported on which axis? A. Axis I B. Axis 2 C. Axis III D. Axis IV E. Axis V |
D
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When performing the cognitive testing part of the mental status examination, which
function needs to be assessed first? A. Abstract reasoning B. Attention C. Fund of knowledge D. Insight E. Memory |
B
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Loosening of association refers to:
A. Pathologic lying B. Inability to name objects C. A conduct disorder among adolescents D. Incoherent communication E. Ideas that are weakly connected, but can be followed |
E
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An elderly male patient is referred to a psychiatrist by a dermatologist who evaluated
him for multiple excoriations. The patient is convinced that his body is infested by bugs, but there are none seen on close examination. The patient agreed to see the psychiatrist to please his family. In this context the patient demonstrates impairment in: A. Abstraction B. Affect C. Fund of knowledge D. Insight E. Mood |
D
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Which is NOT an example of abnormal thought form?
A. Derailment B. Flight of ideas C. Ideas of reference D. Thought blocking E. Word salad |
C
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In the Mental Status Examination, affect describes:
A. the subjective feeling state of the patient sustained over much of the interview B. the patient's understanding of himself or herself in the context of wanting or needing help C. the patient's abilities with regard to attention, orientation, and intellectual functions D. the patient's quality of interactions with the clinician during the interview E. the objective description of the patient's emotional state as observed by the clinician |
E
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A patient reports that he believes he is God. Which category of the Mental Status
Examination will most likely be abnormal? A. Thought content B. Thought process C. Perception D. Cognition E. Mood |
A
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Delusions of persecution are most characteristic of:
A. psychotic depression B. mania C. delirium D. schizophrenia |
D
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Which type of hallucination is more common for schizophrenia?
A. Auditory B. Gustatory C. Olfactory D. Tactile E. Visual |
A
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In schizophrenia, a factor associated with a better outcome is:
A. male gender B. lower IQ C. married D. poor social functioning E. nonparanoid subtype |
C
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Which is NOT a common symptom of schizophrenia?
A. Avolition B. Disorganized speech C. Hallucinations D. Paranoia E. Violence |
E
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A 53-year-old man with a long history of schizophrenia treated with a standard (typical)
antipsychotic presents with irregular involuntary movements of his tongue. He is most likely experiencing: A. an anticholinergic side effect B. dystonia C. neuroleptic-induced parkinsonism D. akathisia E. tardive dyskinesia |
E
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A 26-year-old man is brought into the emergency room with a history of recent
onset agitation, suspiciousness, and visual hallucinations; his hand appears to be bloodied and a friend accompanying him states he just "went wild" earlier and acted like he felt nothing when he put his right hand through a wall at his girlfriend's home. When you examine him he is mute, catatonic, and diaphoretic. Increased deep tendon reflexes and vertical nystagmus is noted. In your differential diagnosis, you suspect intoxication with which of the following drugs: A. Ethanol B. Phencyclidine C. Cocaine D. Nicotine E. Methamphetamine |
B
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Which of the following is the most reliable sign of drug dependence (as contrasted
with drug abuse)? A. Impaired control B. Denial C. Preoccupation D. Continued use despite adverse consequences E. Physiological dependence (tolerance and/or withdrawal) |
A
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A 66-year-old patient with a history of chronic alcohol abuse presents to the
emergency department (ED) with auditory hallucinations of an unstructured, maligning, reproachful type but with a clear sensorium. The patient reports having this symptom for 4 days. Which of the following is a likely diagnosis? A. Alcohol-induced mood disorder B. Alcohol-induced psychotic disorder C. Delirium tremors D. Idiosyncratic alcohol intoxication E. Alcoholic encephalopathy |
B
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The most common illicit drug among adults in the United States is:
A. cocaine B. heroin C. marijuana D. methamphetamines E. hallucinogens |
C
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Which clinical feature would distinguish delirium tremens from uncomplicated
alcohol withdrawal? A. Anxiety and restlessness B. Confusion and disorientation C. Cold and clammy sweats D. Elevated blood pressure and pulse E. Elevated temperature |
B
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A 28-year-old female who is a known substance abuser is brought by a friend to
the emergency room. She is irritable, has rhinorrhea, and complains of an upset stomach and muscle cramps. She is most likely experiencing: A. alcohol intoxication B. alcohol withdrawal C. opiate withdrawal D. cocaine intoxication E. hallucinogen withdrawal |
C
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A 25-year-old patient is brought to the emergency department (ED) by his friends
after attending a party. Physical examination shows tachycardia, hypertension, excessive perpiration, and pupillary dilation. The patient is most likely under the influence of: A. alcohol B. marijuana C. an inhalant D. PCP E. cocaine |
E
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Wich of the following are present during cocaine withdrawal?
A. Euphoria B. Piloerection C. Dilated pupils D. Decreased pupils E. Hypersomnolence |
E
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A 21 year-old man uses marijuana on a daily basis. During the acute intoxication
of his "high," he might more likely experience the psychiatric symptom of: A. depression B. manic-like symptoms C. panic attacks D. paranoia E. depersonalization |
D
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A patient presents with tachycardia, dilated pupils, anger, hypervigilance, elevated
blood pressure, and chills. A toxicology screen will most likely reveal: A. amphetamines B. marijuana C. alcohol D. heroin E. inhalants |
A
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A 27-year-old patient is seen in the emergency department (ED). The patient
reports insomnia, hoplessness, anorexia, and diminished concentration for the past 2 weeks and is acutely suicidal. The patient had been consuming alcohol on a daily basis for the past 3 months. Which of the following is a diagnosis? A. Dysthymic disorder B. Major depressive disorder C. Alcohol-induced mood disorder D. Adjustment disorder E. Cyclothymic disorder |
C
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CAGE, a screening battery for alcohol abuse, stands for:
A. cut down, annoyed, garbled speech, everyday B. craving, abstinence, guilty, eye opener C. craving, annoyed, garbled speech, eye opener D. cut down, annoyed, guilty, eye opener E. cut down, abstinence, guilty, everyday |
D
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What symptom would differentiate alcohol dependence from alcohol abuse?
A. Blackouts B. Intoxication C. Loss of control D. Slurred speech E. Withdrawals |
E
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A 5-year-old boy is hospitalized for a hematologic disorder. In response to this
medical illness, his physician would most expect him to: A. appreciate educational materials regarding his illness B. fear that his body will be mutilated during hospitalization C. carry a transitional object D. worry that he will be different from other hospitalized children E. lose his attachment to his parents |
B
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Which of the following factors is most associated with increased risk of completed
suicide in adolescents with depression? A. Comorbid attention-deficit hyperactivity disorder (ADHD) B. Excessive sleep deprivation C. Previous suicide attempts D. Lack of peer supportsports |
C
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A 6-year-old boy reports hearing voices ever since he discovered his mother in a
diabetic coma and called 911 approximately 3 weeks ago. The boy also has become more irritable, fearful, and insistent on sleeping with his mother. The diagnosis most likely is: A. schizophrenia B. adjustment disorder C. generalized anxiety disorder D. postraumatic stress disorder E. acute stress disorder |
E
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In educating parents about the course of Tourette's syndrome, the psychiatrist
should inform them that: A. the course is usually relentlessly progressive B. the symptoms usually decrease in the face of other stressors C. the symptoms usually improve during adulthood D. the tic behaviors are usually intentionally provocative |
C
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A 7-year-old child frequently reports having stomachaches and headaches, which occur most often in the mornings when getting ready for school and result in frequent absences from school. The child also has frequent nightmares about being kidnapped, although the parents deny any traumatic events in the child's history. Which of the following is the most likely diagnosis?
A. Major depressive disorder B. Reactive attachment disorder C. Avoidant personality disorder D. Posttraumatic stress disorder E. Separation anxiety disorder |
E
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In Erickson's stages of development, the adolescent grapples with:
A. Autonomy vs. shame and doubt B. Industry vs. inferiority C. Trust vs. mistrust D. Identity vs. role confusion E. Intimacy vs. isolation |
D
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A 15-year-old boy is brought in by his parents for a psychiatric evaluation because
they are concerned about his recent school performance. The boy begins by telling the physician that he does not care what the physician's name is, and he does not need a "crazy doctor". Which of the following would be the best approach in handling the situation during the session? A. Ignore the adolescent and direct comments and questions to the parents. B. Tell the adolescent that he does not have the legal right to refuse since he is a minor. C. Explain that the evaluation will have to be delayed until the adolescent is cooperative. D. Thank the adolescent for coming in and ask him if he would prefer to be seen alone or with his parents. E. Excuse the adolescent and spend the session with the parents obtaining history. |
D
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Attention deficit disorder in two-year-olds and borderline personality disorder in
twelve-year-olds cannot be diagnosed because: A. diagnostic criteria are unclear B. parental accounts are unreliable C. there is excessive media attention D. what is pathological at one age can be normal at another |
A
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Instead of depressed mood, children with major depressive disorder may primarily
show: A. hallucinations B. delusions of omnipotence C. sleepwalking D. encopresis E. irritability |
E
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A 7-year-old child is brought in for an evaluation. The child began using phrase
speech at 48 months of age, has poor self-help skills, and has an inability or unwillingness to follow instructions in class. The child does not engage in appropriate eye contact, respond to the social signal of others, nor engage in imaginitive play. The child's language is still moderately delayed. The most likely diagnosis is: A. childhood schizophrenia B. oppositional deviant disorder C. Asperger's disorder D. Rett syndrome E. autism |
E
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A 7-year-old boy has significant impairment in social interaction, lectures rather
than converses, and is obsessed with dinosaurs. His cognitive and language development are age appropriate. The most likely diagnosis is: A. autism B. Asperger's disorder C. social anxiety disorder D. oppositional defiant disorder E. Rett's disorder |
B
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How does a history of being the victim of sexual abuse or sexual trauma relate to
an individual's weight? A. There is no relation between these two factors B. Trauma survivors have PTSD and weight loss will trigger a psychotic break. C. For some trauma survivors, weight can be protective. D. Obesity is a direct result of trauma survivorship. |
C
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The most common psychiatric diagnosis seen in the emergency room is:
A. schizophrenia B. panic disorder C. obsessive compulsive disorder D. major depressive disorder E. bipolar disorder |
B
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A 21 year-old man experiences recurrent unpleasant thoughts of harm befalling his
family. These thoughts are temporarily relieved by telephoning his family throughout the day. The most likely diagnosis is: A. Panic disorder B. Specific phobia C. Obsessive-compulsive disorder D. Post traumatic stress disorder E. Generalized anxiety disorder |
C
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Which is NOT an example of a common symptom of social phobia?
A. fear of being in an elevator alone B. fear of eating or writing in front of others C. fear of initiating or maintaining a conversation D. fear of public speaking E. fear of using a public bathroom |
A
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Ms. J. is a 24 year-old female who reports problems with nightmares, anxiety when
watching the nightly news regarding Iraq, decreased interest in activities, feeling like her future has no hope, and problems with her marriage over the past two years. Her husband complains that she is no longer emotionally involved in family life and she has been much more irritable and "jumpy". She has also had problems with sleep and concentration. She is no longer able to go to work and her husband is threatening divorce if she does not get help. She was an Army reservist who was called to active duty during the Gulf War in 1991. She reports her nightmares are of a missile attack on her unit during the War. The psychiatric diagnosis most likely based on her history is: A. generalized anxiety disorder B. panic disorder without agoraphobia C. post traumatic stress disorder D. obsessive compulsive disorder E. acute stress disorder |
C
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Mr. V.E. is a 32 year old male who reports problems with fear that he will act in a humiliating way in meeting others or while working at this job. He currently works in sales for an electronics company. He has had problems with anxiety for 9 years and is single. He feels his fear is excessive and would like to meet other people but is overwhelmed in social situations. His symptoms have resulted in his being placed on probation by his employer for his decrease in sales compared to other staff. He struggles through meeting new customers and is exchausted by the end of the day. He has found alcohol to be effective in controlling his anxiety and has started to have a shot of vodka prior to going to work over the past two weeks. The psychiatric diagnosis most likely based on the history is:
A. acute stress disorder B. generalized anxiety disorder C. anxiety disorder not otherwise specified D. social phobia E. obsessive compulsive disorder |
D
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Regarding the (1) prevalence and (2) mortality of anorexia nervosa (AN) versus
bulimia nervosa (BN), which of the following is true: A. (1) AN is more common than BN, an (2) AN has a highter mortality than BN B. (1) AN is more common thant BN, and (2) AN has a lower mortality than BN C. (1) AN is less common than BN, and (2) AN has a higher mortality than BN D. (1) AN is less common than BN, and (2) AN has a lower mortality rate than BN |
C
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Anorexia has a mortality rate of approximately
A. 1 percent B. 18 percent C. 30 percent D. 42 percent E. 50 percent |
A
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Mary was a gaunt 15-year-old high school student evaluated at the insistence of her
parents, who were concerned about her weight loss. She was 5 feet 3 inches tall and had reached her greatest weight, 100, pounds a year earlier. Shortly thereafter she decided to lose weight to be more attactive. She felt "chubby" and thought she would be more appealing if she were thinner. First she eliminated all carbohydrate-rich foods, and gradually intensified her dieting until she was eating only a few vegetables a day. She also started a vigorous exercise program. Within 6 months, she was down to 80 pounds. She then became preoccupied with food and started collecting recipes from magazines in order to prepare gourmet meals for her family. She had difficulty sleeping and was irritable and depressed, having several crying spells every day. Her menses started the previous year, but she had only a few normal periods. Mary had always had high grades in school and had spent a great deal of time studying. She had never been active socially and had never dated. She was conscientious and perfectionistic in everything she undertook. She had never been away from home as long as a week. Her father was a business manager. Her mother was a housewife who for the past 2 years was on a low-carb diet. During the interview, Mary said she felt fat, even though she weighed 80 pounds, and she described a fear of losing control and eating so much food that she would become obese. She did not feel she was ill and thought that hospitalization was unnecessary. The diagnosis of anorexia nervosa can be made on the basis of Mary's: A. 20 pound weight loss B. Feeling fat at a weight of 80 pounds and a height of 5 feet 3 inches C. Having had only a few normal periods D. Fear of becoming obese E. All of the above. |
E
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What physical sign is more likely to be found in a purely restrictive-type eating
disorder: A. Amenorrhea B. Calluses on dorsum of hand C. Dental enamal erosion D. Melanosis coli E. Parotid enlargement |
A
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Anorexia nervosa patients have been reported to have a high rate of:
A. major depression B. anxiety disorders C. obsessive compulsive disorder D. social phobia E. all of the above |
E
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Bipolar II disorder is NOT characterized by:
A. Asymptomatic intervals B. Major depressive episodes C. Manic episodes D. Seasonal patterns E. Sleep disturbances |
C
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A 54-year-old depressed man was convinced that he was unable to speak
because he said that he had not spoken for a long time while he was depressed. On exam, he was able to speak loudly and clearly. His depressive disorder can be best classified as: A. melancholic depression B. psychotic depression C. atypical depression D. catatonic depression E. chronic depression |
B
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A 77-year-old woman whose husband died six weeks ago presents for evaluation at an outpatient clinic. Six weeks prior, her husband of 23 years died while at hospice. The patient angrily complains about the length of time it took for her husband's doctors to diagnose him accurately. During the initial meeting, she sounds irritable and looks fatigued. She says, "My husband was everything to me.
I can't accept that he's gone...I think I should have been able to save him." She has one friend with whom she speaks frequently and has grown children with whom she is on good terms. She says, however, that "when the real darkness descends on me, especially in the middle of the night, I don't want to call anyone. I don't want to burden them." Which of the following symptoms in this patient would be most indicative of a major depressive episode rather than uncomplicated bereavement? A. Worrying constantly about financial matters B. Hearing the voice of her husband C. Having insomnia and loss of appetite D. Experiencing feelings of guilt E. Having thoughts of suicide |
E
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A 40-year-old married woman with six children was admitted with symptoms of insomnia, decreased appetite, marked somatic complaints such as dizziness and nausea, and a paranoid delusion that her husband is trying to poison her. Her subsequent course of treatment included mood stabilizers, antidepressants, and antipsychotics. Despite the treatment, she has displayed marked fluctuations of mood from sadness to euphoria five times over the course of a year. Her most
likely diagnosis is: A. schizoaffective disorder B. bipolar II disorder C. paranoid personality disorder D. bipolar disorder with rapid cycling E. major depression with psychotic features |
D
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Women are at highest risk for major depression during:
A. latency B. menopause C. their reproductive years D. their early teenage years before puberty E. their early childhood |
C
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Which of these statement(s) is/are true regarding depression and medical illness?
A. Depression is associated with increased risk of death following myocardial infarction. B. Depression is associated with decreased cognitive functioning in stroke. C. Depressed patients, as a group, remain hospitalized longer than non- depressed patients. D. People with coronary artery disease are at increased risk of becoming depressed. E. All of the above. |
E
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Which of the following statements is true regarding suicidality:
A. Psychiatrists can always predict which patients are likely to attempt suicide. B. Asking about suicidal thoughts increase the risk that a patient will develop suicidal ideation. C. Asking family members about a patient's risk for suicide is a violation of patient confidentiality. D. Men are more likely to complete suicide when they do attempt. E. All people who attempt suicide have depression. |
D
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A 26-year-old woman with a history of major depressive disorder is brought by her
family for 1 week of persistently elevated mood. She reports needing only a few hours of sleep every night, as she has been working currently on several projects. On exam, she has pressured speech. She denies depressed mood, psychotic symptoms, or substance abuse. Her coworkers have noticed a difference in her behaviors, but she is able to continue working. Her most likely diagnosis is: A. Bipolar disorder, type I, currently manic B. Bipolar disorder, I, currently mixed C. Bipolar disorder, type II D. Cyclothymic disorder E. Bipolar disorder, not otherwise specified |
C
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Melancholia is characterized by:
A. anhedonia B. oversleeping C. reactive mood D. hypersensitivity to rejection E. worsening of mood at the end of the day |
A
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The diagnosis of depression is difficult to make in a medically ill patient because
the symptoms of depression often overlap with the symptoms of medical illness. For example, a patient with congestive heart failure will report fatigue, and fatigue is also a depressive symptom. Medically ill patients who are suffering from major depression are more likely than those who are not to acknowledge: A. hopelessness B. fatigue C. low concentration D. insomnia E. lack of appetite |
A
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A 34-year-old woman presents for the first time for psychiatric treatment, stating
she has been "unable to reach her potential." She states that her mood switches frequently (day-to-day, sometimes within one day) from mildly to moderately depressed to happy and energetic. She states "I have no idea what kind of mood I'll be in when I wake up in the morning." She has not had episodes clearly meeting criteria for mania. The history suggests that the most appropriate diagnosis for this patient's primary disorder is: A. major depressive disorder, recurrent B. cyclothymic disorder C. borderline personality disorder D. histrionic personality disorder E. bipolar I disorder with rapid cycling |
B
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A 46-year-old man with mild-to-moderate depression precipitated by finiancial
stressors is referred for psychotherapy. His therapist focuses therapy on challenging his distorted belief that he is "nothing" without money. The therapy most likely used is: A. psychodynamic psychotherapy B. cognitive behavioral therapy C. interpersonal therapy D. exposure therapy E. supportive therapy |
B
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A 35-year-old woman presents for an outpatient evaluation of depression. She
complains of sadness, anhedonia, decreased energy, and decreased concentration. The most appropriate next step for the physician would be to: A. refer her for psychotherapy B. order laboratory studies to rule out a medical condition C. prescribe an antidepressant medication D. prescribe an antidepressant medication with an antianxiety medication E. prescribe an antidepressant medication with a mood stabilizer medication |
B
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Which of the following is most suggestive of an underlying bipolar illness in a 27-
year-old female patient who presents with her first major depressive episode? A. A family history of bipolar disorder B. Age of onset C. Prominent anxiety D. Female gender E. A family history of alcoholism |
A
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Psychotic episodes can occur in the following conditions EXCEPT:
A. Bipolar I disorder B. Borderline personality disorder C. Dysthymic disorder D. Temporal lobe epilepsy E. Toxic delirium |
C
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You are asked to assess a medically hospitalized man with paranoia. Which of the following additional history would make you suspect a mediccal or neurological cause of paranoia instead of a primary psychiatric illness?
A. insidious onset of symptoms B. stable medication regimen C. prior psychiatric history D. age greater than 40 years old |
D
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An 81 year-old woman is post-op day one from hip surgery. You are called urgently by the orthopedic team for a of delirium. A cardinal derangement of delirium which distinguishes it from dementia is:
A. memory impairment B. clouding of conciousness C. hallucinations D. paranoia |
B
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All of the following statements are true of delirium EXCEPT:
A. Characterized by poor attention and fluctuating levels of conciousness B. Common in elderly patients C. Majority have identifiable underlying cause D. May have psychotic symptoms like hallucinations E. Thorough medical work up is not essential |
E
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Which factor can most likely cause delirium?
A. Aluminum B. Bright light C. Excessive sleep D. Malnutrition E. Medications |
E
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Which psychiatric condition increases the likelihood of developing delirium?
A. Bipolar disorder B. Borderline personality disorder C. Conversion disorder D. Dementia E. Major depression |
D
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All of the following statements are tru of dementia EXCEPT:
A. Alzheimer's Disease is the most common cause B. Depression is an uncommon morbidity C. Onset is insidious and course is progressive D. Personality and behavioral changes reported by family E. Significant impairment in memory |
B
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What clinical feature would differentiate delirium from dementia?
A. Acute onset of illness B. Hallucinations C. Impaired social functioning D. Poor memory E. Word-finding difficulty |
A
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The most prevalent psychiatric disorders in elderly persons are:
A. Mood Disorders B. Anxiety Disorders C. Substance-related disorders D. Cognitive Disorders E. Psychotic Disorders |
D
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Which of the following dementias is most common?
A. Alzheimer's B. Vascular C. Dementia due to HIV D. Dementia due to Parkinson's E. Pseudodementia |
A
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Dementia that progresses in a stuttering, step-wise fashion is most likely due to:
A. Alzheimer's disease B. Lewy-Body disease C. Vascular dementia D. Prion disease E. Pick's disease |
C
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An individual with a personality disorder often times does not have insight into his or
her own psychopathology. They regard their patterns of behavior and emotional responses as part of themselves and not the result of pathology, which describes the concept of: A. egocentric B. egosyntonic C. egodystonic D. egomaniac |
B
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All of the following are consistent features of personality disorders EXCEPT:
A. Deeply ingrained, inflexible patterns of behavior B. Distress to others close to the individual C. Functional impairment D. Maladaptive interpersonal relations E. Onset of behavior is late adulthood |
E
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True statements about the aspects of personality called "tempermant" included all of
the following except: A. They are heritable B. They are observable early in childhood C. They are relatively stable over time. D. They are inconsistent in different cultures E. They are predictive of adolescent and adult behavior |
D
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Which symptom is most characteristic of individuals with narcissistic personality
disorder? A. Chronic feelings of emptiness B. Fear of abandonment C. Lack of empathy D. Intense unstable relationships E. Recurrent suicidal behavior |
C
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A 35 year old woman has few friends besides her parents and siblings, cannot make
decisions or take action without seeking parental advice, and has low self-esteem and excessive self-doubt. Which of the following personality disorders is most likely characterized by this pattern of behavior? A. Avoidant B. Borderline C. Dependent D. Histrionic E. Self-defeating |
C
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