clinical psychiatry

Select which of the following ways exercise may improve mood A. All of the above (a,b,c) B. Less Stress, Anxiety, and Depression C. Better Sleep D. Improved Energy and decreased fatigue

A

True or False: Asking depressed patients whether or not they have had thoughts of wanting to kill themselves plants the seed of suicide, increasing risk. A. False B. True

A

Which of the following statements are true regarding exercise and depression? A. Some studies have shown similar antidepressant treatment efficacy with exercise comparable to medication and psychotherapy B. Exercise should not be recommended as a depression treatment adjunct as those with depression have symptoms of low motivation C. Recommending exercise increases a depressed individual's sense of obligation which overtime often worsens their depression D. Despite exercise increasing feelings of achievement and mastery, this has no impact on positive self beliefs

A

Which of the following statements are true regarding progressive muscle relaxation? A. Among other potential uses, Progressive B. Muscle Relaxation can be used to help an individual suffering from anxiety and chronic pain B. The skill involves using the 5 senses of sight, touch, hearing, smell, and taste C. This should only be taught by a licensed therapist or psychiatrist D. The skill is incredibly difficult to master and takes a lot of practice

A

What percent of the population will die by suicide? A. 1% B. 2% C. 5% D. 20%

A. 1%

What is the mortality rate for delirium at 6 months? A. 22% B. 80% C. 1% D. 5%

A. 22%

Patients with anorexia are about ____ more likely to die by suicide than the general population: A. 30-60% B. 1% C. 5-10% D. 80-100%

A. 30-60%

At what age are most children in the US bowel and bladder trained (aka potty trained)? A. 4y B. 3y C. 2y D. 1y

A. 4y

How long does an average untreated manic episode last for bipolar I? A. 6 months B. 1 week C. 1 month D. 1 year

A. 6 months

How long would someone need to have anxiety symptoms such as feeling "worried most days" to meet criteria for Generalized Anxiety Disorder? A. 6 months B. 1 month C. 1 week D. 1 day

A. 6 months

A 43-year-old woman is brought to the clinic by her mother because she has refused to leave the house over the past 6 months. She has started working online to avoid going to her place of employment, and no longer goes to the shopping mall or theater with friends where it might be crowded; otherwise, she describes a sense of feeling trapped. She has stopped using public transportation for the same reason. Which of the following is the most likely diagnosis? A. Agoraphobia B. Panic disorder C. Social anxiety disorder D. Specific phobia

A. Agoraphobia

What phobia results in fear regarding public spaces and avoidance of places, situations in which the patient may feel trapped, helpless or embarrassed? A. Agoraphobia B. Arachnophobia C. Xenophobia D. Photophobia

A. Agoraphobia

What movement disorder (sometimes a side effect of antipsychotic medication) causes a patient to appear restless and to pace or move constantly? A. Akathisia B.Dystonia C. Parkinsonism D. Tardive Dyskinesia

A. Akathisia

What is the most common cause of dementia? A. Alzheimer's B. Vascular Dementia C. Lewy Body Dementia D. Parkinson's

A. Alzheimer's

What personality disorder is characterized by lack of remorse and indifference towards others? A. Antisocial personality disorder B. Paranoid personality disorder C. Avoidant personality disorder D. Schizoid personality disorder

A. Antisocial personality disorder

How long must a patient's symptoms last for in order to meet the criteria for PTSD? A. At least 4 weeks B. At least 2 days C. At least 6 months D. 3 days to 4 weeks

A. At least 4 weeks

What type of hallucination do patients that suffer from schizophrenia usually experience? A. Auditory B. Visual C. Tactile

A. Auditory

What most commonly is the first line of treatment in terms of medications? A. Seretonin Selective Reuptake Inhibitors (SSRIs ) B. Benzodiazepines C. Antipsychotics D. Beta blockers

A. Benzodiazepines

Which class of medication mentioned in the lectures should be avoided in patients with PTSD A. Benzodiazepines B. NSAIDs C. Antidepressants D. Antiepileptics

A. Benzodiazepines

Autism spectrum disorder can be conceptualized as deficits in what primary domain[s]? A. Both B and C B. social communication and interactions C. restricted or repetitive behaviors/interests/activities D. sustained concentration and attention

A. Both B and C

What mnemonic helps us diagnose mania? A. DIGFAST B. SIGECAPS C. SIGCPS D. PCL-5

A. DIGFAST

What is the monoamine hypothesis for depression? A. Disorganized firing of neurons causes depression B. Patients with low monoamines are depressed C. Patients with high monoamines are depressed

A. Disorganized firing of neurons causes depression

What are two symptoms of psychosis? A. Disorganized speech and hallucinations B. Delusions and insomnia C. Irritability and disorganized behavior D. Mutism and delayed movements

A. Disorganized speech and hallucinations

Which of the following should be incorporated into chronic pain treatment? A. Early dialogue that analgesic medications are unlikely to fully treat their pain B. Requiring that patient only see one type of provider (such as a pain specialist) rather than referrals to interdisciplinary team members such as PT, Accupuncturist, Psychotherapist etc. C. Avoidance of any kind of discussion of comorbid mental health conditions as this will make the patient feel their pain isn't being taken seriously D. Liberal use of opioid pain medication at least initially to help the patient feel better before starting physical therapy

A. Early dialogue that analgesic medications are unlikely to fully treat their pain

What is the gold standard for treatment resistant depression? A. Electroconvulsive therapy (ECT) B. Medications C. Exercise D. transmagnetic therapy

A. Electroconvulsive therapy (ECT)

Nocioceptive disorders are those that occur due to damage of PNS or CNS nerves. a. False b. True

A. False

True or False: Dementia is normal when someone ages A. False B. True

A. False

The actions of rolling, sitting up, crawling, walking are examples of milestones from which catagory? A. Gross motor development B. Fine motor development C. Cognitive development D. Social and emotional development

A. Gross motor development

Which of the following is the most important overall goal when addressing chronic pain? A. Improving Functional Capacity B. Decreasing Pain levels C. Getting Pain level down to zero

A. Improving Functional Capacity

What is the most important symptom to screen for in order to not miss a diagnosis of depression? A. Irritability B. sadness C. High energy D. Low energy

A. Irritability

Which of the following is FALSE about major depressive disorder (MDD) in the pediatric population A. Kids are too young to experience depression, anxiety or other mental illnesses B. Tend to see more somatic complaints and irritability compared to adults C. More common in females during adolescence D. Common to have other psychiatric comorbidity

A. Kids are too young to experience depression, anxiety or other mental illnesses

What personality disorder is characterized by exploiting others, lack of empathy, and excessive need for admiration? A. Narcissistic personality disorder B. Schizoid personality disorder C. Antisocial personality disorder D. Histrionic personality disorder

A. Narcissistic personality disorder

Select the correct definition of 'proactive aggression' as discussed in the lecture. A. Premeditated Aggression: manipulative, intentional, goal directed, cold-blooded; requires no provocation; directed toward possessing objects or dominating B. Impulsive Aggression. emotional, hot-blooded, impulsive; a response to provocation C. Based on frustrative non-reward which is increased drive in the absence of expected reward

A. Premeditated Aggression: manipulative, intentional, goal directed, cold-blooded; requires no provocation; directed toward possessing objects or dominating

Which of the following is the best indicator that a patient is at increased risk of suicide? A. Prior suicide attempt B. Diagnosed with a substance use disorder C. Recent divorce D. Parasuicidal behavior (cutting)

A. Prior suicide attempt

How do you tell your patient / client that they may need to see a mental health professional/psychiatrist / therapist? A. Reassurance, normalize, empathize B. Reassurance, criticize, normalize C. Empathize, normalize, infantilize

A. Reassurance, normalize, empathize

What mnemonic helps us diagnose depression? A. SIGECAPS B. DIGFAST C. GOAT D. PCL-5

A. SIGECAPS

Which movement disorder causes uncontrollable movements of the tongue or mouth? A. Tardive dyskinesia B. Dystonia C. Akathisia D. Parkinsonism

A. Tardive dyskinesia

In a patient with sudden onset left lower extremity paralysis following news that her husband was tragically killed, which of the factors is indicative of Conversion Disorder: A. The paralysis is NOT intentionally produced or feigned B. The patient is faking the paralysis in order to assume the role of the injured and be cared for C. The patient needs money and hopes the paralysis will help her get disability D. The patient has a history of hemiplegic migraines and stress often causes flair ups

A. The paralysis is NOT intentionally produced or feigned

How impaired is someone in a manic phase with Bipolar I? A. They end up in jail or in the hospital B. They can still take care of all aspects of their life

A. They end up in jail or in the hospital

Depression is a more common cause of a patient presenting with somatic symptoms than somatic symptom disorder A. True B. False

A. True

Sensitization is where nociceptors have increasing sensitivity with repeated exposure. A. True B. False

A. True

Which group has the HIGHEST rate of suicide? A. White men over 85 B. Young people 20-24 years of age C. Adolescents D. Children

A. White men over 85

What contributes to personality disorders? A. all of them (genetics, early life events, and cultural factors) B. Genetics C. Early life events D. Cultural factors

A. all of them (genetics, early life events, and cultural factors)

What makes us depressed? A. Both A & B B. Nature C. Nurture D. Neither

A. both A and B

Which of the following statements regarding mental illness and violence is true? A. Both A and C B. Those with mental illness are more likely to be victims of violent crime compared to the general population C. Most violence is attributable to severe mental illness D. The general population is just as likely to commit violent acts as those with me

A. both A and C

Aspects of the cognitive assessment include: A. Orientation B. Memory C. Level of consciousness D. Attention and concentration E. All of the above

All of the above

Which of the following is a proper description of "pacing" as outlined in the lecture A. Pacing involves working as hard as you can on some days and then taking days off to rest and recover B. Pacing involves selecting an activity, evaluating how long you can comfortably engage in the activity daily, setting a baseline starting point, and slowly increasing your goal on a regular basis C. The concept of pacing has not been defined and is up to the patient's interpretation D. Pacing involves moving for a set period of time despite pain so you realize overtime that you don't really need rest breaks

B

Which of the following are NOT possible causes of poor food intake in patient with Avoidant Restrictive Food Intake Disorder? A. A fear of choking on food B. A concern about weight gain C. somatic complaints that their stomach hurts after eating or that they feel nauseous D. Sensory issues regarding the taste, smell, color, or texture of food

B. A concern about weight gain

The nurses are upset at doctors over patients' complaints at terrible treatment; the doctors cannot fathom how nurses are siding with the patient as the patient has been angry, resistant, and manipulative with treatment team. What diagnosis are you worried about? A. Schizoid personality disorder B. Borderline personality disorder C. Antisocial personality disorder D. Histrionic personality disorder

B. Borderline personality disorder

What type of therapy links thoughts, behavior, and feelings? A.psychodynamic B. CBT C. exposure D. Supportive

B. CBT

All the following are important in caring the patients with PTSD, except: A. Displaying empathy toward the patient B. Explore each patient's past trauma in extraordinary depth C. Keeping in mind that every individual was given their own "deck of cards" in life

B. Explore each patient's past trauma in extraordinary depth

Individuals that have a combination of traits from various personality types likely have a personality disorder. A. True B. False

B. False

Patients with bulimia are usually underweight A. True B. False

B. False

Schizophrenia is the only cause of psychosis. A. True B. False

B. False

The diagnosis of PTSD requires the individual to have been physically injured? A. True B. False

B. False

To diagnose anorexia, a patient must either have amenorrhea or be <85% of normal body weight A. True B. False

B. False

Which of the following statements regarding mental health in children is FALSE? A. Mental Health in children is impacted by both biological and psychological factors B. It is best to avoid officially diagnosing mental health conditions until the individual reaches age 18 C. The majority of mental health conditions present before age 24 D. Many children with mental health conditions go untreated

B. It is best to avoid officially diagnosing mental health conditions until the individual reaches age 18

Which of the following is NOT a risk factor for suicide? A. Caucasian or Native American B. Married C. Sexual minority D. male

B. Married

What disorder results in anxiety attacks and at least a month of worrying about an anticipated attack? A. Phobia B. Panic disorder C. Obsessive compulsive disorder D. Generalized anxiety disorder

B. Panic disorder

What term best fits the following descritpion of a child's play behavior; 'Child plays beside other children without interacting with them. He usually watches and tries to copy their play but is not ready to interact with them directly.' A. Cooperative play B. Parallel play C. Self-stimulatory play D. Onlooker play

B. Parallel play

A 30-year-old woman presents to the clinic with fear of getting trapped in the elevator. She works at an insurance company which is located on the 10th floor, and she climbs stairs every day to reach her office. She has never had any accidents in an elevator but says that she has had this fear since childhood. She denies this type of anxiety in any other situation. What is the most likely diagnosis? A. Social anxiety B. Specific phobia C. Agoraphobia D. Generalized anxiety disorder

B. Specific phobia

What is the biggest risk factor for premature labor? a. Alcohol b. Tobacco c. Benzodiazepines d. Opiates

B. Tobacco

When I enter the room of an aggressive patient I should try to stand closer to the door than my patient. A. False B. True

B. True

Which movement disorder (sometimes a side effect of antipsychotic medication) causes a tremor, cogwheel rigidity? A. dystonia B. parkinsonism C. akathisia D. tardive dyskinesia

B. parkinsonism

Which of the following factors does NOT contribute to mental illness? A. Family History of mental illness B. Genetics C. An individual's willpower D. Trauma

C

Which of the following statements is FALSE regarding breathing exercises? A. Timed breathing can slow heart rate and lower blood pressure B. During anxiety our breathing often increase C. Time breathing activates the sympathetic nervous system and thus is good for use in melancholic depression D. Time breathing often invovles slowing down ones breathe

C

Which of the following statements regarding exercise and anxiety are true? A. Exercise is not recommended for those with panic attacks as the bodily response between anxiety and panic often feels similar B. Exercise is not recommended for anxiety management as it might make symptoms worse C. Those with anxiety may initially interpret the natural bodily response of exercise as a sign that a catastrophe is about to ensue D. Even with long-term exercise training and PT exercise will continue to trigger a fear response in those with anxiety

C

Which of the following is NOT a risk factor for first episode depression occurring later in life? A. Female sex B. Widowed C. Higher socio-economic status D. Pain

C.

Which of the following is an appropriate way to react to an agitated elderly patient? A. Get angry B. Shout your frustration at them C. Deescalate the situation and remain calm D. Push them

C.

Substance use disorder is defined as a problematic pattern of behavior leading to distress or impairment, manifested by the development of______ or more of the 11 criteria over a ____ period of time? a. 2 criteria over 1 month b. 2 criteria over 36 months c. 2 criteria over 12 months d. 3 criteria over 6 months

C. 2 criteria over 12 months

Lawrence Kohlberg (1927-1987) is an american psychologist who is attributed for the creation of which of the following developmental theories? A. 5 PHASES OF PSYCHOSEXUAL DEVELOPMENT B. 4 COGNITIVE DEVELOPMENTAL STAGES C. 6 STAGES OF MORAL DEVELOPMENT D. 8 STAGES OF PSYCHOSOCIAL DEVELOPMENT

C. 6 STAGES OF MORAL DEVELOPMENT

Which of the following is FALSE about Gate Control Theory of Pain? A. Negative states of mind amplify signals B. Positive states of mind mitigate signals C. Certain behaviors facilitate gate opening such as meditation and exercise D. Certain behaviors facilitate gate opening such as smoking, poor diet and no exercise.

C. Certain behaviors facilitate gate opening such as meditation and exercise

What movement disorder (sometimes a side effect of antipsychotic medication) causes painful cramping often in the jaw? A. Akathisia B. Tardive dyskinesia C. Dystonia D. Parkinsonism

C. Dystonia

A medical student makes frequent appointments with his PCP as he is concerned he has the various illnesses he learns about in lectures. He is reassured by normal test results only to learn of a new disease which he is very concerned he may have. The medical student most likely has which of the following conditions: A. Somatic Symptom Disorder B. Hypochondriasis C. Illness Anxiety Disorder D. Conversion Disorder

C. Illness Anxiety Disorder

What is psychosis? A. A period of unbridled energy, often resulting in insomnia and hyperactivity B. Progressive cognitive impairment including memory loss C. Loss of contact with reality

C. Loss of contact with reality

45% of Chronic Pain Patients have A. Dependent Personality Disorder B. Substance Use Disorder C. Mood Disorder D. Borderline Personality Disorder

C. Mood Disorder

Which of the following diagnoses' hallmark feature is 'Recurrent patterns of negativistic, hostile, or defiant behavior directed at authority figures'? A. ADHD B. Selective Mutism C. Oppositional Defiant Disorder (ODD) D. Intermittent Explosive Disorder (IED)

C. Oppositional Defiant Disorder (ODD)

Which of the following statements regarding Somatic Symptom Disorder is FALSE: A. Symptoms often worsen in the setting of increased psychological distress B. Patients endorse physical symptoms that are not explained by a medical condition C. Symptoms are consciously produced or feigned by the patient for attention D. Normal physiological functions are often misinterpreted

C. Symptoms are consciously produced or feigned by the patient for attention

Which of the following is NOT a primary domain of developmental milestones recommended to be followed by the CDC? A. language B. physical C. biological D. Cognitive

C. biological

What type of therapy focuses on familiarizing the source of distress to the patient? A. Psychodynamic B. CBT C. exposure D. Supportive

C. exposure

What are the 5 main principles when interviewing someone using the skill of motivational interviewing A. Empathize with the patient, always agree with them so as not to make them feel judged, if you sense resistance change the topic, do not point out any discrepancies in their thinking, encourage whatever the patient wants B. None of the above C. Point out what they're doing wrong, educate them on what you recommend, debate if needed, make an action plan, as the clinician be unwavering in what you know is right D. Express empathy, avoid arguing with the patient, roll with resistance, develop discrepancy, support the patient's self-efficacy

D

Which of the following is characteristic of delirium, and NOT dementia? A. Slow in duration and onset (months to years) B. Patients usually have normally alertness C. Patients usually have normal awareness D. Can acutely happen in the ICU

D

Which class of medications are considered first line treatment for PTSD? A. Alpha 2 antagonists B. Antipsychotics C. Mood stabilizers D. Antidepressants

D. Antidepressants

What is the most common form of eating disorder? A.Anorexia Nervosa B. Avoidant Restrictive Food Intake Disorder C. Bulimia Nervosa D. Binge Eating Disorder

D. Binge Eating Disorder

If a patient is exaggerating their symptoms and inducing harm to themselves to be admitted to a hospital, but there is no motive for a secondary gain, the patient likely has/is: A. Illness anxiety disorder B. Malingering C. Conversion disorder D. Factitious disorder

D. Factitious disorder

What are delusions? A. False beliefs about their body B. Paranoid thoughts C. Auditory hallucinations D. False thoughts that conflict with reality.

D. False thoughts that conflict with reality.

The 30-year old project supervisor's editing team works until 2am every night because they are not up to her standards, and she constant gives feedback daily about things that need to be addressed. When met with suggestions, she is rigid and has to do things her way, believes that as supervisor, she needs to "control everything and make sure it's all perfect." What personality disorder diagnosis would be most aligned with this description? A. Antisocial disorder B. Avoidant personality disorder C. Obsessive compulsive disorder D. Obsessive compulsive personality disorder

D. Obsessive compulsive personality disorder

What disorder results in a persistent, excessive, unreasonable fear of a particular object or situation? A. Panic disorder B. panic disorder C. generalized anxiety disorder D. Phobia

D. Phobia

Which of the following is something that happens with normal aging? A. Forgetting how to use a remote B. Not being able to recognize their children C. Confusion D. Slower at learning new information

D. Slower at learning new information

In 2022 the CDC recommended what change in standardived developmental surveillance of childhood milestones? A. using the 90th percentile for developmental surveillance B. using the 50th percentile for developmental surveillance C. using the 25 th percentile for developmental surveillance D. using the 75th percentile for developmental surveillance

D. using the 75th percentile for developmental surveillance

How many drinks are metabolized by the liver in an hour on average? a. 1 b. 3 c. 5 d. 7

a. 1

Acronym to screen for alcohol use disorder? a. CAGE b. MORE c. CAPE d. MADISON

a. CAGE

Delerium Tremens typically occur in the first 24 hours of detoxification from alcohol. a. True b. False

b. False

CNS depressants such as benzodiazepines, primarily effect which neurotransmitter pathway? a. Norepinephrine b. GABA c. Serotonin d. Dopamine

b. GABA

Drugs that are the most addictive have Low potency and cross the blood brain barrier (BBB) quickly? a. True b. False

b. false

Which neurotransmitter is most directly responsible for the reinforcing/pleasure signals in the brain? a. Serotonin b. Norepinephrine c. GABA d. Dopamine

d. Dopamine

Dysphoric mood, muscles aches, lacrimation, pupillary dilation, diarrhea and yawning are constellation of symptoms from which type of withdrawal? a. Tobacco b. Marijuana c. Benzodiazepines d. Tobacco e. Opiates

e. Opiates