Study Guide to Intro to Psychiatry Exam 1 Questions
A
A 10 year old boy is brought to his family physician by his parents. He has had recurrent severe behavioral outbursts at home and at school several times a week for the past several years. Outbursts are typically in reaction to minor disappointments or when is is asked to do chores. His parents did not previously seek attention because they thought he would grow out of it. Between the outbursts, the boy is "grumpy". What is the most likely diagnosis? A. Disruptive mood dysregulation disorder B. Bipolar 2 disorder C. Major depressive disorder D. Persistent depressive disorder E. Unspecified depressive Disorder
D
A 17 year old girl is brought in by her parents. She spends lots of time staring at her nose in the mirror and has been saving up for a rhinoplasty. She says that she thinks her nose is ugly and that her classmates make fun of it through coded references. She cannot be reassured by her family that her nose is normal. She is demoralized by her concerns, but is not depressive or psychotic. There is no evidence of thought disorder or disorganization. What is the best diagnosis? A. OCD with somatic obsessions B. Obessive-compulsive personality disorder C. Delusional disorder, somatic type D. Body dysmorphic disorder E. Schizophrenia
B
A 19 y/o college student reports that for the past 2 weeks, since smoking weed for the first time, she has felt cut off from herself. She says that she feels she is watching herself go through the motions, and feels unable to connect with her experiences. She did not feel this way prior to smoking. What is the best diagnosis? A. Dissociative identity disorder B. Depersonalization/derealization disorder C. Dissociative amnesia D. Substance-induced mood disorder E. Schizophrenia
C
A 19 y/o comes in, convinced that his intestines are rotting and that he may already be dead. He isn't able to cite any symptoms that give rise to this conviction. PE and labs are normal. The patient doesn't accept reassurance that he's healthy. What is the most likely diagnosis? A. Somatic symptom disorder B. Illness anxiety disorder C. Schizophrenia D. Malingering E. Unspecified somatic symptom disorder
D
A 20 y/o college student develops symptoms of intense anxiety, heart racing, dizziness, sweating and SOB. The symptoms resolve in 30 minutes. Prior to onset, he had consumed several cups of coffee in order to stay awake studying. What is the most likely diagnosis? A. Panic disorder B. Specific phobia C. Social phobia D. Substance-induced anxiety disorder E. Generalized anxiety disorder
B
A 24 y/o man seeks help because of problems with irritability and feeling of being "on guard" since a car accident 2 weeks earlier. Luckily, he only had minor injuries, but his car was destroyed. Since the accident, he has had intrusive memories and nightmares about the event. He has been using public transport now and avoids the scene of the accident. What is the most likely diagnosis? A. PTSD B. Acute stress disorder C. Adjustment disorder with anxious features D. Unspecified anxiety disorder E. None of the above
D
A 24 y/o woman is referred to neurology for evaluation of spells that began 2 months earlier. She reports having seizures two to three times a week that are characterized by bilateral arm flapping without impairment of consciousness or loss of bowel or bladder control. The ECG is negative for leptiform activity, and labs are unremarkable. What is the most likely diagnosis? A. Somatic symptom disorder B. Convulsive disorder C. Factitious disorder D. Conversion disorder E. Malingering
C
A 24 year old woman presents to the ER complaining of the sudden onset of SOB, dizziness, diaphoresis, chest pain, and a sense of impending doom. Her medical workup is negative, and her symptoms resolve within 30 minutes. She has had multiple prior episodes and fears her next spell. She avoids public places for fear of having an episode in public. What is the most likely diagnosis? A. Generalized anxiety disorder B. Specific phobia C. Panic disorder D. Separation anxiety disorder E. Social anxiety disorder
D
A 28 year old man is brought to the ER by the police for a psychiatric evaluation after his neighbors reported that he was behaving erratically. He is irritable and displays pressured speech, and he has only slept a few hours in the past several days. He believes the FBI has implanted a microchip in his brain to record his thoughts and send him messages. He has been spending several hours each day making blueprints for lethal booby traps for his home to protect himself. His PE is significant for dental carries, and his urine drug screen is positive for amphetamines. Why would it be premature to diagnose this patient with bipolar 1 disorder based on this presentation? A. Presence of psychosis B. Persecutory delusions C. Mood is irritable rather than elevated D. Amphetamines present in drug screen E. Lack of grandiosity
B
A 30 y/o man comes in with a concern that he may have a brain tumor. He states for the past week he's felt tingling on his scalp and has a mild headache that can be resolved with ibuprofen. At his last visit a few months ago, he was concerned he had pancreatic cancer because he noticed a small area of yellow discoloration on his arm. What is his most likely diagnosis? A. Somatic symptom disorder B. Illness anxiety disorder C. Factitious disorder D. Conversion disorder E. Malingering
B
A 30 y/o man sees a psychiatrist at his wife's insistence. She is concerned he has OCD after seeing a TV show about hoarding. He has a very large video game collection he has been accumulating since he was 7. His collection is neatly arranged on shelves and does not take up too much space. He is proud of his collection and does not want to rid of it. He enjoys playing video games an hour or so each day, but otherwise is busy with work. He is tight with money and insists on doing many chores himself because he believes his family can't ever do things to his standards. He doesn't have a problem with depression or anxiety. What is the most likely diagnosis? A. OCD B. Obsessive compulsive personality disorder C. Hoarding disorder D. Gaming addiction E. Partner relational problem
D
A 30 y/o veteran is seen in a follow-up for his PTSD precipitated by wartime combat. He reports ongoing disturbing nightmares about his past experiences. He continues to have other symptoms, but they are less distressing. Which of the following medications is most appropriate to target his chief complaint? A. Sertraline B. Venlafaxine C. Diazepam D. Prazosin E. Lithium
B
A 30 y/o woman complains to her physician of feeling "wound up" all the time and that she is a "worrier" and has always been. She has chronic insomnia and reports having muscle tension in her neck and shoulders. She has a cup of coffee in the morning but denies other stimulants. She denies depression or substance abuse. What is the most likely diagnosis? A. Separation anxiety disorder B. Generalized anxiety disorder C. Substance induced anxiety disorder D. Agoraphobia E. Panic Disorder
D
A 34 y/o man with Generalized anxiety disorder tells his doctor that he is worried he may have OCD. He checks his door locks repetitively each morning for about 5-10 minutes. He worries burglars could enter his house, but is able to put the thought out of his mind after he leaves his house. He has had these behaviors since adolescence and no one else in his family has OCD. What should the doctor tell this patient? A. We should start medication for OCD B. OCD is not likely, based on the age of onset C. OCD is not likely, based on the negative family history D. OCD is not likely, based on the mild symptoms E. OCD is not likely, based on the established diagnosis of generalized anxiety
C
A 35 y/o man presents to the ER. He shows the staff his driver's licence and requests help because he has forgotten who he is and where he lives. His license shows that he lives in a town 100 miles away. A medical workup shows that brain imaging is unremarkable. Neuropsychological assessment shows gaps in his ability to recall autobiographical information, but formal testing of memory is normal. What is the most likely diagnosis? A. Dissociative identity disorder B. Depersonalization/Derealization disorder C. Dissociative amnesia D. PTSD E. Factitious Disorder
B
A 35 year old woman comes to your clinic to establish care. She reports that she has been depressed since adolescence with ongoing symptoms of low mood throughout the day, feelings of worthlessness, hypersomnia, low energy, and poor concentration. She doesn't remember any recent period in the past several years that she was free of depression. What is the best diagnosis? A. Major depressive disorder B. Persistent depressive disorder C. Disruptive mood dysregulation disorder D. Unspecified depressive disorder E. Bipolar 2 disorder
D
A 35 year old woman reports to her psychiatrist that, as part of a governmental conspiracy, a mind control device was implanted in her brain. She believes the FBI is using this device to spy on her. Further, she says the device can control her body movements, making her feel like a puppet on a string. She describes how the device can remove thoughts from her brain like a vacuum cleaner while implanting thoughts that are not hers. Which of the following symptoms is *NOT* consistent with this patient's delusional system? A. Delusions of passivity B. Thought withdrawal C. Though insertion D. Somatic delusions E. Persecutory delusions
E
A 6 y/o girl is brought to a child psychiatrist by her new foster parents. She has been removed from her biological parents at an early age due to neglect and has been in multiple foster homes. Since moving to her new home, her foster parents have noticed she'll start conversations with strangers at the supermarket and once tried to go home with another family. Testing has shown the child has a mild intellectual disability, and there is no history of mood disturbance. What is the best diagnosis? A. PTSD B. Intellectual development disorder C. Bipolar 1 Disorder D. Adjustment disorder with depressed mood E. Disinhibited social engagement disorder
B
A 60 y/o man on disability sees his doctor for a follow up on chronic pain. He reports pain in multiple joints and frequently asks for opiods for the pain. Diagnostic studies only show changes consistent with normal aging. There is no evidence the patient misuses medications and he has been trying PT with no improvement. What is the most likely diagnosis? A. Pain disorder B. Somatic symptom disorder C. Opioid use disorder D. Conversion disorder E. Malingering
B
A 60 year old woman develops depressive symptoms following the death of her husband. She has trouble sleeping, feelings of guilt, low energy, decreased appetite, and difficulty paying attention. She has not had prior episodes of depression and is not suicidal. Her symptoms have lasted 3 weeks. What is the best diagnosis? A. Bereavement B. Major depressive disorder C. Unspecified depressive disorder D. Persistent depressive disorder E. Bipolar 2 disorder
C
A 7 y/o boy is brought in. He had been removed from his parents at an early age due to neglect and has been in several foster homes. They report that he is sullen much of the time and almost never smiles. He often becomes irritable and they are unable to console him. He appears to interact normally with his peers. What is the most likely diagnosis? A. PTSD B. Autism spectrum disorder C. Reactive attachment disorder D. Adjustment disorder with depressed mood E. Disinhibited social engagement disorder
C
A 7 year old girl is brought to a therapist by her parents because of refusing to attend school. She has pretended to be sick several times each week for the past month to avoid going to school. She reports fear of being away from her mother during the day due to nightmares of "bad accidents" happening to her. What is the most likely diagnosis? A. Generalized anxiety disorder B. Social anxiety disorder C. Separation anxiety disorder D. Panic disorder E. Specific phobia
A
A doctor is asked to consult on a 25 y/o man admitted to a general neurological service for sudden onset of lower extremity weakness. The patient has reported that he cannot walk, although diagnostic studies have not shown any physical reason to account for the symptoms. The patient asks if he will ever get any better. How should the doctor respond? A. "Your condition will most likely improve with time" B. "You will most likely have permanent disability" C. "Your prognosis is guarded" D. "It is too early to draw and conclusions" E. "It will depend on your willingness to engage in cognitive behavioral therapy"
A
A major depressive episode characterized by interpersonal rejection sensitivity, increased appetite, and hypersomnia indicates which of the following? A. Atypical features B. Melancholic features C. Catatonic features D. Diurnal variation E. None of the above
A
A man believes he is preventing cancer and maximizing his health by taking an expensive but otherwise innocuous herbal supplement. If asked, he will discuss the supplement with great interest but dismisses evidence that does not confirm his beliefs. Otherwise, this interest in the supplement has no significant influence on his day to day life. Which of the following terms best describes the man's beliefs? A. Overvalued ideation B. Delusion C. Poor abstraction D. Impaired fund of knowledge E. Illogicality
D
A patient admits to her psychiatrist that she sometimes worries that events she reads about in magazines indirectly comment on her personal life. For example, one of her favorite magazines had a recipe for banana cream pie, which made her think that somehow the editor knew this was her favorite pie. The psychiatrist asks her if she really believes this, and the patient reports that sometimes it does seem "silly". What term best describes the woman's suspicion? A. Illogicality B. Persecutory delusions C. Delusions of reference D. Ideas of reference E. Thought broadcasting
D
A patient comes to a doctor for treatment of OCD. He has been to several doctors and therapists in the past 10 years, but he is frustrated because none of the treatments have been curative. How should the psychiatrist respond to this patient's concern? A. Review the patient's adherence to specific medications B. Ask how long the patient has been able to stay in exposure therapy C. Recommend a new medication D. Inform the patient that OCD tends to be chronic E. None of the above
A
A psychiatrist asks a patient if he enjoyed his own birthday party the prior week. The patient responds by laboriously describing preparations for the party and then going into minute detail about the party. Ten minutes into this story, the psychiatrist realizes that the patient never answered his question. What is this an example of? A. Circumstantiality B. Pressured speech C. Derailment D. Tangentiality E. Distractable speech
C
A psychiatrist asks a patient to recall a list of three objects after 5 minutes. What type of memory does this test? A. Ultrashort-term memory B. Very short-term memory C. Short-term memory D. Medium-term memory E. Long-term memory
B
A psychiatrist asks a patient to tell her what the phrase "don't cry over spilled milk" means. The patient replies "Milk isn't worth crying over because it's easy to come by". What does the patient's answer suggest? A. Illogicality B. Poor abstraction C. Derailment D. Circumstantiality E. Poverty of content of speech
E
A psychiatrist asks a patient where she lives. She replies "I live in Springfield. It will be spring in another couple of months, but at least this winter has been mild. The winter tends to be pretty bad in Atlanta, which is where I lived until I moved to Springfield, but birds fly south in the winter. I'd really like to go to the beach just now" What is this an example of? A. Tangentiality B. Circumstantiality C. Incoherance D. Illogicality E. Derailment
B
A psychiatrist is asked to see a 25 year old man with chronic renal failure admitted to a general medical floor for complications resulting from poor compliance with recommended dialysis. He has demanded to leave against medical advice. He has been threatening and verbally abusing staff members. He has fair understanding of his medical condition and is not delirious or confused. Review of his background shows a long history of legal and disciplinary problems dating to childhood. What is the best diagnosis? A. Psychological factors affecting another medical condition B. Antisocial Personality disorder C. Malingering D. Unspecified depressive disorder E. Somatic symptom disorder
A
A psychiatrist is asked to see a 25 year old man with chronic renal failure admitted to a general medical floor for complications resulting from poor compliance with recommended dialysis. He shows a fair understanding of his medical condition but reports that he just feels like taking a day off from dialysis every now and again. Further interview doesn't reveal clear evidence of depression, anxiety, cognitive impairment, psychosis or personality disorder. What is the most likely diagnosis? A. Psychological factors affecting another medical condition B. Factitious disorder C. Malingering D. Unspecified depressive disorder E. Somatic symptom disorder
D
A psychiatrist is called to evaluate a patient in the ER whose chief complaint is homicidal ideation. The psychiatrist remains calm and speaks softly. She seats herself and allows distance between her and the patient. She is careful to always make direct eye contact and to project empathy and concern. She asks nonjudgemental questions during the interview. Which of the following behaviors displayed by the psychiatrist is *not* recommended? A. Speaking softly B. Sitting during the interview, because the psychiatrist should stand C. Projecting empathy and concern because it can seem patronizing to the patient D. Use of direct eye contact E. Asking nonjudgemental questions
C
A psychiatrist is interviewing a manic patient. The patient speaks very rapidly, and it is very difficult for the psychiatrist to get a word in. The patient is unable to adequately answer many routine questions because he is distracted by objects in the room such as chairs, the psychiatrist's tie, and the clock on the wall. Which of the following options best describes the patient's speech? A. Pressured speech B. Distractable speech C. Both pressured and distractable speech D. Catatonic excitement E. Circumstantiality
B
A psychiatrist notes that a patient is very slow to answer questions and that his speech and body movements are slow. What is the correct term for this symptom? A. Depression B. Psychomotor retardation C. Psychomotor agitation D. Thought blocking E. Alogia
D
A teacher asks the parents of a 10 year old boy to meet with her. She reports that since the boy started school 2 months ago he has barely said a word in class and participates minimally. The parents report that the boy is talkative at home and they haven't noticed anything of concern. What is the most likely diagnosis? A. Generalized anxiety disorder B. Social anxiety disorder C. Separation anxiety disorder D. Selective mutism E. Specific phobia
D
A teacher gives a child a piece of candy as a reward for answering a question correctly to encourage her students to participate more in class. The candy functions as which of the following? A. Behavioral activation B. Negative reinforcement C. Conditioned stimulus D. Positive reinforcement E. Unconditioned stimulus
B
A teacher gives a child a piece of candy as a reward for answering a question correctly to encourage her students to participate more in class. This is an example of which of the following? A. Classical conditioning B. Operant conditioning C. Behavorial activation D. Negative reinforcement E. Exposure
C
Aggressive behavior is associated with which of the following findings in the cerebrospinal fluid? A. Dopamine excess B. Norepinephrine excess C. Serotonin deficiency D. Acetylcholine deficiency E. Glutamine excess
C
All but which of the following medication classes is effective in treating social anxiety disorder? A. SSRI B. MAOI C. TCAs D. B-Blockers E. Benzodiazepines
A
An earthquake occurs during a lecture, frightening several students, although it does not cause serious damage. In the following weeks, attendance at the lectures drops significantly. The lecture functions as which of the following? A. Conditioned stimulus B. Unconditioned stimulus C. Positive reinforcement D. Negative reinforcement E. Punishment
D
Bipolar 2 disorder first appeared in which edition of the DSM? A. DSM 1 B. DSM 2 C. DSM 3 D. DSM 4 E. DSM 5
C
Fill in the blank. Suicide is the ____ leading cause of death in persons between ages 15-24 A. First B. Second C. Third D. Fifth E. Eleventh
A
For which group of patients is suicide frequently preceded by the loss of a relationship in the past year? A. Alcoholic persons B. Patients with major depressive disorder C. Older patients with cognitive decline D. Adolescents with behavior problems E. People with a personality disorder
B
Gambling disorder develops through which of the following? A. Classical conditioning B. Operant conditioning C. In vivo exposure D. Exposure E. Flooding
A
How many somatic symptoms are required to make a DSM diagnosis of somatic symptom disorder? A. One B. Two C. Four D. Six E. Eight
A
In excoriation disorder, where is the most common site for skin picking? A. Face B. Hands C. Feet D. Arms E. Torso
E
In response to a routine question, a patient begins to answer appropriately, but stops mid-sentence and stares off into space for 15 seconds. She then asks the interviewer to repeat the question. What does this exemplify? A. Poverty of speech B. Poverty of content of speech C. Circumstantiality D. Perservation E. Though blocking
C
Suicide is associated with which of the following in the CSF? A. Dopamine excess B. Norepinephrine excess C. Serotonin deficiency D. Acetylcholine deficiency E. Glutamine excess
E
The treatment of generalized anxiety disorder usually involves individual psychotherapy in addition to which of the following medications? A. Buspirone B. Escitalopram C. Venlafaxine D. Duloxetine E. All of the above
B
What class of medication is the first-line treatment for depression? A. 2nd generation antipsychotic B. SSRI C. Tricyclic antidepressant D. SNRI E. Monoamine oxidase inhibitor (MAO)
C
What does it mean for a patient with bipolar disorder to have "rapid cycling"? A. Severe mood swings throughout the day B. Switching between mania and depression several times throughout a week C. At least four distinct mood episodes in 1 year D. At least four distinct mood episodes in 1 month E. None of the above
A
What is the best medication of choice for PTSD? A. Sertraline B. Venlafaxine C. Diazepam D. Prazosin E. Lithium
D
What is the best treatment for an adjustment disorder? A. Sedative-hypnotics B. SSRIs C. Antipsychotics D. Supportive therapy E. Cognitive-based therapy
C
What is the lifetime prevalence for major depression? A. 3% B. 10% C. 17% D. 38% E. >50%
D
What is the literal meaning of the term *agoraphobia*? A. Fear of people B. Fear of crowds C. Fear of open spaces D. Fear of the marketplace E. Fear of enclosed spaces
D
What is the minimum duration of a manic episode? A. 12 hours B. 1-2 days C. 4 days D. 7 days E 2 weeks
C
What is the most common precipitating event for women diagnosed with PTSD? A. Natural disaster B. Experiencing a fire C. Sexual assault D. Hospitalization in an ICU E. Combat
B
What is the most common stressor for adults with an adjustment disorder? A. Divorce or separation B. Marital problems C. Work problems D. Financial problems E. Moving
B
What is the most common stressor to cause an adjustment disorder in adolescents? A. Marital problems in parents B. School problems C. Drug or alcohol problems D. Parental rejection E. Boyfriend/Girlfriend problems
D
What is the primary fear that underlies social anxiety disorder? A. Social situations B. Intimacy C. Sexual inadequacy D. Public humiliation E. Narcissistic injury
C
What is the recommended treatment for somatic symptom disorder? A. SSRI B. Benzodiazepines C. Regularly scheduled visits with the same physician D. Referral to specialists for higher levels of care E. Aggressive workup to offer greater reassurance to the patient
E
What is the standard treatment for depersonalization/derealization disorder? A. Bezodiazepines B. Fluoxetine C. Second-generation antipsychotic D. Psychotherapy E. There is no standard treatment for depersonalization/derealization disorder
C
What is the typical age at onset for social anxiety disorder? A. Preschool years B. Elementary school age C. Adolescence D. Early adulthood E. Middle adulthood
B
What kind of psychotherapy is recommended for trichotillomania? A. Supportive psychotherapy B. Behavioral therapy C. Psychodynamic psychotherapy D. Interpersonal psychotherapy E. Acceptance and commitment therapy
E
What medications are associated with lowered rates of suicide? A. Haloperidol B. Lithium C. Carbmazepine D. Options A and B E. Options B and C
A
What substance has been implicated in the "false suffocation alarm" theory of panic disorder? A. CO2 B. O2 C. Sodium lactate D. Melatonin E. CO
C
Which individual probably is at the highest risk for completing suicide? A. 25 y/o divorced African American man B. 55 y/o married white woman C. 60 y/o widowed white man D. 19 y/o single African American woman E. 40 y/o divorced white woman
D
Which is the most common method used to commit suicide in the US? A. Overdose B. Cutting C. Hanging D. Firearm E. Jumping
B
Which of the following best describes the natural history of antisocial and borderline personality disorders? A. Patients tend to act out more as they age B. Patients tend to act out less as they age C. Patients' tendancy to act out does not change D. Patients only tend to act out less with age if they do not have a childhood history of conduct disorder E. Patients only tend to act out less with age if they do not have a childhood history of fire setting or cruelty to animals
D
Which of the following combinations of medications is commonly given to calm acutely agitated patients? A. Alprazolam and diphenhydramine B. Chlorpromazine and clonazepam C. Olanzapine and lorazapam D. Haloperidol and lorzapam E. Droperidol and alprazolam
B
Which of the following disorders appears to be genetically linked with OCD? A. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) B. Touretter's disorder C. Epilepsy D. Huntington's disease E. Syndenham's chorea
E
Which of the following feature is consistent with a hypomanic episode but *not* a manic episode? A. Presence of psychotic symptoms such as hallucinations and delusions B. Duration of at least 1 week C. Elevated mood D. Decreased need for sleep E. Lack of marked social and occupational dysfunction
B
Which of the following features is more characteristic of bipolar 2 disorder than bipolar 1 disorder? A. Multiple hospitalizations B. Depressive episodes more prominent during the course of illness C. Presence of psychotic symptoms D. Lack of a comorbid substance use disorder E. Better response to lithium
B
Which of the following is *NOT* a clinical reason to diagnose patients? A. To reduce the complexity of clinical phenomena B. To provide the patient a label with which to identify C. To facilitate communication between clinicians D. To predict the course of illness E. To determine treatment options
C
Which of the following is *NOT* a compulsive ritual? A. Handwashing B. Counting C. Gambling D. Checking E. Symmetrical arranging
B
Which of the following is *NOT* an advantage of the DSM system? A. It has substantially improved reliability of diagnoses B. It has substantially improved validity of diagnoses C. It has clarified the diagnostic process and history taking D. It has clarified and facilitated the process of differential diagnosis E. All of the above are advantages of the DSM system
E
Which of the following is *not* associated with completed suicide? A. Depressive disorder B. Male sex C. Hopelessness D. Substance use disorder E. African American race
D
Which of the following is *not* considered an obsession according to the DSM 5? A. Recurrent concerns about germs or contamination B. Fixation on the appearance of a particular body part C. Intrusive and disturbing thoughts about a loved one being murdered D. Obsessive desire to achieve an ambitious career goal to fulfill long standing dreams E. Need to collect worthless items and being unable to throw things away
D
Which of the following is one of the strongest correlations of suicidal behavior, independent of psychiatric diagnosis? A. Presence of mental illness B. History of violence C. Recent psychiatric hospitalization D. Hopelessness E. Psychosocial stressors
A
Which of the following is required for a diagnosis of adjustment disorder? A. Identifiable stressor B. Depressive symptoms C. Anxious symptoms D. Disturbance of conduct E. None of the above
E
Which of the following is the single best predictor of future violent behavior? A. Threats of violence B. Diagnosis of a severe mental illness C. Prior psychiatric hospitalization D. Substance abuse history E. History of violence
C
Which of the following is true with regard to most people who commit suicide? A. They usually do not tell anyone before committing suicide B. They may tell a friend or family member but usually do not seek medical help C. They usually communicate their suicidal intentions to and see physicians before they die D. They usually see a physician but do not usually tell their physician that they are having suicidal thoughts E. They usually do not have a PCP
E
Which of the following medications can be used to treat OCD? A. Clomipramine B. Fluoxetine C. Behavior therapy D. Clomipramine and behavior therapy E. All of the above
D
Which of the following medications is *least* appropriate for the treatment of acute mania? A. Carbemazepine B. Lithium C. Second generation antipsychotic D. Gabapentin E. Valproate
E
Which of the following medications is the best long term treatment for specific phobia? A. Fluoxetine B. Lorazepam C. Sertraline D. Alprazolam E. None of the above
B
Which of the following options is a pattern of speech in which sounds rather than meaningful relationships among words appears to govern word choice? A. Incoherance B. Clanging C. Distractable speech D. Pressured Speech E. Alogia
B
Which of the following personality disorders is most associated with violent behavior? A. Paranoid personality disorder B. Antisocial personality disorder C. Schizotypal personality disorder D. Narcissistic personality disorder E. Schizoid personality disorder
B
Which of the following symptom areas is *NOT* a required part of the PTSD diagnosis? A. Reexperiencing the trauma through intrusive thoughts or dreams B. Dissociative symptoms such as derealization or depersonalization C. Avoidance of stimuli associated with the event D. Negative alterations in mood such as feeling numb or detached from others E. Alterations in arousal and reactivity such as irritability/angry outbursts and exaggerated startle response
C
Which of the following terms is used to describe collections of symptoms that tend to co-occur and appear to have a characteristic course and outcome? A. Disease B. Symptomatology C. Syndrome D. Pathophysiology E. Illness
D
Which personality disorder is frequently comorbid with dissociative identity disorder? A. Schizotypal personality disorder B. Schizoid personality disorder C. Dependent personality disorder D. Borderline personality disorder E. Narcissistic personality disorder
C
Which tricyclic antidepressant has shown benefit for trichotillomania? A. Imipramine B. Doxepin C. Clomipramine D. Amitriptyline E. Notriptyline
C
Which two psychiatric disorders are the most likely to be comorbid with panic disorder? A. Generalized anxiety disorder (GAD) and major depressive disorder B. GAD and social anxiety disorder C. Major depressive disorder and alcohol use disorder D. Specific phobia and alcohol use disorder E. Persistent depressive disorder and GAD
C
Which was the first edition of DSM to provide specific diagnostic criteria for mental disorders? A. DSM 1 B. DSM 2 C. DSM 3 D. DSM 4 E. DSM 5
B
Who first differentiated bipolar disorder from schizophrenia? A. Eugen Bleuler B. Emil Kraepelin C. Sigmund Freud D. Kurt Schneider E. Carl Jung
D
You are asked to evaluate a 55-year-old man on a general medical floor. You determine that he is delirious because of a hepatic encephalopathy. You learn that he drinks large quantities of distilled spirits daily and smokes one pack of cigarettes per day. Taking into account the ICD and DSM rules, how would you record his diagnoses (i.e, in order of importance)? A. Delirium (principal diagnosis), alcohol use disorder, tobacco use disorder B. Delirium due to hepatic encephalopathy (principle diagnosis), alcohol use disorder, tobacco use disorder C. Alcohol use disorder (principle diagnosis), delirium due to hepatic encephalopathy, tobacco use disorder D. Hepatic encephalopathy, delirium due to hepatic encephalopathy (principle diagnosis), alcohol use disorder, tobacco use disorder E. Delirium due to hepatic encephalopathy, hepatic encephalopathy, alcohol use disorder, tobacco use disorder
D
You are evaluating a patient in the emergency room who you believe is likely experiencing a psychotic maniac episode (bipolar 1 with psychotic features). The patient is a poor historian and you are not currently able to obtain collateral information to confirm the diagnosis. According to DSM, how should you document the diagnosis to reflect your uncertainty? A. Rule out bipolar disorder, type 1 B. Evaluate for bipolar disorder, type 1 C. Bipolar disorder, type 1, versus psychosis not otherwise specified D. Bipolar Disorder, type 1 (provisional) E. Bipolar Disorder, type 1
B
You are seeing a 25 year old woman in the outpatient clinic for a routine follow-up visit. Her major problems reported at the visit are her stormy interpersonal relationships and frequent anger outbursts. You conclude that these symptoms result from her borderline personality disorder. The patient's symptoms also meet criteria for generalized anxiety disorder, and she smokes 10 cigarettes daily. How would you record the diagnoses according to DSM 5? A. Axis 1: generalized anxiety disorder, tobacco use disorder; Axis 2: borderline personality disorder (principle diagnosis) B. Borderline personality disorder (principle diagnosis), generalized anxiety disorder, tobacco use disorder C. Generalized anxiety disorder, borderline personality disorder, tobacco use disorder D. Tobacco use disorder, borderline personality disorder, generalized anxiety disorder E. Borderline personality disorder (provisional), generalized anxiety disorder, tobacco use disorder
C
You are seeing a patient with schizophrenia in the ER. The patient acknowledges his diagnosis and reports worsening of symptoms. He reports he has been hearing voices that have been telling him to kill a family member, something that he does not want to do. He has been hospitalized multiple times but does not have a history of violence. The patient is currently pleasant and cooperative. Which of the following is the most concerning risk factor for violence? A. Lack of insight B. Stated desire to hurt or kill C. Presence of command hallucinations D. Diagnosis of schizophrenia E. History of psychiatric hospitalization
