Brains, Behavior, and Bloopers
Which of the following types of glial cells assist in forming myelin sheaths in the peripheral nervous system?
A. Schwann
B. Microglia
C. Astrocytes
D. Ependymal
E. Oligodendrocytes
A. Schwann
Following a normal full-term birth, by what age are circadian sleep rhythms similar to those of an adult generally established in the child?
A. 1 month
B. 6 months
C. 12 months
D. 18 months
E. 24 months
B. 6 months
A school consults a psychiatrist after some parents refuse to vaccinate their children, citing concerns that such vaccines may cause autism. In advising the school on how to persuade this group to allow vaccination, which of the following strategies is best grounded in social psychological principles an most likely to be successful?
A. Offer a monetary incentive to parents who allow vaccination
B. Organize a debate between "anti-vaccine" and "pro-vaccine" parents
C. Show how vaccination can be congruent with the group's core values
D. Present information demonstrating the dangers of not vaccinating children
E. Provide the parents with valid scientific information that addresses their concerns
C. Show how vaccination can be congruent with the group's core values
Psychiatry is consulted about a 37-year-old patient who has just undergone bone marrow transplantation (BMT) to treat leukemia. The BMT was uneventful. Staff report concerns that the patient is now much more anxious and fearful than he was during the pre-transplant planning. The patient acknowledges having trouble sleeping, and states he is fearful about leaving the hospital. The mental status examination is otherwise unremarkable. Which of the following is the most appropriate diagnosis for the psychiatrist to make?
A. Acute stress disorder
B. Generalized anxiety disorder
C. Adjustment disorder with anxiety
D. Dependent personality disorder
E. Major depressive disorder
C. Adjustment disorder with anxiety
A patient with depression complains of low energy, poor concentration, and weight gain. Which of the following medications would be the best choice to prescribe for this patient?
A. Amitriptyline
B. Bupropion
C. Mirtazapine
D. Phenelzine
E. Selegiline
B. Bupropion
A 71-year-old patient with no prior medical history presents to an emergency department with a recent and severe "thunderclap" headache. The patient also notes unilateral eye pain and blurred vision. Examination reveals mildly dilated pupils and conjunctival injection. Which of the following diagnostic tests is most likely to reveal the most likely cause of this patient's headache?
A. Lumbar puncture
B. Temporal artery biopsy
C. Magnetic resonance angiography
D. Intraocular pressure measurement
E. Cranial computed tomography without intravenous contrast
D. Intraocular pressure measurement
Boys with which of the following variables are more likely to delay first sexual intercourse until after age 18?
A. Anxiety symptoms
B. Physical aggression
C. Depressive symptoms
D. Increased alcohol use
E. Higher maternal education level
A. Anxiety symptoms
A non-Hindu, Western-trained psychiatrist has been asked to treat a 40-year-old Hindu patient who emigrated to the United States two years ago. The patient presents with complaints of weakness, fatigue, headaches, insomnia, palpitations, and decreased appetite. The patient also reports a five-pound weight loss over the last month, dysphoric mood with intermittent anxiety, and suicidal ideation. In addition to assessing the patient's level of suicidality, it would be appropriate for the psychiatrist to do which of the following when beginning treatment?
A. Offer the patient psychiatric hospitalization
B. Assess the circumstances of the patient's immigration
C. Inquire what the patient believes explains the symptoms
D. Assess self-identification with culture of origin vs. culture of immigration
E. Make a diagnosis of major depression and prescribe antidepressant medication
C. Inquire what the patient believes explains the symptoms
A college student reports feeling embarrassed at school, particularly when speaking publicly or choosing a seat in the cafeteria, at which time the patient experiences blushing, muscle twitching and a feeling of shame. The patient expresses sadness about not having friends. Which of the following is the most likely diagnosis?
A. Panic disorder
B. Specific phobia
C. Social anxiety disorder
D. Major depressive disorder
E. Schizoid personality disorder
C. Social anxiety disorder
A 28-year-old female with a history of heroin dependence has been stabilized on methadone maintenance for the past year. The patient is now three months pregnant and presents to the psychiatrist to find out what is the best treatment approach for her and her unborn child. Which of the following is the best recommendation for the psychiatrist to make?
A. Continue methadone maintenance
B. Immediately discontinue methadone
C. Use naloxone to facilitate detoxification
D. Switch to L-alpha-acetyl-methadone
E. Taper and discontinue methadone over the next several weeks
A. Continue methadone maintenance
Which of the following areas is most consistently associated with the rewarding effects of alcohol?
A. Amygdala
B. Locus coeruleus
C. Anterior cingulate
D. Mammillary body
E. Nucleus accumbens
E. Nucleus accumbens
Which of the following is characteristic of sleep-in individuals over the age of 65, as compared to that of young adults?
A. Increased total REM
B. Increased fragmentation
C. Lower frequency of nightmares
D. Increased percentage of slow wave sleep
E. Lower incidence of restless leg syndrome
B. Increased fragmentation
An individual who is afraid of loud noises has a panic attack in a grocery store when a shelving unit crashes to the floor. The individual needs to take a lorazepam immediately, and goes home. Subsequently, the individual avoids the grocery store due to feeling fearful. According to classical conditioning, what is the conditioned stimulus in this scenario?
A. Lorazepam
B. Loud sound
C. Panic attack
D. Grocery store
E. Shelving unit
D. Grocery store
There is an increased risk of schizophrenia diagnosis in the relatives of patients with which of the following personality disorders?
A. Antisocial
B. Avoidant
C. Paranoid
D. Schizoid
E. Schizotypal
E. Schizotypal
A 55-year-old psychiatrically hospitalized patient with chronic schizophrenia is stabilized on clozapine. Two weeks following hospital discharge the patient presents with impending signs of psychotic relapse. Assuming patient adherence to medication and negative serum and urine toxicology studies for illicit substances, which of the following is the most likely explanation for the patient's relapse?
A. Change in diet
B. Renal insufficiency
C. Vitamin B supplementation
D. Clozapine treatment failure
E. Resumption of heavy smoking
E. Resumption of heavy smoking
An 82-year-old man presents with progressive dementia and myoclonus over three months. An electroencephalograph demonstrates periodic sharp waves with a frequency of 1Hz over both hemispheres. Which of the following is the most likely diagnosis?
A. Hepatic failure
B. Status epilepticus
C. Alzheimer disease
D. Creutzfeldt-Jakob disease
E. Hashimoto encephalopathy
D. Creutzfeldt-Jakob disease
Typically developing children acquire an understanding of the difference between inner life and outer reality (theory of mind) by what age?
A. Six months
B. Two years
C. Four years
D. Seven years
E. Ten years
C. Four years
Which of the following is an example of the "change talk" elicited in motivational interviewing?
A. "If I didn't smoke, I could use the money for music."
B. "I love smoking, nothing you say can make me quit."
C. "Yes, I know smoking is bad for you, everyone says so."
D. "All my friends smoke, and I don't want to lose my friends."
A. "If I didn't smoke, I could use the money for music."
Multiple neurologists have evaluated a patient for self-reported concerns of a brain tumor. The patient reports no symptoms suggestive of a brain tumor and states, "but I have a cousin who died from a brain tumor." Physical examinations have been non-focal and unremarkable. Although one neuroimaging study was negative, the patient repeatedly requests a new MRI, still concerned there is an undetected tumor. Which of the following is the most likely diagnosis?
A. Delusional disorder
B. Illness anxiety disorder
C. Somatic symptom disorder
D. Generalized anxiety disorder
E. Functional neurological symptom disorder
B. Illness anxiety disorder
Which of the following medications used in the treatment of attention-deficit/hyperactivity disorder carries an FDA black box warning for suicidal ideation in children and adolescents?
A. Modafinil
B. Atomoxetine
C. Methylphenidate
D. Lisdexamfetamine
E. Dextroamphetamine
B. Atomoxetine
Which of the following neurotransmitter effects, when dysfunctional, has been shown to most comprehensively replicate the core symptoms of schizophrenia?
A. Serotonin
B. Glutamate
C. Dopamine
D. Acetylcholine
E. Norepinephrine
B. Glutamate
A ten-year-old child remains sad and angry about his parents' divorce but no longer believes that he caused the separation. This cognitive change is an example of which of the following principles?
A. Decentration
B. Reversibility
C. Egocentrism
D. Sublimation
E. Magical thinking
A. Decentration
The Freudian stage of latency is correlated with Erikson's stage of:
A. trust vs. mistrust.
B. industry vs. inferiority.
C. initiative vs. guilt.
D. autonomy vs. shame.
B. industry vs. inferiority.
At any given time, approximately what proportion of medical students, worldwide, report having suicidal ideation?
A. 0.1%
B. 1%
C. 10%
D. 30%
E. 50%
C. 10%
Which of the following medications would be preferable for use in an anxious patient with pulmonary disease?
A. Alprazolam
B. Bupropion
C. Buspirone
D. Clonazepam
E. Propranolol
C. Buspirone