Neurology and Neurosciences
After a head injury, a patient is observed to have personality changes, including increased impulsivity and euphoria. Which of the following is the most likely site of the injury?
A) Amygdala
B) Cerebellum
C) Ventral striatum
D) Orbitofrontal cortex
E) Anterior cingulate cortex
D) Orbitofrontal cortex
A recently retired woman mentions regret that she did not pursue a graduate degree and worries about her grown children. She would like to do something meaningful in her last few decades of her life. Which of the following stages of psychosocial development is characterized by this patient?
A) Initiate vs. guilt
B) Industry vs. inferiority
C) Ego integrity vs. despair
D) Identity vs. role confusion
E) Generativity vs. stagnation
C) Ego integrity vs. despair
Which of the following study designs is most likely to answer the question whether exposure to bupropion increases the risk of patients with schizotypal personality disorder developing psychotic symptoms?
A) Cohort
B) Crossover
C) Case control
D) Parallel group
E) Cross-sectional
A) Cohort
Which of the following medications, when taking in overdose, is most clearly associated with an increased risk of seizure?
A) Duloxetine
B) Trazodone
C) Fluoxetine
D) Mirtazapine
E) Clomipramine
E) Clomipramine
When a psychiatrist accepts flowers from a paranoid patient, thereby helping the patient feel more relaxed in the treatment setting and more willing to discuss symptoms, this demonstrates which of the following behaviors?
A) Social skills training
B) Empathic reflection
C) Boundary crossing
D) Behavioral activation
E) Therapeutic mirroring
C) Boundary crossing
Which of the following hormones is released from the adipose tissue and enters the brain to provide a negative feedback signal and reduce food intake?
A) Leptin
B) Ghrelin
C) Peptide YY
D) Cholestokinin
E) Glucagon-like peptide 1
A) Leptin
A 16-year-old girl experiences occasional heterosexual fantasies involving degradation and masochism. She describes these fantasies as disturbing an accompanied by both excitement and anxiety. These fantasies most likely represent which of the following?
A) A risk factor for future paraphilic sexual behavioR
B) Evidence of pior exposure to sexual maltreatment
C) A normal precursor to homosexual orientation in adulthood
D) Turning against the self as defense against unresolved Oedipal wishes
E) Part of the normal process of determining personal sexual behavior patterns
E) Part of the normal process of determining personal sexual behavior patterns
Which of the following mos seriously threatens the external validity of a research study?
A) Placebo responses in the study population
B) A study population that is not representative of the population to be treated
C) Mortality of differential attrition during the course of treatment during the study
D) Maturation due to natural change during the period between baseline and post-test
E) Statistical regression or regression toward the mean
B) A study population that is not representative of the population to be treated
A 32-year-old patient presents to the emergency department complaining of diarrhea of two weeks duration. She appears anxious and tremulous and is not oriented to date or time of day. She denies use of alcohol or other drugs. Which of the following medications would most likely cause the symptoms described?
A) Carbamazepine
B) Valproic acid
C) Lithium
D) Lamotrigine
E) Topiramate
C) Lithium
A patient with narcolepsy is experiencing episodes described as, "weakness in the arms and legs" brought on with laughter. This symptom is most likely to respond to treatment with which of the following?
A) Modafinil
B) Melatonin
C) Venlafaxine
D) Clonazepam
E) Methylphenidate
C) Venlafaxine
At 47-year-old patient with epilepsy has seizures that are well controlled on an epileptic drug monotherapy but the patient develops nausea, ataxia and the diplopia when treated with erythromycin for a sinus infection. This patient is most likely taking which of the following anti-epileptic drugs?
A) Valproate
B) Gabapentin
C) Topiramate
D) Levetiracetam
E) Carbamazepine
E) Carbamazepine
In females, which of the following is typically the first marker of impending puberty?
A) Menarche
B) Increase in total body fat
C) Acceleration of linear growth
D) Increase in muscle mass and strength
E) Appearance of secondary sexual characteristics
C) Acceleration of linear growth
Which of the following types of studies is most likely to offer relevant information about whether an available genetic test for diagnosing neurodegenerative disorder is accurate enough to warrant use?
A) Cohort
B) Crossover
C) Cross-sectional
D) Quasi-experimental
E) Randomized controlled
C) Cross-sectional
Which of the following psychotropic medications is relatively contraindicated for those with moderate-to-severe renal impairment?
A) Clozapine
B) Quetiapine
C) Olanzapine
D) Aripiprazole
E) Paliperidone
E) Paliperidone
Highest rates of PTSD are found in which of the following?
A) Witnessing an assault
B) Experiencing sexual violence
C) Witnessing an unnatural death
D) Experiencing a natural disaster
E) Becoming injured in a motor vehicle accident
B) Experiencing sexual violence
A 40-year-old patient reports episodes of flailing of the arms and tonic postures described as “fencing”. Video/electroencephalogram monitoring confirms electrographic seizure. Which of the following seizure types is most likely associated with this phenomenon?
A) Alcohol withdrawal
B) Temporal lobe
C) Occipital lobe
D) Frontal lobe
E) Febrile
D) Frontal lobe
Piaget's major contribution to development was a theory that explains which of the following phenomena?
A) Environmental influences on learning and behavior
B) Unconscious influences on behavior and actions
C) Individuals' emotional separation from caretakers
D) How individuals learn about and understand the world
E) The ways in which individuals acquire physical and motor skills
D) How individuals learn about and understand the world
A double-blind randomized placebo-controlled trial finds that disease progressed in 28% of placebo-treated subjects and in 16% of those treated with the study drugs. The difference between these two incidence rates is called:
A) Relative risk
B) Hazard ratio
C) Absolute risk
D) Attributable risk
E) Relative probability
D) Attributable risk
Which of the following SSRI augmentation agents would be the best choice for a 58-year-old female patient with depression and pronounced psychomotor retardation?
A) Lithium
B) Estrogen
C) Olanzapine
D) Mirtazapine
E) Liothyronine
E) Liothyronine
Of the following, which is a correct list of the memory types that can be impacted by dissociative amnesia?
A) Localized, generalized, segmented, and systematized amnesia
B) Segmented, generalized, continuous, and systematized amnesia
C) Localized, generalized, continuous, and segmented amnesia
D) Localized, segmented, continuous, and systematized amnesia
E) Localized, generalized, continuous, and systematized amnesia
E) Localized, generalized, continuous, and systematized amnesia
A patient with a long history of poorly controlled seizures is treated by a neurologist. Under this provider’s care the patient achieves several months without a seizure. However, the patient begins to exhibit the paranoid delusion that the provider wishes harm to patients. Which of the following types of seizures does the patient more likely have?
A) Absence
B) Nonepileptic
C) Simple partial
D) Complex partial
E) Generalized tonic-clonic
D) Complex partial
A five-year-old is watching her first July 4th parade with her parents. As the parade begins, she asks her father, "Daddy, will there be clowns in the parade today like at the circus we went to?" This question is most likely the result of which of the following?
A) Contextual overgeneralization
B) Conflation of fantasy and reality-testing
C) Still forming a definition of the word "parade"
D) An early example of formal operational thinking
E) Use of previous experiences to think categorically
E) Use of previous experiences to think categorically
According to evidence based medicine, which of the following would be most appropriate to review for the management of a patient with schizophrenia?
A) CATIE
B) STAR*D
C) STEP-BD
D) TADS
E) TORDIA
A) CATIE
Which of the following is the most likely mechanism for QTc interval prolongation related to antipsychotic medications?
A) Sodium influx
B) Calcium influx
C) Sodium channel blockade
D) Stimulation of ATPase pump
E) Potassium channel blockade
E) Potassium channel blockade
A 62-year-old woman presents to the emergency room for acute chest pain and is subsequently admitted to the hospital for further evaluation. Throughout the admission process, the patient is provided information on lifesaving and life-sustaining measures. She is then questioned as to which lifesaving measure she would like if for some reason her condition declines during her hospitalization. Patient details that she agreed to allow a tube to be put down her throat and to be placed on a ventilator, though she declined wanting chest compressions or cardiac resuscitation if they were necessary. The criteria identified in this patient is MOST consistent with which of the following?
A) Tarasoff
B) The Uniform Rights of the Terminally Ill Act
C) Informed consent
D) Withdrawing life support
E) DNI (Do Not Intubate)
B) The Uniform Rights of the Terminally Ill Act