Genetics
What type of genetic variation is most commonly investigated in genome-wide association studies?
A. mRNA abundance
B. Translation efficiency
C. Insertions or deletions
D. Copy number variants
E. Single nucleotide polymorphisms
E. Single nucleotide polymorphisms
A researcher follows two groups of people to assess for the development of dementia. One group has a history of lorazepam use and the other does not. What type of study design is being used?
A. Case series
B. Case control
C. Prospective cohort
D. Retrospective cohort
E. Randomized controlled trial
C. Prospective cohort
Which of the following cognitive responses to environmental stimuli has been found to be more
characteristic of patients with anxiety disorders when compared to patients with depression?
A. Misattributions regarding stimuli
B. Hopelessness regarding meaning of stimuli
C. Automatic negative thoughts toward the stimuli
D. Attentional bias toward potentially threatening stimuli
E. Lack of awareness of physiological responses to stimuli
D. Attentional bias toward potentially threatening stimuli
In cases of severe lithium toxicity, extracorporeal treatment is typically indicated. Lithium is readily dialyzable due to its:
A. high tissue binding.
B. high protein binding.
C. low molecular weight.
D. high volume of distribution.
E. low proximal tubule resorption.
C. low molecular weight.
A patient treated for major depression is in remission. Presence of which of the following risk factors would suggest the need for maintenance pharmacotherapy?
A. History of panic attacks
B. History of atypical depression
C. Lifetime history of 3 episodes of depression
D. Onset of initial depressive episode prior to age 60
E. Inadequate response to the initial dose of antidepressant medication
C. Lifetime history of 3 episodes of depression
Which of the following is the central principle of “the goldwater rule” for psychiatrists?
A. Psychiatrists may not give unsolicited information regarding public figures to the media
B. Psychiatrists may not receive financial compensation for opinions on public figures
C. It is unethical for psychiatrists to offer professional opinions on public figures without a face to face eval
D. Psychiatrists may offer their professional opinion on public figure if in their opinion it is not misrepresenting the public figure
E. Psychiatrists may offer their professional opinion on public figures if they include a disclaimer that no personal evaluation was conducted
C. It is unethical for psychiatrists to offer professional opinions on public figures without a face to face eval
Which of the following genetic mechanisms is involved in the development of velocardiofacial syndrome?
A. Aneuploidy
B. CAG repeat
C. Polymorphism
D. Genetic deletion
E. Single gene mutation
D. Genetic deletion
The psychiatrist is reviewing the literature to find out which antidepressant has the best evidence to treat depression in "real world" settings. The psychiatrist should seek evidence from which of the following types of research studies?
A. Efficacy
B. Prevalence
C. Cross-over
D. Effectiveness
E. Retrospective
D. Effectiveness
A professional dancer who sees a psychiatrist for psychotherapy made her Broadway debut last week. Although her performance and the show won wide acclaim, she cannot stop replaying a minor misstep she made. It does not appear that the misstep was noticed by the audience or other performers. Despite being congratulated on her performance she feels that, because of the error, she has let herself down. Which of the following cognitive errors is the patient displaying?
A. Minimization
B. Personalization
C. Overgeneralization
D. Selective abstraction
E. Dichotomous thinking
D. Selective abstraction
Which of the following vitamins has been found to be effective as an adjunct to antidepressant medications for the treatment of depression?
A. B1
B. B9
C. C
D. D3
E. E
D. D3
A recently adopted three-year-old is brought for evaluation of inhibited, emotionally withdrawn behavior. The child rarely seeks or responds to comfort when distressed, and has limited positive affect and emotional responsiveness. What additional history is needed for the most likely diagnosis?
A. Serious neglect
B. Restricted interests
C. Ritualized behaviors
D. Developmental delay
A. Serious neglect
Under HIPAA, a practitioner must obtain specific consent or authorization from a patient before sharing individually identifiable health information to:
A. A third party payer for payment purposes
B. An investigator for the purpose of epidemiological research
C. A health care provider who is taking over the ongoing care of the patient
D. A non-clinical hospital administrator for the purpose of quality improvement
E. Another clinician unfamiliar with the patient for medical consultation purposes
B. An investigator for the purpose of epidemiological research
An epigenetic cause of fragile X syndrome involves which of the following changes regarding the
fragile X mental retardation 1 gene?
A. Acetylation of lysine K4 on histone 3
B. Methylation of lysine K9 on histone 3
C. Methylation of the CpG sites of the promoter region
D. Six to 50 repeats of the trinucleotide CGG in the FMR1 gene
E. Turning on the gene to produce fragile x mental retardation protein
C. Methylation of the CpG sites of the promoter region
Which of the following is the definition of type 1 error?
A. Sample size lacks sufficient power
B. False hypothesis has not been rejected
C. True null hypothesis is erroneously rejected
D. Variance does not follow a normal distribution
E. Statistical analysis does not reach significance
C. True null hypothesis is erroneously rejected
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
A patient is brought to the emergency department after a syncopal episode with hyperthermia, headache, flushing, and tachycardia. The patient has significant hypotension requiring fluid resuscitation. According to family, the patient has a history of schizophrenia, generalized anxiety
disorder, and alcohol use disorder. An interaction with which of the following medications is most likely to have caused the patient's symptoms?
A. Amitriptyline
B. Disulfiram
C. Fluoxetine
D. Haloperidol
E. Lorazepam
B. Disulfiram
Which of the following is the best predictor of later functional and adaptive outcomes in autism
spectrum disorder?
A. Age of onset
B. Verbal ability at age five years
C. Hyporeactivity to sensory input
D. Presence of highly restricted, fixated interests
E. Frequency of stereotyped or repetitive motor movements
B. Verbal ability at age five years
Which of the following disorders carries the greatest global burden of disease according to the WHO’s estimates of years lived with disability?
A. Bipolar
B. Alcohol use
C. Schizophrenia
D. Major depressive
E. Generalized anxiety
D. Major depressive
A young girl has marked developmental regression, progressive loss of acquired motor and language
skills, stereotyped repetitive hand movements, muscle hypotonia, autonomic dysfunctions, and severe cognitive impairment. Which of the following genes is most likely to be involved in the etiology of these symptoms?
A. INPPE coding for pharbin
B. Elastin gene on chromosome 7
C. ASXL1 coding for a chromatin-binding protein
D. MECP2 coding for methyl CpG-binding protein 2
E. Partial deletion of the short arm of chromosome number 5
D. MECP2 coding for methyl CpG-binding protein 2
Which of the folLowing statistical measures could be used to determine how two independent variables
in a study, such as depression and alcohol use disorder, affect the frequency of the occurrence event,
such as suicide?
A. T test
B. Survival
C. Odds ratio
D. Relative risk
E. Regression analysis
D. Relative risk
A seven-year-old child is evaluated for anxiety after repeatedly refusing to get on the school bus, and
voicing an irrational fear that the bus will crash. Which of the following questions would be most useful
for exploring an operant conditioning model as an explanation for the child's anxiety?
A. "How do you feel when you're on the bus?"
B. "How often do you suppose buses get into accidents?"
C. "Have you ever been in a car accident, even a small one?"
D. "Have you ever seen any bad bus accidents on television?"
E. "How do your parents respond when you are afraid of the bus?"
E. "How do your parents respond when you are afraid of the bus?"
Current evidence regarding the efficacy of family therapy as a treatment for eating disorders reports that it:
A. is superior to individual therapy for patients of all ages.
B. is efficacious for adults, but adolescents are less likely to respond.
C. is superior to individual therapy for adolescents 6-12 months after treatment.
D. improves remission rates for adults in anorexia nervosa but not in bulimia nervosa.
E. is superior to individual therapy at the end of treatment, but effects are not sustained.
C. is superior to individual therapy for adolescents 6-12 months after treatment.
A 16-year-old is expelled from school for the third time since the beginning of the academic year, this time for bringing a knife. The previous expulsions were for fighting and stealing from the teacher. The adolescent has also been suspended several times for bullying classmates and skipping school. Over the next decade, these types of behaviors will most likely:
A. increase.
B. decrease.
C. wax and wane.
D. remain the same.
B. decrease.
The three primary components of “meaningful use” for EMRs include the use of a certified EMR in a meaningful manner, the use of certified EMR to submit clinical quality measures and which of the following?
A. Incorporation of telemedicine into routine practice
B. Implementation of secure email or text messaging with patients
C. Electronic exchange of health information to improve quality of care
D. Availability of electronic patient education materials to the general public
E. Electronic access to a healthcare professional for clinical advice 24 hours per day
C. Electronic exchange of health information to improve quality of care
The three major epigenetic mechanisms include DNA methylation, histone modification, and:
A. changes in base pairing.
B. trinucleotide repeat expansion.
C. expression regulation by micro-RNAs.
D. transcription regulation by coding RNAs.
C. expression regulation by micro-RNAs.
A researcher examines the relationship between two dichotomous variables, parental depression (yes or no) and child anxiety (yes or no). Which of the following inferential statistics is best employed in the
interpretation of these data?
A. T-test
B. Chi square test
C. Linear regression
D. Logistic regression
E. Pearson correlation
B. Chi square test
A mother's capacity to understand her infant's internal states, which is communicated by mirroring is
called:
A: holding.
B. internalization.
C. rapprochement.
D. identity diffusion.
E. projective identification.
A: holding.
Deep brain stimulation targeting what brain region has been most frequently studied for the experimental treatment of depression?
A. Subthalamic nucleus
B. Basolateral amygdala
C. Subcallosal cingulate cortex
D. Anterior limb of the internal capsule
E. Centromedian-parafascicular thalamic complex
C. Subcallosal cingulate cortex
In a patient presenting with early-stage cognitive impairment, identification of which of the following suggests a subcortical rather than cortical dementia?
A. Preserved euthymia
B. Preserved upright posture
C. Preserved calculation skills
D. Preserved cognitive processing speed
E. Preserved recall memory and recognition
C. Preserved calculation skills
Which of the following is a feature of the Medicare system?
A. Part A covers outpatient care.
B. Part B provides subsidy payments for prescription drugs.
C. Part B is an optional purchasable benefit for senior citizens.
D. Medicare also provides healthcare coverage to indigent children.
E. Medicare covers costs of long-term institutional care in nursing homes.
C. Part B is an optional purchasable benefit for senior citizens.