Child & Adolescent
Geriatrics
Addiction/Forensics
Schizophrenia
Bipolar
100
The birth of a new sibling is associated with recurrence of toileting accidents in a 3- year old child who has previously successfully toilet trained. This behavior would be considered an example of: A.Cognitive delay B.Normal regression C.Acting out behavior D.Neurotic regression E. Adjustment disorder
What is normal regression?
100
An 80 year-old male patient tells the PCP that he is certain that his wife of 55 years is having an affair with a younger man. The patient states that his wife denies the allegation and that their 2 middle-aged children “side with their mother”. The patient acknowledges that there is no clear evidence for his beliefs. This patient is healthy, has no psychiatric history, and has never experienced hallucinations. Cognitive testing is within normal limits for his age. Which of the following is the most likely diagnosis for this patient? A: Schizophrenia B: Delusional disorder C: Schizoaffective disorder D: Schizophreniform disorder E: Psychotic disorder due to another medical condition
What is delusional disorder?
100
Alcohol withdrawal symptoms generally peak within how many hours cessation of alcohol use? A - 8h B - 12h C - 48h D - 96h E - 120h
What is 48h?
100
A 16 year old adolescent is being evaluated for possible schizophrenia. A family history of which of the following personality disorders is most strongly associated with this diagnosis? A - Avoidant B - Paranoid C - Schizoid D - Borderline E - Schizotypal
What is schizotypal?
100
Lamotrigine is effective for the treatment of which of the following mood disorders? A: Hypomania B: Persistent depression (dysthymia) C: Acute mania D: Bipolar depression E: Unipolar depression
What is bipolar depression?
200
After a stranger says "hello", a 12 month old child turns and looks at his mother before responding. When the mother smiles and nods her head the infant laughs and smiles in response to the stranger. The behavior is an example of A. secure attachment B. object constancy C. object permanence D. theory of mind E. social referencing
What is social referencing?
200
An 80 year old patient with Alzheimer dementia who lives with the daughter is brought in for evaluation of increasingly combative behavior. The daughter would like to keep the patient at home,if possible. Which of the following intervention would be most helpful in this situation? A. Providing consequences,like time-outs, for unwanted behaviors B. Varying the patient’s schedule of daily activities C. Assessing for caregiver burnout D. Using restraints
When to assess for caregiver burnout?
200
In determining the disclosure of psychiatric treatment information in court, which of the following is considered to fold privilege. A. Judge B. Patient C. Psychiatrist D. Ombudsman E. District Attorney
What is the patient?
200
Psychiatric evaluation is requested on the management of a 32 year old patient admitted by internal medicine for treatment of symptoms of severe gastrointestinal viral infection,including dehydration,nausea, vomiting, and fever. The patient has history of schizoaffective disorder, which has been controlled with stable doses of clozapine over the past year. The staff are concerned that the patient be delusional or hallucination as the patient has appeared some what confused and inattentive. On examination the patient is oriented person and place but not to time. The patient is somewhat slow and appears visibly ill and tired. The patient complains of stiffness and there is some rigidity to the movements. Which of the following recommendations would be most appropriate ? A. Add Lorazepam B. Add Benztropine C. Increase Clozapine D. Discontinue Clozapine
When to discontinue Clozapine?
200
Which of the following medications significantly increases a patient’s serum level of lamotrigine within its clinically prescribed dosing range? A: Valproate B: Primidone C: Phenytoin D: Phenobarbital E: Carbamazepine
What is valproate?
300
When compared with adult onset Schizophrenia, children with schizophrenia have A. a less severe clinical course B. better long term prognosis C. similar deficits in attention, learning and abstraction D. a lower rate of schizophrenia in first degree relatives E. less comorbid with depression and OCD
What are similar deficits in attention, learning and abstraction?
300
Which of the following is characteristic of sleep in individuals over the ge 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
What is increased fragmentation?
300
The immediate phase of amphetamine withdrawal is characterized by dysphoria and anhedonia as well as euphoric recall of the drug use and craving for the drug. The anhedonia and dysphoria are usually much improved in which of the following time frames A. 6 to 12 hours B. 1 to 2 days C. 1 to 2 weeks D. 2 to 4 months
What lasts 2-4 months?
300
Which of the following characteristics or brief psychotic disorder best differentiates it from schizophrenia? A - Paranoid Ideation B - Onset in early adulthood C - Auditory hallucinations of mutiple voices D - Thought disorganization with loose associations E - Confusion with impaired memory of recent event
What is confusion with impaired memory of recent event ?
300
15. A 24 year old patient has recurrent episodes of inflated self esteem, decreased sleep,increased goal directed activity a and racing thoughts, usually last a few days and representing a clear change in functioning but not marked impairment. The patient also has periods of depression,feelings of worthlessness , hypersomnia and hyperphagia. These symptoms last up to a week in duration. The patient reports that these mood episodes occur very frequently,perhaps as many as 20 episodes per year. Which of the following the most likely diagnosis A) Cyclothymia B) Bipolar I disorder, rapid cycling C) Bipolar II disorder, rapid cycling D) Borderline Personality disorder
What is Bipolar II disorder, rapid cycling?
400
When compared to other subtypes of ADHD, children with inattentive type have higher rates of anxiety, somatic complaints and A. tic disorder B. substance abuse C. conduct disorder D. learning disorder E. oppositional defiant disorder
What is tic disorder?
400
Patients over 65 years of age with bipolar disorder differ from younger patients with the same diagnosis in that they have: A - More mixed episodes B - More manic episodes C - Poorer response to Lithium D - Fewer acute affective episodes E - More comorbidity with substance abuse
What are more mixed episodes?
400
A patient with long history of substance abuse is admitted to the hospital for shortness of breath. The patient is found to have multiple granulomas in both lungs; a biopsy reveals the presence of talc within the granulomas. Which of the following substances was the patient most likely abusing? A. Methylphenidate B. Spray paint C. Marijuana D. Absinthe E. Psilocybin
What is methylphenidate?
400
Which of the following statements characterizes late onset-schizophrenia? A. Has poor prognosis B. Is poorly responsive to treatment C. Occurs more frequently in Women than men D. Prodromal features occur after age of 60
What is occurs more frequently in Women than men?
400
Which of the following mood-stabilizers is most firmly associated with a decrease in long-term likelihood of suicide among patients with bipolar disorder? A: Valproate B: Olanzapine C: Lithium D: Carbamazepine E: Lamotrigine
What is lithium?
500
Which of the following is typically the initial recommended approach for a child with new-onset tic disorder? A: Clinical monitoring B: Relaxation training C: Habit-reversal training D: Alpha-agonist medication E: Antipsychotic medication
What is clinical monitoring?
500
A 75 year old patient presents with symptoms of dementia. Especially poor perfomance on which of the following Neuropsychological test might suggest a diagnosis of vascular dementia rather than Alzheimer dementia? A. Wechsler Adult Intelligence Scale (WAIS III) Digit span B. Wechsler Memory Scale Revised C. Wisconsin Card Sorting Test (WCST) D. Boston Naming Test
What is the Wisconsin Card Sorting Test (WCST)?
500
In a patient receiving long-term opioid therapy for management of chronic pain, which of the following is most indicative of opioid addiction? A: Reporting increased pain over time B: Exhibiting signs of physical dependence C: Needing increasing doses for pain relief D: Developing withdrawal symptoms upon cessation of use E: Administering opioids by alternative routes than prescribed
What is exhibiting signs of physical dependence?
500
Deficits in which of the following neurocognitive skills is most highly correlated with schizophrenia? A - Calculation B - Working memory C - Long term memory D - Visuospatial construction E - Recent episodic memory.
What is working memory?
500
A patient with bipolar disorder is treated with lithium and paroxetine. Despite a therapeutic lithium level, athe patient has had recurrent mood episodes, experiencing two manic and two depressive episodes in the past 9 months. Which of the following is the best step to take next in treating this patient? A: Add divalproex B: Add levothyroxine C: Taper and discontinue paroxetine D: Discontinue lithium and start lamotrigine E: Discontinue paroxetine and add carbamazepine
What is taper and discontinue paroxetine?
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