Showdown #2

Diagnosis This

100

A 15 year old boy develops psychosis, tremor involving the proximal upper extremities ("Wing beating") and has several family members with similar movement disorders and psychiatric problems. Abnormal metabolism of which substance is the cause of the abnormality? A. copper; B. lead; C. iron; D. sodium; E. phosphorus;

A. copper What test are you going to order after suspecting this?

200

Hypertensive intracranial hemorrhages are classically located in what area? A. Subarachnoid space; B. Subdural space; C. Epidural space; D. Basal ganglia; E. Mesial temporal lobe;

D. Basal ganglia

300

Which of the following combinations of tests would be most helpful in evaluation of a peripheral neuropathy? A. Nerve conduction studies and somatosensory evoked potentials; B. Somatosensory evoked potentials and electromyography; C. Electromyography and nerve conduction studies; D. Repetitive nerve stimulation and electromyography; E. Repetitive nerve stimulation and somatosensory evoked potentials;

C. Electromyography and nerve conduction studies

400

A child presents to clinic for episodes of night awakening with drooling and twitching of the face and arm ipsilaterally. EEG is most likely show: A. 3 per second spike and waves; B. Multifocal spike and waves; C. Centrotemporal sharp activity; D. Delta activity; E. Vertex waves

C. Centrotemporal sharp activity And the Diagnosis is:

500

An AIDS patient presents to clinic for headache. A head CT is performed showing multiple ring-enhancing lesions. Further history reveals the presence of a cat and dog in the patient�s home. What do the lesions on CT most likely represent? A. Cerebral toxoplasmosis; B. Tuberculosis; C. Multiple sclerosis; D. Brain tumor; E. Lyme abscesses

A. Cerebral toxoplasmosis

Bad Combination

100

Which drug(s) can phenytoin interact with? A. Fluoxetine; B. Valproic acid ; C. Citalopram; D. Both Fluoxetine and Citalopram; E. Both Fuoxetine and Valproic acid

E. Both Fuoxetine and Valproic acid

200

Which enzyme does grapefruit juice inhibit? A. CYP3A4; B. CYP2C29; C. CYP2D6; D. CYP2C9; E. CYP2C19; B. CYP2C29; C. CYP2D6; D. CYP2C9; E. CYP2C19

A. CYP3A4

300

Which of the following drugs should not be used in combination with lorazepam? A. Sodium oxybate; B. Phenytoin; C. Valproic acid; D. Ceftriaxone; E. Methylphenidate

A. Sodium oxybate

400

Which enzyme would duloxetine inhibit? A. Cytochrome P450 2D6; B. Tyrosine hydroxylase; C. Glutaminase; D. Cytochrome P450 1A2; E. Alcohol dehydrogenase

A. Cytochrome P450 2D6 Bonus: What are the other BIG 3?

500

Which drug would duloxetine interact with? A. Buspirone; B. Gabapentin; C. Desipramine; D. Clozapine; E. Phenytoin

C. Desipramine

PGY IIs Only

100

Gait change, incontinence, impaired cognition and memory suggest what disorder? A. Normal pressure hydrocephalus; B. Parkinson's disease; C. CVA; D. Depression; E. Alzheimer's disease

A. Normal pressure hydrocephalus

200

Which of the following would be classified as moderate mental retardation? A. IQ below 20; B. IQ 20 to 40; C. IQ 35 to 55; D. IQ 50 to 70; E. IQ 70 to 85;

C. IQ 35 to 55

300

Which of the following is not a diagnostic criteria of somatoform disorder? A. unexplained pain in two different sites; B. two gastrointestinal symptoms other than; C. one sexual or reproductive symptom other than pain; D. one symptom suggestive of pseudoneurologic disorder; E. all of these symptoms lack a clear medical etiology or are in excess of what would be expected

A. unexplained pain in two different sites Bonus: what age must it occur by:

400

An 80 year old man hospitalized for congestive heart failure complains that strangers have started coming into his room at night and going through his possessions. The most likely diagnosis is A. Charles Bonnet Syndrome; B. Delusional Disorder; C. Adjustment disorder with anxiety; D. REM sleep disorder; E. Delirium

E. Delirium Bonus: what is Charles Bonnet Syndrome? Hint Discussed at last Jeopardy

500

All of the following are criteria of a Major Depressive Episode except: A. insomnia; B. hypersomnia; C. decreased need for sleep; D. fatigue; E. psychomotor agitation;

C. decreased need for sleep

Psych disorders

100

A patient is preoccupied with perfectionism, is overly devoted to work, inflexible, reluctant to delegate tasks and focused upon orderliness, perfectionism and control. This patient is most likely suffering from: A. Obsessive-Compulsive Personality Disorder; B. Borderline Personality Disorder; C. Dependent Personality Disorder; D. Narcissistic Personality Disorder; E. Antisocial Personality Disorder

A. Obsessive-Compulsive Personality Disorder

200

Which of the following is a "first rank" symptom as described by Kurt Schneider? A. Bizarre delusions; B. Auditory hallucinations of voices talking about oneself; C. Delusions of persecution; D. Alogia and affective flattening; E. Talking to oneself

B. Auditory hallucinations of voices talking about oneself; Others are thought broadcasting and withdrawal

300

All of the following are criteria of antisocial personality disorder except: A. failure to conform to social norms with respect to lawful behavior; B. deceitfulness; C. reckless disregard for the safety of self or others; D. lack of remorse; E. a pattern of unstable and intense interpersonal relationships

E. a pattern of unstable and intense interpersonal relationships

400

All of the following are signs of cocaine withdrawal except: A. fatigue; B. hypersomnia; C. increased appetite; D. dysphoric mood; E. euphoria

E. euphoria

500

What percentage of panic disorder patients report having at least one nocturnal-sleep panic attack in their life time? A. 90%; B. 44-71%; C. 30-45%; D. 25%; E. 10%;

B. 44-71%

Behave

100

Learned helplessness is often used as a model of which of the following? A. bereavement; B. depression; C. schizophrenia; D. panic disorder; E. post traumatic stress disorder

B. depression

200

Whenever James uses the can-opener, his cat comes running looking for food. This event occurs because the can-opener serves as a _______ for the cat: A. Unconditioned stimulus; B. Unconditioned response; C. Conditioned stimulus; D. Conditioned response;

C. Conditioned stimulus

300

Which of the following would be an example of a Variable-Ratio (VR) schedule of reinforcement? A. A slot machine in a casino; B. A truck driver being paid $1 for every mile he drives; C. A paycheck that is delivered every 2 weeks; D. A bus that makes stops an average of every 2 minutes

A. A slot machine in a casino

400

A dog that has been conditioned to associate a sound with a painful and unavoidable electrical shock is later found to make no effort to avoid being shocked. This is an example of: A. Habituation; B. Operant conditioning; C. Classical conditioning; D. Learned helplessness;

D Learned helplessness

500

Which of the following is a school of thought that believes that the mind should be understood through study of its elementary components: A. Functionalism; B. Behaviorism; C. Structuralism; D. Ethology; E. Dualism

C. Structuralism - developed by William Wundt