Showdown #3 Continued

Diagnosis THIS!

100

Which of the following features best distinguishes anorexia nervosa from bulemia nervosa? A: Amenorrhea; B: Decreased body weight; C: calluses on the dorsum of the hand; D: dental enamel erosion; E: Enlarged parotid glands

B: Decreased body weight

200

An 11-year girl is referred for an evaluation of school problems. Her teachers and parents describe her as argumentative, hostile, disrespectful, and difficult. The girl often refuses to listen, will not obey instructions, does not do her work, has temper tantrums, and insists on having her own way. She has been this was since preeschool. The most likely diagnosis is? A: antisocial personality disorder; B: attention deficit hyperactivity disorder; C: conduct disorder; D: intermittent explosive disorder; E: oppositional defiant disorder

E: oppositional defiant disorder

300

Which of the following differentiates Lewy body dememtial from Alzheimer's type? A: Apraxia; B: Choreiform movements; C: Executive dysfunction; D: Gradual progression of deficits; E: Recurrent visual hallucinations

E: Recurrent visual hallucinations

400

A 45-year old woman complains of blurred vision, ocular pain, and headache and was noted to have increased ocular pressure. Which of the recently started medications in the most likely cause? A: lamotrigine; B: oxcarbazepine; C: tiagabine; D: topiramate; E: valproate

D: topiramate

500

A 23-year-old woman presented with a 2 week history of difficulty sleeping, hearing voices, and problems thinking. She was fearful and suspicious, and talked about evil alien forces out in the world. Some of her relatives have had "nervous breakdowns" requiring hospitalizations. Further evaluation revealed the woman had been raped three weeks earlier. She had no recollection of the event. One week after presention, her symptoms have disappeared and she has returned to normal functioning. The most likely diagnosis at this time: A: acute stress disorder; B: brief psychotic disorder; C: schizoaffective disorder; D: posttraumatic stress disorder; E: schizophreniform disorder

B: brief psychotic disorder

Medicate THIS!

100

Which of the following medications is considered first-line monotherapy for PTSD? A: clonazepam; B: sertraline; C: olanzapine; D: valproate; E: propanolol

B: sertraline

200

Which of the following antidepressants is most likely to be associated with substantial weight gain? A: buproprion; B: fluoxetine; C: sertraline; D: venlafaxine; E: mirtazepine

E: mirtazepine

300

A 38-year-old patient provides a 12-year history of obsessive concerns about dirt, germs, and contamination and spends more than 3 hours a day with washing and cleaning rituals. Which of the following would be preferred as an initial medication treatment? A: desipramine; B: duloxetine; C: paroxetine; D: phenelzine; E: vanlafaxine

C: paroxetine

400

A 32-year-old woman with bipolar I disorder has been adequately maintained on lamotrigine. Recently she has experienced an exacerbation of her manic symptoms, and her physician elects to add a second mood stabilizer. Instead of improving, the patient's symptoms worsen. Her serum lamotrigine levels are nearly undetectable. What was the most likely mood stabilizer that was added? A: olanzapine; B: carbamazepine; C: valproate; D: topirimate; E: lithium

B: carbamazepine Bonus: which of the above increases the level of lamotrigine

500

Which of the following antipsychotic drugs has the greatest effect on prolonging the QT interval on the electrocardiogram? A: aripiprazole; B: haloperidole; C: olanzapine; D: thioridazine; E: ziprasidone

D: thioridazine

Potpourri

100

Of the following, which is the most common reason psychiatrists are sued for malpractice? A: Sexual improprieties with patients; B: Suicide; C: Failure to obtain informed consent; D: Tardive dyskinesia; E: Unnecessary commitment

B: Suicide

200

Cocaine-induced euphoria is most highly associated with which of the following neurotransmitters? A: serotonin; B: dopamine; C: norepinephrine; D: Gamma-aminobutyric acid; E: acetylcholine

B: dopamine

300

The strong association between physical illness and suicide has been demonstrated for which of the following conditions? A: ALS; B: Blindness; C: Epilepsy; D: Hypertension; E: Diabetes

C: Epilepsy

400

A patient reports regularly taking a drug bought on the street. ITS effect is pleasurable, but it sometimes causes nausea, restlessnes, and teeth grinding. The drug is most likely: A: methamphetamine; B: flunitrazepam (Rohypnol); C: methylenedioxymethamphetamine (MDMA); D: cocaine

C: methylenedioxymethamphetamine (MDMA);

500

Which of the following agents would be most appropriate for a geriatric patient who has parkinson's disease and agitation? A: risperidone; B: diazepam; C: quetiapine; D: haloperidol; E: lithium

C: quetiapine

Do We Do Kids?

100

In an infant, social smiling is elicited preferentially by the mother at: A: under 4 weeks of age; B: 4 to 8 weeks; C: 8 to 12 weeks; D: 3 to 4 months;

B: 4 to 8 weeks

200

Which of the following theorists is considered the founder of attachment theory? A: Heinz Kohut; B: Adolf Meyer; C: John Bolby; D: Melanie Klein; E: Otto Kernberg

C: John Bolby

300

In terms of pharmokinetics, as compared to adults, children have - A: lower hepatic capacity; B: higher glomerular filtration rates; C: more fatty tissue; D: increased half-lives of medications; E: all

B: higher glomerular filtration rates

400

The most common inherited cause of mental retardation is: A: Down's Syndrome; B: Fragile X Syndrome; C: Fetal Alcohol Syndrome; D: Prader-Willi syndrome;

B: Fragile X Syndrome

500

Rhett's disorder: A: does not involve motor abnormalities; B: is associates with normal intelligence; C: is seen only in girls; D: shows no loss of social skills

C: is seen only in girls

Interns Only

100

In the initial assessment of a depressed patient, what is the most critical decision that the psychiatrist must make? A: type of psychotherapy; B: choice of medication; C: level of care; D: medical workup E: involvement of family

C: level of care

200

Weight gain is most likely to occur with which of the following antipsychotic drugs? A: aripiprazole; B: clozapine; C: haloperidol; D: ziprasidone; E: risperidone

B: clozapine

300

A 20 year-old woman with depression has suicidal ideation. Which of the following characterists is the most strongly associated with a greater risk of completed suicide? A: limited cognitive abilities; B: perfectionistic characteristics; C: previous suicide attempts; D: strong religious beliefs; E: superficial cutting of forearms

C: previous suicide attempts

400

Which of the following signs or symptoms alone would be sufficient to meet criterion A for the active phase of schizophrenia? A: bizarre delusions; B: catonic behavior; C: incoherent speech; D: negative symptoms; E: tactile hallucinations

A: bizarre delusions

500

A 23-year old patient with chronic schizophrenia complains of a milky discharge from her nipples. Medication-induced antagonism of which of the following receptors is responsible? A: acetylcholine; B: dopamine; C: GABA; D: norepinephrine; E: serotonin;

B: dopamine