Show:
Neuro
Adult Psych
EM Psych
Somatic Tx
Forensics
100
Contralateral leg weakness with sparing of the face and arm associated with urinary incontinence and abulia are atypical for stroke in the territory of which of the following arteries?
Anterior cerebral
100
Which of the following is the most effective treatment for obstructive sleep apnea?
positive pressure therapy
100
A 58 year old patient with chronic alcohol use disorder presents to the emergency department vomiting and with unsteady gait. IV dextrose with water (D5W) is started for dehydration. Shortly thereafter the patient becomes disoriented and restless with trouble following the examiner's finger during eye examination. Which of the following is the most appropriate treatment?
Thiamine
100
Trazodone used as an antidepressant requires much larger doses than when used as a hypnotic because of its comparatively low potency for which of the following?
Serotonin Transporter
100
To prove medical malpractice, a plaintiff must establish duty, dereliction, damages, and direct causation by what burden of proof?
Preponderance of evidence
200
In examination of a 32 year old woman with vertigo and diplopia, it is found that when she looks to the left, she has nystagmus of the left eye only, with failure of adduction o the right eye. This disorder of ocular motility suggests the diagnosis of:
Multiple sclerosis
200
Which of the following is the key factor distinguishing factitious disorder from malingering?
Motivation to be identified as ill
200
Which of the following mood-stabilizers is most firmly associated with a decrease in long-term likelihood of suicide among patients with bipolar disorder?
Lithium
200
Which of the following laboratory test has the greatest sensitivity for detecting the regular ingestion of 5 or more drinks of alcohol daily over several weeks?
Carbonhydrate-deficient transferrin (CDT)
200
Which of the following conditions is held to a stricter confidentiality standard by federal law?
Substance abuse
300
A 6 year old has brief episodes of staring lasting a few seconds. Rhythmic, fast, and fine blinking movements occur during these episodes. Which of the following medications would be most appropriate to treat this child's condition?
Valproic acid
300
Avoidant personality disorder differs from schizotypal personality disorder by the:
desire for social relationships
300
While assessing a suicidal patient for exposure to domestic violence, the examiner makes the following comments to the patient and spouse, "the tension that builds up between you must be incredibly stressful. It's not unusual that people who are stressed out can have trouble controlling themselves or can do things they didn't intend, like screaming at or even hitting their partner. Has anything like that ever happened to you?" Which of the following techniques is the examiner using?
Normalization
300
A patient treated for major depression is in remission. Presence of which of the following risk factors would suggest the need for maintenance pharmacotherapy?
Lifetime history of 3 episodes of depression
300
An individual with schizophrenia is arrested after trying to break into a grocery store. This person would be found incompetent to stand trail if he/she:
Believes that all lawyers are demons and refuses to speak to them
400
An intravenous methamphetamine user develops sever back pain, followed after several days by bilateral lower extremity weakness, lower extremity sensory loss, and bladder incontinence. Physical examination reveals a low-grade fever, tenderness to percussion over the second and third lumbar vertebrae, paraparesis, and loss of sensation to light touch and pinprick both legs, buttocks, and sacral region. Which of the following is the most likely explanation for this presentation?
Spinal epidural abscess
400
A 40 year old male patient reports that for many years he has suffered from mild, but continuous dysphoria, accompanied by chronic insomnia and fatigue. Despite these symptoms, the patient is able to go to work; however, he feels his mood negatively affects his job performance. For the past month, he has become increasingly despondent and tearful. He says that he now has no energy at all, frequently calls in sick to work, and spends most days in bed. On physical examination, he appears healthy, but moves and talks slowly. Which of the following is the most appropriate diagnosis?
Double depression
400
A 41 year old patient presents to the emergency department with a blood alcohol concentration (BAC) of 0.425 g/dL. The patient is stuporous, the pulse is 75bpm, and the blood pressure is 110/70 mmHg. there are no other drugs of abuse detected in the blood or urine. Which of the following would be the most immediate clinical concern?
Respiratory failure
400
Which of the following medications significantly increases a patient's serum level of lamotrigine within its clinically prescribed dosing range?
Valproate
400
A patient in outpatient psychiatric treatment describes being involved in a minor parking lot accident at work in which the police were summoned. After investigation, the police rendered an opinion that the patient and other driver were equally at fault and were thus responsible for their own damages. The patient tells the psychiatrist, "I will get even with the other driver by slashing his tires the next time I see his car in the parking lot." The psychiatrist is unable to dissuade the patient. What legal obligation does the psychiatrist have?
No legal obligation
500
A patient develops progressive weakness over several days. Examination reveals an absence of reflexes and muscular weakness that is more prominent in the lower extremities than the upper extremities. Nerve conduction studies show slow conduction velocity, prolonged distal motor latency, and conduction block. The most likely diagnosis is:
Acute inflammatory polyneuropathy
500
Hallucinations in patients with conversion disorder are characterized as:
having a childish, fantastic quality
500
A patient with a history of schizophrenia is brought to the ED with a 2 day history of unusual behavior and refusal to eat or take medications. The patient resists transfer from wheelchair to gurney, makes no eye contact and says nothing. While examining arm movement the examiner notes the patient's arm remains extended rather than returning to resting posture. Which of the following medications is most appropriate to administration?
Lorazepam
500
Which of the following is the most serious side effect of repetitive transcranial magnetic stimulation (rTMS)?
Seizures
500
In liability claims to APA's not practicing sure, allegations of harm as a result of which of the following adverse outcomes are most common?
incorrect diagnosis