Psychopharmacology
A patient with treatment-resistant depression has a rapid antidepressant response to a single dose of intravenous ketamine. Antagonism of which neurotransmitter system has been most implicated in this treatment response?
NMDA
During an intensive psychotherapy session, a patient becomes increasingly annoyed at the therapist and blurts out, "You must really hate me." This is most accurately understood as which defense mechanism?
Projection
A new mother repeatedly imagines dropping her baby, believing that these thoughts will cause the action to occur, although she says she knows this is not realistic. These thoughts cause her intense distress, which she reduces by silently praying for the child and waiting to hold the child until the thoughts have subsided. Which disorder is most likely to account for this presentation?
Obsessive-Compulsive Disorder
A patient presents with acute onset of pain and decreased vision in the right eye. The patient reports that colors look faded when viewed through the right eye. On exam, the patient is noted to have a right afferent pupillary defect and a swollen right optic disc. The patient spontaneously recovers over the next six weeks. Which disorder is the patient most likely to later develop?
Multiple Sclerosis
A two year old child with normal language development should be capable of what linguistic milestone?
Form two-word combinations
An elderly male has been on longstanding antiepileptic medication. Recently, he has had a fall without detected fracture, and a bone scan reveals low bone density. Which antiepileptic medication should be avoided to prevent further bone loss?
Valproate
A patient who presents to a follow up appointment smelling like cigarette smoke while asking for literature references on effective nicotine cessation therapies is in which stage of change?
Contemplation
The parent of a 43 y/o patient died 5 years ago from pancreatic cancer. Four years ago, the patient noticed occasionally feeling uncomfortably full after eating large, fatty meals, and began fearing that this was an early sign of pancreatic cancer. The patient acknowledges that this is unlikely, but feels the need to frequently weigh himself to be reassured that he is not losing weight. The patient had previously scheduled annual physicals, but now avoids seeing the doctor due to the fear of being diagnosed with cancer. There are no other psychiatric symptoms. Which is the most likely diagnosis?
Illness anxiety disorder
A 25 y/o patient reports having visual hallucinations described as similar to the wavy distortions produced by heat rising from asphalt and affecting the whole of both visual fields. These episodes of visual disturbance are accompanied by vertigo, dysarthria, and tingling in both hands and feet, and sometimes around both sides of the mouth followed by occipital headache. Which of the following is the most likely explanation for this patient’s symptoms?
Basilar Migraine
A 4 y/o child has been raised in a series of foster homes. The child minimally smiles during interactions with a responsive caregiver. When upset, the child does not seek comfort from the caregiver. The child has episodes of unexplained irritability and sadness. Which of the following is the most likely diagnosis?
Reactive Attachment Disorder
A psychiatrist evaluates a 26 y/o woman, who presents with an episode of major depressive disorder that began two weeks after the birth of her child. Which antidepressant medication has both the lowest passage into breastmilk and the most evidence for infant safety? - Sertraline
Sertraline
A patient begins seeing a therapist for depressed mood and describes feeling incompetent. When asked about the meaning of these thoughts, the patient states, “I am worthless.” In cognitive behavioral therapy, the patient’s statement is an example of what?
Core belief
Deficits in which type of memory is a core characteristic of dissociative amnesia?
Autobiographical
A patient is able to recognize happiness, sadness, and disgust, but is unable to distinguish fear and anger in people's voices and facial expressions. A lesion in what part of the brain might produce these findings?
Amygdala
By what age is cisgender identity usually well established?
Three Years
Which medication has been shown to be effective in the treatment of motor tics associated with Tourette syndrome refractory to treatment with antipsychotics and alpha-adrenergic agonists?
Tetrabenazine
A couple participating in psychotherapy for sexual dysfunction is encouraged to explore each other’s bodies except for the breast and genital areas, as homework. This exercise is a description of which therapeutic technique?
Sensate Focusing
Which psychiatric disorder is associated with the greatest economic burden of chronic disability than any other mental disorder, and results in a disproportionate share of the healthcare costs relative to its incidence and prevalence?
Schizophrenia
A 15 y/o patient has had an 18 month history of waxing and waning episodes of non-rhythmic and recurrent eye blinking, shoulder shrugging, and facial grimacing. The patient can suppress the movements for short periods, but they get worse when he is tired or anxious. Which is the most likely diagnosis?
Persistent Motor Tic Disorder
A child pretending that a puppet represents their mother has achieved a milestone of which cognitive developmental period?
Preoperations
Which cognitive enhancer circulates largely unbound to serum proteins and has limited significant drug interactions? (Choices: Modafinil, Donepezil, Memantine, Galantamine, Rivastigmine)
Rivastigmine
Which neuroscientist suggested that normal learning, learning of neurotic behavioral patterns, and unlearning of these behaviors through psychotherapy, might involve long-term functional and structural changes in the brain through altered gene expression?
Eric Kandel
Independent of depression history, which of the following is the most significant risk factor for postpartum depression? (Choices: Birth weight, high education, caesarean delivery, maternal age below 35, or pregestational diabetes)
Caesarean delivery
A 72 y/o woman presents with acute headache and an inability to read. Additional testing reveals that the woman is unable to write fluently, but her verbal fluency is intact. Thrombosis of which artery would result in this syndrome?
Left Posterior Cerebral Artery
Which of the following is the most significant risk factor for the development of primary enuresis? (Choices: A child's bladder capacity, a family hx of enuresis, multiple adverse childhood experiences, a dx of ADHD, or abnormal circadian production of plasma arginine vasopressin)
A family history of enuresis