Genetics
Neurosciences
Treatment
Behavioral Sciences
Diagnostics
Research
100
Which of the following epigenetic processes is most implicated in the development of fragile X syndrome?
A. DNA acetylation
B. DNA methylation
C. Histone acetylation
D. Histone methylation
E. Histone phosphorylation
B. DNA methylation
100
Norepinephrine is derived from which neurotransmitter?
A. Serotonin
B. Dopamine
C. Glutamate
D. Epinephrine
E. Acetylcholine
B. Dopamine
100
Which of the following medications is most effective for migraine prophylaxis?
A. Sumatriptan
B. Topiramate
C. Fluoxetine
D. Duloxetine
E. Naproxen
B. Topiramate
100
In cognitive behavioral therapy for psychosis, what is the primary goal of
challenging and restructuring distorted thoughts?
A. Discontinue antipsychotic medications
B. Eliminate hallucinations and delusions
C. Explore past traumatic experiences and their impact
D. Encourage patient to embrace their delusional beliefs
E. Reduce distress associated with psychotic experiences
E. Reduce distress associated with psychotic experiences
100
Which of the following lab abnormalities is associated with refeeding syndrome?
A. Hyperkalemia
B. Hypocalcemia
C. Hyperglycemia
D. Hypermagnesemia
E. Hypophosphatemia
E. Hypophosphatemia
100
The validity of an assessment instrument refers to the extent to which it:
A. measures what it intends to measure.
B. can be used successfully in cross-national studies.
C. provides consistent results when used at different times.
D. provides consistent results when used by different examiners.
E. produces higher rates of false-negative measures.
A. measures what it intends to measure.
200
In patients with Trisomy 21 (Down syndrome), there are three copies of the gene coding for which of the following proteins?
A. Presenilin 1 protein
B. Presenilin 2 protein
C. Apolipoprotein, (APOE)-e2
D. Apolipoprotein, (APOE)-e4
E. Amyloid precursor protein (APP)
E. Amyloid precursor protein (APP)
200
The stroke seen in the CT scan of the brain below would result from occlusion of which of the following cerebral arteries?
A. Basilar
B. Vertebral
C. Middle cerebral
D. Anterior cerebral
E. Anterior choroidal
C. Middle cerebral
200
Because it acts as both an inducer and substrate of CYP3A4, which of the
following medications might require a dose increase after several weeks to
maintain steady-state blood levels?
A.Lithium
B. Phenytoin
C. Phenobarbital
D. Carbamazepine
E. Valproic acid
D. Carbamazepine
200
A patient repeatedly self-discontinues antidepressants due to lack of immediate benefit. Each time a new agent is considered, the patient praises the psychiatrist's skills and appears hopeful but asks complex questions about potential side effects. Which of the following approaches is most likely to improve this patient's response to future pharmacologic treatments?
A. Exploring the patient's fears about medications
B. Minimizing discussions of potential side effects
C. Using countertransference to guide medication selection
D. Discounting unrealistic expectations about medication benefits
E. Challenging the patient's idealized perception of the psychiatrist
A. Exploring the patient's fears about medications
200
A patient reports frequent "mood swings" with alternating depression and mood elevation. These episodes only last one to two days. As a result, the patient
reports difficulty focusing at work. There is no history of psychiatric hospitalization, self-harm, or psychotic symptoms. What is the most likely diagnosis?
A. Cyclothymic disorder
B. Schizoaffective disorder
C. Borderline personality disorder
D . Attention-deficit/hyperactivity disorder
E. Bipolar disorder, type Il, with rapid cycling
A. Cyclothymic disorder
200
A research team is studying risk factors for developing major depressive
disorder (MDD). They select two groups from a defined population: one with a
history of insomnia and one without. Neither group meets the criteria for MDD at the beginning of the study. Both groups will be followed for five years to observe the incidence of MDD. Which epidemiological research study design does this example illustrate?
A. Cohort study
B. Descriptive study.
C. Case-control study
D. Randomized controlled trial
E. Randomized controlled trial (prevention trial)
A. Cohort study
300
A 25-year-old with a history of developmental delays presents for evaluation of anger outbursts. Prior karyotyping has demonstrated a microdeletion of genetic material. This finding is most likely to be seen in which of the following disorders?
A. Phenylketonuria
B. Down syndrome
C. Tuberous sclerosis
D. Fragile X syndrome
E. Prader-Willi syndrome
E. Prader-Willi syndrome
300
A 35-year-old patient who was diagnosed with AIDS three years prior develops new-onset headache associated with cognitive decline. Magnetic resonance imaging of the brain demonstrates multiple ring-enhancing lesions. Which of the following is the most likely cause?
A. Lymphoma
B. Cytomegalovirus
C. Pneumocystis carinii
D. Toxoplasmosis gondii
E. Progressive multifocal leukoencephalopathy
D. Toxoplasmosis gondii
300
An 18-year-old with bipolar I disorder has been euthymic for over one year on lithium monotherapy, however he has struggled academically, noting difficulty focusing on his readings and maintaining attention. Both he and his parents describe a prior history consistent with attention-deficit/hyperactivity disorder, inattentive subtype. Which of the following interventions may improve the patient's cognitive symptoms without increasing his risk of subsequent mania?
A. Switch to lamotrigine
B. Switch to valproic acid
C. Addition of venlafaxine
D. Addition of methylphenidate
E. Switch to atypical antipsychotic
D. Addition of methylphenidate
300
A “timeout” used to change the frequency of undesirable behaviors in children represents which type of operant conditioning?
A. Positive reinforcement
B. Positive punishment
C. Negative reinforcement
D. Negative punishment
E. Extinction
D. Negative punishment
300
Which of the following neuropsychological tests examines both executive and visuospatial functioning?
A. Clock drawing
B. Facial recognition
C. Verbal fluency test
D. Digit span backward
E. Wisconsin card sorting test
A. Clock drawing
300
A randomized controlled trial is performed to compare the addition of metformin to usual treatment in the prevention of diabetes in patients currently prescribed an antipsychotic medication. Eighteen percent of patients in the metformin group develop diabetes while twenty percent of patients in the usual treatment group develop diabetes, with p<.01. In this study what is the number needed to treat in order to prevent diabetes in one individual taking antipsychotic medication?
A. 2
B. 5
C. 15
D. 25
E. 50
E. 50
400
Transcription of brain-derived neurotrophic factor is induced by valproic acid
through which epigenetic mechanism?
A. mRNA degradation
B. Microtubule destabilization
C. Inhibition of histone deacetylation
D. Regulation of small interfering RNAs
E. Inhibition of alpha-tubulin acetylation
C. Inhibition of histone deacetylation
400
A 55-year-old woman undergoes gastric bypass surgery and, several weeks later, develops gait imbalance and numbness in the feet. Neurological examination is remarkable for hyperreflexia, spasticity in the legs and absent vibration sensation at the toes. Serum B12 level is normal. Deficiency of which of the following is most likely to cause these symptoms?
A. Iron
B. Folate
C. Copper
D. Thiamine
E. Pyridoxine
C. Copper
400
Which of the following measures is used in biofeedback as a marker of autonomic activity?
A. Heart rate variability
B. Systolic blood pressure
C. Diastolic blood pressure
D. Respiratory rate variability
E. Core body temperature
A. Heart rate variability
400
Which of the following historic figures in psychiatry coined the term "schizophrenogenic mother" to capture aberrant qualities of mothering believed at one time to be a pathway to development of schizophrenia?
A. Carl Rodgers
B. Melanie Klein
C. Sigmund Freud
D. Harry Stack Sullivan
E. Frieda Fromm-Reichman
E. Frieda Fromm-Reichman
400
A patient has failed several antidepressants and the psychiatrist is interested in starting the patient on a nortriptyline trial. The psychiatrist obtains a baseline electrocardiogram to obtain the patient's QTc interval. Which of the following QTc intervals is the shortest recommended to withhold nortriptyline?
A. 430 ms
B. 450 ms
C. 470 ms
D. 490 ms
E . 500 ms
B. 450 ms
400
Which research design summarizes key concepts and evidence on a topic that has not been comprehensively reviewed before?
A. Meta-analysis
B. Scoping review
C. Systematic review
D. Observational study
E. Descriptive review
B. Scoping review
500
A 65-year-old patient has progressive dysarthria, weakness, and muscle atrophy. Exam shows tongue fasciculations and hyperreflexia. The father had a similar syndrome and died three years from onset. Testing is most likely to show what?
A. Hexosaminidase A deficiency
B. Deletion in the dystrophin gene
C. Elevated angiotensin-converting enzyme levels
D. Mutation in the gene encoding the enzyme superoxide dismutase
E. Antibodies to acetylcholine receptor and muscle-specific tyrosine kinase
D. Mutation in the gene encoding the enzyme superoxide dismutase
500
Inflammatory cytokines mediate depression through which of the following neurophysiological changes?
A. Decreased levels of glutamate in the basal ganglia
B. Increased release of dopamine into the basal ganglia
C. Increased expression of serotonin reuptake transporters
D. Increased expression of brain derived neurotrophic factor
E. Decreased conversion of the amino acid tyrosine to serotonin
C. Increased expression of serotonin reuptake transporters
500
Which of the following is a pharmacological effect of lithium?
A. Protein kinase C inhibition
B. Breakdown of neuronal catenins
C. Increased free intracellular inositol
D. Inositol monophosphatase activation
E. Glycogen synthase kinase-3 inhibition
E. Glycogen synthase kinase-3 inhibition
500
Psychodynamic theory, which focuses on the here-and-now interactions between therapist and patient and identifies transference and countertransference as uniquely co-created by patient and therapist together, has its roots in which school of classical psychoanalytic theory?
A. Drive theory
B. Ego psychology
C. Object relations
D. Self-psychology
E. Attachment theory
D. Self-psychology
500
The Simpson-Angus Rating Scale assesses which of the following types of symptoms?
A. Motor
B. Anxiety
C. Cognitive
D. Psychotic
E. Depression
A. Motor
(EPS scale)
500
A research team is developing a brief rating scale to assess the severity of obsessive-compulsive disorder (OCD) symptoms. To evaluate the effectiveness of this tool, the team compares its results with those from the Yale-Brown Obsessive Compulsive Scale, a well-established tool for assessing OCD severity. This example illustrates what type of validity?
A. Content
B. Criterion
C. Construct
D. Predictive
E. Concurrent
E. Concurrent
