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The Expert Consultant
100
Which of the following diagnostic criteria most clearly distinguishes paranoid personality disorder from paranoid schizophrenia, delusional disorder, and mood disorder with psychotic features? A: absence of positive psychotic symptoms; B: age at onset; C: degree of impairment in interpersonal relationships; D: Duration of symptoms; E: pervasive nature of symptoms
A: absence of positive psychotic symptoms
100
Whick one of the following psychotropics is most likely to casue a seizure? A: clozapine; B: aripiprazole; C: olanzapine; D: risperidone; E: quetiapine
A: clozapine
100
Suicide rates - A: have remained relatively stable except for 15- to 24- year olds, whose rates have decreased two to three fold; B: have averaged five per 1,000,000 in the 20th century; C: make suicide the 8th leading cause of death in the United States; D: reflect about 10,000 suicides each year in the United states
C: make suicide the 8th leading cause of death in the United States
100
Which of the following headache varieties is most often associated with mood changes? A: Migraine; B: Trigeminal neuralgia; C: Giant cell artritis; D: Cluster headaches; E: Idiopathic intracranial hypertension
A: Migraine; BONUS highlight the key features of Migraine
100
Antidepressants should be used cautiously in cardiac patients due to increased risks of which of the following: A: hypertension; B: suicide; C: conduction side effects; D: noncompliance; E: all of the above
C: conduction side effects
200
Attention deficit hyperactivity disorder (ADHD) appears to be most strongly associated with prenatall exposure to: A: caffeine; B: lithiun: C: nicotine; D: SSRIs E: valproate
C: nicotine;
200
Which of the following is the greatest risk factor for depression complicating epilepsy? A: duration of epilepsy; B: partial complex epilepsy; C: family history of epilepsy; D: frequent seizures
B: partial complex epilepsy
200
Among men suicide peaks after 45, among women, it peaks after: A: 35; B: 40; C: 50; D: 55
D: 55
200
Which type of headache do brain tumors most often mimic? A: Tension-type; B: Migraine; C: Cluster; D: Subarachnoid hemmorhage; E: Trigeminal neuralgia
A: Tension-type; BONUS: highlight the KEY features of TTH
200
Which of the following is the most common reason for a consultation-liason psychiatrist to be consulted? A: anxiety; B: depression; C: disorientation; D: treatment problems; E: sleep disorders
D: treatment problems
300
Which of the following medications is most likely to be associated with polycystic ovarian syndrome? A: carbamazepine; B: gabapentin; C: Lithium; D: topirimate; E: valproate
E: valproate
300
A 28-year-old man was admitted to the hospital following several seizures. He denied prior seizures, head trauma, and systemic systemic systems. He had been maintained in a methadone program for narcotic addiction. His seizures were finally attributed to a congenital cerebral injury. His physicians gave him phenytoin and renewed his methadone. Several days later he developed agitation, anxiety to the point of incoherence, diaphoresis, and tachycardia. Which should be the consulting psychiatrist's first step? A: administer a tranquilizer B: administer an SSRI C: Administer an atypical neuroleptic D: Increase the daily methadone dose E: increase the phenytoin dose F: Change the AED
D: Increase the daily methadone dose; BONUS: explain the mechanism of action behind why you would do this
300
Which of the following neurobiological findings is also associated with suicide? A: increased 5-hydroxyindoleacetic acid (5-HIAA) levels in the CSF; B: changes in the dopaminergic system; C: serotonin deficiency; D: increased levels of platelet monoamine oxidase (MAO); E: normal findings on EEG
C: serotonin deficiency
300
Which condition is usually cyclic or periodic, develops predominently in med, and responds to lithium? A: Migtaine; B: Cluster headaches; C: Trigeminal neuralgia; D: Giant cell arteritis
B: Cluster headaches
300
Dailysis Dementia - A: Can occur after a patient's first dailysys treatmet; B: Is a common occurrence; C: Can cause seizures and dystonias; D: Rarely leads to depression and suicide; E: All of the above
C: Can cause seizures and dystonias
400
What is the most common comorbid condition in children with autistic disorder? A: ADHD; B: Major Depression C: Mental Retardation D: Schizophrenia E: social phobia
C: Mental Retardation - approximately 80% of children with autistic d/o are mentally retarded.
400
In which phase of sleep is a seizure lease likely to occur? A: stage 2 NREM B: REM C: sleep following sleep deprivation D: awakening from sleep
B: REM
400
Suicide rates among patients with schizophrenia: A: is low; B: is approximately 10 percent; C: occurs most often in the later years of the illness; D: occurs most often in older, women patients; E: is most frequently secondary to command hallucinations
B: is approximately 10 percent
400
An obese young woman suddenly develops severe right periorbital pain, prostration, a right third crabial nerve palsy, and nuchal rigidity. What is the most likely explanation? A: a ruptired aneurysm in the circle of Willis; B: An ocula migraine; C: Myasthenia gravis; D: none of the above
A: a ruptired aneurysm in the circle of Willis
400
A cardiac cancer patient presents to a psychiatrist with a complaint of mood symptoms and of seeing yellow rings around objects in the visual field. The medication most likely responsible for these symptoms is: A: reserpine; B: digoxin; C: clonidine; D: Beta-blocker; E: Alpha-blocker
B: digoxin
500
Which of the following is a technique of supportive dynamic psychotherapy? A: transference interpretation; B: promoting therapeutic regression; C: extreme passivity of the therapist; D: problem-solving focus E: frequent genetic reconstruction
D: problem-solving focus
500
What proportion of individuals with well-documented psychogenic seizures also has epileptic seizures? A: <10% B: 25% C: 50% D: 66%
A: <10%
500
In a urine test for phencyclidine, a false positive test can occur if a person has ingested: A: dextromethorphan; B: ibuprofen; C: tonic water; D: phenelephrine; E: diphenhydramine
A: dextromethorphan; Ibuprofen can cause a false positive for marijuana metabolites. Tonic water can cause a false positive for opiates. Phenylephrine can cause a false positive for amphetamines.
500
A 4-year-old boy has headaches with incapacitating nausea and vomiting complicated by comfusion, incoherence, and agitation. However, he has no paresis or nuchal rigidity. His mother has a history of migraine. Between attacks, he appears normal. Serum lactate and pyruvate levels are elevated. Which of the following is the most likely explanation for the child's attacks? A: Tension-Type headaches; B: Brain tumor C: Diabetes D: Mitochondrial encephalopathy
D: Mitochondrial encephalopathy
500
Risk factors for developing postoperative delirium include all of the following EXCEPT: A: older age; B: alcohol use; C: cognitive impairment; D: male gender; E: type of surgery
D: male gender