Patient getting psych exam to determine suitability for a job must be
informed: Right Ans - Examination is not confidential
Pt calls ED c/o command hallucinations telling him to kill others. Which action
should psych take first? Right Ans - Obtain phone # & address from which
pt is calling
Which question is useful for evaluating immediate recall Right Ans - Can
you repeat these six numbers?
Which of following symptoms is typical of idiopathic Parkinson disease, rather
than another Parkinsonian syndrome? Right Ans - Asymmetrical onset and
progression of motor symptoms
In addition to life support measures, which class of medications can be
considered for treatment of NMS? Right Ans - Dopamine agonists
4yo girl w NL development in 1st 18m, but afterwards, decelerated head
growth, loss of purposeful hand movements, midline UE stereotypies (hand‐
wringing), severe PMR, & social withdrawal. Right Ans - Rett disorder
Which was 1st edition of DSM to exclude homosexuality as a dx? Right Ans
- DSM II (1974 edition)
Exposure to valproate during pregnancy associated with incr risk Right
Ans - Neural tube defects
15yo w h/o seizures starting at 9yo, followed by prolonged motor or sensory
deficits lasting days - weeks. Pattern of seizures and focal deficits has changed
over time. Also has h/o hemicranial HAs. No family hx of similar symptoms.
(Recent MRI shown) Dx? Right Ans - MELAS (Mitochondrial
encephalomyopathy, lactic acidosis and stroke)
Which is most common psychiatric presentation s/p CVA? Right Ans -
Depression
,Which intervention is example of harm reduction technique used in people
with opioid dependence? Right Ans - Needle exchange
Therapeutic index is a relative measure of which characteristic of a
medication Right Ans - Safety
Which is adequate monotherapy for juvenile myoclonic epilepsy? Right Ans
- Valproate
Decreased attention to social cues is most common among children with
Right Ans - Autism
Which viral agent is frequently associated with idiopathic unilateral facial
nerve palsy? Right Ans - Herpes simplex
Largest percentage of malpractice suit settlements & adverse verdicts in
psychiatry covered by professional liability insurers is for cases involving:
Right Ans - Patient self‐harm
Emil Kraepelin is an important figure in the history of psychiatry b/c of his
insight that Right Ans - The major mental illnesses have different courses
and outcomes
Homicide and homicidal behaviors are most often related to: Right Ans -
Emotions not associated w mental illness
Which of following developmental disability syndromes is asstd w triple‐
repeat genetic abnormality Right Ans - Fragile X syndrome
26yo man occasionally awakened by HA in early morning, which can be
excruciating & usually lasts 60‐90 minutes. Sometimes during day, he gets
similar HAs, beginning w sharp stabbing sensation in L nostril, followed by
severe retro‐orbital pain, tearing of L eye, & rhinorrhea. Indicates his wife has
noted some swelling of his face during the HA. Neuro exam is NL. Diagnosis:
Right Ans - Cluster headache
In operant conditioning, a partial or intermittent (opposed to continuous)
reinforcement schedule results in: Right Ans - Maintaining a behavior that
is resistant to extinction
,Which of following neuropsychological tests is most useful in early diagnosis
of Alzheimer disease Right Ans - 10‐item word list learning task
A securely attached 4yo child attempts to delay bedtime by asking one parent
to let the other parent "read one more story" before turning out the light. This
behavior is an example of: Right Ans - The use of verbal skills to negotiate
normative conflicts
Interpersonal exploitativeness is a diagnostic feature of which personality
disorder Right Ans - Narcissistic
Which is characteristic of alcohol withdrawal seizures Right Ans - They
develop within several hours to a few days after alcohol cessation
Which medication is most likely to cause cognitive side effects if taken at same
time as ECT Right Ans - Lithium
In helping a victim of rape in the ED, the 1st intervention should be Right
Ans - Restore a sense of safety
78yo M brought by family for starting to accuse spouse of infidelity. Has a h/o
Alzheimer dementia, & lives w spouse & adult daughter. On evaluation, asserts
the spouse is unfaithful. During interview, he is alert & pleasant, and acts
congenially toward spouse, almost making light of accusations. Patient's only
medication is donepezil. Negative medical & laboratory evaluation. Preferred
intervention for this delusion: Right Ans - Arrange for regular evaluations
of the patient & reassure the family
Mental competency of an elderly patient is determined by Right Ans -
Judicial hearing
46yo F p/w incr dysphoria. Progressively increased freq of washing her hands
to point of excoriation. Fearful she will make people sick unless she keeps her
hands clean. Dosage range of an effective treatment agent is: Right Ans -
Fluvoxamine 200‐300mg daily
16yo comes to psych s/p a single grand mal seizure. Parents noted occasional
sudden jerks of entire body, resulting in dropping objects & being labeled as
, clumsy. EEG shows rare 4‐ 6Hz irregular polyspike & wave bursts. Diagnosis:
Right Ans - Juvenile myoclonic epilepsy
Hippocampus & parahippocampal gyrus mediate Right Ans - Declarative
memory (facts)
A psychiatrist conducting individual psychotx w pt, and family tx w pt &
family is at most risk to violate which ethical guideline: Right Ans -
Avoiding dual relationships
5yo referred for behavioral problems at school. Was in & out of foster care for
1st 2y of life. Seems very friendly & affectionate w others, even strangers.
Parents report they don't always feel "close" to the child & that the child
doesn't seem to have enduring friendships. Most likely diagnosis? Right
Ans - Reactive attachment disorder
61yo comes to ED w family who report pt is unable to remember recent
events. Pt's memory problems began 2h prior, and was cognitively intact
before this episode. Pt is alert, slightly anxious & frustrated, & repeatedly asks,
"why am I in the hospital, is someone sick?" Presentation consistent w
Right Ans - Transient global amnesia
A pt w schizoid personality disorder has elaborate fantasy relationships but
has no real friends. Which therapy would be most helpful in assisting pt in
forming satisfying interpersonal relationships? Right Ans - Group therapy
Extent to which an instrument represents the construct being measured is
what type of validity Right Ans - Content
38yo pt c/o difficulty talking, reports h/o diffuse muscular aching & stiffness.
PE shows enlarged tongue & percussion myoedema. Right Ans -
Hypothyroidism
42yo pt w chronic abdominal pain, constipation, & nausea x 14m. Extensive
medical w/u is negative, but pt insists these are sx of a serious disease. Pt &
spouse deny any notable psychosocial stressors during this time period; pt
denies psychological factors might contribute to physical sx. Due to reported
discomfort, pt has missed several family gatherings, canceled social dates, &
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