2015 Flashcards
1. Dolores, the patient in the film clip, exhibited the following symptoms during the interview
A. Looseness of association
B. Flight of ideas
C. Depressed affect
D. All of the aboveAnswer: A. As can be seen from the film clip, Dolores did not have depressed affect, in fact her emotions were in harmony with the ideas she was expressing. Her face and body language showed happiness/pride when she was talking about her shirt. She also did not have a flight of ideas, it was more of the shakeyness of the connections of her ideas.
2. It is said to be the center of motivation
A. Deep limbic system
B. Temporal lobe
C. Prefrontal cortex
D. CingulateAnswer: C. According to the trans ‘Introduction to Clinical Psychiatry’, the prefrontal cortex is the motivation center.
3. If Dolores is confined in Ward 7 of PGH, during mileu therapy, the team should address rebuilding/recovery of which of the following?
A. Executive ego
B. Synthetic ego
C. Self confidence
D. Super egoAnswer: B. While executive ego remains intact in patients with psychiatric conditions, it is their synthetic ego that gets shattered, and is the entity that the team in Ward 7 tries to reconstruct.
- On confinement at Ward 7, which of the following will most likely happen?
A. She will be given a hospital gown
B. She will be asked to wear an ID
C. She will not be allowed to bring her personal things/needs because the ward will provide for her needs
D. She will be assigned a bed
Answer: D. Ward 7 of PGH adapts mileu therapy. One of mileu therapy’s thrust is to create an environment close to a harmonious home.
5. Dolores has problem in focusing and with her attention span. Which part of the brain most likely is impaired with this kind of problem?
A. Deep limbic system
B. Temporal lobe
C. Prefrontal cortex
D. CingulateAnswer: D. According to the ‘Intro to Clinical Pyschiatry’, the cingulate allows shift in attention from thought to thought.
6. A 35yo married man awoke one morning with a paralyzed right arm after observing his wife’s close involvement with a friend the previous night. Physical examination was within normal limits. What somatoform disoreder could he have?
A. Somatization disorder
B. Pain disorder
C. Hypochondriasis
D. Conversion disorderAnswer: D. Having a sudden neurologic symptom – paralysis of R arm, after a seemingly traumatic experienceis suggestive of conversion disorder.
7. A 36yo woman fell at work and since then had had constant back pain unrelieved by medication. At first, no physical pathology was found. However, following repeated investigation, the 4th orthopedic surgeon she consulted diagnosed a protruding intervertebral disc. She went into surgery but experienced no symptomatic improvement. She has been quiet disabled for 3 years, dependent on her husband, and moderately depressed. What somatoform disorder could she have?
A. Somatization disorder
B. Pain disorder
C. Hypochondriasis
D. Conversion disorderAnswer: B. Depression may have been the psychological factor exacerbating the pain felt by this woman. This is characteristic of pain disorder.
8. A 57yo woman presented dramatically to her general practicioner in a state of agitation, complaining of headache and dizziness, and convinced that she had a brain tumor. She settled temporarily after PE, reassurance and the help of anxiolytic medication. Her mother had recently died of cancer, two brothers and one niece had also died of cancer, and her daughter had survived cancer. In the preceding month, her 2 unmarried daughters had told her that they were planning to leave home. What could she have?
A. Somatization disorder
B. Pain disorder
C. Hypochondriasis
C. Conversion disorderAnswer: C. This patient is firmly believing that she has brain tumor, even though there are no clinical manifestations to support her claim. This patient is suffering from hypochondriasis.
- A 45yo woman with a history of intermittent asthma since her teenage years developed more severe and more frequent attacks. History revealed an impending separation and increasing hostility between herself and her husband. What seems to be her diagnosis?
A. Psychological factors affecting a medical condition
B. Factitious disorder
C. Conversion disorder
D. Malingering
Answer: A. Clearly, the anxiety of an impending separation, has exacerbated a true medical condition.
- A 35yo lawyer had been having strange “attacks” about once a month for several years. An “attack” was usually heralded by a sudden feeling of nervousness and awareness that his heart was pounding. This was followed by the experience that all objects in his visual field had diminished to about half their normal size and by the perception that people’s actions took on a mechanical, jerky character, “as in silent movies”. These symptoms would be accompanied by the experience that he had become someone else (“I don’t know who, but not myself”). Recently, while driving his car, his “attack” occurred and he perceived that his arm had become detached from his body and continued to steer the car “on their own”. What could he be suffering from?
A. Depersonalization disorder
B. Dissociative fugue
C. Dissociative identity
D. Dissociative amnesia
Answer: A. Words like ‘I don’t know who, but not myself’ shows estrangement from one’s self. The patient’s arm, steering the car on their own is a sense of absence of control of his actions. These two manifestations say a lot about depersonalization disorder.
- Ganser Syndrome involves which of the following symptoms?
A. Complete or partial loss of the ability to perform movements that are normally under voluntary control
B. Temporary alteration of the state of consciousness by the loss of usual sense of personal identity
C. Paralogia with clouding of consciousness
D. An individual feels taken over by a spirit or power
Answer: C. According to WebMD website, Ganser syndrome is a type of disorder where one acts that he has physical/mental illness even though he has not. Purpose is usually to gain attention or sympathy. One symptom of this disease is that the patient appears confused.
- Which disorders are thought to occur when patients suffer bodily symptoms and ill health which are best understood to be psychological or social rather than biological in origin
A. Disorders of somatic function or perception
B. Mood disorders
C. Psychotic disorders
D. Personality disorders
Answer: A.
13. The patient has a fear of the disease, physical symptoms, may or may not have an actual physical disease but is unable to voluntarily control her illness. What would she likely have? A. Conversion disorder B. Somatization disorder C. Hypochondriasis D. Pain disorder
C
- The patient may or may not have a fear of a disease, has physical symptoms, no physical disease but has voluntary control over the illness. What would the patient have?
A. Psychological factors affecting a medical condition
B. Factitious disorder
C. Conversion disorder
D. Pain disorder
B
15. Around 4-6% of medical students can present with this disorder A. Body dysmorphic disorder B. Pain disorder C. Hypochondriasis D. Conversion disorder
C
16. A patient points in fear at the long white curtain billowing in the wind, saying that it is a white lady waving at her by the window. This is an example of A. Hallucination B. Panphobia C. Illusion D. Apparition
C
- A hypnagogic hallucination is defined as
A. A false sensory perception occurring while awakening from sleep and is generally considered nonpathological
B. A false sensory perception occurring while awakening from sleep and is generally considered pathological
C. A false sensory perception occurring while falling asleep and is generally considered nonpathological
D. A false sensory perception occurring while falling asleep and is generally considered pathological
C
18. The persistent, irrational, exaggerated and invariably pathological dread of a specific stimulus or situation is called A. Phobia B. Fear C. Anxiety D. Noesis
A
19. Indirect speech that is delayed in reaching the point but eventually gets from original point to desired goal A. Loosening of association B. Word salad C. Circumstantiality D. Tangentiality
C
20. A patient reports that his thoughts can be heard by others as though they were being broadcast over the air. This is an example of A. Thought withdrawal B. Thought insertion C. Thought blocking D. Thought control
Answer: This was a bonus since it should be thought broadcasting.
21. A 40-year old man is brought to the emergency room on account of a laceration sustained while doing construction work. He is a fairly good worker, has a family, and gets along well with others. He is convinced however that a former classmate is spying n him and plotting to take way his wife. Which of the following is the most likely diagnosis? A. Schizoaffective disorder B. Schizophrenia C. Delusional disorder D. Schizophreniform disorder
C
22. A 35-year old woman has lived in a psychiatric facility for the past 10 years. She spends most of the day rocking, muttering softly to herself, or just staring blankly ahead. She needs help with dressing and showering, anbd she often giggles and laughs for no apparent reason. Which of the following is the most likely diagnosis? A. Schizoaffective disorder B. Schizophrenia C. Delusional disorder D. Schizophreniform disorder
B
23. A patient presents with hallucinations and bizarre delusions lasting eight weeks. Which of the following is the most likely diagnosis? A. Schizoaffective disorder B. Schizophrenia C. Delusional disorder D. Schizophreniform disorder
Answer: D. Timeframe is too short to be diagnosed as Schizophrenia
24. Among the following subtypes of schizophrenia, the one with the best prognosis is A. Paranoid Type B. Disorganized type C. Catatonic Type D. Undifferentiated Type
A
- Among the following, the highest prevalence of schizophrenia is found among
A. Dizygotic twins of schizophrenic patients
B. Children of two parents with schizophrenia
C. Non-twin siblings of patient with schizophrenia
D. Spouses of patients with schizophrenia
Answer: A. Although this was contested in the feedback. Answer should be B. According to Ma’am’s lecture and the trans, monozygotic twins and offspring of parents with schizophrenia have the highest relative risk of developing schizophrenia.
- Treatment model where is the focus of treatment is the mental disorder
A. Model I
B. Model II
C. Model III
D. Model IV
B
- The phenomenon of sensitization of drug addiction is defined as
A. Decreased in the expected effect of a drug after repeated administration
B. Persistent hypersensitivity to the effect of a drug in a person with previous exposure
C. Neurobiologic mechanisms involved in anhedonia
D. Typically associated with stimulant abuse and increase in serotonergic function
B
- Individual non-pharmacologic intervention most effective for substance abuse prevention
a. Therapeutic community
b. Alcoholics or Narcotics Anonymous
c. Out patients relapse prevention
d. Motivational interviewing
D
- The intense desire to reexperience the effects of a psychoactive substance is known as
a. Priming
b. Craving
c. Physiological dependence
d. Reward
B
- Neurotransmitter mediating cognitive enhancement in Nicotine use
a. Acetylcholine
b. Dopamine
c. Beta endorphin
d. Serotonin
A
- Psychological ways in which individuals react to the stress of illness
a. Carry on as if everything is normal
b. Mastering knowledge about the illness
c. A and B
d. None of the above
C
- Denial
a. Is not normal
b. Is adaptive
c. Is not healthy
d. Facilitates early treatment
B
- Denial
a. Most helpful
b. The opposite of anger
c. Initial psychological reaction
d. All of the above
C
34. Anxiety A. Is pathologic B. May be precipitated by fear of strangers C. Can be normal D. AOTA*
Answer: D. *According to feedback but we contested this. A and C cannot be true at the same time. Though anxiety can be pathologic, it isn’t always so, C true. B is also true. AOTA would be the best answer if CAN was used instead of IS in option A.
- Fear of the loss or injury of body parts
A. Can be intensified if the patient has surgery during adulthood
B. Evokes derivatives of castration anxiety in men
C. Is always based on meaning of body parts on the patient’s self-esteem*
D. AOTA
Answer: C. *According to the feedback. But AOTA was asked to be considered, since castration anxiety in men was also mentioned in the lecture along with C, and according to the principles of testmanship AOTA would’ve been the “best” choice. If my memory serves me right contested # rin ‘to.
- The 2 basic theories of why we sleep are:
A. For restorative and adaptive functions
B. For learning and memory enhancement
C. For problem-solving and dream
D. For protection and dream
A
