AP Prep 1/ Flashcards
Lack of insight is a strong predictor of ___ to make medical decisions.
incapacity
___-based approaches are powerful for identifying rare high penetrance gene variants.
Pedigree
*Repetitive ___ for the treatment of unipolar depression targets the left prefrontal cortex/dorsolateral prefrontal cortex.
transcranial magnetic stimulation (At NR Tina target’s the left prefrontal cortex/Dorsolateral PFC)
Patients with ___ disorders have attentional bias toward potentially threatening stimuli.
anxiety
Clenching a fist can ___ hypoactive deep tendon reflexes in a leg.
enhance
*___ is the main cause of death in people with SMI.
Heart disease
Topiramate may help migraine ___.
prophylaxis.
Methylation is an epigenetic mechanism that ___ transcriptional machinery from accessing DNA and thus leads to decreased gene transcription.
inhibits
Patients with Lewy body disease may be more likely to develop ___ extrapyramidal side effects from neuroleptics.
severe
Medication overuse is a strong risk factor for development of ___ daily headache in adults.
chronic
Glycine is a predominantly ___ neurotransmitter
inhibitory
___ is the main excitatory neurotransmitter in the central nervous system.
Glutamate
GABA is the main inhibitory ___ in the adult vertebrate brain.
neurotransmitter
Maintenance of ___ is dependent on the ascending reticular activating system.
wakefulness
Intense fear of gaining weight is a necessary feature to ___ anorexia nervosa.
diagnose
Abstraction is a new cognitive capacity gained when children reach the stage of ___ operations.
formal (13-> adulthood)
Prader-Willi syndrome (obesity, ID, short) involves a ___ of genetic material.
microdeletion
The ___ connects the amygdala to the septal area and the hypothalamus.
stria terminalis
Family psychoeducation is a strongly evidence-based practice that reduces ___ and symptoms, and improves medication adherence in schizophrenia.
relapses
Longitudinal follow-up reliably ___ bipolar from unipolar depression in a patient who presents with an initial episode of depression.
differentiates
Elementary school-age children typically start to engage in social activities without their parents, have a best friend, can show ___ though may sometimes impulsively say things to friends that are unkind.
empathy
Schizophrenia is one of the WHO Global Burden of Disease Study top ten conditions for disability in terms of loss of ___ life years for ages 15-44 in men and women.
productive
Advance directives convey a dying patient’s instructions about wishes regarding ___ interventions when the patient is no longer able to make decisions.
medical
Heavy smoking (and polycyclic aromatic hydrocarbons) may lower levels of olanzapine because cigarettes induce CYP___.
1A2
(Olanzapine is metabolized by CYP 450 1A2, 2D6 (minor), and direct glucuronidation; t1/2 1-2 days). CYP 1A2 inhibitors (eg, fluvoxamine) may increase olanzapine bioavailability by 50-100%. Adjust olanzapine dosing in presence of 1A2 inducers or inhibitors).
Veracity is an ethical principle that means ___ or “speaking truly” from “verax.”
accuracy
___ is the most common comorbid psychiatric disorder in patients with epilepsy.
Major depressive disorder
___ neurons regulate sleep and originate in the tuberomammillary brain nuclei.
Histaminergic
A holding environment, per Winnicott’s thoughts on infant development of assertiveness and sense of competence, encourages ___ while protecting the infant from harm.
spontaneity
24/7 mental healthcare coverage is one characteristic of ___ community treatment (ACT) for the treatment of the severely mentally ill.
assertive
Norepinephrine is mostly synthesized in the ___
locus coeruleus
The ___ has the highest concentration of serotonin-producing cells in the brain.
raphe nuclei
Electrocardiogram is appropriate to detect the most common ___ complications associated with myotonic dystrophy.
cardiac
Training ___ how to recognize potential threats is important to protect hospital systems against EMR data breach.
employees
Participating voluntarily is one of the features of ___ consent.
informed
Goodness of fit describes the relevance of understanding ___ in working with parent-child relational problems.
temperament
Gait ___ may be seen in normal pressure hydrocephalus.
apraxia (deficit and, thus, has a cerebral localization. Patients with gait apraxia have a hard time getting started with walking and may have a “magnetic” or shuffling gait. Gait apraxia is commonly seen in dementia (especially vascular dementia) and in NPH.)
Adolescent cortical synapse remodeling is also believed to be associated with preferential loss of ___ synapses.
excitatory
Urea and electrolytes may be helpful studies for a geriatric patient suspected of ___, which can cause confusion and is a potential antidepressant side effect.
hyponatremia
Remember that responses to ___ may at times be normative.
stress
In those with persistent pain the ___ receptor is down-regulated in the ventral striatum.
dopamine
Cholecystokinin is a peptide released in the gastrointestinal tract to convey ___ information to the brain in response to food intake.
satiety
Hypophosphatemia is one of the lab abnormalities that may be seen in ___ syndrome.
refeeding
___ increases formation of tetrahydrobiopterin (BH4) , which increases production of serotonin, norepinephrine, and dopamine which may be how it is an effective augmentation agent for depression.
L-methylfolate
The AMPA receptor is ___ by the presence of glutamate.
stimulated
When Pavlov’s dog drooled on hearing a bell, the drool is the ___ response.
Conditioned
Beginning to develop concern for others and learning to share typically happens at ___ years.
four
___ neurotransmitter system facilitates sexual arousal.
Dopaminergic
In utero exposure to cannabis during neuronal development is associated with cognitive ___ in the infant.
deficits
In children with cancer, ___ prophylaxis of pain and stress during difficult procedures may result in Post traumatic stress disorder.
Inadequate
One in four people born with the ___ deletion develop schizophrenia.
22q11.2
DiGeorge syndrome/22q11.2 deletion syndrome/ velocardiofacial syndrome is a syndrome caused by the deletion of a small segment of chromosome 22. It is characterized by developmental delay, cardiac abnormalities, palate defects, immune deficiency, and an increased risk of schizophrenia.
___ ___ can be used to determine how two independent variables in a study, such as depression and alcohol use disorder, affect the frequency of the occurrence event, such as suicide.
Regression analysis
Per Classical conditioning, to ___ the conditioned stimulus from the unconditioned stimulus, have the dog listen to the bell in the absence of food.
unpair
PharmacoKINETICs is the branch of pharmacology concerned with the ___ of drugs within the body.
movement
PharmacoDynamics is the branch of pharmacology concerned with the ___ of drugs and the mechanism of their action.
effects
Decreased hepatic ___ flow in older adults is a common physiologic change that affects drug pharmacokinetics.
blood
Microglia are implicated in both neural circuit ___ of the developing brain and scavenging for damaged neurons, plaques and infectious agents.
formation
[Microglia secrete innate proinflammatory cytokines TNF-a and IL-1B in patients with inflammatory conditions that affect the brain.]
It is essential that caregivers, for example of Alzheimer patients, take ___ of themselves, for example by continuing to go to their church group that is important to them.
care
Exemption from course requirements is something that may be included as part of an Individualized Education Program, but would not be included in a ___ plan.
504
Reduction in hippocampal volume is associated with ___ memory impairment.
declarative
The multiple sleep ___ test is used to diagnose narcolepsy.
latency
Clear and ___ evidence is the minimal degree of legal certainty that is constitutionally required for an involuntary mental health comitment.
convincing
Donepezil binds and reversibly ___ the cholinesterases, thus inhibiting hydrolysis of acetylcholine. This increases acetylcholine concentrations at cholinergic synapses.
inactivates
oxybutynin (treats overactive bladder) has anticholinergic effects that would ___ with efficacy of cholinesterase inhibitors like donepezil, galantamine, rivastigmine.
inhibit
An 80yo woman presents to the psychiatrist complaining of lack of energy, forgetfulness, difficulty concentrating. Which of the tests below would be of most help initially in formulating diagnosis?
- CT scan
- Sleep study
- Neuropsychological testing
- Electroencephalogram
- Cerebrospinal fluid studies
Neuropsychological testing
Research regarding the process of acculturation reports that formation of a ___ identity is the best adaptational outcome for immigrant youth.
bicultural
___-regulatory elements are mediators of transcriptional activity in gene expression.
Cis
What is the first step to manage behavioral agitation?
Attempt verbal de-escalation
Initial treatment for female ___ disorder usually includes directed masturbatory training.
orgasmic
___ duration of trauma likely predisposes to dissociative amnesia after a traumatic event.
Longer
When considering assessment instruments, ___ is defined as whether the instrument actually measures what it purports to measure.
validity
Tuberous sclerosis is transmitted in an ___ ___ inheritance pattern.
Autosomal dominant
Higher level of education is considered a ___ factor for suicide attempt in transitional-aged youth with schizophrenia.
risk
A ten-year-old child is pervasively irritable and has had four severe temper outbursts weekly for the past two years. The outbursts involve hitting others, throwing tows, screaming and can occur with minimal provocation. The child’s teacher reports that the child is alienating peers and has difficulty functioning in the classroom. Which diagnosis best characterizes this presentation?
Disruptive mood dysregulation disorder
Associated functions of the ___ lobe include:
- Perception and integration of somatosensory information (e.g., touch, pressure, temperature, and pain)
- Visuospatial processing
- Spatial attention
- Spatial mapping
- Number representation
parietal
A genetic researcher wishing to study polymorphisms including short tandem repeats could use ___ to produce many copies of the portion of the genome under study.
polymerase chain reaction
A patient has psychosis, acute abdominal pain, reduced strength and tendon reflexes. Elevation in ___ would explain her symptoms.
Porphobilinogen (Pt has Acute Intermittent Porphyria)
A patient has chiropractic neck manipulation and soon after has dysarthric speech, ataxic gait, numbness over R body. The patient also complains of increased severity of neck pain radiating to the occiput. The symptoms likely caused by:
vertebral artery dissection
A talk show psychiatrist saying at start of show that they aren’t entering a physician-patient relationship with callers who seek his advice is addressing this broad claim that needs to be proven in malpractice cases:
Duty
___ analysis may identify a gene responsible for autistic-like traits displayed by multiple members of a family.
Linkage
Linkage analysis: Study aimed at establishing linkage between genes. Today linkage analysis serves as a way of gene-hunting and genetic testing. Linkage is the tendency for genes and other genetic markers to be inherited together because of their location ___ one another on the same chromosome.
near
Medical anthropological research has shown that, worldwide, dissociative symptoms most commonly represent ___ components of religious and ritual events.
normal
Motivational enhancement therapy for alcoholism focuses on patient ___ as a key treatment target.
ambivalence
Frieda Fromm-Reichman coined the term “___ ___” to capture aberrant qualities of mothering believed at one time to be a pathway to development of schizophrenia.
schizophrenogenic mother
Parental engagement in frequent conversation and thinking aloud is key to a toddler’s ___ development.
language
Greater therapist experience is closely associated with ___ dropout rate in outpatient psychotherapy.
decreased
The initial learning phase of a skilled motor sequence requires recruitment of the ___ and corticocerebellar systems.
corticostriatal
By age four years, most children have developed sufficient language skills to be able to engage in:
- parallel play
- puns and wordplay
- organized arguments
- moral decision-making
- story telling using words
story telling using words
___ circulating levels of GABA have been described in patients with depressive disorders.
Reduced
___gonadism is an adverse effect of maintenance treatment with methadone for opioid dependence.
Hypo
Naturalistic investigations of a treatment’s effects examine which of the following factors?
- Efficacy
- Accuracy
- Precision
- Efficiency
- Effectiveness
Effectiveness
The FDA specifically warns that antipsychotic medications prescribed for dementia-related behavioral disturbances are associated with stroke and increased risk of ___.
death
Confounding efforts to develop effective diagnostic tools and disease-modifying therapies is the realization that Alzheimer’s disease is mixed proteinopathy (amyloid and ___) frequently associated with other age-related processes such as cerebrovascular disease and Lewy body disease.
tau
Tourette syndrome is distinguished from other tic disorders by the presence of multiple motor tics and one or more ___ tics.
vocal
The Simpson-Angus Rating Scale assesses ___ symptoms.
motor
A seven-year-old continues to have enuresis despite monitoring fluid intake, adequate toileting and using a reward system. The pediatrician next suggests using an enuresis alarm. This treatment, also referred to as the bell-and-pad technique, is a form of ___ ___.
Classical conditioning
The human lymphocyte antigen HLA-B1502 is associated with significantly increased risk of Stevens-Johnson syndrome in the context of carbamazepine or lamotrigine use. The HLA-B1502 gene complex is most common among ___ Americans.
Asian
A female patient whose father got an aggressive upper GI tumor, drinks one standard alcoholic drink/day and wants to know if she should stop drinking to decrease her risk of cancer. Long-term abstinence would reduce her risk ___.
significantly
Which of the following represents the greatest vulnerability to development problems in children?
- Maternal non-infectious illness
- Maternal use of antidepressants
- Maternal mental illness diagnosed before child’s birth
- Early childhood infectious illness prior to age five
- Early childhood non-infectious illness prior to age five years
Maternal mental illness diagnosed before child’s birth
*Excessive ___ is the largest contributor to waste in health care.
ADMINISTRATION
Aspects of successful older age include independent living, positive adaptation, mastery, and growth. Which of the following factors is most important in achieving this success?
- Economic security
- Emotional well-being
- Cognitive preservation
- Lack of physical disability
- Active social engagement
Cognitive preservation
A 40yo comes to the ED following euphoria and feeling like they were “flying above the dance floor” at the club. The patient is now showing nystagmus and is socially withdrawn. Which of the drugs below would be most likely to produce this constellation of symptoms?
- Methcathinone
- Cocaine
- Amphetamine
- Ketamine
- Alcohol
Ketamine
What is primary pharmacotherapy indicated for catatonia?
Benzodiazepines (Lorazepam)
___ has a major role in the acute reinforcing effects of drugs of abuse.
Dopamine
Anorexia nervosa has a significant treatment literature supporting the use of structural ___ therapy.
family
In psychodynamic therapy, when a patient takes an action, prior to encouraging, asking or the therapist taking some other action, first ___ the patient’s action.
interpret
Which of the following examples of documentation of medication dosage is considered confusing and dangerous, and is therefore unapproved by the Joint Commission on Accreditation of Healthcare Organizations? 0.1 mg 40 mg 1.0 units 5,000 units 2,000 units
1.0 units is confusing and dangerous
In-person, telephone, or e-mail doctor-to-doctor “curbside” consultations are provided as part of low-intensity ___ mental health services.
telemedicine
___ acetylation activates transcription.
Histone
A 40yo was diagnosed with AIDS four years ago and has new-onset headache and cognitive decline. Brain MRI shows multiple ring-enhancing lesions suggesting ___ ___.
Toxoplasmosis gondii
Offering personal counseling and financial counseling services at the same location for healthcare provider burnout is a good idea to help ensure success by reducing ___.
stigma
For a child with ADHD and oppositional defiant disorder it may be helpful to find out what the child enjoys and create a behavior ___ program at home and at school.
rewards
From a neurodevelopmental perspective, the youngest age at which a child possesses sufficient cognitive ability such that the child is likely to meet the Appelbaum criteria for general healthcare decisision-making capacity is approximately ___ years.
twelve
The predominant site of the endocannabinoid receptor CB1 is the ___ membrane.
presynaptic
___ of patients impedes the process of cohesion with inpatient group therapy.
Turnover
Narcolepsy is associated with a ___-1 deficiency.
hypocretin
Whole ___ sequencing provides a highly efficient method for sequencing all protein-coding regions.
exome
If a patient sleeps 3-4 hours/night for up to two weeks in a row, to identify the mood disturbance contributing to the patient’s sleep pattern it would be helpful to ask “During these periods, how well rested do you ___ during the day?”
feel
A 25-year-old with seizure disorder since childhood is seen for evaluation of poorly controlled seizures. She has adenomas on the face, mostly around the nasolabial folds and cheeks. A fibrotic plaque is found in the lower back. The most likely diagnosis is which of the following:
- neurofibromatosis
- tuberous sclerosis
- Von Hippel Lindau
- Tay Sachs disease
- Sturge Weber syndrome
tuberous sclerosis
Which of the following features of schizophrenia has become less common in Western cultures?
- Alogia (“Without speech”)
- Catatonia
- Stilted speech
- Religious delusions
- Disorganized thought
Catatonia
After a stranger says “hello,” a 12-month-old child turns and looks at his mother before responding. When the mother smiles and nods her head, the infant laughs and smiles in response to the stranger. This behavior is an example of social ___.
referencing
___ is contained in sleep-promoting neurons of the ventrolateral preoptic nucleus.
GABA
A patient with dementia is admitted after a fall and is found to have a fractured wrist. The team recommends surgery, however the patient refuses. Which of the following is the most appropriate next step?
- Watchful waiting
- Seek a surrogate decision maker
- Assess patient’s capacity to refuse
- Perform the necessary procedures
- Contact the court for an emergency guardian
Assess patient’s capacity to refuse
Which of the following is most significantly affected when syringomyelia (cyst or cavity develops in the spinal cord) first presents?
- Proprioception
- Pain perception
- Auditory perception
- Vibratory perception
- Light touch perception
Pain perception
___cardia is an expected side effect for patients prescribed rivastigmine for Alzheimer disease.
Brady (rivastigmine is an anticholinesterase so boosts acetylcholine and is cholinergic, slowing heart rate)
___ is indicated for catatonia, neuroleptic malignant syndrome and major depressive disorder with psychotic features.
ECT
The ability of preschool children to regulate their ___ is strongly enhanced by the development of language.
emotions
The three major ___ mechanisms include DNA methylation (decreases transcription), histone modification (histone acetylation activates transcription) and expression regulation by micro-RNAs.
epigenetic
Which of the following genetic tests is preferred for the detection of Trisomy 21?
- G-banded karyotyping
- Single-nucleotide polymorphism
- Fluorescence in situ hybridization
- Comparative genomic hybridization
G-banded karyotyping
For X-linked dominant inheritance of genetic disorders, females are ___ as likely as males to be affected in a multigenerational pedigree.
twice
A patient with social phobia avoids almost all social gatherings. The avoidance is regulated by a reciprocal connection between the amygdala and the ___ ___ ___ ___ ___ ___.
periaqueductal gray area of the brainstem
Which two of the following compulsions are the most common in adults with obsessive-compulsive disorder?
- Cleaning
- Ordering
- Counting
- Checking
Cleaning and checking are the most common compulsions.
When used in treatment of insomnia, benzodiazepines ___ REM sleep.
decrease
Oral contraceptives containing estrogens ___ serum levels of lamotrigine.
decrease
Maternal ___ use prenatally is a perinatal factor specifically associated with the development of attention-deficit/hyperactivity disorder.
tobacco
Acute alcohol intoxication is likely mediated by ___ receptor antagonism and GABA-A receptor agonism.
NMDA
A 16-year-old is expelled from school for the third time since the beginning of the academic year, this time for bringing a knife. The previous expulsions were for fighting and stealing from the teacher. The adolescent has also been suspended several times for bullying classmates and skipping school. Over the next decade, these types of behaviors will most likely:
- increase
- decrease
- wax and wane
- remain the same
decrease
St. John’s wort is an alternative treatment for depression that carries a risk of ___ mania in patients with bipolar disorder.
inducing
In combination with growth hormone, ___ hormones are required to initiate the adolescent growth spurt.
gonadal (estrogen, progesterone, and testosterone)
The impaired physician who fails to obtain or benefit from treatment may require the services of an administrative psychiatrist skilled in performing fitness-for-duty evaluations. In these situations, the administrative psychiatrist is ___ bound by the usual parameters of confidentiality.
not
Contralateral leg weakness with sparing of the face and arm associated with urinary incontinence and abulia (inability to act decisively) are typical for a stroke in the territory of the ___ cerebral artery.
anterior
Which of the following is the most common comorbidity in a patient with an anxiety disorder?
- A mood disorder
- A personality disorder
- Another anxiety disorder
- A substance use disorder
- An impulse control disorder
Another anxiety disorder
A 60yo man has gastric bypass and a few weeks later develops gait imbalance and numbness in his feet. On exam he has hyperreflexia, spasticity in the legs and absent vibration sensation in the toes. Serum B12 is normal. Deficiency of which of the following is most likely to cause these symptoms?
- Iron
- Folate
- Copper
- Thiamine
- Pyridoxine
Copper
The ___ ___ measures the magnitude of difference between two intervention groups.
effect size
A 30yo has worsening disorientation and suspected delirium after initially having severe headache after starting a high protein, low carbohydrate diet. The patient had slow growth as a child. To definitively diagnose the individual, ___ transcarbamylase sequencing may be helpful.
Ornithine
Schizotypal personality disorder is suspected in patient with odd speech patterns, constricted affect and eccentric appearance. Which of the following additional features would support schizotypal personality disorder?
- Anhedonia
- Paranoid ideation
- Lack of social anxiety
- Auditory hallucinations
- Delusions of reference
Paranoid ideation
Retaining ___ in the relationship distinguishes empathy from identification.
objectivity
The clock drawing neuropsychological test examines both ___ and visuospatial functioning.
executive
*The number of new events in proportion to the population at risk for the event is referred to as ___ ___.
cumulative incidence
An insurance company pays a physician a single, standardized sum for a patient’s care during a one-year period. This is known as what type of payment?
Capitation
___ gender is associated with prolonged or complicated bereavement.
Male
Which of the following antiepileptic drugs reduces the efficacy of oral contraceptives?
- Valproate
- Gabapentin
- Zonisamide
- Levetiracetam
- Carbamazepine
Carbamazepine
DiGeorge syndrome/22q11.2 deletion syndrome/ velocardiofacial syndrome is a syndrome caused by the ___ of a small segment of chromosome 22. It is characterized by developmental delay, cardiac abnormalities, palate defects, immune deficiency, and an increased risk of schizophrenia.
deletion
___ muscle tone on electromyography when seen during REM sleep is suggestive of REM sleep behavior disorder.
Excess
A 12yo’s parents say he is “sleepy” during the day, often dazed and out of it. He is often not hungry and sometimes says he has nausea. On exam he has red eyes, runny nose and red sores around the mouth. He is likely using ___.
aerosols
Medicare Part B is an ___ purchasable benefit for senior citizens.
optional
Which of the following immunomodulators is associated with increased risk of significant depression in patients with cancer?
- Mitoxantrone
- Natalizumab
- Glatiramer
- Interferon
- Fingolimod
Interferon
Which of the following antipsychotics has the lowest risk of QT prolongation?
- Quetiapine
- Haloperidol
- Ziprasidone
- Aripiprazole
- Thioridazine
Aripiprazole
Parents meet with psychiatrist about their teen who has confusion about gender and identity, and the teen refused to come to the appointment. It would be worthwhile to first ask the parents (in this visit where teen is not present and its just the parents), “what ___ do you want me to use when referring to your child.”
pronoun
Personalized dosing according to CYP genotype is best established for which of the following classes of medications?
- Opioids
- Mood stabilizers
- Typical antipsychotics
- Atypical antipsychotics
- Tricyclic antidepressants
Tricyclic antidepressants
Which of the following physical health conditions has the highest risk of suicide?
- Epilepsy
- Back pain
- Brain injury
- COPD
- HIV
Brain injury
A mother’s capacity to understand her infant’s internal states, which is communicated by ___ is called holding.
mirroring
___ community treatment is an appropriate treatment modality option to take care of a patient who has a long history of non-adherence with treatment, multiple hospitalizations, impulsive / violent behaviors and family family members have become reluctant to take care of the patient.
Assertive
Slow-wave sleep enhances the secretion of ___ ___.
growth hormone
In a patient with early-stage cognitive impairment, preserved calculation skills suggest a ___ rather than cortical dementia.
subcortical
___ ___ ___ ___ = 1 / (Absolute risk reduction)
Number needed to treat
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 ___-psychology.
self
Which of the following disorders is the most common among patients who complete suicide?
- Mood
- Somatoform
- Anxiety
- Psychotic
- Personality
Mood
Individuals exposed in utero to the 1944-45 Dutch “hunger winter” have elevated rates of disease, including heart disease, breast cancer, obesity, and cognitive function. Robust evidence has implicated differences in DNA ___.
methylation (which decreases transcription)
Which of the following approaches has demonstrated efficacy in the treatment of trichotillomania?
- Group therapy
- Habit reversal therapy
- Relapse prevention therapy
- Interpersonal psychotherapy
- Psychodynamic psychotherapy
Habit reversal therapy
Which of the following infant attachment styles is characterized by paying little overt attention to the parent’s presence?
- Secure
- Avoidant
- Resistant
- Ambivalent
- Disorganized
Avoidant
Magnetic resonance imaging is the most sensitive, non-invasive clinical tool for monitoring ___ in patients with multiple sclerosis.
inflammation
A 30yo patient with diabetes comes in with eyelid ptosis that worsens towards the end of the day. They have double vision while reading. The symptoms improve upon awakening the following morning. The patient denies pain and eye exam is otherwise unremarkable. Likely cause is ___ ___.
Myasthenia gravis
antibodies against postsynaptic acetylcholine receptors
A 30yo with intellectual disability and autism spectrum disorder presents with depression. On exam, the patient has a long face, large everted ears, prominent jaw, macroorchidism and a ___ arched palate as well as frequent hand flapping. The patient likely has Fragile X syndrome (caused by trinucleotide expansion of the FMR1 gene, the most common INHERITED form of intellectual disability).
high
Fragile X syndrome is caused by a (CGG) trinucleotide expansion of the FMR1 gene and is the most common ___ form of intellectual disability.
inherited
Down syndrome is the most common ___ cause of intellectual disability.
genetic
What is the most common genetic cause of intellectual disability?
Down syndrome
What is the most common inherited cause of intellectual disability?
Fragile X syndrome
A 67yo woman notes tearfulness, sadness and intermittent insomnia since the sudden death of her husband seven months ago due to a stroke. She says she still can’t believe he is gone, thinks about him much of the day and while she wishes she were dead so she could be with him, does not have thoughts of harming herself. Which of the following is the most likely diagnosis?
- Normal grief
- Major depressive disorder
- Separation anxiety disorder
- Posttraumatic stress disorder
- Persistent complex bereavement disorder
Normal grief
Between 2001 and 2013 which two of the following groups experienced the greatest increase in high-risk drinking and alcohol use disorder diagnoses?
- Males
- Adolescents
- Older adults
- Majority race/ethnicity
- Higher socioeconomic groups
Adolescents and older adults
Which of the following is most strongly associated with higher frequency of medically certified sick leave from work?
- High workload
- Limited use of skill set
- Limited decision authority
- Unclear workplace policy and procedures
- Perceived poor relationship with supervisor
Perceived poor relationship with supervisor
When initially speaking with a patient who feels sad about recently learning they have end stage disease, feels hopeless, no plan to hurt themself, a fair approach would be to initially ___ the patient as having a normal reaction to an overwhelming situation.
validate
Dialectical behavioral therapy focuses on providing psychoeducation, validating patient’s emotional vulnerability and encouraging ___.
change
Widening concern for the larger social system and differentiation of one’s own social, political and historical system from others primarily occurs primarily during the developmental transition from ___ ___ to ___ ___.
Young adulthood to middle adulthood
In the mesocorticolimbic system dopaminergic neurons originate in the ___ ___ ___.
ventral tegmental area
Which of the following is most often cited by the literature as a significant barrier to adopting an electronic health record (EHR)?
- Age of many practitioners
- Initial cost of introducing a system
- Effects of system on physician autonomy
- Lack of interoperability with other systems
- Ambiguity of Federal and State policies on EHR use
Initial cost of introducing a system
___ is often an appropriate initial step prior to psychotherapy or pharmacotherapy.
Psychoeducation
Using an internet search to gather information about a patient may be appropriate to ___ between the patient’s grandiose delusions and reality.
distinguish
Which of the following antipsychotics is absorbed primarily through the oral mucosa?
- Clozapine
- Asenapine
- Iloperidone
- Aripiprazole
- Ziprasidone
Asenapine/Saphris
What is the rate-limiting enzyme in the synthesis of norepinephrine?
Tyrosine hydroxylase (converts L-Tyrosine to L-Dihydroxyphenylalanine aka L-DOPA)
The ___ cingulate cortex is a key component of the salience network.
anterior
If a patient in remission has a lifetime history of 3 episodes of depression ___ pharmacotherapy is likely appropriate.
maintenance
The Continuous Performance Test measures ___ attention.
sustained
Family-based genetic association studies have the advantage over case-control association studies in that family-based genetic association studies are less affected by ___ population differences.
systematic
*___ ___ is the most common cause of premature death in individuals with schizophrenia.
Cardiovascular disease
___ codes as compared to genetic codes are three-dimensional structures.
Epigenetic
Emotional ___ is an essential parental factor for healthy child development.
attunement
In the first two years of life the motor cortex (front lobe) develops ___ of the sensory cortex (parietal lobe).
ahead
FDA-approved use of deep brain stimulation for treatment-resistant obsessive-compulsive disorder involves stimulation of the ___ ___ ___ ___ ___ ___.
anterior limb of the internal capsule
The ___ ___ cortex is most closely associated with working memory (temporarily storing and manipulating information).
dorsolateral prefrontal
