Behavioral Health Tests Questions

Question 1

A 32YO man is accused of murdering four people. The man has a history of impulsivity and refusal to conform to social norms. On interview, you note a charming, intellligent man who seems to show no remorse. He denies any wrongdoing and appears self-centered and insincere. Which diagnoses is supported by your interview?

Answer 1

anti-social personality disorder

Question 2

Irresistible impulses to repeat a rituallistic act over and over again (i.e., handwashing) is known as a(n)

Answer 2

Compulsion

Question 3

A 25YO woman presents to your office for the 10th time over the course of 3 months. She complains of vague abdominal pain, urinary difficulties, and fevers on and off for the past 2 weeks. After an extensive workup, including a consultatioin with a gastrointestinal and genitourinary specialist, you have found no etiology for her complaints. Her past medical history includes generalized anxiety disorder, depression, and one failed suicide attempt one year ago. What is the most likely diagnosis?

Answer 3

Somatization disorder

Question 4

Paroxitine and fluoxetine are used to treat depressive conditions. What is their mechanism of action?

Answer 4

Block reuptake of serotonin

Question 5

Cluster A personality disorders as described as______________ and include which disorders________________

Answer 5

(odd or eccentric)

Paranoid personality disorder:
characterized by a pattern of irrational suspicion and mistrust of others, interpreting motivations as malevolent

Schizoid personality disorder:
lack of interest and detachment from social relationships, and restricted emotional expression

Schizotypal personality disorder:
a pattern extreme discomfort interacting socially, distorted cognitions and perceptions

Question 6

Cluster B personality disorders as described as______________ and include which disorders________________

Answer 6

(Dramatic, Emotional, Erratic, Dependent)

Antisocial personality disorder:
a pervasive pattern of disregard for and violation of the rights of others, lack of empathy

Borderline personality disorder:
pervasive pattern of instability in relationships, self-image, identity, behavior and affects often leading to self-harm and impulsivity

Histrionic personality disorder:
pervasive pattern of attention-seeking behavior and excessive emotions

Narcissistic personality disorder:
a pervasive pattern of grandiosity, need for admiration, and a lack of empathy

Question 7

Cluster C personality disorders as described as______________ and include which disorders________________

Answer 7

(Avoidant, Obsessive-Compulsive)

Avoidant personality disorder:
pervasive feelings of social inhibition and inadequacy, extreme sensitivity to negative evaluation

Dependent personality disorder:
pervasive psychological need to be cared for by other people.

Obsessive-compulsive personality disorder (not the same as obsessive-compulsive disorder):
characterized by rigid conformity to rules, perfectionism and control

Question 8

Patients with Conversion Disorder usually describe

Answer 8

one or two neurological complaints

Question 9

Patients with Hypochondriasis usually are

Answer 9

Focused less on symptoms, and more on the belief that they have a specific disease,

Question 10

Patients with Somatization Disorder usually describe

Answer 10

Many physical complaints affecting many organ systems.

Question 11

The most important initial component of evaluating a patient with depressive illness is

Answer 11

assessment of suicide risk.

Question 12

An almost continuous flow of rapid speech with sudden changes of topic is BEST described as:

Answer 12

flight of ideas

Question 13

What is the drug class of choice for treating a patient with major depression?

Answer 13

Selective Seratonin Reuptake Inhibitors

Question 14

A 28 year-old male patient is being treated for depression and has been taking paroxetine (Paxil) for the past two months with a marked improvement in his symptoms. The patient reports problems with sexual functioning which he believes is related to the medication. Which of the following is an immediate concern with abrupt discontinuation of the medication?

Answer 14

withdrawal symptoms

Question 15

48 year old patient comes to the clinic with a strong history of depression. She has trouble keeping weight on due to the nausea associated with her chemotherapy. She was diagnosed with colon cancer last year. Which medication can you recommend for her depression?

Answer 15

mirtazapine (Remeron)

Question 16

Tim pursues pleasure, even when it is short-lived and results in punishment. He is egocentric, insensitive to others, and does not plan ahead for the consequences of his actions. Tim suffers from:

Answer 16

antisocial personality disorder

Question 17

In a dying patient, which of the following is used to detect depression?

Answer 17

pervasive hopelessness

Question 18

58 year old Jane Doe has recently been diagnosed with depression. She went into complete remission from her previous two episodes over her lifetime. What is the likelihood of recurrence after the remission of this diagnosis?

Answer 18

90%

Question 19

Substance-related, anxiety and/or somatoform disorders are among those that are found in DSM-IV under

Answer 19

Axis I

Question 20

Psychosocial factors that bear inclusion on DSM diagnosis are found on axis

Answer 20

Axis IV

Question 21

Axis V of the DSM-IV includes

Answer 21

a global assessment of functioning..

Question 22

A 32 year-old female was referred to your office for evaluation. Upon entering the room you see a tearful, slow-to-react female who describes a gradual worsening in feelings of worthlessness for the last month. She is unkempt. She is fully oriented. What diagnostic category does this scenario fit?

Answer 22

depression

Question 23

A 54 year-old female enters your practice. She has a history of poor interpersonal relationships, chronic headaches and previous suicide attempts. After a few visits, you appreciate that she has an extremely demanding attitude and often directs anger toward you. Which of the following is the most likely diagnosis?

Answer 23

borderline personality disorder

Question 24

Freud’s psychodynamic model of human behavior theorized that

Answer 24

human behavior is determined by underlying psychological forces of which the person is not consciously aware..

Question 25

The neurotransmitter theory states that unipolar depression is a result of:

Answer 25

reduced neuronal firing arttributed to decreased levels of norepinephrine and/or serotonin in the brain.

Question 26

If the patient is depressed and also has a severe neuropathy, which agent would you think about using first-line?

Answer 26

Cymbalta

Question 27

Which antidepressant medication would be helpful in addition to an SSRI if the patient is suffering from sexual side effects?

Answer 27

Welbutrin (buproprion)

Question 28

FDA Pregnancy risk Category C means

Answer 28

Weigh Risks/Benefits before using this medication

Question 29

FDA Pregnancy risk category Category B means

Answer 29

Caution Advised when using this medication

Question 30

FDA Pregnancy Category A means

Answer 30

Generally considered safe

Question 31

FDA Pregnancy risk Category X means

Answer 31

Risks Outweigh Benefits, and this medication is contraindicated in pregnancy

Question 32

The 5 stages of death according to Elisabeth Kubler-Ross proceed in which order:

Answer 32

Shock/Denial, Anger, Bargaining, Depression, Acceptance

Question 33

A 29 year old, established patient comes into the clinic with complaints of difficulty getting out of bed. She just got back from a trip to Europe a week ago and states she had a great time. She has not adjusted to getting up for work on time. She states she gets enough sleep, but feels it is not refreshing. Her past medical history includes seasonal allergies and type 1 bipolar disorder. What might be a primary concern regarding her sleep?

Answer 33

Triggering a manic episode

Question 34

It is important to check LFTs and Platelets in which mood-stabilizer medication?

Answer 34

Valproate (Depakote)

Question 35

This medication is recommended as a first-line treatment for acute depression in bipolar disorder:

Answer 35

Lamotrigine (Lamictal)

Question 36

Your first patient of the day while in a family clinic is an 18-year-old male you have never seen before. He is sitting in the exam room alone. His mental status exam reveals he is fully oriented, but his affect is inappropriate. He indicates a belief that people are trying to harm him, and he has bizarre hand gestures. He also believes that people can read his mind. This could be a presentation of what diagnostic category?

Answer 36

Schizophrenia

Question 37

A 24-year-old man with a history of schizophrenia presents with a fever, shaking chills, and rigors. He was well until a few days ago when he returned from an unplanned trip across the country by train. He was started on a new antipsychotic medication 6 weeks ago. A stat CBC reveals a white blood cell count of o.2. The most likely antipsychotic agent the patient has been taking is:

Answer 37

Clozapine
(this drug is known to cause agranulocytosis, in approximately 1 in 100 patients who take it for at least one year. Therefore, the white blood cell count should be measured (with a blood test) prior to starting treatment and regularly (weekly) while patients receive this medication, and for 4 weeks after it is stopped.)

Question 38

The first symptom of ADHD to remit with treatment is usually:

Answer 38

hyperactivity

Question 39

When Donna contemplates going to the grocery store, she is terrified. At small gatherings she may experience dizziness, loss of bladder control, or vomiting. She rarely goes out of the house, especially alone. Donna is suffering from:

Answer 39

agoraphobia.

Question 40

The most prevalent group of mental disorders is

Answer 40

anxiety

Question 41

An 8-year old boy presents to the clinic. He does not engage verbally with other people but, he is an intellegent boy who likes school. When the other kids are playing kick ball, he is reading about the Civil War. He knows more about the Battle of Gettysburg than anyone else in Yellowstone County but cannot be bothered with third grade Social Studies. Adults enjoy him but he has few peer relationships and really does not want them. The best diagnosis is:

Answer 41

Ausberger’s

Question 42

which agent is the most appropriate treatment for a patient with acute bipolar disorder?

Answer 42

lithium

Question 43

The diagnosis of Bipolar I differs from Bipolar II in that Bipolar I is characterized by:

Answer 43

Full manic episodes.

A person with bipolar I has manic episodes, while someone with bipolar II has hypomanic episodes

Question 44

Based on the knowledge of the relationship between certain neurotransmitters and unipolar depression, what prediction might you make regarding the relationship between neurotransmitters and bipolar disorders?

Answer 44

manic symptoms are related to excessive norepinephrine activity.

Question 45

A 6YO boy presents with a 7-month history of inattentiveness, hyperactivity, and fidgeting. His teacher reports that he is easily distracted and has difficulty orgainizing tasks. What is the most likely diagnosis?

Answer 45

Attention defeicit hyperactivity disorder (ADHD)

Question 46

A 25YO woman presents with her mother for being “out of control.” The mother states that over the past few weeks her daughter has not been sleeping and has been spending money recklessly and that she has been fired from four jobs over the past 6 months. On examination, you note the daughter’s pressured speech, lack of focus, and distractibility. Her past medical history is unremakable. Which of the following is the most likely diagnosis?

Answer 46

bipolar I

Question 47

This problem is characterized by a triad of painful reexperiencing, pattern of avoidance, and hyperarousal.

Answer 47

Post Traumatic Stress Disorder

Question 48

A milder pattern of mood swings that does not reach the severity of bipoar disorder but does include brief depressive and manic episodes is called:

Answer 48

Cyclothymia.

Question 49

A 41 year old male comes to your office complaining of long-standing feelings of sadness, low self esteem, and decreased energy that he has experienced most of the time for several years. He has never been hospitalized, never made a suicide attempt, and never stopped working. He has not limited his social activities. He recently got divorced. While he thinks his symptoms have contributed to his relationship difficulties, he is not particularly distresseed about the divorce. The most likely diagnosis:

Answer 49

Dysthymic disorder.

Question 50

A state od breathless euphoria, or frenzied energy, in which people have an exaggerated belief in their omnipotence describes:

Answer 50

mania

Question 51

A mother brings her 5-year-old child to the hospital after the child collapses at home. The mother states the child has been having diarrhea for the last 3 days. She has tried to get him to drink fluids. Upon further questioning, the mother states the child has had 12 loose stools a day for the last 3 days. Examination reveals the child to be responsive, but lethargic and dehydrated. The child is admitted to the hospital and mom is very involved in the child’s care. While mom is there, the child is improving slightly, but still having multiple loose stools. When the mother had to leave to go to work, the child repsonded well to treatment without any further episodes of diarrhea. What is the most likely diagnosis?

Answer 51

Münchausen by proxy

Question 52

What best differentiates panic attacks form generalized anxiety disorder (GAD)?

Answer 52

Fluctuating appearance of symptoms.

Question 53

A lasting and groundless fear of a specific object, activity, or situation is called a:

Answer 53

phobic disorder

Question 54

Jack was outside the parking garage of the World Trade Center when the explosion occurred. At the the time he had visions of the building falling on him, ever since the bombing he has had periods of anxiety and sleeplessness. Jack is most likely suffering from:

Answer 54

PTSD

Question 55

A 24YO woman presents to the clinic at the urging of her friends. She denies feeling ill and states she has never felt better and is currently “at the top of her game.” One of her friends accompanying her to the visit, tells the provider that she has been acting strangely. Over the last 2 weeks, the patient has been staying up to all hours of the night, has been bringing multiple strange men home, and has been running up incredible amounts of credit dard debt from wildl shopping sprees. Her past medical history is remarkable for depression, for which she has been treated for 4 months with paroxetine. PE reveals a mildly agitated woman who cannot seem to sit still but otherwise appears normal. Neuoropsychiatric examination is remakable only for a virtually continuous flow of accelerated speech that is impossible to interrupt. Which of the following is the most appropriate management at this time?

Answer 55

Discontinue paroxetine and start lithium immediately

Question 56

This drug class is viewed as first-line therapy for the pharmacological treatment of PTSD.

Answer 56

SSRIs

Question 57

A 36 year-old patient presents requesting something to help him sleep. He reports that he has always had a problem sleeping, admits to feeling nervous most days for the last 2 years, and that he has always been “uptight” and a “worry wart.” During the previous eight months he has frequently felt tense, shaky, sweaty, with palpitations and frequent
headaches. He reports being irritable with his 5 year-old son. Which of the following is the best treatment option for this patient?

Answer 57

Paroxetine (Paxil)

SSRI’s, specifically Paxil, are the mainstay for treatment of generalized anxiety disorder.

Question 58

You are seeing a 25YO female who states she is being told that she is poisonous and people shouldn’t touch her. She must cover all of her body with cloth including her head so she doesn’t hurt anybody. She also believes that anything made of metal can transmit her brain waves into outerspace and bring aliens to earth. On PE she is oriented x 3, but her thoughts are disorganized and she shows flight of ideas. She has a history of 2 deprissive episodes in the past, the last one was 7 months ago and lasted 3 months but has resolved. She denies any depressive or manic symptoms at this time. She denies any thought of suicidal ideation. She takes no medication. What is the most likely diagnosis of this patient?

Answer 58

Schizoaffective disorder.
The mood symptoms in schizoaffective disorder are more prominent, and last for a substantially longer time than those in schizophrenia. Schizoaffective disorder may be distinguished from a mood disorder by the fact that delusions or hallucinations must be present in persons with schizoaffective disorder for at least two weeks in the absence of prominent mood symptoms. The diagnosis of a person with schizophrenia or mood disorder may change later to that of schizoaffective disorder, or vice versa.

Question 59

An 18 year old female college student is brought to the ED by police for creating a disturbance on campus. On examinatin she has auditory hallucinations, agitation, and rapid, incoherent speech. The length of time that she has had symptoms is unclear. A CBC & CMP are normal, RPR is nonreactive, urine toxicology screen is negative. The most likely diagnosis at this time is:

Answer 59

Schizophreniform disorder.

Symptoms must be present for longer than 6 months to be schizophrenia, less than 6 months = Schizophreniform

Question 60

Dysgraphia is

Answer 60

Difficulty expressing thoughts in writing

Question 61

Dyslexia is

Answer 61

Impairment in the brain’s ability to translate written images received from the eyes into meaningful language.

Question 62

Dyscalculia is Difficulty performing math calculations.

Answer 62

Difficulty performing math calculations.

Question 63

ADHD symptoms include

Answer 63

Fails to follow instructions, difficulty with organizing tasks and activities, easily distracted, forgetful, interrupting and intruding on others, excessive running or climbing, difficulty remaining still

Question 64

Conduct Disorder symptoms include

Answer 64

animal cruelty, vandalism, fighting, defying authority

Question 65

Autism symptoms include

Answer 65

Failure to anticipate interaction with others, poor social interaction, language development delay, repetitive motor behaviors

Question 66

Oppositional Defiant Disorder symptoms include

Answer 66

Deliberately annoys people, argues with adults, angry and resentful, spiteful and vindictive

Question 67

You are seeing a 58YO male who has schizophrenia and has been on reperidone (Resperdol) for the last 12 years. Today you notice that he is puckering his lips contuously and moving his jaw from side to side. This type of movement is referred to as __________________

Answer 67

Tardive dykinesia

Question 68

Which anti-depressant medication should not be given to bulimic patients secondary to decreased seizure threshold?

Answer 68

Welbutrin (bupropion)

Question 69

onset of delirium

Answer 69

hours to days