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L3 (1ST BMEX) > PSYCHIA 1 > Flashcards

PSYCHIA 1 Flashcards

1
Q

A 42-year-old man comes to the emergency room with the chief complaint that “the men are following me”. He also complains of hearing a voice telling him to hurt others. He tells the examiner that the news anchorman gives him messages about the state of the world every night through the TV. Which of the following psychiatric findings best describes the last belief of the patient?

A. Grandiose delusion
B. Loose association
C. Idea of reference
D. Clouding of consciousness

A

C. Idea of reference

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2
Q

This is not a negative symptom of schizophrenia

A. Affective flattening
B. Derailment
C. Alogia
D. Avolition
E. None of the above

A

B. Derailment

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3
Q

According to the DSM V criteria C (duration) for schizophrenia, continuous signs of the disturbance should persist for at least

A. 2 weeks
B. 1 month
C. 6 months
D. 1 year
E. 2 years

A

C. 6 months

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4
Q

Pharmacotherapy for schizophrenia includes the following drug classes

A. Selective serotonin reuptake inhibitor (SSRI)
B. Serotonin-dopamine antagonist (SDA)
C. Dopamine receptor antagonist (DRA)
D. SDAs, SSRIs
E. DRAs, SDAs

A

E. DRAs, SDAs

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5
Q

All of the following are subtypes of delusional disorder, except

A. Persecutory
B. Jealous
C. Manic
D. Somatic

A

C. Manic

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6
Q

The Mental Status Examination of the patients with schizophrenia most commonly demonstrates a marked disorder of

A. orientation
B. memory
C. mood
D. thinking

A

D. thinking

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7
Q

Which of the following statements regarding delusions is true?

A. Delusions are almost exclusively found in schizophrenia
B. Delusions are rarely encountered except in mania
C. Delusions involve disturbance of cognition
D. Delusions involve disturbance in perception
E. Delusions are a type of hallucination

A

A. Delusions are almost exclusively found in schizophrenia

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8
Q

A 16-year-old boy has 2-year history of gradual onset of social withdrawal and decreased emotional responsiveness. Recently, he believes that his neighbors are watching his every move. He hears them talking about him all the time, even in the middle of the night. He has lost weight and has started to neglect personal hygiene. He has no history of substance abuse or general medical condition. Which of the following is the most likely diagnosis?

A. Schizophrenia
B. Schizophreniform disorder
C. Schizoaffective disorder
D. Delusional disorder

A

A. Schizophrenia

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9
Q

A 42-year-old Med Rep is arrested for breaking into the home of a popular television actress. He insists that he had been involved in a romantic relationship with the actress and that she has been betrayed him for being romantically involved with her main costar. The actress, who called the police, has never met the intruder. If this patient has a delusional disorder, which of the following subtypes is most likely present?

A. Grandiose type
B. Jealous type
C. Erotomanic type
D. Hypochondriacal type
E. Somatic type

A

C. Erotomanic type

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10
Q

Which is not a major brain area implicated in schizophrenia?

A. Basal ganglia
B. Limbic structures
C. Frontal structures
D. Pons

A

D. Pons

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11
Q

Hypomanic is a feature of

A. Bipolar I disorder
B. Bipolar II disorder
C. Cyclothymia
D. Schizophrenia & bipolar II disorder
E. Cyclothymia & bipolar II disorder

A

E. Cyclothymia & bipolar II disorder

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12
Q

Which of the following is NOT considered to be a psychotic disorder (in DSM 5)?

A. Schizotypal personality disorder
B. Bipolar I mood disorder with psychotic features
C. Delusional disorder
D. Schizophrenia

A

B. Bipolar I mood disorder with psychotic features

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13
Q

The diagnosis of schizoaffective disorder includes all of the following, EXCEPT

A. The condition includes all the characteristic symptoms of schizophrenia
B. The condition includes major depressive symptoms or a manic episode
C. The condition includes delusions or hallucinations in the absence of prominent mood symptoms
D. The condition can occur in response to the effects of a substance

A

D. The condition can occur in response to the effects of a substance

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14
Q

Cognitive triad of Arron Beck, except

A. Negative self-review (things are bad because I am bad”
B. Negative interpretation of experience (everything has always been bad)
C. Negative symptoms (anhedonia, abolition, alogia)
D. Negative view of the future (anticipation failure)

A

C. Negative symptoms (anhedonia, abolition, alogia)

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15
Q

The following are included in the 9 symptoms regarding acute major depressive episode according to DSM V, except

A. Excessive or inappropriate guilt
B. Significant weight loss or gain
C. Insomnia or hypersomnia
D. Hallucinations and delusions

A

D. Hallucinations and delusions

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16
Q

Of the 9 symptoms of major depressive episode, only 5 are listed in criteria A. At least one of this is

A. weight loss or insomnia
B. suicidal ideation or recurrent thoughts of death
C. feelings of worthlessness
D. psychomotor retardation
E. depressed mood or loss of interest or pleasure

A

A. weight loss or insomnia

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17
Q

The duration of these symptoms in #16 must be present for at least

A. 2 months
B. 1 month
C. 2 weeks
D. 1 week

A

C. 2 weeks

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18
Q

True about mood

A. It is a sustained emotional tone perceived along a continuum of sad to happy
B. People have a wide range of mood and have an equally large repertoire of affected feelings
C. May be normal, elevated or depressed
D. None of the above
E. All of the above

A

E. All of the above

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19
Q

Patient had at least 1 major depressive episode and 1 hypomanic episode but no manic episode

A. Bipolar I disorder
B. Bipolar II disorder
C. Cyclothymic disorder
D. Dysthymic disorder
E. None of the above

A

B. Bipolar II disorder

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20
Q

This statement is true about manic episodes

A. Distinct period of persistently elevated mood lasting 1 week
B. Not cause marked impairment of occupational functioning
C. Increased need of sleep due to hyperfunctioning
D. None of the above

A

A. Distinct period of persistently elevated mood lasting 1 week

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21
Q

A response to a known, external, non-conflictual threat

A. Fear
B. Anxiety
C. Phobia
D. Fear and anxiety

A

A. Fear

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22
Q

Prompts a person to take necessary steps to lessen the consequence of a threat

A. Fear
B. Anxiety
C. Phobia
D. Fear and anxiety

A

B. Anxiety

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23
Q

This refers to an acute, intense anxiety accompanied by feelings of doom and usually but not always associated with fear of open spaces

A. Ailurophobia
B. Panic attack
C. Panic disorder
D. Agoraphobia

A

C. Panic disorder

24
Q

This refers to a group of pharmacological agents effective for the treatment of all types of anxiety disorder which exerts its effects to the gamma aminobutyric acid receptors

A. SSRIs
B. Benzodiazepines
C. Antidepressants
D. Beta-blockers

A

B. Benzodiazepines

25
Q

The following are considered in the etiology of anxiety disorders, EXCEPT

A. Norepinephrine, serotonin, GABA
B. Increased sympathetic tone of the autonomic nervous system
C. Anxiety is a conditioned response to a specific environmental stimulus
D. Gas leak from the stomach to the brain

A

D. Gas leak from the stomach to the brain

26
Q

The drug of choice for generalized anxiety disorder is

A. SSRI
B. Valproate
C. Benzodiazepine
D. Carbamazepine

A

C. Benzodiazepine

27
Q

Which of the following is an SSRI?

A. Paroxetine
B. Clonazepam
C. Diazepam
D. None of the above

A

A. Paroxetine

28
Q

A 25-year-old woman describes a lifelong history of being scared of heights. She becomes uncomfortable when in higher than three stories and whenever traveling or shopping becomes preoccupied with knowing the heights of buildings on finding herself at a significant elevation, she has severe anxiety symptoms such as trembling, lightheadedness, and tingling and a fear of dying. Which of the following is the most likely diagnosis?

A. Specific phobia
B. Agoraphobia
C. Generalized anxiety disorder
D. Social anxiety disorder

A

A. Specific phobia

29
Q

The best treatment for phobia

A. Benzodiazepines
B. SSRI
C. Insight-directed psychotherapy
D. Systemic desensitization

A

D. Systemic desensitization

30
Q

A 28-year-old woman comes to her internist with a chief complaint of muscle tension. She states that she has experienced a considerable amount of muscle tension during her entire life, but it has become increasingly worse over the past 7 months. She describes herself as a worrier, and since her first child was born last year, her worrying has increased. She was unable to stop worrying even when she actively tries to do so. She worries about a whole host of issues – the status of the Philippines relations with other countries, her husband’s health, and the stock market. The patient also reports symptoms of restlessness and insomnia. What is the most likely diagnosis?

A. Generalized anxiety disorder
B. Agoraphobia
C. Panic disorder
D. Specific phobia

A

A. Generalized anxiety disorder

31
Q

What should be the duration of symptoms to diagnose PTSD?

A. At least 4 days
B. Two weeks
C. At least 1 month
D. Three days to one month

A

C. At least 1 month

32
Q

How long should symptoms last before Acute Stress Disorder is diagnosed?

A. Two weeks
B. At least 4 days
C. At least 1 month
D. Three days to one month

A

D. Three days to one month

33
Q

Which of the following accurately describes depersonalization?

A. Persistent or recurrent experiences of unreality of surroundings
B. Persistent or recurrent experiences of feeling detached from and as if one were an outside observer of one’s mental processes or body
C. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events
D. Marked alterations in arousal and reactivity associated with the traumatic events

A

B. Persistent or recurrent experiences of feeling detached from and as if one were an outside observer of one’s mental processes or body

34
Q

Which of the following correctly describes derealization?

A. Persistent or recurrent experiences of unreality of surrounding
B. Persistent or recurrent experience of feeling detached from, and if on were an outside observer of, one’s mental processes or body
C. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s)
D. Part of the PTSD diagnostic criteria for children <6 years old
E. Marked alterations in arousal and reactivity with the traumatic event(s)

A

A. Persistent or recurrent experiences of unreality of surrounding

35
Q

Which of the following is NOT part of the main criteria for PTSD?

A. Persistent avoidance of the stimulus that relates to the trauma
B. Persistent or recurrent experiences of feeling detached from, feeling a sense of unreality of self or body or moving time slowly
C. Intense or prolonged psychosocial distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s)
D. Marked alterations in arousal and reactivity with the traumatic event(s)

A

D. Marked alterations in arousal and reactivity with the traumatic event(s)

36
Q

Which of the following describes the intrusion symptoms of PTSD?

A. Directly experiencing a traumatic event
B. Problems with concentration
C. Marked reactions to internal or external cues that symbolize or resemble an aspect of traumatic events
D. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about, or closely associated with the traumatic event

A

C. Marked reactions to internal or external cues that symbolize or resemble an aspect of traumatic events

37
Q

Which of the following specifiers for adjustment disorders are described to be associated with low mood, tearfulness, and feelings of hopelessness?

A. With anxiety
B. With depressed mood
C. With mixed anxiety and depressed mood
D. With disturbance of conduct

A

B. With depressed mood

38
Q

This disorder may accompany other medical conditions and may be the major psychological response to a medical disorder

A. Acute stress disorder
B. Post-traumatic stress disorder
C. Major depressive disorder
D. Adjustment disorder

A

D. Adjustment disorder

39
Q

Which of the following is part of the first-line pharmacotherapy of trauma-related disorders?

A. Valproic acid
B. Alprazolam
C. Haloperidol
D. Sertraline

A

D. Sertraline

40
Q

What best describes a patient with PTSD indication for hospitalization?

A. Patient with recurrent nightmares and difficulty at school
B. Patient with persecutory auditory hallucination and depressed mood
C. Patient with command auditory hallucination with thoughts of self-harm
D. Patient with recurrent episodes of palpitation

A

C. Patient with command auditory hallucination with thoughts of self-harm

41
Q

A 54-year-old man presents to the clinic stating, “he can no longer feel his legs”. He has no other accompanying symptoms and the physical examination results are normal, including motor strength bilaterally. However, after receiving an injection of sodium amytal, his symptoms markedly improved. What is his diagnosis?

A. Factitious disorder
B. Conversion disorder
C. Malingering
D. Histrionic personality disorder

A

A. Factitious disorder

42
Q

Which of the following conditions combines symptoms of pain and psychiatric signs and symptoms?

A. Fibromyalgia
B. Migraine
C. Irritable bowel syndrome
D. All of the above

A

D. All of the above

43
Q

Which of the following is not true about conversion disorders?

A. The onset is acute but symptom or deficit are short in duration
B. It usually follows a chronic cause
C. It usually is associated with antisocial personality disorder
D. Do not respond well to a confrontation of the “false” nature of the symptoms

A

B. It usually follows a chronic cause

44
Q

Chronic pain is associated with

A. substance use disorder
B. anxiety disorder
C. dementia
D. depressed mood

A

D. depressed mood

45
Q

A 65-year-old woman lives alone in a dilapidated house, although her family members have tried in vain to move her to a better dwelling. She wears odd and out-of-fashion clothes and rummages in the garbage cans of her neighbors to looks for redeemable cans and bottles. She is very suspicious of her neighbors. She is convinced that her neighbors are plotting against her life for a brief time after she was mugged and thrown onto the pavement by a teenager, but now thinks that this is not the case. She believes in “power of crystals to protect me” and has them strewn haphazardly throughout her house. Which of the following is the most likely diagnosis?

A. Schizophrenia, paranoid type
B. Schizotypal personality disorder
C. Avoidant personality disorder
D. Schizoid personality disorder

A

B. Schizotypal personality disorder

46
Q

A 32-year-old man is diagnosed with major depressive disorder. He and his psychiatrist discuss starting an antidepressant. The patient is concerned about the chance for impairment of his ability to get an erection on these kinds of medications. Which of the following medications should the patient be started on to treat his depression but avoid these symptoms?

A. Imipramine
B. Phenelzine
C. Fluoxetine
D. Desipramine

A

C. Fluoxetine

47
Q

A 28-year-old patient begins seeing a psychiatrist because, she says, “I’m just so very lonely.” Her speech is excessively impressionistic and lacks specific details. She first constantly with the physician and is “hurt” when the therapist doesn’t notice her new clothes or hairstyle. Which personality disorder represents the most likely diagnosis?

A. Histrionic
B. Antisocial
C. Obsessive-compulsive
D. Dependent

A

A. Histrionic

48
Q

A 42-year-old man comes to the psychiatrist at the insistence of his boss because he constantly misses important deadlines. The man states that everyone at work is lazy and that no one lives up to his own standards for perfection. He is angry when the psychiatrist starts the interview 3 minutes later than the appointed time. He notes that he is always fighting with his wife because he is a pack rat and is unable to throw anything out. During the interview, he appears rigid and stubborn. What personality disorder represents the most likely diagnosis?

A. Obsessive-compulsive
B. Antisocial
C. Paranoid
D. Narcissistic

A

A. Obsessive-compulsive

49
Q

A 34-year-old woman comes to psychiatrist on the advice of her mother, because the patient still lives at home and will not make any decisions without her mother’s reassurance. The patient’s mother accompanies the patient to the appointment. She states that the patient becomes anxious when her mother was leaving the home because the patient is terrified that her mother will die and the patient will have to take care of herself, something she feels incapable of doing. Which personality disorder represents the most likely diagnosis?

A. Obsessive-compulsive
B. Dependent
C. Paranoid
D. Antisocial

A

B. Dependent

50
Q

A 25-year-old high school dropout has been arrested more than 12 times for various assault, fraud, and attempted murder charges. He has been in many physical fights, usually after he got caught cheating at playing cards. On examination, he seems relaxed and even cocky, and he shows no remorse for his actions. Which personality disorder represents the most likely diagnosis?

A. Antisocial
B. Obsessive compulsive
C. Dependent
D. Paranoid

A

A. Antisocial

51
Q

The positive symptom/s of schizophrenia, include the following EXCEPT:

A. Hallucinations and delusions
B. Disorganized speech
C. Generalized disorganized behavior
D. Associality

A

D. Associality

52
Q

Which of the following are major associated physical symptoms of stimulant intoxication?

A. Tachycardia, hypotension, mydriasis
B. Tachycardia, hypertension, mydriasis
C. Tachypnea, hypertension, miosis
D. Tachypnea, hypotension, miosis

A

B. Tachycardia, hypertension, mydriasis

53
Q

Which among the following are important symptoms to be noted during your assessment of a patient with possible alcohol withdrawal?

A. Auditory disturbances, disorientation and change in sensorium, paroxysmal sweats
B. Agitation, chest pain and difficulty breathing, headache
C. Visual disturbances, anxiety, depressive mood
D. Tactile disturbances, symptoms of mania, tremors

A

A. Auditory disturbances, disorientation and change in sensorium, paroxysmal sweats

54
Q

You are at the emergency room presents with onset of nausea and abdominal pain, restlessness, anxiety, and agitation, noted after staying up the entire night studying for her finals. Upon further interview, she reveals she drank three bottles of energy drinks throughout the night, as well as four espresso shots that morning. Which among the following is the most likely diagnosis for your patient?

A. Caffeine withdrawal
B. Caffeine use disorder
C. Caffeine induced anxiety disorder
D. Caffeine intoxication

A

D. Caffeine intoxication

55
Q

Which of the following are the clinical features of recent episodes of cannabis use?

A. Respiratory depression, auditory hallucinations
B. Psychomotor agitation, changes in sensorium
C. Increase appetite, pupil constriction
D. Increase appetite, tachycardia, dilation of conjunctival blood vessels

A

D. Increase appetite, tachycardia, dilation of conjunctival blood vessels

L3 (1ST BMEX) (18 decks)

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