Psychiatry Flashcards
1
Q
All of the following are cardiovascular effects of tricyclics antidepressants in patients with heart disease EXCEPT
A. tachycardia B. bradycardia C. arrhythmias D. hypotension E. heart block
A
B
Sadock, et al
2011
pp 244-5
2
Q
Psychoneurosis includes all of the following disorder EXCEPT
A. anxiety disorder B. obsessive-compulsive disorder (OCD) C. sexual dysfunction D. dysthymia E. delusional disorder
A
E
Sadock, et al
2011
p 68
3
Q
Stereotypy is
A. ingrained, habitual involuntary movement
B. repetitive fixed pattern of physical action or speech
C. pathological imitation of movements of one person by another
D. subjective feeling of muscular tension and restlessness secondary to antipsychotic or other medication
E. temporary loss of muscle tone and weakness precipitated by a variety of emotional states
A
B
Sadock, et al
2011
p 68
4
Q
Alexithymia is
A. an unpleasant mood
B. a state in which a person is easily annoyed and provoked into anger
C. a loss of interest in and withdrawal from pleasurable activities
D. an inability to describe or to be aware of emotions or mood
E. a normal range of mood, implying absence of depressed or elevated emotional state
A
D
Sadock, et al
2011
p 68
5
Q
A psychiatric patient who, although coherent, never gets to the point has a disturbance in form of thought called
A. blocking B. tangentiality C. verbigeration D. circumstantiality E. word salad
A
B
Sadock, et al
2011
p 68
6
Q
Which of the following is a paramnesia?
A. Eidetic images B. Jamais vu C. Lethologica D. Repression E. Screen memories
A
B
Sadock, et al
2011
p 69
7
Q
The “Alice in Wonderland” effect is another name for
A. dysmegalopsia B. dysphasia C. trailing phenomenon D. dysmetria E. fausse reconnaissance
A
A
Sadock, et al
2011
p 69
8
Q
Antidepressant should be used cautiously in cardiac patients because of increased risk of which of the following?
A. conduction side effects B. hypertension C. noncompliance D. suicide E. all of the above
A
A
Sadock, et al
2011
p 245
9
Q
Compared with primary process thinking, secondary process thinking is
A. illogical B. related to the id C. influenced by the environment D. immediate gratification seeking E. magical
A
C
Sadock, et al
2011
p 69
10
Q
A 41-year-old man presents to his psychiatrist upon his wife’s request. Four weeks earlier, the patient was hospitalized for a mild injury to his head after crashing his car into a tree. He has a 3-year history of alcoholism. The patient recounts that while shopping in his local grocery store 2 weeks ago, he had the realization that the store clerk is simply an imposter replacing his wife. The patients wife insists that her husband is completely delusional and is on the verge of divorcing him if he continues to neglect her as his actual, lawful wife of 15years. Which of the following types of delusions is the patient expressing?
A. Capgras syndrome B. Clerambault syndrome C. Delusional jealousy D. Delusion of doubles E. Fregoli phenomenon
A
A
Sadock, et al
2011
p 70
11
Q
Alzheimer’s dementia is
A. associated with hypoactive levels of acetylcholine
B. associated with pathognomonic neurofibrillary tangles
C. more common in men
D. linked to chromosome 7
E. a clinical diagnosis
A
A
Sadock, et al
2011
p 87
12
Q
Creutzfeldt-Jakob disease is characterized by
A. rapid deterioration B. myoclonus C. diffuse, symmetric, rhythmic slow waves and sharp spikes in EEG D. postmortem definitive diagnosis E. all of the above
A
E
Sadock, et al
2011
pp 87-8
13
Q
The core features of dementia with Lewy bodies include
A. disturbance of consciousness
B. recurrent detailed visual hallucinations
C. cognitive decline caused by cerebrovascular disease
D. progressive language dysfunction
E. gradual changes in personality
A
B
Sadock, et al
2011
p 88
14
Q
Which of the following is a TRUE statement about Parkinson’s disease?
A. It is a result of a degeneration of the substantia nigra, global pallidus, putamen, and caudate
B. It cannot be distinguished from parkinsonian syndromes that arise from a variety of causes.
C. Dementia is more common in early-onset disease.
D. It is a prototype of a cortical degenerative disease.
E. The only cells affected are those containing dopamine.
A
A
Sadock, et al
2011
p 89
15
Q
Huntington’s disease
A. is linked to the long arm of chromosome 4
B. is associated with “boxcar” ventricles on brain scanning
C. is not usually associated with emotional symptoms
D. shows striatal hypermetabolism on positron emission tomography (PET)
E. affects men only
A
B.
Sadock, et al
2011
p 90
16
Q
The criteria for mild cognitive impairment includes all of the following EXCEPT
A. memory complaints B. objective memory impairment C. preserved general cognitive function D. intact daily living activities E. dementia
A
E
Sadock, et al
2011
p 90
17
Q
True statements about Alzheimer’s disease include all of the following EXCEPT
A. The age at onset is earlier in patient with a family history of the disease.
B. Brain imaging studies are used to exclude other identifiable causes.
C. The early-onset type may have a more rapidly progressive course.
D. There is clear phenomenological separation between early-onset and late-onset cases.
E. No features of the physical examination or laboratory evaluation are pathognomonic.
A
D.
Sadock, et al
2011
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18
Q
Factors that predispose to delirium include all of the following EXCEPT
A. vision impairment B. use of bladder catheterization C. smoking history D. age older than 60 years E. abnormal glucose level
A
D
Sadock, et al
2011
p 90
19
Q
The most common cause of delirium within 3 days post-operatively in a 40-year-old man with a history of alcohol dependence is
A. delirium tremens B. infection C. pain medication D. postoperative pain E. stress of the surgery
A
A.
Sadock, et al
2011
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20
Q
Which of the following drugs is best used to treat acute delirium
A. amobarbital B. chlorpromazine C. diazepam D. haloperidol E. physostigmine salicylate
A
D
Sadock, et al
2011
p 91
21
Q
In delirium
A. epinephrine is hypothesized to be the major neurotransmitter involved
B. the major pathway implicated is the dorsal tegmental pathway
C. the electroencephalogram (EEG) usually shows diffuse background quickening.
D. there is hyperactivity in the nucleus accumbens.
E. the level of consciousness is preserved
A
B
Sadock, et al
2011
p 91
22
Q
Mr. E is 68 years old and married with two children. His wife reports changes in his memory and behavior over the past 9 years. She reports that he frequently forgets his keys, he goes into the house to get something and then forgets what he wants, and he has changed from an outgoing pleasant person to one who avoids conversation. She says that he seems hostile at times for no apparent reason. Mr. E is in good general health, taking no medications, and his alcohol consumption is limited to two to three beers a day. What may you observe on examination of Mr. E?
A. a grasp reflex B. paranoid delusions C. pathological crying D. poor hygiene E. all of the above
A
E.
Sadock, et al
2011
p 91
23
Q
Of the following cognitive functions, the one most likely to be difficult to evaluate and interpret on formal testing is
A. abstraction B. calculations C. memory D. reading and writing E. visuospatial and constructional ability
A
A.
Sadock, et al
2011
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24
Q
Amnestic disorders
A. are secondary syndromes caused by primary etiologies
B. are most often caused by nutritional deficiencies related to chronic alcohol dependence
C. may be diagnosed in the context of delirium
D. may be diagnosed in the context of dementia
A
A
Sadock, et al
2011
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25
Bovine spongiform encephalopathy is associated with all of the following EXCEPT
```
A. amyloid plaques
B. astrocyte proliferation in the cerebral cortex
C. "bulls eye" rash on the thigh
D. neuronal loss
E. spongiform vacuolization
```
C
Sadock, et al
2011
p 94
26
A 77-year-old widower presents for a routine health check-up accompanied by his daughters. His medical history is significant for diabetes, hypertension, and peripheral vascular disease. Eight months ago, he had a stroke and still experiences left leg weakness. His daughter reports that her father sometimes does not remember to call her back and forgets to take his diabetes medications at least once a week. Once in a while, the patient is noted to "word hunt" during conversations. The patient insists he is "fine" and that he drives places without getting lost, does his own grocery shopping, and is never in a bad mood. The patient visits his best friend once a month. He admits that occasionally he has difficulty falling asleep. Which of the following is the most likely diagnosis?
```
A. depression
B. Alzheimer's dementia
C. Frontotemporal dementia
D. vascular dementia
E. normal aging changes
```
E
Sadock, et al
2011
94
27
Which of the following statements regarding cancer and alcohol use is CORRECT?
A. Cancer may be caused by the immunosuppressive effect of ethanol.
B. Cancer is the second leading cause of premature death in alcoholics
C. Increases in breast cancer have been noted with just two drinks per day.
D. Alcohol can be directly linked to cancers of mucous membranes.
E. All of the above
E
Sadock, et al
2011
p 109
28
Which of the following statements regarding alcohol's effect on sleep is FALSE?
A. Heavy drinkers often awaken at night and have difficulty going back to sleep.
B. Alcoholics tend to have more dreams later in the night.
C. Alcohol increase rapid eye movement (REM)
D. Alcohol can significantly impair normal sleep patterns.
E. Alcohol use tends to inhibit stage 4 sleep.
C
Sadock, et al
2011
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29
Acute PCP intoxication is NOT treated with
```
A. diazepam
B. cranberry juice
C. phentolamine
D. phenothiazines
E. all of the above
```
D
Sadock, et al
2011
p 109
30
In distinguishing schizophrenia from amphetamine-induced toxic psychosis, the presence of which of the following is most helpful?
```
A. tactile or visual hallucinations
B. paranoid delusions
C. intact orientation
D. clear consciousness
E. auditory hallucinations
```
A
Sadock, et al
2011
p 109
31
Which of the following is NOT a therapeutic indication for use of anabolic-androgenic steroids?
```
A. anemia
B. hereditary angioedema
C. hyperthyroidism
D. male hypogonadism
E. osteoporosis
```
C
Sadock, et al
2011
p 110
32
Ms. E is a 32-year-old single white woman employed full time at a local factory. She is a smoker and occasionally has flares of her asthma. She typically drinks four to five mugs of coffee each day and prefers to drink it without cream, milk, or sugar. Physicians had recommended she cut down or stop her coffee use because of complaints of mild indigestion, and she abruptly stopped her caffeine intake as a result of these recommendation. Which of the following statements regarding caffeine is TRUE?
A. Caffeine is slowly absorbed and metabolized by the kidneys.
B. Caffeine's effects on the body include bronchoconstriction
C. Caffeine metabolism is markedly increase at the end of pregnancy
D. Caffeine increases the metabolism of the antipsychotic clozapine.
E. The rate of caffeine elimination is increase by smoking.
E
Sadock, et al
2011
p 110
33
Which of the following is contraindicated for the treatment of acute disulfiram overdose?
```
A. activated charcoal
B. decontamination
C. gastric lavage
D. hemodialysis
E. syrup of ipecac
```
E
Sadock, et al
2011
p 110
34
Minor signs and symptoms of the benzodiazepine discontinuation syndrome commonly include
```
A. hyperpyrexia
B. grand mal seizures
C. psychosis
D. nightmares
E. death
```
D
Sadock, et al
2011
p 111
35
Which of the following is NOT a therapeutic effect for which cannabinoids are commonly used?
```
A. weight loss
B. reduced muscle spasticity
C. relief of nausea and vomiting
D. decreased intraocular pressure
E. appetite stimulant
```
A
Sadock, et al
2011
p 111
36
Amphetamine and cocaine are similar in
A. their metabolic pathways
B. the induction of paranoia and production of major cardiovascular toxicities
C. their mechanisms of action at the cellular level
D. their duration of action
E. all of the above
B
Sadock, et al
2011
p 111
37
Inhalant use most often correlates with which of the following comorbid conditions?
```
A. borderline personality disorder
B. conduct disorder
C. major depression
D. manic episode
E. schizophrenia
```
B
Sadock, et al
2011
pp 111-2
38
Which of the following drugs is an opioid antagonist?
```
A. naloxone
B. naltrexone
C. nalorphine
D. apomorphine
E. all of the above
```
E.
Sadock, et al
2011
p 112
39
You are called for a consult on a 42-year-old woman with alcohol dependence who is complaining of persisting severe depression symptoms despite 5 days of abstinence. In the initial stage of the interview, she noted that she had "always been depressed" and believed tat she "drank to cope with the depression." Her current complaint includes a prominent sadness that has persisted for several weeks, difficulties concentrating, initial and terminal insomnia, and feelings of hopelessness and guilt. What is the most appropriate next step to distinguish between alcohol-induced depression and an independent major depressive episode?
```
A. chronological history
B. trial of electroconvulsive therapy (ECT)
C. proton emission tomography (PET) scan
D. antidepressant treatment
E. intensive psychotherapy
```
A
Sadock, et al
2011
p 112
40
Cocaine
A. competitively blocks dopamine reuptake by the dopamine transporter
B. does not lead to physiological dependence
C. does not induce psychotic disorders
D. has been used by 40 percent of the United States population since 1991
E. is no longer used as a local anesthetic
A
Sadock, et al
2011
p 112
41
Which of the following is NOT a component of acute nicotine intoxication?
```
A. tachycardia
B. visual hallucinations
C. bizarre dreams
D. lability of mood
E. cardiac arrhythmias
```
B
Sadock, et al
2011
p 112
42
Mouth ulceration is associated with which of the following types of withdrawal?
```
A. alcohol
B. benzodiazepines
C. cocaine
D. nicotine
E. opioids
```
D
Sadock, et al
2011
p 113
43
A 35-year-old male dentist with no history of other substance problems complains of problems with nitrous oxide abuse for 10 years. This had begun as experimentation with what he had considered a harmless substance. However, his rate of use increased over several years, eventually becoming almost daily for months at a time. He felt a craving before sessions of use. Then, using the substance while alone in his office, he immediately felt numbness, a change in his temperature and heart rate, and an alleviation of depressed feelings. "Things would go through my mind. Time was erased," he said. He sometimes fell asleep. Session might last a few minutes or up to 8 hours; they ended when the craving and euphoria ended. He had often tried to stop or cut down, sometimes consulting a professional about the problem. Which category best fits the condition of the above patient?
```
A. hallucinogen-related disorder not otherwise specified
B. opioid-related disorder NOS
C. inhalant-related disorder NOS
D. phencyclidine-related disorder NOS
E. anabolic steroid-related disorder NOS
```
C
Sadock, et al
2011
p 113
44
A 31-year-old woman is hospitalized after sustaining multiple rib fractures from a motor vehicle accident. Forty-eight hours later, she complains to the hospital's patient relations department that the nurses are constantly hiding in the bathroom of her hospital room and making fun of her. After extensively speaking with the nurses, the hospital administration finds no evidence that any such behavior has occurred. Her vital signs are stable. The patient has no psychiatric history, denies smoking or recreational drugs, and has four standard drinks daily. On the sixth day of hospitalization, the patient is no longer agitated and does not have the same complaints. What is the most likely diagnosis?
```
A. paranoid personality disorder
B. brief psychotic disorder
C. adjustment disorder
D. alcoholic hallucinosis
E. posttraumatic stress disorder
```
D
Sadock, et al
2011
pp 113-4
45
Which of the following statements about the dopamine hypothesis is TRUE?
A. Dysregulation of dopaminergic neurotransmission is caused by postsynaptic sensitivity.
B. Dopamine release caused by amphetamine challenge is higher during remission.
C. Higher amphetamine-provoked dopamine release predicts worsening psychotic symptoms.
D. Overactivity of dopamine in the subcortical basal ganglia contributes to negative symptoms.
E. There is lower occupancy of D2/3 receptors in relapsed patients
C
Sadock, et al
2011
p 122
46
All of the following lead to an increased risk of schizophrenia EXCEPT
A. having a deviant course of personality maturation and development
B. having previously attempted suicide
C. having a schizophrenic family member
D. having a history of temporal lope epilepsy
E. having low levels of monoamine oxidase, type B, in blood platelets
B
Sadock, et al
2011
p 123
47
True statements about violence and schizophrenia include all of the following EXCEPT?
A. Violence in a hospital setting can result from undiagnosed neuroleptic-induced acute akathisia.
B. Patients with schizophrenia are more violent as a group than the general population.
C. It is more difficult to prevent most schizophrenic homicides compared with the general population.
D. Patients with disorganized schizophrenia are at much greater risk to commit violence than those with paranoid schizophrenia.
E. Command hallucinations do not appear to play a particularly important role in violence.
D
Sadock, et al
2011
p 123
48
In general, pooled studies show concordance rates for schizophrenia in monozygotic twins of
```
A. 0.1 percent
B. 5 percent
C. 25 percent
D. 40 percent
E. 50 percent
```
E
Sadock, et al
2011
p 124
49
A schizophrenic patient who states that he feels his brain burning is most likely experiencing a
```
A. cenesthetic hallucination
B. delusional feeling
C. gustatory hallucination
D. haptic hallucination
E. hypnopompic hallucination
```
A
Sadock, et al
2011
p 124
50
Late-onset schizophrenia
A. is more common in men
B. is associated with a preponderance of paranoid symptoms
C. is clinically distinguishable from early-onset schizophrenia
D. results in poorer response to antipsychotic medications
E. has an onset after age 60 years
B
Sadock, et al
2011
p 124
51
Which of the following is NOT typically associated with catatonia?
```
A. mannerisms
B. mutism
C. stereotypies
D. verbigeration
E. waxy flexibility
```
D
Sadock, et al
2011
p 124
52
Persons in the United States who develop schizophrenia are more likely to
A. have been born abroad
B. have been born in the months from January to April
C. have been born in the months from July to September
D. have been exposed to parainfluenza virus
E. all of the above
B
Sadock, et al
2011
p 125
53
Which of the following statements comparing the serotonin-dopamine antagonists (SDAs) with dopamine receptor antagonists (DRAs) is TRUE?
A. The DRAs remain the first choice of treatment for schizophrenia.
B. The SDAs affect both serotonin and glutamate receptors.
C. The SDAs produce more extrapyramidal symptoms than the DRAs.
D. The SDAs produce more neurological adverse effects than the DRAs.
E. The SDAs are less effective than the DRAs for positive symptoms of schizophrenia.
B
Sadock, et al
2011
p 125
54
Clozapine (Clozaril)
A. has been associated with few, if any, extrapyramidal side effects
B. is believed to exert its therapeutic effect mainly by blocking dopamine receptors
C. causes significant increases in prolactin levels
D. is associated with a 10 to 20 percent incidence of agranulocytosis
E. requires monthly monitoring of blood chemistry
A
Sadock, et al
2011
p 125
55
Investigations into the cause of schizophrenia have revealed that
A. a specific family pattern play a causative role in the development of schizophrenia.
B. the efficacy and potency of most antipsychotics correlate with their ability to act primarily as antagonists of the dopamine type 1 (D1) receptor.
C. a particular defective chromosomal site has been found in all schizophrenic patients.
D. no significant abnormalities appear in the evoked potentials in schizophrenic patients.
E. a monozygotic twin reared by adoptive parents has schizophrenia at the same rate as his or her twin raised by biological parents.
E
Sadock, et al
2011
p 125
56
Features weighing toward a good prognosis in schizophrenia include all of the following EXCEPT
```
A. depression
B. a family history of mood disorders
C. paranoid features
D. undifferentiated or disorganized features
E. an undulating course
```
D
Sadock, et al
2011
p 126
57
MRI studies of patient with schizophrenia have found evidence for
```
A. increased cortical gray matter
B. increased temporal cortex gray matter
C. increased volume of the amygdala
D. increased volume of basal ganglia nuclei
E. increased volume of the hippocampus
```
D
Sadock, et al
2011
p 126
58
A married man, age 38 years, with a history of dependable, conscientious work as a bookkeeper, became sleepless, anxious, and unable to concentrate three months prior. He developed the belief that his vision was failing because of poisons secretly placed in his food by former neighbors. He found a misprint in the newspaper that he believed was placed there by the editor to shame him publicly. Admitted to the psychiatric service of a general hospital, he said that cars passing up and down the street contained agents who were spying on him. He believed that the electric light bulbs in his room were emanating a purifying radiation to counteract syphilitic germs, which he was supposedly breathing into the atmosphere, although a physical examination was negative for syphilis. Which of the following psychiatric conditions is the most likely diagnosis?
```
A. brief psychotic disorder
B. schizophrenia, paranoid type
C. delusional disorder
D. schizophrenia, disorganized type
E. malingering
```
B
Sadock, et al
2011
p 127
59
A 32-year-old woman with a history of schizophrenia presents to clinic with her sister. The patient has been treated for the past 3 years on risperidone (Risperdal). The patient's sister states she believes the patient's symptoms are well controlled; however, she is worried about unusual movement she noticed recently. She states that the patient has been protruding her tongue and making strange noises with her lips. Which of the following is the most likely diagnosis?
```
A. akathisia
B. tardive dyskinesia
C. Parkinsonism
D. Dystonia
E. none of the above
```
B
Sadock, et al
2011
p 128
60
The delusion that a familiar person has been replaced by an imposter is referred to as
```
A. intermetamorphosis
B. Cotard syndrome
C. Capgras syndrome
D. olfactory reference syndrome
E. conjugal paranoia
```
C
Sadock, et al
2011
pp 135-6
61
All of the following are associated with a good prognosis in a brief psychotic disorder EXCEPT
```
A. confusion during psychosis
B. severe precipitating stressor
C. sudden onset of symptoms
D. few premorbid schizoid traits
E. no affective symptoms
```
E
Sadock, et al
2011
p 136
62
In schizoaffective disorder, all of the following variables indicate poor prognosis EXCEPT
```
A. early onset
B. depressive type
C. bipolar type
D. no precipitating factor
E. a predominance of psychotic symptoms
```
C
Sadock, et al
2011
p 136-7
63
Folie á deux is another name for
```
A. erotomania
B. brief psychotic disorder
C. shared psychotic disorder
D. delusional disorder, persecutory type
E. schizoaffective disorder
```
C
Sadock, et al
2011
p 137
64
The best documented risk factor for delusional disorder is
```
A. family history
B. advanced age
C. social isolation
D. sensory impairment
E. recent immigration
```
A
Sadock, et al
2011
p 137
65
Delusional disorder
```
A. usually begins by age 20 years
B. is more common in men than in women
C. is less common than schizophrenia
D. is an early stage of schizophrenia
E. is caused by frontal love lesions
```
C
Sadock, et al
2011
p 137
66
Of the following somatic treatments for delusional disorder, which is considered the LEAST likely to be successful?
A. dopamine receptor antagonists
B. electroconvulsive treatment
C. selective serotonin reuptake inhibitors
D. serotonin-dopamine antagonists
E. all of the above are considered equally effective
B
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2011
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67
Postpartum psychosis
A. occurs more commonly in multigravida women
B. is rarely correlated with perinatal complications
C. almost always begins within 8 weeks of delivery
D. usually occurs abruptly, with no prodromal psychotic symptoms
E. is essentially an episode of psychotic disorder
C
Sadock, et al
2011
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68
All of the following are true statements about postpartum psychosis EXCEPT
A. Generally, it is not considered a psychiatric emergency.
B. Delusional material may involve the idea that the baby is dead.
C. The risk is increased if the patient had a recent mood disorder.
D. Hallucinations involve voices telling the patient to kill her baby.
E. It is found in one to two per 1,000 deliveries.
A
Sadock, et al
2011
p 139
69
Most studies of normal pregnant women indicate that the percentage who report the "blues" in the early postpartum period is about
```
A. 10%
B. 25%
C. 50%
D. 75%
E. 100%
```
C
Sadock, et al
2011
p 139
70
Attaque de nervios
A. is usually associated with acute fear
B. usually results in deteriorating course
C. is most common in Puerto Ricans
D. usually has no precipitating stressful event
E. usually features a sense of being out of control
E
Sadock, et al
2011
p 139
71
Erotomania is also referred to as
```
A. Ganser's syndrome
B. Fregoli's syndrome
C. Cotard's syndrome
D. Clérambault's syndrome
E. Capgras syndrome
```
D
Sadock, et al
2011
p139
72
Acute and transient psychotic disorder
A. can be definitively diagnosed without an extensive past history
B. is easily recognized early in its course
C. is often only definitively retrospectively
D. may have a better outcome with acute onset
E. has a higher age of onset in developing countries
C
Sadock, et al
2011
p140
73
A 13-year-old girl presents to clinic for unusual behavior. Her father states that for the last 3 months, his daughter claims she has been "communicating with unidentified flying objects from
outer space." During this period, it has become increasingly difficult to communicate with his daughter, and she has become an introvert. What is the most likely diagnosis?
```
A. schizophrenia
B. brief psychotic disorder
C. schizoaffective disorder
D. schizophreniform disorder
E. none of the above
```
D
Sadock, et al
2011
p 140
74
Mild, nonpsychotic depression with predominant anxiety is called
```
A. endogenomorphic depression
B. bipolar disorder
C. chronic depression
D. Dysthymia
E. anxiety disorder
```
D
Sadock, et al
2011
p148
75
The following situations call for a break in doctor-patient confidentiality EXCEPT
A. A patient with a delusional disorder thinks his boss is out to get him and threatens to kill her
B. A patient with major depressive disorder who is sexually promiscuous contracts syphillis
C. A patient with Bipolar I disorder admits he is homosexual
D. A patient with conduct disorder thrives on the sexual abuse of young children.
E. A patient with schizoaffective disorder hallucinates that he can fly.
C
Sadock, et al
2011
p148
76
A 27-year-old patient has been diagnosed with bipolar disorder. Before starting this patient on lithium for mood stabilization, which of the following laboratory tests should be obtained?
A. Thyroid function tests, creatinine, pregnancy test
B. Thyroid function tests, creatinine, liver function tests
C. Thyroid function tests, creatinine, complete blood count
D. Thyroid function tests, liver function tests, pregnancy test
E. Thyroid function tests, complete blood count, pregnancy test
A
Sadock, et al
2011
p148
77
Which of the following statements regarding mood disorders is FALSE?
A. One of four patients with an acute depressive episode will have recurrences throughout life.
B. Approximately 15% of depressed patients eventually commit suicide.
C. Incidence of depression in younger age groups is increasing.
D. Manic forms of mood disorders predominate in men.
E. Depressive disorders are more common in women.
A
Sadock, et al
2011
p149
78
All of the following are vegetative disturbances of depression EXCEPT
```
A. hypersexuality
B. anorexia
C. hypersomnia
D. insomnia
E. Circadian dysregulation
```
A
Sadock, et al
2011
p149
79
Serotonin
A. helps to regulate circadian rhythms
B. is an important regulator of sleep, appetite, and libido
C. stores are increased by transient stress and depleted by chronic stress
D. permits or facilitates goal-directed motor and consummatory behavior in conjunction with norepinephrine and dopamine
E. all of the above
E
Sadock, et al
2011
p149
80
Double depression is characterized by
A. two family members with major depressive disorder concurrently
B. recurrent major depressive disorder with current symptoms twice as disabling as usual
C. two episodes of major depressive disorder per month consistently
D. superimposed bipolar II disorder and atypical depression
E. recurrent major depressive disorder superimposed with dysthymia disorder
E
Sadock, et al
2011
p150
81
Depression and mania share which of the following symptoms?
```
A. psychomotor acceleration
B. low self-esteem
C. grandiosity
D. anger
E. pessimism
```
D
Sadock, et al
2011
p150
82
The person LEAST likely to develop major depressive disorder in is or her lifetime is
A. a 60-year-old man with pancreatic cancer
B. a 19-year-old woman who was raped 3 weeks ago
C. a 12-year-old girl mourning the death of her mother
D. a 10-year-old boy diagnosed with dysthymia
E. an identical twin of a patient with major depressive disorder who committed suicide
B
Sadock, et al
2011
p150
83
The defense mechanism most commonly used in depression is
```
A. undoing
B. sublimation
C. projection
D. introjection
E. altriusm
```
D
Sadock, et al
2011
p150
84
Which of the following is NOT an indicator of a good prognosis for major depressive disorder?
A. stable family functioning
B. no more than one previous hospitalization
C. a history of more than one previous depressive episode
D. advanced age of onset
E. the absence of psychotic symptoms
C
Sadock, et al
2011
p151
85
Reactive depression can best be compared to
```
A. adjustment disorder
B. atypical depression
C. conduct disorder
D. oppositional defiant disorder
E. schizoaffective disorder
```
A
Sadock, et al
2011
p151
86
Which of the following statements regarding rapid cycling bipolar disorder is TRUE?
A. Alcohol, stimulants, and caffeine use are risk factors
B. It is defined as at least four episodes per month.
C. Hospitalization of these patients is rare.
D. It is more common in men than women.
E. If often responds to tricyclic antidepressants.
A
Sadock, et al
2011
p151
87
All of the following are common causes of misdiagnosis of mood disorder as schizophrenia EXCEPT
A. reliance on the longitudinal rather than cross-sectional picture
B. flight of ideas perceived as loose associations
C. ascribing irritable mood to paranoid delusions
D. mistaking depressive depersonalization for schizophrenic emotional blunting
E. incomplete interepisodic recovery equated with schizophrenic defect
A
Sadock, et al
2011
p151
88
All of the following statements regarding cyclothymic disorder are true EXCEPT
A. Symptoms must be present for at least 2 years
B. It occurs at the same rate in men and women.
C. Symptoms may satisfy criteria for major depression.
D. it consists of hypomania alternating with depressed mood.
E. Its lifetime prevalence rate is about 0.4 to 1 percent.
C
Sadock, et al
2011
p 151
89
Dysthymic disorder differs from major depressive disorder because in dysthymic disorder
```
A. depression is episodic
B. the symptoms outnumber the sign
C. the onset is usually late in life
D. manic episodes are common
E. has a high-grade chronicity
```
B
Sadock, et al
2011
p 151
90
Psychomotor retardation is characterized by all of the following EXCEPT
```
A. indecisiveness
B. paucity of spontaneous movements
C. poor concentration
D. reduced speech amplitude and flow
E. restlessness
```
E
Sadock, et al
2011
p152
91
Features of anhedonia may include all of the following EXCEPT
A. derealization
B. difficulty describing or being aware of emotions
C. inability to experience normal emotions
D. loss of pleasure
E. withdrawal from interests
B
Sadock, et al
2011
p152
92
The HIGHEST suicide rates are in which of the following age groups?
```
A. younger than age 15 years
B. 15 to 24 year olds
C. 25 to 44 year olds
D. 45 to 64 year olds
E. older than age 65 years
```
E
Sadock, et al
2011
p152
93
Which of the following is the best predictor of the likelihood of attempting suicide in the future?
```
A. alcohol abuse
B. gender
C. prior suicide attempt
D. recent divorce
E. unemployment
```
C
Sadock, et al
2011
p152
94
In the differential diagnosis, the diagnosis of schizoaffective disorder should be restricted to
A. mixed episode of bipolar disorder
B. affective psychosis with concurrent brain disease
C. full affective and schizophrenic symptoms simultaneously
D. affective psychosis superimposed on mental retardation
E. a contagious expansive and elated affect
C
Sadock, et al
2011
p152
95
Which of the following antidepressants would NOT be the best choice for a patient with a history of suicidal ideation?
```
A. bupropion
B. disulfiram
C. a selective serotonin reuptake inhibitor
D. a tricyclic antidepressant
E. venlafaxine
```
D
Sadock, et al
2011
p152
96
Which of the following statements regarding electroconvulsive therapy (ECT) is FALSE?
A. ECT should be used in cases of psychotic depression only.
B. Bilateral ECT is somewhat more effective than unilateral ECT
C. Retrograde memory impairment is a common side effect.
D. ECT is often used for refractory mood disorders
E. Eight to 12 treatments are usually needed for symptomatic remission
A
Sadock, et al
2011
p152-3
97
A 57-year-old woman presents to you after being diagnosed with major depressive disorder. She has been depressed ever since the death of her husband 2 years earlier. She has been taking the same antidepressant since her diagnosis 1 year ago, with no relief of her symptoms. She states she would like your help in ending her life. The best option for your next step is:
A. respect the patient's wishes because she is of sound mind
B. seek to more adequately treat her depression
C. seek family members to make a more informed decision
D. contact the hospital ethics committee
E. obtain information from the state regarding physician-assisted suicide laws
B
Sadock, et al
2011
p153
98
A 64-year old woman with an extensive smoking history has recently been diagnosed with small cell lung cancer. She develops a depressed mood, decreased interests, and difficulty concentration soon thereafter because she reports she cannot stop thinking about how worthless her life has been. She eats incessantly and has gained 10lbs in the last 5 weeks; she also reports increased sleep. You decide to prescribe phenelzine for her symptoms of atypical depression. Which of the following is contraindicated in those patients taking phenelzine?
```
A. valproic acid
B. trazodone
C. lithium
D. fluoxetine
E. clomipramie
```
D
Sadock, et al
2011
p154
99
Which of the following is NOT a sign of poor prognosis in obsessive-compulsive disorder (OCD)?
```
A. childhood onset
B. coexisting major depression
C. good social adjustment
D. bizarre compulsions
E. delusional beliefs
```
C
Sadock, et al
2011
p 160
100
Sigmund Freud postulated that the defense mechanisms necessary in phobias are
A. regression, condensation, and dissociation
B. regression, condensation, and projection
C. regression, repression, and isolation
D. repression, displacement, and avoidance
E. repression, projection, and displacement
D
Sadock, et al
2011
p161
101
General anxiety disorder
A. is least likely to coexist with another mental disorder
B. has a female-to-male ratio of 1:2
C. is a mild condition
D. has about a 50% chance of a recurrence after recovery
E. has a low prevalence in primary care settings
D
Sadock, et al
2011
p162
102
Physiological activity associated with PTSD include all EXCEPT
```
A. decreased parasympathetic tone
B. elevated baseline heart rate
C. excessive sweating
D. increased circulating thyroxine
E. increased blood pressure
```
D
Sadock, et al
2011
p162
103
All of the following are true for the course of panic disorder EXCEPT
A. patients become concerned after the first one or two panic attacks
B. excessive caffeine uptake can exacerbate symptoms
C. comorbid depression increases risk for committing suicide
D. the overall course is variable
E. patients without comorbid agoraphobia have a higher recovery rate
A
Sadock, et al
2011
p162
104
All of the following have been noted through brain imaging in patients with panic disorder EXCEPT
A. magnetic resonance imaging (MRI) studies have shown pathological involvement of both temporal lobes
B. generalized cerebral vasoconstriction
C. right temporal cortical atrophy
D. increased blood flow to the basal ganglia
E. positron emission tomography scans have implicated dysregulation of blood flow in panic disorder
D
Sadock, et al
2011
p163
105
A patient with OCD might exhibit all of the following brain imaging findings EXCEPT
A. longer mean T1 relaxation times in the frontal cortex normal control subjects
B. significantly more gray matter and less white matter than normal control subjects
C. abnormalities in the frontal lobes, cingulum, and basal ganglia
D. decreased caudate volumes bilaterally compared with normal control subjects
E. lower metabolic rates in basal ganglia and white matter than in normal control subjects
E
Sadock, et al
2011
p 163
106
Buspirone acts as a
A. dopamine partial agonist useful in the treatment of OCD
B. serotonin partial agonist useful in the treatment of OCD
C. dopamine partial agonist useful in the treatment of generalized anxiety disorder
D. serotonin partial agonist useful in the treatment of generalized anxiety disorder
E. none of the above
D
Sadock, et al
2011
p163
107
Which of the following medical disorders are NOT associated with panic disorder due to a general medical condition?
```
A. cardiomyopathy
B. Parkinson's disease
C. epilepsy
D. Sjogren's syndrome
E. chronic obstructive pulmonary disease
```
D
Sadock, et al
2011
p163
108
Which of the following disorders is rarely confused with anxiety that stems primarily from medical disorders?
```
A. panic disorder
B. specific phobia
C. obsessive-compulsive disorder
D. posttraumatic stress disorder
E. generalized anxiety disorder
```
B
Sadock, et al
2011
p163
109
First-line medication treatments of anxiety disorders may generally include all of the following EXCEPT
```
A. diazepam
B. fluoxetine
C. fluvoxamine
D. nefazodone
E. venlafaxine
```
A
Sadock, et al
2011
p164
110
Therapy for phobias may include all of the following EXCEPT
```
A. counterphobic attitudes
B. flooding
C. phenelzine
D. propranolol
E. systematic desensitization
```
A.
Sadock, et al
2011
p164
111
Which of the following is the gold standard for diagnosis of factitious disorder by proxy?
A. confession by the child
B. finding inconsistencies in the medical records
C. direct observation of the caretaker doing harm
D. improvement when the child is removed from the caretaker
E. discovery of illness-inducing agents in the caregiver's possession
C
Sadock, et al
2011
p 180
112
Factitious disorder
```
A. usually have a good prognosis
B. may occur by proxy
C. usually begin in childhood
D. are best treated with psychoactive drugs
E. are synonymous with Ganser's syndrome
```
B
Sadock, et al
2011
p181
113
The term Munchausen's syndrome was coined by
```
A. Baron Karl Friedrich Hieronymus von Munchausen
B. Richard Asher
C. Jean-Marie Charcot
D. Roy Meadow
E. Alan Gelenberg
```
B
Sadock, et al
2011
p182
114
Which of the following symptoms would a patient with Munchausen syndrome most likely present with?
```
A. amnesia
B. depression
C. hemoptosis
D. pain disorder
E. psychosis
```
C
Sadock, et al
2011
p183
115
Factitious disorders are best treated by which of the following?
A. confrontation about the patient's deceit
B. immediate discharge from the hospital
C. focusing on management rather than cure
D. performing only minimally invasive procedures to satisfy the patient
E. using low-dose neuroleptics to decrease the patient's physical distress
C
Sadock, et al
2011
p183
116
Ganser's syndrome
A. is associated with a severe personality disorder
B. has a chronic remitting and relapsing course
C. is motivated by involuntary phenomena
D. is a factitious disorder
E. is more common in women than in men
A
Sadock, et al
2011
p 183-4
117
The systemized type of dissociative amnesia is
A. the failure to recall successive event as they occur
B. the inability to recall events related to a circumscribed period of time
C. the failure to recall one's entire life
D. amnesia for certain categories of memory
E. the ability to remember some, but not all, of the events occurring during a circumscribed period
D
Sadock, et al
2011
p188
118
Which of these statements regarding the prognosis of dissociative identity disorder is INCORRECT?
A. Recovery is generally complete.
B. The earlier the onset of dissociative identity disorder, the poorer the prognosis is.
C. The level of impairment is determined by the number and types of various personalities.
D. Individual personalities may have their own separate mental disorders.
E. One or more of the personalities may function relatively well.
A
Sadock, et al
2011
p188
119
"Reduplicative paramnesia" is a condition of which of the following disorders?
```
A. Deja vu
B. depersonalization disorder
C. dissociative amnesia
D. dissociative fugue
e. dissociative identity disorder
```
B
Sadock, et al
2011
p188
120
Which of the following statements regarding transient global amnesia is FALSE?
A. Complete recovery does not occur.
B. It usually lasts 6 to 24 hours
C. It is an acute retrograde amnesia.
D. It is most often caused by transient ischemic attacks.
E. It affects recent memories more than remote memories.
A
Sadock, et al
2011
p189
121
The mental status examination of a patient with dissociative identity disorder would most likely reveal which of the following?
```
A. decreased concentration
B. flat affect
C. impaired recent memory
D. orientation difficulties
E. normal examination results
```
E
Sadock, et al
2011
p189
122
The most common cause of organic fugue is probably
```
A. brain tumors
B. epilepsy
C. head trauma
D. hypoglycemia
E. migraines
```
B
Sadock, et al
2011
p189
123
All of the following are true statements about dissociative fugue EXCEPT
A. It is usually a long-lasting state.
B. Recovery is spontaneous and rapid.
C. It is a rare type of dissociative disorder.
D It is characterized by a lack of awareness of the loss of memory.
E. It is not characterized by behavior that appears extraordinary to others.
A
Sadock, et al
2011
p190
124
Patients predisposed to dissociative fugue include those with all of the following EXCEPT
```
A. borderline personality disorder
B. heavy alcohol abuse
C. histrionic personality disorder
D. mood disorders
E. schizophrenia
```
E
Sadock, et al
2011
p190
125
Depersonalization disorder is characterized by
```
A. gradual onset
B. onset impaired reality testing
C. ego-dystonic symptoms
D. a brief course and a good prognosis
E. occurrence in the late decades of life
```
C
Sadock, et al
2011
p190
126
A patient normally without cognitive deficits, who seem out of touch with the environment and in a dream-like state for a brief period of time and who has amnesia regarding the experience when it is ended is likely to have
```
A. dementia
B. dissociative fugue
C. localized amnesia
D. generalized amnesia
E. sleepwalking disorder
```
E
Sadock, et al
2011
p190
127
Which part of the brain is directly involved in sexual drive in mammals?
```
A. temporal lobe
B. the limbic system
C. neo cortex
D. frontal lobe
E. parietal lobe
```
B
Sadock, et al
2011
p196
128
Among the following, the sexual dysfunction NOT correlated with phases of the sexual response cycle is
```
A. sexual aversion disorder
B. vaginismus
C. premature ejaculation
D. postcoital dysphoria
E. male erectile disorder
```
B
Sadock, et al
2011
p196
129
Which of the following statements is TRUE about paraphilias?
A. Paraphilias are usually not distressing to the person with the disorder.
B. Paraphilias are found equally among men and women.
C. According to the classic psychoanalytic model, paraphilias are caused by a failure to complete the process of genital adjustment.
D. With an early age of onset, paraphilias are associated with a good prognosis.
E. Paraphilias such as pedophilia usually involve vaginal or anal penetration of the victim.
C
Sadock, et al
2011
p196
130
The term "partialism" refers to fetishes involving
```
A. a specific item of clothing
B. a nonsexual body part
C. a specific type of material
D. a nonsexual behavior
E. a specific food item
```
B
Sadock, et al
2011
p196
131
In a patient with Turner's syndrome, all of the following are common findings EXCEPT
```
A. atypical female sex identification
B. gonadal dysgenesis
C. female genetalia
D. small uterus
E. dyspareunia
```
A
Sadock, et al
2011
p 204
132
In patients born with ambiguous genitalia, which of the following is the predominant factor by which assigned sex is determined?
A. wishes of the parents
B. genetic phenotype and potential for reproduction
C. extent of virilization
D. surgical team capabilities
E. wishes of the patient at the time of puberty
B
Sadock, et al
2011
p 204
133
In biological me undertaking estrogen hormone treatment, all of the following side effects are common EXCEPT
```
A. testicular atrophy
B. change in pitch of voice
C. diminished erectile capacity
D. breast enlargement
E. decrease in density
```
B
Sadock, et al
2011
p205
134
Which of the following statements does NOT apply to the treatment of gender identity disorder?
A. Adult patients generally enter psychotherapy to learn how to deal with their disorder, not to alter it.
B. Before sex-reassignment surgery, patient must go through a trial of cross-gender living for at least 3 months.
C. A one-to-one play relationship is used with boys in which adults' role model masculine behavior.
D. Hormonal therapy is not required as a preceding event in sex-reassignment surgery.
E. During hormonal treatments, both males and females need to be watched for hepatic dysfunction and thromboembolic phenomena.
D
Sadock, et al
2011
p205
135
Anorexia nervosa has a mortality rate of up to approximately
```
A. 1%
B. 18%
C. 30%
D. 42%
E. 50%
```
B
Sadock, et al
2011
p209
136
Which of the following is the most common comorbid disorder associated with anorexia nervosa?
```
A. body dysmorphic disorder
B. bulimia
C. depression
D. obsessive-compulsive disorder
E. social phobia
```
C
Sadock, et al
2011
p 210
137
Patients with "atypical anorexia nervosa"
```
A. have a distorted body image
B. recognize their thinness
C. respond poorly to treatment
D. have less favorable outcomes
E. none of the above
```
B
Sadock, et al
2011
p 210
138
Which of the following is NOT an endocrine or structural change noted as a result of starvation?
```
A. thyroid suppression
B. increased total brain volume
C. hypercortisolemia
D. gonadotropin-releasing hormone suppression
E. enlarged ventricles
```
B
Sadock, et al
2011
p 210
139
Medical complications of eating disorders related to weight loss include all of the following EXCEPT
A. abnormal taste sensation
B. bradycardia
C. constipation and delayed gastric emptying
D. erosion of dental enamel with corresponding decay
E. osteoporosis
D
Sadock, et al
2011
p211
140
Patients who binge eat but do not compensate in any way afterward are most likely to have
```
A. anorexia nervosa
B. bulimia nervosa
C. binge eating disorder
D. obesity
E. night eating syndrome
```
C
Sadock, et al
2011
p211
141
Pickwickian syndrome is
A. when persons eat excessively after they have had their evening meal
B. binge eating without the appropriate compensatory behaviors
C. when a person is 100% over desirable weight with cardiorespiratory pathology
D. when persons feel their bodies are grotesque and loathsome.
E. sudden, compulsive ingestion of very large amounts of food in a short time
C
Sadock, et al
2011
p211
142
Sleep is best described as the integrated product of the following two factors
A. age and health
B. seasonality and photoperiods
C. sleep homeostat and the circadian rhythm
D. melatonin peak and temperature nadir
E. transition from day to night (dusk) and night to day (dawn)
C
Sadock, et al
2011
p218
143
Which of the following is the treatment of choice for patients with obstructive sleep apnea?
```
A. benzodiazepines
B. theophylline
C. uvulopalatoplasty
D. weight loss
E. nasal continuous positive airway pressure
```
E
Sadock, et al
2011
p218
144
You begin treating a blind woman who presents with difficulty sleeping. This patient is most likely to be experiencing which of the following circadian disturbances?
```
A. no disturbances
B. non-24-hour sleep-wake cycle
C. delayed sleep phase syndrome
D. irregular sleep-wake rhythm
E. advanced sleep phase syndrome
```
B
Sadock, et al
2011
p218-9
145
All of the following statements regarding nightmare are true EXCEPT
A. REM-suppressing drugs can bring about nightmares
B. Children who have nightmares do not awaken confused.
C. Creative people have been shown to have nightmares more frequently.
D. Massive autonomic signs often accompany nightmares in children
E. Nightmares occur in up to 50% of children aged 3 to 6 years
D
Sadock, et al
2011
p219
146
An experiment is performed in which sleeping patients are awakened at the beginning of REM cycles. The are then allowed to sleep with repeated interruptions. Which of the following will be the result of this experiment?
```
A. increase in REM latency
B. more frequent nighttime awakenings
C. increase in the number of REM periods
D. decrease in the length of REM periods
E. no change in sleep patterns
```
C
Sadock, et al
2011
p219
147
A dysfunction in the hypocretin system plays a critical role in which of the following disorders?
```
A. insomnia
B. sleepwalking
C. restless legs syndrome
D. narcolepsy
E. sleep paralysis
```
D
Sadock, et al
2011
p 219
148
In REM sleep,
A. there is infrequent genital tumescence
B. cerebral glucose metabolism is decreased
C. respiratory rate is decreased
D. cardiac output is decreased
E. brain temperature is decreased
D
Sadock, et al
2011
p220
149
Which of the following is NOT true about restless leg syndrome?
A. Unpleasant sensations are partially or totally relieved by movement.
B. Sensations are worse in the evening.
C. It consists of uncontrollable movement of the legs.
D. It is worse when sitting or lying down.
E. It has an onset in middle-aged people and usually has a progressive course
C
Sadock, et al
2011
p220
150
The symptoms of narcolepsy include all of the following EXCEPT
```
A. sleep paralysis
B. hallucinations
C. daytime sleepiness
D. catalepsy
E. cataplexy
```
D
Sadock, et al
2011
p220
151
True statements about sleep in the elderly include all of the following EXCEPT
A. Individuals with periodic limb movements sleep about 1 hour less per night than control subjects
B. Death rates are higher in the elderly both in people who sleep more than 9 hours and those who sleep fewer than 5 hours.
C. After the age of 65 years, one-third of women and one-fifth of men report that they take more than 30 minutes to fall asleep.
D. The incidence of nocturnal myoclonus increases with age.
E. The average daily total sleep time decreases after the age of 65 years.
E
Sadock, et al
2011
p220-1
152
Which of the following features is NOT typical of REM sleep?
A. Dreams are typically concrete and realistic.
B. Polygraph measures show irregular patterns.
C. The resting muscle potential is lower in REM sleep than in waking state.
D. Near-total paralysis of the postural muscles is present.
E. A condition of temperature regulation similar to that in reptile occur.
A
Sadock, et al
2011
p221
153
Which of the following statements does NOT correctly describe sleep regulation?
A. Melatonin secretion helps regulate the sleep-wake cycle.
B. Destruction of the dorsal raphe nucleus of the brainstem reduces sleep.
C. L-tryptophan deficiency is associated with less time spent in NREM sleep.
D. REM sleep can be reduced by increased firing of noradrenergic neurons.
E. Disrupted REM sleep patterns in patients with depression show shortened REM sleep.
C
Sadock, et al
2011
p221
154
Which of the following statements regarding Kleine-Levin Syndrome is FALSE?
A. It involves recurrent episodes of hypersomnia with 18 to 20-hour sleep periods.
B. Other symptoms include voracious eating, hypersexuality, and disinhibition.
C. It only affects adolescent males.
D. Episodes last for a few days up to several weeks once to 10 times per year.
E. A monosymptomatic hypersomnolent form can occur.
C
Sadock, et al
2011
p221
155
Which of the following is NOT a neuroendocrine change noted in patients with abnormal aggression?
```
A. deranged serotonin neurotransmission
B. low cerebrospinal fluid (CSF) levels of 5-hydroxyindolacetic acid (5-HIAA)
C. decreased platelet serotonin reuptake
D. elevated CSF testosterone
E. increased glucose metabolism
```
E
Sadock, et al
2011
p226
156
A 28-year-old man had been repeatedly brutalized by his alcoholic mother throughout childhood and early adolescence. He felt particularly humiliated when she would slap his face during frequent bouts of uncontrollable anger. One evening while they were drinking at a local tavern, friend playfully slapped his cheek. The patient suddenly "saw red," broke a beer bottle over the man's head, and then mauled him severely. Which of the following defense mechanisms is this patient with intermittent explosive disorder exhibiting?
```
A. regression
B. reaction formation
C. passive-aggressive behavior
D. identification with the aggressor
E. controlling
```
D
Sadock, et al
2011
p226
157
Which of the following selections is NOT associated with intermittent explosive disorder?
A. Patients may feel helpless before an episode.
B. The disorder usually grows less severe with age.
C. A predisposing factor in childhood is encephalitis.
D. Dopaminergic neurons mediate behavioral inhibition.
E. Neurological examination can show left-right ambivalence.
D
Sadock, et al
2011
p226-7
158
The term epileptoid personality has been used in reference to patients with which of the following?
```
A. pyromania
B. kleptomania
C. trichotillomania
D. intermittent explosive disorder
E. seizure disorder
```
D
Sadock, et al
2011
p227
159
Which impulse-control disorder is structured more like a substance use disorder?
```
A. pyromania
B. pathological gambling
C. kleptomania
D. intermittent explosive disorder
E. trichotillomania
```
B
Sadock, et al
2011
p227
160
All of the following have been identified as predisposing factors for the development of pathological gambling EXCEPT
A. childhood enuresis
B. inappropriate parental discipline
C. family emphasis on material symbols
D. loss of a parent before the child is 15 years old
E. attention-deficit/hyperactivity disorder
A
Sadock, et al
2011
p228
161
Which of the following is true of kleptomania?
A. Children and adolescents who steal become kleptomaniac adults.
B. Men are more likely to present for psychiatric treatment.
C. Men are more likely to be sent to prison.
D. Patients only steal from stores.
E. Thefts are committed to express anger.
C
Sadock, et al
2011
p228
162
Commonly associated features of pyromania include all of the following EXCEPT
```
A. sexual dysfunctions
B. kleptomania
C. alcohol intoxication
D. below-average IQ
E. resentment toward authority figures
```
B
Sadock, et al
2011
p228
163
Onionmania is another term used for
```
A. compulsive buying
B. internet compulsion
C. hairballs accumulating in the alimentary tract
D. seizure-like quality of outbursts
E. mobile phone compulsions
```
A
Sadock, et al
2011
p228-9
164
A 22-year-old man has been offered a job overseas and will be leaving home for the first time. He is very worried about living in another country, not knowing the language, and being unfamiliar with a new culture. For the past 2 months, he has been unable to sleep and feels edgy. This has been impacting his performance at work as he is exhausted all day long. What is the most likely diagnosis?
A. major depressive disorder
B. adjustment disorder with disturbance of conduct
C. adjustment disorder with depressed mood
D. adjustment disorder with anxiety
E. generalized anxiety disorder
D
Sadock, et al
2011
p233
165
Which of the following is NOT recommended in psychotherapeutic treatment of patient with borderline personality disorder?
A. The therapist is a passive listener.
B. The patient and therapist mutually develop a hierarchy of priorities.
C. Clear roles of patient and therapist are established.
D. Mutually agreed limit setting is used.
E. Concomitant individual and group approaches are used.
A
Sadock, et al
2011
p237-8
166
A pervasive pattern of grandiosity, lack of empathy, and need for admiration suggests the diagnosis of which of the following personality disorders?
```
A. borderline
B. narcissistic
C. paranoid
D. passive-aggressive
E. schizotypal
```
B
Sadock, et al
2011
p238
167
Traits that have been identified as forming the stylistic components of behavior known as temperament include all of the following EXCEPT
```
A. harm avoidance
B. novelty seeking
C. persistence
D. reward dependence
E. shyness
```
E
Sadock, et al
2011
p238
168
The defense mechanism most often associated with paranoid personality disorder is
```
A. splitting
B. projection
C. isolation
D. hypochondriasis
E. dissociation
```
B
Sadock, et al
2011
p238
169
Which of the following biological factors pertaining to personality disorders is TRUE?
A. Smooth pursuit eye movements are saccadic in persons who are introverted.
B. Low platelet monoamine oxidase levels have been noted in some patients with histrionic personality disorder.
C. Compulsive traits are associated with high levels of testosterone.
D. Antisocial personalities may have fast wave activity on electroencephalography.
E. 5-HIAA levels have been foud to be high in suicide attempters.
A
Sadock, et al
2011
p238
170
Borderline personality disorder is associated with
A. a decreased risk of psychotic symptoms
B. an increased risk for premature death
C. a decreased risk for other coexisting personality disorders
D. a decreased risk for bulimia
E. a decreased risk for posttraumatic stress disorder
B
Sadock, et al
2011
p239
171
Persons with narcissistic personality disorders
```
A. are easy to treat
B. handle aging well
C. are unlikely to feel depressed
D. are usually immune to criticism
E. may benefit from a psychoanalytic treatment approach
```
E
Sadock, et al
2011
p239
172
True statements about the aspects of personality called temperament include all of the following EXCEPT
A. they are heritable
B. they are relatively stable in time
C. they are inconsistent in different cultures
D. they are observable early in childhood
E. they are predictive of adolescent and adult behavior
C
Sadock, et al
2011
p239
173
A 33-year-old woman presents for psychiatric evaluation after making suicidal threats. She reports a long-standing pattern of self-mutiliation, impulsiveness, and no relationship lasting longer than 1 month. Which of the following is the most likely diagnosis?
```
A. histrionic personality disorder
B. antisocial personality disorder
C. narcissistic personality disorder
D. borderline personality disorder
E. none of the above.
```
D
Sadock, et al
2011
p240
174
Phantom limb occurs after leg amputation in what percentage of patients?
```
A. 10%
B. 50%
C. 80%
D. 90%
E. 98%
```
E
Sadock, et al
2011
p245
175
Which of the following is NOT a physiological response of the gastrointestinal (GI) system to acute stress?
A. increased resting tone of the upper esophageal sphincter
B. decreased contraction amplitude in the distal esophagus
C. decreased antral motor activity in the stomach
D. reduced migrating motor function in the small intestine
E. increased myoelectrical motility in the large intestine
B
Sadock, et al
2011
p245
176
The most frequent functional GI disorder is
```
A. globus
B. irritable bowel syndrome
C. functional abdominal bloating
D. functional heartburn
E. functional chest pain
```
D
Sadock, et al
2011
p245
177
Which of the following is NOT a sign of overt hypothyroidism?
```
A. normal thyroid hormone concentrations
B. patient are symptomatic
C. thyroid-stimulating hormone (TSH) is elevated
D. low thyroid hormone concentrations
E. none of the above
```
A
Sadock, et al
2011
p246
178
Which of the following statements about psychoneuroimmunology is TRUE?
A. Immunological reactivity is not affected by hypnosis.
B. Lymphocytes cannot produce neurotransmitters
C. The immune system is affected by conditioning.
D. Growth hormone does not affect immunity.
E. Marijuana does not affect the immune system.
C
Sadock, et al
2011
p246
179
A decrease in T lymphocytes has been reported in all of the following EXCEPT
A. bereavement
B. nonpsychotic inpatients
C. medical students during final examinations
D. women who are having extramarital affairs
E. caretakers of patients with dementia of the Alzheimer's type
D
Sadock, et al
2011
p247
180
A highly emetogenic anticancer agent is
```
A. bleomycin
B. cisplatin
C. doxorubicin
D. vinblastine
E. vincristine
```
B
Sadock, et al
2011
p248
181
Psychogenic pruritus differs from neurologic pruritus in that psychogenic pruritus is characterized by
```
A. a chronic course
B. a greater intensity
C. accompanied pain in the same location
D. unlikely occurrence at night
E. insomnia
```
D
Sadock, et al
2011
p249
182
Which of the following is the most common reason for a C-L psychiatrist to be consulted?
```
A. anxiety
B. depression
C. disorientation
D. sleep disorders
E. adverse effects of medications
```
D
Sadock, et al
2011
p249
183
You are a C-L psychiatrist called to consult on a patient who is scheduled for a liver transplant. You learn the patient now needs a transplant after he was infected with hepatitis C because of promiscuous sexual activity. Which of the following is this patient at increased risk for?
```
A. adjustment disorder
B. major depression
C. medication noncompliance
D. organ rejection
E. suicide
```
C
Sadock, et al
2011
p249
184
A 53-year-old male patient is found to have an occipital lobe tumor. He would be LEAST LIKELY to exhibit which of the following symptoms and complaints?
```
A. headache
B. homonymous hemianopsia
C. papilledema
D. paranoid delusions
E. visual hallucinations
```
D
Sadock, et al
2011
p249
185
Which of the following is NOT a stage of the human sexual response cycle?
```
A. initiation
B. excitement
C. refractory period
D. orgasm
E. resolution
```
A
Sadock, et al
2011
p256
186
Fetal sex steroid exposure exerts organizational effects upon the fetal
```
A. central nervous system
B. testes
C. ovary
D. neuromuscular system
E. cardiovascular system
```
A
Sadock, et al
2011
p257
187
Pseudocyesis is
A. another name for Braxton-Hicks contractions (i.e. false labor)
B. when the father of a child undergoes a simulated labor as if he were giving birth
C. the development of the classic symptoms of pregnancy in a nonpregnant woman
D. falsely elevated human chorionic gonadotropin levels occurring with choriocarcinoma and hydatidiform moles
E. masking of the symptoms of postpartum depression
C
Sadock, et al
2011
p257
188
Which of the following terms refers to a condition in which the muscles around the outer third of the vagina have involuntary spasms?
```
A. anorgasmia
B. vaginismus
C. dyspareunia
D. vulvodynia
E. none of the above
```
B
Sadock, et al
2011
p257-8
189
It is generally considered safest to perform a tubal ligation at which of the following times?
A. immediately postpartum
B. laparoscopically several weeks after delivery
C. As an open procedure several weeks after delivery.
D. As an open procedure 6 months after delivery
E. Hysterectomy
B
Sadock, et al
2011
p258
190
Premenstral dysphoric disorder (PMDD) affects what percentage of reproductive age women?
```
A. 1%
B. 3%
C. 5%
D. 7%
E. 9%
```
C
Sadock, et al
2011
p258
191
Secondary victimization is characterized by all of the following EXCEPT
```
A. disbelief and denial
B. discounting
C. blaming the victim
D. verbal abuse
E. stigmatization
```
D
Sadock, et al
2011
p266
192
Workplace violence is documented to be increased in all of the following professions EXCEPT
```
A. law enforcement
B computer specialists
C. mental health workers
D. taxi drivers
E. bartenders
```
B
Sadock, et al
2011
p266
193
Spouse abuse is
A. carried our by men who tend to be independent and assertive
B. a recent phenomenon
C. least likely to occur when the woman is pregnant
D. directed at specific actions of the spouse
E. an act that is self-reinforcing
E
Sadock, et al
2011
p267
194
Which of the following forms of incest is most common?
```
A. father-daughter
B. mother-daughter
C. father-son
D. brother-brother
E. uncle-niece
```
A
Sadock, et al
2011
p267
195
Which of the following provides the best proof that child abuse is occurring?
A. significant recovery when the caretaking is altered
B. child shows evidence of repeated skin injuries
C. failure to thrive
D. child is dressed inappropriately for the weather
E. unusual knowledge of sexual acts
A
Sadock, et al
2011
p267
196
Which of the following is the correct order of the five phases of child sexual abuse?
A. engagement, secrecy, sexual interaction, suppression, disclosure
B. sexual interaction, secrecy, disclosure, suppression, engagement
C. engagement, sexual interaction, secrecy, disclosure, suppression
D. secrecy, engagement, sexual interaction, suppression, disclosure
E. secrecy, sexual interaction, engagement, disclosure, suppression
C
Sadock, et al
2011
p267
197
Which of the following statements about rape is FALSE?
A. About 10 -25% of rapes are reported to authorities.
B. The greatest danger of rape exists for women 16-24 years of age.
C. Most men who commit rape are between 25 and 44 years of age.
D. Alcohol is involved in at least 75% of forcible rapes.
E. About 50% of rapes are committed by strangers.
D
Sadock, et al
2011
p268
198
Exit therapy is designed to help people
```
A. in bereavement
B. who are involved in cults
C. with acculturation problems
D. with occupational problems
E. with adult antisocial behavior
```
B
Sadock, et al
2011
p273
199
White collar crime
A. is a term coined by Robert Merton
B. occurs mainly by people who deem themselves to be decent
C. is not influenced by technological advances
D. does not include violations of environmental and health laws
E. costs society less than robbery, burglary, car theft, and larceny
B
Sadock, et al
2011
p271
200
Which of the following disorders is the Axis II diagnosis most closely associated with suicide?
```
A. mood disorders
B. antisocial personality disorder
C. borderline personality disorder
D. substance abuse disorders
E. schizophrenia
```
C
Sadock, et al
2011
p276
201
Suicide among schizophrenic patients
A. is most frequently secondary to command hallucinations
B. occurs most often in the later years of the illness
C. occurs most often in older female patients
D. is approximately 10%
E. is low
D
Sadock, et al
2011
p277
202
The first task in evaluating violent behavior should be
```
A. admission to a hospital
B. ascertaining degree of injuries
C. determination of the cause
D. establishing a treatment plan
E. obtaining information from observers
```
C
Sadock, et al
2011
p278
203
A 36-year-old female patient with schizophrenia presents to the emergency department after experiencing auditory hallucinations commanding her to kill herself. She reports that the hallucinations have become more frequent over the course of the past week. The patient has previously attempted to take her life on two occasions when she overdose on sleeping pills. She is also an alcoholic and recently divorced her husband of 4 years. Of the following factors, which poses the greatest risk factor for suicide in this patient?
```
A. alcoholism
B. divorce
C. age
D. gender
E. previous suicide attempts
```
E
Sadock, et al
2011
p279
204
Cotherapy is most often used with
```
A. mood disorders
B. schizophrenia
C. substance abuse
D. sleep disorders
E. pain disorders
```
C
Sadock, et al
2011
p283-4
205
Flooding
```
A. involves relaxation exercises
B. works best with specific phobias
C. is synonymous with "explosion"
D. is a hierarchical exposure technique
E. is indicated in anxious patients who are psychologically fragile because of its rapid response rate
```
B
Sadock, et al
2011
p284
206
Dialectical behavior therapy
A. focuses on patient insight
B. is a cognitive behavioral treatment
C. does not directly target suicidal behavior
D. has not been empirically evaluated for efficacy
E. favors inpatient treatment when self-destructive risk is high
B
Sadock, et al
2011
p284
207
Brief focal psychotherapy
A. is very helpful for self-destructive acting-out paranoia
B. involves setting a termination date in advance
C. usually lasts less than 10-12 sessions
D. does not focus on transference
E. involves a detached therapist
B
Sadock, et al
2011
p284
208
In combined individual and group therapy, patients with which of the following disorders are at a higher risk of playing off one therapy against the other?
```
A. borderline personality disorder
B. paranoid personality disorder
C. obsessive-compulsive personality disorder
D. schizoid personality disorder
E. schizotypal personality disorder
```
A
Sadock, et al
2011
p285
209
The goals of social skills training include all of the following EXCEPT
A. decreasing social anxiety
B. generalization of the acquired skills to similar situations
C. acquisition of conversational skills
D. acquisition of insight into the social deficit
E. relearning of social skills
D
Sadock, et al
2011
p285
210
The time, course, and intensity of a drug's effect are referred to as:
```
A. pharmacokinetics
B. pharmacodynamics
C. pharmacogenetics
D. placebo effect
E. idiosyncratic reaction
```
B
Sadock, et al
2011
p292
211
In the elderly population, anticholinergic medications can produce
A. improvement of positive symptoms of psychosis
B. improved storage of new information into long-term memory
C. worsening ideational apraxia
D. impairment in cognitive functioning
E. worsening of orientation subscales
D
Sadock, et al
2011
p293
212
H2 receptor antagonist nizatidine is efficacious as a secondary prevention strategy for associated weight gain in which of the following antipsychotic drugs?
```
A. olanzapine
B. quetiapine
C. risperidone
D. clozapine
E. ziprasdone
```
A
Sadock, et al
2011
p293
213
Which of these benzodiazepines is not completely absorbed after oral administration?
```
A. midazolam
B. clorazepate
C. alprazolam
D. triazolam
E. estazolam
```
B
Sadock, et al
2011
p293
214
Which is the only antidepressant that has received approval from the U.S. Food and Drug Administration for the preventive treatment of seasonal affective disorder?
```
A. imipramine
B. mirtazapine
C. citalopram
D. bupropion
E. trazodone
```
D
Sadock, et al
2011
p293-4
215
In which of the following psychiatric disorders did buspirone not demonstrate any clear efficacy?
```
A. generalized anxiety disorder
B. major depressive disorder
C. sexual dysfunction
D. psychosis
E. premenstrual syndrome
```
D
Sadock, et al
2011
p294
216
The prevalence of dementia in cross-sectional studies among patient suffering from Parkinson's disease is approximately
```
A. 10%
B. 20%
C. 30%
D. 40%
E. 50%
```
D
Sadock, et al
2011
p294
217
Which of the following agents is NOT a first-generation antipsychotic?
```
A. haloperidol
B. thioridazine
C. risperidone
D. perphenazine
E. chlorpromazine
```
C
Sadock, et al
2011
p294
218
Which one of the following is the MOST frequently prescribed agent for insomnia therapies?
```
A. benzodiazepines
B. sedating antidepressants
C. first-generation antipsychotics
D. second-generation antipsychotics
E. antihistamines
```
B
Sadock, et al
2011
p294-5
219
Among the following newer antidepressants, which is the only one that is a potent antagonist of histamine-1 receptors?
```
A. mirtazapine
B. mianserin
C. citalopram
D. paroxetine
E. trazodone
```
A
Sadock, et al
2011
p295
220
Among the following antidepressants, which one is a monoamine oxidase inhibitor (MAO-I)?
```
A. tranylcypromine
B. amitriptyline
C. mirtazapine
D. fluvoxamine
E. clomipramine
```
A
Sadock, et al
2011
p295
221
Which of the following conditions is a contraindication for the use of nefazodone?
```
A. tuberculosis
B. hepatic disease
C. renal illnesses
D. diabetes mellitus
E. hypertension
```
B
Sadock, et al
2011
p295
222
Among the common side effect of opioids, the one that tends to persist after methadone treatment is
```
A. nausea
B. dizziness
C. sedation
D. constipation
E. hypotension
```
D
Sadock, et al
2011
p295
223
How many hours does the blockade of exogenous ingested opioids in the central nervous system by naltrexone last?
```
A. up to 12 hours
B. up to 24 hours
C. up to 36 hours
D. up to 48 hours
E. up to 72 hours
```
E
Sadock, et al
2011
p295
224
Which of the following drugs are considered "dual reuptake inhibitors?"
```
A. clomipramine
B. imipramine
C. amitriptyline
D. venlafaxine
E. all of the above
```
E
Sadock, et al
2011
295
225
Which of the following disorders is most closely associated with thyroid disease?
```
A. schizophrenia
B. alcoholism
C. depression
D. phobia
E. borderline personality disorder
```
C
Sadock, et al
2011
p296
226
Electroconvulsive therapy is the MOST effective treatment in which of the following mental disorders?
```
A. panic disorder
B. bipolar disorder
C. obsessive-compulsive disorder
D. major depression
E. borderline personality disorder
```
D
Sadock, et al
2011
p296
227
Slidenafil
A. is rapidly absorbed after a fatty meal
B. is mostly excreted in the urine
C. is a nitric oxide enhancer
D. decreases levels of cyclic guanosine monophosphate
E. carries a high risk of priapism
C
Sadock, et al
2011
p297
228
Zolpidem
A. is solely indicated as a hypnotic
B. is not contradicted for use by nursing mothers
C. is generally associated with rebound insomnia after discontinuation of its use for short periods
D. may be used as a muscle relaxant
E. reaches peak plasma levels in about 4-6 hours
A
Sadock, et al
2011
p298
229
Dantrolene is a potentially effective treatment for each of the following disorders EXCEPT
```
A. acute mania
B. catatonia
C. malignant hyperthermia
D. neuroleptic malignant syndrome
E. serotonin syndrome
```
A
Sadock, et al
2011
p298
230
Factors that predict a better response to carbamazepine than to lithium in bipolar I disorder include each of the following EXCEPT
```
A. first episode of mania
B. dysphoric mania
C. comorbid seizure disorder
D. negative family history
E. rapid cycling
```
A
Sadock, et al
2011
p299
231
At what age does a normally developing child reach half of his or her potential adult height?
```
A. 1 year old
B. 2 years old
C. 3 years old
D. 4 years old
E. 5 years old
```
B
Sadock, et al
2011
p303
232
Which of the following tools is considered most appropriate to facilitate the play component of an interview?
```
A. chess
B. puppets
C. video games
D. elaborate toys
E. stock characters (e.g., Barbie or Disney figures)
```
B
Sadock, et al
2011
p303
233
Neurological soft signs include all of the following EXCEPT
```
A. contralateral overflow movements
B. learning disabilities
C. asymmetry of gait
D. nystagmus
E. poor balance
```
B
Sadock, et al
2011
p 306
234
Physical anomalies with associated mental retardation include all of the following EXCEPT
```
A. multiple hair whorls
B. low-set ears
C. high-arched palate
D. flattened philtrum
E. persistent Babinski reflex
```
E
Sadock, et al
2011
p306
235
Profound mental retardation is defined as
```
A. an IQ of 70 or below
B. an IQ between 40 and 55
C. an IQ of 25 or below
D. an IQ of 25 to 40
E. an IQ of 55 to 70
```
C
Sadock, et al
2011
p313
236
A decline in IQ begins at approximately 10-15 years in which of the following disorders?
```
A. Down syndrome
B. Fragile X syndrome
C. cerebral palsy
D. nonspecific mental retardation
E. fetal alcohol syndrome
```
B
Sadock, et al
2011
p313
237
Which of the following disorders is LEAST often associated with fragile X syndrome?
```
A. Autistic disorder
B. Schizotypal personality disorder
C. Attention-deficit/hyperactivity disorder
D. Bipolar disorder
E. Social anxiety disorder
```
D
Sadock, et al
2011
p313
238
A microdeletion on chromosome 7 is the primary cause of
```
A. Prader-Willi syndrome
B. Fragile X syndrome
C. Williams' syndrome
D. Rett syndrome
E. none of the above
```
C
Sadock, et al
2011
p313
239
A child must be at least how old for a diagnosis of written expression disorder to be made?
```
A. 5 years old
B. 6 years old
C. 7 years old
D. 8 years old
E. 9 years old
```
D
Sadock, et al
2011
p319-20
240
In children with developmental coordination disorder, unintentional muscle movements are identified using which of the following terms?
```
A. dyskinesia
B. glossolalia
C. dyspraxia
D. synkinesia
E. hypotonia
```
D
Sadock, et al
2011
p324
241
In which disorder or syndrome does head growth begin to decelerate between the ages of 6 months and 1 year?
```
A. Fragile X syndrome
B. Autistic disorder
C. Rett syndrome
D. Learning disorder
E. Asperger's disorder
```
C
Sadock, et al
2011
p333
242
Which of the following is NOT a characteristic of Asperger's disorder?
```
A. visible awkwardness
B. inappropriate affect
C. poor coordination
D. odd posture
E. bouncy gait
```
B
Sadock, et al
2011
p335
243
The first symptom of ADHD to remit is usually
```
A. hyperactivity
B. distractibility
C. careless mistakes in schoolwork
D. impulsivity
E. learning difficulties
```
A
Sadock, et al
2011
p340
244
To be diagnosed with childhood-onset conduct disorder, at least one criterion for the disorder must be met before what age?
```
A. 10 years
B. 11 years
C. 12 years
D. 13 years
E. 14 years
```
A
Sadock, et al
2011
p343
245
The most common comorbid condition of conduct disorder is considered to be
```
A. attention-deficit/hyperactive disorders
B. major depressive disorder
C. paranoid psychotic disorders
D. oppositional defiant disorder
E. substance used disorders
```
A
Sadock, et al
2011
p344
246
Family studies have shown a relationship between OCD and what other group of disorders?
```
A. mood disorder
B. tic disorder
C. learning disorder
D. elimination disorder
E. phobic disorder
```
B
Sadock, et al
2011
p353
247
In Tourette's disorder, the initial tics are in the
```
A. face and neck
B. arms and hands
C. body and lower extremities
D. respiratory system
E. alimentary system
```
A
Sadock, et al
2011
p353
248
Which of the following distinguishes transient tic disorder from chronic motor or vocal tic disorder and Tourette's disorder?
A. age of onset
B. the presence of motor tics only
C. the presence of vocal tics only
D. the presence of both motor and vocal tics
E. temporal progression of the tic symptoms
E
Sadock, et al
2011
p354
249
To make a diagnosis of enuresis in an 8-year-old child who wets the bed, at least how oten must the child wet the bed?
```
A. once an hour
B. once a day
C. once a week
D. once a month
E. once a year
```
D
Sadock, et al
2011
p358
250
Childhood PTSD was officially recognized as a psychiatric disorder in what year?
```
A. 1978
B. 1979
C. 1980
D. 1981
E. 1982
```
D
Sadock, et al
2011
p370
