Psychiatry Flashcards
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
B
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2011
pp 244-5
Psychoneurosis includes all of the following disorder EXCEPT
A. anxiety disorder B. obsessive-compulsive disorder (OCD) C. sexual dysfunction D. dysthymia E. delusional disorder
E
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2011
p 68
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
B
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p 68
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
D
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2011
p 68
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
B
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p 68
Which of the following is a paramnesia?
A. Eidetic images B. Jamais vu C. Lethologica D. Repression E. Screen memories
B
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2011
p 69
The “Alice in Wonderland” effect is another name for
A. dysmegalopsia B. dysphasia C. trailing phenomenon D. dysmetria E. fausse reconnaissance
A
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2011
p 69
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
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2011
p 245
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
C
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2011
p 69
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
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2011
p 70
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
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2011
p 87
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
E
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2011
pp 87-8
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
B
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2011
p 88
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
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2011
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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
B.
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2011
p 90
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
E
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p 90
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.
D.
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2011
p 90
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
D
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p 90
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.
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2011
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Which of the following drugs is best used to treat acute delirium
A. amobarbital B. chlorpromazine C. diazepam D. haloperidol E. physostigmine salicylate
D
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p 91
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
B
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2011
p 91
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
E.
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2011
p 91
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.
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p 93
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
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2011
p 93
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
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p 94
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
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94
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
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2011
p 109
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
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p 109
Acute PCP intoxication is NOT treated with
A. diazepam B. cranberry juice C. phentolamine D. phenothiazines E. all of the above
D
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p 109
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
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2011
p 109
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
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2011
p 110
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
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2011
p 110
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
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p 110
Minor signs and symptoms of the benzodiazepine discontinuation syndrome commonly include
A. hyperpyrexia B. grand mal seizures C. psychosis D. nightmares E. death
D
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2011
p 111
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
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2011
p 111
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
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2011
p 111
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
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2011
pp 111-2
Which of the following drugs is an opioid antagonist?
A. naloxone B. naltrexone C. nalorphine D. apomorphine E. all of the above
E.
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p 112
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
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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
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2011
p 112
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
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p 112
Mouth ulceration is associated with which of the following types of withdrawal?
A. alcohol B. benzodiazepines C. cocaine D. nicotine E. opioids
D
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2011
p 113
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
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2011
p 113
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
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2011
pp 113-4
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
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2011
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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
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2011
p 123
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
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2011
p 123
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
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p 124
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
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2011
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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
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2011
p 124
Which of the following is NOT typically associated with catatonia?
A. mannerisms B. mutism C. stereotypies D. verbigeration E. waxy flexibility
D
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2011
p 124
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
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2011
p 125
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
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2011
p 125
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
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2011
p 125
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
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2011
p 125
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
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2011
p 126
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
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2011
p 126
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
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2011
p 127
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
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2011
p 128
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
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2011
pp 135-6
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
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2011
p 136
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
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2011
p 136-7
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
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2011
p 137
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
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2011
p 137
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
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2011
p 137
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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138-9
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
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2011
p 139
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
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2011
p 139
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
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2011
p 139
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
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2011
p 139
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
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2011
p139
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
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2011
p140
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
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2011
p 140
Mild, nonpsychotic depression with predominant anxiety is called
A. endogenomorphic depression B. bipolar disorder C. chronic depression D. Dysthymia E. anxiety disorder
D
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2011
p148
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
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2011
p148
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
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2011
p148
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
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2011
p149
All of the following are vegetative disturbances of depression EXCEPT
A. hypersexuality B. anorexia C. hypersomnia D. insomnia E. Circadian dysregulation
A
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2011
p149
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
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2011
p149
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
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2011
p150
Depression and mania share which of the following symptoms?
A. psychomotor acceleration B. low self-esteem C. grandiosity D. anger E. pessimism
D
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2011
p150
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
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2011
p150
The defense mechanism most commonly used in depression is
A. undoing B. sublimation C. projection D. introjection E. altriusm
D
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2011
p150
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
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2011
p151
Reactive depression can best be compared to
A. adjustment disorder B. atypical depression C. conduct disorder D. oppositional defiant disorder E. schizoaffective disorder
A
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2011
p151
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
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2011
p151
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
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2011
p151
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
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p 151
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
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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
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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
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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
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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
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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
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2011
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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
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2011
p152
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
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p152-3
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
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2011
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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
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2011
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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
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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
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