A 37-year-old woman is abducted, beaten, and repeatedly raped. For five months after the attack she is nervous, tearful, easily fatigued, and has difficulty concentrating. She also notes difficulty sleeping and lack of appetite, and is hyperreactive to unexpected or loud stimuli. By six months she has returned to her characteristic pre-attack behavioral patterns. Which of the following is the most likely diagnosis?
A. Acute stress disorder
B. Adjustment disorder with mixed anxiety and depressed mood
C. Major depressive disorder
D. Panic disorder without agoraphobia
E. Post-traumatic stress disorder
Answer
A 37-year-old woman who was diagnosed with AIDS 3 years earlier is unable to work, is physically debilitated, and requests her physician to provide her with medications with which to take her own life. The most common emotional disorder that results in such requests by patients is
A. bipolar I disorder, manic type
B. borderline personality disorder
C. factitious disorder
D. major depressive disorder
E. schizophrenic disorder
Answer
A 4-year-old girl is discovered pulling the tail of the family dog. Her mother, who had warned her previously that this behavior was unacceptable, now assigns the girl to a 5 minute time out period. A timer is set up so that the girl can keep track of the time period. After two minutes of the period, the girl begins to scream and cry. At this point, the mother's best response would be to
A. do nothing until the time out period has ended
B. explain to the child why this type of punishment is necessary
C. offer the child a choice between becoming quiet or "being paddled"
D. reset the timer to add an additional 5 minutes to the time out period
E. tell the child that if she quiets down she will be rewarded by a treat at the end of the time out period
Answer
A child psychiatrist would like to evaluate the intellectual ability of a 3-year-old patient. Which of the following is the most appropriate test for him to use?
A. Denver Developmental Scale
B. Stanford-Binet Scale
C. WAIS-R
D. WISC III
E. WPPSI
Answer
A 55 year old man presents with a 10 day history of confusion. His friend mentions that he drinks 15 units of alcohol a day. Which of the following strongly suggests a diagnosis of Korsakoff’s psychosis?
A. Absence seizures
B. Delusional beliefs
C. Poor long term memory
D. Auditory hallucinations
E. Confabulation
AnswerTags:
MCQ, Psychiatry, Korsakoff's syndrome
A 45 year man was arrested following abnormal behaviour in the streets. He was brought to the hospital for assessment because he was felt to have delusional behaviour, but then had a grand mal seizure during examination. What medication may have led to the seizure?
A. Amphetamine
B. LSD
C. Barbiturate
D. Cocaine
E. Chlorpromazine
AnswerTags:
MCQ, Psychiatry, Drug Abuse
A 65 year old man presents with an episode of amnesia for the second time. 2 days ago he had an episode of confusion, according to his wife. He was, however, able to have a normal conversation despite having been found wandering. After 2 hours, he abruptly returned to normal and could not remember what happened. What is the most likely diagnosis?
A. Alcoholic encephalopathy
B. Subarachnoid haemorrhage
C. Complex partial seizures
D. Transient ischaemic attack
E. Transient global amnesia
AnswerTags:
MCQ, Psychiatry, Amnesia
A 40 year old man complains of poor memory and comes to the hospital for cognitive testing. Which of the following features suggest dissociative amnesia?
A. Disorientation in time
B. Disorientation in place
C. Depressive features
D. Poor memory
E. Fluctuating recall
AnswerTags:
MCQ, Psychiatry, Dissociative Amnesia
A 35 year old man was brought by ambulance into hospital. He was found by the police in a corner and was reported to have stood there without moving in a stuporose state for two hours. The motor disturbance which is likely is:
A. Flaccid paralysis
B. Narcolepsy
C. Cataplexy
D. Catalepsy
E. Mannerisms
Answer
A 42 year old man presents witha depressive illness. the following factors would support an unfavourable prognosis
Except A. loss of mother prior to 12 years of age.
B. previous depressive illness.
C. involvement with local charitable organisations.
D. obsessional personality.
E. a wife house bound with multiple sclerosis.
Answer
Following a bereavement the following are shown to be true
except
A. Approximately 20% of widowers die in the first year.
B. Mortality is greater for women than for men.
C. Mortality is still greater than expected at 2 years post bereavement.
Answer
Which one of the following is indicated in the diagnostic workup for attention-deficit/hyperactivity disorder (ADHD)?
A) A TSH level
B) An EEG
C) A blood lead level
D) Continuous performance testing
E) Home- and school-specific ADHD rating scales
Answer
A 17-year-old white female is brought in by her parents because of concern about her recent weight loss. Her past medical history is unremarkable. Physical examination is notable for a body mass index of 23, bilateral parotid gland enlargement, dental erosions on the lingual surfaces of her teeth, submandibular lymphadenopathy, and elongated abrasions on the dorsal surface of her right hand.
The most likely diagnosis is:
A) hyperthyroidism.
B) Sjogren's syndrome.
C) sarcoidosis.
D) bulimia nervosa.
E) HIV infection.
Answer
Of the following antidepressants, which one is LEAST likely to cause drug interactions?
A) Citalopram (Celexa)
B) Fluoxetine (Prozac)
C) Paroxetine (Paxil)
D) Mirtazapine (Remeron)
E) Imipramine (Tofranil)
Answer
Which one of the following is a common early side effect of fluoxetine (Prozac)?
A) Constipation
B) Loss of appetite
C) Orthostatic hypotension
D) Atrioventricular block
E) Skin rash
Answer
You diagnose attention-deficit/hyperactivity disorder in a 10-year-old male, and the parents ask about medication treatment.
Which one of the following would you tell the parents with regard to potential side effects of medication treatment?
A) Methylphenidate (Ritalin) may precipitate seizures.
B) Although anorexia may occur, it will not lead to substantial short term weight loss.
C) Methylphenidate has significantly fewer side effects than dextroamphetamine (Dexedrine).
D) The effect on eventual adult height is minimal in patients treated with methylphenidate or dextroamphetamine.
E) Children treated with stimulants have an increased risk of developing addiction to illegal drugs in adolescence.
Answer
A patient with bipolar disorder is being treated with lithium. Of the following, which one is the most likely side effect of this therapy?
A) Hypoparathyroidism
B) SIADH
C) Hypothyroidism
D) Diabetes insipidus
E) Hypoaldosteronism
Answer
An 18-year-old female visits you because she is having difficulty sleeping, cannot concentrate, and is more irritable. She also says that people around her remark on how overly alert and wary she seems to be and how easy it is to startle her. With gentle probing you discover that 6 months ago she was driving a car that was involved in an accident in which a close friend was killed. Since that time she avoids driving and always tries to avoid the intersection where the accident occurred. In spite of trying to put it out of her mind, she still dreams about the event, and even during the day may relive the accident. Her mother is concerned because she has begun to withdraw from participation in school and church activities and just broke off a relationship with her long-term boyfriend.
The most probable PRIMARY diagnosis in this patient is which one of the following?
A) Acute stress disorder
B) Adjustment reaction with depressed mood
C) Major depression
D) Generalized anxiety disorder
E) Post-traumatic stress disorder
Answer
An 18-year-old female complains of generalized headache, dizziness (characterized as lightheadedness), and generally not feeling well for 3 days. This started at the same time as her menses and coincided with a major examination in a college class she is taking. Her review of symptoms is otherwise negative. Her past medical history includes a recent acute onset of low back pain related to lifting and a recent depressive episode which responded well to medication. Her current medications include an oral contraceptive, which she has taken for 2 years, a corticosteroid nasal spray, and ibuprofen for the past 2 weeks. She was on paroxetine (Paxil), 30 mg/day, for 7 months, but this was stopped 5 days ago because of sexual dysfunction. Because of her symptoms she has not taken any medications for the past 2 days. Since then the headache has eased substantially, but the feeling of lightheadedness has remained. A physical examination is unremarkable.
Which one of the following is the most likely cause of her symptoms?
A) Allergic rhinitis
B) Paroxetine withdrawal
C) Serotonin syndrome
D) Viral infection
E) Stress
Answer
The predominant symptom associated with dysthymic disorder is:
A) incoherence.
B) loosening of associations.
C) delusions.
D) depression.
E) trichotillomania.
Answer
