Psychiatry Medicine 2023

Question 1 of 405

Which of the following sentences best describes type 2 bipolar disorder?

At least one manic episode and often accompanied by depressed or hypomanic periods.
One manic episode and one hypomanic episode.
At least one hypomanic episode, at least one major depressive episode and absence of manic episodes.
Depressed mood co-exists with manic symptoms.
Alternating periods of hypomania and periods of mild to moderate depressive symptoms over the course of two years.

Question 2 of 405

Which of the following statements about lithium is FALSE?

It is excreted by the kidneys.
Blood levels > 3 mmol require hemodialysis.
It alters neuronal sodium transport.
Lethal levels of lithium are > 6 mmol
The onset of action of lithium is 5-7 days.

Question 3 of 405

Which of the following activities should be discouraged in patients taking benzodiazepines?

Deep-sea diving
Smoking
Ranitidine
Driving
Consuming tyramine rich foods

Question 4 of 405

Which of the following sentences regarding phobias is FALSE?

At least 5-10% of the US population is affected.
Social phobias are far more frequently seen than specific phobias.
Average age of onset is in the mid-teens.
Phobias are the most common mental disorders.
Females are more commonly affected than males.

Question 5 of 405

Which one of the following drugs is the first line of management for anxiety?

Beta-blockers
Zolpidem
Selective serotonin reuptake inhibitors (SSRIs)
Buspirone
Benzodiazepines

Question 6 of 405

Which of the following defense mechanisms are commonly seen in cluster A personality disorders?

Reaction formation and rationalization
Acting out and passive aggression
Passive aggression, intellectualization and acting out
Projection, denial and rationalization
Intellectualization and reaction formation

Question 7 of 405

Which vitamin is given to alcohol dependent people to prevent Wernicke’s or Korsakoff’s syndrome?

Vitamin B
Vitamin C
Vitamin B1
Vitamin B6
Vitamin D3

Question 8 of 405

Which of the following is FALSE about nicotine?

Stomach cancer is the most common cause of death associated with nicotine
Children with second hand smoking are at risk for otitis media, SIDS and low birth weight
The lifetime prevalence of nicotine addiction is 20%
Nicotine stimulates the autonomic ganglia of sympathetic and parasympathetic nervous systems
Addiction is due to the involvement of the dopaminergic system

Question 9 of 405

Which of the following lists the correct sequence of phases of pathological gambling?

Desperation – winning – progressive winning
Winning – progressive winning – progressive losses
Winning – progressive losses – desperation
Progressive winning – anxiety – desperation
Progressive losses – winning – desperation

Question 10 of 405

Which of the following statements regarding eating disorders is TRUE?

Purging is seen typically in anorexia.
Males tend to have anorexia more commonly than females.
Bulimia is ego-dystonic while anorexia is ego-syntonic.
The median age of onset for bulimia is 30 years while that in anorexia is 25 years of age.
Bulimic patients tend not to seek help from doctors for treatment but anorexic patients tend to seek help from the doctors for treatment.

Question 11 of 405

Which of the following is NOT a post-mortem finding seen in Alzheimer’s disease?

Intraparenchymal cysts
Enlarged ventricles
Neurofibrillary tangles
Tau proteins
Senile plaques

Question 12 of 405

What phase of child development is characterized by egocentricity?

Latency
Adolescence
Infancy
Pre-adolescence
Pre-school

Question 13 of 405

Which of the following is NOT a side effect of polypharmacy in the elderly?

Decreased cognition
Increased tolerance
Increased drug adverse effects
Prescribing cascade
Drug interactions

Question 14 of 405

A 16-year-old girl recalls the first day she tried to sing at school. What type of memory is this?

Procedural memory
Episodic memory
Semantic memory
Geographical memory
Autobiographical memory

Question 15 of 405

Which of the following statements regarding the management of dissociative identity disorder is TRUE?

It is usually chronic with incomplete recovery.
Cognitive-behavioral therapy is very effective.
Patients with an older age of onset have a poor prognosis.
Pharmacotherapy such as SSRIs is the first-line treatment.
ECT is done in severe and resistant cases.

Question 16 of 405

Which of the following would NOT yield relevant information about the past medical history of a patient suspected to have somatization disorder?

Lifetime psychiatry symptoms
Parental care during childhood
Past medical records – any pattern of suspected ailments that were not confirmed
Similar symptoms in neighbors
Prior treatment with any psychotropic agents

Question 17 of 405

A 17-year-old girl presents to a pediatrician with her mother, who says that her daughter spends 3 hours each day getting ready in order to hide a 1-cm scar on her right arm. During the interview, the girl frequently voices concerns about her appearance. What condition could she likely have?

Obsessive-compulsive disorder
Normal teenage behavior
Body dysmorphic disorder
Anorexia nervosa
Somatoform disorder

Question 18 of 405

What is a primary indication for zolpidem?

Anxiety disorder
General anxiety disorder
Post-traumatic stress disorder (PTSD)
Agoraphobia
Insomnia

Question 19 of 405

What is a possible mechanism of action of lithium?

Reduction of inositol triphosphate
Inhibition of G protein-coupled receptors with increased production of cyclic AMP
Reduction in plasma GABA levels
Reduction in intracellular calcium
Decreasing the availability of glutamate in postsynaptic neurons

Question 20 of 405

Which of the following is NOT an element of the mental status exam?

Thought process
Mood/Affect
Gait
Speech
Perception

Question 21 of 405

A patient says she owns a gun and intends to use it to kill herself. What type of suicidal ideation is she displaying?

Active suicidal ideation
Static suicidal ideation
Passive suicidal ideation
Initiative suicidal ideation
Active homicidal ideation

Question 22 of 405

Which of the following statements best defines the mechanism of sublimation?

Alleviating negative feelings via unsolicited generosity
Appreciating the amusing nature of an anxiety-provoking situation
Satisfying one's wishes or impulses in an acceptable manner
Involuntarily withholding an idea or feeling from conscious awareness
Intentionally withholding an idea or feeling from conscious awareness

Question 23 of 405

Regarding thought disorders, which of the following terms best describes “the repetition of the same words or ideas by the patient, even after the interview topic has changed”?

Clanging
Alogia
Perseveration
Word salad
Word interruption

Question 24 of 405

Which of the following options are therapeutic options for the management of neuroleptic malignant syndrome?

Dantrolene, Benzodiazepines and heating pads
IV fluids, cooling, and Dantrolene
IV fluids, anticholinergics and high potency D2 blockers
IV fluids, high potency D2 blockers and β-blockers
β-blockers, cooling and Cholinergic agents

Question 25 of 405

What percentage of people with 2 previous episodes of major depression are more likely to experience a third one?

70%
50%
80%
40%
60%

Question 26 of 405

All the following statements regarding bipolar disorder are true, EXCEPT:

90% of individuals with a history of one manic episode will have another manic episode.
The mean age of onset for type I bipolar disorder is 18 years of age and type II bipolar disorder is 20 years of age.
It is often misdiagnosed as schizophrenia in ethnic minorities.
The estimated lifetime prevalence among adults worldwide is 10%.
It equally affects both sexes.

Question 27 of 405

Which of the following is a side effect of lithium?

Resting tremors
Hyperthyroidism
Weight loss
Leukocytopenia
Nephrogenic diabetes insipidus.

Question 28 of 405

Which of the following statements regarding cognitive-behavioral therapy (CBT) is FALSE?

CBT combined with pharmacotherapy is more advantageous for the patient than using a single option.
CBT completely replaces pharmacological therapy.
Breathing therapy, exposure, and muscle relaxation are some techniques used in CBT.
CBT is just as important as pharmacotherapy
CBT addresses panic attacks, anxiety about panic attacks, and avoidance sensation.

Question 29 of 405

Which of the following statements regarding factors leading to phobias is FALSE?

The occipital lobe is involved in the development of phobias.
Fears can be innate and biologically determined.
Specific phobias aggregate in families.
Traumatic events can trigger phobias in some patients.
First degree relatives of the patients with social phobias are more likely to develop the disorder.

Question 30 of 405

Which amongst the following statements about anxiolytics is FALSE?

Benzodiazepines are the most commonly prescribed agents.
Anxiolytics are also used for managing alcohol withdrawal symptoms.
Antipsychotics have anxiolytic effects at very high doses.
Antidepressants take 4–6 weeks to express their effects.
Anxiolytics/hypnotics work diffusely in the brain causing a sedative effect.

Question 31 of 405

Which of the following sentences regarding histrionic personality disorder is FALSE?

High doses of diazepam is used as the first line of treatment
They consider relationships to be more intimate than they actually are
A rapidly shifting and shallow expression of emotions
Some experience attenuation of symptoms with age
It is more commonly seen in females than males

Question 32 of 405

Which of the following is NOT a syndrome associated with alcohol withdrawal?

Withdrawal seizures
Minor withdrawal
Delirium tremens
Alcoholic hallucinations
Alcoholic mania

Question 33 of 405

Which of the following is TRUE about cocaine abuse?

A patient on cocaine appears sober and depressed
Cocaine’s vasoconstricting effect results in renal ischemia and death
Cocaine blocks dopamine uptake from the synaptic cleft causing a stimulant effect
Cocaine is protective against the development of myocardial infarction
Cocaine tesst stays positive 1 week after use

Question 34 of 405

Which defense mechanisms are most commonly seen in gambling disorders?

Idealization and intellectualization
Rationalization and denial
Intellectualization and denial
Projection and rationalization
Regression and projection

Question 35 of 405

A 7-year-old girl is brought in by her mother complaining that she has been eating small pebbles for the past 2 months, even after the mother’s repeated attempts to stop her. What is the most likely diagnosis in this patient?

Attention deficit hyperactivity disorder
Bulimia nervosa
Obsessive-compulsive personality disorder
Rumination disorder
Pica

Question 36 of 405

Which of the following is an autosomal dominant disease that features dementia and caudate atrophy?

Parkinson’s disease
Alzheimer’s disease
Pick's disease
Creutzfeldt-Jakob disease
Huntington’s disease

Question 37 of 405

At which stage of development does the child struggle to create a sense of identity separate from his/her parents?

Adolescence
Infancy
Post-school
Preschool
Latency

Question 38 of 405

Which of the following is NOT one of the stages of dying according to Kubler-Ross?

Guilt
Denial
Acceptance
Depression
Bargaining

Question 39 of 405

Which sentence regarding dissociative amnesia is TRUE?

It is a potentially reversible memory impairment where the patient is not bothered by it.
Older men are more affected.
Comorbid conditions include bipolar disorder type 2 and anorexia nervosa.
The prevalence is around 40% in the general population.
It results due to sudden health deterioration due to general medical conditions.

Question 40 of 405

Which of the following is NOT a feature of depersonalization?

Absent reality testing
Associated anxiety and panic
Persistent or recurrent
Preserved awareness
Detachment from one’s self, environment, or social situation

Question 41 of 405

Which of the following must always be done when attending to a patient with suspected somatization disorder?

Immediate dismissal of the symptoms as non-life-threatening
A thorough physical examination
Referring the patient to another physician
Try to convince the patient that their symptoms are psychiatric in origin
A diagnosis of the specific psychiatric illness should be made first

Question 42 of 405

Which of the following should NOT be done when managing a patient with benzodiazepine abuse, agitation, and suicidal intentions in the ER?

Admit to the ICU if delirious
Assess for safety after medically stabilizing the patient
Check vitals
Stopping the benzodiazepine immediately
Psychiatry consult once the patient is stabilized

Question 43 of 405

What is the most accurate statement about ramelton?

It is used to induce anesthesia.
It is most active in the ventromedial hypothalamus.
It is excreted through the kidneys without metabolism.
It is mainly used to treat trichotillomania.
It is a melatonin receptor agonist.

Question 44 of 405

According to some guidelines, lithium is contraindicated in which condition?

In combination with antipsychotics for schizophrenia
Bipolar disorder I
Bipolar disorder II
Breastfeeding
In combination with antidepressants for major depressive disorder

Question 45 of 405

Which of the following would be the expected characteristics of the speech of a manic patient?

Rapid, interruptible and continuous
Rapid, uninterruptible and pressured
Slow, uninterruptible and continuous
Slow, continuous and pressured
Rapid, uninterruptible, discontinuous

Question 46 of 405

All the following are modifiable risk factors for suicide, EXCEPT:

General medical conditions (e.g. chronic pain, end-stage cancer)
History of physical or sexual abuse
Substance abuse
Underlying mental illness (e.g. depression, anxiety)
Professional supports (e.g. access to psychiatric care)

Question 47 of 405

Purposely ignoring an unacceptable impulse or emotion in order to diminish discomfort and accomplish a task is the definition of which of the following defense mechanisms?

Sublimation
Repression
Humor
Suppression
Altruism

Question 48 of 405

Which of the following is a metabolic disorder that can be associated with psychosis?

Wilson’s disease
Phenylketonuria
SLE
Maple syrup urine
Fabry disease

Question 49 of 405

Which of the following is a notable side effect of Clozapine?

Thrombocytopenia
Erythrocytosis
Hyperemesis
Agranulocytosis
Aplastic anemia

Question 50 of 405

Which of the following statements regarding depression in elderly patients is TRUE?

It often presents as irritability instead of low mood.
They are twice less likely to commit suicide as the general population.
It requires underlying dementia for diagnosis.
Depression is present in 50% of the nursing home residents.
The symptoms can be mistaken with memory and cognitive disturbances related to aging.

Question 51 of 405

Which of the following agents unmask manic episodes in patients with bipolar disorder?

Corticosteroids
Antipsychotics
Bronchodilators
Antidepressants
Dopamine antagonists

Question 52 of 405

Which of the following drugs can be used to treat trigeminal neuralgia, seizures, and stabilize mood?

Diazepam
Phenobarbital
Clonazepam
Valproic acid
Carbamazepine

Question 53 of 405

Which of the following statements about relapse prevention is TRUE?

Encourages patients to apply their coping skills
Can only be done in a hospital setting
Must be done one year after discontinuing CBT
Involves addition of a Benzodiazepine
Must be done using an SNRI drug

Question 54 of 405

Which of the following is considered a risk factor for situational phobias?

Disgust sensitivity
Mistrust sensitivity
Social sensitivity
Anxiety sensitivity
Positional sensitivity

Question 55 of 405

Which of the following intermediate-acting benzodiazepines are used for treating alcohol withdrawal?

Chlordiazepoxide
Lorazepam
Temazepam
Diazepam
Alprazolam

Question 56 of 405

Which of the following personality disorders can be described as a pervasive pattern of grandiosity with a need for admiration and lack of empathy?

Paranoid personality disorder
Narcissistic personality disorder
Borderline personality disorder
Histrionic personality disorder
Avoidant personality disorder

Question 57 of 405

Which receptors are inhibited by alcohol?

Glutamate
Serotonin
ACH
GABA
FSH

Question 58 of 405

When a crash occurs during cocaine withdrawal, how should it be managed?

IV fluids through a large bore needle
Rest and sleep
High dose haloperidol
Low dose benzodiazepines
Psychotherapy

Question 59 of 405

Which of the following is a co-morbid disorder of kleptomania?

Gambling disorder
Pyromania
Bulimia nervosa
Agoraphobia
Generalized anxiety disorder

Question 60 of 405

Which of the following disorders features repeated regurgitation not associated with a medical or psychiatric condition?

Gastroesophageal reflux disease.
Rumination disorder
Pyloric stenosis
Pediatric binge eating disorder
Pica

Question 61 of 405

Which of the following is NOT seen in normal pressure hydrocephalus?

Incontinence
Dementia
Myoclonus
Gait disturbance
Enlarged ventricles

Question 62 of 405

Which theory describes that the reciprocal process of bonding is based on the care and relationship that develops between the infant and the primary caregiver?

Freud’s psychosexual model
Mary Ainsworth theory
Mahler’s separation-individuation process
Bowlby’s attachment theory
Erikson’s epigenetic model

Question 63 of 405

Which of the following statements is FALSE regarding major depression in the elderly?

Patients may appear demented; however, their symptoms are only secondary to their underlying depression.
Pseudodementia is the presence of apparent cognitive deficits in patients with major depression.
Depressive symptoms include problems with memory and cognitive functioning.
Depressive symptoms are present in 15% of the nursing home residents.
The elderly with depression are not as likely to commit suicide than the general population.

Question 64 of 405

A 27-year-old woman is brought into the clinic by her friend who complains she has been acting differently since a major car accident last week. The friend says that although the patient did not suffer any major physical injury, she has been giving absurd answers to simple questions. What is the patient manifesting?

PTSD
Ganser syndrome
Normal grief
Schizophrenia
Malingering

Question 65 of 405

Which of the following regarding depersonalization is FALSE?

It has an increased incidence of comorbid depression and anxiety.
Half of all college students experience depersonalization.
The average age of onset is 30-40 years old.
Severe stress is a predisposing factor.
The prevalence in the United States is 20%.

Question 66 of 405

Which of the following is NOT a diagnostic criterion for somatic symptom disorder?

Although the specific somatic symptoms may change, the disorder is persistent for more than 6 months.
The time and energy devoted to the symptoms or health are excessive.
Persistent thoughts about the seriousness of the symptoms
Persistent, severe anxiety about the symptoms or one’s general health
One or more first-degree relatives with a previous diagnosis of somatic symptom disorder

Question 67 of 405

Which of the following situations is NOT a scenario where confidentiality can be breached by the clinician?

A patient’s spouse requests the health information.
Records are requested for legal purposes.
The patient has waived confidentiality.
If there is harm to a third party.
Medical emergencies

Question 68 of 405

What statement is most accurate regarding suvorexant?

Suvorexant is the primary choice for insomnia during pregnancy.
Suvorexant is excreted in breast milk and should not be used by nursing women.
Suvorexant is non-addictive and safe to use by patients with substance abuse issues.
It is best avoided in patients on medications that strongly inhibit the liver enzyme CYP3A.
Suvorexant is not excreted in breast milk and may be used by nursing women

Question 69 of 405

Which statement is TRUE?

Duloxetine is not recommended for diabetic neuropathy.
Amitriptyline is indicated for chronic pain.
Selegiline is often indicated for smoking cessation.
Tricyclic antidepressants are rarely indicated in major depression.
Tricyclic antidepressants have fewer side effects than selective serotonin reuptake inhibitors.

Question 70 of 405

Which of the following components of mood best describes how quickly a person appears to shift between emotional states?

Quality
Congruency
Motility
Appropriateness to content
Intensity

Question 71 of 405

A patient with suicidal intention has access to guns/weapons. How can this risk factor be modified?

Treat him with SSRIs
Refer to community therapy
Teach him how to use the firearms
Refer to vocational training programs
Educate about removing the firearms from the home

Question 72 of 405

Which of the following statements best defines the mechanism of displacement?

Withholding a feeling from conscious awareness
Expressing unacceptable feelings and thoughts through actions
Shifting emotions from an undesirable situation to one that is personally tolerable
Separating feelings from ideas and events
Avoiding the fact of a painful reality

Question 73 of 405

Which of the following dopaminergic pathways is responsible for the extrapyramidal symptoms and tardive dyskinesia schizophrenic patients experience?

Mesocortical
Mesolimbic
Nigrostriatal
Tuberoinfundibular
Infundibulo Limbic

Question 74 of 405

Which one of the following drugs can be used for both psychosis and major depression?

Olanzapine
Clozapine
Risperidone
Quetiapine
Ziprasidone

Question 75 of 405

Which of the following groups of drugs is NOT useful in the management of depression?

Selective serotonin reuptake inhibitors
Tricyclic antidepressants
Antipsychotics
Monoamine oxidase inhibitors
Dopamine inhibitors

Question 76 of 405

Which of the following psychosocial factors does NOT contribute to the development of Bipolar disorders?

Childhood maltreatment
Abuse
Experimentation with illicit drugs (e.g. cocaine)
Poverty
Stressful life events

Question 77 of 405

Which of the following is a life-threatening side effect of Lamotrigine?

Stevens-Johnson syndrome
Leukocytosis
Diabetes Insipidus
Renal failure
Fine tremors

Question 78 of 405

How can obsessions be defined?

Repetitive, intrusive voices instructing to follow commands.
Repetitive usage of the same words without making sense.
Repetitive hand movements causing mental relaxation.
Repetitive, intrusive thoughts that cause anxiety or distress.
Repetitive mental or behavioral acts that neutralize obsessive thoughts.

Question 79 of 405

What’s the definition of separation anxiety disorder?

Stage fright
Fear of being separated from a loved one or away from home.
Fear of heights
Fear of open spaces, public places, or simply being outside home.
Fear of life-threatening events.

Question 80 of 405

Which of the following is NOT a side effect of benzodiazepines?

Drowsiness
Reduced motor coordination
Impairment in intellectual function
Muscle rigidity
Respiratory depression

Question 81 of 405

Which of the following is NOT seen in borderline personality disorder?

The pattern is stable and of long duration, often tracing back to adolescent age
Identity disturbances
The enduring pattern is not attributable to drug abuse or another medical condition
Inappropriately cool demeanor with which they handle situations
Unstable and intense interpersonal relationships

Question 82 of 405

Which of the following regarding the metabolism of alcohol is FALSE?

Alcohol dehydrogenase converts alcohol to acetaldehyde.
Asians tend to have facial flushing and nausea due to a deficiency of aldehyde dehydrogenase.
Age, sex, weight, and speed of consumption, determine the absorption and elimination rates of alcohol in an individual.
It activates glutamate receptors

Question 83 of 405

Which of the following differentiates MDMA from Dexedrine?

MDMA releases dopamine and serotonin causing stimulating and hallucinogenic effects.
The drug screen stays positive for 1-2 days in MDMA abuse.
It causes psychomotor changes.
MDMA can also be used for depression and ADHD.
It causes euphoria, nausea, dilated pupils and weight loss.

Question 84 of 405

Which of the following about kleptomania is TRUE?

Symptoms often occur after an episode of syncope.
It is more common in women than men.
The patient often has a preexisting seizure disorder.
It occurs in 50 % of the shoplifters.
The illness is usually acute following a traumatic event.

Question 85 of 405

The content of what was ingested may indicate if the intent is due to pica or self-injurious. Which of the following would elevate your suspicions of self-injury?

Gum
Clay
Chalk
Batteries
Hair

Question 86 of 405

Which of the following is FALSE regarding Creutzfeldt-Jakob disease?

Patients worsen over a short period of time due to the rapidity of the disease.
It is a prion disease.
Death typically occurs within 6 months.
There is no effective treatment for this condition.
Myoclonus is an associated finding.

Question 87 of 405

Which theory of development describes the concepts of differentiation, practicing, rapprochement, and object constancy?

Mary Ainsworth theory
Erikson’s epigenetic model
Mahler’s separation-individuation process
Piaget-cognitive development
Freud’s psychosexual model

Question 88 of 405

Which of the following is used for treating severe cases of depression in the elderly?

Cognitive-behavioral therapy
Diazepam
Minocycline
Electroconvulsive therapy
Bromocriptine

Question 89 of 405

Which type of amnesia features an inability to recall one’s entire life history and identity?

Overt dissociative amnesia
Covert amnesia
Localized amnesia
Selective amnesia
Generalized amnesia

Question 90 of 405

Which of the following terms describes the difficulty to identify and verbalize emotions?

Dyslexia
Allodynia
Agraphia
Alexithymia
Dysthymia

Question 91 of 405

Which of the following is NOT a feature of conversion disorder?

Involves the presence of voluntary motor or sensory function
Belle indifference
Associated with traumatic events
Can be preceded or exacerbated by a psychological stressor
Always explained by an underlying medical disorder

Question 92 of 405

Which of the following terms describes the process of hospitalizing a person against his or her will?

Confidentiality
Voluntary civil commitment
Criminal commitment
Informed commitment
Involuntary civil commitment

Question 93 of 405

What is NOT a feature of ramelton?

Used to treat a non-24-hour sleep-wake disorder
Acts on receptors in the suprachiasmatic nucleus
Used to treat insomnia
Highly addictive
Low risk of abuse

Question 94 of 405

Which statement is correct?

Flumazenil is an antidote to barbiturates.
Benzodiazepines bind to the GABA-a receptor at the interface between the α and γ subunits.
Benzodiazepines are more potent than barbiturates.
Benzodiazepines bind to the GABA-a receptor at the interface solely at the γ subunit.
Benzodiazepines work by antagonizing the effects of gamma-aminobutyric acid (GABA) in the liver.

Question 95 of 405

When examining a patient’s thought process, which of the following defines tangentiality?

Fast stream of thoughts with lack of goal-directed associations between ideas
Multiple tangential thoughts taking a circuitous path before reaching the point of conversation
Lack of connection from one thought to another
Failing to reach the point of conversation due to lack of goal-directed associations between ideas
Never reaching the point of conversation due to abrupt cessation of communication

Question 96 of 405

When diagnosing a psychiatric illness, which of the following would NOT be considered among the biological factors?

Considering contributing and protective factors
Any treatment history of family members with mental illness
Optimizing treatment of medical issues
Family history of meningitis
Screening and addressing substance abuse issues

Question 97 of 405

Which of the following terms defines the “avoidance of negative feelings by excessive use of intellectual functions and by focusing on irrelevant details or inanimate objects”?

Isolation of affect
Controlling
Displacement
Sublimation
Intellectualization

Question 98 of 405

The ventromedial prefrontal cortex, part of the mesocortical pathway, is responsible for which of the following in schizophrenia?

Motivation
Cognitive and executive functions
Positive symptoms
Motor planning
Emotion and affect

Question 99 of 405

Which of the following is available as both short and long acting injectables?

Ziprasidone
Risperidone
Aripiprazole
Clozapine
Quetiapine

Question 100 of 405

Which of the following statements regarding serotonin syndrome is FALSE?

It can also result in coma and death.
The patient often presents with seizures.
It is seen when monoamine oxidase inhibitors and selective norepinephrine reuptake inhibitors are used together.
It can occur when the patient is on a high dose of an SSRI.
Hypothermia is one of its hallmarks.

Question 101 of 405

Which of the following statements regarding the development of Bipolar disorder is FALSE?

Brain structure and function are altered in Bipolar disorder.
Early development processes that modulate emotional behavior are disrupted as evidenced by neuroimaging.
Inflammation is associated with immune system dysregulation.
There's a single "candidate" gene responsible for the development of Bipolar disorder.
Family, twin and adoption studies demonstrate that inherited factors are involved in the pathogenesis.

Question 102 of 405

What is the goal of treatment with mood stabilizers?

Augmentation
Sedation
Stabilization
Response
Remission

Question 103 of 405

Which of the following statements about obsessive-compulsive disorder (OCD) is FALSE?

Females are more affected than males.
25% of cases occur before 14 years of age.
Lifetime prevalence is 2-3% in the general population.
Women specifically have an early onset of the disease (before 10 years of age).
Mid 20's is the main age of onset.

Question 104 of 405

Which of the following is NOT used to treat specific phobias?

SSRIs
Systematic desensitization
Exposure based treatment
Relaxation techniques
Breathing techniques

Question 105 of 405

Zolpidem (Ambien) is used in limited doses in women because of which of the following side effects?

Memory problems
Weight gain
Respiratory depression
No tolerance or dependence
Rebound insomnia

Question 106 of 405

Patients with borderline personality disorder have an increased risk of developing the following, EXCEPT:

Eating disorders
Post-traumatic stress disorder
Suicidal ideation
Delusion of grandiosity
Drug abuse

Question 107 of 405

Coma and death can be seen at which blood level of alcohol?

1–2%
0.3–0.4%
0.4–0.5%
2–3%
0.1–0.2%

Question 108 of 405

Which of the following is the mechanism of action of angel dust (PCP)?

Antagonizes dopaminergic receptors and activates NMDA receptors
Activates serotonergic receptors
Activates GABA receptors
Inhibits serotonergic and activates dopaminergic receptors
Antagonizes NMDA glutamate receptors and activates dopaminergic receptors

Question 109 of 405

Which of the following is NOT a treatment option for kleptomania?

Paroxetine
Naltrexone
Imipramine
Systematic desensitization
Aversion conditioning

Question 110 of 405

Which of the following comorbid medical conditions is associated with binge eating disorder?

Chronic kidney disease
Hyperlipidemia
Hyperuricemia
Hyponatremia
Diabetes mellitus

Question 111 of 405

What is the key MRI finding of Huntington’s disease?

Enlarged ventricles
Atrophy of the caudate nucleus
Atrophy of the frontotemporal lobes
Small infarcts
Prominent neuronal loss of substantia nigra

Question 112 of 405

According to Freud’s psychosexual model, during which age does the child fall in love with the parent of the opposite sex and want to have exclusive possession of that parent and eliminate the other?

-18 years
1-3 years
Birth-1 year
6-11 years
3-5 years

Question 113 of 405

Why should amitriptyline be avoided in elderly patients?

Renal abnormalities
Cardiac abnormalities
Cognitive disturbances
Liver toxicity
Respiratory failure

Question 114 of 405

Which of the following describes overt dissociative amnesia (type 1)?

Partial memory for a period of time
Inability to recall one's life history but with an integral recollection of one's identity
A common type of amnesia often not uncovered
Lack of autobiographical memory for a specific time period
Dramatic and profound loss of memory about personal history and identity

Question 115 of 405

Which of the following is NOT a differential diagnosis of depersonalization/derealization disorder?

Major depression
Panic disorder
Schizophrenia
Dissociative fugue
PTSD

Question 116 of 405

Which of the following statements regarding the development of conversion disorder is FALSE?

According to the dynamic theory, the structure and function of the right hemisphere are altered and cortical communication is impaired.
The dynamic hypothesis says that conversion is a solution to an unconscious conflict.
An underlying autoimmune disease is the main predisposing factor.
According to the suggestibility theory, people who do not have a sense of self and have high levels of hypnotizability are more likely to develop conversion disorder.
Hypercritical families create unspeakable dilemmas.

Question 117 of 405

Which of the following terms describes the right of a person to file a petition if they believe they have been illegally deprived of their liberty (e.g. involuntary commitment)?

Writ of corpus habeas
Consumer right
Writ of habeas corpus
The constitutional right of freedom
HIPAA

Question 118 of 405

Based on the amine hypothesis of depression, which hormonal change within the synaptic cleft is responsible for depression?

High levels of GABA
Low levels of acetylcholine
High levels of dopamine
High levels of serotonin
Low levels of norepinephrine

Question 119 of 405

Which medication is appropriate to treat situational anxiety?

Alprazolam
Norketamine
Amlodipine
Phenobarbital
Propofol

Question 120 of 405

All of the following questions inquire about the history of the present illness, EXCEPT:

How have the patient's work and relationships been affected?
What were the events leading up to the present moment?
What medication was the patient previously on?
What is the relationship between physical and psychological symptoms?
What is the patient’s support system?

Question 121 of 405

Which of the following is used as the diagnostic standard for mental illnesses in the United States?

ICD-5 by the World Health Organization
ICD-10 by the American Psychiatric Association
DSM-5 by World Health Organization
DSM-10 by World Health Organization
DSM-5 by the American Psychiatric Association

Question 122 of 405

A young man met with a major road traffic accident and recounts the details to the police without any emotion. Which defense mechanism is he using?

Displacement
Repression
Intellectualization
Isolation of affect
Controlling

Question 123 of 405

Intoxication of PCP/Angel dust produces a clinical syndrome similar to schizophrenia. Which of the following neurotransmitters is involved in this process?

Serotonin
Glutamate
Epinephrine
Norepinephrine
GABA

Question 124 of 405

All the following statements regarding treatment with Clozapine are true, EXCEPT:

Discontinue treatment when the absolute neutrophil count (ANC) is <1,500/microL.
WBC and ANC must be checked weekly for the first 18 weeks and every 28 days after that time.
2-5% of patients develop seizures
Clozapine is among the most common atypical antipsychotics to cause metabolic syndrome.
We can continue the treatment if the WBC count is >3500.

Question 125 of 405

When is ElectroConvulsive Therapy (ECT) indicated as a treatment modality?

Patients not responding to one antidepressant.
It's given to all cases of depression, even those responsive to antidepressant therapy.
When the patient presents with catatonia
Only when an adjunctive mood stabilizer is given
It's offered as first-line therapy in all cases of major depression.

Question 126 of 405

Which of the following is NOT a diagnostic criterion for Bipolar disorder?

Increased distractibility
Impulsivity
Decreased need for sleep
Flight of ideas
Low self-esteem

Question 127 of 405

Which of the following statements regarding panic attacks is FALSE?

It affects much of the general population.
It presents as a sudden onset of shortness of breath, chest pain, numbness and tingling in the extremities along with nausea.
It is a mental disorder.
It is a discrete period of heightened anxiety.
It is an acute episode of fear.

Question 128 of 405

Which of the following is NOT a factor for developing obsessive-compulsive disorder (OCD)?

Premenstrual and post-partum periods
Traumatic brain injury
Infection by Staphylococcus Aureus
Genetics
Exposure to traumatic events

Question 129 of 405

Which of the following is NOT a risk factor for post-traumatic stress disorder (PTSD)?

The unexpected death of loved ones
Motor vehicle collision
War and armed conflicts (combat exposure)
Intimate partner violence
Childhood seizures

Question 130 of 405

Which of the following psychiatric conditions can be caused by propranolol?

Seizure disorder
Anxiety
Bipolar type 2
Depression
Previous cardiovascular diseases

Question 131 of 405

Which psychotherapy is best used for borderline personality disorder?

Cognitive behavior therapy
Dialectical behavioral therapy
Biofeedback
Functional analytical psychotherapy
Intensive short-term psychotherapy

Question 132 of 405

Which of the following is NOT a screening tool used for alcohol use disorder?

AUDIT (Alcohol Use Disorder Identification Test)
PESQ (Personal Experience Screening Questionnaire)
MAST (Michigan Alcohol Screening Test)
ADI (Adolescent Drinking Inventory)
CAGE Questionnaire

Question 133 of 405

All the following symptoms are seen in PCP intoxication, EXCEPT:

Muscle rigidity
Impulsivity
Rotatory nystagmus
Restlessness
Hypotension

Question 134 of 405

Which of the following is NOT true about Pyromania?

The fire setting is not better explained by conduct disorder, manic episodes or antisocial personality disorder.
Prognosis is better in adults than children.
One of the diagnostic criteria includes more than one episode of intentional fire setting.
More common in men.
More common in intellectually disabled individuals.

Question 135 of 405

Which of the following is FALSE regarding binge eating disorder?

Patients often feel disgusted with themselves, depressed, and guilty after overeating.
Binge eating disorder is associated with increased craving for food in patients occurring every day.
Unipolar major depression along with social and specific phobias are often seen in patients with binge eating disorder.
Large weight fluctuations can be seen.
No regular use of inappropriate compensatory behaviors is seen.

Question 136 of 405

Which of the following is NOT a feature of delirium?

The sensorium is waxing and waning in patients with delirium.
Potentially reversible
Chronic onset
There are moments of lucidity punctuated by hallucinations in patients with delirium.
Disorder of cognition

Question 137 of 405

Which theory of development describes a pattern or loop of behavior with stimulus-response-awareness where the child follows a continuous pattern of adaptive behaviors and responses to various stimuli in the environment?

Piaget's cognitive development model
Erikson’s epigenetic model
Bowlby’s attachment theory
Freud’s psychosexual model
Mary Ainsworth theory

Question 138 of 405

Which of the following distinctly differentiates normal grief from abnormal grief?

Sleep disturbances
Weight loss
Feelings of sadness
Feelings of guilt
Resolution of symptoms

Question 139 of 405

Which of the following statements regarding dissociative fugue is FALSE?

It is a rare disorder with unknown prevalence.
The patients are aware of their amnesia and are often distressed by it.
It affects a subset of patients with generalized dissociative amnesia.
It is marked by purposeful and sudden, unexpected travel from home that is associated with amnesia for identity.
Patients often assume an entirely new identity and occupation after arriving in a new location.

Question 140 of 405

Which of the following does NOT characterize somatization disorders?

There is no organic etiology.
These individuals often refuse to see a physician despite their ailments.
The complaint of multiple vague symptoms involving various organ systems.
The patients attribute the distress to physical illnesses.
They experience somatic distress in response to psychosocial stress.

Question 141 of 405

Which of the following is an effective treatment for conversion disorder?

Group counseling
Selective serotonin receptor inhibitors
Desensitization
Insight-oriented psychotherapy
Cognitive-behavioral therapy

Question 142 of 405

Which of the following regarding civil commitment is FALSE?

It involves the deprivation of fundamental rights guaranteed under the constitution of the United States.
Due process is the proper procedural protection granted before a state can deprive an individual of their fundamental rights.
An individual can only be involuntarily committed if he or she is a danger to themselves or others.
The person has a documented mental condition.
An involuntary admission of a patient to an inpatient psychiatry unit is referred to as civil commitment.

Question 143 of 405

Which monoamine oxidase inhibitor is matched with its mechanism of action?

Hydracarbazine: a selective MAO-B inhibitor
Tranylcypromine: a selective MAO-A inhibitor
Moclobemide: a non-selective MAOI
Selegiline: a MAO-B inhibitor
Phenelzine: a selective MAO-A inhibitor

Question 144 of 405

Which medication interacts with SSRIs and carries a risk of serotonin syndrome?

Atorvastatin
Aspirin
Lithium
Selegiline
Acetaminophen

Question 145 of 405

Which of the following questions would NOT be useful during the psychiatric interrogation of the present illness?

"Have you heard strange sounds or voices, or seen things that aren't there?"
"Has anyone in your family been diagnosed with cancer?"
"What's your day like when these things aren't bothering you?"
"Are you having problems with your sleep or appetite?"
"Has something like this happened to you before?"

Question 146 of 405

Which of the following terms describes the “therapist’s redirection of unconscious feelings about influential figures in his/her life onto the patient”?

Dream interpretation
Countertransference
Free association
Displacement
Transference

Question 147 of 405

A movie star addicted to drugs starts a new campaign: “Say No to Drugs.” What defense mechanism is he displaying?

Reaction formation
Passive aggression
Regression
Splitting
Rationalization

Question 148 of 405

Which phase of schizophrenia is marked by flat affect, social withdrawal and odd thinking or behavior?

Residual phase
Psychotic phase
Prodromal phase
Intermittent phase
Convalescence phase

Question 149 of 405

Which of the following neurotransmitter changes are seen in depression?

↑serotonin, ↑norepinephrine, ↓dopamine
↓serotonin, ↓norepinephrine, ↓dopamine
↓serotonin, ↑norepinephrine, ↑dopamine
↓serotonin, ↑norepinephrine, ↓dopamine
↑serotonin, ↑norepinephrine, ↑dopamine

Question 150 of 405

Which of the following drugs acts by blocking the reuptake of noradrenaline and serotonin?

Mirtazipine
Fluoxetine
Selegiline
Amitriptyline
Clozapine

Question 151 of 405

What makes a manic episode a psychiatric emergency?

The "flight of ideas" symptom
The patient's inflated ego
It's a state of severely impaired judgment.
It can last up to a week.
The presence of insomnia

Question 152 of 405

Which of the following disorders commonly accompanies panic disorder?

Major depression
Schizoaffective disorder
Generalized anxiety disorder
Bulimia Nervosa
Bipolar disorder

Question 153 of 405

Which circuit in the brain is involved in obsessive-compulsive disorder (OCD)?

Rubro-cortico-striato
Cerebello-thalamic
Ventromedial thalamic
Cortico-striato-thalamo-cortical (CSTC)
Cortico-medio-pontine

Question 154 of 405

The following statements about post-traumatic stress disorder (PTSD) are true, EXCEPT:

The patient can experience intense fear and hopelessness during the event.
The patient can experience vivid nightmares related to the event.
It can occur due to physical assault.
Lifetime prevalence ranges from 50%-60% in the general population.
Symptoms lead to considerable social, occupational and interpersonal dysfunction.

Question 155 of 405

Which of the following receptors are targeted by buspirone to achieve its anxiolytic effect?

Dopamine
5-HT-1A
ACH
Glutamate
GABA

Question 156 of 405

Which of the following personality disorders is more prone to having a mid-life crisis?

Antisocial
Histrionic
Avoidant
Narcissistic
Borderline

Question 157 of 405

A 50-year-old male was brought to the emergency room by the police in an unconscious state. The patient appears to be homeless and has a strong odor of alcohol. What is the first step in management of this patient?

Test for glucose by fingerstick.
Start IV insulin and glucose.
Start chlordiazepoxide.
Assess airway, breathing and circulation.
Administer thiamine and naloxone.

Question 158 of 405

A 22-year-old college student is brought to the emergency department by the police. The patient looks drowsy and is slurring his words. On examination, his pupils are constricted and respiratory rate is marked to be 8 breaths per minute. He has vomited twice since he was brought to the emergency room. Later, he admits to taking “some pills” at a party. Which drug is most likely involved?

Opiates
MDMA
Marijuana
LSD
Cocaine

Question 159 of 405

Which of the following is used to treat Pyromania?

Systematic desensitization
Amitriptyline
Duloxetine
Group discussion therapy
Lithium

Question 160 of 405

Which of the following is an effective therapy for binge eating disorder?

Individual behavior therapy
Lithium monotherapy
Pulse dosed benzodiazepines
Three weeks of SSRIs combined with benzodiazepines
Behavioral therapy with stimulant and antidepressant medication

Question 161 of 405

Which of the following is done to distinguish quiet delirium from depression?

Mini-Mental Status Examination (MMSE)
Abbreviated mental test score
Beck Depression Inventory (BDI)
Positive and Negative Syndrome Scale (PANSS)
Comprehensive Psychopathological Rating Scale (CPRS)

Question 162 of 405

Which intellectual quotient score indicates a significantly below-average intellectual function?

<50
<20
<40
<70
<90

Question 163 of 405

Which statement is TRUE regarding sleep disturbances in the elderly?

Regular physical activity increases the incidence of sleep disturbances.
The incidence of sleep disorders decreases with age.
There is decreased daytime napping in the elderly.
The elderly have decreased daytime sleep with prolonged nighttime sleep.
The underlying cause can be medications, general medical conditions, or environmental changes.

Question 164 of 405

Which of the following is NOT a predisposing factor for dissociative fugue?

Cannabis use
Heavy alcohol use
Stressful life event
Head trauma or epilepsy
Major depression

Question 165 of 405

Which of the following statements best describes the “wandering womb” belief held by the ancient Egyptians regarding the somatization disorders?

Implicates a patient's ability to recall symptoms from either their own or a role model’s experience as a means of expressing distress.
Pain and suffering are used as intrapsychic defense. They are seen as deserved and used as atonement for hostile impulses.
They believed that hysteria was caused by the uterus migrating throughout the body.
It is a communication asserting to doctors that one is deserving of care.
Family aggregation can be due to genetics, environment, or both.

Question 166 of 405

General medical conditions must be ruled out when a patient presents with all the following symptoms of conversion disorder, EXCEPT…?

…shifting paralysis.
…mutism.
…sore throat.
…seizures.
…blindness.

Question 167 of 405

What is the CORRECT sequence of procedures to gain a patient’s informed consent?

Assess patient’s target symptoms – perform informed consent – explain diagnosis – offer recommendations
Offer recommendations – explain diagnosis – assess symptoms – perform informed consent
Assess patient’s target symptoms – offer recommendations – explain diagnosis – perform informed consent process
Assess patient’s symptoms – offer recommendations – performed informed consent – explain the diagnosis
Explain diagnosis – offer recommendations – assess patient’s symptoms – perform informed consent

Question 168 of 405

What is a feature of tricyclic antidepressants?

Dialyzable
Insignificant first-pass metabolism
Low side effect profile
Lower seizure threshold
Low volume of distribution

Question 169 of 405

What is NOT a characteristic of classical antipsychotic medications?

They have a high affinity for both D1 and D2 receptors.
They have a high rate of extrapyramidal side effects.
The most commonly used medication in the emergency setting is haloperidol.
Tardive dyskinesia is a side effect.
They easily cross the blood-brain barrier.

Question 170 of 405

During the psychiatric interrogation, which of the following points would provide the MOST RELEVANT information regarding past substance abuse?

Preferred substances, frequency of intoxication, withdrawals, and quitting attempts
Recent history of travel
Previous surgeries
Evidence of secondary gain
Suicide attempts when clean

Question 171 of 405

A rat in a cage receives a treat every time it pushes a lever. This is an example of which of the following?

Flooding
Operant conditioning
Classic deconditioning
Classic conditioning
Systematic desensitization

Question 172 of 405

Regarding delusions, which of the following terms best defines the “belief that some event is uniquely related to him/her”?

Thought broadcasting
Delusion of grandeur
Ideas of reference
Paranoid delusion
Hallucination

Question 173 of 405

All the following are risk factors for suicide in the patient with schizophrenia, EXCEPT:

Age under 30
Living alone
Female gender
Comorbid substance abuse
Recent hospital discharge

Question 174 of 405

According to the monoamine hypothesis, what is the mechanism of action of antidepressants?

Antidepressants decrease the concentration of NE and serotonin in the synapse by upregulating the postsynaptic receptors.
Antidepressants increase the concentration of NE and serotonin in the synapse by downregulating the pre-synaptic receptors
Antidepressants decrease the concentration of NE and serotonin in the synapse and downregulate the post-synaptic receptors.
Antidepressants increase the concentration of NE and serotonin in the synapse and upregulate the pre-synaptic receptors.
Antidepressants increase the concentration of NE and serotonin in the synapse and downregulate the post-synaptic receptors.

Question 175 of 405

Which of the following conditions is not treated with Selegiline?

Fibromyalgia
Hypochondriasis
Treatment resistant cases of depression
Atypical depression
Anxiety

Question 176 of 405

Which of the following is NOT a diagnostic feature of Cyclothymic disorder?

Depressive episodes do not meet criteria for major depressive disorder
It has lasted at least 2 years.
It includes periods of persistently elevated and expansive mood.
Hypomanic episodes that severely impair functionality
It includes periods of persistently depressed mood.

Question 177 of 405

PTSD can be defined as…

Experience of panic attacks accompanied by a persistent fear of having additional attacks.
A brief episode of depressed mood associated with suicidal intentions.
Persistent, excessive anxiety and hyperarousal about daily general events.
A response to a catastrophic life event where the patient re-experiences the trauma.
Alternating episodes of panic and anger as a response to major trauma.

Question 178 of 405

Which of the following options is strongly linked to obsessive-compulsive disorder (OCD)?

Histrionic personality disorder
Paranoid delusions
Bipolar with hypomania
Suicidal thoughts
Schizoaffective disorder

Question 179 of 405

When interrogating a patient with likely post-traumatic stress disorder (PTSD), all of the following must be asked to assess the patient’s current mental health EXCEPT?

Signs of isolation and occupational gatherings
Feelings of detachment/estrangement
Past medical illness
Flashbacks and intrusive recollection
Sleeping difficulties

Question 180 of 405

Which of the following statements about personality disorders is FALSE?

They are ingrained, and the individual thinks there is perfect harmony
They are a set of behaviors, values, feelings, goals, and ideal self-image
They do not cause alarm to the individual
Personality disorders are ego syntonic (non-disruptive for the individuals)
It is an enduring set of stable, predictable, emotional and behavioral traits

Question 181 of 405

Which of the following is FALSE regarding antisocial personality disorder?

They are very likely to have been diagnosed with conduct disorder, before the age of 15 years
It is very sensitive to treatment
It tends to occur 5 times more often in first-degree relative of males with the disorder
it is more common in men than in women
The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder

Question 182 of 405

Which of the following treatment modalities has the highest rate of success in the treatment of alcoholism?

Psychotherapy
Disulfiram
Chlordiazepoxide
Alcoholics Anonymous
Naltrexone

Question 183 of 405

Which region in the brain is most associated with impulsive behavior?

Limbic system
Cerebellum
Pons
Medulla
Parietal lobe

Question 184 of 405

Which of the following predisposes to trichotillomania?

Diabetes mellitus
Binge eating
Hair fall
Schizophrenia
Stressful events

Question 185 of 405

Which of the following is used for assessing cognitive functioning?

Mini-Mental Status Examination (MMSE)
Minnesota Multiphasic Personality Inventory (MMPI)
Multidimensional battery aptitude
California psychological inventory
Statistical hypothesis testing

Question 186 of 405

Which type of delirium is most commonly seen?

Depressed type
Intermediate type
Agitated type
Quiet type

Question 187 of 405

Which of the following is described as a disruptive behavioral disorder that does not impinge on another person’s rights?

Oppositional defiant disorder
Antisocial personality disorder
Attention deficit hyperactivity disorder
Childhood autistic disorder
Conduct disorder

Question 188 of 405

Which of the following is NOT a side effect of sedative-hypnotic drugs in the elderly?

Paradoxical excitement
Memory impairment
Agitation
Rebound insomnia
Ataxia

Question 189 of 405

When assessing dissociative fugue, all of the following will yield relevant information for the diagnosis, EXCEPT:

Any missing important events in life
If the patient feels safe
Any blackouts or blank spells
Gaps in your memory
Orientation in place, time, and person

Question 190 of 405

Which theory of somatization disorders hypothesizes that somatic symptoms represent care-seeking behavior in a patient with insecure attachments?

Learning theory
Cultural stigma
Biological model
Genetic model
Interpersonal model

Question 191 of 405

What is a factitious disorder?

It is a disorder where an individual will intentionally produce medical or psychological symptoms in order to assume the role of a sick patient.
It includes somatic symptoms with excessive thoughts, feelings, or behaviors associated with somatic symptoms.
It is a disorder where a patient will intentionally produce illness to his family or friends in order to assume the role of a caretaker.
It is a condition of faking or exaggerating symptoms for an obvious external benefit like money or disability.
It is a disorder where the mother produces symptoms in her child in order to gain an external benefit.

Question 192 of 405

Which of the following situations would NOT require informed consent?

Pregnancy care
Voluntary surgical procedure
Treatment of an STD
Treatment for COPD in a pulmonology ward
Lifesaving medical emergency

Question 193 of 405

Which mechanism of action and side effects are matched INCORRECTLY?

Serotonin antagonist: nausea
Histamine antagonist: sedation, drowsiness, weight gain
Alpha-1 antagonist: priapism
Acetylcholine antagonist: blurred vision, dry mouth, constipation
Alpha-2 antagonist: alertness, blurred vision

Question 194 of 405

Which symptom is LEAST likely to be adequately managed by typical antipsychotic medications?

Pressured speech
Apathy
Delusions
Paranoia
Hallucinations

Question 195 of 405

All of the following points would yield relevant information about past medical/surgical history when interrogating a psychiatric patient EXCEPT…?

head injury/concussion.
traumatic brain injury.
seizures.
suicide attempts in the family.
HIV/AIDS.

Question 196 of 405

Which of the following terms best describes “deconditioning involving intensive thought of anxiety-producing situations or events in a patient’s life”?

Systematic desensitization
Aversion
Operant deconditioning
Flooding
Implosion

Question 197 of 405

Mr. Smith irrationally fears that he is being followed by the FBI. Which of the following types of Delusional disorder does Mr. Smith have?

Delusion of grandeur.
Paranoid delusion
Persecutory delusion
Somatic delusion.
Delusion of guilt.

Question 198 of 405

Which of the following sentences about schizophrenia is NOT true?

Head CT scan can show ventricular enlargement and cortical atrophy.
There are 3 phases of schizophrenia.
Approximately 30% of the patients commit suicide.
Negative symptoms are considered as the core and are difficult to treat.
Eugen Bleuler coined the term schizophrenia.

Question 199 of 405

What changes are seen in the Hippocampus during depression?

Decreased dopamine affects the functionality of the Hippocampus.
Elevated cortisol during stress is neurotoxic to the Hippocampus.
Elevated concentrations of NE acts as a neurotoxic agent on the Hippocampus.
Elevated serotonin is neurotoxic to the Hippocampus.
Cortisol level falls during the times of stress and impairs the functions of the Hippocampus.

Question 200 of 405

Which of the following groups of antidepressants produces hypertensive crisis when taken with tyramine-rich foods?

Atypical antidepressants
Selective norepinephrine reuptake inhibitors (SNRI)
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants (TCA)
Monoamine Oxidase Inhibitors (MAOI)

Question 201 of 405

Which of the following best defines rapid cycling disorder?

6 or more mood episodes in weeks
4 or more mood episodes in months
Absence of mood symptoms for 4 or more months in months
Occurrence of depression every year during winter
Numerous episodes of hypomania in the discrete time frame

Question 202 of 405

Which of the following is NOT a vulnerability factor for panic disorder?

Neuroticism
Sexual abuse
Asthma
Alcoholism
First-degree relative affected by the disorder

Question 203 of 405

Which of the following would NOT be considered compulsions?

Washing
Counting
Repeating numbers
Repetitive behaviors
Urges

Question 204 of 405

Which of the following is NOT a diagnostic criterion of post-traumatic stress disorder (PTSD)?

The duration of disturbance must be more than 1 year.
Persistence avoidance of stimuli associated with the traumatic events.
Exposure to actual or threatened death, serious injury or sexual violence.
Not related to other medical, substance or psychiatric conditions.
Marked alterations in arousal and reactivity with the traumatic event.

Question 205 of 405

What is the approach to manage personality disorders?

Establish goals — psychotherapy — medication — align with the patient
Align with the patient — psychotherapy — establish goals — medication
Establish goals — align with the patient — psychotherapy — medication
Medication — align with the patient — establish goals — psychotherapy
Align with the patient — establish goals — psychotherapy — medication

Question 206 of 405

Which of the following is a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts?

Avoidant personality disorder
Obsessive compulsive disorder
Schizoid disorder
Borderline disorder
Paranoid disorder

Question 207 of 405

Which of the following statements regarding disulfiram is FALSE?

It has a terrible reaction when taken along with alcohol causing facial flushing and nausea.
It inhibits the mu opioid receptors.
It is used as an aversion therapy leading to negative conditioning when the patient drinks alcohol.
Side effects include metallic taste, flushing, headache, tachycardia and nausea.
It inhibits aldehyde dehydrogenase.

Question 208 of 405

Which of the following statements about impulse and impulse control disorders is FALSE?

There is no relief or satisfaction even after the behavior is completed.
Anxiety or tension is often experienced prior to the impulse.
Impulse is characterized by an inability to resist behaviors that may bring harm to oneself or to others.
Testosterone is the hormone most associated with aggressive behavior.
Serotonin is decreased in the CSF of patients with impulse control disorders.

Question 209 of 405

Which of the following is NOT useful for managing trichotillomania?

Hypnosis
Antipsychotics
SSRIs
Mood stabilizers
Electro-convulsive therapy (ECT)

Question 210 of 405

Which of the following is NOT a component of the mini-mental status examination (MMSE)?

Recall
Orientation
Language
Intellectual quotient (IQ)
Executive function

Question 211 of 405

Which of the following is NOT a differential for delirium?

Psychosis
Dementia
Schizophrenia
Depression
Wernicke’s encephalopathy

Question 212 of 405

Which of the following is FALSE regarding conduct disorder?

It involves the violation of the basic right of others or of social norms and rules.
There is an increased comorbidity of ADHD, mood disorders, substance abuse, and criminal behavior in adulthood
More commonly seen in boys than in girls
There is a high risk of developing antisocial personality disorder in adulthood
Conduct disorder is rarely seen nowadays due to advancements in the health care systems.

Question 213 of 405

Which of the following statements about elder abuse is FALSE?

Neglect or misuse of finances is also considered abuse.
It more commonly occurs in small towns as compared with the bigger cities.
The perpetrator is usually a caregiver who lives with the victim.
The abuse can include physical, sexual, and psychological.
It occurs in 10% of all people over 65 years old.

Question 214 of 405

Which of the following sentences best describes the difference between dissociative amnesia and dissociative fugue?

Patients with dissociative amnesia are aware that they have forgotten something.
Patients with dissociative fugue are aware that they have forgotten something.
Patients with amnesia are completely distressed by the memory disturbance.
Fugues tend to occur in the young population, whereas amnesia tends to occur in the elderly.
Fugues spontaneously resolve within minutes, hours, or sometimes within days.

Question 215 of 405

Which of the following statements about somatization is FALSE?

It is more likely in people with high socioeconomic rank compared to people with low social status.
The incidence in women is 5-20 times greater than in men.
50% of these patients often have a co-morbid mental disorder.
Patients are often under-educated.
It is often seen in minority ethnic status.

Question 216 of 405

Which of the following statements regarding the management of a somatization or somatic symptom disorder is FALSE?

The goal of treatment is to provide care and not focus on curing the disease.
Schedule regular follow-up visits with diagnostic testing to rule out any missing diseases.
Introduce psychological issues slowly.
Avoid a struggle over labeling the disease.
Do no more and no less for the somatic patient than for another patient.

Question 217 of 405

Minors are considered emancipated under the following conditions, EXCEPT:

Self-supporting
Go to college before the age of 18/have an above-average IQ
Married
Military service
Have children of their own

Question 218 of 405

Which of the following is a mechanism of action of bupropion?

It is a non-competitive antagonist of nicotinic acetylcholine receptors.
It inhibits dopamine release from the presynaptic neuron.
It selectively induces dopamine re-uptake.
It inhibits noradrenaline release from the presynaptic neuron.
It selectively induces noradrenaline re-uptake.

Question 219 of 405

What is true about molindone?

It is never used in the treatment of Tourette syndrome or schizophrenia.
It is used in the treatment of Tourette syndrome alone.
It is only used in the treatment of schizophrenia.
It is used in the treatment of both Tourette syndrome and schizophrenia.
It has been removed from the market.

Question 220 of 405

Which of the following elements is distinctive in psychiatric history?

Past medical history
Family history
Social history
Substance abuse history
Past surgical history

Question 221 of 405

Which of the following best explains the concept of biofeedback?

A negative stimulus repeatedly paired with specific behavior to create an unpleasant response.
Rewards given after specific behaviors to positively reinforce them.
Performing relaxation techniques while being exposed to increasing doses of an anxiety provoking stimulus.
Immersing an individual in their feared stimulus.
Physiological data are given to the patients as they try to mentally control physiological states.

Question 222 of 405

Which type of hallucination is experienced by patients with Lewy body dementia?

Olfactory hallucination
Paranoid hallucination
Visual hallucination
Auditory hallucination
Somatic hallucination

Question 223 of 405

Which of the following is NOT criteria for diagnosing schizophrenia?

The disorder affects domains of life including social and occupational functioning.
Not due to substances or a general medical condition.
An underlying medical condition that justifies psychotic behavior must be present.
Schizoaffective disorder and mood disorder with psychotic features have been ruled out.
If the patient has a history of pervasive developmental disorder, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are present for at least a month (or less if successfully treated).

Question 224 of 405

Which of the following is NOT a diagnostic criterion for major depression?

Changes in appetite and weight.
Recurrent thoughts of suicide.
Loss of interest in once pleasurable activities (anhedonia)
Alternating mood between depression and anxiety
Psychomotor agitation or retardation.

Question 225 of 405

All of the following statements regarding Citalopram are true, EXCEPT:

Citalopram along with Selegiline can cause severe hypotension
They increase synaptic serotonin by decreasing the serotonin reuptake pump in the presynaptic neurons
Stopping citalopram abruptly after usage of a high dose can produce SSRI discontinuation syndrome
It can also be used for treating OCD and PTSD
Its toxicity can produce QTC prolongation on the ECG

Question 226 of 405

A patient presented with Bipolar disorder associated with hallucinations. Which of the following symptoms should be targeted first by the physician?

Mood
Impulsivity
Hallucinations
Pressured speech
Insomnia

Question 227 of 405

Which of the following receptors are responsible for panic disorder?

GABA-benzodiazepine receptors and serotonin receptor systems
NE receptors and dopamine receptors
NMDA receptors and glutamate receptors
Glutamate receptors and NE receptors
Dopamine receptors and NMDA receptors

Question 228 of 405

Which of the following is NOT related to obsessions?

Overestimating threat
Avoidance of people, places or things that might trigger the thoughts
Gaining pleasure from the thoughts
Overvaluing the importance of thoughts
Intrusive thoughts

Question 229 of 405

Which of the following terms corresponds to a sense of unreality of self, detachment from the body or a feeling of being an outside observer in one’s own life?

Decortication
Derealization
Demoralization
Desensitization
Depersonalization

Question 230 of 405

Which of the following is the therapeutic goal of psychodynamic psychotherapy when treating personality disorders?

Improving symptoms such as aggression, impulsivity, anxiety, depression, and psychosis
Sedating the patient by using hypnosis
Transforming the ego — syntonic state to an ego — dystonic state
Transforming an ego — dystonic state to an ego — syntonic state
Changing aggression to psychosis

Question 231 of 405

Which of the following disorders is defined as “a pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fear of separation, beginning by early adulthood and present in a variety of contexts”?

Obsessive-compulsive personality disorder
Borderline personality disorder
Avoidant personality disorder
Histrionic personality disorder
Dependent personality disorder

Question 232 of 405

Which of the following is TRUE regarding delirium tremens?

Anorexia is a diagnostic feature.
It is the most serious form of alcohol withdrawal.
Fine resting tremors are typically seen.
Tapering doses of antipsychotics show the best response.
Begins within 24 hours of cessation of drinking.

Question 233 of 405

Which of the following is NOT a type of impulse?

Intermittent explosive disorder
Trichotillomania
Pyromania
Kleptomania
Pyrophobia

Question 234 of 405

All the following statements about anorexia nervosa is true, EXCEPT:

It is up to 3 times more common in females than in males.
The lifetime prevalence in adolescents is 0.3%.
Restricting and binge eating are the two types of anorexia nervosa.
Amenorrhea is no longer a diagnostic criterion for anorexia.
Female physicians are at high risk for developing anorexia nervosa.

Question 235 of 405

Which of the following is FALSE regarding the Montreal cognitive assessment (MoCA)?

It is more sensitive in detecting mild cognitive impairment.
It is a screening test used in older adults.
It includes a wider range of cognitive domains.
It takes approximately 10 minutes to administer it.
It is a 20-point test and a score of less than 10 suggests dysfunction.

Question 236 of 405

How should a delirious patient be monitored when treated with quetiapine?

Serum urea
Serum bilirubin
Hemoglobin
Serum creatinine
Telemetry monitoring

Question 237 of 405

Which of the following is NOT a treatment approach for behavioral disorder?

Parenting skills teaching
Electroconvulsive therapy
Behavioral modification
Problem-solving skills
Psychotherapy

Question 238 of 405

Which of the following drugs is a once-a-day pill which is a non-stimulant, non-addictive, drug that increases the concentration in patients with attention-deficit/hyperactivity disorder (ADHD)?

Ritalin
Adderall
Focalin
Atomoxetine
Alprazolam

Question 239 of 405

Which of the following therapeutic options is the most useful and effective for treating dissociative fugue?

Calcium carbonate
Hypnosis
Diazepam
Sodium amobarbital
Lorazepam

Question 240 of 405

Which of the following is likely to be found in the evaluation of an individual with somatization disorder?

No history of physical or sexual abuse
An individual who asks to be referred to a psychiatrist
No organic etiology for the symptoms
A cerebral mass on MRI
The complaint of a single well-defined symptom

Question 241 of 405

Which of the following statements about hypochondriasis is FALSE?

Patients misinterpret normal bodily symptoms as indicative of a disease.
It is an abrupt and short duration of concerns about health and possible illness.
About 80% of the patients have coexisting depression.
The average age of onset is 20-30 years old.
Men are more commonly affected than women.

Question 242 of 405

Which of the following is an INCORRECT statement about the assessment process of informed consent?

One should Identify the target symptoms of the patient.
Individuals do not need to be told the side effect profiles of a drug.
One should ask about family members taking the proposed medication and their response to the drug.
One should find out if the individual has tried any other medications and if they have had reactions.
One should ask about the patient’s allergies.

Question 243 of 405

Which statement is LEAST accurate?

Duloxetine may be used for diabetic neuropathy.
Venlafaxine has a relatively high rate of discontinuation syndrome.
Duloxetine has minimal withdrawal symptoms.
Duloxetine may be used for neuropathic pain.
Venlafaxine should be used cautiously in patients with hypertension.

Question 244 of 405

Which patient is most likely to benefit from treatment with benztropine?

A 35-year-old male diagnosed with acute dystonia
A 7-year-old patient diagnosed with Tourette's syndrome
A 79-year-old patient coming in with Lewy body dementia
A 92-year-old man diagnosed with Alzheimer's disease
A 21-year-old woman with a history of hallucinations and severe anxiety diagnosed with schizophrenia

Question 245 of 405

When taking a history about sensitive material such as substance use or history of violence, which is the most appropriate approach?

Ask open-ended questions indirectly.
Continuously persuade the patient to answer quickly to obtain the most reliable version of the events.
Request the patient to select among multiple options prepared on a form.
Open and direct
Ask the patient to fill up a consent form to provide accurate information.

Question 246 of 405

Which type of behavioral therapy is specifically used for borderline personality disorder?

Cognitive-behavioral therapy
Supportive therapy
Motivational interviewing
Dialectical behavior therapy
Interpersonal therapy

Question 247 of 405

Regarding thought disorders, which of the following terms best defines the “sudden loss of the train of thought exhibited by the patient as interruption of speech”?

Thought blocking
Thought transference
Alogia/poverty of speech
Loosening the association of thought
Thought reference

Question 248 of 405

All the following are good prognostic factors for schizophrenia, EXCEPT:

Early onset
Family support
Female sex
Presence of hallucinations
Good premorbid functioning

Question 249 of 405

Which of the following options would NOT provide relevant information when diagnosing major depression?

Take a thorough medical history and do a complete physical exam
Check levels of vitamins and thyroid hormones
Check complete blood counts, renal, liver functions tests, and urine drug screen
Take detailed info regarding current medication, including over the counter drugs
Obtain EEG of brain

Question 250 of 405

Which of the following can be used to treat sexual dysfunction related to selective serotonin reuptake inhibitors (SSRIs)?

Cognitive behavioral therapy
Mirtazapine
Sildenafil
Fexofenadine
Escitalopram

Question 251 of 405

A patient with known Bipolar disorder was brought to the emergency department by his neighbors who saw him with a knife threatening to kill himself. Which of the following should be done after stabilizing the patient?

Observe him in the emergency department for the next 4 days
Immediate admission
Request the neighbor who brought him to take care of the patient
Designate a caretaker and send him home
Partially hospitalize the patient

Question 252 of 405

Which of the following statements best describes agoraphobia?

Fear of blood or injury
Fear of fire
Fear of enclosed spaces
Fear of heights
Fear of public or crowded places

Question 253 of 405

Which of the following must be considered when assessing a compulsion?

Psychiatry Medicine 2023

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