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
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 isA. bipolar I disorder, manic typeB. borderline personality disorderC. factitious disorderD. major depressive disorderE. schizophrenic disorderAnswer
An adolescent reports difficulty sleeping. Which one of the following statements concerning insomnia is correct?A.Getting up at the same time every day can increase the restfulness of sleep.B.Daytime drowsiness, excessive snoring, and confusion if awakened from sleep are associated with restless legs syndrome.C.Insomnia rarely occurs in the elderly.D.There is little correlation between insomnia and depression.E.Patients must take hypnotic drugs for a prolonged period to cure insomnia.AnswerTags: MCQ, Psychiatry, Adolescent, Insomnia
An 18-year-old white male is having rapid mood changes, and his speech is pressured and difficult to interpret. These findings suggest a/an:A.obsessive-compulsive disorder.B.manic episode.C.paranoid schizophrenia.D.borderline personality.E.antisocial personality.AnswerTags: MCQ, Psychiatry, Mood Disorders
In a 19-year-old college student taking a selective serotonin reuptake inhibitor (SSRI), addition of bupropion (Wellbutrin) should be considered if the patient develops which one of the following side effects?A.DystoniaB.NauseaC.HeadacheD.Sexual dysfunctionE.Desire for cigarettesAnswerTags: MCQ, Psychiatry, SSRI, Serotonin
The physician counseling a 4-year-old child about the death of a loved one should keep in mind that children in this age group:A.often feel no sense of loss.B.often believe that they are somehow responsible for the death.C.should not attend a funeral.D.should usually be told the loved one is having a long sleep.E.usually accept the finality of death with little question.AnswerTags: MCQ, Psychiatry, Child, Grief
A 10-year-old male comes in for follow-up of his attention deficit hyperactivity disorder (ADHD). At the time of his last visit 1 month ago he was taking methylphenidate (Ritalin) each morning. At the time his mother reported that he did extremely well in class during the morning, but by the end of the day he was having problems with inattentiveness. This carried over into difficulties concentrating on homework after school. These problems were affecting his grades and causing distress to him and his mother. The child expressed a desire not to take medicine during the school day. You switched his medicine at that visit to a long-acting form of methylphenidate (e.g., Concerta).At this visit the mother reports that her son is now doing well through the entire school day and is able to get his homework done. However, she notes that his appetite at dinner has decreased and that he has lost 2 lbs. She also reports that it is somewhat more difficult for him to fall asleep.What is the most ap
A 19-year-old female comes to your office accompanied by her boyfriend. In the last 9 months she has withdrawn from college and has requested a leave of absence from her part-time job. She no longer will accept social engagements. Though she was formerly active in church and teaching Sunday school, she has also withdrawn from theses activities. Her relationship with her boyfriend remains strong, she sleeps well, and she continues independent running and cycling.Which one of the following would be appropriate as initial treatment?A.Lithium (Eskalith)B.Paroxetine (Paxil)C.Haloperidol (Haldol)D.Alprazolam (Xanax)E.Trazodone (Desyrel)AnswerTags: MCQ, Psychiatry, Depression, anxiety
A mother brings her 18-year-old daughter to you because of excessive showering and dressing rituals, which have been present for 3 years. You suspect, and a psychiatric consultant concurs, that the daughter has obsessive-compulsive disorder (OCD).Which one of the following statements about this patient is true?A) Obsessive-compulsive disorder (OCD) is a rare psychiatric diagnosis in adolescence.B) Her disease is likely to remit spontaneously.C) Unlike a schizophrenic patient, she would consider her rituals irrational.D) If behavior therapy fails, treatment with any tricyclic antidepressant will be effective in controlling her symptoms.E) If clomipramine (Anafranil) is used for drug therapy, blurred vision and dry mouth would be very uncommon side effects.AnswerTags: MCQ, Psychiatry, Obsessive Compulsive Disorder
In evaluating an 8-year-old boy for attention deficit hyperactivity disorder you would especially want to know:A) the results of an electroencephalogram.B) the result of a trial of antidepressants.C) the result of an enhanced CT scan of the head.D) the results of psychometric tests.E) your receptionist's assessment of the child's behavior in the waiting room.AnswerTags: MCQ, Psychiatry, ADHD
Which one of the following statements concerning suicide is correct?A) Elderly grandparents have the lowest rate of suicide.B) Adolescent males are much less likely than adolescent females to commit suicide.C) Firearms are the most common method for committing suicide.D) Youth suicides are rarely related to media reports of suicides.E) Homosexual adolescent and heterosexual adolescent suicides are of equal incidence.AnswerTags: Psychiatry, Suicide, MCQ, Multiple choice Questions
An 18-year-old white female is considered a difficult patient. She is hostile and exceedingly demanding, often requests specific medications, and once asked you to bring her back a souvenir from your vacation. She seems accident-prone and has frequently gotten into minor trouble as a teenager. She has multiple somatic complaints and has been diagnosed as having chronic fatigue syndrome by another physician.Of the following, the most likely diagnosis is:A) chronic mononucleosis.B) dysthymia.C) depression.D) borderline personality disorder.E) antisocial personality disorder.AnswerTags: MCQ, Psychiatry, Somatic
A 7-year-old is brought in by his parents for evaluation of possible attention-deficit/hyperactivity disorder (ADHD). You review the history carefully and perform a thorough physical examination, including visual and hearing evaluations. You conclude that the problem is more likely due to ineffective discipline than to ADHD.Which one of the following would be a strong clue that your interpretation is correct?A) The child has frequent motor and vocal ticsB) The child acts as if he is in "another world" when playingC) If a sibling is present, the child will play alongside, rather than with, the siblingD) There is a clear pattern of varying sleep cycles, varying from periods when the child needs little sleep and is euphoric, t to periods of excessive sleep and a depressed moodE) The parents react extremely emotionally when the child misbehaves during the office visitAnswerTags: MCQ, Psychiatry, ADHD
Which one of the following is true regarding attention-deficit/hyperactivity disorder (ADHD)?A) It frequently coexists with specific learning disabilities/cognitive deficitsB) It is more prevalent in girlsC) Megavitamins have proved helpful in the treatment of ADHDD) It rarely coexists with psychiatric behavioral disordersE) Antisocial personality disorders are unusual in adults who had ADHD as childrenAnswerTags: MCQ, Psychiatry, ADHD, Pediatrics
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 Tags: MCQ, Psychiatry, Child, ADHD
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) HypoparathyroidismB) SIADH C) Hypothyroidism D) Diabetes insipidus E) HypoaldosteronismAnswer Tags: MCQ, Psychiatry, Bipolar Disorders
Which one of the following is a common early side effect of fluoxetine (Prozac)?A) ConstipationB) Loss of appetiteC) Orthostatic hypotensionD) Atrioventricular blockE) Skin rashAnswerTags: MCQ, Psychiatry, Drugs, Side Effects
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 Tags: MCQ, Psychiatry, Depression
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 disorderB) Adjustment reaction with depressed moodC) Major depressionD) Generalized anxiety disorderE) Post-t
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 like
Which one of the following statements would be the most accurate advice to give to an adolescent beginning light therapy for seasonal affective disorder?A) The 10,000-lux fixture is more effective and less time consuming than the 2500-lux fixture.B) Sunscreen must be avoided for maximal benefit from therapy.C) Light treatment is most effective when given in one daily session.D) Patching the eyes during therapy is optional.E) If clinical response is not demonstrable after 7 days of therapy, alternative therapy is indicated.AnswerTags: MCQ, Psychiatry, Seasonal Affective Disorder
You diagnose depression in a 17-year-old white male and prescribe bupropion (Wellbutrin XL). He returns for a follow-up visit 4 weeks later. He now reports less despondency, but says he has developed severe insomnia. He also tells you that his mind "races" all the time, and that he has received two speeding tickets in the past 2 weeks.Which one of the following would be appropriate now?A) Substitute sertraline (Zoloft) for the bupropionB) Add valproate (Depakote)C) Add alprazolam (Xanax)D) Add imipramine (Tofranil) at bedtimeE) Add haloperidol (Haldol)AnswerTags: MCQ, Psychiatry, Depression, Mania
Which one of the following is characteristic of drug-seeking behavior in patients who abuse prescription drugs? A) They refuse non-narcotic alternatives.B) They rarely report drug allergies. C) They request that other modalities be tried first before narcotics are used. D) They minimize their symptoms. E) They frequently only see one physician.AnswerTags: MCQ, Psychiatry, Addiction
Which one of the following is indicated in the diagnostic workup for attention-deficit/hyperÂactivity disorder (ADHD)?A) A TSH levelB) An EEGC) A blood lead levelD) Continuous performance testingE) Home- and school-specific ADHD rating scalesAnswerTags: MCQ, Psychiatry, ADHD
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.AnswerTags: MCQ, Psychiatry, Bereavement
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.AnswerTags: MCQ, Psychiatry, Depression
