Category: Psych


How long after a stroke is a patient at a higher risk for developing a depressive disorder?

  1.  Two weeks
  2.  Two months
  3.  Six months
  4.  One year
  5.  Two years

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After a recent news segment about scoliosis, the mother of several of your female patients calls to ask about the condition. You explain to her that idiopathic scoliosis would be most commonly found in her daughters in which age range?

  1.  Birth to 3 years
  2. 4 to 10 years
  3. 11 to 18 years
  4. 19 to 25 years
  5. >25 years

the answer is below…

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A 16-year-old girl, accompanied by her mother, is in your office for a well-adolescent visit. The mother asks about drug and alcohol abuse. You explain that the warning signs of abuse include which of the following?

  1. Excessive concern for weight and body configuration
  2. Improved school performance
  3. Recent changes from age-appropriate, acceptable friends to younger associates
  4. Deterioration in personal habits, hygiene, dress, grooming, speech patterns, and fluency of expression
  5. Improvement in relationships with adults, siblings, and authority figures

the answer is below…

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After a recent suicide by one of his students, the local high school principal asks you to talk with teachers and students about adolescent suicide. Which of the statements is appropriate to include in the discussion?

  1. Girls tend to use more lethal means
  2. The number of attempted suicides is much higher among boys
  3. Those who are successful have a history of a prior attempt or prior serious suicidal ideation
  4. Inquiry by pediatricians, high school teachers, parents, or friends about suicidal thoughts precipitates the act
  5. The number of suicides in adolescents 10 to 19 years of age has decreased significantly since the 1950s

the answer is below…

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A 64-year-old man is admitted to the psychiatric unit after an unsuccessful suicide attempt. Following admission, he attempts to cut his wrists three times in the next 24 hours and refuses to eat or drink anything. He is scheduled to have electroconvulsive therapy (ECT) because he is so severely depressed that an antidepressant is deemed too slow-acting. Which of the following side effects should the patient be informed is common after ECT?

a. Headache

b. Palpitations

c. Deep venous thromboses

d. Interictal confusion

e. Worsening of the suicidal ideation

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A 28-year-old woman sees her physician with the chief complaint of a depressed mood. She also notes that she is sleeping more than usual—up to 14 hours per night—but does not feel rested and that she feels tired and fatigued all the time. She has gained 14 lb in the last month, something that she is very unhappy about, but she says that she seems to have such a craving for sweets that the weight gain seemed inevitable. Which of the following is the most likely diagnosis?

a. Mood disorder secondary to a general medical condition

b. Substance-induced mood disorder

c. Cyclothymia

d. Seasonal affective disorder

e. Dysthymic disorder

the answer is below…

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A 22-year-old college student calls his psychiatrist because for the past week, after cramming hard for finals, his thoughts have been racing and he is irritable. The psychiatrist notes that the patient’s speech is pressured as well. The patient has been stable for the past six months on 500 mg of valproate twice a day. What is the first step the psychiatrist should take in the management of this patient’s symptoms?

a. Hospitalize the patient

b. Increase the valproate by 500 mg/d

c. Prescribe clonazepam 1 mg qhs

d. Start haloperidol 5 mg qd

e. Tell the patient to begin psychotherapy one time per week

the answer is below…

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A 24-year-old man comes to the physician with the chief complaint that his nose is too big, to the point of being hideous. The patient states that his nose is a constant embarrassment to him, and he would like it surgically reduced. He tells the physician that three previous surgeons had refused to operate on him because they said his nose was fine, but the patient asserts that “they just didn’t want such a difficult case.” The physician observes that the patient’s nose is of normal size and shape. Based on this patient’s clinical picture, which of the following is the most likely diagnosis?

a. Schizophrenia

b. Narcissistic personality disorder

c. Body dysmorphic disorder

d. Anxiety disorder not otherwise specified

e. Schizoaffective disorder

the answer is below…

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A 26-year-old woman with panic disorder notes that during the middle of one of her attacks she feels as if she is disconnected from the world, as though it were unreal or distant. Which of the following terms best describes this symptom?

a. Dulled perception

b. Illusion

c. Retardation of thought

d. Depersonalization

e. Derealization

the answer is below…

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A 28-year-old man comes to the physician with the chief complaint that he has been depressed for years. He notes that his mood is never good, though he has never seriously considered suicide. He often feels hopeless and has problems concentrating. His sleep pattern and appetite have not changed. He denies hallucinations of any kind. Based on this clinical picture, which of the following is the most likely diagnosis?

a. Conversion disorder

b. Avoidant personality disorder

c. Dysthymic disorder

d. Major depression

e. Adjustment disorder

the answer is below…

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