Q: Factor with most evidence to support its protective effect in the bereavement of a spouse? - ANSWERA: Quality of the social support of the bereaved
Q: CNS responses to fear-provoking stimuli are mediated through which structure? - ANSWERA: Central nucleus of the amygdala
Q: 28 yo F w/ recent o...
Q: Factor with most evidence to support its protective effect in the bereavement of a spouse? -
ANSWERA: Quality of the social support of the bereaved
Q: CNS responses to fear-provoking stimuli are mediated through which structure? - ANSWERA:
Central nucleus of the amygdala
Q: 28 yo F w/ recent onset of 1-2min episodes of putting clean silverware back in dishwasher while
making chewing movements and unable to interrupt. Pt cannot recall them. Most likely diagnosis: -
ANSWERA: Complex partial seizures
Q: Best reponse by psychiatrist when pt states: "you will be just like the others, no doctor ever listens
to me"? - ANSWERA: "I am sorry you felt unheard in the past. Can you describe that experience?"
Q: What is the mechanism affected by maternal licking and grooming behavior on the stress
reactivity of the offspring? - ANSWERA: DNA methylation affecting glucocorticoid receptor expression
Q: 23 yo pt w/ BPD and 20+ past suicide attempts presents for DBT and therapist asks pt for
commitment to refrain from self-harm for 1 yr. Pt says "sure, that won't be a problem at all". Best
response consistent w/ DBT principles? - ANSWERA: Draw pt's attention to the fact that this
commitment would be extremely difficult to abide by.
Q: 47 yo with seizure disorder well controlled on antiepileptic monotherapy but develops nausea,
ataxia and diplopia when treated w/ erythromycin for sinus infection. Most likely antiepileptic? -
ANSWERA: Carbamazepine
Q: Retired woman in outpt psychotherapy to cope w/ recent transitions: regret of not pursuing a
graduate degree, worries about her grown children and unsure about the next steps in her life. Stage
of psychosocial developement? - ANSWERA: Ego integrity vs despair
Q: In social psychology the contradiction between attitudes or between attitude and behavior is a: -
ANSWERA: Cognitive dissonance
Q: Pt w/ substance use disorder and GAD talks to Dr. about anxiety after attending their 1st AA
meeting. Psychiatrist's answer most consistent with 12-step facilitation therapy? - ANSWERA: "You
did the most important thing, you went to the meeting. It will get easier."
Q: Change in polysomnogram associated with MDD? - ANSWERA: Short REM latency
Q: 32 yo at the ER w/ diarrhea for 2 wks. Appears anxious/tremulous and is not oriented to
date/time. She doubled the dose of her medication for bipolar about 1 month ago. Medication? -
ANSWERA: Lithium
Q: 21 y/o pt hospitalized for excessive bleeding after induced 1st trimester abortion. Psych consulted
to evaluate for depression. Important fact for psychiatrist to be aware of: - ANSWERA: The strongest
predictor of depression after elective abortion is a h/o pre-pregnancy depression
,Q: Excessive activation of which receptor contributes to cell death in Alzheimer disease? - ANSWERA:
NMDA
Q: Established risk factor for develoment of bulimia nervosa? - ANSWERA: Childhood sexual abuse
Q: Which medication in overdose is most clearly associated w/ increased risk of seizure? (duloxetine,
trazodone, fluoxetine, mirtazapine, clomipramine) - ANSWERA: Clomipramine
Q: A new instrument to assess for PTSD covers intrusion, avoidance, cognitive and mood symptoms
but doesn't inquire about presence of a traumatic event. This raises concern about which type of
validity? - ANSWERA: Content validity
Q: Which of the following is a basic emotion, learned directly or inferred by infants? - ANSWERA:
Fear
Q: Bilateral resection of which structure leads to Kluver-Bucy syndrome (placidity, hyperorality,
hypersexuality and hyperphagia)? - ANSWERA: Temporal lobes
Q: 13 y/o went from 75th percentile in weight to 20th and wants to lose another 5-10 lbs, self-
concious about her appearance, restricts many foods and spends much time researching nutritional
content of foods. Dx? - ANSWERA: Anorexia nervosa
Q: Mental disorder ranking in the top-10 worldwide for greatest burden of disease by WHO? -
ANSWERA: MDD
Q: College student excessively asks for advice and reassurance from others. This is a compensatory
strategy associated with which core belief? - ANSWERA: I cannot be trusted to make a good decision
Q: When do withdrawal symptoms from chronic heroin use peak? - ANSWERA: 36 hrs
Q: Site of injury in a pt w/ head injury experiencing personality changes, impulsivity and euphoria? -
ANSWERA: Orbitofrontal cortex
Q: First marker of impending puberty in girls? - ANSWERA: Acceleration in linear growth
Q: Adolescent is hospitalized due to sudden onset of vision loss w/o structural abnormalities. When
walking w/ pt they approach a trash can and pt walks around it. Most likely dx? - ANSWERA:
Conversion disorder
Q: 35 yo w/ h/o migraines complaining about nearly daily HAs for the past 3 months. Has been taking
sumatriptan daily and occasional ibuprofen. Preferred initial tx approach? - ANSWERA: Discontinue
the sumatriptan
Q: Intervention most likely to decrease suicide risk in an inpt psych unit while maintaining a
therapeutic environment and minimizing staff burden? - ANSWERA: Redesigning the physical space
to eliminate potential anchor points for hanging
Q: Which type of cells secrete the innate pro-inflammatory cytokines TNFgamma and IL-1beta in pts
w/ inflammatory brain conditions? - ANSWERA: Microglia
Q: Biological sample easiest to falsify on a drug screen? - ANSWERA: Urine
Q: Nutritional deficiency most likely associated in the case of a 72 y/o w/ profound sensory ataxia,
loss of vibratory sensation and cognitive issues (irritability fluctuating w/ somnolence)? - ANSWERA:
Cobalamin
, Q: Altered connectivity between medial prefrontal cortex and the amygdala is implicated in the
neurology of which disorder? - ANSWERA: MDD
Q: Core characteristic of "system of care" movement in community mental health: - ANSWERA:
Empowering families to participate in treatment plan decisions.
Q: Pt unable to see objects on the upper L quadrant (L homonymous superior quadrantinopia).
Where is the lesion? - ANSWERA: R. temporal lobe
Q: Pt w/ h/o bipolar presents w/ immobility, posturing and echopraxia. 1st line treatment? -
ANSWERA: Lorazepam
Q: Neurocognitive disorder associated w/ fluctuating rate of progression, marked visuospatial
impairment, early unilateral resting tremor and increased muscle tone in the arm? - ANSWERA:
Dementia with Lewy bodies
Q: Which exam finding suggests an L5 radiculopathy in a pt w/ back pain and foot drop? - ANSWERA:
Weakness of ankle inversion
Q: Methodological advantage of genome-wide association study in comparing pts w/ schizophrenia
to demographically-matched controls? - ANSWERA: It can detect common gene variants that have a
small effect on disease risk
Q: In the integrated setting w/ primary care and mental health, what is a population-based technique
used to provide collaborative care? - ANSWERA: Tracking clinic pts in a registry
Q: Hormone released from the adipose tissue that enters the brain to provide negative feedback
signal and reduce food intake? - ANSWERA: Leptin
Q: Difficulty w/ which tasks would be most concerning in an elementary school child? - ANSWERA:
Jumping and hopping
Q: Electrolyte abnormality most typically associated w/ MDMA use? - ANSWERA: Hyponatremia
Q: Factor that increases lifetime risk of individuals in the US to develop MDD? - ANSWERA: Living in a
rural area
Q: Finding on EEG that would support the dx of conversion disorder in a pt complaining of
involuntary myoclonic movements: - ANSWERA: Rising pre-movement potentials
Q: Mandate of the 2010 Affordable Care Act designed in part to increase access to mental health
services: - ANSWERA: Prohibition on pre-existing denials due to h/o mental disorder
Q: According to cognitive theory, which maladaptive schema is prominent in depressive disorders? -
ANSWERA: Negative evaluations of self
Q: Medication helpful for antipsychotic-induced drooling? - ANSWERA: Glycopyrrolate
Q: Give an example of a sentinel event: - ANSWERA: Inpt elopement leading to adverse event
Q: What is produced when dopamine hydroxylase modifies dopamine? - ANSWERA: Norepinephrine
Q: Decline in sharing behavior between ages 2-3 is most closely related to which normal
developmental milestones? - ANSWERA: Sense of being an autonomous self
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