Etiology of Posttraumatic Stress Disorder

Exemplary of psy MCQsSelect ONE correct answer1. The term for a false perception of a sensory stimulus in the absence of a stimulus is :A) Hallucination

B) Illusion

C) Delusion

D) Derealization

E) Depersonalization

2. A condition in which the patient feels detached from herself is called

A) Derealization

B) Depersonalization

C) Illusion

D) Hallucination

E) Detachment

3. A person who laughs one minute and cries the next without any clear stimulus has :A) Flat affect

B) Euphoria

C) Labile mood

D) Labile affect

E) Split personality

4. Posttraumatic stress disorder differs from adjustment disorder in that

A) it occurs in veterans

B) impairment of social functioning occurs

C) it persists long after the stress has abated

D) it is characterized by preoccupation with the stress

E) it can be accompanied by depression5. Which of the following psychotropic drugs is most likely to produce a severe withdrawal syndrome when suddenly discontinued?A) amtitriptylineB) alprazolam

C) chlorpromazine

D) benztropine

E) lithium carbonate6. The term ego syntonic refers specifically to

A) ideas suggested by another individual rather than independently derived

B) a dissociative state such as psychogenic fugue or amnesia

C) the recognition ones own thoughts as unacceptableD) the belief in ones own hallucinationsE) a character style where patients don't recognize that anything is wrong with them that need to be changed

7. Premenstrual Dysphoric Disorder is characterized by all the following EXCEPTA) psychological complaints or physical symptoms

B) begin the week prior to menstruation

C) resolve shortly after the onset of the menstrual flow

D) a well established etiology

E) symptoms must be of such severity as to impair functioning

8. The treatment of choice for reversing anti-cholinergic delirium is A) dantrolene

B) bethanecol

C) physostigmine

D) bromocriptine

E) haloperidol

9. A patient reported that he saw a man feeding two cats in the park on his way. He says that this means his future will be decided in 2 weeks. The term that best describes this mode of thinking isA) delusion controlB) hallucination

C) delusion of reference

D) loosed association

E) neologism

10. An adequate trial of lithium therapy has proved unsuccessful in the treatment of a 24-year-old woman. Which of the following drugs would be most reasonable to describe next?

A) chlorpromazine

B) carbamazepine

C) alprazolam

D) amitriptyline

E) olanzapine11. Identity disorder of adolescence is considered to be related to which of the following types of adult personality disorder?A) borderline

B) paranoid

C) narcissistic

D) schizoid

E) dependent12. Antisocial personality disorder is considered to be

A) synonymous with criminal behavior

B) the male counterpart of histrionic personality disorderC) correlated with EEG studies suggesting cortical immaturity

D) a more serious personality disorder than compulsive personality disorder

E) amenable to pharmacologic treatment with anti-androgenic agents

13. The term circumstantiality refers specifically to A) a formal thought disorder in which there is a lack of goal-directed thinking B) the enunciation of a long string of nonsense syllables

C) an atypical expression for malingering in the special case of factitious disorder

D) speech that unnecessarily long-winded and tedious but that maintains logical direction

E) the tendency to be retiring and noncommittal in an interview14. The development and incidence of schizophrenia are LEAST influenced by which of the following demographic factors?

A) age

B) sex

C) socioeconomic status

D) marital status

E) birth order

15. All of following statements regarding the clinical presentation of anorexia nervosa are true EXCEPT thatA) there may be emphasized interest in food preparation and consumption

B) self-induced vomiting is often presentC) female patients may report menstrual irregularity or amenorrhea

D) patients frequently complain about being underweight

E) there may be an associated abuse of laxatives or diuretics or both16. Of the following antipsychotic drugs, which has the lowest anti-cholinergic potency?A) haloperidol

B) fluphenazine

C) trifluoperazine

D) chlorpromazine

E) thioridazine17. Delirium is distinguished from dementia by the presence ofA) impaired judgment

B) impaired memory

C) clouding of consciousness

D) thought disorder

E) disorientation

18. A 30-year-old man complaining of panic attacks and anticipatory anxiety. Which one of the following drugs would be effective for his treatment?A) haloperidol

B) venlafaxine

C) pentobarbital

D) carbamazepineE) clonazepam

19. All the following statements regarding agoraphobia are true EXCEPT that

A) affected persons suffer an intense and irrational fear of leaving home

B) affected individuals are aware that their fear is unreasonable

C) medication is often effective in titrating agoraphobic panic

D) initial treatment often focuses on the behavioral aspects of the phobia rather than on underlying psychodynamic concerns

E) the phobic anxiety, once treated, is very unlikely to recur

20. A person with which one of the following personality disorders is less likely to seek medical care or psychiatric treatment?A) dependent

B) antisocial

C) borderline

D) schizoid

E) obsessive-compulsive

21. All of the following phenomena occur in children during the first third of the major sleep episode (slow wave sleep) EXCEPTA) night terrors

B) bed-wetting (enuresis)

C) sleep-walking (somnambulism)

D) nightmares

E) sleep paralysis

22. Characteristics of AD/HD include all of the following EXCEPTA) hyperactivity

B) abnormalities in coordination

C) emotional lability

D) thought disorder

E) a strong male predominance

23. The DSM-IV uses an approach to diagnosis of psychiatric disorder that emphasizes all of the following EXCEPTA) observed behavior

B) descriptions of syndromes

C) underlying causes

D) diagnostic criteria

E) multiaxial model

24. Conversion disorder (also known hysterical neurosis, conversion type) is distinguished by the following symptoms EXCEPTA) suggest a physical disorder

B) under voluntary control

C) expressive of a psychological conflict

D) elicit attention and support from others

E) causes clinically significant distress in occupational functioning

25. Which of the following statements regarding pain disorder is NOT TRUEA) Placebo response is positive in about two thirds of whatever population is tested

B) antidepressants may alleviate chronic pain independently of effects on mood or arousal

C) the threshold of pain varies from person to person

D) biofeedback and relaxation techniques are of documented value in pain control

E) the experience of pain is largely subjective

26. The most important reason to monitor lithium levels is

A) to check on patient compliance

B) because the toxic dose is very similar to the therapeutic level

C) because lithium is rapidly excreted from the body

D) because lithium is a salt rather than a drug

E) none of the above

27. Agoraphobia is best characterized by which of the following statements?

A) it is caused by a specific trauma

B) it is treated with -adrenergic blockers

C) it involves fear of height

D) it is a symptom of schizophrenia

E) it commonly accompanies panic attacks

28. Obsessions are

A) intrusive thoughts or impulses

B) anxious thoughts

C) symptoms of unconscious conflict

D) fear of heights

E) psychotic symptoms

29. Effective medications for OCD include

A) lorazepam

B) desipramine

C) fluoxetine

D) carbamazepine

E) trifluoperazine

30. Appropriate management of phobias includes which of the following?

A) systematic desensitization

B) atypical anti-psychotics

C) biofeedback

D) supportive psychotherapy

E) anti-depressants

31. Which of the following is the most accurate statement about vascular dementia?

A) agitation in vascular dementia is best treated with benzodiazepines

B) early signs include memory loss, irritability, and difficulty concentrating

C) women are affected more commonly than men

D) the condition is rarely characterized by sudden exacerbations or by remissions

E) the condition is usually first evident in individuals over age 80

32. Which one of the following symptoms is the most distinguishing feature of delirium?

A) fever

B) memory impairment

C) personality changes

D) reduced clarity of awareness

E) tremulousness

33. Which f the following disorders is thought to be especially related to OCD?

A) somatization disorder

B) body dysmorphic disorder

C) conversion disorder

D) pain disorder

E) factitious disorder

34. The concurrent presence of a mood disorder is more likely in which of the following?

A) schizoid personality disorder

B) paranoid personality disorder

C) borderline personality disorder

D) avoidant personality disorder

E) antisocial personality disorder

35. Cluster C, anxious group of personality disorders, includes avoidant, dependant, and

A) histrionic personalities

B) schizoid personalities

C) borderline personalities

D) obsessive-compulsive personalities

E) depressive personalities

36. Perceptual abnormalities include all of the following EXCEPTA) hallucinations

B) depersonalization

C) illusions

D) perseverations

E) depersonalization

37. Medical conditions that can cause manic-like symptoms include all of the following EXCEPTA) AIDS

B) Wilson disease

C) Hyperthyroidism

D) TB

E) Cushing disease

38. Individuals with personality disorders have chronic impairments in their ability to work and love and tend to be less educated, drug addicts, and sex offenders. The prevalence of these disorders in the general population is striking and threaten any modern society as it ranges from:

A) 30 to 40%

B) 13 to 15 %

C) 11 to 23 %

D) 5 to 10 %

E) 23 to 33 %

39. Anti-cholinergic poisoning is characterized by all of the following EXCEPTA) warm, dry skin

B) mydriasis

C) psychosis

D) tachycardia

E) coryza

40. An obsessive-compulsive personality disorder man is likely to exhibit all of the following symptoms EXCEPTA) perfectionism that interferes with performance

B) compulsive checking or hand-washing behaviors

C) preoccupation and concern for rules

D) indecisiveness

E) stinginess with compliments

41. Which of the following statements regarding autistic disorder is most accurate?A) the child has usual language development

B) the disorder commonly begins after the age of 5 yearsC) preoccupation with the internal world of the individual to the exclusion of external reactivity D) autistic children often treat other individuals intimately

E) social development is nearly normal

42. Negative symptoms of schizophrenia include all of the following EXCEPT

A) affective blunting and flattening

B) hallucination of voices speaking to the patient

C) lack of motivation and initiative

D) anhedonia

E) poverty of thought content

43. Which of the following statements regarding bulimia nervosa is FALSEA) there is a prominent focus on body image

B) wide fluctuations in weight are common

C) "binges" may be separated by prolonged periods of normal eating

D) documentation of purging behavior is necessary to establish diagnosis

E) nervous overeating followed by guilt for doing so

44. According to the DSM-IV, which of the following is NOT a member of impulse control disorders not elsewhere classified?A) kleptomaniaB) dipsomania

C) trichotillomaniaD) pyromaniaE) pathological gambling45. Brief psychotic disorder is characterized withA) impairment in reality testing for at least 6 monthsB) two (or more) of delusion, hallucination, disorganized speech, and grossly disorganized behaviorC) may include a symptom that is culturally sanctionedD) the duration is at least one day

E) there is always a marked stressor shortly prior to the onset of illness46. Nightmares are anxiety-provoking dreams that occur during

A) non-REM sleep during the second half of the sleep period

B) REM sleep during the first half of the sleep period

C) REM during the first third of the sleep period

D) non-REM during the first half of the sleep period

E) REM sleep during the second half of the sleep period

47. Regarding delusional disorder, all of the following are true EXCEPTA) delusions involve situations that occur in real life

B) erotomanic type involve delusion that another person of higher status is in love with the individualC) delusions are systematized and persistantD) the patient shows marked impairment in his behavior and affect

E) high possibility of impulsive self-harm or aggression

48. A patient has been suffering from significant weight loss, insomnia, psychomotor retardation, markedly diminished ability to concentrate, and recurrent suicidal ideation. For fulfilling the criteria to diagnose a major depressive episode which of the following criteria is necessary?A) the symptoms should be present during the same one-week periodB) depressed mood most of the day of at least two days periodC) excitation and destructiveness

D) markedly diminished interest in almost all activities, most of the day, nearly everyday for the same 2-week period in the presence of other symptoms

E) symptoms are attributed to bereavement49. The following are diagnostic criteria sufficient to diagnose a manic episode

A) distinct period of abnormally elevated mood, lasting at least 4 days

B) more talkative than usual, flight of ideas, and inflated self-esteemC) decreased need for sleep (feels rested after only 3 hours of sleep) D) all of the above, together, are sufficient to diagnose a manic episodeE) all of the above are not sufficient to diagnosis of manic episode50. Bipolar II disorder is characterized byA) presence (or history) of one major depressive episode

B) presence (or history) of at least one manic episodeC) presence (or history) of at least one hypomanic episodeD) A & BE) A & C51. Panic disorder is characterized by all of the following EXCEPTA) an increased risk of incident agoraphobia

B) an increased risk of incident major depression

C) higher rates for men than for women

D) perceptual abnormalities

E) un-expected panic attacks occurring without any trigger

52. Social phobia is

A) one of the specific phobias

B) an anxiety disorder last at least 6 months in persons aged less than 18 years

C) characterized by marked and persistent fear of being alone

D) characterized by marked and persistent fear that is not recognized by the person as excessive or unreasonableE) Low tendency to chronicity53. Pathological imitation of movements of one person by anotherA) echolalia

B) stereotyped behavior

C) mannerism

D) echopraxia

E) multiple tics54. Examples of specific disturbances in form of thought are

A) neologism

B) verbigeration

C) echolalia

D) all of the above

E) none of the above

55. A mentally retarded child showing frequent bizarre behavior and absolute dependence. His I.Q. was found to be approximately 15, the most probable diagnosis is

A) mild mental retardation

B) moderate mental retardation

C) severe mental retardation

D) profound mental retardation

E) borderline intelligence

56. Concrete thinking means:A) multidimensional thinking

B) limited use of metaphor without understanding of nuances of meaning

C) abstraction

D) false fixed beliefs

E) none of the above

57. A maladaptive pattern of substance use characterized by 3 (or more criteria) occurring in the same 12 months, of which are: tolerance, withdrawal, and taking the substance in larger amount than was intended. This condition describes:A) substance use disorderB) substance withdrawal

C) substance dependence

D) substance intoxicationE) substance adverse effect

58. A disorder that meets all criteria for schizophrenia, its duration is not less than one month but less than 6 months is called

A) schizoid personality disorder

B) schizoaffective disorder

C) brief psychotic disorder

D) psychotic disorder NOS

E) schizophreniform disorder

59. Anhedonia is described as

A) an affective state means reduction in intensity of feeling tone

B) behavioral abnormality means motiveless resistance to all instructios

C) mood variant indicating loss of interest in and withdrawal from all regular and pleasurable activities

D) lack of reaction to surroundings

E) blocking out those things that generate anxiety

60. Appropriate, flat, restricted, labile are expressions used to describe :A) mood

B) behavior

C) thinking process

D) affect

E) speech

61. Dissociative amnesia is defined according to the DSM-IV as:A) amnesia due to the direct physiological effects of a neurological condition

B) an inability to recall important personal information, usually of a traumatic or stressful nature and subdivided into five types

C) normal forgetfulness following recovery fron general mesdical condition

D) a somatoform disorder in which the person can't recall important personal information

E) amnesia for one's identity, which is coupled with sudden, unexpected travel

62. which of the following is true regarding dissociative identity disorderA) existence of two or more distinct personality states that exchange executive control of the person's behavior

B) previously called mixed personality disorderC) synonym of gender identity disorder

D) more prevalent in men than women

E) the patient is always able to recall important personal information

63. Frotteurism meansA) genital exposureB) use of nonliving objects for sexual behavior

C) rubbing against or touching a nonconsenting person

D) clandestine observation of another person's undressing, toileting, or sexual behavior

E) sexual behavior with prepubescent or peripubertal children

64. Regarding gender identity disorder, all of the following are true EXCEPTA) a strong and persistent gender identification

B) one possible source is congenital virilizing adrenal hyperplasia

C) in boys, the disturbance is manifested by assertion that his penis or testes are disgusting

D) persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex

E) the disturbance is not concurrent with a physical intersex condition65. Primary dyssomnias are: primary insomnia, primary hypersomnia, brathing-related sleep disorder, circadian rhythm sleep, and which one of the following?A) nightmares

B) sleep terror disorder

C) sleep walking disorder

D) narcolepsy

E) sleep bruxism66. All of the following statements regarding adjustment disorder are true EXCEPTA) its prevalence ranges across studies between 7.6 to 10 %B) it occurs within 12 months of the onset of an identifiable stressor

C) females predominate males by approximately 2 to 1

D) it is associated with psychosocial stress without which it would not arise

E) causes significant impairment in social or occupational (academic) functioning67. DSM-IV general diagnostic criteria for a personality disorder involve An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas EXCEPTA) interpersonal functioning

B) affectivity

C) impulse control

D) cognition

E) intrapersonal personal functioning

68. Psychiatric disorders that constitute risk factors for suicide are all of the following disorders EXCEPTA) personality disorders as schizotypal and schizoid types

B) depressive disorders

C) panic disorder

D) schizophrenia

E) alcohol use disorders

69. Regarding the accusation of dopamine in the pathogenesis of schizophrenia, one of the following statements is FALSEA) too much dopamine causes psychosis

B) dopamine agonists induce psychosis

C) altered subcortical and limbic dopamine could cause negative symptoms (such as anhedonia and avolition)

D) reduced cortical dopamine could explain hypofrontality, impaired cognition, and negative symptomsE) dopamine exerts its effects through at least five receptor types where typical and atypical neuroleptics exert their different actions on positive and negative symptoms

70. Characteristic symptoms of schizophrenia are: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms. To fulfill criterion (A), the following is necessary

A) one of the five symptoms for a significant portion of time during a 1-month periodB) two (or more) of the 5 symptoms for 6 months of an active phase

C) the three phases are evident i.e., prodroma, active, and residual

D) one criterion A symptom if delusions are bizarre lasting for a significant portion of time during a 1-month period

E) two (or more) of the 5 symptoms for 2-month period

71. Subtypes of schizophrenia are:all of the following EXCEPT

A) melancholic

B) paranoidC) catatonicD) disorganized

E) undifferentiated72. Paranoid schizophrenia is characterized by A) marked regression to primitive and disinhibited behavior

B) prominent psychomotor disturbancesC) when delusions or hallucination occur, they are neither prominent nor accompanied by strong affectD) dominant negative symptoms

E) preoccupation with one or more delusions or frequent auditory hallucination DIRECTIONS (Questions 73 through 78): Each group of items in this section consists of lettered headings followed by a set of numbered words or phrases, select the ONE lettered heading that is most closely associated with it. Each lettered heading may be selected once, more than once, or not at all.For each statement below describing drug side effects, select the psychotropic medication with which it is most likely to be associated.

(A) lithium carbonate

(B) phenelzine

(C) diazepam

(D) clozapine

(E) haloperidol

(F) thioridazine

73. Dosage above the recommended upper limit can lead to retinitis pigmentosa74. Sudden development of a severe throbbing headache signals a possible medical emergency

75. GI distress and fine tremor of the hands indicate toxicity

76. In low doses, its relative lack of autonomic side effects make it a drug of choice in the treatment of agitation in elderly individuals

77. Inhibition of ejaculation is a characteristic side effect

78. Agranulocytosis737475767778

DIRECTIONS (Questions 79 through 100): Each group of items in this section consists of lettered headings followed by a set of numbered words or phrases, select the ONE lettered heading that is most closely associated with it. Each lettered heading should be selected ONCE.

Questions 79 through 83In conducting a mental status examination, assessment of language and communication is essential in determining whether or not a patient has a formal thought disorder. For each description of verbal behavior, select the term with which it is associated.

(A) incoherence

(B) derailment(C) perseveration(D) neologism(E) pressure of speech79. An increase in the amount of spontaneous speech as compared with what is considered ordinary80. A pattern of speech that is essentially incomprehensible

81. A pattern of spontaneous speech in which ideas slip into other ideas that are clear but unrelated

82. New word formation, either a word in which the derivation cannot be understood or a word in which the meaning will be evident even though the usage is peculiar.

83. The repetition of the same words or phrases (persisting response) in response to a new stimulus (a new examiner's question)7980818283

Questions 84 through 88A) conversion disorder

B) hypochondriasis

C) panic disorder

D) somatization disorder

E) body dysmorphic disorder

F) cerebro-vascular accident

84. complaints of episodic chest tightness and breathing difficulty occurring spontaneously with palpitation, depersonalization, and fear of death85. sudden loss of sensation and flaccid paralysis of the entire left arm without any evident central neurological defect in a 20-year-old woman86. preoccupation with some imagined defect in the body, usually the face that lead to frequent visits to doctors87. multiple chronic joint pains in a 35-year-old man with chronic bloating and nausea, impotence, and localized left lower limb weakness88. a 30-year-old woman chronically preoccupied with fears that she have a breast cancer although through investigations revealed nothing8485868788

Questions 89 through 93The following specifiers are assigned as specific types of delusional disorder, based on predominant delusional theme. For each delusional description, match the type of delusional disorderA) erotomanic type

B) grandiose typeC) jealous typeD) persecutory typeE) somatic typeF) mixed type

89. Delusions that the individual's sexual partner is unfaithful90. Delusions that the person has physical defect or general medical condition91. Delusions that another person, of higher status, is in love with the individual

92. Delusions that the person (or someone to whom the person is close) is being malevolently treated in some way93. Delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person 8990919293

Questions 94 through 100Many disorders in psychiatry are linked to a specific period of time in order to fulfill the diagnostic criteria. Select the minimum duration of time needed for each of the following conditionsA) 1 day

B) 2 days

C) 4 days

D) 7 days

E) 2 weeksF) 1 month

G) 6 months

H) 2 years

94. Major depressive episode95. Manic episode

96. Dysthymia

97. Hypomanic episode

98. Acute stress disorder

99. Brief psychotic disorder100. Post-traumatic stress disorder

949596979899100

PAGE 17Comprehensive Exam Psychiatry Group B Tuesday, 5/12/2006