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PRITE 202 5 PART 1 EXAM WITH COMPLETE SOLUTIONS
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Which if the following findings on the mental status exam of a psychiatric patient is the strongest predictor of inability to make medical decisions? A. Lack of insight B. Poor judgement C. Suicidal ideation D. Perceptual disturbances E. Abnormal thought content - ANSWER A
Pedigree-based approaches are most powerful for identifying what type of gene variant? A. Copy number B. Rare high penetrance C. Simple tandem repeat D. Common low penetrance E. Single nucleotide polymorphism - ANSWER B
Repetitive transcranial magnetic stimulation for the treatment of unipolar depression targets which of the following brain regions? A. Ventral striatum B. Locus coeruleus C. Periamygdaloid cortex D. Medial temporal cortex E. Dorsolateral prefrontal cortex - ANSWER E
Which of the following cognitive responses to environmental stimuli has been found to be more characteristic of patients with anxiety disorders when compared to patients with depression? A. Misattributions regarding stimuli B. Hopelessness regarding meaning of stimuli C. Automatic negative thoughts toward the stimuli D. Attentional bias toward potentially threatening stimuli E. Lack of awareness of physiological responses to stimuli - ANSWER D
SKIP - ANSWER
Which of the following instructions can enhance hypoactive DTR in the leg? A. Clench a first B. Elevate an arm C. Stare at a distant object D. Think of moving the limb E. Sensory stimulation of the opposite limb - ANSWER A
What is the leading cause of death in persons with severe mental illness? A. Cancer B. Suicide C. Diabetes D. Accidents E. Cardiovascular disease - ANSWER E
Which of the following medications is most effective for migraine prophylaxis? A. Sumitriptan B. Topiramate
Which of the following neurotransmitters is predominantly inhibitory? A. Norepinephrine B. Glutamate C. Dopamine D. Tyrosine E. Glycine - ANSWER E
Maintenance of wakefulness is dependent on which of the following areas of the brain? A. Oral pontine B. Midbrain tegmentum C. Posterior hypothalamus D. Anterior cingulate parietal cortex E. Ascending reticular activating system - ANSWER E
Which of the following signs or symptoms is necessary to make a diagnosis of anorexia nervosa? A. Amenorrhea B. Perfectionistic behaviors C. Intense fear of gaining weight D. Body mass index less than 20 E. A subjective felling of loss of control while eating - ANSWER C
When a child reaches the stage of formal operations, which of the following is a new cognitive capacity gained? A. Centration B. Abstraction C. Reversibility D. Egocentrism
E. Object permanence - ANSWER B
A 25-year-old with a history of developmental delays presents for evaluation of anger outbursts. Prior karyotyping has demonstrated a microdeletion of genetic material. This finding is most likely to be seen in which of the following disorders? A. Phenylketonuria B. Down syndrome C. Tuberous sclerosis D. Fragile X syndrome E. Prader-Willi syndrome - ANSWER E
Which of the following areas are connected by the stria terminalis? A Broca's and Wernike's area B Hippocampus and subgenual cingulate C Lateral habenular and ventral tegmental area D Amygdala to the medial dorsal thalamic nucleus E Amygdala to the septal area and the hypothalamus - ANSWER E
Which of the following is an evidence-based practice with the most available research that reduces relapses and symptoms, and improves medication adherence in schizophrenia? A Case management B Occupational therapy C Group psychotherapy D Family psychoeducation E Cognitive behavioral therapy - ANSWER D
Which of the following assessment strategies is most reliable in differentiating bipolar from unipolar depression in a patient presenting with an index depressive episode?
C Advance directives D Surrogate decision maker E Durable power of attorney - ANSWER C
Heavy smoking is most likely to affect the dosing of which of the following antipsychotic medications? A Olanzapine B Ziprasidone C Aripiprazole D Risperidone E Quetiapine - ANSWER A
A 29-year-old woman presents to the ED accompanied by her partner reporting worsening mania after stopping valproic acid prescribed by her outpatient psychiatrist. She wants to get pregnant, but her partner is not sure the patient is psychologically ready. The outpatient psychiatrist and patient have not discussed her desire to get pregnant, nor has she inquired about psychiatric treatment options that could maintain mood stability with minimal risk to a fetus. The ED psychiatrist documents in the EMR the full set of concerns raised by the patient and her partner. What ethical principle is being applied by the psychiatrist documenting the concerns? A Fidelity B Veracity C Compassion D Confidentiality E Nonmaleficence - ANSWER B
In a patient with epilepsy, which of the following is the most common comorbid psychiatric disorder? A Schizophrenia B Bipolar disorder C Major depressive disorder
D Generalized anxiety disorder E Borderline personality disorder - ANSWER C
Histaminergic neurons that regulate sleep originate in which of the following brain nuclei? A Raphe nucleus B Locus coeruleus C Tuberomammillary D Ventrolateral preoptic E Laterodorsal tegmental - ANSWER C
According to Winnicott's theory of the development of infants' assertiveness and sense of competence, which of the following best describes the critical function of the "holding environment"? A Encourages spontaneity while protecting the child from harm B Uses "scaffolding" as a technique to facilitate cognitive development C Anticipates the child's wishes before the child experiences frustration D Reinforces prosocial behavior in relationships with caregivers and peers E Establishes a consistent daily schedule for activities e.g. meals, play, toileting - ANSWER A
Which of the following is a characteristic if assertive community treatment (ACT) for the treatment of the severely mentally ill? A Primarily office-based care B 24-hour-a-day mental healthcare coverage C Use of day hospital at least three days a week D Indirect involvement in admissions and discharges by the ACT team E Integration of primary care through a federally qualified health centers - ANSWER B
A Goodness of fit B Slow to warm up C Social referencing D Intensity of reaction E Affective attunement - ANSWER A
SKIP - ANSWER
The cortical synaptic remodeling characteristic of normal adolescence is also believed to be associated with which of the following neurobiological changes? A Increased brain glucose metabolism B Increased overall electroencephalograph amplitude C Predominant synaptic changes in the temporal cortex D Preferential loss of excitatory synapses E Loss of cortical volume in the parietal cortex - ANSWER D
A 70-year-old patient with depression presents with confusion two weeks following initiation of fluoxetine and an adverse effect from the drug is expected. Neurological exam is normal. Which of the following evaluations would be most useful to confirm this suspicion? A CT of the head B Electrocardiogram C Creatinine phosphokinase D urea and electrolytes E Hepatic panel - ANSWER D
Shortly after a five-year-old child enters kindergarden, the child's parents report to the pediatrician that their child seems more emotionally reactive at home, displaying some regressive behavior and being more demanding of parental attention. The child's teacher describes no behavioral or academic concerns. Which of the following factors
most likely accounts for the change noted by the parents? A Modeling of immature behavior by peers B An unrecognized learning disability in the child C The effects of poor parent-school communication D Incipient symptoms of separation anxiety disorder in the child E Normative response to stress associated with school transition - ANSWER E
In an individual with persistent pain, which of the following neurotransmitter receptors is downregulated in the ventral striatum? A Cortisol B Serotonin C Dopamine D Substance P E Norepinephrine - ANSWER C
Which of the following peptides is released in the GI tract to convey satiety information to the brain in response to food intake? A Leptin B Insulin C Orexin D Ghrelin E Cholecystokinin - ANSWER E
Which of the following lab abnormalities is associated with refeeding syndrome? A Hyperkalemia B Hypocalcemia C Hyperglycemia D Hypermagnesemia
concern for others and learning to share? A 2 years B 4 years C 6 years D 8 years E 10 years - ANSWER B
Which of the following neurotransmitter systems facilitates sexual arousal? A GABAergic B Glycinergic C Serotonergic D Dopaminergic E Glutamatergic - ANSWER D
In utero exposure to cannabis during neuronal development is associated with which of the following in the infant? A cognitive delays B language delays C abstinence syndrome D slowed physical growth E congenital abnormalities - ANSWER A
In children with cancer, inadequate prophylaxis of pain and stress during difficult procedures, such as bone marrow biopsies, is most likely to result in which of the following conditions? A panic disorder B nightmare disorder C somatization disorder
D generalized anxiety disorder E PTSD - ANSWER E
One in four individuals born with the 22q11.2 deletion develop which of the following psychiatric disorders? A schizophrenia B panic disorder C bipolar disorder D borderline personality disorder E obsessive-compulsive disorder - ANSWER A
Which of the following statistical measures could be used to determine how two independent variables in a study, such as depression and alcohol use disorder, affect the frequency of the occurrence event, such as suicide? A T test B Survival C Odds ratio D Relative risk E Regression analysis - ANSWER E
A patient who first got drunk when a certain song played on the radio now experiences a strong urge to drink whenever hearing that song. According to the classical conditioning, which of the following methods would best serve to unpair the conditioned stimulus from the unconditioned stimulus? A Give the patient non-alcoholic beer while listening to the song B Teach the patient relaxation techniques for use during cravings C Have the patients listen to a different song during therapy sessions D Have the patient repeatedly listen to the song in the absence of alcohol E Give the patient disulfuram prior to a small amount of alcohol to induce nausea - ANSWER D
Which of the following school accommodations may be included as part of an IEP, but would not be included in a 504 plan as supported by the section 504 of the rehab act of 1973 of the American with Disabilities Rehabilitation Act? A Extra time on tests B Hearing/listening device C Preferential classroom seating D Extra breaks between assignments E Exemption from course requirements - ANSWER E
Reduction in hippocampal volume is associated with what type of memory impairment? A Iconic B Implicit C Working D Procedural E Declarative - ANSWER E
The multiple sleep latency test is used to diagnose which of the following? A Cataplexy B Narcolepsy C Night terrors D Sleep walking E Sleep-phase delay - ANSWER B
What is the minimal degree of legal certainty that is constitutionally required for involuntary mental health commitment? A Up to individual states B Beyond a reasonable doubt C Clear and convincing evidence
D Preponderance of evidence E Likelihood of dangerous behavior - ANSWER C
The psychiatrist is considering prescribing Donepezil for an 87-year-old patient. Which of the following medications would most significantly interfere with its efficacy? A Oxybutynin B Loratidine C Metoprolol D Omeprazole E Warfarin - ANSWER A
A 75-year-old man presents to the psychiatrist complaining of forgetfulness, lack of energy and difficulty concentrating. Which of the following tests would be most helpful initially, in making a diagnosis? A sleep study B EEG C CSF studies D Neuropsych testing E CT scan - ANSWER D
Research regarding the process of acculturation reports that which of the following is the best adaptational outcome for immigrant youth? A Formation of a bicultural identity B Complete assimilation into the new culture C Maintenance of original culture into adolescence D Separation from both cultures and formation of unique identity E Identification with whatever culture the family chooses - ANSWER A
What is the role of cis-regulatory elements in gene expression?
C Accept the gift but pay the pt for the cost of the cookie D Refuse the cookie and explore the meaning of the gift with the pt E Refuse the cookie and tell the pt that the psychiatrist does not accept gifts from pts - ANSWER A
A 72-year-old pt with two days of confusion and fever is evaluated in the ED for new-onset seizure. MRI of the brain demonstrates hemorrhage and swelling of the temporal lobes. CSF shows increased lymphocytes and protein. Which of the following meds is most likely to be effective in treating the pt's condition? A Acyclovir B Prednisone C Ceftriaxone D Amphotericin E Pyrimethamine - ANSWER A
A pt who takes Buprenorphine is admitted following a MVA and requires surgery to repair a femur fracture. Which of the following is the most appropriate step in the treatment of the patient's pain? A Continue Buprenorphine at a lower dose B Switch to methadone prior to the surgery C Switch to an NSAID D Continue Buprenorphine at maintenance dose E Discontinue pain medications and treat withdrawal symptoms symptomatically - ANSWER B
Which of the following neurotransmitter systems most directly regulates impulsive or affective aggression? A GABAergic B Serotonergic C Oxytocinergic
D Dopaminergic E Noradrenergic - ANSWER B
Which of the following best describes a ten-year-old's understanding of the death of a pet? A The pet can be brought back by wishful thinking B The pet's death is a punishment for bad behavior C Death is permanent and the pet will not be returning D The pet is gone now, but is expected to return in the future E The pet is buried underground and can feel hungry and cold - ANSWER C
A 40-year-old pt has been unable to speak at all after having a screaming argument with the spouse. The pt writes, "I have been trying to speak, but cannot make a single sound." Physical exam, including exam of the throat, is unremarkable except for occasional loud cough. Which of the following is the most likely dx for the pt? A Selective mutism B Conversion disorder C Illness anxiety disorder D Somatic symptom disorder E Aphonia due to vocal cord injury - ANSWER B
In psychoanalytic psychotherapy, which of the following is accepted as the primary mechanism by which therapeutic change occurs during treatment? A Integration of insight B Experience of shame C Patient interest in treatment D Development of transference E Advice-giving by the therapist - ANSWER A
