1
Q
- Amanda is a 29-year old female, who was brought to the PGH Emergency Room by her husband because of behavioral changes of 2 weeks duration. According to the informant, Amanda has been sleeping for 2-3 hours, often doing household chores in the middle of the night. She would talk non-stop, is extremely irritable and critical of everyone, and picks fight with her family and the neighbors. She is noted to be highly distractible and hyperactive. She made plans to buy a number of condominium units but her husband reports that they can’t afforde these. According to her husband, Amanda was previously diagnosed with an unrecalled psychiatric condition two years ago when she had the same symptoms and was admitted at PGH Ward 8. She was however lost to follow up and was irregularly compliant with her medications. What is your primary working impression?
a. Schizophrenia, Disorganized Type
b. Attention Deficit Hyperactivity Disorder
c. Brief Psychotic Disorder
d. Bipolar Disorder, Most Recent Episode Manic
A
D
2
Q
- Which of the following medications is the best choice for Amanda’s condition?
a. SSRI + Mood Stabilizer
b. SSRI + Serotonin Dopamine Antagonists
c. Mood Stabilizer + Serotonin Dopamine Antagonists
d. Psychostimulants + Mood Stabilizer
A
C
3
Q
- Whici of the following mood episdoes needs to be present before a diagnosis of bipolar I disorder can be made?
a. Manic episode
b. Major depressive episode
c. Hypomanic episode
d. AOTA
A
A
4
Q
- Which of the following mood episodes can a patient with bipolar disorder have?
a. Manic episode
b. Majr depressive episode
c. Hypomanic episode
d. AOTA
A
D
5
Q
- Which receptor/s do most of the atypical antipsychotic block?
a. D2 and NE
b. 5HT2A and D2
c. NE and 5HT2A
d. M1 and D2
A
B
6
Q
- Carlos is a 17-year old teenaged boy brought to the clinic by his mother because of insomnia of three day’s duration. According to the mother, Carlos went out drinking with his friend on a Friday evening, but came home with paranoia and irritability. He locked the windows and door and looked out repeatedly, telling his mom that some people were out to get him. He had difficulty sleeping at night, with poor appetite. He also appeared to be talking to someone even if there was no one in the room. Which of the following substances is most likely result to Carlos’ behavior?
a. Alcohol
b. Metamphetamine
c. Nicotine
d. Cannabis
A
B
7
Q
- What if the following neurotransmitters is primaritly involved in the reward pathway (positioned to explain substance related disorders)?
a. GABA
b. Histamine
c. Serotonin
d. Dopamine
A
D
8
Q
- The diagnostic criteria for substance dependencee include which of the following?
a. Development of substance specific syndrome due to cessation of substanc eus e that has been prolonged
b. Recurrent substance related legal problems
c. Development of a reversible substance specific syndrome due to recent ingestion of a substance
d. The substance is often taken in
A
A
9
Q
- The lifetime prevalence of alcohol dependence is:
a. 10%
b. 14%
c. 18%
d. 20%
A
B
10
Q
- Which of the following is a core symptom of panic disorder?
a. Panic attacks when exposed to situations that trigger a flashback of previous traumatic situations
b. Panic attacks in performance situations
c. Panic attacks when exposde to specific objects or situations
d. Recurrent unexpected panic attacks
A
D
11
Q
- Which class of medications is the preferred long-term treatment for panic disorders?
a. Benzodiazepines
b. Antidepressants
c. Mood stabilizers
d. Atypical antipsychotics
A
B
12
Q
- The following is true of the role of serotonin in Panic Disorder
a. Panic results from excess levels of serotonin or excess postsynaptic sensitivity to serotonin
b. Panic results from deficient levels of serotonin in the periaqueductal gray area (PAG)
c. It is not known what role serotonin plays in Panic Disorder
d. A and B are true
e. AOTA
A
D
13
Q
- In acute stress disorder, the symptoms
a. Must last for a maximum of two days
b. Can last for a maximum of eight weeks
c. Must occur within one year of the trauma
d. Must occur within six months of the tauma
A
A
14
Q
- PTSD symptoms of:
a. Hypomania, hyperarousal, looseness of associations, flashbacks and phobias
b. Commonly can be classified into hypervigilance, avoidance, intrusions and regression
c. Commonly can be classified into hypervigilance, avoidance, intrusions and constriction
d. NOTA
A
C
15
Q
- An example of an intrusion symptom in PTSD is
a. Hypervigilance
b. Nightmares
c. Irritability
d. Sleep difficulty
A
B
16
Q
- Which of the folloing medications would be the best choice for a patient with panic disorder?
a. Escitalopram
b. Quetiapine
c. Haloperidol
d. Risperidone
A
A
17
Q
- Which of the following theories best explains biological explanation of panic attacks?
a. Dopamine excess
b. Serotonin excess
c. Norepinephrine excess
d. Hormonal imbalance
A
B
18
Q
- Most depressive disorders bein by age:
a. 10-15
b. 18-25
c. 26-30
d. 30-45
A
D
19
Q
- The prevalence of depression in the Philippines according to a study by Dr. Perlas et al is:
a. 1%
b. 4%
c. 5.3%
d. 10%
A
C
20
Q
- A 45-year old man comes for consultation with a chief complaint of fatigue. Because of heavy drinking over the past 9 months, he has received several reprimands at work and his wife has threatened to leave him. He drinks 6 to 12 bottles of beer a day plus several ounces of hard liquor. He reports blackuts, an inability to quit drinking and not becoming intoxicated as easily. He has tried to quit on several occasions but has been unable to do so. Which of the following is the most likely diagnosis?
a. Alcohol intoxication
b. Alcohol abuse
c. Alcohol dependence
d. Alcohol withdrawal
A
C
21
Q
- Which of the following factors in his history is the most specific for the diagnosis?
a. Marital conflicts
b. Occupational problems
c. Not becoming intoxicated as easily
d. 9-month history of heavy drinking
A
C
22
Q
- At least 2 years of alternating depression and hypomanic episodes:
a. Cyclothymia
b. Dysthymia
c. Bipolar I Disorder
d. Bipolar II Disorder
A
A
23
Q
- The following are drugs used to treat mania, except:
a. Carbamazepine
b. Divalproate sodium
c. Lamotrigine
d. Olanozapine
A
C
24
Q
- Indicators for Major Depression in medically ill patients:
a. Not participating in medical care inspite of his/her ability to do so
b. Not progressing despite improved medical condition
c. Functioning at a lower level that the medical condition warrants
d. AOTA
A
D
25
25. When a primary care physician detects depression in medically ill patient, what is his best recourse?
a. Tell the patient that it is “all in the mind” and he shouls snap out of it/
b. Refer him immediately to a psychiatrists
c. Explain that he has depression, a medical condition that is highly treatable.
d. AOTA
C
26
26. According to the Biopsychosocial model:
a. States of health are the result of the interaction of the biological, psychological and social factors
b. A person may be thought of as composed of hierarchical subsystems
c. The systems theory is useful as its theoretical basis
d. AOTA
D
27
27. From the biopsychosocial perspective, a person
a. Is composed of systems of body organs
b. Interacts with his sociocultural environment
c. Influences his own bodily functions
d. AOTA
D
28
28. According to DSM IV-TR, all of the following are core symptoms of depression EXCEPT:
a. Depressed mood most of the day
b. Markedly diminished interest/pleasure
c. Decreased goal directed activities
d. Diminished ability to think and/or concentrate
C
29
29. According to DSM IV-TR, in order to diagnose major depressive disorder:
a. Presence of at least 3 core symptoms for at least 2 weeks duration
b. Presence of at least 5 core symptoms for at least 2 weeks duration
c. Presence of at least 3 core symptoms for at least 1 week duration
d. Presence of at least 5 core symptoms for at least 1 week duration
B
30
1. Which of the following antipsychotics are atypical?
a. Flupentixol
b. Levomepromazine
c. Paliperidone
d. Chlorpromazine
e. NOTA
C
31
31. Clonazepam relieves anxiety symptoms by acting on the:
a. Serotonin transporter
b. Dopamine receptor
c. GABA receptor complex
d. NMDA receptor
e. Noradrenergic transporter
C
32
32. According to DSM-IV TR, all of the following are symptoms of criterion for schizophrenia EXCEPT:
a. Fixed false beliefs
b. Perceptual disturbances
c. Frequent derailments or incoherence of fear
d. Noticable weight loss or anorexia
e. Grossly disorganized behavior
D
33
33. Decreased dopamine activity in this tract produces negative symptoms of schizophrenia:
a. Mesolimbic
b. Mesocortical
c. Nigrostriatal
d. Tuberoinfundibular
B
34
34. Which is a goal of pharmacologic treatment of psychiatric disorders?
a. Reduce or remove symptoms
b. Ensure good quality of life
c. Minimize the risk of recurrence of symptoms
d. AOTA
D
35
example of an SSRI:
a. Olanzapine
b. Sertraline
c. Risperidone
d. Duloxetine
B
36
36. General guidelines for the use of psychotherapeutic drugs include which of the following?
a. Emotional responses to ordinary life situations should generally still be medicated.
b. Acquire a detailed knowledge of pharmacokinetic and pharmacodynamic data relevant to psychotropic drugs.
c. A patient’s past treatment for the same illness is usually not useful.
d. The dose should be titrated according to response & adverse effects; the “standard dose” is always followed.
B
37
37. The extrapyramidal side effects of medications for schizophrenia is caused by blocing the receptors in the:
a. Nigrostriatal tract
b. Tuberuinfundibular tract
c. Mesolimbic tract
d. Mesocortical tract
A
38
38. If a patient with Bipolar I disorder maintained on adequate dose of Lithium suddenly presents with command auditory hallucinations, paranoid delusions and aggressive behavior, what would be the best treatment option?
a. Augment with atypical antipsychotics
b. Increase dose of Lithium
c. Augment with Valproic
d. Decreased current Lithium and initiate atypical antipsychotics
A
39
39. The following drugs have the best empirical evidence in the maintenance treatment of Bipolar disorders EXCEPT:
a. Lithium
b. Carbamazepine
c. Topiramate
d. Valproate
e. No exceptions
C
40
40. What mode of treatment can best be used as add-on to pharmacotherapy in the caseof a bipolar II patient who is poorly compliant with medications and feels stigmatized by his disorder?
a. Psychodynamic psychotherapy
b. Cognitive behavioral therapy
c. Music therapy
d. Family therapy
B
PSYCH 202 FINALS
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