Psychology 1

A 4-year-old boy exhibits a lack of social interaction manifest by a lack of facial expression and eye to eye gaze. He has no interest in sharing the activities or excitement of other children. Which of the following is the most likely diagnosis?

An 8-year-old boy has facial tics and is disruptive in the school classroom because of outbursts of profanity and, at other times, echolalia in which he repeats sentences of his teacher. Which of the following is the most likely diagnosis?

Methadone therapy is to be initiated in a 32-year-old man in treatment of intravenous substance abuse. He should be advised that which of the following is the most likely adverse effect?

An 8-year-old boy has facial tics and is disruptive in the school classroom because of outbursts of profanity. Tourette syndrome is diagnosed. Which of the following is the preferred initial therapy?

Lithium therapy is to be initiated in a 33-year-old woman in treatment of bipolar disorder. Which of the following is proper counseling for the patient?

A 28-year-old female presents with sudden onset of shortness of breath, a choking sensation, circumoral and carpopedal paresthesia, and carpopedal spasm. She also complains of vague chest pain. Review of systems is unremarkable except for recent increase in stress at work. Vital signs are BP: 110/70 mmHg; R: 32 breaths/min and shallow; P: 82 beats/ min, regular; and an oral temperature of 98.6 degrees F. ECG shows a normal sinus rhythm. Exam reveals tachypnea, although the patient’s breath sounds are normal, and the exam is otherwise normal. Check X-ray reveals no acute cardiopulmonary disease. Which of the following is the most likely diagnosis?

A patient is experiencing cannabis intoxication, which of the following symptoms and/or signs are you most likely to discover?

A 4-year-old boy is disruptive because he interrupts the activities of others and can not stay focused to complete tasks. Attention deficit hyperactivity disorder is diagnosed and the patient is treated with methylphenidate. Which of the following is the most likely adverse effect?

A 30-year-old woman has taken clonazepam for 3 months for treatment of generalized anxiety disorder. Which of the following is the most likely effect if the medication is withdrawn too rapidly?

A 9-year-old girl has excessive mood swings at home and in school causing behavioral disturbances. Her appetite is excellent. Blood pressure is 150/50 mm Hg, pulse 112/min/regular, and respirations 14/min. A fine tremor is present. Which of the following is the most likely diagnosis?

You are evaluating a 70-year-old patient whose medical record indicates a recent history of depression. By this history, you would expect this patient to have most commonly presented with which of the following symptoms?

Which of the following is not a medical emergency?

A 35-year-old man is evaluated in the emergency department complaining of chest pain, nausea, chills, and sweats. During his initial evaluation, the patient’s affect ranges broadly from anger to crying to euphoria. He is hypervigilant with mild psychomotor agitation and excessive perspiration. Physical examination further discloses the following: temperature = 100°F, pulse = 120 RRR, R = 20 RR, and BP = 200/110. The patient’s pupils are dilated but responsive to light. His ECG and cardiac enzymes are all normal. The most likely diagnosis is:

Which of the following is the most worrisome indicator of suicide potential?

A 35-year-old presents requesting treatment for her chronic anxiety. She admits to consistently worrying and feeling anxious, nearly on a daily basis, about her completion of work and home-related tasks. Her symptoms are so significant that she has been having difficulty concentrating on her work and is missing deadlines for her work assignments. The patient states that she tries to just ignore the worrying and anxious feelings, but has been unable to control the symptoms. In addition to her anxiety, she admits to feeling on edge, being easily fatigued, being irritable, and has been having difficulty sleeping. Her symptoms have been in place for more than 6 months and she presents today as her employer has threatened her job if her work does not improve. She denies taking any illicit substances or using alcohol and has no significant medical history other than the above. The most likely diagnosis for this patient is:

A 35-year-old woman arrives at the office saying that she feels “worried all the time.” She relates that she always feels “keyed up and on edge” no matter what is going on. “I can be watching a funny show on television, and I just feel afraid that something bad is going to happen.” The patient reports that she is easily fatigued but cannot sleep because she is worrying about things. She sometimes experiences palpitations and shortness of breath or dizziness when she is really worried about something. “I guess I’m just like my mother. She was always a worrier,” the woman says. Which of the following medications would not be best indicated in this patient’s treatment?

The classic triad of nystagmus, ataxia, and confusion in a younger patient who drinks alcohol for the past 5 years is consistent with a diagnosis of:

A patient has been experiencing numerous periods of hypomanic symptoms and mild depressive symptoms consistently over the past 2½ years. His changes in mood are irregular, and abrupt, and sometimes occur within hours. He has never had any period of time without symptoms that lasted more than 2 weeks. This patient is suffering from:

A woman is brought to the emergency department with symptoms of acute mania. The patient has no prior history of mania or other psychiatric disorders in her personal medical history or family history. Which of the following is not a possible cause of acute mania?

Your 19-year-old male patient is brought in by his parents who suspect he has a substance addiction. Over the last year, he has seemed to be significantly withdrawn, has dropped out of school, lost all of his friends, and does not seem to be caring for himself, rarely bathing and often appearing disheveled. You are able to elicit that your patient has a relatively consistent poorly responsive affect, inability to initiate and maintain eye contact, and reduced body language (i.e., affective flattening). His parents do state that sometimes he smiles and seems to “warm up”, but his affective range seems significantly narrowed in comparison to other persons. His parents state that when conversing, he has brief, laconic, and seemingly empty replies (i.e., alogia) and often seems to stray from the conversation jumping from one topic to another (i.e., derailment) or answering questions with a completely unrelated thought (i.e., tangentiality). Additionally, he often seems to sit for long periods of time and does not seem to show interest in social or work activities (i.e., avolition). You are also able to elicit that your patient believes that some lyrics in the music he listens to are specifically directed toward him (i.e., referential delusions). His signs and symptoms have been occurring over the last 8 months although his parents state that he has been having somewhat odd behaviors, including mumbling to himself and vague responses during a conversation for at least a year prior to the onset of his more recent signs and symptoms (i.e., prodromal symptoms). He does not appear to have symptoms consistent with depression, mania, or hypomania, and denies using any illicit substances. Which of the following diagnoses would be most appropriate for this patient?

A 38-year-old woman has come to the clinic complaining for the first time of sudden, severe stomach pain. She believes she has an ulcer. The examination shows no signs of any type of ulcer and she appears to be in good physical health. She is known to be an honest and upstanding individual and she has a history of anxiety and depression. From which ofthe following somatoform disorders is the patient most likely suffering?

A 34-year-old female comes to the office complaining of nausea and occasional vomiting after taking the antidepressant sertraline, 50 mg daily. She is taking sertraline for depression. She asks if there is another medication you could give her that won’t cause nausea. What medication should you prescribe as a substitute for this patient?

A 23-year-old female patient thought to be suffering from a personality disorder is brought to the clinic. She experiences frequent mood swings and severe bouts of seemingly uncontrollable anger. She has great difficulty with being alone, but cannot maintain normal relationships. She also shows signs of self-mutilation. From what type of personality disorder is the patient most likely suffering?

An 18-year-old male is brought into the office by his mother. She states she is concerned, because for the last few months he has exhibited “strange” behavior, which seems to be worsening. Although she states he has always been a bit “different”— occasionally talking gibberish to himself and wearing outlandish clothes—she said the unusual behaviors are becoming worse. He is seeing things such as bats flying in the house. He seems to think the programs on TV are real, and he talks about the characters as if he knows them. He becomes withdrawn at times, but can also become agitated for no apparent reason, shouting obscenities and throwing things. The patient sometimes refuses to bathe or brush his teeth. What is the most likely diagnosis in this patient?

A 40-year-old female comes to the office complaining of swelling at the base of her neck, rapid heartbeat, increased appetite, sudden weight loss, nervousness, tremor, irregular menstruation, and insomnia. Her resting pulse is 102. She has had one period in the last three months and has lost 10 pounds. She states she is only sleeping about three hours a night. What is the most likely diagnosis?

A 20-year-old woman is brought into the clinic by her mother, who is asking for an antidepressant for her daughter. The daughter is crying and refuses to answer questions. Her mother says she is “very depressed” and “doing scary things.” When asked to explain specifics of her daughter’s behavior, the mother states that her daughter frequents bars and picks up men for sex. She is also drinking heavily. The daughter recently wrecked a car belonging to her father. When confronted about the accident, the daughter became very angry and screamed at her father. At other times, her daughter is withdrawn and doesn’t want to talk to anyone. She is unable to hold down a job or keep friends. She does not like being alone. In the past, she has cut herself with razor blades, making small incisions on her arms and legs. She has also expressed thoughts of suicide. Although she has seen a psychiatrist, the daughter will not take her medications as prescribed. What is the most likely diagnosis?

Which of the following medications commonly prescribed for ADHD is a non-stimulant drug?

In order to diagnose ADHD in an adult, the symptoms of the disorder must:

A 16-year-old female presents with irrational preoccupation with her appearance. She has a history of several visits to a plastic surgeon. Your clinical diagnosis is body dysmorphic disorder. Which of the following medications would you prescribe to treat this psychological disorder?

A 17-year-old female presents with blindness, inability to speak, and numbness in the extremities. She expresses little or no concern about the symptoms she is experiencing. Full workup, including bloodwork and radiographic study, fail to find any clinical explanation for the symptoms. Based on the patient’s presentation and workup, which of the following is the most appropriate diagnosis?