NYU School of Medicine - Department of Psychiatry

NYU Psychiatry ITP Module 1

INSTRUCTIONS: Select your answer(s) to each question and choose the corresponding letter(s). Submit the completed test by pressing the "Submit Test" button. You will receive notification of your test results immediately.

DIRECTIONS: For questions 1-1 through 1-9, choose the single answer that best answers the question.

1-1. What is the best approach that a physician can take with a hostile patient who is hospitalized?

a. offer straightforward explanations of procedures

b. be sympathetic about the patient's fears

c. set firm limits on the patient's behavior

d. avoid isolating the patient

e. let the patient share in the treatment decisions

1-2. Each of the following drugs is helpful in treating obsessive-compulsive disorder EXCEPT

a. bupropion

b. fluvoxamine

c. sertraline

d. fluoxetine

e. clomipramine

1-3. The generally accepted therapeutic range of blood levels for lithium carbonate is:

a. 0.8 to 1.0 mEq/liter

b. 0.8 to 1.5 mEq/liter

c. 8.2 to 2.5 mEq/liter

d. 8 to 15 mEq/liter

e. 10 to 20 mEq/liter

1-4. The side-effect that is least likely to be caused by fluoxetine (Prozac) is

a. orgasmic dysfunction

b. insomnia

c. nausea

d. fatigue

e. constipation

1-5. It is advisable to measure serum lithium concentrations how many hours after a dose?

a. 2 hours

b. 4 hours

c. 6 hours

d. 12 hours

e. 24 hours

1-6. A 40-year old physician was hospitalized following a Femoral fracture in an automobile accident. Orthopedic surgery was uneventful and for the first 2 recovery days the patient was restless but well oriented. On the third day after surgery the patient rapidly became confused and fearful, and reported visual and tactile hallucinations of snakes and scorpions crawling over the bedclothes. Physical examination revealed dilated pupils, coarse tremor of the hands and eyelids, profuse diaphoresis, and a rapid, pounding heartbeat. His oral temperature was 100 degree F. His previous medical history was unremarkable. He is described as a moderate social drinker and denied use of other drugs. The diagnosis most strongly suggested by this description is:

a. alcohol withdrawal delirium

b. postanesthesia delirium

c. septicemia

d. subdural hematoma

e. uremia

1-7. Adverse reactions of tricyclic antidepressants are most likely to be clinically significant in patients with:

a. migraine

b. Parkinsonism

c. insomnia

d. pseudo tumor cerebri

e. benign prostatic hypertrophy

1-8. The drug least likely to cause extra pyramidal symptoms is:

a. phenelzine

b. amoxapine

c. perphenazine

d. haloperidol

e. fluphenazine

1-9. The psychotropic drug with the lowest degree of lipid solubility is:

a. chlorpromazine

b. haloperidol

c. amitriptyline

d. lithium carbonate

e. diazepam

DIRECTIONS: For questions 1-10 through 1-18, one or more of the following alternatives given are correct. After deciding which alternatives are correct, click on the appropriate button according to the following key:

Mark "A" if alternatives l, 2 and 3 only are correct.
Mark "B" if alternatives 1 and 3 only are correct.
Mark "C" if alternatives 2 and 4 only are correct.
Mark "D" if alternative 4 only is correct.
Mark "E" if all four alternatives are correct.

SUMMARY OF DIRECTIONS

A B C D E

1, 2, 3 1, 3 2, 4 4 ALL only only only only correct

1- 10. Conditions that represent absolute or relative contradictions to the use of monoamine oxidase inhibitors:







  1.   bronchial asthma





  2.   pheochromocytoma





  3.   dementia





  4.   premenstrual dysphoria

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-11. Important elements of cognitive therapy include:







  1.   eliciting automatic thoughts





  2.   testing automatic thoughts





  3.   identifying underlying maladaptive assumptions





  4.   testing the validity of maladaptive assumptions

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-12. A patient is post-MI. He appears to have physically recovered quite well but he is feeling depressed. Which of the following therapeutic techniques have been shown to be useful in dealing with different aspects of this type of depression:

 1.   cognitive therapy





 2.   behavior therapy





 3.   family therapy





 4.   group therapy

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-13. Tricyclic antidepressants at or just above therapeutic plasma levels frequently have the following effects on the EKG:

 1.   shorten S-T interval





 2.   prolong QRS





 3.   facilitate intraventricular conduction





 4.   prolong P-R interval

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-14. A drug interaction with lithium that results in increased plasma lithium levels is:

 1.   tetracycline





 2.   theophylline





 3.   ibuprofen





 4.   mannitol

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-15. In alcohol hallucinosis:

 1.   hallucinations are usually tactile





 2.   hallucinations usually begin within 48 hours after stopping alcohol





 3.   dependence on alcohol is not a feature





 4.   a clear sensorium is present

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-16. A patient complains of feeling depressed for many years. He states his appetite seems normal, and he sleeps 7-8 hours every night. He has never had active suicidal ideation. He begins to see a cognitive psychiatrist. This therapist would be most likely to:

 1.   explore interpersonal psychodynamics





 2.   prescribe antidepressant medication





 3.   develop a hierarchical construction of feared situations which patient can either imagine or





      be exposed to in real life





 4.   assign homework where the patient records his thinking

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-17. Advantages of methadone for long-term maintenance of heroin addicts include:

 1.   it is taken orally and once daily





 2.   it is effective at relatively low dosage





 3.   it blocks both opioid withdrawal and opioid hunger





 4.   it is nonaddicting

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

1-18. Side effects of electroconvulsive therapy may include:

 1.   memory impairment





 2.   prolonged seizure





 3.   headache





 4.   premature ventricular contractions

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

DIRECTIONS FOR QUESTIONS 1-19 TO 1-30:
Each group of questions consists of lettered headings, followed by a list of numbered words or statements (questions). For each numbered word or statements select the one lettered heading that is most closely associated with it.

QUESTIONS 1-19 TO 1-22
Each of the following antidepressant drugs is closely associated with a particular side effect.

 a.   Clomipramine (Anafranil)





 b.   Trazodone (Desyrel)





 c.   Amoxapine (Asendin)





 d.   Venlafaxine (Effexor)





 e.   Alprazolam (Xanax)

1-19. Parkinsonism

 a.   Clomipramine (Anafranil)





 b.   Trazodone (Desyrel)





 c.   Amoxapine (Asendin)





 d.   Venlafaxine (Effexor)





 e.   Alprazolam (Xanax)

1-20. Priapism

 a.   Clomipramine (Anafranil)





 b.   Trazodone (Desyrel)





 c.   Amoxapine (Asendin)





 d.   Venlafaxine (Effexor)





 e.   Alprazolam (Xanax)

1-21. Anorgasmia

 a.   Clomipramine (Anafranil)





 b.   Trazodone (Desyrel)





 c.   Amoxapine (Asendin)





 d.   Venlafaxine (Effexor)





 e.   Alprazolam (Xanax)

1-22. Blood pressure elevation

QUESTIONS 1-23 TO 1-26

 a.   Chlorpromazine (Thorazine)





 b.   Thioridazine (Mellaril)





 c.   Haloperidol (Haldol)





 d.   Fluphenazine decanoate (Prolixin decanoate)





 e.   Molindone (Moban)

1-23. Autonomic instability

 a.   Chlorpromazine (Thorazine)





 b.   Thioridazine (Mellaril)





 c.   Haloperidol (Haldol)





 d.   Fluphenazine decanoate (Prolixin decanoate)





 e.   Molindone (Moban)

1-24. Retrograde ejaculation

 a.   Chlorpromazine (Thorazine)





 b.   Thioridazine (Mellaril)





 c.   Haloperidol (Haldol)





 d.   Fluphenazine decanoate (Prolixin decanoate)





 e.   Molindone (Moban)

1-25. Acute dystonic reaction

 a.   Chlorpromazine (Thorazine)





 b.   Thioridazine (Mellaril)





 c.   Haloperidol (Haldol)





 d.   Fluphenazine decanoate (Prolixin decanoate)





 e.   Molindone (Moban)

1-26. Orthostatic hypotension

QUESTIONS 1-27 TO 1-30

 a.   Verapamil





 b.   Dantrolene





 c.   Carbamazepine





 d.   Propranolol





 e.   Clonazepam

1-27. Effective in reducing essential and lithium-induced tremor

 a.   Verapamil





 b.   Dantrolene





 c.   Carbamazepine





 d.   Propranolol





 e.   Clonazepam

1-28. Calcium channel blocker with reported anti manic activity

 a.   Verapamil





 b.   Dantrolene





 c.   Carbamazepine





 d.   Propranolol





 e.   Clonazepam

1-29. Calcium antagonist with efficacy in decreasing voluntary muscle activity in neuroleptic malignant syndrome

 a.   Verapamil





 b.   Dantrolene





 c.   Carbamazepine





 d.   Propranolol





 e.   Clonazepam

1-30. Benzodiazepine anticonvulsant trial is effective in suppressing panic attacks

REFERENCES:

Comprehensive Textbook of Psychiatry, 6th Edition, Harold Kaplan, M.D. and Benjamin Sadock, M.D., Williams&Wilkins, Baltimore, 1995
Synopsis of Psychiatry, 7th Edition, Harold Kaplan, M.D. and Benjamin Sadock, M.D., Williams&Wilkins, Baltimore, 1994

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DIRECTIONS: For questions 1-1 through 1-9, choose the single answer that best answers the question.

1-1. What is the best approach that a physician can take with a hostile patient who is hospitalized?

1-2. Each of the following drugs is helpful in treating obsessive-compulsive disorder EXCEPT

1-3. The generally accepted therapeutic range of blood levels for lithium carbonate is:

1-4. The side-effect that is least likely to be caused by fluoxetine (Prozac) is

1-5. It is advisable to measure serum lithium concentrations how many hours after a dose?

1-7. Adverse reactions of tricyclic antidepressants are most likely to be clinically significant in patients with:

1-8. The drug least likely to cause extra pyramidal symptoms is:

1-9. The psychotropic drug with the lowest degree of lipid solubility is:

DIRECTIONS: For questions 1-10 through 1-18, one or more of the following alternatives given are correct. After deciding which alternatives are correct, click on the appropriate button according to the following key:

SUMMARY OF DIRECTIONS

DIRECTIONS FOR QUESTIONS 1-19 TO 1-30: Each group of questions consists of lettered headings, followed by a list of numbered words or statements (questions). For each numbered word or statements select the one lettered heading that is most closely associated with it.

REFERENCES:

DIRECTIONS FOR QUESTIONS 1-19 TO 1-30:
Each group of questions consists of lettered headings, followed by a list of numbered words or statements (questions). For each numbered word or statements select the one lettered heading that is most closely associated with it.