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 2-1 through 2-13, choose the single answer that best answers the question.

2-1. Tricyclic antidepressants have been shown to produce clinical improvement in which of the following cardiac disturbances when given to depressed patients:

a. right bundle branch block
b. left bundle branch block
c. congestive heart failure
d. mitral valve prolapse
e. ventricular premature depolarization

2-2. A patient has experienced four episodes of major depression in five years. If he responds to antidepressant medication, he should be advised to remain on the medication for:

a. three months
b. six months
c. one year
d. two years
e. an indefinite period

2-3. In general, when the patient requires emergency restraints, the emergency clinician should:

a. so inform the patient beforehand
b. not inform the patient beforehand
c. insure the patient knows restraint is sanctioned by law
d. insure that the patient knows he is terrifying
e. obtain consent from a relative or hospital administrator

2-4. There is a danger that higher than usual lithium levels may occur with all the following EXCEPT:

a. use of thiazide diuretics
b. high sodium diet
c. low sodium diet
d. dehydration
e. impaired renal function

2-5. The one drug that is out of place in the following group is:

a. bromocriptine
b. trihexyphenidyl
c. levodopa
d. physostigmine
e. amantadine

2-6. The establishment of the therapist-patient relationship is sufficient involvement on the part of the therapist to impose on him or her an obligation of care for the safety not only of the patient, but also of others. This is most clearly raised in the case of:

a. Wyatt v. Stickney
b. O'Connor v. Donaldson
c. Tarasoff v. Regents of University of California
d. Durham v. United States
e. United States v. Brauner

2-7. The nortriptyline level associated with an adequate clinical response is:

a. 351 - 450 mEq
b. 251 - 350 mEq
c. 151 - 250 mEq
d. 75 - 100 mEq
e. 10 - 50 mEq

2-8. A report on the therapeutic efficacy of carbamazepine in preventing relapse in mania states that, when compared to placebo, the results are significant to the p. 05 level. This means:

a. Carbamazapine's potency is 20 times greater than placebo's
b. The ratio of carbamazepine responders to carbamazepine non responders is 19:1
c. No conclusions are possible without the N figure
d. There is a 5 percent probability that the results are due to change alone
e. There is a 50 percent probability that the results are to placebo alone

2-9. A patient with a fear of heights is brought to the top of a tall building and required to remain there as long as necessary for the anxiety to dissipate. This is an example of:

a. graded exposure
b. participant modeling
c. aversion therapy
d. flooding
e. implosion

2-10. The most appropriate laboratory study to obtain prior to initiating tricyclic antidepressant therapy in an elderly patient is:

a. computed tomography (CT scan)
b. complete blood count
c. serum glutamic oxaloacetic transaminase
d. electrocardiogram
e. urinalysis

2-11. The most important initial task of the physician performing the psychiatric interview is to:

a. make a diagnosis
b. develop a treatment plan
c. contact relevant family members
d. establish rapport
e. give advice

2-12. A dysphoric response to a test of a neuroleptic is helpful in predicting

a. improvement
b. relapse
c. diagnostic accuracy
d. noncompliance
e. tardive dyskinesia

2-13. All of the following are necessary criteria for selecting patients who will benefit from brief dynamic psychotherapy except:

a. a circumscribed chief complaint
b. psychological-mindedness
c. above-average intelligence
d. motivation only for symptom relief
e. ability to tolerate considerable anxiety without regression

DIRECTIONS: For questions 2-14 through 2-25, 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

2-14. The "rabbit syndrome" typically:
1. has an onset after long-term neuroleptic treatment 2. involves rhythmic movements of the lips 3. improves with antiparkinsonism medication 4. is present during sleep

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-15. A 78-year-old male resident in a nursing home exhibits the following symptoms only in the evening hours: confusion, motor restlessness, repetition of no sense monosyllables. Appropriate management of this patient includes:
1. increased lighting in the patient's room 2. haloperidol ( 2 mg) 3. companionship 4. flurazepam (15 mg)

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-16. Psychotropic drugs prescribed for the elderly:
1. are best given in a single night time dose 2. should be given in equally divided doses 3 or 4 times over a 24-hour period 3. should be given along with antiparkinsonian drugs that are prescribed prophylactically 4. frequently cause changes in blood pressure

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-17. Symptoms of abrupt withdrawal from heroin include:
1. pinpoint pupils 2. abdominal pain 3. seizures 4. muscle twitching

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-18. Which of the following are a feature of secondary gain:
1. financial benefits 2. obtaining drugs of abuse 3. avoidance of family obligations 4. reduction in anxiety

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-19. Which drugs interact with MAO to cause a hypertensive crisis:
1. Pseudoephedrine 2. L-Dopa 3. Fluoxetine 4. Meperidine

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-20. The reported incidence of suicide in the United States is:
1. more than two times in males as females 2. higher in upper class than lower 3. higher in Protestants than Jews of Catholics 4. higher before age 30 than after

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-21. In order to stand trial, a person must:
1. understand the nature of the proceedings against him or her 2. have the capacity to consult a lawyer 3. be able to assist in preparing the defense 4. not have a mental illness

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-22. Following the last dose, the withdrawal syndrome from:
1. heroin begins within 6 to 8 hours 2. methadone begins within 1 to 3 days 3. heroin lasts 7 to 10 days 4. methadone lasts 3 to 4 weeks

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-23. Abrupt discontinuation of which drug is likely to cause seizures:
1. alprazolam 2. morphine 3. secobarbital 4. phenelzine

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-24. A 23-year-old male student seen in consultation by a university health service psychiatrist states that he has plans to kill a fellow student who formerly was his girlfriend. He explains his reasons on the basis of her having rejected him. The patient states that he has already purchased a gun. In this instance, the psychiatrist should:
1. treat the patient's plans as a confidential communication 2. notify the police of the patient's dangerousness 3. advice the patient to begin a course of psychotherapy 4. warn the intended victim of the plan so that she can protect herself

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

2-25. Unlike malingering, in factitious disorders:
1. drug abuse and demands for pharmacologic treatment are not frequent 2. the patient usually admits deceit if directly challenged 3. there is usually only a single episode of feigned illness 4. there is no discernible goal other than the patient role

a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)

DIRECTIONS FOR QUESTIONS 2-26 TO 2-30:
Each group of questions consists of 4 or 5 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.
For each of the following, match the drug with its major target receptor

a. Serotonin 2A b. NMDA c. Serotonin 1A d. Dopamine D2 e. Dopamine D4

2-26. Clozapine

a.
b.
c.
d.
e.

a. Serotonin 2A b. NMDA c. Serotonin 1A d. Dopamine D2 e. Dopamine D4

2-27. Buspirone

a.
b.
c.
d.
e.

a. Serotonin 2A b. NMDA c. Serotonin 1A d. Dopamine D2 e. Dopamine D4

2-28. PCP

a.
b.
c.
d.
e.

a. Serotonin 2A b. NMDA c. Serotonin 1A d. Dopamine D2 e. Dopamine D4

2-29. Nefazodone

a.
b.
c.
d.
e.

a. Serotonin 2A b. NMDA c. Serotonin 1A d. Dopamine D2 e. Dopamine D4

2-30. Haloperidol

a.
b.
c.
d.
e.

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

When you are sure of your answers, choose "Submit Test"
You will receive notification of your test results immediately

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© 1995, 1996 Interactive Testing in Psychiatry (ITP)

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Department of Psychiatry
© 2002 New York University
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About the Department l For the Public \| For the Psychiatrist \| Reference Desk l Training Programs Research \| Faculty \| Seminars/Conferences l Psychiatry Home

New York University School of Medicine Department of Psychiatry © 2002 New York University Ethics and Disclaimer

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 2-1 through 2-13, choose the single answer that best answers the question.

2-1. Tricyclic antidepressants have been shown to produce clinical improvement in which of the following cardiac disturbances when given to depressed patients:

2-2. A patient has experienced four episodes of major depression in five years. If he responds to antidepressant medication, he should be advised to remain on the medication for:

2-3. In general, when the patient requires emergency restraints, the emergency clinician should:

2-4. There is a danger that higher than usual lithium levels may occur with all the following EXCEPT:

2-5. The one drug that is out of place in the following group is:

2-6. The establishment of the therapist-patient relationship is sufficient involvement on the part of the therapist to impose on him or her an obligation of care for the safety not only of the patient, but also of others. This is most clearly raised in the case of:

2-7. The nortriptyline level associated with an adequate clinical response is:

2-8. A report on the therapeutic efficacy of carbamazepine in preventing relapse in mania states that, when compared to placebo, the results are significant to the p. 05 level. This means:

2-9. A patient with a fear of heights is brought to the top of a tall building and required to remain there as long as necessary for the anxiety to dissipate. This is an example of:

2-10. The most appropriate laboratory study to obtain prior to initiating tricyclic antidepressant therapy in an elderly patient is:

2-11. The most important initial task of the physician performing the psychiatric interview is to:

2-12. A dysphoric response to a test of a neuroleptic is helpful in predicting

2-13. All of the following are necessary criteria for selecting patients who will benefit from brief dynamic psychotherapy except:

DIRECTIONS: For questions 2-14 through 2-25, 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 2-26 TO 2-30: Each group of questions consists of 4 or 5 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:

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

DIRECTIONS FOR QUESTIONS 2-26 TO 2-30:
Each group of questions consists of 4 or 5 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.

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