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 3-1 through 3-10, choose the single answer that best answers the question.

3-1. The diagnosis of Alzheimer's Disease is established by:

a. CSF

b. EEG

c. CT

d. MRI

e. None of the above

3-2. Relative contraindications to electroconvulsive therapy include each of the following EXCEPT:

a. brain tumor

b. extreme hypertension

c. fever

d. prostatic hypertrophy

e. coronary ischemia

3-3. In using the muscle relaxant succinylcholine during Electro convulsive therapy, the physician must be alert to the rare complication that the:

a. relaxant may potentials the convulsive effect

b. patient may constitutionally lack succinylcholinesterase and so stay apneic

c. succinylcholine may precipitate a toxic psychosis

d. muscle relaxant may cause acute hemolysis

e. patient is resistant to the succinylcholine

3-4. The antipsychotic properties of neuroleptic drugs are due to their ability to block which of the following receptors:

a. Dopamine D-1

b. Dopamine D-2

c. Alpha adrenergic

d. Cholinergic

e. GABAergic

3-5. The use of denial by myocardial infarction patients in the coronary care unit is:

a. often found to precede a psychotic decompensation

b. commonplace and not necessarily harmful

c. most commonly found in blue-collar populations

d. a primitive reaction which predicts a poor outcome

e. a probable cause of chronic invalidism

3-6. Plasma concentrations of which of the following drugs is least likely to be altered by coadministration of fluvoxamine:

a. alprazolam

b. triazolam

c. propranolol

d. astemizole

e. hismanal

3-7. Which of the following would most clearly and directly serve the primary prevention of mental illness:

a. improvement of the early social environment of children

b. increased use of behavior modification therapy

c. more trained psychiatrists

d. mental health screening programs for school children

e. increasing psychiatric training of pediatricians

3-8. The most effective approach for the physician to take with the person experiencing acute grief reaction is to:

a. prescribe antianxiety drugs

b. prescribe antidepressants

c. encourage ventilation of feelings

d. recommend electroconvulsive therapy

e. support the defense or denial

3-9. A parent is instructed to ignore her child's tantrums rather than reinforce them with attention: this is an example of:

a. flooding

b. classical conditioning

c. covert conditioning

d. extinction

e. avoidance learning

3-10. A patient has insidious onset of jealous delusional preoccupations about his wife. He is not having hallucinations or other delusions: there is no affective instability or evidence of an organic mental disorder. According to criteria in DSM-IV, this patient most likely has:

a. shared delusional disorder

b. paranoid personality disorder

c. schizophrenia

d. delusional disorder

e. amphetamine delusional disorder

DIRECTIONS: For questions 3-11 through 3-21, 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

3-11. Patients with factitious disorders are frequently reported to:

 1.   have extensive histories of travel



 2.   have histories of extensive medical treatment 



      and hospitalization as children



 3.   work in health-related fields



 4.   experience somatic delusions

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-12. In the management of a hypochondriacal patient, the clinician should:

 1.   reassure the patient that there is nothing seriously wrong



 2.   schedule times to see the patients that are not contingent 



      on the patient's being sick



 3.   use low-dose neuroleptics to decrease the patient's physical distress



 4.   limit the patient's demand for time and attention

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-13. Which of the following are treatments that might reasonably be considered for patients with anesthesia of the left arm in a "glove" distribution:

 1.   hypnosis



 2.   ECT



 3.   amytal



 4.   flooding

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

QUESTIONS 3-14 TO 3-15

A patient who is being treated with tranylcypromine (Parnate) calls your office from his vacation home complaining of a sudden onset of the following-symptoms: occipital headache, sweating, nausea and vomiting. The patient is afebrile. You instruct the patient go to the nearest emergency room.

3-14. A procedure that would be most important is establishing the cause of these symptoms should include which one or more of the following:





 1.   fundoscopic examination of the eye



 2.   electroencephalogram



 3.   blood pressure recording



 4.   microscopic examination of cerebrospinal fluid

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-15. If the patient's blood pressure is significantly elevated, appropriate treatment would involve administration of:

 1.   nifedipine



 2.   bupropion



 3.   phentolamine



 4.   venlafaxine

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-16. Early behavioral characteristics seen in demented persons include:





  1.   lack of initiative



  2.   increased irritability



  3.   reduced interest in previous areas of activity



  4.   intellectual fatigue and inability to think clearly

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-17. An increased risk of relapse of major depressive disorder is strongly related to:





  1.   low family income



  2.   longer duration of prior depressive episodes



  3.   older age



  4.   residual dysthymia

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-18. Precipitant of manic episode in bipolar patients:





  1.   ECT



  2.   sleep deprivation



  3.   tricyclic antidepressants



  4.   phenothiazines

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-19. Which of the following tests help to monitor hematological changes in a patient being treated with carbamazepine:





  1.   complete blood count



  2.   reticulocyte count



  3.   serum iron



  4.   platelet count

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-20. Psychiatric disorders that occur with higher than expected frequency in somatization disorder patients are:





  1.   antisocial personality disorder



  2.   alcohol abuse



  3.   drug abuse



  4.   suicide

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

3-21. Narcolepsy is characterized by:





  1.   genetic transmission



  2.   episodes of paralysis



  3.   REM sleep episodes during sleep attacks



  4.   non-refreshing sleep attacks

a. (1, 2, 3)

b. (1, 3)

c. (2, 4)

d. (4 only)

e. (ALL)

DIRECTIONS FOR QUESTIONS 3-22 TO 3-30:
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 3-22 TO 3-25

Enzyme involved in the metabolism of the compounds listed below:





 a.   Catechol-O-methyl transferase



 b.   alpha-methyl-p-tyrosine



 c.   Aldehyde dehydrogenase



 d.   Anticholinesterase



 e.   Dopamine beta-hydroxylase

3-22. Norepinephrine





 a.   Catechol-O-methyl transferase



 b.   alpha-methyl-p-tyrosine



 c.   Aldehyde dehydrogenase



 d.   Anticholinesterase



 e.   Dopamine beta-hydroxylase

3-23. Extra cellular dopamine





 a.   Catechol-O-methyl transferase



 b.   alpha-methyl-p-tyrosine



 c.   Aldehyde dehydrogenase



 d.   Anticholinesterase



 e.   Dopamine beta-hydroxylase

3-24. Inhibited by physostigmine





 a.   Catechol-O-methyl transferase



 b.   alpha-methyl-p-tyrosine



 c.   Aldehyde dehydrogenase



 d.   Anticholinesterase



 e.   Dopamine beta-hydroxylase

3-25. Inhibited by disulfarim

QUESTIONS 3-26 TO 3-30





 a.   Locus ceruleus



 b.   Nigrostriatal pathway



 c.   Nucleus basalis of Meynert



 d.   Pineal gland



 e.   Raphe nuclei

3-26. Acetylcholine





 a.   Locus ceruleus



 b.   Nigrostriatal pathway



 c.   Nucleus basalis of Meynert



 d.   Pineal gland



 e.   Raphe nuclei

3-27. Dopamine





 a.   Locus ceruleus



 b.   Nigrostriatal pathway



 c.   Nucleus basalis of Meynert



 d.   Pineal gland



 e.   Raphe nuclei

3-28. Melatonin





 a.   Locus ceruleus



 b.   Nigrostriatal pathway



 c.   Nucleus basalis of Meynert



 d.   Pineal gland



 e.   Raphe nuclei

3-29. Serotonin





 a.   Locus ceruleus



 b.   Nigrostriatal pathway



 c.   Nucleus basalis of Meynert



 d.   Pineal gland



 e.   Raphe nuclei

3-30. Norepinephrine

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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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 3-1 through 3-10, choose the single answer that best answers the question.

3-1. The diagnosis of Alzheimer's Disease is established by:

3-2. Relative contraindications to electroconvulsive therapy include each of the following EXCEPT:

3-3. In using the muscle relaxant succinylcholine during Electro convulsive therapy, the physician must be alert to the rare complication that the:

3-4. The antipsychotic properties of neuroleptic drugs are due to their ability to block which of the following receptors:

3-5. The use of denial by myocardial infarction patients in the coronary care unit is:

3-6. Plasma concentrations of which of the following drugs is least likely to be altered by coadministration of fluvoxamine:

3-7. Which of the following would most clearly and directly serve the primary prevention of mental illness:

3-8. The most effective approach for the physician to take with the person experiencing acute grief reaction is to:

3-9. A parent is instructed to ignore her child's tantrums rather than reinforce them with attention: this is an example of:

3-10. A patient has insidious onset of jealous delusional preoccupations about his wife. He is not having hallucinations or other delusions: there is no affective instability or evidence of an organic mental disorder. According to criteria in DSM-IV, this patient most likely has:

DIRECTIONS: For questions 3-11 through 3-21, 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

QUESTIONS 3-14 TO 3-15

DIRECTIONS FOR QUESTIONS 3-22 TO 3-30: 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 3-26 TO 3-30

REFERENCES:

DIRECTIONS FOR QUESTIONS 3-22 TO 3-30:
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.