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 5-1 through 5-10, choose the single answer that best answers the question.

5-1. Aggressive or violent behavior is associated with which of the following findings:

a. blunted response to a corticotropin-releasing hormone (CRH) stimulation test
b. blunted response to a thyrotropin-releasing hormone (TRH) suppression test
c. blunted growth hormone (GH) response to insulin-induced hypoglycemia
d. abnormal results of a dexamethasone suppression test (DST)
e. decreased levels of 5-Hydroxyindoleacetic acid (5-HIAA) in the CSF


5-2. Obsessive-compulsive disorder is associated with abnormalities of which neurotransmitter system:

a. epinephrine
b. serotonin
c. melatonin
d. acetylcholine
e. norepinephrine


5-3. According to Freud the most common fear of a normal two-year-old concerns:

a. Castration
b. Ghosts and monsters
c. Loss of mother's love
d. Punishment
e. Strangers


5-4. A 55-year-old man is accompanied to your office by his daughter who reports that his behavior has been different for the past month or two. The daughter requested the examination because he had publicly urinated in a department store. When the patient enters the office, he is unshaven, his clothes are dirty and improperly buttoned. He sits down on your chair behind the desk and speaks slowly in bland generalities. The most likely diagnosis is:

a. Schizophrenia
b. Dissociative reaction
c. Unipolar mood disorder
d. Organic mental syndrome
e. Personality disorder


5-5. Regarding adolescent suicide:

a. it is committed more frequently by females than males.
b. the method most commonly used by completed suicides is overdose.
c. the seriousness of the attempt can be assessed by the lethality of the method used.
d. the adolescent typically plans the suicide attempt over 24-28 hours.
e. the attempt usually occurs after an acute disciplinary crisis or humiliation.


5-6. A 64-year-old male with major depression with melancholia has been taking imipramine 100 mg daily for three weeks without response. He received and tolerated electroconvulsive therapy (ECT) during a previous episode of depression. The most appropriate intervention at this point is to:

a. proceed to ECT
b. increase the dosage of imipramine
c. switch to treatment with MAO inhibitors
d. augment the imipramine with methylphenidate (Ritalin)
e. supplement the imipramine with T3


5-7. Patients with obsessive-compulsive disorder have been shown to have abnormalities in which brain region?

a. Cerebellum
b. Caudate
c. Hippocampus
d. Striatum
e. Corpus callosum


5-8. A 38-year-old single man who is recently fired from his job as a building janitor comes to the emergency room complaining of pain in his head above the eyes and saying that his former boss is putting thoughts into his head and controlling his movements. Both memory and orientation are normal. No focal neurological disturbances are noted. The most likely diagnosis is:

a. manic psychosis
b. alcoholic hallucinosis
c. frontal lobe tumor
d. paranoid schizophrenia
e. syphilitic meningoencephalitis


5-9. In patients with untreated Parkinson's disease, the most frequent mental change is:

a. delusional ideation
b. mania
c. depression
d. delirium
e. dementia


5-10. The risk of developing schizophrenia in a non-twin sibling of a schizophrenic patient is:

a. 1%
b. 10%
c. 25%
d. 50%
e. 75%


DIRECTIONS: For questions 5-11 through 5-23, 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


5-11. By 4 months a child should be able to: 




 1.   approach and grasp a toy with one hand



 2.   smile preferentially to mother



 3.   bang and shake a rattle



 4.   follow moving objects to the midline
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-12. A 34-year-old stuporous man has been in the hospital for 3 days and has not spoken to anyone or left his bed. After being given an intravenous injection of sodium amytal, the patient dramatically becomes lucid. The possible diagnoses of the patient include: 




 1.   normal pressure hydrocephalus



 2.   catatonia



 3.   meningioma



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


5-13. The dementia syndrome of depression: 




 1.   intellectual deficits antedate depression



 2.   the patient is very disturbed by memory impairment and poor



 intellectual performance and verbalizes this disturbance



 3.   the patient is usually globally impaired, with consistently poor



 intellectual performance



 4.   performance in a sodium amobarbital interview is improved
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-14. A 35-year-old man has been taking the same dosage of carbamazepine and of lithium carbonate over the past 2 months for treatment of bipolar disorder. The patient's plasma carbamazepine level was 9.0 mg/mL 3 weeks ago and is now 6.0 mg/mL. The decrease is likely due to: 




 1.   vigorous regular exercise



 2.   administration of a thiazide diuretic



 3.   polyuria induced by lithium



 4.   induction of liver enzymes
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-15. Which of the following are indications for tricyclic antidepressant plasma levels: 
 1.   to determine whether side effects are due to toxic plasma levels



 2.   to determine whether the plasma level is within the therapeutic range



 3.   to determine the minimum therapeutic dosage



 4.   to detect non-compliance
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-16. Auditory hallucinations with no cognitive change and no delusional elaborations on the hallucinatory material may be caused by: 




 1.   digitalis



 2.   tumors of the temporal lobe



 3.   tricyclic antidepressants



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


5-17. The terms "incidence" and "prevalence" differ in that: 
 1.   incidence means the number of new cases



 2.   incidence refers to mutually inclusive events only



 3.   prevalence means the total number of cases



 4.   the sampling distribution of prevalence statistics is known
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-18. Useful tests before starting lithium therapy include: 
 1.   sodium loading and clearance studies



 2.   baseline renal function tests



 3.   an EEG during sleep deprivation



 4.   evaluation of thyroid function
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-19. Multi-infarct dementia is characterized by: 
 1.   stepwise deterioration



 2.   a history of hypertension



 3.   abrupt onset



 4.   good prognosis when actively treated
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-20. Standard of proof required for involuntary psychiatric hospitalization include: 
 1.   a preponderance of evidence



 2.   imminence of danger to the community



 3.   evidence that is beyond a reasonable doubt



 4.   clear and convincing evidence
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-21. Neuropsychiatric problems commonly associated with Parkinson's disease include: 




 1.   partial seizures



 2.   dementia



 3.   schizophrenia-like psychosis



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


5-22. Children aged 0 - 5 with mental retardation in the "profound" category should be able to: 




 1.   develop social and communicative skills



 2.   profit from training in self-help



 3.   develop fair motor development



 4.   get by with nursing care
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


5-23. True statements about tic disorders include: 




 1.   dysregulation of the neurochemical systems of the CNS is probably



      the most important etiological factor in the majority of tics



 2.   tics are experienced as irresistible but can be voluntarily suppressed



      for varying lengths of time, from minutes to hours



 3.   CNS stimulants tend to exacerbate tics or cause new tics



 4.   tics occur at equal rates in males and females
a. (1, 2, 3)
b. (1, 3)
c. (2, 4)
d. (4 only)
e. (ALL)


DIRECTIONS FOR QUESTIONS 5-24 TO 5-30:

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 5-24 TO 5-26

Match each of the benzodiazepines listed with the most appropriate description below: 

 a.   Diazepam (Valium)



 b.   Lorazepam (Ativan)



 c.   Alprazolam (Xanax)



 d.   Clonazepam (Klonopin)



 e.   Triazolam (Halcion)


5-24. Primary path of metabolism involves conjugation and glucuronidation

a.
b.
c.
d.
e. 


 a.   Diazepam (Valium)



 b.   Lorazepam (Ativan)



 c.   Alprazolam (Xanax)



 d.   Clonazepam (Klonopin)



 e.   Triazolam (Halcion)

5-25. A hypnotic with a half-life of about 3 to 5 hours

a.
b.
c.
d.
e. 


 a.   Diazepam (Valium)



 b.   Lorazepam (Ativan)



 c.   Alprazolam (Xanax)



 d.   Clonazepam (Klonopin)



 e.   Triazolam (Halcion)

5-26. Has an active metabolite with a half-life of about 100 hours

a.
b.
c.
d.
e.


QUESTIONS 5-27 TO 5-30 

 a.   profound mental retardation



 b.   severe mental retardation



 c.   moderate mental retardation



 d.   mild mental retardation



 e.   none of the above

5-27. Capable of reaching but unlikely to progress beyond 2nd- grade level

a.
b.
c.
d.
e. 


 a.   profound mental retardation



 b.   severe mental retardation



 c.   moderate mental retardation



 d.   mild mental retardation



 e.   none of the above

5-28. Can talk or learn to communicate but unable to profit from vocational training

a.
b.
c.
d.
e. 


 a.   profound mental retardation



 b.   severe mental retardation



 c.   moderate mental retardation



 d.   mild mental retardation



 e.   none of the above

5-29. Can be guided toward social conformity

a.
b.
c.
d.
e. 


 a.   profound mental retardation



 b.   severe mental retardation



 c.   moderate mental retardation



 d.   mild mental retardation



 e.   none of the above

5-30. Can learn academic skills up to approximately 6th-grade level by late teens

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


If your are applying for CME credit, please complete the following items and your test will be submitted to:
NYU Department of Psychiatry

Name:

Title:

Affiliation:

Mailing Address:

Street:
City:
State:
Zip:
Country:

Phone Number:

E-mail address:

Other information or comments you would like to include:

Please be sure to mail your Application & Evaluation forms and payment for CME credit.



© 1995, 1996 Interactive Testing in Psychiatry (ITP)



 

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

 NYU