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Psychiatry 2007
1. 35 year old schizoaffective male comes for a routine checkup to the clinic.
He states that for the last month he has been feeling sad, depressed, losing
interest in things, feels "worthless" and feels like a "burden to his family" for
the past 2 days he has been entertaining suicidal thoughts. He also states
that he has developed telepathic abilities and he is capable of helping many
people all over the world by his "positive telepathic thoughts"
What is true about the findings from his check up?
a. Do not fit a schizophrenic diagnosis
b. There is an impression of over-valued ideation in his thoughts
c. Mood incongruence
d. Mood congruence
e. Suffers from a severe disorder in his logic and has weak associative
skills
2. According to the DSM-IV all of the following answer to the criteria of acute
dystonia except:
a. 28 year old male that has developed tremors and rigidity after he
abruptly stopped taking his valium
b. 30 year old female with neck dystonia 5 days after taking Halidol
c. 25 year old male developed ocular dystonia on the day he stopped
dekinet (?) ‫ דיקנט‬treatment
d. 30 year old female developed ocular dystonia 6 days after taking
parfanon (?) ‫פרפנן‬
e. 25 year old male that developed neck dystonia on the day he started
Artan treatment
3. Adam, 25 year old male was brought to the ER by his family due to a
decline in his situation this past month. The family states that he just sits still
most of the time and you can't move him, doesn't speak, negative and won't
eat or drink. What is the most likely diagnosis?
a. Catatonia
b. NMS (neuroleptics malignant syndrome)
c. Tardive dyskinesia
d. Serotonin syndrome
e. Delirium
4. What is the definition of Alogia?
a. Weak vocabulary, weak conversation matter, weakened logic and long
delayed response time
b. Specific disorder on thought process
c. Specific and severe disorder in logical thought
d. Synonym for affective-flattening
e. Non-specific logic disorder
5. Epidemiologically what is the difference between major depression,
unipolar and bipolar disorders?
a. Bipolar has a stronger genetic foundation than unipolar disorder
b. Unipolar disorder manifests at a young age
c. Bipolar disorder effects woman more than unipolar disorder
d. Unipolar disorder is 2x more common in the general population than
unipolar disorder
e. Unipolar disorder can come with psychosis but if there is psychosis in
bipolar disorder than the diagnosis is schizophrenia
6. 24 year old male comes to the ER states he "sees voices and hears
colors," this is most likely….
a. Neologism
b. Illusion
c. Blocking
d. Dysphoria
e. Synesthesia
7. Which of the following best describes borderline personality disorders?
a. Dramatic behavior and a need to be the center or attention
b. Mood swings, always in some sort of crisis
c. Loner, introverted
d. Loner, strange and introverted
e. Tends not to have a conscience and "run ins" with the law
8. 29 year old female, single +1 first hospitalized 5 years ago approximately 2
months after giving birth. At that hospitalization she is described as bizarre
dress, euphoric affect, exaggerated make up and non-stop speaking. Stated
that the father of her child is "a famous movie actor." After treatment there
was improvement but the thoughts that she was the actors girlfriend persisted.
Since then there have been 2 more manic episodes, her functionality has
decreased over the year, the child was removed from the home on a part of
social services due to neglect.
The most likely diagnosis is:
a. Paranoid Schizophrenia
b. Schizoaffective disorder
c. Delusional disorder-grandiose type
d. Clerambault-kandinsky complex
e. Postpartum psychotic disorder
9. Of the following which is most correct for a man who has been diagnosed
with dissociative amnesia?
a. No organic brain causative factor, forgets where he put his keys
b. There is organic brain causative factor, forgets his early childhood
c. No organic causative factor, forgets stressful events
d. There is organic brain causative factor, forgets what he ate for
breakfast
e. No organic brain causative factor, can't learn new things
10. All of the following are characteristic of grief but a pathological reaction,
except:
a. Hearing voices
b. Inappropriate feelings of guilt
c. Believing that the person is still alive
d. Inappropriate feelings of being pursued
e. No signs of mourning
11. Genetic counseling – allows the family and relations (mark the most
correct answer)
a. To get information from genetic tests
b. To get medical advice regarding genetic illness
c. To get genetic testing
d. To start a lawsuit in the case of genetic illness
e. To get treatment (psychological) when a close family relative has a
genetic illness
12. 30 year old male comes to you for treatment with complaints of feeling
low, sleeping a lot, lack of energy that disrupts his ability to work, weight gain
of 8 kilo and apathy toward work and hobbies that he used to love. He has a
history of 3 such episodes. He states that 5 years ago he went through a
period where he was very active; he spent 80,000 shekel on clothing and
hotels, had an active sex life and believed he would bring the message of love
and peace to the world.
Which drug would you choose to start his treatment with?
a. Lithium
b. carbamazepine (Tegretol)
c. desipramine (Deprexan)
d. paroxetine (Prozac)
e. olanzapine (Zyprexa)
13. According to the DSM-IV the diagnosis of schizoaffective disorder is
based on:
a. The constant presence of all criteria for affective disorder along with
significant schizophrenia criteria
b. Presence of delusions or hallucinations most of the time for at least 2
weeks without prominent affective symptoms
c. Presence of affective disorder criteria in one episode and
schizophrenic disorder criteria in another episode
d. Presence of affective symptoms for at least 2 weeks without
hallucinations
e. Presence of Schizophrenic symptoms with recreational drug use that
influence affect
14. "Normal" from a psychiatric point of view, is:
a.
b.
c.
d.
e.
The ability to understand repressed traits
The ability to adapt after a psychotic break
The ability to adapt to the different stages of development
The ability to return to prior developmental stages in a crisis
The ability to adapt to concrete thought in a crisis
15. What is not true regarding ECT?
a. One of the most useful tools for one with major depression with
psychotic symptoms and is a danger to himself or others
b. Can be used along with tricyclic anti-depressants and anti-psychotics
c. First line of treatment for residual schizophrenia
d. ‫ תופס מקום תוך גוגולותי‬does not present a contraindication for this
treatment
e. Not effective in somatization disorder
16. which of the following according to early theories is acceptable to say
when considering psychosomatic illness?
a.
b.
c.
d.
e.
Repressed anger – asthma
Separation anxiety – ischemic heart disease
Speculative – HTN
Dependence needs that were not met – peptic ulcer
Castration/distortion anxiety – Rheumatoid arthritis
17. Children who suffer from ADHD commonly suffer from all of the following
issues except:
a. Low self esteem
b. Difficulty with administrative skills (organization, planning and
completing a goal set)
c. Defect in deciphering reality
d. Difficulty with social skills
e. Learning disabilities
18. an elderly male with schizophrenia, HTN comes to the ER with after
episodes of passing out and restlessness, minor shakes in his hands and
complains of nausea. What should you check first to reach a diagnosis?
a.
b.
c.
d.
e.
Liver function
Kidney function
Blood sugar levels
Lithium levels in blood
Thyroid function
19. What is not recommended for the treatment of social phobia?
a.
b.
c.
d.
e.
SSRIs
Behavioral treatment
Neuroleptics
Cognitive treatment
Benzodiazepines
20. From the following what is the most correct definition for the term
personality?
a. The feelings and stable reactions that describe the man in his everyday
life and in normal situations
b. The feelings and non-stable reactions that describe the man in his
everyday life and normal situations
c. The feelings and the stable reactions that describe the man in special
circumstances
d. All the personality traits of the man
e. All the events the man experienced in his childhood
21. what is true regarding narcolepsy?
a. Includes sudden attacks of passing out during the day and is therefore
thought to be a form of epilepsy
b. Describes a NREM sleep disorder
c. Includes urinating while sleeping
d. Can be improved with SSRI
e. If coinciding with catalepsy one should think of another disorder
22. what is true regarding depression in the elderly?
a. There is a relative contraindication for ECT
b. The age of the person is the factor that poses a danger to developing
depression
c. In the elderly as opposed to the young the depressive syndrome will
include more physical complaints
d. Elderly with pseudo-dementia will reveal more confabulations than
those with dementia
e. Elderly with depression reveal more verbal disorders to those with true
dementia
23. which of the following is the most correct regarding disturbed impulse
control?
a. Enjoy imagining the harmful activity
b. compulsion for a harmful activity, tension before the act and
pleasure/relief afterward
c. Can not stop hurting themselves
d. compulsion for a harmful act, calm and pleasure before the act and
tension afterward
e. Compulsion to harmful activity, tension before and repulsion after
24. A man comes to you for counseling regarding his inability to fall asleep;
He awakens several times during the night, complains that for the past while
he has concentration issues and is impatient.
Without further complaints. Background- manager of a company that is
currently experiencing financial difficulty. You are the treating doctor. What do
you recommend he do?
a.
b.
c.
d.
Prescribe Non-Benzodiazepine Hypnotics
Anti-depressants
Nothing at this stage
Change way of life and teach "sleep hygiene)
e. Referral to a sleep clinic
25. What is true regarding the term "norm," according to the medical model?
a. No physical complaints
b. No signs or symptoms
c. No findings in lab studies
d. No life problems
e. No insight for sickness
26. Definition of down drift theory:
a. Schizophrenics are born to a high socio-economic class but decline as
a result of the illness
b. Schizophrenics are born to a low socio-economic class but go up as a
result of the illness
c. Schizophrenics are born to all socio-economic classes but decline as a
result of the illness
d. Schizophrenics are born to all socio-economic classes and their
situation does not change as a result of the illness
e. Schizophrenics are born to a low socio-economic class and stay there
without the ability to change
27. which of the following as the most effective treatment for OCD?
a.
b.
c.
d.
e.
Responsive prevention
Systematic desensitization
Flooding
Aversive therapy
Positive connotation (reframing) technique
28. 48 year old female with no history of psychiatric care, was referred to the
ER for complaints that for the last 2 months she feels that she has a special
connection with a famous movie actor. She feels that they have a great love.
Tells of the times she has called his house to suggest they meet. In her
words she states that he says she is bothering him and has asked her to stop,
otherwise he will get the police involved. She interpreted this response as
"proof that he loves her, but wants to keep it a secret." In the ER she states
that she does not know why she was referred to a psychiatrist "I am just fine"
Upon assessment, except for this complete belief in the above situation there
are no other disorders in her thought processes, her full and appropriate affect
and do not reveal any illusions or delusions. What is true regarding the
disorder she is suffering from?
a.
b.
c.
d.
e.
Equally as common as schizophrenia
More common than schizophrenia
The sub-type described is more common in men
Equally as common in woman and men
This type of disorder requires treatment with neuroleptics
29. What is true of the supposed biological changes regarding
schizophrenia?
a. It seems the areas of the brain that are involved are the basal bodies,
limbic system, frontal cortex but not the cerebellum
b. Neuro-developmental theory states: neuron development is not correct
from the early stages of life or on the other hand neuro-degenerative
disorder states: cells degenerate before they should
c. No correlation has been found between the abnormal structure of the
brain in schizophrenics and negative symptoms and defects
d. PET scans, although, not usually used in routine medical care, but the
results are of great prognostic value
e. Atypical anti-psychotics (such as respiradol) help solidify the idea that
serotonin more than dopamine lends to the etiology of schizophrenia
30. What is correct regarding the heredity of Huntington's? If a parent has the
disease the chance that the child will inherit is….
a. 50%
b. 20%
c. 40%
d. 30%
e. 60%
31. The term "paradoxical conduct" refers to a situation where:
a. A patient with paranoia tries to get close to his "pursuers" in order to
find out what they have against him and with this to understand them
b. A patient with paranoia tries to get close to his "pursuers" in order to
become one of them and confuse them
c. A patient with Capgras syndrome behaves friendly to an
"impersonator" in order to get the true person returned
d. A patient with Cotard syndrome acts happy without nihilistic feelings as
protection from despair
e. A patient with delusional disorder of the erotomanic type interprets all
signs of rejection as an expression of hidden love.
32. Regarding a Brief psychotic disorder all are true except:
a. More common amongst women and developing countries
b. 50% will develop into chronic psychiatric disorders
c. Post psychotic depression is rare after remission
d. Usually use neuroleptics in low doses
e. No need for maintenance use of neuroleptics
33. 30 year old male, schizophrenic for 12 years, currently lives in a group
home, declining functionality, neglect of personal hygiene and needs
supervision when taking meds. Prominent negative symptoms and severe
personality defects. Since the outbreak of his illness his clinical state has
been dangerous behavior, lack of goals and judgment, incoherent speech,
generally suspicious and afraid of people, autistic traits, severe loose
association, with inappropriate affect. Which sub-type of schizophrenia is
this?
a. Residual
b.
c.
d.
e.
Disorganized
Paranoid
Schizoaffective
Schizotypical
34. What is epidemiologically true regarding schizoaffective disorder?
a. Not common to see anti-social behavior in men
b. Life time prevalence higher than in schizophrenia
c. Life time prevalence equal in men and women
d. Depressive type is more common amongst the young that in adults
e. Like in schizophrenia the average age of outbreak is higher in women
than in men
35. From the following patients that have schizophrenia, who has the best
prognosis?
a. 50 year old woman, engineer, married +3, suffers from paranoid
schizophrenia as of 5 years ago. History of 3 prior episodes that
needed in-patient care. Takes her med very strictly
b. 45 year old female with a high school education, divorced single
mother of 2, suffers from paranoid schizophrenia as of 5 years ago.
Hospitalized 2 times one of which was forced, partially responsive to
treatment
c. 30 year old male, suffers from disorganized schizophrenia which
started his 4th year of medical school (started directly after high school)
Today he is rehabilitated and works in a sheltered workshop. Does not
have supportive family, does not have now nor has he ever had a
girlfriend
d. 32 year old female, schizoaffective since age 14. History of 8
hospitalizations some of which were forced. Today she has prominent
negative symptoms and drastic personality defects
e. 50 year old male married +3, doctorate in electrical engineering;
however, since age 28 when he became a paranoid schizophrenic he
has not worked. Suffers from chronic positive symptoms and
recognizable defects. Does not take meds
36. 72 year old male, no background of psychiatric care, has been mourning
the loss of his wife for the past 1.5 months. Describes a minor decline in his
mood, confused/disturbed sleep and complains that he has not returned to
being fully functional. Not suicidal or psychotic. Feels bad that he did not
care for her well enough. What do you think is most correct about this man?
a. The man is suffering moderate-major depression
b. This is within normal limits and here is no indication for starting meds
c. The timeframe of his mourning makes it pathological
d. Normal mourning process but in light of his age and symptoms there is
reason to start meds
e. Detailed behavioral treatment is most appropriate
37. Max a 4 year old boy referred for counseling for behavioral problems and
significant restlessness at school and at home. The teacher states that he
come to school, not clean, neglected, and usually late and every day with a
different person bringing him. All of the following are correct except:
a. It is possible that max will approach the counselor without hesitation,
sit on his lap and hug him
b. Possible that Max will stand next to the door and not answer any
questions
c. Possible Max had eating problems as a baby
d. Possible that his game playing skills will be weak and limited
e. Possible that Max has good friends in the school that he plays with
after school
38. Which of the following do not have withdrawal symptoms in humans
(according to the DSM-IV)
a. LSD
b. Heroin
c. Amphetamines
d. Cocaine
e. Alcohol
39. What characterizes dementia in its initial stages?
a. Denial
b. Sarcasm
c. Catastrophic reaction
d. Detailed description of life's events
e. All answers are correct
40. All of the following cause akathisia except:
a. Cyproheptadine
b. Pramine
c. Risperidone
d. Fluoxetine
e. Thioridazine
41. What is true regarding clozapine (Leponex)?
a. Causes a significant increase in prolactin levels in the blood
b. Overdose may lead to delirium as a result of central anticholonergic
effect
c. Augmentation with respiridone is not recommended- 2x more likely to
develop agranulocytosis
d. Agranulocytosis is a side effect based on dosage, 3% of those taking
the drug will develop it
e. Does not increase likelihood of seizures
42. Which of the following will least likely cause seizures?
a. Tarivid
b. Dekinet
c. Propranalol
d. Prednisone
e. Bromocriptine
43. All of the following can describe "attachment" except:
a. Describe the feeling between a baby and his primary caregiver
b. A baby can develop different types of attachment toward the mother
and father
c. Starts to develop in the first days after birth
d. Margaret Einsworth's "stranger situations" test the type of attachment
e. Even children with "secure attachment" develop stranger anxiety
44. A man suffering from schizoaffective disorder was treated with lithium,
halidol, biperidine and valium. He responded well to the treatment and was
released in remission. After 3 weeks he was brought back to the ER by his
wife with moderate restlessness, shakes, hard to speak, some rigidity. He is
fully conscious and his temp is 36.7C. What needs to be done immediately?
a. Stop all treatment and give him fluids
b. Lithium levels, CBC and Fusid
c. Lithium levels, CBC and fluids
d. Hemodialysis
e. Cooling, benzodiazepines and possibly Dantrolin
45. Physical complications caused by restrictive anorexia nervosa include all
of the following except:
a. Decreased gonadotropin
b. Heart muscle mass loss
c. Enlarged parotid gland
d. Osteoporosis
e. Sudden death
46. Somatoform syndrome is characterized by physical complaints that:
a. Are not characterized by known disease
b. They have a known mental factor
c. They leave behind them a mentally adaptable reaction
d. Find a clear cause upon physical assessment
e. No medical cause can be found even after all the proper tests are
performed
47. What is true regarding the prognosis of anorexia nervosa?
a. At least 1/2 will be fully cured
b. Mortality can reach 1%
c. Approximately 10% will develop bulimic symptoms
d. Even after reaching a good body weight most will continue their too
rigorous occupation with nutrition and body weight
e. After cure the patients attain satisfactory social and interpersonal
functionality and good personal achievement
48 8 year old male comes to the ER after his house was hit by a ketusha
(bomb) all are correct regarding his treatment except:
a. The recommended approach is treatment according to the
intervention in a crisis and problem solving model
b. Low dosage of respiridone
c. Support, education about reaction and orientation as to what
happened
d. SSRIs are useful if he develops PTSD
e. There are questions as to the effectiveness of a new method for
desensitizing with eye movements EMDR as a treatment for PTSD
49. 22 year old male in a manic psychotic state being treated as an outpatient
for the past week. Comes to the ER with a clinical picture that includes –
profuse sweating, incontinence, shakes, confusion, incoherent speech, not
hemodynamically stable. His CBC results show leukocytosis. Unable to
answer question about his meds. All of the following are options for
emergency care except:
a. Lithium levels
b. Possibly giving Dantrolin
c. Urine screen (toxicology)
d. Lumbar puncture
e. Give fisostigmine
50. What is true regarding treatment with methylphenidate?
a. Increased appetite
b. High percentage of psychosis
c. Causes severe stunting of growth
d. Causes improvement of concentration in most patients
e. Causes liver damage
51. all of the following are true regarding schizoaffective disorder except:
a. A heterogenic group of disorders that combine psychotic states with
affective states
b. Patients with this disorder respond better to lithium than those with
schizophrenia
c. Have a better prognosis than those with schizophrenia
d. More common than schizophrenia
e. Disorder that is classified with other psychotic disorders
52. In supportive psychotherapy all of the following are components are
significant except:
a. The therapist asking the patient about his mental abilities
b. Helping the patient re-connect to his abilities
c. Testing reality and how he competes with it
d. Deep translation of the sub-conscious in an encouraging atmosphere
e. Flexibility in choosing the method of treatment
53. 9 year old male with dyslexia. Which sentence describes your role as the
psychiatrist?
a. The psychiatrist has no role in this disorder, should be referred to
education and didactic professionals
b. Ritalin treatment can help with dyslexia and therefore should be
recommended
c. Finding and treating other disorders that are present such as ADHD or
depression
d. Guide the teacher in supplemental education
e. Dyslexia usually is a telling sign that another major psychiatric disorder
is present that needs to be diagnosed
54. 77 year old woman is checked in the ER for restlessness, screaming,
accusing her husband that he made the living room in the house a brothel in
the early morning hours, cheats on her with the housekeeper and is trying to
steal her money. Background includes Alzheimer's for the past 5 years. Mark
the most correct answer:
a. This is a rare situation for patients with Alzheimer's, there is reason to
revise the diagnosis
b. This is something that happens at the beginning of the illness
c. This is a catastrophic reaction to the fact that they brought her to be
checked
d. Giving benzodiazepine will worsen her situation
e. Should be treated with a combination of anti-anxiety and mood
stabilizing drugs
55. which of the following is a rare side effect of Valproate?
a. Hair loss
b. Weight gain
c. Persistent elevation of hepatic transaminases
d. Platelet dysfunction
e. Akathisia
56. All of the following are negative symptoms of schizophrenia except:
a. Flat affect
b. Delusions
c. Lack of motivation and initiative
d. Social avoidance
e. Personal neglect
57. When estimating the possibility of violence what I the most telling
harbinger?
a. History of violence
b. Sex of the patient
c. Life event that is currently stressful
d. Socio-economic situation
e. Recreational drug use
58. From the following side effects, what is the least common for atypical antipsychotics?
a. Extra-pyramidal
b. Weight gain
c. Endocrinological
d. Retinopathy pigmentosa
e. Anticholonergic syndromes
59. all of the following factors increase the likelihood of suicide ("successful")
in adolescence except
a.
b.
c.
d.
e.
Aggressive behavior, violent and impulsive
Alcohol use
Depression, psychosis or mania
Sex of adolescent (female)
Presence of live weapons in the house
60. 11 year old male gifted athlete – with no psychiatric past and no behavior
problems is brought to the ER by police officers in a psychotic state that
happened within hours, when he was at home with two friends putting
together a model airplane from plastic.
Assessment shows – aggressive, labile, a strange smell is coming from his
mouth and he has residue of a transparent substance on his face.
The most likely diagnosis is:
a. Inhalant overdose
b. Amphetamine overdose
c. Laughing gas overdose
d. PCP overdose
e. Steroid overdose
61. what is true regarding social phobia?
a. Differential diagnosis with major depression and schizoid personality
disorder
b. Usually manifests after age 35
c. Does not effect educational or work goals
d. Includes xenophobia
e. Not found to be hereditary
62. Which of the following expresses the most significant epidemiological
factor as to the danger of alcohol abuse?
a. Middle to upper class socio-economic standing
b. Low educational level
c. Male
d. Rural living
e. Married
63. 38 year old male was checked by you in the ER. He came after his
mother pressured him "Either you go for treatment by yourself or leave this
house!" Background: single, high school graduate, full army service, started
university after army studying international relations and political science but
left after 3 semesters. Admits to heavy use of cannabis from high school.
Currently works as a shift manager at a movie theater that his family owns.
Denies specific distress but states that he just doesn't want to do anything.
Assessment: neglected, not shaved, slightly overweight, looks apathetic and
indifferent.
Most likely diagnosis is:
a. Addicted to cannabis
b. Depression secondary to drug abuse
c. Amotivational syndrome
d. Borderline personality
e. Residual schizophrenia
64. What exactly describes the term "transference" in reference to
psychotherapy?
a. The patient ascribes traits, wishes and feelings on the therapist, whose
origins are from significant figures from his past
b. The patient ascribes traits, wishes and feelings to figures around him
whose origins are his connection to his therapist
c. Influence of the wishes and feelings that the patient awakens in the
therapist of the connection of the therapist with figures from his life
d. Influence of the wishes and feelings that the patient brings out in the
therapist on the connection the therapist has with other patients
e. Influence of current interpersonal issues in the life of the therapist on
his connection to the patient
65. WAS CANCELLED – you are called to assess a confused patient in
internal medicine. Anamneses – 70 year old male usually independent and
lives alone was found in this state by his daughter after not seeing each other
for a week. What is most likely regarding this man?
a. Suffers from Pick's dementia
b. Also suffering from a high fever and emesis
c. Patient with bipolar disorder that has lithium poisoning
d. Patient with schizophrenia that is taking leponex
e. A blood test will show creatinine >4
66. what is correct regarding the acute psychotic disorder Brief psychotic
disorder?
a. Lasts longer that a few minutes but shorter than a month
b. Most patients who have suffered from this will develop schizophrenia or
affective disorders in the future
c. Confusion and being perplexed during the episode is a good prognostic
factor
d. Organized delusions and the absence of an "emotional storm" are
good prognostic factors
e. In the deciding majority of cases after the acute psychotic episode
there is depression
67. The exaggerated panic reaction in PTSD is mediated by:
a. Amygdala
b. Locus ceruleus
c. Amygdale and locus ceruleus
d. Papez cycle
e. None of the above
68. What's true in connection with conduct disorder?
a. Medications are useful in most cases
b. A small amount of patients also have ADD
c. In most cases the disorder passes at the beginning of puberty with no
effect on development
d. Manifested though injury to the basic rights of others or disregard of
norms and acceptable behaviors
e. Mostly an expression of depression
69. Which of the following expresses the most insight into his illness?
a. A man who denies he is sick
b. A man who knows he is sick abut doesn't think he needs help
c. A man who knows he is sick and needs help but denies it
d. Knows he is sick and knows that the illness is caused by something
unknown in him
e. A man who knows he is sick but blames outside factors
70, you have assessed a man in the ER who is threatening to commit suicide.
What factor is the biggest danger for him?
a. He is 23 years old
b. He is 77 years old
c. He is married
d. He is from a middle to low socio-economic class
e. His brother killed himself last year
71. what's true regarding Night Terrors?
a. Start at puberty, can be the first sign of temporal epilepsy
b. People with this remember their dreams in detail
c. Happens during REM
d. Commonly happens with paralysis during sleep
e. No connection to sleep walking
72. What is true regarding Rorschach tests?
a. No significance to the popularity of the answer
b. Uses only black and white cards and is call the inkblot test
c. Projection test that asks the taker to build a story for the picture
d. There is only a relation to the answer if they see a person
e. Major attention to details is characteristic for obsessive paranoid
personality
73. all of the following are found in the differential diagnosis of PTSD except:
a. Obsessive behavior
b. Panic syndrome
c. GAD
d. Borderline personality
e. Factitious disorder
74. In the psychiatric picture of thyroid disease all are true except:
a. In severe cases of hyperthyroid you will see hallucinations, paranoia
and delirium
b. In severe cases of hypothyroid you will see hallucinations and paranoia
c. Thyroid function is taken as part of an initial assessment of psychosis
d. Thyroid function is part of initial assessment for depression
e. The foundation for checking thyroid function in psychiatry is connected
to lithium levels
75. which of the following is true regarding PTSD?
a.
b.
c.
d.
e.
Injecting lactate ‫ )?(לקטט‬in a PTSD sufferer may cause a flashback
Increased cortisol in blood
Decreased epinephrine levels
Yohimbine will calm panic in these patients
Increased beta-endorphins
76. What is true for withdrawal syndrome from benzodiazepines?
a. Stopping Xanax = alprazolam abruptly will have a relatively easier
withdrawal than that of clonex=clonazepam
b. Can not attribute psychosis to the stopping of benzodiazepines must
find another reason
c. In order to prevent withdrawal syndrome you should stop
benzodiazepines gradually
d. Stopping treatment causes more falls in the elderly because there is
subsequent ataxia
e. The longer the benzodiazepine use the easier the withdrawal
77. Symptoms of Acute Stress Disorder (ASD)
a. Reconstruction, hyperaware, dissociative
b. Depression, avoidance, hyperaware, dissociative amnesia
c. Reconstruction, avoidance, hyperaware, dissociative
d. Reconstruction, dissociative, sleep disorder, hyperaware
e. Reconstruction, avoidance, hyperaware, sleep disorders
78.15.5 year old female after cutting herself deeply on the neck. During
assessment she states that she broke up with her 25 year old boyfriend.
Speaks of wanting and intention to die. Upon speaking to the parents you find
out that she quit school 6 months ago, ran away from home 2x since then,
was caught shoplifting clothing and smokes grass. Upon assessment you
don't find any psychosis or major affectivness. She refuses psychiatric
hospitalization, her parents consent to commit her. Which of the following
statements is true as to how to administrate the situation?
a. There is indication for hospitalization, she is a danger to herself and
refuses hospitalizing
b. Hospitalize her in the psychiatric adolescent ward because the parents
agree
c. Release her from the ER with recommendation to continue treatment
as an out-patient
d. Facilitate the hospitalization under the law "Adolescents law, treatment
and observation"
e. Call the district psychiatrist for a special dispensation
79. All of the following are true regarding psycho-diagnostic tests except:
a. Based on latent stimulation
b. MMPI – Minnesota Multiphasic Personality Inventory is the
characteristic projection test
c. Their interpretation is based on feelings and psychological factors of
the taker
d. There are no right or wrong answers in these tests
e. Rorshach is a characteristic projection test
80. 38 year old male, businessman, no physical illnesses, takes Lorivan every
once in a while when under a lot of pressure. A month after he told his
parents he was getting married he started to complain about sudden bouts of
fear, palpitations, tingling in his fingers, SOB, confusion, and shock. He is
convinced that he is having a heart attack and he is going to die.
In a differential diagnosis all of the following are likely except:
a. Asthma
b. Benzodiazepine overdose
c. Ischemia of the heart muscle
d. Panic attack
e. Amphetamine overdose
81. Which of the following answers is true regarding adolescence?
a. Homosexual experimentation is not rare during this time of life
b. The formal operations stage allows the adolescent to discover ethical
moors that are based on logic and equal division of resources
c. Adolescence is characterized by the ability for concrete thought
regarding the issues of knowledge and health
d. The main psychological issue between parents and adolescents is the
sexuality that is developing in the adolescent
e. Confusion/adolescent turmoil is not part of the normal process of
development
82. what is the most common comorbidity with substance abuse?
a. Anti-social personality
b. Abuse of another substance
c. Depression
d. Suicide
e. Anxiety disorder
83. which of the following answers is true regarding psychiatric evaluation of
children and adolescents?
a. Most 4 year olds still can't differentiate between reality and imagination
b. The assessment for a pre-school child is done in 2 phases: discussion
with the parents and a meeting with the child alone
c. Games, are not usually used as diagnostic tools for children of
elementary school age, because their verbal abilities allow for
discussion
d. All assessments of adolescents should include questions about suicidal
thoughts
e. The mental capabilities of pre-school children have little influence on
psychiatric assessments
84. What is true regarding groupings of personality disorders in the DSM-IV
a. Groups A- anti-social borderline B- paranoid schizoid C- obsessive
avoidant
b. Groups A- paranoid schizoid B- obsessive anti-social C- avoidant
borderline
c. Groups A- paranoid schizoid B- anti-social borderline C- obsessive
avoidant
d. Groups A- obsessive avoidant B- anti-social borderline C- paranoid
schizoid
e. Groups A- paranoid schizoid B- obsessive avoidant C- anti-social
borderline
85. all of the following are correct regarding the psychotherapeutic behavioralcognitive treatment (CBT) except:
a. Explanation about the nature of the disorder and the treatment
b. identification of the "automatic thoughts"
c. Use of guided imagery
d. Therapy for an extended amount of time
e. Revelation of the situations that bring about hardship
86. Which of the following is true regarding the concept of "death" in the
process of development?
a. Children of elementary school age still don't understand the concept of
death, they understand death as the same as sleeping
b. A 5 year old can not express thoughts of suicide, because he doesn't
cognitively understand death
c. Adolescents start to understand that death is unavoidable
d. In stressful life situations the understanding of death on the part of a
child can become convoluted
e. Parents sheltering their elementary school aged children from death
helps these children to adapt to the idea in the future
87. What is true regarding schizoaffective disorder?
a. There is no increase in the number of schizophrenia cases in close
family relations to patients
b. More common than schizophrenia but less common than bipolar
c. The depressed sub-type starts at an older age than the bi-polar subtype
d. Better prognosis for the mixed bipolar type than the depressed bipolar
type
e. Identical criteria in the DSM-IV and the ICD-10
88. What is common to lithium and leponex?
a. Both have been found to lessen suicidal ideas
b. Both have anti- depressant qualities
c. Both cause agranulocytosis
d. Both have the side effect of sick sinus syndrome
e. Synergism of the 2 is accepted and useful to treat mania that is tolerant
to treatment
89. Natalie, 10 year old female referred to hospital for the 4 th time with low
blood sugar. During the past 3 times she underwent a battery of tests and no
organic reason has been found. The child psychiatrist is called to the ward.
Which of the following statements is least likely to be in the anamneses?
a. In the past there have been several pediatric hospitalizations in other
hospitals
b. There are other family members on insulin
c. The mother is a nurse
d. The mother is very interested in help from the welfare and social
services offices
e. The mother has a great knowledge of the details of diabetes
90. 45 year old male brought to the ER unconscious. He smells of alcohol,
his urine tox screen shows benzodiazepines. Debating whether to give him
flumazenil. What is true for this drug?
a. May cause seizure
b. Also useful for alcohol overdose
c. Give once only
d. Can not be given IV
e. Good for opioid overdose
91. which of the following is true for schizophrenia in children?
a. Equally common in children as in adults
b. Approximately 1/2 children with disease also have delusions
c. Hallucinations in childhood are pathogenomic to schizophrenia in
children
d. An imaginary friend in childhood is a sign of delusion
e. The recommended treatment is cognitive-behavioral psychotherapy
92. the term "automatic thoughts" is cognitive therapy includes all of the
following except:
a. Fast streams of thought that come after outside factors
b. Thoughts that influence the emotional response to a situation from
which they are awakened
c. One needs to identify these thoughts in therapy
d. One can reveal characteristic distortions in these thoughts such as
"generalization"
e. It is not possible to introduce alternative thoughts to them
93. 50 year old male referred to your care because he has loss of energy and
some loss of pleasure in life. Both have gotten worse in the past 3 weeks.
He also states a difficulty in concentrating, these difficulties started when he
was diagnosed with IHD 3 months ago, but they were much easier. He
describes many awake periods during the night, waking up early in the
morning and a loss of 10 kilo. He states the disease and its restrictions on
him are causing him to lose self worth, his family life is destroyed by his lack
of functioning for the past 3 months. Which of the following statements is
most correct for this situation?
a. Likely that his IHD has gotten worse and has caused his complaints
b. His emotional state does not influence the prognosis of IHD
c. This is a case of non-adaptability to the IHD, need to give patient time
to mourn loss of health
d. Heart disease does not influence his emotional state
e. Likely this is a depression in conjunction with heart disease
94. Which of the following is correct regarding Korsokoff's syndrome?
a. Includes confusion, ataxia and opthalmoplegia
b. Is only seen in alcoholics
c. When the encephalopathy passes so does the amnesia
d. Approximately 25% recover with proper treatment
e. Usually develops at night
95. Mourning as compared to major depression….(mark the correct
statement)
a. Not restricted by time
b. Doe not bring about a significant change in day to day functioning
c. Is not characterized by change in mood
d. No signs of depression are present
e. No thoughts of guilt are present
96. all are true regarding treatment of eating disorders except:
a. The accepted treatment uses several professionals including, follow-up
by medical professional, psychiatric aspects, dietician,
psychotherapeutic treatment and guidance for parents
b. Medications at times are useful in bulimia nervosa
c. Most of the sufferers are compelled to be hospitalized due to their
physical situation emotional state or after failure of out-patient
treatment
d. Family therapy is important
e. Cognitive-behavior therapy is successful in bulimia nervosa and is also
used for treating anorexia nervosa
97. According to the DSM-IV which of the following is considered a withdrawal
symptom of benzodiazepines?
a. Sleeping a lot
b. Shakes
c. Ataxia
d. Hyperreflexia
e. Suppression of breath
98. 60 year old male brought to you for a psychiatric evaluation at the request
of his family. They state that he has recently become introverted, loner, angry
and sleeps very little. Recently he started speaking incoherently and saying
"There is no reason to go on because all is lost." Also says "It's all over." And
doesn't explain. In the last week he stopped going to work. During a
conversation with his employer he states that for the last month there has
been a marked decline in his productivity. The family denies traumatic events
or mental disorders in his past.
The most likely diagnosis based on this information is:
a. Alzheimer's
b. Unipolar depression
c. Sub-‫)?( תריסיות‬
d. Schizoaffective disorder-depressive episode
e. Bipolar disorder – depressive episode
99. What is true regarding the pharmacological treatment of PTSD?
a. SSRI and TCAs are considered the first line of treatment
b. Sedatives of the benzodiazepine type can help to sedate and to fix
sleep disturbances
c. Must continue treatment for a full year after positive results are seen
d. One can add anti-psychotics in a situation with exaggerated agitation
e. All the answers are correct
100. SIADH (syndrome of secretion of inappropriate ant diuretic hormone) is a
side effect of:
a. Lamotrigin
b. Gabapentin
c. Topiramate
d. Lithium
e. Carbamazepine
101. Which of the following sentences is true regarding major depression?
a. Is slightly more common in males
b. Alcohol consumption is thought to be a defense mechanism
c. Rare relative to sever Alzheimer's
d. Tends to become more moderate over the years
e. Usually manifests in the 3rd decade of life
102. 24 year old female 1 month post partum, referred to the ER after a
drastic change in her mental state last week. Gross psychomotor
restlessness, declined mood, cries a lot, does not function, neglects the baby,
claims the baby is deformed and it's better for him to die.
What is true regarding this state:
a. It is better to treat her as an outpatient so she has a chance to get
used to the baby
b. 10% of women who have given birth develop this disorder
c. This is a crisis situation
d. There is no equivalent disorder in men
e. It has been proven that the etiology is psycho-social only
103. All of the following prognostic factors in OCD are thought to be bad
prognostic factors except:
a. Obsessive compulsive ego-synthesis (?) ‫אגוסינטוניות‬
b. The presence of personality disorders
c. The need for hospitalization
d. Starting at a young age
e. Obsessive compulsive ego-dystonia (?) ‫אגודיסטוניות‬
104. which of the following sentences is the most appropriate for the
psychological manifestations of narcissistic personality disorder?
a. Avoidance, and a tendency to be closed
b. Tendency to see everything in black and white (splitting)
c. Lack of a conscience, lack of empathy, and criminal behavior
d. Sensitive to criticism and low self esteem
e. Tendency to attribute exaggerated importance to control and
cleanliness
105. 76 year old man, active and physically healthy. Referred to the ER for
suicidal thoughts. Upon assessment – feeling down, does not find pleasure in
anything not even from his grandchildren, tends to want to be alone, lies in
bed most of the day with the shutters closed, no appetite, 10 kilo weight loss
over the last month. Neglects himself and does not function at all. States "I
am superfluous and a burden to my family." Feels hopeless and does not see
a way out of this situation. Says "Blood does not run in my veins and my
head is an empty space," a lot States that last week the suicidal thoughts
have become worse and he has a plan to hang himself "I have the rope and I
will do it today." All trials on the part of the psychiatrist in ER to hospitalize
him or give him medicinal treatment failed "I am not willing to accept any
treatment, anyway nothing will help" In addition he refuses to include his
family or the social worker "You have no right to involve anyone, I am over 18,
and therefore only I am responsible for myself according to the law."
You are the psychiatrist in the ER, what do you do in this case?
a. Refer to the district psychiatrist with a recommendation to force
hospitalization due to an emergent situation
b. Refer to the district psychiatrist with a recommendation to hospitalize
but not emergent
c. Because there is no psychosis there is no way to force a hospitalization
but I will turn to the family anyway
d. Because there is no psychosis there is no way to force a
hospitalization, I will inform the relevant community factors
e. According to the law I will release him form the ER and leave the door
open 24 hours to get help
106. What is true regarding dysthymia?
a. Usually starts in the 5th decade of life?
b. Rare disease
c. Equally common amongst females as males
d. A significant number of sufferers also have another mental illness
e. Usually starts in a sudden manner
107. All of the following are related to cognitive theory of depression except:
a. Negative self esteem
b. Negative translation of life experiences
c. Decisions (?) based on little and narrow experience
d. Feelings of despair are real or imagined
e. Overestimation of certain events
108. All of the following support the diagnosis of schizo-affective disorder in
place of schizophrenia except:
a. The active times of major affective syndrome are short in relation to the
residual of the disorder
b. General decline, personality, social, not necessarily functional
c. At least 2 weeks of hallucinations or delusions without noticeable
affective signs during that period
d. The process of the disease includes active affective syndrome in
conjunction with criteria A of schizophrenia
e. Another improvement with the addition of mood stabilizers or antidepressants to anti-psychotics
109.35 year old male who suffers from anti-social personality disorder , is
brought to the ER by the police. He says that he is a war hero, has a
doctorate in humanities and is active in a secret section of the police to
expose criminals. His family states that "these ideas are known to them for a
long time already, and don't take them seriously." Aside from that in his
psychiatric status there is blatant extroverted, manipulative and provocative
behaviors, tends to impress and selectively cooperates, has normal hearing
and understands nuances well. Without disorders in process, abnormal
thought processes or inappropriate affect.
In light of this what is the most likely?
a. Seems apparent that we are seeing delusions of grandeur
b. This is a grandiose approach with distorted insight
c. Appears that "Fantasy" traits are in control
d. ‫ )?(גנזריאניים‬traits
e. Apparently this is a state of hypomania caused by drugs
110. Mark the most correct sentence regarding children with autism.
a. They also may suffer from mental retardation but this is rare
b. They often complain about physical ailments
c. They usually exhibit separation anxiety at pre-school or school
d. They often have sudden mood swings
e. They are often calm and don’t tend to sway
111. All of the following are reasons for orgasmic disorder in males except:
a. Taking SSRIs
b. Prostatectomy
c. Injury to the lumbar spine
d. Alcohol consumption
e. Manic state
112. What is true regarding treatment with TMS (Transcranial Magnetic
Stimulation)?
a. Invasive
b. Causes a general seizure
c. Stimulation of the Broca region causes a delay in speech
d. Currently the first line of treatment for minor to moderate depression
e. Does not help in cases of OCD and PTSD
113. What is true regarding Dementia?
a. Vascular dementia is the most common type
b. Vascular dementia is characterized by slowly developing
c. Alzheimer's dementia has pathogenomic signs in a CT
d. The first sign of Alzheimer's is usually apraxia
e. Mini mental state examination is the tool used to follow and assess a
cognitive state
114. All of the following are characteristic of a panic attack according the
DSM-IV except:
a. Shortness of breath
b. Chest pain
c. Fear of dying
d. De-realization
e. Urine stoppage
115. All of the following are true regarding WAIS (Wechsler Adult Intelligence
Scale except:
a. The most common exam to assess intelligence
b. Includes a verbal and performance section
c. An objective exam
d. IQ less than 70 supports a diagnosis of mentally retarded
e. Average IQ of population is 120
116. You are called for a council in the oncology dept. for a 60 year old male
who has just been told that he has terminal lung cancer. What is likely that
his reaction will be to this news according to Elisabeth Kubler-Ross?
a. Anger
b. Depression
c. Denial
d. Acceptance
e. Bargaining
117. What is true regarding psychiatric faculties in Israel?
a. Their build is significantly different from the general medical faculties
b. Most of the treatment facilities are at the cost of the patient
c. Acute care beds are paid for by public funds
d. The psychiatric wards are in psychiatric hospitals only
e. In psychiatric hospitals only those patients that are recognized as
handicapped due to mental illness according to social security are
hospitalized
118. 46 year old male was diagnosed as a schizophrenic about 10 years ago.
In his history there are 9 hospitalizations, some forced. Usually his flare ups
are due to stopping his meds AMA. In the last 2 years he has been stable
with medicines and supportive psychotherapy. In the past few days he has
had a flare up and is complaining about tearing and diarrhea. Upon physical
exam – pulse 45 and bilateral myosis. His wife suspects he stopped taking
his meds. Which of the following is most likely in this situation?
a. There is no doubt his wife is correct, it appears he stopped taking his
Seroquel suddenly
b. There is no doubt his wife is right, it appears he stopped his Risperdal
gradually
c. There is no doubt his wife is correct, it appears he did not take his
Halidol Decanuate injection a week ago.
d. This time his wife is incorrect, you should take a stat CPK level & WBC
count
e. His wife is correct, it appears he stopped taking his Olanzapine
suddenly
119. A man comes for a check up with his wife, she is complaining about his
behavior. She states he is restless, sleeps little and aggressive. She states
that he claims to be the Messiah.
What as part of your assessment will help to diagnose a manic state?
a. Decreased affect and recognizable weakness of traits
b. The patient is very friendly, excited and entertaining
c. The patient is suspicious of you
d. There is a marked disparity between affect and traits
e. The patient states that they are "stealing" his thoughts and putting
them on the radio
120. Regarding benzodiazepines all are true except:
a. They usually work as hypnotics in high doses and anti-anxiety in low
doses
b. flumazenile (Anexate) is the drug of choice in a benzodiazepine
overdose
c. the longer the half life, the milder the withdrawal symptoms will be
when stopped
d. Zopidem like other benzodiazepines has a sedative effect, muscle
relaxant and anti-seizure quality, this is because it works on the same
GABA receptors
e. In long term benzodiazepine use there is a danger of psychological
dependency