A young woman presents to the emergency room with complaints of palpitations, sweating, shortness of breath, chest pain, and nausea. She thinks that she is having a heart attack. Electrocardiogram (ECG) reveals normal sinus rhythm with no ischemic changes. Cardiac enzymes are not elevated. Given her symptoms, an alternative diagnosis would be:
A. Manic episode
B. Myxedema madness
C. Mad Hatter syndrome
D. Psychotic disorder not otherwise specified (NOS)
E. Panic attack

Which one of the following is true regarding suicide?
A. Completed suicide is most frequently related to bipolar disorder
B. Adolescents most frequently succeed in committing suicide by hanging
C. In recent years the suicide rate has increased dramatically among middle-aged adults
D. Previous suicidal behavior is the best predictor of risk for future suicide
E. Women successfully commit suicide more often than men

Down's syndrome is associated with defects in chromosome 21. This is a feature also shared by:
A. Turner's syndrome
B. Klinefelter's syndrome
C. Huntington's disease
D. Alzheimer's disease
E. Parkinson's disease

A young girl is brought to the pediatrician because she is not eating well. She has a lack of interest in food. She has had significant weight loss and is not growing properly. She is not getting enough nutrition and is missing days of school because she feels physically ill. She has no disturbances in the way her weight or body is experienced. Which one of the following is the most appropriate diagnosis?
A. Avoidant/restrictive food intake disorder
B. Anorexia nervosa
C. Bulimia nervosa
D. Binge eating disorder
E. Atypical anorexia nervosa

Which one of the following will produce a hypodopaminergic state when used chronically?
A. Heroin
B. Phencyclidine (PCP)
C. Alcohol
D. Amphetamines
E. Cocaine

A physician examines a female patient in the emergency room who has recently been diagnosed with a social phobia. Which one of the following answer choices would most likely be the greatest fear for this patient?
A. Having to take responsibility for planning a dinner with her husband
B. Being in a relationship with a new boyfriend
C. Going to a state fair and being around thousands of people
D. Being scrutinized by others
E. Competing for a new position that just opened up in her company

Children with depression often present with which one of the following?
A. Urinary incontinence
B. Violence
C. Irritability
D. Hallucinations
E. Delusions

You see a child in the clinic who has fragile X syndrome. Which one of the following would you not expect him to have?
A. Mental retardation
B. Long ears
C. Narrow face
D. Arched palate
E. Short palpebral fissures

Which one of the following is not a medical complication of weight loss in eating disorders?
A. Cachexia
B. Loss of cardiac muscle
C. Delayed gastric emptying
D. Lanugo
E. Increased bone density

A patient asks you about the data proving that alcoholism is hereditary. During your discussion, the patient asks you the following question: "The study of which group most strongly supports the heredity of alcoholism?" The correct answer is:
A. Siblings
B. Cousins
C. Parents
D. Mothers–daughters
E. Adopted siblings

Which of the following is the most significant risk factor for posttraumatic stress disorder and the best predictor of symptom development following exposure to trauma?
A. A family history of anxiety or depression
B. The availability of psychiatric care immediately following the trauma
C. Low socioeconomic status
D. Being single, divorced, or widowed
E. The nature, severity, and duration of exposure to the trauma

Which one of the following is not a characteristic of a major depressive episode?
A. Constipation
B. Dry mouth
C. Headache
D. Disinhibited behavior
E. Early morning awakening

A psychiatrist is asked to evaluate a child who does not make appropriate eye contact, fails to respond to the social cues of others, lacks the ability for spontaneous make-believe play, and, on close examination, has a delay in language development. What is this child's most likely diagnosis?
A. Schizophrenia
B. Avoidant personality disorder
C. Schizoid personality disorder
D. Conduct disorder
E. Autism spectrum disorder

Which one of the following is not a medical complication of purging seen in eating disorders?
A. Electrolyte abnormalities
B. Salivary gland inflammation
C. Erosion of dental enamel
D. Hyperkalemia
E. Seizures

A young patient presents to your office with dementia. He has been involved in heavy drug use. He has used heroin, PCP, lysergic acid (LSD), amphetamines, and inhalants. If you were to postulate which most likely caused his dementia, which one would you choose?
A. Heroin
B. LSD
C. PCP
D. Amphetamines
E. Inhalants

What is the most important step in treating separation-anxiety disorder in an 11-year-old?
A. Give methylphenidate
B. Give risperidone
C. Rapidly send the child back to school
D. Thorough psychoanalysis of the mother
E. High-dose benzodiazepine treatment

How long should a patient remain on antidepressant medication after having experienced four major depressive episodes in the past 5 years?
A. 3 months
B. 6 months
C. 12 months
D. 2 years
E. Indefinitely

A psychiatrist is asked to evaluate an 8-year-old girl. She does not want to go to school, and refuses to do her homework. Her teacher reports that she will not read out loud in class. She likes to go and spend the weekends at friends' houses or go on overnight trips with her grandparents. Her IQ is average. What diagnosis should the informed psychiatrist most strongly consider?
A. ADHD
B. Conduct disorder
C. Separation-anxiety disorder
D. Autism spectrum disorder
E. Specific learning disorder with impairment in reading

A bulimic patient admits to you that she has been using large quantities of ipecac on a daily basis. Which of the following medical issues should you be most concerned with?

While on call in the emergency room you receive a phone call from emergency medical services (EMS) to say that they are bringing in a patient who is highly intoxicated and behaviorally out of control. The patient's friend told EMS that he has been taking amphetamines. If this is true, what is the most prominent psychiatric symptom you would expect to see?
A. Hallucinations
B. Suicidal tendencies
C. Disorganized speech
D. Paranoia
E. Anxiety

Which of the following anxiety disorders has equal rates in both males and females?
A. Panic disorder
B. Generalized anxiety disorder
C. Social phobia
D. Obsessive–compulsive disorder
E. Specific phobia

Violent or aggressive behavior is associated with:
A. Decreased levels of 5-HIAA in spinal fluid
B. Decreased growth hormone response to insulin-induced hypoglycemia
C. Abnormal dexamethasone suppression test
D. Decreased response to corticotrophin-releasing hormone stimulation test
E. Decreased response to thyrotropin-releasing hormone suppression test

A diagnosis of intellectual disability (intellectual development disorder) may not be based on which one of the following?
A. Deficits in reasoning
B. Deficits in adaptive functioning
C. Deficits in social-emotional reciprocity
D. Onset during childhood development
E. Deficits in learning from experience

The main factor differentiating binge eating disorder from bulimia nervosa is:
A. Lack of control over eating
B. Must occur once per week for 3 months
C. Consuming a large amount of food in a 2-hour period
D. Feelings of embarrassment
E. Absence of inappropriate compensatory behaviors

Phencyclidine (PCP) exerts its hallucinogenic effects primarily by mediation of which of the following receptors?
A. Serotonin 2A
B. Serotonin 1A
C. NMDA
D. Dopamine 2
E. NE