Block 13 USMLE Behavior And Pharm

23 Questions | Total Attempts: 142

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USMLE Quizzes & Trivia

Questions and Answers
  • 1. 
    A 20-year-old man arrives at the emergency room asking for a strong pair killer because he is in serious pain. The attending physician notices that he is very anxious and is sweating. The man states that he has no appetite and has a runny nose, nausea, stomach cramps, and diarrhea. He said that he took his temperature at home, which was 100°Fahrenheit. While he talks, he yawns and appears constantly restless. The attending physician recognizes that he is abusing a certain substance and is experiencing withdrawal. Which substance is it?
    • A. 

      Alcohol

    • B. 

      Cocaine

    • C. 

      Amphetamines

    • D. 

      Barbiturates

    • E. 

      Opioids

  • 2. 
    A 35-year-old man is brought to the emergency room vomiting and with severe epigastric pain radiating to the back that does not change with positions. Patient says that he has epilepsy, but he can not remember the name of the medicine that he is taking. He also says that he does not drink alcohol. Lab exams show elevated amylase and lipase. What medication is likely associated with this clinical picture?
    • A. 

      Diazepam

    • B. 

      Etosuxamide

    • C. 

      Phenytoin

    • D. 

      Valproic Acid

    • E. 

      Vigabatrin

  • 3. 
    A 35-year-old shift worker was having difficulty sleeping during his free time. He takes a long time to fall asleep and does not feel fresh after waking up. He was given a short acting, potent benzocliazepine, but the drug caused psychiatric disturbances (paradoxical rage reaction-hallucinations, agitation, and aggressive behavior). What drug was most likely used in this patient?
    • A. 

      Diazepam

    • B. 

      Flurazepam

    • C. 

      Temazepam

    • D. 

      Triazolam

    • E. 

      Zolpidem

  • 4. 
    A 7-year old boy is brought into clinic by his parents, who are concerned about his low grades in school. His teachers report that although he is not having any behavioral problems in school, he is having a great deal of trouble paying attention in class. Neuropsychological testing reveals normal IQ and cognitive function, but the child occasionally asks that questions be repeated after staring blankly into space for a few seconds. What medication be most appropriate:
    • A. 

      Methylphenidate

    • B. 

      Dextroamphetamine

    • C. 

      Amoxetine

    • D. 

      Etosuxamide

    • E. 

      Olanzapine

  • 5. 
    A 46-year-old male with nor-insulin dependent diabetes presents with a recent onset of nausea, vomiting, abdominal pain, anorexia, and dark-colored urine. Laboratory examination reveals an AST = 136 U/L and an ALT = 142 U/L. Based on these findings, what oral hypoglycemic agent is the patient most likely taking?
    • A. 

      Acarbose

    • B. 

      Glipizide

    • C. 

      Metformin

    • D. 

      Repaglinide

    • E. 

      Troglitazone

  • 6. 
    A 54-y/o female has reported to your office with complaints of increased Voiding, dry mouth, and profuse sweating at night. Her blood glucose level is 248 mg/dL. The patient presents the following lipid profile: HDL=27g/dL; LDL=185mg/dL, TG=485mg/dL. What therapeutic agent would give an increase in HDL cholesterol and a decrease in TG levels?
    • A. 

      Glyburide

    • B. 

      Repaglinide

    • C. 

      Pioglitazone

    • D. 

      Acarbose

    • E. 

      Insulin

    • F. 

      Metformin

  • 7. 
    A 32-year-old woman undergoing an uncomplicated abdominal hysterectomy develops severe hypotension (64/32 mmHg) and bradycardia (44 bpm) 4 hours after surgery and unresponsive to 3 doses of atropine 1mg. The surgery was performed under general anesthesia with a single induction dose of etomidate followed by maintenance with succinylcholine. What should be administered to improve her condition?
    • A. 

      Saline solution

    • B. 

      Dopamine

    • C. 

      Hydrocortisone

    • D. 

      Colloid infusion

    • E. 

      Dobutamine

  • 8. 
    A 46-year-old woman visits her podiatrist to have several bunions removed from her right foot. She chooses conscious sedation rather than general anesthesia for this procedure. She is given intravenous midazolam to supplement the local anesthetics that are injected into her foot. Midway through the surgery, she suddenly becomes agitated, combative, and exhibits involuntary movements.  The anesthesiologist determines that she is having a paradoxical reaction to the midazolam. What drug would be best to counteract the reaction to midazolam?
    • A. 

      Flumazenil

    • B. 

      Glucagon

    • C. 

      Naloxone

    • D. 

      Nitrite

    • E. 

      Prota mine

  • 9. 
    A 57-year-old man presents with a steady, severe pain in the right hypochondrium, nausea, vomiting, and a temperature of 102 F. He states that his signs and symptoms began shortly after eating his favorite pizza with extra cheese, pepperoni, and sausage. Laboratory examination reveals a white blood cell count of 13,400/mL and a serum bilirubin value of 2.8 mg/dL. Hepatobiliary imaging reveals an obstructed cystic duct. What would be the drug of choice for the treatment of this patient's pain?
    • A. 

      Meperidine

    • B. 

      Morphine

    • C. 

      Naproxen

    • D. 

      Oxycodone

    • E. 

      Propoxyphene

  • 10. 
    A 50-year-old man reported to the surgical outpatient department for endoscopic examination. It was decided to give him a long acting and more potent amino ester as a local anesthetic. What local anesthetic is likely to be to be administered in this patient?
    • A. 

      Bupivacaine

    • B. 

      Chloroprocaine

    • C. 

      Tetracaine

    • D. 

      Benzocaine

    • E. 

      Lignocaine

  • 11. 
    Certain personality traits cause patients to violate the expectations of the sick role and elicit corrective or punitive responses from caretakers, especially in medical settings. Hospital staff often find themselves disagreeing with one another over the legitimacy of the patient's distress; patients may alternate between angry rejection of proffered help and undue passivity or neediness. This is a representation of what personality trait?
    • A. 

      Dependent strivings

    • B. 

      Antisocial ity

    • C. 

      Narcissism

    • D. 

      Borderline traits

    • E. 

      Compulsiveness

    • F. 

      Schizotypy

    • G. 

      Suspiciousness/mistrust (nonpsychotic paranoia)

    • H. 

      Passivity

    • I. 

      Histrionic personality style

  • 12. 
    A 28-year-old man who appears very restless is brought in the night to the ER. He seems to be having frightening visual hallucinations and is totally confused and disoriented to time and place. Not only is he uncooperative, but is also difficult to understand because of slurred speech. As the examining doctor what would be your diagnosis?
    • A. 

      Brief reactive psychosis

    • B. 

      Delirium

    • C. 

      Mania

    • D. 

      Psychotic depression

    • E. 

      Schizophrenia

  • 13. 
    Which personality disorder is MOST typical of the following defining qualities? Lacks desire for close relationships, even with family; lacking in sexual interest; emotionally detached, flattened affect; strongly prefers solitary activities.
    • A. 

      Avoidant

    • B. 

      Dependent

    • C. 

      Obsessive-compulsive

    • D. 

      Schizoid

    • E. 

      Schizotypal

    • F. 

      Antisocial

    • G. 

      Histrionic

    • H. 

      Narcissistic

    • I. 

      Borderline

    • J. 

      Paranoid

  • 14. 
    Which diagnosis is the MOST appropriate for the following clinical case vignette? Case\: A 22-year-old woman is brought in by her parents, for reasons she can't explain. On questioning, she does admit to hearing derogatory voices commenting on her every move for about the past week. She says she first felt not entirely herself about three months ago, just after graduating from college. She can't quite say how she felt unwell; things 'just seemed different, somehow.' She was planning to get a job, but has been staying at her parents' house, often sleeping much of the day and wandering at right. Her speech is a bit odd, with tangential answers to some questions. She has no relevant medical history. She has not smoked marijuana for two years and never used other drugs. She drinks only rarely on big social occasions.
    • A. 

      Delusional disorder

    • B. 

      Schizotypal disorder

    • C. 

      Schizophreniform disorder

    • D. 

      Schizophrenia, paranoid type

    • E. 

      Schizophrenia, catatonic type

    • F. 

      Schizophrenia, disorganized type

    • G. 

      Schizophrenia, undifferentiated type

    • H. 

      Bipolar, manic, with mood congruent psychotic features

    • I. 

      Substance-induced psychosis

    • J. 

      Schizoaffective disorder

  • 15. 
    Which psychiatric condition is the MOST appropriate for the following clinical scenario? A 50-year-old woman is admitted to the hospital for the sixth time. She is withdrawn, irritable, fearful and restless. She reports feeling depressed for about six weeks, with difficulty falling and staying asleep and a fifteen pound weight loss due to loss of appetite. She has suicidal ideation with a plan to take an overdose, which she has done in the past under the influence of command auditory hallucinations. She hears voices pretty much continuously, but when she is not depressed, they do not talk of suicide. She has been divorced for many years and has trouble holding jobs due to her suspiciousness and odd responses to other people.
    • A. 

      Major depressive episode

    • B. 

      Dysthymic disorder

    • C. 

      Major depressive episode with mood congruent psychotic features

    • D. 

      Major depressive episode with mood incongruent psychotic features

    • E. 

      Schizoaffective, depressed

    • F. 

      Bipolar disorder, most recent episode depressed

    • G. 

      Major depressive episode, melancholic

    • H. 

      Major depressive episode with atypical features

    • I. 

      Substance induced mood disorder

    • J. 

      Adjustment disorder with depressed mood

  • 16. 
    Which psychiatric syndrome BEST describes the following mental status examination case? Appearance: Disheveled 52-year-old woman with excess makeup, tight fitting clothes and elaborate manicure, with some broken nails. Level of consciousness: Alert. Mood: Euphoric, irritable. Affect: Cheerful, inappropriate at times (giggles describing loss). Speech: Pressured, emphatic. Thought form: Flight of ideas without loose associations; circumstantiality. Thought content: Grandiose plans to start her own business, take over the hospital; content is quite fluid and she rationalizes extensively when challenged; some assaultive thoughts but not homicidal or suicidal. No hallucinations admitted. Fleeting paranoid ideas that she does not cling to. No ideas of reference. Formal testing: Oriented X 2.5 (off by one day on date); 3/3 objects at five minutes, remote memory apparently normal except some confusion in sequencing; Can name presidents backward to Carter (omitting Ford); Serial sevens done rapidly with three errors; digit span six forward, four backward; Continuous performance testing\: no errors. Proverbs: Abstract, personalized. Formal judgment: would mail a stamped letter, knows why criminals are locked up, but history suggests personal judgment impaired (spent $600 on winter clothes in July; keeps calling her ex-husband, despite restraining order).
    • A. 

      Delirium

    • B. 

      Amnestic disorder (Korsakoff's psychosis)

    • C. 

      Pseudodementia

    • D. 

      Generalized Anxiety

    • E. 

      Depression

    • F. 

      Mania

    • G. 

      Schizophreniform psychosis

    • H. 

      Delusional disorder

  • 17. 
    Which personality disorder is MOST typical of the following defining qualities? Peculiar thinking with nondelusional ideas of reference; inappropriate/constricted affect; odd, eccentric behavior and speech; illusions; lack of close friends except first degree relatives; excessive, inextinguishable social anxiety.
    • A. 

      Avoidant

    • B. 

      Dependent

    • C. 

      Obsessive-compulsive

    • D. 

      Schizoid

    • E. 

      Schizotypal

    • F. 

      Antisocial

    • G. 

      Histrionic

    • H. 

      Narcissistic

    • I. 

      Borderline

    • J. 

      Paranoid

  • 18. 
    A 52-year-old white male who had been found wandering the streets is brought into the hospital by the police. On initial physical exam, his motor behavior is notable for bradykinesia and a 4-6 Hz hand tremor at rest. He is kept under observation in the psychiatric ward, but is not medicated. Over the next few days, his motor symptoms start to abate, but he becomes increasingly paranoid and confused and insists that he is the President of the United States. Question: What condition best describes the patient at the time of admission?
    • A. 

      Alcoholic suffering from acute symptoms of withdrawal

    • B. 

      Chronic amphetamine user suffering from drug-induced psychosis

    • C. 

      Chronic schizophrenic suffering from tardive dyskinesia

    • D. 

      Parkinsonian patient overmedicated with L-dopa

    • E. 

      Schizophrenic overmedicated with haloperidol

  • 19. 
    A 49-year-old patient is evaluated for suicidal ideation after he is found laying on train tracks by police. The man is disheveled and malodorous and states that he has "reached the end" and would rather die. He admits to depressed mood, anhedonia, poor energy, and appetite; he feels miserable and regrets what he has done with his life and wants to put an end to it. He states he has felt this way since age 26, after he was discharged from the military. The man indicates that his life was "great" until he increased his drinking, which caused a divorce at age 30. He has had 2 arrests for driving under the influence. He was in jail for 6 months after he had an accident while drunk that resulted in public property damage. He remembers that he initially felt sick in jail, with sweating, vomiting, shaking, and he experienced a seizure. He then improved after a few days and felt better during the rest of his imprisonment without any depression. Question: What criteria most strongly suggests alcohol abuse?
    • A. 

      Desire to cut down

    • B. 

      Recurrent drunk driving

    • C. 

      Seizure after withdrawal

    • D. 

      Suicidal ideation

    • E. 

      Tolerance

  • 20. 
    A 25-year-old male presents to his family physician with the following statement: "Doctor, I can't urinate in public restrooms. I can if there is no one around, but if I go to the restroom in a movie theater, an airport, at the ball park, or anywhere that someone else comes in, I can't urinate. Even if I have already started, it just stops and I can't get it going until the other person leaves. I am so embarrassed. What do they think of me if they see I can't do what every other man can do?" What is the most likely diagnosis?
    • A. 

      Anxiety disorder due to a general medical condition

    • B. 

      Panic disorder

    • C. 

      Social phobia

    • D. 

      Specific phobia

    • E. 

      Substance-induced anxiety disorder

  • 21. 
    There is a classic zoo story about a cage with 3 monkeys in it. The largest monkey steals the middle-sized monkey's banana. The middle-sized monkey then screams with rage, hits the smallest monkey on the head, and then steals his banana. The middle-sized monkey is using what mechanism of defense?
    • A. 

      Displacement

    • B. 

      Projection

    • C. 

      Reaction formation

    • D. 

      Regression

    • E. 

      Repression

    • F. 

      Buxbauming

  • 22. 
    A 48-year-old actor is admitted to a major medical center with complaints of malaise and cough. He is diagnosed with influenza by the emergency room physician and sent home, but demands to be seen by the Chief of Staff because he feels he is not getting care appropriate to his own importance. On the way down the hall, the man tells the orderly that he should have been nominated for an Academy Award, but was passed over because of jealousy among his co-workers. Question: What diagnosis best describes this man's behavior?
    • A. 

      Avoidant personality disorder

    • B. 

      Borderline personality disorder

    • C. 

      Dependent personality disorder

    • D. 

      Narcissistic personality disorder

    • E. 

      Schizotypal personality disorder

  • 23. 
    A 35-year-old unmarried woman lives alone. She has a Master's of Business Administration (MBA) and was employed as a stock broker. She was fired from her most recent job because on 3 separate occasions over the last 2 years, she acted rashly without the consent of her clients. Despite lacking her clients' authorization, she sold all the securities in their accounts and invested the money in securities that had pretty, glossy portfolios, but were worthless. On these 3 occasions, she had worked 22-24 hours each day for 10 days at a time, gorged herself on "junk food," and drank alcohol excessively. Question: What is the most likely diagnosis?
    • A. 

      Bipolar disorder, type I

    • B. 

      Bipolar disorder, type II

    • C. 

      Cyclothymic disorder

    • D. 

      Schizophrenic disorder, paranoid type

    • E. 

      Substance-induced delirium

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