HY 1/

Question 1

Antisocial personality disorder (an adult diagnosis) involves a pattern of violation of basic societal rules and the rights of others and requires a history of some symptoms of conduct disorder before age ___.

Answer 1

15

Question 2

DSM-5 describes ___ as intentional fire setting on more than one occasion to relieve internal tension. There is no obvious motive (eg, profit, revenge, political statement, recognition).

Answer 2

pyromania

Question 3

In bulimia nervosa, the binge eating and inappropriate compensatory behaviors occur, on average, at least ___ a week for 3 months.

Answer 3

once

Question 4

___ views symptoms as serving a purpose in the family, to in some way maintain the equilibrium of the system by identifying one member as being the problem (the identified patient). This therapy, however, conceptualizes the solution as a reconfiguration of the roles and relationships of the entire family unit while de-emphasizing the psychopathology of the identified patient.

Answer 4

Family systems therapy

Question 5

___ is an X-linked genetic disorder associated with a MECP2 mutation found on the X chromosome, usually occurring in females, characterized by regressed and delayed milestones. Head size regression is a common finding along with the hallmark finding of stereotypic, repetitive hand movements consisting of wringing, clapping, or washing. Behavioral manifestations include bruxism, screaming spells, and autistic-like features. A frequent complication is seizures.

Answer 5

Rett Syndrome

Question 6

___ is the probability of the test being positive IN INDIVIDUALS WHO HAVE the disease. It identifies true positives. It is calculated by using true positives/ (true positives + false negatives)

Answer 6

Sensitivity

Question 7

___ is the probability of test being negative IN PEOPLE WITHOUT the disease. It identifies true negatives. True negatives/ (true negatives + false positives) is used to calculate it.

Answer 7

Specificity

Question 8

A ___-year-old child should be able to copy a circle and use a fork/spoon to eat. They should be able to describe their age and gender (cognitive), climb stairs with alternating feet, ride a tricycle (gross motor) and speak in simple sentences (language). They also engage in parallel play but not co-operatively with others (social).

Answer 8

3

Question 9

The test for PKU, if not performed during the routine newborn screening test, is normally done 2 to 7 days after birth, AFTER the newborn has ingested a diet that contains ___, an essential amino acid that is present in, among other foods, breast milk. In most cases, a repeat test should be performed at about two weeks of age to verify the initial test and to uncover phenylketonuria that was initially missed.

Answer 9

phenylalanine

Question 10

Obedience and punishment orientation is the ___ stage of the pre-conventional stage of Kohlberg’s moral development in which the child fears punishment so he tries his level best to be a good boy/girl. They see the rules to be unchangeable and formed by person in authority.

Answer 10

first

Question 11

Individualism and exchange is the second stage of the ___ stage of Kohlberg’s moral development in which the child understands that rules differ from one person to another so they start questioning them. They learn about getting rewards in exchange for behaving good enough so they anticipate this more than fearing the punishment.

Answer 11

pre-conventional

Question 12

Good interpersonal relationships is the ___ stage of the conventional stage of Kohlberg’s moral development in which a child is more concerned about maintaining good interpersonal relationships and he/she tries to be good to seek social approval.

Answer 12

first

Question 13

Maintaining social order is the ___ stage of the conventional stage of moral development according to Kohlberg. The person is now aware of the social law and order and he follows them to avoid feelings of guilt and maintain social decorum.

Answer 13

second

Question 14

___ is the process of sharing one’s experience of observing an object or event with another person by pointing, gesturing, or vocalizing, and typically emerges around 9 months of age.

Answer 14

Joint attention

Question 15

___ spells in school can masquerade as inattention. The child is then frustrated by his inability to grasp explanations or follow directions, potentially developing a secondary behavior disorder.

Answer 15

Absence

Question 16

Schizophreniform disorder is characterized by the same symptoms of schizophrenia (negative and positive symptoms) present for more than 1 month but less than ___, after which diagnosis changes to schizophrenia. Symptoms include two or more of the following: delusions, hallucinations, disorganized speech, grossly disorganized behavior, and negative symptoms.

Answer 16

6 months

Question 17

Olfactory reference syndrome is a specifier for “other specified ___ and related disorder” in the DSM-5.

Answer 17

obsessive-compulsive

Question 18

Small hippocampal volume has been identified as a risk factor for early-onset ___, especially in the interaction with early-life adversity.

Answer 18

depression

Question 19

Medications are not recommended as a first-line treatment for insomnia in children and adolescents. ___ aims to correct the negative behaviors associated with insomnia. The patient is advised to use their bed only for sleeping, removing all the distractions that could interfere with sleep. They should leave the bed if they are unable to sleep rather than lying in bed and becoming increasingly frustrated.

Answer 19

stimulus control

Question 20

In a collaborative team model the medical team and the psychiatric consultant share decision-making and responsibility for patient care, the ___ team approach requires direct involvement in contrast to a resource consultation model where lack of follow-up is common.

Answer 20

collaborative

Question 21

The Diagnostic Interview Schedule for Children-Revised (DISC-R) is a fully structured interview with complete instructions for the questions so that a trained ___ need not have any experience with child psychiatry; it assesses symptoms over the previous 6 months.

Answer 21

layperson

Question 22

___ is also known as acquired epileptic aphasia. This disorder typically occurs in healthy children who begin to lose expressive and receptive language skills most commonly between the ages of 4 and 7 years, although children at both younger and older ages may manifest initial symptoms. Concurrent with the development of aphasia, paroxysmal epileptiform EEG changes, and, in many cases, seizures occur.

Answer 22

Landau-Kleffner syndrome

Question 23

Pica is a symptom of various neurological disorders. Parent-child problems, such as parental neglect, increase the risk for development and maintenance of this symptom. Pica can only be diagnosed when the eating of non-nutritive substances is inappropriate to developmental age. Before the age of ___ months, mouthing and sometimes eating of non-nutritive substances is not uncommon. Thus, pica would not be dx before 18-24months.

Answer 23

18 to 24 months

Question 24

The frequency and duration of binge eating episodes in binge eating disorder and bulimia are similar in both disorders, at least ___ a week for 3 months.

Answer 24

once

Question 25

The ___ use disorder identification test (AUDIT) is a widely used screening tool consisting of 10 questions that can be self-administered or read aloud. Higher scores indicate hazardous or harmful alcohol consumption. It has been used successfully in adolescents and youth aged 14-18.

Answer 25

alcohol

Question 26

Males are ___ times as likely as females to have autism spectrum disorder, but females are more likely to exhibit intellectual disability. Females are more likely to have delayed or missed diagnosis making the ratio appear even larger.

Answer 26

3-4

Question 27

___ prevention targets high-risk people having minimal but detectable signs and symptoms which foreshadow a mental illness but do not meet formal criteria for a fully diagnosed syndrome.

Answer 27

Indicated

Question 28

___ prevention targets people at high risk of developing a condition but without any signs or symptoms of the condition.

Answer 28

Selective

Question 29

___ prevention reduces the prevalence of disease through early detection and treatment. It is designed to detect the illness early and prevent the illness already established from getting worse.

Answer 29

Secondary

Question 30

Tertiary prevention includes interventions that ___ disability and prevents relapse of the illness. It improves functional outcomes in patients who already have the disease.

Answer 30

reduce

Question 31

If a child perceives that they are being stopped and freedom of behavior is affected, they may show ___ and deliberately break the rules.

Answer 31

reactance

Question 32

___ behavior is marked by children exhibiting behavioral aggressiveness and resistance and rejection of ANY authority imposed on them. If usually occurs in children between the age of 9 and 13yo.

Answer 32

Rebellious

Question 33

For depression, in ___, the gender ratio is 1:1 female to male, whereas during adolescence it is 3:1 female to male. The prevalence of depression in the preadolescent years is 2% and during adolescence is 4-8%. Hispanic children are 1.4 times more likely to be diagnosed with depression than euro children.

Answer 33

preadolescence

Question 34

In panic disorder, at least one attack is followed by at least a ___ of persistent worry about additional panic attacks or a maladaptive change in behavior related to the attacks.

Answer 34

month

Question 35

Children from about 6 to 12 years of age are at the stage of ___ operations. At this stage, they are mastering the following cognitive skills: hierarchical classification (sorting by type), reversibility (the undoing of a task by following the steps backwards), and conservation (understanding that pouring liquid into different size containers does not alter the amount of liquid).

Answer 35

concrete

Question 36

Children in the 3-4 years age range are known to possess a combination of egocentricity and illogical thinking. They are known to proscribe self-blame to their suffering. Therefore, it is necessary to uncover and correct any ___ misconceptions the child might harbor.

Answer 36

self-blaming

Question 37

Age-related ___ of the autonomic nervous system response may be responsible for the lower prevalence of panic disorder in older adults.

Answer 37

dampening

Question 38

Adjustment disorder involves emotional or behavioral symptoms associated with an identifiable stressor. These symptoms should develop within 3 months of the stressor and last no longer than ___ months AFTER the END of the stressful event.

Answer 38

6

Question 39

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 replaced Aid to Families with Dependent Children with Temporary Assistance to Needy Families. There was a 40% ___ in the numbers of dependent families along with a substantial increase in labor force participation by mothers. Overall, welfare reform from this legislation does not appear to have reduced child poverty.

Answer 39

reduction

Question 40

___ Syndrome is characterized by developmental disability and intellectual disability, it is caused by genetic imprinting and lack of function of chromosome 15 that is inherited from the mother.

Answer 40

Angelman

Question 41

___ attachment is an insecure type of attachment. Infants stay close to their mother and explore very little. When the mother leaves, they become very distressed. Upon her return, they remain close to her but they seem angry at her for having left them and resist physical contact initiated by the mother and may push her away. The ___ infant tends to cry more and explore less than the secure infant.

Answer 41

Resistant

Question 42

___ attachment is also an insecure attachment in which infants show little distress when the mother leaves and will turn away from and ignore her even when she tries to get their attention. The ___ infant may seem undisturbed by a stranger even with the mother absent.

Answer 42

Avoidant

Question 43

___ or disoriented attachment is a combination of resistant and avoidant patterns that show confusion about whether the infant should approach or avoid their mother. The infant's behavior is erratic and confusing in the disoriented or ___ type of attachment.

Answer 43

Disorganized

Question 44

School officials have the authority to remove a student and place them in an ___ setting if a weapon is brought to the school, after clarifying they don't warrant a psychiatric hospitalization.

Answer 44

alternative

Question 45

The Massachusetts Youth Screening Instrument (MAYSI) is a 52-item self-report inventory that is administered to youths entering ___ settings. It identifies mental illness and has been shown to decrease suicide attempts if given in the first 24 hours of entering the facility.

Answer 45

juvenile

Question 46

A phase ___ clinical trial is conducted to permit safety and efficacy data to be collected for experimental drugs.

Answer 46

I

Question 47

A phase ___ clinical trial compares the results of subjects taking a new treatment with the results of subjects taking the standard treatment, and determines if a new treatment results in fewer or more side effects than standard treatments.

Answer 47

III

Question 48

A phase ___ clinical trial evaluates the side effects of a new treatment that were not apparent prior to receiving FDA indication.

Answer 48

IV

Question 49

Children up to ___ years of age do not fully understand the finality of death. Typically school-age children are able to view death as permanent whereas preschool children look at death as reversible.

Answer 49

6

Question 50

The Peabody Picture Vocabulary Test assesses a person's non-verbal intelligence and doesn't require reading. Thus, it can help ___ between impairment in language comprehension and in reading. In the Peabody Picture Vocabulary Test, the subject is shown 175 picture plates with 4 pictures on each plate. The subject points to the picture most like the stimulus word (shown on card).

Answer 50

differentiate

Question 51

The Thematic Apperception Test (TAT) is a projective test assessing a person's interpretations of ambiguous ___ situations. Thus, it sheds light on a person's interpersonal function and can also identify psychotic processes in the case of idiosyncratic interpretations.

Answer 51

interpersonal

Question 52

___ exposure gradually desensitizes the body to sensations and decreases the anxiety associated with them. This is one of the physiological techniques of cognitive behavioral therapy (CBT) that is usually used for panic disorder, obsessive-compulsive disorder, and specific phobias.

Answer 52

Interoceptive

Question 53

Intermittent explosive disorder is marked by recurrent impulsive outbursts of aggression that are disproportionate to stressors and are typically followed by feelings of remorse and/or embarrassment. To establish the diagnosis, the pt needs to be >=___ years old and the outbursts need to occur >=2 times weekly for 3 months without injury to others or destruction of property.

Answer 53

6

Question 54

Enlargement of the testes and scrotum is the first sign of puberty in boys. It is associated with Tanner stage 2. Increased muscle mass, deepening of the voice, facial hair, and spermarche occur ___ testicular enlargement.

Answer 54

after

Question 55

Children with pica are at a very high risk of lead poisoning and the pediatrician must maintain a high level of suspicion for lead poisoning as the cause or contributor to the child's ___ delay.

Answer 55

developmental

Question 56

Disinhibited social engagement disorder (DSED) is an attachment disorder that is characterized by a pattern of behavior involving culturally inappropriate and excessively familiar behavior with relative strangers. The child usually has a history of social neglect, frequent changes of primary caregivers, or rearing in unusual settings. A diagnosis of Disinhibited Social Engagement Disorder (DSED) should not be established before a child is developmentally able to form selective attachments, therefore, in order to make the DSED diagnosis the child should have a developmental age of at least ___ months.

Answer 56

9

Question 57

Prenatal stress is considered a risk factor for the development of schizophrenia. Stress in the prenatal period causes changes in the development of the prefrontal cortex which is expressed as cognitive impairment in patients with schizophrenia. Prenatal stress induces epigenetic changes in the reelin gene promoter causing downregulation of reelin expression during prenatal development. Reelin is an extracellular matrix protein that is involved in the regulation and ___ of neurons in the developing brain.

Answer 57

positioning

Question 58

Tourette syndrome is another name for combined vocal and motor multiple tic disorder. It is characterized by multiple motor tics and one or more vocal tics that have been present for more than a ___.

Answer 58

year

Question 59

Cyclothymic disorder is a condition characterized by intermittent periods of mild depression alternating with symptoms suggestive of hypomania but that fail to meet full criteria for a hypomanic episode. This pattern must persist for at least ___ year for children and adolescents and for at least two years in adults. The symptom-free intervals should not be longer than two months during those time frames.

Answer 59

one

Question 60

___ involves the application of existing schemas or mental images to deal with a new object or situation.

Answer 60

Assimilation

Question 61

___ involves remodeling the existing schema by acquiring new knowledge about a particular situation or an object.

Answer 61

Accommodation

Question 62

IDEA extends support to children with behavioral and emotional disturbances and suicidality. Part ___ aims at providing early interventional support to children with disabilities aged 3 years to 21 years, including teens with suicidal behavior and emotional turmoil.

Answer 62

B

Question 63

The Peabody Picture Vocabulary Test assesses ___ language or comprehension. It does this by requiring the subject to choose the 1 picture out of 4 that is most similar to the stimulus word (that is presented written on a card). The test can also be used for subjects with expressive language impairment because it doesn't require them to make a verbal response.

Answer 63

receptive

Question 64

The two most common co-morbidities in patients with Tourette syndrome are ___ and attention-deficit hyperactivity disorder.

Answer 64

obsessive-compulsive disorder (OCD)

Question 65

Patients with avoidant personality disorder usually avoid social interactions because of fear of being rejected or judged. Moreover, they show ___ for rejection and criticism. Borderline personality disorder also presents with hypersensitivity towards rejection, but they respond with anger, self-harm, and manipulative demands.

Answer 65

hypersensitivity

Question 66

Harry Harlow's well-known work with surrogate cloth and wire mothers for rhesus monkeys demonstrated the effects of social ___ and the importance of contact comfort for normal development.

Answer 66

deprivation

Question 67

The new beginnings program (NBP) is a 10-session, group-based program that helps parents guide their children and help them to adjust following ___ or divorce. The NBP helps them build a stronger relationship with their kids, reduce long-term aggression, sexual abuse, drug abuse, and builds higher self-esteem in children. Long-term monitoring has shown improvement in school grades too.

Answer 67

separation

Question 68

Multisystemic therapy (MST) is an extremely effective tool to help ___ juvenile delinquents with a history of serious criminal offenses.

Answer 68

reform

Question 69

___ inhibition tends to be a major risk factor for most anxiety disorders, including agoraphobia. Social inhibition enforced by parents is a stronger risk factor for selective mutism and social anxiety disorder.

Answer 69

Behavioral

Question 70

The pathogenesis behind the development of ADHD is ___ dysregulation. Changes in the cerebellum, corpus callosum, caudate nucleus, putamen, and globus pallidus have been found.

Answer 70

dopamine

Question 71

Altered ___ receptor signaling is found in schizophrenia.

Answer 71

NMDA

Question 72

Selective mutism is often marked by high social anxiety, and an additional diagnosis of ___ is often appropriate. Separation anxiety disorder is the second most common comorbid condition associated with selective mutism.

Answer 72

social anxiety disorder

Question 73

The use of SSRIs, especially fluoxetine, in a patient receiving cyclosporine for immunosuppression is known to have the potential to increase serum cyclosporine levels and potentially cause ___ side-effects.

Answer 73

psychiatric

Question 74

In utero exposure to valproic acid is now a known risk factor for the development of an ___ spectrum disorder. Valproic acid carries a black box warning from the FDA for its teratogenic concerns.

Answer 74

autism

Question 75

Persisting ___ hypertension of the newborn is seen in selective serotonin reuptake inhibitor (SSRI) use in the third trimester.

Answer 75

pulmonary

Question 76

The characteristic feature of ___ sleep EEG is its synchronization.

Answer 76

NREM

Question 77

___ sleep EEG is unsynchronized.

Answer 77

REM

Question 78

Which serotonin receptor subtype is most commonly implicated in the pathophysiology of depressive disorders?

Answer 78

5-HT1A (recall, abilify is an antagonist of 5HT2A (like all second generation antipsychotics), and a PARTIAL agonist of dopamine AND 5HT1A!

Question 79

Carbamazepine induces the metabolism of lamotrigine, resulting in a 40% reduction in serum lamotrigine levels at a given dose. Therefore, lamotrigine, is usually initiated at ___ the usual recommended dose in patients on carbamazepine.

Answer 79

twice

Question 80

Phenylketonuria is ___ for in the first week of life in all 50 states in the US. ID and seizures occur in several intellectual disability syndromes. Eczema is a sign that more specifically suggests phenylketonuria. Phenylketonuria is a genetic abnormality that causes deficiency of the hepatic enzyme phenylalanine hydroxylase. Phenylalanine hydroxylase converts phenylalanine to tyrosine and, when deficient, leads to toxic phenylalanine and phenyl ketone levels. The treatment is to provide the patient with a diet low in phenylalanine.

Answer 80

screened

Question 81

___ is a genetic condition that results in overproduction of uric acid. Symptoms include kidney damage, self-injurious behaviors, and gouty arthritis.

Answer 81

Lesch Nyhan Syndrome

Question 82

Dyslexia is a learning disorder characterized by severe deficits in reading and spelling even though cognitive function and intelligent quotient are normal. Dyslexia is believed to be caused by abnormalities in the phonological system that result in the inability to create and identify sounds in spoken words. Kids with dyslexia have poor letter-sound knowledge that directly translates into poor reading skills and significantly reduced reading speed. They also struggle with spelling and usually can spell only about 10% of the words correctly in reading dictation tasks. Treatment is through intervention programs such as ___, which are aimed at helping children identify and manipulate phonemes to improve decoding skills.

Answer 82

phonemic awareness training

Question 83

A link between TV viewing and ___ behavior during adolescence and adulthood has been identified. TV viewing may promote an unrealistic view of life, impairs the ability to bond with family and society, and may be the first step towards as-yet-unforeseen negative effects of the electronic relationship age that we live in.

Answer 83

aggressive

Question 84

The hallmark triad of Huntington's Disease (Autosomal dominant, CAG repeat expansion) is movement disturbance, cognitive decline, and psychiatric disturbance. The movement disturbances include chorea and loss of motor control, often presenting initially as clumsiness or incoordination. On imaging, the basal ganglia are often reduced in size, particularly the ___ nuclei (also globus pallidus, putamen).

Answer 84

caudate

Question 85

ADHD diagnosis inattentive and/or hyperactive/impulsive type involves six or more symptoms (of a given category eg inattention) for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least ___ months, and they are inappropriate for developmental level:

Answer 85

6

Question 86

Enuresis is traditionally defined as wetting from the age of ___ years and encopresis as soiling from 4 years onwards - after all organic causes have been excluded.

Answer 86

5

Question 87

Sertraline in children is only FDA approved for one thing, ___ in children 6+ (6ertraline).

Answer 87

OCD

Question 88

Fluvoxamine in children is only FDA approved for one thing, ___ in children 8+

Answer 88

OCD

Question 89

Escitalopram in children is only FDA approved for one thing, ___ in children 12+. Citalopram has no FDA indications in children.

Answer 89

Major depression

Question 90

Fluoxetine in children is FDA approved for two things, Major depression (___) and OCD (7+).

Answer 90

8+

Question 91

Clomipramine is FDA approved for children with OCD, ages ___-17.

Answer 91

10

Question 92

Imipramine (get ECG first) is FDA approved for children with nocturnal enuresis (1st line bell and pad, 2nd line DDAVP/Desmopressin, 3rd line Imipramine), ages 6-17. Note, enuresis is traditionally defined as wetting from the age of ___ years (vs. encopresis is soiling from 4yo) onwards.

Answer 92

5

Question 93

Duloxetine has one pediatric FDA indication, Generalized anxiety disorder from ___-17 years.

Answer 93

7 (FDA approval age range is same for lithium for bipolar acute mania / maintenance, and duloxetine for GAD, 7-17yo)

Question 94

Hormonal changes order: 1) the ___ begins to release pulses of GnRH; 2) cells in the anterior pituitary respond by secreting LH and FSH into the circulation; 3) the ovaries or testes respond to the rising amounts of LH and FSH by growing and beginning to produce estradiol and testosterone, and 4) rising levels of estradiol and testosterone produce the body changes that characterize female and male puberty.

Answer 94

hypothalamus

Question 95

Parametric linkage analysis is used for traits with Mendelian inheritance while non-parametric linkage analysis is used for traits with no clear mode of inheritance. Parametric linkage analysis uses logarithm of the odds (LOD) score. Logarithm of the odds (LOD) score of greater than 3.0 shows evidence for linkage. Positive logarithm of the odds (LOD) score shows presence of linkage while negative LOD score shows absence of linkage. There are 2 different approaches used in the ___: parametric and non-parametric linkage analysis.

Answer 95

genetic linkage analysis

Question 96

___, also known as black and white thinking, refers to the belief that all events are either totally good or totally bad and that no other outcome is possible. Individuals with this distortion find it hard to accept outcomes that are less than ideal and often use words such as "never" and "always."

Answer 96

Absolutism

Question 97

___ refers to a cognitive error where a person takes responsibility for undesirable or unhealthy external events that are out of their control.

Answer 97

Personalization

Question 98

___ is a cognitive distortion that leads a person to draw conclusions based on false assumptions.

Answer 98

Arbitrary inference

Question 99

In the cognitive distortion ___ people view things out of context while focusing on only the negatives of a situation.

Answer 99

selective abstraction

Question 100

Individuals with the cognitive distortion ___ expect the most terrible outcomes on the basis of a single negative event. For example, a person who is ___ might think they will never be able to get a job after they do badly in one interview.

Answer 100

catastrophizing