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H01.001&mcs&0&N&<b><i>RS is a 28 yo WF who was recently diagnosed with panic disorder.  She has not received any previous treatment.  RS is started on paroxetine po 20 mg qd.</b></i><br><br>Which of the following is a disadvantage to using paroxetine to treat panic disorder in this patient:&Delayed response&Short duration of action;Life threatening withdrawal symptoms upon discontinuation;High abuse potential;&&&&a&undefined.0&&&&&1&&&N.
H01.002&mcs&0&N&When should a trial discontinuation of the paroxetine be implemented?&12 to 24 months after full remission&12 to 24 days after full remission;12 to 24 weeks after full remission;A trial discontinuation should not be attempted (ie indefinite treatment);&&&&a&undefined.0&&&&&1&&&N.
H01.003&mcs&0&N&<b><i>LR is a 38 yo AAM whose panic disorder has been successfully managed with lorazepam 3mg TID with occasional PRN doses (2-3x per week).</b></i><br><br>Which of the following is a symptom of a panic attack?&chest pain&constipation;headache;diarrhea;&&&&a&undefined.0&&&&&1&&&N.
H01.004&mcs&0&N&LR goes on vacation for a week and forgets to bring his lorazepam.  What sort of 	withdrawal symptoms might he potentially develop?&insomnia, anxiety, seizures&hypotension, shortness of breath, vomiting;hypertension, fatigue, mania;respiratory depression, psychosis, hyperthermia;&&&&a&undefined.0&&&&&1&&&N.
H01.005&mcs&0&N&<b><i>TM is a 29 yo WF who was sexually abused x 7 yrs.  She c/o recurrent 	nightmares, but has difficulty recalling details about her abuse.  She feels depressed, has difficulty concentrating, and is easily startled.  She has been symptomatic for several years but has never been treated.</b></i><br><br>TM�s physician would like to start her on a medication.  Which of the following 	would be the best agent for this patient based on her anxiety disorder and presenting symptoms?&Paroxetine&Clonidine;Alprazolam;Valproic Acid;&&&&a&undefined.0&&&&&1&&&N.
H01.006&mcs&0&N&If TM�s symptoms resolve with medication, when should a trial discontinuation be attempted?	&12 to 24 months&3 to 6 months;6 to 12 months;A trial discontinuation should not be attempted (i.e., indefinite treatment);&&&&a&undefined.0&&&&&1&&&N.
H01.007&mcs&0&N&<b><i>JT is a 28 yo BM who is admitted to your psychiatric hospital for suicidal 	ideation and depressed mood.  He has a 10 year history of daily alcohol 	consumption.  He usually consumes approximately one pint per day of vodka.</b></i><br><br>Which of the following set of symptoms are consistent with alcohol withdrawal?&hand tremors, hypertension, hallucinations, and seizures&diarrhea, piloerection, chills, and vomiting;shortness of breath, hypotension, hyperthermia, and rhinorhea;depression, hypothermia, constipation, and vomiting;&&&&a&undefined.0&&&&&1&&&N.
H01.008&mcs&0&N&If JT�s depressive symptoms were secondary to his alcohol use, when would you expect them to resolve?&Within 4 weeks of becoming abstinent &Within 1 day of becoming abstinent;Within 10 days of becoming abstinent;Within 12 weeks of becoming abstinent;&&&&a&undefined.0&&&&&1&&&N.
H01.009&mcs&0&N&	JT has been successfully detoxified and is ready to be discharged from the 	hospital.  The treatment team would like to discharge him with adjunctive 	pharmacotherapy to reduce the likelihood of a relapse.  Which of the following would be an appropriate recommendation?	&Disulfiram po 500mg qd for 1-2 weeks, then 250mg qd&Naloxone po 100mg qd for 1-2 weeks, then 50mg qd;Carbamazepine po 200mg TID for 1-2 weeks, then 400mg TID;Haloperidol po 5mg qhs for 1-2 weeks, then 10mg qhs;&&&&a&undefined.0&&&&&1&&&N.
H01.010&mcs&0&N&<b><i>DL is a 32yo WF admitted to a psychiatric facility for suicidal ideation and 	depressed mood.  She has a 10 yr history of IV heroin use (~$100/d).  Her 	toxicology screen is positive for opioids. PMH is significant for Hepatitis B, C and asthma.</i></b><br><BR>DL has been successfully detoxified. Her physician would like to start Naltrexone 50mg po as adjunctive therapy to reduce the risk of relapse.  Which of the following would you recommend as baseline monitoring before initiating Naltrexone in this patient?&Liver function tests&Platelets;Urinalysis;Pulmonary function tests;&&&&a&undefined.0&&&&&1&&&N.
H01.011&mcs&0&N&<b><i>KM is a 40 yo WM who admits to snorting cocaine 3-4x per week, spending $200-300 at a time. He recently lost his job and his wife. He recognizes that cocaine has contributed to his problems and has decided to stop using.</b></i><br><br>Which of the following symptom(s) is KM likely to experience upon cocaine 	cessation?	&Depression&Vomiting and diarrhea;Hypertension;Tremors;&&&&a&undefined.0&&&&&1&&&N.
H01.012&mcs&0&N&A 12 year-old boy is changed from imipramine 150mg/day to bupropion 75mg/day in an effort to decrease daytime sedation and weight gain thought to be due to imipramine. The boy experiences severe nausea, diarrhea, sweating and generally feels ill.  The most likely reason is:&cholinergic rebound from imipramine discontinuation&influenza;subtherapeutic dose of bupropion;pharmacokinetic interaction between imipramine and bupropion;&&&&a&undefined.0&&&&&1&&&N.
H01.013&mcs&0&N&CT is a 6 y.o. 30kg boy diagnosed with ADHD and treated with methylphenidate 5mg tid x 2 weeks with no significant improvement in symptoms but good tolerability.  The next step toward optimal treatment is:&increase dose of methylphenidate to 10mg qam, 10mg qnoon, 5mg q3pm&change from methylphenidate immediate-release to Concerta 18mg qd;allow 2 more weeks for an adequate trial of 15mg/day;change to bupropion due to lack of stimulant response;&&&&a&undefined.0&&&&&1&&&N.
H01.014&mcs&0&N&JQ is a 12 year-old boy with enuresis who wets the bed 5-6x/week.  He has taken 	desmopressin acetate 200mcg tablet x 1 week with no increase in dry nights.  	Your recommendation is:&increase dose of desmopressin to 400mcg per night&change to imipramine which has greater efficacy in older children;change to desmopressin nasal spray 20mcg/night;allow 2 more weeks for an adequate trial;&&&&a&undefined.0&&&&&1&&&N.
H01.015&mcs&0&N&SH is an 11 year-old girl with ADHD and Tourette�s disorder.  She cannot tolerate even low-dose stimulants due to worsening of her tics.  She takes 	clonidine 0.1mg qid with only moderate symptom relief but excessive daytime sedation.  Which of the following is a reasonable replacement for clonidine with less sedation and low to no risk of tic exacerbation.&guanfacine&bupropion;clonazepam;fluoxetine;&&&&a&undefined.0&&&&&1&&&N.
H01.016&mcs&0&N&VM is a six-year old girl with OCD and associated trichtotillomania. She has been prescribed sertraline 50mg/day.  Compared to adults, VM is more likely to experience what reaction associated with sertraline therapy?&behavioral activation&headache;motor or vocal tics;orthostatic hypotension;&&&&a&undefined.0&&&&&1&&&N.
H01.017&mcs&0&N&CS is a 36 yo female with schizoaffective disorder, 5�10�� 145lbs, who complains of excessive daytime sleepiness related to clozapine therapy. Her clinician titrated up to a target dose of 500mg qhs 3 months ago.   Her symptoms are stable on clozapine 500mg qhs with valproate 1000mg qhs.  Steady state clozapine plasma level is 550 ng/ml.  Steady state valproate plasma level is 60mcg/ml.  Which of the following options is best for decreasing excessive daytime sleepiness in CS?&decrease clozapine to 400mg qhs &add modafinil 100mg bid;add atomoxetine 20mg qam;decrease valproate to 500mg qhs;&&&&a&undefined.0&&&&&1&&&N.
H01.018&mcs&0&N&TW, is an 18 year-old girl  5�5��, 120 lbs.  She reports falling asleep during the day and experiencing the sensation of being unable to move as she falls asleep at night.  She reluctantly admits to hallucinations as she falls asleep.  During the day she reports falling to the floor if someone at work makes her laugh.  She is started on Modafinil 100mg bid.  Which of the following symptoms is modafinil most effective in treating?&sleep attacks&associated cataplexy (loss of muscle tone with emotion);hypnagogic hallucinations;sleep paralysis;&&&&a&undefined.0&&&&&1&&&N.
H01.019&mcs&0&N&Modafinil is ineffective in significantly improving TW�s sleep attacks after one month 	of 400mg/day she is not willing to try a higher dose of 600mg/day due to concern over worsening headaches.  Select the best alternative for TW?&methylphenidate&sodium oxybate;pemoline;atomoxetine;&&&&a&undefined.0&&&&&1&&&N.
H01.020&mcs&0&N&Which of the following treatments is appropriate for treating PLMS in a 72 year-old otherwise healthy woman with sleep apnea:&pramipexole&propoxyphene;temazepam;oxycodone;&&&&a&undefined.0&&&&&1&&&N.
H01.021&mcs&0&N&JE is a 42 year-old woman with chronic insomnia characterized by trouble falling asleep and mid-night awakenings.  She requests a treatment with low to no abuse potential as she has been sober x 5 years.  Treatable medical and psychiatric causes have been addressed.  She currently takes pantoprazole (prolonix�) 40mg qam and citalopram 60mg qam.  Which of the following treatments is most appropriate&trazodone&chloral hydrate;melatonin;zolpidem;&&&&a&undefined.0&&&&&1&&&N.
H01.022&mcs&0&N&Which of the following target symptoms is generally not associated with bipolar disorder?&dementia&depression;delusions;distractibility;&&&&a&undefined.0&&&&&1&&&N.
H01.023&mcs&0&N&AR is a 44 year old female who is receiving 1500 mg/d of lithium.  Her most 	recent serum level is 0.9 mEq/L.  Two weeks after her last visit with you she calls complaining of severe diarrhea, nausea, and a hand tremor.  Her only change was that she visited her primary care provider and was started on HCTZ for hypertension.  What is the most likely cause of her diarrhea?&a drug-drug interaction&diarrhea leading to dehydration producing lithium toxicity;known side effects of lithium;adverse reaction to HCTZ;&&&&a&undefined.0&&&&&1&&&N.
H01.024&mcs&0&N&The treatment of choice for a patient with severe toxicity secondary to lithium treatment is?&hemodialysis&peritoneal dialysis;normal saline bolus;activated charcoal;&&&&a&undefined.0&&&&&1&&&N.
H01.025&mcs&0&N&Which of the following is considered a positive predictor of response for 	carbamazepine treatment?&negative family history of mood disorders&normal EEG;late onset mania;mild manic episode;&&&&a&undefined.0&&&&&1&&&N.
H01.026&mcs&0&N&Baseline monitoring for valproic acid therapy would include all of the following <i>except</i>		&TFTs&LFTs;CBC;Pregnancy test;&&&&a&undefined.0&&&&&1&&&N.
H01.027&mcs&0&N&Lamotrigine appears to be useful for the depressed phase of bipolar disorder.  However, which of the following adverse effects has limited its use&rash&anxiety;tremor;sedation;&&&&a&undefined.0&&&&&1&&&N.
H01.028&mcs&0&N&The cholinesterase inhibitors are considered drugs of choice for the management 	of Alzheimer�s Disease (AD).  What stage of AD are they most useful for?	&mild to moderate AD&moderate to severe AD;prophylactically;severe to end stage AD;&&&&a&undefined.0&&&&&1&&&N.
H01.029&mcs&0&N&The most common adverse reaction associated with acetylcholinesterase inhibitors is	&nausea, vomiting, diarrhea&increase in LFTs;worsening agitation during initiation;excitement and euphoria;&&&&a&undefined.0&&&&&1&&&N.
H01.030&mcs&0&N&AB is a 77 year old male with a history of Alzheimer�s disease who is receiving rivastigmine 12 mg/d.  Which of the following rating scales would be the best to monitor his mental status over time?  
&ADAS&MMSE;AIMS;DISCUS;&&&&a&undefined.0&&&&&1&&&N.
H01.031&mcs&0&N&Which of the following is the most frequently encountered behavioral symptom of 	Alzheimer�s Disease (AD)&aggression&sundowning;hypersexuality;irritability;&&&&a&undefined.0&&&&&1&&&N.
H01.032&mcs&0&N&The best pharmacological class of medications to treat delusions, hallucinations and psychosis associated with Alzheimer�s Disease (AD) is	&an atypical antipsychotic&an antidepressant;a short acting benzodiazepine;a typical antipsychotic;&&&&a&undefined.0&&&&&1&&&N.
H01.033&mcs&0&N&Which of the following describes one of the differences between OCD and trichotillomania?	&Trichotillomania is an impulse control disorder whereas OCD is an anxiety disorder&OCD responds to clomipramine  whereas trichotillomania does not ;Trichotillomania is more common in men whereas OCD is more common in women;Trichotillomania is associated only with obsessions but OCD is associated with compulsions and obsessions;&&&&a&undefined.0&&&&&1&&&N.
H01.034&mcs&0&N&CW is a 24 year-old carpenter.  He recently sought help at the urging of his wife who thinks he drinks too much alcohol.  He says that he drinks at night because he can't sleep.  He fears he may lose his job.  He's often late for work because he checks and re-checks his toolbox in the morning.  All his actions must be precisely correct or he fears some harm may come to his wife or children.  He also finds his work delayed because he often returns his lumber because it isn't cut straight enough.  He needs to pound each nail a specific number of times, or pull out the nail and pound the nail again.  The obsession exhibited by CW is which of the following?	&Fearing harm may come to his family if he is inexact&Rechecking his toolbox in the morning;Pounding a nail a specific number of times;Drinking an excessive amount of alcohol.;&&&&a&undefined.0&&&&&1&&&N.
H01.035&mcs&0&N&AL is a 21 year old woman who has come to the internal medicine clinic due to complaints of headaches.  The Nurse Practitioner notices that AL has bare spots 	on her scalp and only scant eyebrows and eyelashes.  AL admits that she pulls out her hair, eyebrows, and eyelashes.  The medication most likely to effectively treat AL is which of the following?&Clomipramine 200 mg Q AM&Desipramine 50 mg BID;Fluoxetine 40 mg QD;Risperidone 2 mg Q HS;&&&&a&undefined.0&&&&&1&&&N.
H01.036&mcs&0&N&Which of the following is the most likely initial presentation for a patient 	suffering from GAD?&Visits family practitioner complaining of nonspecific headaches and irritable bowel&Visits a psychiatrist complaining of hearing voices;Visits local hospital Emergency Department complaining of severe pelvic pain and requesting  intravenous narcotics;Brought into local hospital Emergency Department by police, appears disorients and agitated.;&&&&a&undefined.0&&&&&1&&&N.
H01.037&mcs&0&N&RQ is a bus driver who suffers from GAD.  She doesn't want to take anything that will impair her driving so her doctor prescribed buspirone 10 mg TID, which 	she has taken for two months.  She has shown no response and still feels anxious.  She hurt her neck lifting weights and takes Tylenol #3 for a pinched nerve.  The most appropriate course of action is which of the following?&Stop buspirone and begin venlafaxine 37.5 mg BID&Continue buspirone for another two weeks before making any changes;Augment buspirone with 0.125 mg BID of alprazolam;Stop buspirone and begin paroxetine 20 mg QD;&&&&a&undefined.0&&&&&1&&&N.
H01.038&mcs&0&N&VL is a 64 year old accountant with GAD.  He has received clonazepam 1 mg BID for the last 6 weeks.  He has responded well but doesn't like taking medications and would like to stop taking the medication  His physician has suggested that he slowly taper the clonazepam  over the next month.  Which statement is true regarding VL?&He has an approximately 50% chance of relapsing after stopping the clonazepam&If he had continued clonazepam 1 mg BID the anxiolytic effect would have decreased over the next 6 weeks.;He needs to be tapered off of clonazepam because he has become addicted to it.;If he relapses after stopping clonazepam he should reinstate treatment with alprazolam because it's more effective for GAD;&&&&a&undefined.0&&&&&1&&&N.
H01.039&mcs&0&N&PW is a 27 year old man who works as an elementary school teacher.  He is 5'10" and weighs 310 lbs.  He impulsively binges at home, especially after work and on week ends.  He eats between 2000 and 5000 calories during a binge over an approximately 30 minute period.  He feel unhappy and disgusted with himself afterwards.  He has attempted suicide on many occasions and feels chronically empty.  He has a history of intense and unstable personal relationships that end abruptly.  PW's behaviors are most consistent with which of the following diagnoses?	&Binge eating disorder, borderline personality disorder&Bulimia nervosa, histrionic personality disorder;Binge eating disorder, schizotypal personality disorder;Bulimia nervosa, antisocial personality disorder;&&&&a&undefined.0&&&&&1&&&N.
H01.040&mcs&0&N&AB is a 16 year-old woman.  She is 5'6" and weighs 97 lbs.  On physical exam she appears essentially normal except for bilateral swelling around her jaw, a 	callus on the top of her right hand, and discolored and worn-appearing enamel on her teeth.  Additionally, her menstrual periods have been absent for the past 2 years.  AB most likely suffers from which of the following?&Anorexia nervosa, bingeing/purging subtype&Bulimia nervosa, purging type;Anorexia nervosa, restrictive subtype;Bulimia nervosa, nonpurging subtype;&&&&a&undefined.0&&&&&1&&&N.
H01.041&mcs&0&N&TM is a 24 year old woman with borderline personality disorder and complaints 	of: feelings of emptiness and abandonment, rapidly fluctuating moods, suicidal ideation, interpersonal sensitivity, low self-esteem, and irritability.  She has just been started on fluoxetine 20 mg QD.  The symptoms most likely to respond to fluoxetine treatment include which of the following?&Suicidal ideation, fluctuating moods, and irritability&Interpersonal sensitivity, irritability, and suicidality;Irritability, feelings of abandonment and rapidly fluctuating moods.;Feelings of abandonment, low self-esteem, and suicidal ideation.;&&&&a&undefined.0&&&&&1&&&N.
H01.042&mcs&0&N&LO is a 29 year old woman with a long-standing diagnosis of borderline personality disorder.  Over the last 3 years her mood lability and interpersonal sensitivity have shown some improvement with a regimen of valproic acid and psychotherapy.  Last year LO married and she now desires to start a family.  She wants to continue receiving medication and psychotherapy.  Which of the following would be the best way to manage LO's medication?	&Switch from valproic acid to fluoxetine&Leave her on valproic acid;Switch from valproic acid to carbamazepine;Switch from valproic acid to lithium;&&&&a&undefined.0&&&&&1&&&N.
H01.043&mcs&0&N&ET is a 22 year-old patient with bulimia nervosa.  Approximately 6 months ago 	she received treatment with desipramine for her bulimia nervosa.  Her bingeing 	and purging episodes decreased by about 60% for the 6 month period during 	which she took the medication.  However, upon discontinuing desipramine she 	rapidly relapsed.  Which regimen is likely to be associated with the best and 	longest lasting response in ET?&Cognitive Behavioral Therapy plus fluoxetine&Cognitive Behavioral Therapy;Retreatment with desipramine;Fluoxetine alone;&&&&a&undefined.0&&&&&1&&&N.
H01.044&mcs&0&N&GG is a 22 year-old woman who suffers from anorexia nervosa.  She is 5'4" and 	weighs 86 lbs.  Her anorexia began at the age of 13 and she has only had 2 spontaneous menstrual periods over the past 9 years.  She is disturbed to find that she has osteoporosis.  Which regimen is most likely to at least partially restore 	bone density in GG?&rIGF-1 plus oral contraceptives&Oral contraceptives plus calcium;Vitamin D plus calcium;rIGF-1 plus Vitamin D;&&&&a&undefined.0&&&&&1&&&N.
H01.045&mcs&0&N&An 82 year-old man with a 35 year history of depression is severely emaciated, dehydrated and catatonic upon admission to the hospital.  Four weeks ago, the man began withdrawing from relatives, talking constantly about death, and stopped eating and drinking unless prompted by his daughter.  He has lost more than 20 lbs.  Prior to exhibiting these symptoms the man was healthy.  After the patient is medically stabilized, the treatment of choice would be:	&Electroconvulsive therapy&Fluoxetine;Desipramine;Haloperidol;&&&&a&undefined.0&&&&&1&&&N.
H01.046&mcs&0&N&RS, a 69 year old woman goes to her psychiatrist office for her monthly visit, and 	is diagnosed with depression.  Sertraline 50 mg is initiated, and she is given a 6-month supply.  A follow-up appointment is made for 6 months from today.  On follow-up RS complains that she is still experiencing symptoms of depression.  What medication change would you recommend?    	&Maximize the sertraline dose.&Stop sertraline and start paroxetine;Stop sertraline and start venlafaxine;Decrease the sertraline dose gradually and overlap with venlafaxine.;&&&&a&undefined.0&&&&&1&&&N.
H01.047&mcs&0&N&A 72 year-old man is started on nefazodone.  What monitoring exam would you recommend at baseline and follow-up?&LFTs&EKG;HAM-D;Lipid profile;&&&&a&undefined.0&&&&&1&&&N.
H01.048&mcs&0&N&CD is a 59 year-old female who was taken to the emergency room after she was discovered by her husband in the bathtub with her wrists cut.  Her cuts were superficial, and after they were bandaged, CD was admitted to the psychiatric unit for a work up. CD�s husband reports that she has been sleeping poorly over 	the last month, she hardly eats anything and he believes that she has lost weight.  	He states that she does not want to go out at all, even though she used to enjoy 	going out to the movies and dinner every weekend.  He also states that their sex life has suffered over the last six months.  In a private conversation, CD admits 	that she had been hearing voices telling her that she is worthless and should kill herself.  Based on the symptoms listed above, which of the following combinations of medications would be the best choice for treating CD�s symptoms?&Sertraline and risperidone&Olanzapine and lithium;Topiramate and paroxetine;Lithium and fluoxetine;&&&&a&undefined.0&&&&&1&&&N.
H01.049&mcs&0&N&Mr. C, a 76 year old male, was brought into the hospital after having to be �talked 	down� from a local bridge.  When asked, he describes overwhelming feelings of sadness and guilt.  He also complains that he has not been sleeping or eating 	and that he has experienced a 15 lb. weight loss over the past six weeks.  This is 	his first episode of depression.  You decide at this point that the patient needs medication treatment.  His labs are within normal limits.  His EKG shows a 	prolonged QTc interval of 475 and bradycardia.  Which of the following medications would you choose to treat his illness?	&Paroxetine&Amitriptyline;Imipramine and olanzapine;Trazodone;&&&&a&undefined.0&&&&&1&&&N.
H01.050&mcs&0&N&Once Mr. C�s symptoms have remitted, how long should he stay on the antidepressant that you have chosen?&six months&one month;two months;forever;&&&&a&undefined.0&&&&&1&&&N.
H01.051&mcs&0&N&Mr. C. will be seen for follow-up of his response to antidepressant therapy at monthly intervals.  Which of the following self-rated rating scales would you have him fill out at his clinic visit to determine his response to medication?&Beck Depression Inventory&Hamilton Rating Scale for Depression;Montgomery-Asberg Depression Rating Scale;Clinical Global Improvement Scale;&&&&a&undefined.0&&&&&1&&&N.
H01.052&mcs&0&N&<b><i>LM, a patient in your clinic was recently diagnosed with schizophrenia and started on therapy with risperidone.  She has no other medical conditions.</i></b><br><br>Upon counseling LM, how long will you tell her that it will take for her auditory hallucinations to significantly resolve?	&One month&One day;One week;One year;&&&&a&undefined.0&&&&&1&&&N.
H01.053&mcs&0&N&LM has been receiving risperidone for one week and has returned to your clinic 	for follow-up.  Which of the following rating scales would you use to monitor for 	response of her positive and negative symptoms to medication?&Brief Psychiatric Rating Scale&Montgomery Asberg Scale;Barnes Akathisia Scale;Clinical Global Impression Scale;&&&&a&undefined.0&&&&&1&&&N.
H01.054&mcs&0&N&A 35 year old male is brought into the emergency department for an acute 	psychotic episode.  He received haloperidol 5 mg IM upon admission.  Although 	he appears calmer and more sedated, he is complaining of stiffness, in his back 	and neck, as well as tongue swelling.  What medication would you recommend 	for him?&diphenhydramine 25 mg IM &haloperidol 5 mg po;lorazepam 1 mg IM;flumazenil 0.2 mg IV;&&&&a&undefined.0&&&&&1&&&N.
H01.055&mcs&0&N&A patient with a long history of schizophrenia has primary symptoms of flat 	affect, withdrawn behavior, poor grooming and auditory hallucinations. He has 	taken multiple medications in the past with only partial response.  Which of the 	following medications would be most likely to improve both his positive and 	negative symptoms?	&clozapine&thioridazine;haloperidol;fluphenazine;&&&&a&undefined.0&&&&&1&&&N.
H01.056&mcs&0&N&AS , a 55 year old male, is admitted to the inpatient psychiatric unit with auditory 	hallucinations and paranoa..  Initial monitoring tests show a previous myocardial 	infarction, coronary artery disease, and the EKG shows a QTc of 435.  Which of 	the following antipsychotics would you recommend for AS?&Risperidal&Chlorpromazine;Thioridazine;Ziprasidone;&&&&a&undefined.0&&&&&1&&&N.
H01.057&mcs&0&N&JD, a 49 year old female, with a long history of schizophrenia comes to your 	clinic for the first time.  She is currently stabilized on olanzepine. Her medical 	history is significant for hypertension and obesity.  Which of the following labs 	are most important to monitor in this patient?	&Blood glucose and lipids&Thyroid function tests and lipids;Liver function test and thyroid function test;Lipids and liver function tests;&&&&a&undefined.0&&&&&1&&&N.
H01.058&mcs&0&N&KJ is hospitalized secondary to noncompliance with his thiothixene.  He states 	that is makes him feel restless.  Which of the following medications would you 	recommend to treat the restlessness?&Propranolol&Diphenhydramine;Physostigmine;Bromocriptine;&&&&a&undefined.0&&&&&1&&&N.
H01.059&mcs&0&N&<i><b>PZ is a 30 year old male with Fragile X syndrome.  He functions in the severe 	range of mental retardation.  He is referred for psychiatric assessment for 	severe 	self-injurious behaviors.  The behaviors occur whenever he is in 	situations where he is in contact with unfamiliar people or situations.  These 	behaviors have interfered with his ability to participate in group activities, 	receive ADL training, and obtain medical attention.  They manifest as 	banging the base of his hands on the sides of his head whenever he is asked 	to be removed from his residence.  There are no associated changes in appetite 	or sleep.  He currently has no significant medical conditions and is not 	receiving any medications.  The psychiatrist orders a referral for a 	functional analysis.</i></b><br><br>How could a functional analysis be useful in the assessment and management of 	PZ?&To identify specific environmental factors contributing to PZ�s behavior&To determine which drug treatments are indicated for PZ;To assess PZ�s intellect and adaptive functioning;To diagnose Axis I mental illness which may be present in PZ;&&&&a&undefined.0&&&&&1&&&N.
H01.060&mcs&0&N&Which of the following is true regarding psychopathology in individuals with 	Fragile X Syndrome?&Social withdrawal and discomfort around others is consistent with autism 	or social phobia&Females affected with Fragile X syndrome typically display more severe symptoms than males;Symptoms resembling ADHD are rare;Premature development of cognitive disorders has been frequently noted;&&&&a&undefined.0&&&&&1&&&N.
H01.061&mcs&0&N&JB is a 27 year old male with Autistic Disorder functioning in the profound range 	of mental retardation.  He is nonverbal, but has been trained to perform basic 	ADL�s.  He has displayed a chronic pattern of ritualistic behaviors, including 	playing with his shoelaces, rearranging furniture, and picking up lint from the 	floor.   He often becomes aggressive toward staff when they attempt to redirect 	him from these rituals. These behaviors have prevented him from benefiting from occupational and recreational programming.  What is best initial drug treatment for JB�s behaviors?	&Risperidone 1 mg po BID&Thioridazine 50 mg po BID;Divalproex 500 mg po BID;Fluvoxamine 50 mg po BID;&&&&a&undefined.0&&&&&1&&&N.
H01.062&mcs&0&N&Which of the following is true regarding communication in individuals with 	Aspberger�s Syndrome?&Vocabulary is not significantly restricted and speech is often verbose&Verbal communication develops normally until adolescence and then gradually regresses;Many individuals never speak;Nonverbal communication in social situations is generally intact;&&&&a&undefined.0&&&&&1&&&N.
H01.063&mcs&0&N&LT is a 29 year old male with mild mental retardation.  He is referred for a 	medical workup for evaluation of a recent 12-pound weight loss (from baseline 	weight of 176 pounds).   He has been in good health prior to this weight loss.  Upon physical examination, he appears sluggish and is malodorous.  There is a 	long scar on the distal aspect of his left arm.  Although he is verbal, he only 	minimally participates with the physician�s history-taking.  After some prodding, 	he reveals that he has been very upset after the recent death of his brother and that 	he feels responsible for the motor vehicle accident that took his life.  The scar on his arm was determined to be from a suicide attempt.  What is the best treatment for LT?	&Citalopram 20 mg po QD&Oxcarbazepine 600 mg po BID;Olanzapine 10 mg po qhs;Methylphenidate 5 mg po qam and noon;&&&&a&undefined.0&&&&&1&&&N.
H01.064&mcs&0&N&The pharmacokinetics of which of the following anticonvulsants is most affected 	by severe renal impairmen&Levetiracetam&Zonisamide;Lamotrigine;Topiramate;&&&&a&undefined.0&&&&&1&&&N.
H01.065&mcs&0&N&<b><i>KJ is a 67 year old male with diagnosed with Parkinson�s disease seven years ago.  He exhibits symptoms of rigidity and bradykinesia that are well controlled 	with medication.  He currently receives the following:</i></b><br><br>	     <li> Sinimet CR 50/200 1 tab po TID	     <li> Ropinirole 1 mg po TID	     <li> Vitamin E 800 IU po BID <br><br><b><i>KJ�s wife is complaining that he is acting very paranoid recently.  He has been 	accusing her of stealing his personal items whenever he misplaces them in the 	house.  This frequently presents with combative behaviors.  As his primary 	caretaker, the wife is becoming very frustrated with this behavior.</i></b><br><br>Which of the following is the best initial regimen for KJ�s symptoms?&Quetiapine 12.5 mg po qhs&Selegiline 5 mg po BID;Tolcapone 100 mg po BID;Clozapine 25 mg po BID;&&&&a&undefined.0&&&&&1&&&N.
H01.066&mcs&0&N&<b><i>BK, a 33-year-old female, is complaining of recurrent headaches that started 	shortly after beginning a new job. Prior to this time, she experienced headaches 	infrequently. She describes the headaches as a constant, dull, pressure around 	her head. KB rates the typical severity as 7/10. The headaches are usually associated with tightness in her neck. The headaches usually start late in the day and last for  several hours. She denies GI upset or visual disturbances.  She is allergic to aspirin (wheezing), so she has taken acetaminophen products with little relief.</i></b><br><br> What abortive therapy is indicated for BK�s headaches?&Sumatriptan 25-50 mg po at onset of headache&Ibuprofen 400 mg po q 4 hr PRN;Tylenol #3 1 tablet po q 4-6 hr PRN;Propranolol 20 mg po BID;&&&&a&undefined.0&&&&&1&&&N.
H01.067&mcs&0&N&Which of the following is the best initial prophylactic regimen for BK?	&Imipramine 25 mf po qhs&Methysergide 2 mg po BID;Lithium 300 mg po BID;Frovatriptan 5 mg po qd;&&&&a&undefined.0&&&&&1&&&N.
H01.068&mcs&0&N&Which of the following treatments is the best initial treatment of diabetic peripheral neuropathy?	&Gabapentin 600 mg po BID&Lamotrigine 100 mg po BID;Clonidine 0.1 mg po BID;Propoxyphene/Acetaminophen 1 tablet po QID;&&&&a&undefined.0&&&&&1&&&N.
H01.069&mcs&0&N&<i><b>A 52 week randomized, double-blind study compared aripiprazole 30 mg/d with 	haloperidol 10 mg/d for the treatment of 1,294 patients with acute relapse of 	chronic schizophrenia.  One of the key outcomes of the study was the percent 	patients with a decrease of 20% in the PANSS total at any time.  The results 	were 72% for aripiprazole compared to 69% for haloperidol (not statistically 	different).  The secondary outcome was a decrease of 30% in the PANSS 	total at any time.  Aripiprazole was 52% of patients compared to haloperidol 	44% (p=0.003).  (Kujawa M, Saha A, Ingenito GG, et al.  Aripiprazole for 	long-term maintenance treatment of schizophrenia.  Poster presented at 	XXIII 	Collegium Internationale Neuropsychopharmacologicum Congress, June 23-	27, 2002 Montreal, Candada)</i></b><br><br>The study design for this study is:	&Experimental&Case Control;Descriptive;Follow-up;&&&&a&undefined.0&&&&&1&&&N.
H01.070&mcs&0&N&Which of the following would have introduced more bias into the study?	&Using a single-blind methodology&Using block randomization;Having one investigator conduct all of the patient evaluations;Adding pill counts to assess compliance;&&&&a&undefined.0&&&&&1&&&N.
H01.071&mcs&0&N&You criticize this study because the researchers did not compare aripiprazole with atypical antipsychotic agents since that is what you see more commonly used in your practice.  This issue would be an example of which of the following study design issues?	&External validity&Internal validity;Reliability;Instrument validity;&&&&a&undefined.0&&&&&1&&&N.
H01.072&mcs&0&N&If the PANSS was the only assessment used to assess if patients responded to therapy, and you believe other instruments should have been used to assess clinical response, bias could be introduced in the study.  Which type of bias would 	this most closely represent this issue?	&Classification bias&Selection bias;Compliance bias;Hawthorne effect;&&&&a&undefined.0&&&&&1&&&N.
H01.073&mcs&0&N&Which of the following is the most appropriate interpretation of the p value of 	0.003 for the secondary endpoint?&This represents the probability the result is due to chance alone (in this case 3 in 1000).&Because this value is <0.05 it means the results are clinically useful.;A p value of 0.003 represents a far more important result than a value of 0.04.;Represents the probability the authors made a Type II error in interpreting their results.;&&&&a&undefined.0&&&&&1&&&N.
H01.074&mcs&0&N&Calculate the number needed to treat for the secondary outcome.&12.5&1.4;8;20;&&&&a&undefined.0&&&&&1&&&N.
H01.075&mcs&0&N&Which of the following is a limitation of randomized clinical trials when trying to apply the information to patient care situations?	&Patients with specific characteristics are included in the trial.&Measurements are standardized.;Randomization;Double-blinding;&&&&a&undefined.0&&&&&1&&&N.
H01.076&mcs&0&N&Which of the following is true concerning outcome studies?	&Uses a more heterogeneous study sample.&Is not scientific;Do not usually use statistics;Have limited applicability;&&&&a&undefined.0&&&&&1&&&N.
H01.077&mcs&0&N&A health care organization viewed zolpidem and zaleplon therapeutically 	equivalent with equal outcomes in terms of efficacy and similar side effects.  If you did a pharmacoeconomic evaluation on this issue, which type of study would it be?	&Cost-minimization&Cost-effectiveness;Cost-utility;Cost-benefit;&&&&a&undefined.0&&&&&1&&&N.
H01.078&mcs&0&N&You are evaluating aripiprazole and want to compare the outcomes to haloperidol.  These drugs have different efficacy depending on which measurement you select 	and very different adverse effect profiles. If you did a pharmacoeconomic evaluation on this issue, which type of study would it be?	&Cost-effectiveness&Cost-minimization;Cost-utility;Cost-benefit;&&&&a&undefined.0&&&&&1&&&N.
H01.079&mcs&0&N&An example of a humanistic outcome in managing chronic schizophrenia would be:	&Social relationships&Cost of laboratory testing;PANASS score;BPRS score;&&&&a&undefined.0&&&&&1&&&N.
H01.080&mcs&0&N&Dominance refers to:	&The concept of which issues merit doing a pharmacoeconomic analysis, such as the high cost but higher effectiveness drugs&That you should always use the least costly alternative when conducting a pharmacoeconomic analysis.;The least costly branch on  a decision analysis;Redoing the analysis to determine the range of plausible values.;&&&&a&undefined.0&&&&&1&&&N.
H01.081&mcs&0&Y&Question&1&2;3;4;&&&&a&undefined.0&&&&&1&&&N.