BLOCK 1 PSYCHE REVIEW

1.

A 70 y/o F presents to her PCP complaining of fatigue for the past 7 weeks. She admits to difficulty falling asleep, poor appetite w/ a 10# wt
loss, & thoughts of wanting to die. She admits to having had symptoms similar to these on several occasions in the past, but never this bad.
Her medical probs include asthma & high cholesterol. She uses an albuterol inhaler PRN only. Which of the following symptoms is necessary
in order to make a diagnosis of major depressive disorder?
a. Depressed mood
b. Decreased appetite
c. Excessive guilt
d. Fatigue
e. Suicidal ideation
2. According to Erikson, which of the following is a major developmental task for most kids around 15 yr of age?
a. Developing a clear identity
b. Developing a sense of integrity
c. Developing intimate relationships
d. Learning about sex
e. Learning to be independent
3. A young child is able to walk when held by 1 hand & speaks in strings of unrecognizable words. When placed in a room w/ other kids, the child
stays close to his mother but plays by himself. Based on these observations, in the next 6-8 months the child is most likely to learn to:
a. Ride a tricycle
b. Stand on his tiptoes
c. Draw a circle
d. Build a tower of blocks
e. Play peek-a-boo
4. A 3 y/o boy speaks in sentences. He can ride a tricycle, but cannot ride a bicycle. He scribbles spontaneously but cannot copy a line. He
knows his name & gender but doesnt play competitive games. Which of the following developmental aspects is likely delayed in this patient?
a. Social
b. Gross motor
c. Language
d. Fine motor
e. Behavioral
5. A 60 y/o M come to the MD bc he has been feeling depressed after the death of his wife 2 months ago. He says he has had a hard time
sleeping & even has imagined that she is still in their home w/ him. He has not been able to return to work yet & has difficulty motivating
himself to resume his normal activities. What additional symptom would cause the MD to diagnose the pt w/ abnormal grieving?
a. Delusions that his wife is controlling his thoughts
b. Depressive symptoms
c. Experiences the anniversary reaction, in which symptoms of grief reoccur on anniversaries or holidays
d. Guilt that causes him to blame himself for his wifes death
e. Initial denial that his wife had died
6. A 4 y/o boy has just been reunited w/ his biological mom after spending 6m in foster care. He was initially removed from his home for severe
neglect secondary to substance abuse. The boy is noted to play in a destructive & disorganized manner, throwing & breaking his toys. When
his mom tries to stop him from throwing blocks at her, he starts kicking & biting. Which of the following is the most likely diagnosis?
a. ODD oppositional defiant disorder
b. ADHD
c. Reactive attachment disorder
d. PTSD
e. Major depression
7. A child observed walking down the stairs using alternating feet, can throw & catch a ball, states her gender accurately & is able to correctly
name the colors of presented objects. Based on this evidence, which of the following geometric shapes did the child most recently learn to
draw?
a. Triangle
b. Diamond
c. Square
d. Cross
e. Circle
8. A 7 y/o child has been exhibiting impulsivity & disruptive behaviors at school. When further evaluation reveals that the child has been unable to
sleep at night for at least 3m out of fear that his parents may divorce, which of the following is an important diagnostic possibility?
a. Depression
b. ADHD
c. Conduct disorder
d. Generalized anxiety disorder
e. Separation anxiety disorder
9. An infant presents to the pedi MD for a routine check-up. His mother reports that he plays peek-a-boo at home, waves bye-bye, & will say
dada. He cannot yet drink from a cup. He seemed somewhat apprehensive when the MD entered the room. He can life his head when lying
on stomach, sit unassisted, & stand w/ help. He has a (+) Babinskis reflex. If this infant has met all his developmental milestones
appropriately, how old is he?
a. 4-5m
b. 7-11m
c. 12-15m
d. 18m
e. 24m
10. An 80 y/o F pt tells you that she is concerned bc she forgets the addresses of people she has just met & takes longer than in the past to do
the Sunday crossword puzzle. She plays cards regularly w/ friends, is well groomed, & shops & cooks for herself. This pt is probably:
a. Showing normal aging
b. Showing evidence of Alzheimer disease

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c. Experiencing depression
d. Developing an anxiety disorder
e. Unable to live alone
Jane, a 17 y/o new Yorker, presents to obstetrics clinic for her regular ante-natal check-up 1 wk after her scheduled apt. She seems a little
depressed & sad. She says she could visit on time as there was no one to bring her to the clinic. A factor which is probably not assoc w/
Janes pregnancy is:
a. Increased risk of birth of child earlier than 37w gestation
b. Increased risk of BP lower than normal limits
c. Increased risk of antepartum hemorrhage
d. Increased risk of child weighing < 2000g
Conformity w/peers is a core characteristic of a number of normative developmental stages. In general, conformity of children to the norms of
their peer groups is most intense at a time of development that also features:
a. Toilet training
b. Use of transition of objects
c. Focal attachment to the caretaker
d. Beginning of formal schooling
e. Puberty
Although much of human behavior is learned, infants are born w/ certain capacities. Which of the following important behavioral skills are
present in most infants at birth?
a. Following objects to midline
b. Laughing aloud
c. Putting feet in mouth
d. Reaching & grasping
e. Recognition of the mother
10 y/o F attains score of 44 on a standard intelligence test. A table showing median test score for specific ages.
AGE
7
8
9
10
11
12

MEDIAN SCORE
25
29
32
35
40
44

Based on this table, most likely the IQ for this 10 y/o girl is:

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20.

a. 85
b. 100
c. 120
d. 125
A 67 y/o F visits her MD 2 months after the death of her husband. She reports that she has difficulty sleeping & often finds herself crying at the
smallest things. The MD notices that she has lost wt & seems to avoid eye contact when interviewed. With some embarrassment, she
confesses that she came to see the MD after thinking that she saw her husband across the street in a crowd, an experience that left her
confused & shaken. At this point, the MDs best response would be to:
a. Ask her if she has much interest in sex lately
b. Ask her to talk about her relationship w/ her husband prior to his death
c. Detain her for observation as a suicide precaution
d. Tell her that these are normal reactions & that adjustment takes time
A 10 y/o child has an IQ of 60. The mental ability of this child is equivalent to that of a child aged:
a. 4y
b. 6y
c. 8y
d. 10y
Mild mental retardation is an IQ between:
a. 70-100
b. 50-69
c. 35-49
d. 20-34
Which of the following is not a projective test?
a. MMPI
b. Rorschach test
c. Sentence completion test
d. Thematic appreciation
Increase in penis width development of the glans, & darkening of scrotal skin characterize tanner stage:
a. 1
b. 2
c. 3
d. 4
e. 5
Mother is concern about her son bc he is engaging in behavior that is dangerous & potentially life threatening. The age of child is most likely:
a. 11y
b. 13y
c. 15y
d. 18y
e. 20y

21. A terminally ill pt who uses a statement such as It is the doctors fault that I become ill, doc didnt do EKG when I came for my last office visit,
is most likely in which stage of dying, according to Elizabeth Kubler-Ross?
a. Denial
b. Anger
c. Bargaining
d. Depression
e. Acceptance
22. A MD conducts a physical exam on an active, independent 75 y/o F. Which of the following is most likely?
a. Decrease in size of brain ventricle
b. Increase brain mass
c. Increase immune response
d. Decrease bladder control
e. Severe memory problem
23. 6 month after the death of a loved one. Which 1 of the following is most likely indicate that person is experiencing a complicated grief reaction?
a. Crying
b. Irritability
c. Illusion
d. Hallucination
e. Denial that the loved one has died
24. A girl tells her mother that she hates the boys bc they are noisy & stupid. The age of this girl is most likely:
a. 4y
b. 6y
c. 9y
d. 13y
e. 15y
25. A childs pet has recently died. The child believes that pet will soon come back to life. This child is most likely to be the age of:
a. 4y
b. 6y
c. 7y
d. 9y
e. 11y
26. A couple who are first time parents present to your office w/ concerns about their 3m old boy. They report that on being picked up from his crib,
he extends his arm & legs, & they feel this is not a natural response. You then tell them that this normal reaction is known as the:
a. Babinski reflex
b. Moro reflex
c. Palmar grasp
d. Rooting reflex
e. Tracking reflex
27. Ben is going to be 2y in 1 month time. However, his parents are very concerned bc he has been having frequent temper tantrums in public.
They discuss the problem w/ their family physician. What should the MD recommend?
a. Avoid taking him to public places
b. Ignoring the tantrums as much as possible
c. Punishing him after the tantrum has stopped
d. Spanking him while he is throwing a tantrum
e. Threatening to desert him in the place where tantrum occur
28. John is healthy 2m old infant, who has appropriate motor & social development for his age. Whenever someone gets his attn., he coos & also
gurgles. He also follows his fathers face as his father moves from 1 side to the other. This pattern of following his fathers face disappear at:
a. 3m
b. 4m
c. 12m
d. Continues to childhood
29. Gregory is a child who can say his own name & also has the motor strength to throw a ball on his own. When you call him towards you, he
takes a few steps towards you, but then goes back to his mom. Gregory is probably:
a. 15m
b. 18m
c. 24m
30. Control of bowels is attained at:
a. First 3m of life only
b. First 12-18m of life
c. 2y
d. 3y
e. 4y
31. A child is able to eat food using a spoon & fork by herself by:
a. First 3m of life only
b. First 12-18m of life
c. 2y
d. 3y
e. 4y
32. The palmar grasp reflex is present at birth. At what age does it normally disappear?
a. 2m
b. 3m
c. 4m
d. 12m
33. Roger lives in California w/ his parents & 2 older siblings. On examining him for a neurological assessment, the MD finds that on eliciting the
plantar reflex, Rogers big toe dorsiflexes & the other 4 toes fan out. The MD tells his parents that is was abnormal for his age & that he would
have to carry out more motor function tests on Roger. Roger probably is:
a. 2m

b. 6m
c. 10m
d. 24m
34. Laura is very energetic girl who takes care of herself very well. Her language ability & ability to comprehend to situations is appropriate to her
age. Her favorite game is soccer, which she plays w/ her friends who live in the same building. She asks you how she is different from her
friend Peter. She also talks about Anne, her friend. But, there is no Anne in her friends circle. Laura is probably aged:
a. 3 years
b. 4 years
c. 5 years
d. 6 years
35. Jennifer, a bubbly 12 year old girl, presents to the emergency room with complaints of abdominal pain and nausea vomiting since 2 days. You
take a detailed history and start examining her. You find that she has long and curly pubic hair. On examining her breasts, you find that her
areola is elevated more than the rest of her breast. Jennifer is in which phase of sexual development?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
e. Stage 5

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34.

E
B
D
D
A
C
D
E
B
A
B
E
D
C
D
B
B
A
D
C
B
D
D
C
A
B
B
D
B
D
C
D
D
B
35. C