Child, Organic & Miscellaneous MCQs

Psychiatry · 6 free questions with answers & explanations.

1. A 7-year-old boy is brought by his parents because his teacher reports he is disruptive in class, cannot sit still, frequently calls out answers before questions are completed, and is constantly losing his school supplies. At home he cannot complete tasks, is easily distracted, and his parents say 'his engine is always running.' His IQ testing is in the average range. Symptoms have been present since age 4 and occur in both school and home settings. What is the most appropriate first-line pharmacological treatment?
2. A 3-year-old boy is brought for evaluation because his parents are concerned about his development. He does not respond to his name being called, avoids eye contact, has not developed any words, prefers lining up toys over imaginative play, and becomes intensely distressed if his daily routine changes. He was a quiet infant who did not babble. Hearing is normal on audiology testing. What is the most likely diagnosis?
3. A 70-year-old retired professor is brought by his family because of gradual memory loss over 3 years. He initially forgot names and appointments, then became unable to recall recent events, and now cannot recognize close family members. He gets lost in familiar neighborhoods. His mood is stable and he has no focal neurological deficits. MRI shows bilateral hippocampal and entorhinal cortical atrophy. What is the most likely diagnosis, and which neurotransmitter deficit is most prominent?
4. A 75-year-old woman is admitted post-hip replacement surgery. On postoperative day 2 she becomes acutely confused, disoriented to time and place, agitated at night but drowsy during the day, and she is picking at her IV lines believing they are insects. Her nurse notes she was fully oriented on the evening before surgery. Which features of this presentation best distinguish this condition from dementia?
5. A 14-year-old girl is referred for evaluation of episodes where she suddenly stops responding, stares blankly for 10–20 seconds, then resumes normal activity without any postictal confusion. Her parents notice she sometimes performs purposeless lip-smacking during these episodes. EEG confirms the diagnosis. She is subsequently started on valproate. Six months later, she reports menstrual irregularities and weight gain, and her gynecologist detects polycystic ovaries on ultrasound. What is the most likely cause of the new findings?
6. A 10-year-old boy is referred for behavioral problems at school. He frequently defies teacher instructions, argues with adults, deliberately annoys classmates, and blames others for his mistakes. These behaviors have been present for at least 8 months and occur primarily at school, not at home. His academic performance is otherwise adequate. He has never destroyed property, stolen, or seriously violated others' rights. What is the most likely diagnosis?