Test Bank for Kaplan and Sadock’s Synopsis
of Psychiatry 11th Edition Sadock
Questions, Answers & Rationales
1. A 24-year-old patient has had 8 days of elevated mood, decreased need for sleep, pressured
speech, grandiosity, and marked impairment requiring hospitalization. Which diagnosis best fits?
A. Cyclothymic disorder
B. Bipolar I disorder, current manic episode
C. Bipolar II disorder
D. Persistent depressive disorder
...,,,Answer,,,... B
Rationale: Bipolar I disorder is defined by at least one manic episode; hospitalization or severe impairment
strongly supports mania.
2. A patient with major depressive disorder has early-morning awakening, loss of appetite,
psychomotor retardation, and mood nonreactivity. Which specifier is most consis tent?
A. Atypical features
B. Melancholic features
C. Mixed features
D. Seasonal pattern
...,,,Answer,,,... B
Rationale: Melancholic features include anhedonia or nonreactive mood plus characteristic neurovegetative
and psychomotor changes.
3. Which neurotransmitter is most closely associated with the pathophysiology of Parkinson disease
and is also relevant to antipsychotic-induced extrapyramidal symptoms?
A. Dopamine
B. GABA
C. Glutamate
D. Acetylcholine
...,,,Answer,,,... A
Rationale: Dopamine deficiency in nigrostriatal pathways contributes to Parkinsonian symptoms; dopamine
receptor blockade can produce extrapyramidal effects.
4. A patient develops fever, severe muscle rigidity, autonomic instability, and elevated creatine kinase
after an antipsychotic dose increase. What is the most likely diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant catatonia
, D. Delirium tremens
...,,,Answer,,,... B
Rationale: Neuroleptic malignant syndrome is characterized by rigidity, hyperthermia, autonomic inst ability,
altered mental status, and elevated CK after dopamine blockade.
5. Which feature most strongly distinguishes delirium from dementia?
A. Memory impairment
B. Disorientation
C. Acute onset with fluctuating attention
D. Sleep disturbance
...,,,Answer,,,... C
Rationale: Delirium typically has an acute, fluctuating course with prominent disturbance of attention and
awareness.
6. A patient repeatedly experiences unexpected panic attacks and has persistent concern about
additional attacks. Which diagnosis is most appropriate?
A. Social anxiety disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Illness anxiety disorder
...,,,Answer,,,... B
Rationale: Panic disorder involves recurrent unexpected panic attacks followed by persistent concern or
maladaptive behavioral change.
7. Which psychotherapy has the strongest evidence base for obsessive -compulsive disorder?
A. Psychoanalysis alone
B. Exposure and response prevention
C. Supportive therapy alone
D. Dream analysis
...,,,Answer,,,... B
Rationale: Exposure and response prevention is a core cognitive-behavioral treatment for OCD.
8. A patient has hallucinations, delusions, and disorganized speech for 3 weeks, with eventual full
return to baseline. Which diagnosis is most likely?
A. Schizophrenia
B. Schizophrenif orm disorder
C. Brief psychotic disorder
D. Schizoaffective disorder
...,,,Answer,,,... B
Rationale: Schizophreniform disorder involves psychotic symptoms lasting at least 1 month but less than 6
months.
of Psychiatry 11th Edition Sadock
Questions, Answers & Rationales
1. A 24-year-old patient has had 8 days of elevated mood, decreased need for sleep, pressured
speech, grandiosity, and marked impairment requiring hospitalization. Which diagnosis best fits?
A. Cyclothymic disorder
B. Bipolar I disorder, current manic episode
C. Bipolar II disorder
D. Persistent depressive disorder
...,,,Answer,,,... B
Rationale: Bipolar I disorder is defined by at least one manic episode; hospitalization or severe impairment
strongly supports mania.
2. A patient with major depressive disorder has early-morning awakening, loss of appetite,
psychomotor retardation, and mood nonreactivity. Which specifier is most consis tent?
A. Atypical features
B. Melancholic features
C. Mixed features
D. Seasonal pattern
...,,,Answer,,,... B
Rationale: Melancholic features include anhedonia or nonreactive mood plus characteristic neurovegetative
and psychomotor changes.
3. Which neurotransmitter is most closely associated with the pathophysiology of Parkinson disease
and is also relevant to antipsychotic-induced extrapyramidal symptoms?
A. Dopamine
B. GABA
C. Glutamate
D. Acetylcholine
...,,,Answer,,,... A
Rationale: Dopamine deficiency in nigrostriatal pathways contributes to Parkinsonian symptoms; dopamine
receptor blockade can produce extrapyramidal effects.
4. A patient develops fever, severe muscle rigidity, autonomic instability, and elevated creatine kinase
after an antipsychotic dose increase. What is the most likely diagnosis?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant catatonia
, D. Delirium tremens
...,,,Answer,,,... B
Rationale: Neuroleptic malignant syndrome is characterized by rigidity, hyperthermia, autonomic inst ability,
altered mental status, and elevated CK after dopamine blockade.
5. Which feature most strongly distinguishes delirium from dementia?
A. Memory impairment
B. Disorientation
C. Acute onset with fluctuating attention
D. Sleep disturbance
...,,,Answer,,,... C
Rationale: Delirium typically has an acute, fluctuating course with prominent disturbance of attention and
awareness.
6. A patient repeatedly experiences unexpected panic attacks and has persistent concern about
additional attacks. Which diagnosis is most appropriate?
A. Social anxiety disorder
B. Panic disorder
C. Generalized anxiety disorder
D. Illness anxiety disorder
...,,,Answer,,,... B
Rationale: Panic disorder involves recurrent unexpected panic attacks followed by persistent concern or
maladaptive behavioral change.
7. Which psychotherapy has the strongest evidence base for obsessive -compulsive disorder?
A. Psychoanalysis alone
B. Exposure and response prevention
C. Supportive therapy alone
D. Dream analysis
...,,,Answer,,,... B
Rationale: Exposure and response prevention is a core cognitive-behavioral treatment for OCD.
8. A patient has hallucinations, delusions, and disorganized speech for 3 weeks, with eventual full
return to baseline. Which diagnosis is most likely?
A. Schizophrenia
B. Schizophrenif orm disorder
C. Brief psychotic disorder
D. Schizoaffective disorder
...,,,Answer,,,... B
Rationale: Schizophreniform disorder involves psychotic symptoms lasting at least 1 month but less than 6
months.
