NR547 DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH
PRACTICUM EXAM REVIEW
1. When differentiating between Major Depressive Disorder (MDD) and Hypothyroidism,
which laboratory finding is most critical for ruling out a medical cause for depressive
symptoms?
A. Comprehensive Metabolic Panel (CMP)
B. Complete Blood Count (CBC)
C. Thyroid Stimulating Hormone (TSH)
D. Urinalysis
Answer: C
Conceptual Explanation: Elevated TSH levels indicate hypothyroidism, which can present
with symptoms identical to MDD, such as fatigue, lethargy, and depressed mood.
,2. A 24-year-old patient presents with symptoms of mania lasting 4 days, including inflated
self-esteem and decreased need for sleep. There is no marked impairment in social
functioning. What is the most likely diagnosis?
A. Bipolar I Disorder
B. Brief Psychotic Disorder
C. Cyclothymic Disorder
D. Bipolar II Disorder
Answer: D
Conceptual Explanation: Bipolar II requires a hypomanic episode lasting at least 4 days
without significant impairment or hospitalization, whereas Bipolar I requires a full manic
episode (7 days or requiring hospitalization).
3. Which characteristic most distinguishes Delirium from Dementia in an elderly patient?
A. Acute onset and fluctuating course
B. Memory loss
C. Difficulty with word-finding
D. Apathy and withdrawal
Answer: A
Conceptual Explanation: Delirium is characterized by a rapid, acute onset and a
fluctuating level of consciousness, unlike the slow, progressive decline seen in Dementia.
, 4. In the differential diagnosis of ADHD in children, which condition is most often confused
with ADHD due to shared symptoms of irritability and distractibility?
A. Autism Spectrum Disorder
B. Generalized Anxiety Disorder
C. Conduct Disorder
D. Pediatric Bipolar Disorder
Answer: D
Conceptual Explanation: Pediatric Bipolar Disorder shares irritability and hyperactivity
with ADHD, but Bipolar is distinguished by episodic mood changes and decreased need for
sleep.
5. A patient exhibits intense fear of abandonment, unstable interpersonal relationships, and
chronic feelings of emptiness. Which Personality Disorder cluster does this belong to?
A. Cluster A
B. Cluster B
C. Cluster C
D. Cluster D
Answer: B
Conceptual Explanation: Borderline Personality Disorder is in Cluster B, which is
characterized by dramatic, emotional, or erratic behavior.
PSYCHIATRIC-MENTAL HEALTH
PRACTICUM EXAM REVIEW
1. When differentiating between Major Depressive Disorder (MDD) and Hypothyroidism,
which laboratory finding is most critical for ruling out a medical cause for depressive
symptoms?
A. Comprehensive Metabolic Panel (CMP)
B. Complete Blood Count (CBC)
C. Thyroid Stimulating Hormone (TSH)
D. Urinalysis
Answer: C
Conceptual Explanation: Elevated TSH levels indicate hypothyroidism, which can present
with symptoms identical to MDD, such as fatigue, lethargy, and depressed mood.
,2. A 24-year-old patient presents with symptoms of mania lasting 4 days, including inflated
self-esteem and decreased need for sleep. There is no marked impairment in social
functioning. What is the most likely diagnosis?
A. Bipolar I Disorder
B. Brief Psychotic Disorder
C. Cyclothymic Disorder
D. Bipolar II Disorder
Answer: D
Conceptual Explanation: Bipolar II requires a hypomanic episode lasting at least 4 days
without significant impairment or hospitalization, whereas Bipolar I requires a full manic
episode (7 days or requiring hospitalization).
3. Which characteristic most distinguishes Delirium from Dementia in an elderly patient?
A. Acute onset and fluctuating course
B. Memory loss
C. Difficulty with word-finding
D. Apathy and withdrawal
Answer: A
Conceptual Explanation: Delirium is characterized by a rapid, acute onset and a
fluctuating level of consciousness, unlike the slow, progressive decline seen in Dementia.
, 4. In the differential diagnosis of ADHD in children, which condition is most often confused
with ADHD due to shared symptoms of irritability and distractibility?
A. Autism Spectrum Disorder
B. Generalized Anxiety Disorder
C. Conduct Disorder
D. Pediatric Bipolar Disorder
Answer: D
Conceptual Explanation: Pediatric Bipolar Disorder shares irritability and hyperactivity
with ADHD, but Bipolar is distinguished by episodic mood changes and decreased need for
sleep.
5. A patient exhibits intense fear of abandonment, unstable interpersonal relationships, and
chronic feelings of emptiness. Which Personality Disorder cluster does this belong to?
A. Cluster A
B. Cluster B
C. Cluster C
D. Cluster D
Answer: B
Conceptual Explanation: Borderline Personality Disorder is in Cluster B, which is
characterized by dramatic, emotional, or erratic behavior.
