PRITE 2024- 2025 (PART II) QUESTIONS AND ANSWERS BASED
ON FINAL EXAMS VERIFIED!!
1. A patient's spouse calls the patient's psychiatrist to ask about changes in the patient's
medication. Which of the following would be an appropriate initial response for the psychiatrist
to make?
A. Invite the spouse to share information in person.
B. Inform the spouse that the psychiatrist cannot accept the call.
C. Discuss the rationale for changes in the patient's medication with the spouse.
D. Listen to the spouse's information and give the reason for changes in the patient's medication.
E. Inform the spouse that the patient's consent is required to discuss treatment.
Correct answer: E
2. A 71-year-old nursing home resident experiences symptoms including Parkinsonian gait
disturbance, prominent delusions, fluctuation in level of attention, visual hallucinations, and
sensitivity to the extrapyramidal effects of antipsychotic medications. This clinical presentation
is most consistent with which of the following diagnoses?
A. Frontal dementia
B. Vascular dementia
C. Dementia with Lewy bodies
D. Normal pressure hydrocephalus
E. Alzheimer disease
Correct answer: C
3. A 44-year-old man, found wandering aimlessly, is brought to the emergency department by
police. Blood pressure is 200/132 and heart rate is 112 and regular. The patient is belligerent,
picking at his skin, and reporting feeling crawling insects on his skin. The patient is oriented only
to name, is tremulous, and is unable to cooperate with a thorough neurological examination. The
patient is diaphoretic and his pupils are dilated. The patient has palmar erythema and spider
,angiomata on the chest. Which of the following is the most likely explanation for the patient's
symptoms?
A. Opioid withdrawal
B. Psilocybin intoxication
C. Phencyclidine (PCP) intoxication
D. Schizophrenia, paranoid type
E. Delirium tremens
Correct answer: E
4. A 55-year-old married woman with a steady job continues to intermittently feel very sad about
her 7-year-old child passing away from leukemia 25 years ago, often still thinking and
wondering what the child would be doing if he had lived. While she feels stressed about her
work, she still enjoys spending time with her grandchildren and is able to sleep and eat well.
Which of the following best describes this woman's continued thoughts of her deceased child?
A. Appropriate reaction to a significant loss
B. Indication of undiagnosed depression
C. Sign of problematic character traits
D. Symptom of complicated bereavement
E. Symptom of delayed mourning
Correct answer: A
5. Mirtazapine mediates increased release of norepinephrine and serotonin through which of the
following mechanisms?
A. Serotonin reuptake inhibition
B. Alpha 2-adrenergic blockade
,C. Cholinergic receptor antagonism
D. Alpha 1-adrenergic blockade
E. Dopamine reuptake inhibition
Correct answer: B
6. A 6-year-old child is generally healthy, but throws a tantrum every time the family goes
hiking. Exposure to a snake during one hike led the child to become loud and agitated. The child
now experiences intense distress when hiking, and pleads to stay next to the parents at all times.
Which of the following is the most likely diagnosis?
A. Panic disorder
B. Specific phobia
C. Generalized anxiety disorder
D. Posttraumatic stress disorder (PTSD)
E. Obsessive-compulsive disorder (OCD)
Correct answer: B
7. Use of which of the following substances in adolescence has been associated with subsequent
development of schizophrenia?
A. LSD
B. Cocaine
C. Cannabis
D. Methamphetamine
E. Phencyclidine (PCP)
Correct answer: C
, 8. A 65-year-old patient has fallen several times over the past 6 months. The patient's mental
status exam is normal. Smooth pursuit and saccadic movements are impaired, more prominently
for vertical gaze, but full range of motion is easily elicited by doll's head maneuvers. The patient
has mild symmetric rigidity and bradykinesia. There is no tremor. A brain magnetic resonance
imaging (MRI) scan is unremarkable, as are the results of cerebrospinal fluid (CSF) and routine
laboratories, including toxic drug screens. Which of the following is the most likely patient
diagnosis?
A. Corticobasal degeneration
B. Olivopontocerebellar degeneration
C. Idiopathic Parkinson disease
D. Primary progressive aphasia
E. Progressive supranuclear palsy
Correct answer: E
9. A 35-year-old patient with chronic insomnia is evaluated in a sleep laboratory. The
polysomnographic tracing indicates that the patient fell asleep in 10 minutes, slept for 7 hours
with 90% efficiency and had few awakenings. However, the patient maintains that it took at least
one hour to fall asleep, with frequent nighttime awakenings and less than 2 hours of total sleep.
Medical and psychiatric workups are negative. Which of the following is the best diagnosis to
account for the difference between the sleep laboratory findings and the patient's own report?
A. Factitious disorder
B. Paradoxical insomnia
C. Somatoform disorder
D. REM sleep behavior disorder
E. Histrionic personality disorder
answers: B
11. Acamprosate is thought to exert its action through which of the following neurotransmitter
systems?
ON FINAL EXAMS VERIFIED!!
1. A patient's spouse calls the patient's psychiatrist to ask about changes in the patient's
medication. Which of the following would be an appropriate initial response for the psychiatrist
to make?
A. Invite the spouse to share information in person.
B. Inform the spouse that the psychiatrist cannot accept the call.
C. Discuss the rationale for changes in the patient's medication with the spouse.
D. Listen to the spouse's information and give the reason for changes in the patient's medication.
E. Inform the spouse that the patient's consent is required to discuss treatment.
Correct answer: E
2. A 71-year-old nursing home resident experiences symptoms including Parkinsonian gait
disturbance, prominent delusions, fluctuation in level of attention, visual hallucinations, and
sensitivity to the extrapyramidal effects of antipsychotic medications. This clinical presentation
is most consistent with which of the following diagnoses?
A. Frontal dementia
B. Vascular dementia
C. Dementia with Lewy bodies
D. Normal pressure hydrocephalus
E. Alzheimer disease
Correct answer: C
3. A 44-year-old man, found wandering aimlessly, is brought to the emergency department by
police. Blood pressure is 200/132 and heart rate is 112 and regular. The patient is belligerent,
picking at his skin, and reporting feeling crawling insects on his skin. The patient is oriented only
to name, is tremulous, and is unable to cooperate with a thorough neurological examination. The
patient is diaphoretic and his pupils are dilated. The patient has palmar erythema and spider
,angiomata on the chest. Which of the following is the most likely explanation for the patient's
symptoms?
A. Opioid withdrawal
B. Psilocybin intoxication
C. Phencyclidine (PCP) intoxication
D. Schizophrenia, paranoid type
E. Delirium tremens
Correct answer: E
4. A 55-year-old married woman with a steady job continues to intermittently feel very sad about
her 7-year-old child passing away from leukemia 25 years ago, often still thinking and
wondering what the child would be doing if he had lived. While she feels stressed about her
work, she still enjoys spending time with her grandchildren and is able to sleep and eat well.
Which of the following best describes this woman's continued thoughts of her deceased child?
A. Appropriate reaction to a significant loss
B. Indication of undiagnosed depression
C. Sign of problematic character traits
D. Symptom of complicated bereavement
E. Symptom of delayed mourning
Correct answer: A
5. Mirtazapine mediates increased release of norepinephrine and serotonin through which of the
following mechanisms?
A. Serotonin reuptake inhibition
B. Alpha 2-adrenergic blockade
,C. Cholinergic receptor antagonism
D. Alpha 1-adrenergic blockade
E. Dopamine reuptake inhibition
Correct answer: B
6. A 6-year-old child is generally healthy, but throws a tantrum every time the family goes
hiking. Exposure to a snake during one hike led the child to become loud and agitated. The child
now experiences intense distress when hiking, and pleads to stay next to the parents at all times.
Which of the following is the most likely diagnosis?
A. Panic disorder
B. Specific phobia
C. Generalized anxiety disorder
D. Posttraumatic stress disorder (PTSD)
E. Obsessive-compulsive disorder (OCD)
Correct answer: B
7. Use of which of the following substances in adolescence has been associated with subsequent
development of schizophrenia?
A. LSD
B. Cocaine
C. Cannabis
D. Methamphetamine
E. Phencyclidine (PCP)
Correct answer: C
, 8. A 65-year-old patient has fallen several times over the past 6 months. The patient's mental
status exam is normal. Smooth pursuit and saccadic movements are impaired, more prominently
for vertical gaze, but full range of motion is easily elicited by doll's head maneuvers. The patient
has mild symmetric rigidity and bradykinesia. There is no tremor. A brain magnetic resonance
imaging (MRI) scan is unremarkable, as are the results of cerebrospinal fluid (CSF) and routine
laboratories, including toxic drug screens. Which of the following is the most likely patient
diagnosis?
A. Corticobasal degeneration
B. Olivopontocerebellar degeneration
C. Idiopathic Parkinson disease
D. Primary progressive aphasia
E. Progressive supranuclear palsy
Correct answer: E
9. A 35-year-old patient with chronic insomnia is evaluated in a sleep laboratory. The
polysomnographic tracing indicates that the patient fell asleep in 10 minutes, slept for 7 hours
with 90% efficiency and had few awakenings. However, the patient maintains that it took at least
one hour to fall asleep, with frequent nighttime awakenings and less than 2 hours of total sleep.
Medical and psychiatric workups are negative. Which of the following is the best diagnosis to
account for the difference between the sleep laboratory findings and the patient's own report?
A. Factitious disorder
B. Paradoxical insomnia
C. Somatoform disorder
D. REM sleep behavior disorder
E. Histrionic personality disorder
answers: B
11. Acamprosate is thought to exert its action through which of the following neurotransmitter
systems?
