PA PSYCHIATRY ACTUAL EXAM MARKING TIP 2025/2026
QUESTIONS WITH ANSWERS MARKED A+
✔✔PTSD vs acute stress disorder - ✔✔PTSD: event occurred any time in the past and
symptoms are >1 month
ASD: event occurred <1 month ago and symptoms last <1 month
✔✔Specific phobias and social phobia - ✔✔irrational fear that causes avoidance of the
feared object or situation.
A specific phobia is a strong, exaggerated fear of a specific object or situation
A social phobia (also called social anxiety disorder) is a fear of social situations in which
embarrassment can occur.
✔✔Specific phobias criteria - ✔✔I. Persistent excessive fear brought on by a specific
situation or object.
2. Exposure to the situation brings about an immediate anxiety response.
3. Patient recognizes that the fear is excessive.
4. The situation is avoided when possible or tolerated with intense anxiety.
5. If person is under age 18, duration must be at least 6 months.
✔✔Specific phobia tx - ✔✔• Behavior therapy is most effective, and systemic
desensitization (such as graded exposure and flooding) is a common technique.
• If necessary, a short course of benzodiazepines or beta blockers may be used during
desensitization to help control autonomic symptoms.
✔✔Social phobia Tx - ✔✔• Paroxetine (Paxil), an SSRI, is FDA approved for the
treatment of social anxiety disorder.
• Beta blockers are frequently used to control symptoms of performance anxiety.
• Cognitive and behavioral therapies are useful adjuncts.
✔✔Schizophrenia - ✔✔psychiatric disorder characterized by a constellation of
abnormalities in thinking, emotion, and behavior. There is no single symptom that is
pathognomonic, and there is a diverse clinical presentation. Schizophrenia is usually
chronic, with significant psychosocial and medical consequences to the patient.
✔✔Positive symptoms of schizophrenia - ✔✔Hallucinations, delusions, bizarre behavior,
disorganized speech.
These tend to respond more robustly to the current antipsychotic medications.
✔✔Negative Symptoms of schizophrenia - ✔✔Blunted affect, anhedonia, apathy,
alogia, and lack of interest in socialization.
These symptoms are often treatment resistant and contribute significantly to the social
isolation of schizophrenic patients.
, ✔✔Cognitive symptoms of schizophrenia - ✔✔Impairments in attention, executive
function, and working memory. These symptoms may ~ poor work and school
performance.
✔✔Schizophrenia criteria - ✔✔Two or more of the following must be present for at least
1 month:
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (such as flattened affect) Note: Only one of the above symptoms
are required if delusions are bizarre or hallucinations consist of a voice keeping up a
running commentary on the person's behavior or thoughts, or two or more voices
conversing with each other.
• Must cause significant social or occupational functional deterioration.
• Duration of illness for at least 6 months (including prodromal or residual periods in
which above criteria may not be met).
• Symptoms not due to medical, neurological, or substance-induced disorder.
✔✔Schizophrenia paranoia type - ✔✔Often higher functioning, older age of onset. Must
meet the following criteria:
• Preoccupation with one or more delusions or frequent auditory hallucinations.
• No predominance of disorganized speech, disorganized or catatonic behavior, or
inappropriate affect
✔✔Schizophrenia disorganized type - ✔✔Poor functioning type, early onset. Must meet
the following criteria:
• Disorganized speech
• Disorganized behavior
• Flat or inappropriate affect
✔✔Schizophrenia catatonic type - ✔✔Rare.
Must meet at least two of the following criteria:
• Motor immobility
• Excessive purposeless motor activity
• Extreme negativism or mutism
• Peculiar voluntary movements or posturing
• Echolalia or echopraxia
✔✔Schizophrenia residual type - ✔✔Prominent negative symptoms (such as flattened
affect or social withdrawal) with only minimal evidence of positive symptoms (such as
hallucinations or delusions).
✔✔Mental status exam of schizophrenia - ✔✔• Disheveled appearance
• Flattened affect
QUESTIONS WITH ANSWERS MARKED A+
✔✔PTSD vs acute stress disorder - ✔✔PTSD: event occurred any time in the past and
symptoms are >1 month
ASD: event occurred <1 month ago and symptoms last <1 month
✔✔Specific phobias and social phobia - ✔✔irrational fear that causes avoidance of the
feared object or situation.
A specific phobia is a strong, exaggerated fear of a specific object or situation
A social phobia (also called social anxiety disorder) is a fear of social situations in which
embarrassment can occur.
✔✔Specific phobias criteria - ✔✔I. Persistent excessive fear brought on by a specific
situation or object.
2. Exposure to the situation brings about an immediate anxiety response.
3. Patient recognizes that the fear is excessive.
4. The situation is avoided when possible or tolerated with intense anxiety.
5. If person is under age 18, duration must be at least 6 months.
✔✔Specific phobia tx - ✔✔• Behavior therapy is most effective, and systemic
desensitization (such as graded exposure and flooding) is a common technique.
• If necessary, a short course of benzodiazepines or beta blockers may be used during
desensitization to help control autonomic symptoms.
✔✔Social phobia Tx - ✔✔• Paroxetine (Paxil), an SSRI, is FDA approved for the
treatment of social anxiety disorder.
• Beta blockers are frequently used to control symptoms of performance anxiety.
• Cognitive and behavioral therapies are useful adjuncts.
✔✔Schizophrenia - ✔✔psychiatric disorder characterized by a constellation of
abnormalities in thinking, emotion, and behavior. There is no single symptom that is
pathognomonic, and there is a diverse clinical presentation. Schizophrenia is usually
chronic, with significant psychosocial and medical consequences to the patient.
✔✔Positive symptoms of schizophrenia - ✔✔Hallucinations, delusions, bizarre behavior,
disorganized speech.
These tend to respond more robustly to the current antipsychotic medications.
✔✔Negative Symptoms of schizophrenia - ✔✔Blunted affect, anhedonia, apathy,
alogia, and lack of interest in socialization.
These symptoms are often treatment resistant and contribute significantly to the social
isolation of schizophrenic patients.
, ✔✔Cognitive symptoms of schizophrenia - ✔✔Impairments in attention, executive
function, and working memory. These symptoms may ~ poor work and school
performance.
✔✔Schizophrenia criteria - ✔✔Two or more of the following must be present for at least
1 month:
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (such as flattened affect) Note: Only one of the above symptoms
are required if delusions are bizarre or hallucinations consist of a voice keeping up a
running commentary on the person's behavior or thoughts, or two or more voices
conversing with each other.
• Must cause significant social or occupational functional deterioration.
• Duration of illness for at least 6 months (including prodromal or residual periods in
which above criteria may not be met).
• Symptoms not due to medical, neurological, or substance-induced disorder.
✔✔Schizophrenia paranoia type - ✔✔Often higher functioning, older age of onset. Must
meet the following criteria:
• Preoccupation with one or more delusions or frequent auditory hallucinations.
• No predominance of disorganized speech, disorganized or catatonic behavior, or
inappropriate affect
✔✔Schizophrenia disorganized type - ✔✔Poor functioning type, early onset. Must meet
the following criteria:
• Disorganized speech
• Disorganized behavior
• Flat or inappropriate affect
✔✔Schizophrenia catatonic type - ✔✔Rare.
Must meet at least two of the following criteria:
• Motor immobility
• Excessive purposeless motor activity
• Extreme negativism or mutism
• Peculiar voluntary movements or posturing
• Echolalia or echopraxia
✔✔Schizophrenia residual type - ✔✔Prominent negative symptoms (such as flattened
affect or social withdrawal) with only minimal evidence of positive symptoms (such as
hallucinations or delusions).
✔✔Mental status exam of schizophrenia - ✔✔• Disheveled appearance
• Flattened affect
