, USMLE Step 3 Psychiatry Q-Bank Essentials
(2025/2026)/ High-Yield Psychiatry Scenarios,
Pharmacology & Diagnostic Traps.
night dream, screaming, crying then fall asleep, no recollection events
night terror; midnight to 4am;
diff between nightmare vs night terror
NM: REM sleep, starttled after awakening; give full details of dream , NT: crying during sleep, can go
back to sleep. no recollection
refractory schizo
clozapine; s/e agranulocytosis; weekly monitoring of WBC
serum drug levels are monitored
lithium, valoproic acid, notriptylin
primitive idealization
one aspect of splitting; look other person as perfect; present in borderline personality disorder
compensation
overemphasize one aspect of success to compensate failure in other areas
projection
attributes thought that are socially unacceptable to another perspon
reaction formation
deal with stress by doing totally opposite
dissociation
avoids a situation by not recognizing part of it (amnesia)
tx of borderline disorder
dialectical therapy; behvior modification and building of skills; TCA contraindicated;
opioid withdrawal
mydriasis; n/v/abd cramps/watery eyes tx methadone or clonidine/buprenorphine
tremor, hypertension, occas seizure
(2025/2026)/ High-Yield Psychiatry Scenarios,
Pharmacology & Diagnostic Traps.
night dream, screaming, crying then fall asleep, no recollection events
night terror; midnight to 4am;
diff between nightmare vs night terror
NM: REM sleep, starttled after awakening; give full details of dream , NT: crying during sleep, can go
back to sleep. no recollection
refractory schizo
clozapine; s/e agranulocytosis; weekly monitoring of WBC
serum drug levels are monitored
lithium, valoproic acid, notriptylin
primitive idealization
one aspect of splitting; look other person as perfect; present in borderline personality disorder
compensation
overemphasize one aspect of success to compensate failure in other areas
projection
attributes thought that are socially unacceptable to another perspon
reaction formation
deal with stress by doing totally opposite
dissociation
avoids a situation by not recognizing part of it (amnesia)
tx of borderline disorder
dialectical therapy; behvior modification and building of skills; TCA contraindicated;
opioid withdrawal
mydriasis; n/v/abd cramps/watery eyes tx methadone or clonidine/buprenorphine
tremor, hypertension, occas seizure
