Kaplan and Sadock's Synopsis of Psychiatry
12th Edition Test Bank ( QUESTIONS WITH
COMPLETE SOLUTIONS)
Course
Synopsis of Psychiatry
✅ 1. Which of the following neurotransmitters is most closely associated with
the pathophysiology of schizophrenia?
A. Norepinephrine
B. Dopamine
C. Serotonin
D. Acetylcholine
Answer: B. Dopamine
Explanation:
Schizophrenia has been strongly associated with dopaminergic hyperactivity, particularly in
the mesolimbic pathway, which contributes to positive symptoms such as hallucinations and
delusions. The dopamine hypothesis remains a foundational theory in the pathophysiology of
schizophrenia.
✅ 2. A 25-year-old man presents with disorganized speech, hallucinations, and
negative symptoms lasting over 6 months. What is the most likely diagnosis?
A. Brief psychotic disorder
B. Schizophreniform disorder
C. Schizoaffective disorder
D. Schizophrenia
Answer: D. Schizophrenia
Explanation:
Schizophrenia is diagnosed when psychotic symptoms last for at least 6 months, including at
least 1 month of active symptoms such as delusions, hallucinations, or disorganized speech.
This patient meets the duration and symptom criteria.
✅ 3. Which antidepressant is most associated with the risk of causing
hypertensive crisis when dietary restrictions are not followed?
,A. Fluoxetine
B. Bupropion
C. Phenelzine
D. Sertraline
Answer: C. Phenelzine
Explanation:
Phenelzine is a monoamine oxidase inhibitor (MAOI). MAOIs inhibit the breakdown of
tyramine, and consuming tyramine-rich foods (e.g., aged cheese, red wine) can lead to a
hypertensive crisis.
✅ 4. What is the mechanism of action of benzodiazepines in treating anxiety
disorders?
A. Inhibition of serotonin reuptake
B. Dopamine D2 receptor blockade
C. Modulation of glutamate activity
D. Enhancement of GABA-A receptor activity
Answer: D. Enhancement of GABA-A receptor activity
Explanation:
Benzodiazepines enhance the activity of GABA, the primary inhibitory neurotransmitter in the
CNS, by increasing the frequency of chloride channel opening via the GABA-A receptor.
✅ 5. A patient with bipolar I disorder is started on lithium. What laboratory
test is essential to monitor during treatment?
A. Liver function tests
B. Complete blood count
C. Thyroid function and renal function tests
D. Coagulation profile
Answer: C. Thyroid function and renal function tests
Explanation:
Lithium can cause hypothyroidism and renal dysfunction. Regular monitoring of TSH, BUN,
and creatinine is critical in patients on long-term lithium therapy.
,✅ 6. Which of the following is a first-generation (typical) antipsychotic?
A. Risperidone
B. Clozapine
C. Haloperidol
D. Olanzapine
Answer: C. Haloperidol
Explanation:
Haloperidol is a typical (first-generation) antipsychotic, primarily acting as a dopamine D2
receptor antagonist, and is associated with higher rates of extrapyramidal symptoms (EPS).
✅ 7. Which personality disorder is characterized by instability in relationships,
self-image, and affect, and by marked impulsivity?
A. Narcissistic personality disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Avoidant personality disorder
Answer: B. Borderline personality disorder
Explanation:
Borderline personality disorder features emotional instability, intense and unstable
relationships, impulsivity, and often self-harming behavior. Splitting is a common defense
mechanism.
✅ 8. A 10-year-old child is disruptive, argues with adults, and refuses to comply
with rules, but does not harm others or animals. What is the likely diagnosis?
A. Conduct disorder
B. Oppositional defiant disorder
C. ADHD
D. Intermittent explosive disorder
Answer: B. Oppositional defiant disorder
Explanation:
ODD involves hostile, defiant, and noncompliant behavior without the aggression or
violations of the rights of others seen in conduct disorder.
, ✅ 9. Which sleep stage is most associated with dreaming and rapid eye
movements?
A. Stage 1 NREM
B. Stage 2 NREM
C. REM sleep
D. Stage 4 NREM
Answer: C. REM sleep
Explanation:
REM sleep is characterized by vivid dreams, muscle atonia, and rapid eye movements. It
occurs cyclically throughout the night and increases in duration in the later sleep cycles.
✅ 10. A patient on clozapine reports fever and sore throat. What should be done
immediately?
A. Increase the dose of clozapine
B. Check a complete blood count with differential
C. Discontinue clozapine and switch to risperidone
D. Start antibiotics empirically
Answer: B. Check a complete blood count with differential
Explanation:
Clozapine can cause agranulocytosis, a potentially life-threatening drop in neutrophils. Fever
and sore throat may indicate infection; a CBC with differential must be done immediately to
assess for neutropenia.
✅ 11. Which of the following symptoms is classified as a negative symptom of
schizophrenia?
A. Delusions
B. Hallucinations
C. Affective flattening
D. Disorganized speech
Answer: C. Affective flattening
Explanation:
Negative symptoms include affective flattening, alogia, avolition, and anhedonia. These
12th Edition Test Bank ( QUESTIONS WITH
COMPLETE SOLUTIONS)
Course
Synopsis of Psychiatry
✅ 1. Which of the following neurotransmitters is most closely associated with
the pathophysiology of schizophrenia?
A. Norepinephrine
B. Dopamine
C. Serotonin
D. Acetylcholine
Answer: B. Dopamine
Explanation:
Schizophrenia has been strongly associated with dopaminergic hyperactivity, particularly in
the mesolimbic pathway, which contributes to positive symptoms such as hallucinations and
delusions. The dopamine hypothesis remains a foundational theory in the pathophysiology of
schizophrenia.
✅ 2. A 25-year-old man presents with disorganized speech, hallucinations, and
negative symptoms lasting over 6 months. What is the most likely diagnosis?
A. Brief psychotic disorder
B. Schizophreniform disorder
C. Schizoaffective disorder
D. Schizophrenia
Answer: D. Schizophrenia
Explanation:
Schizophrenia is diagnosed when psychotic symptoms last for at least 6 months, including at
least 1 month of active symptoms such as delusions, hallucinations, or disorganized speech.
This patient meets the duration and symptom criteria.
✅ 3. Which antidepressant is most associated with the risk of causing
hypertensive crisis when dietary restrictions are not followed?
,A. Fluoxetine
B. Bupropion
C. Phenelzine
D. Sertraline
Answer: C. Phenelzine
Explanation:
Phenelzine is a monoamine oxidase inhibitor (MAOI). MAOIs inhibit the breakdown of
tyramine, and consuming tyramine-rich foods (e.g., aged cheese, red wine) can lead to a
hypertensive crisis.
✅ 4. What is the mechanism of action of benzodiazepines in treating anxiety
disorders?
A. Inhibition of serotonin reuptake
B. Dopamine D2 receptor blockade
C. Modulation of glutamate activity
D. Enhancement of GABA-A receptor activity
Answer: D. Enhancement of GABA-A receptor activity
Explanation:
Benzodiazepines enhance the activity of GABA, the primary inhibitory neurotransmitter in the
CNS, by increasing the frequency of chloride channel opening via the GABA-A receptor.
✅ 5. A patient with bipolar I disorder is started on lithium. What laboratory
test is essential to monitor during treatment?
A. Liver function tests
B. Complete blood count
C. Thyroid function and renal function tests
D. Coagulation profile
Answer: C. Thyroid function and renal function tests
Explanation:
Lithium can cause hypothyroidism and renal dysfunction. Regular monitoring of TSH, BUN,
and creatinine is critical in patients on long-term lithium therapy.
,✅ 6. Which of the following is a first-generation (typical) antipsychotic?
A. Risperidone
B. Clozapine
C. Haloperidol
D. Olanzapine
Answer: C. Haloperidol
Explanation:
Haloperidol is a typical (first-generation) antipsychotic, primarily acting as a dopamine D2
receptor antagonist, and is associated with higher rates of extrapyramidal symptoms (EPS).
✅ 7. Which personality disorder is characterized by instability in relationships,
self-image, and affect, and by marked impulsivity?
A. Narcissistic personality disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Avoidant personality disorder
Answer: B. Borderline personality disorder
Explanation:
Borderline personality disorder features emotional instability, intense and unstable
relationships, impulsivity, and often self-harming behavior. Splitting is a common defense
mechanism.
✅ 8. A 10-year-old child is disruptive, argues with adults, and refuses to comply
with rules, but does not harm others or animals. What is the likely diagnosis?
A. Conduct disorder
B. Oppositional defiant disorder
C. ADHD
D. Intermittent explosive disorder
Answer: B. Oppositional defiant disorder
Explanation:
ODD involves hostile, defiant, and noncompliant behavior without the aggression or
violations of the rights of others seen in conduct disorder.
, ✅ 9. Which sleep stage is most associated with dreaming and rapid eye
movements?
A. Stage 1 NREM
B. Stage 2 NREM
C. REM sleep
D. Stage 4 NREM
Answer: C. REM sleep
Explanation:
REM sleep is characterized by vivid dreams, muscle atonia, and rapid eye movements. It
occurs cyclically throughout the night and increases in duration in the later sleep cycles.
✅ 10. A patient on clozapine reports fever and sore throat. What should be done
immediately?
A. Increase the dose of clozapine
B. Check a complete blood count with differential
C. Discontinue clozapine and switch to risperidone
D. Start antibiotics empirically
Answer: B. Check a complete blood count with differential
Explanation:
Clozapine can cause agranulocytosis, a potentially life-threatening drop in neutrophils. Fever
and sore throat may indicate infection; a CBC with differential must be done immediately to
assess for neutropenia.
✅ 11. Which of the following symptoms is classified as a negative symptom of
schizophrenia?
A. Delusions
B. Hallucinations
C. Affective flattening
D. Disorganized speech
Answer: C. Affective flattening
Explanation:
Negative symptoms include affective flattening, alogia, avolition, and anhedonia. These
