NRNP 6635 FINAL EXAM - ADVANCED
PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING
1. Which neuroanatomical structure is primarily responsible for the ‘fear circuitry’ and is
often hyperactive in patients with Post-Traumatic Stress Disorder (PTSD)?
A. Prefrontal Cortex
B. Amygdala
C. Hippocampus
D. Basal Ganglia
Answer: B
Conceptual Explanation: The amygdala is the core of the brain’s fear circuitry, processing
emotional stimuli and triggering the fight-or-flight response. In PTSD, the amygdala is
typically hyperresponsive, while the prefrontal cortex fails to inhibit this arousal.
,2. A 28-year-old male presents with a 7-month history of auditory hallucinations, social
withdrawal, and ‘flattened affect.’ He has no history of mood episodes. What is the most
likely diagnosis?
A. Schizophrenia
B. Schizophreniform Disorder
C. Schizoaffective Disorder
D. Brief Psychotic Disorder
Answer: A
Conceptual Explanation: Schizophrenia requires symptoms for at least 6 months.
Schizophreniform is 1-6 months. Brief Psychotic Disorder is less than 1 month. The absence
of mood episodes rules out schizoaffective disorder.
3. In differentiating Bipolar I from Bipolar II Disorder, which clinical feature is the deciding
factor?
A. The presence of at least one Major Depressive Episode
B. The duration of symptoms being at least 2 weeks
C. The presence of a full Manic Episode
D. The severity of the depressive symptoms
Answer: C
, Conceptual Explanation: Bipolar I requires at least one manic episode (lasting at least 1
week or requiring hospitalization). Bipolar II requires a hypomanic episode AND a major
depressive episode, but never a full manic episode.
4. Which neurotransmitter pathway is most associated with the positive symptoms of
Schizophrenia, such as delusions and hallucinations?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Excess dopamine in the mesolimbic pathway is hypothesized to
cause positive symptoms. Conversely, dopamine deficit in the mesocortical pathway is
associated with negative symptoms.
5. A patient presents with a persistent fear of being scrutinized in social situations, leading to
avoidance that impairs their professional life. What is the first-line pharmacological
treatment?
A. Buspirone
B. Propranolol
C. Benzodiazepines
PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING
1. Which neuroanatomical structure is primarily responsible for the ‘fear circuitry’ and is
often hyperactive in patients with Post-Traumatic Stress Disorder (PTSD)?
A. Prefrontal Cortex
B. Amygdala
C. Hippocampus
D. Basal Ganglia
Answer: B
Conceptual Explanation: The amygdala is the core of the brain’s fear circuitry, processing
emotional stimuli and triggering the fight-or-flight response. In PTSD, the amygdala is
typically hyperresponsive, while the prefrontal cortex fails to inhibit this arousal.
,2. A 28-year-old male presents with a 7-month history of auditory hallucinations, social
withdrawal, and ‘flattened affect.’ He has no history of mood episodes. What is the most
likely diagnosis?
A. Schizophrenia
B. Schizophreniform Disorder
C. Schizoaffective Disorder
D. Brief Psychotic Disorder
Answer: A
Conceptual Explanation: Schizophrenia requires symptoms for at least 6 months.
Schizophreniform is 1-6 months. Brief Psychotic Disorder is less than 1 month. The absence
of mood episodes rules out schizoaffective disorder.
3. In differentiating Bipolar I from Bipolar II Disorder, which clinical feature is the deciding
factor?
A. The presence of at least one Major Depressive Episode
B. The duration of symptoms being at least 2 weeks
C. The presence of a full Manic Episode
D. The severity of the depressive symptoms
Answer: C
, Conceptual Explanation: Bipolar I requires at least one manic episode (lasting at least 1
week or requiring hospitalization). Bipolar II requires a hypomanic episode AND a major
depressive episode, but never a full manic episode.
4. Which neurotransmitter pathway is most associated with the positive symptoms of
Schizophrenia, such as delusions and hallucinations?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Excess dopamine in the mesolimbic pathway is hypothesized to
cause positive symptoms. Conversely, dopamine deficit in the mesocortical pathway is
associated with negative symptoms.
5. A patient presents with a persistent fear of being scrutinized in social situations, leading to
avoidance that impairs their professional life. What is the first-line pharmacological
treatment?
A. Buspirone
B. Propranolol
C. Benzodiazepines
