Barkley Differential Diagnosis Practice ACTUAL
EXAM ALL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Section 1: Psychiatric Differential Diagnosis (Questions 1-25)
Question 1
A 24-year-old male presents with 3 weeks of decreased need for sleep, pressured speech,
grandiose delusions about being a billionaire, and risky sexual behavior. He has no history of
depression. Which medication is the FIRST-LINE treatment for acute stabilization?
A. Fluoxetine
B. Lithium
C. Haloperidol
D. Lamotrigine
Correct Answer: B
Rationale: Lithium is first-line for acute mania in bipolar I disorder without depressive history.
Fluoxetine (antidepressant) can worsen mania. Haloperidol may be used for severe agitation but
is not first-line monotherapy. Lamotrigine is for bipolar depression maintenance, not acute
mania .
Question 2
According to DSM-5-TR, what is the MINIMUM duration required to diagnose persistent
depressive disorder (dysthymia) in adults?
A. 3 months
B. 6 months
C. 2 years
D. 5 years
,Correct Answer: C
Rationale: DSM-5-TR requires depressed mood for most of the day, for more days than not, for
at least 2 years in adults (1 year in children/adolescents) to diagnose persistent depressive
disorder .
Question 3
Which symptom best differentiates PTSD from Acute Stress Disorder?
A. Flashbacks
B. Dissociation
C. Duration of symptoms
D. Nightmares
Correct Answer: C
Rationale: PTSD symptoms persist beyond one month, while Acute Stress Disorder is diagnosed
when symptoms occur within 1 month of trauma and last 3 days to 1 month. Both conditions
can present with flashbacks, dissociation, and nightmares .
Question 4
A 30-year-old patient presents with persistent worry about multiple life domains, irritability, and
sleep disturbance for 8 months. What is the most likely diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Adjustment Disorder
D. Social Anxiety Disorder
Correct Answer: B
Rationale: Generalized Anxiety Disorder (GAD) is characterized by chronic, excessive worry
lasting ≥6 months with associated symptoms like irritability and sleep disturbance. Panic
disorder involves discrete panic attacks; adjustment disorder occurs within 3 months of a
stressor .
Question 5
A patient presents with flat affect, social withdrawal, and impaired motivation for 6 months.
There are no psychotic symptoms. What is the most likely diagnosis?
,A. Schizophrenia
B. Schizoaffective Disorder
C. Major Depressive Disorder with psychotic features
D. Schizoid Personality Disorder
Correct Answer: D
Rationale: Long-standing social detachment, flat affect, and limited emotion indicate a
personality disorder rather than acute psychotic illness. Schizoid personality disorder is
characterized by social withdrawal and introversion without psychotic symptoms .
Question 6
A patient presents with chronic, excessive worry lasting ≥6 months with associated symptoms.
This presentation is most consistent with:
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Adjustment Disorder
D. Social Anxiety Disorder
Correct Answer: B
Rationale: Generalized Anxiety Disorder (GAD) is characterized by chronic, excessive worry
lasting ≥6 months with associated symptoms like irritability and sleep disturbance .
Question 7
What is a key diagnostic criterion for anorexia nervosa?
A. Excessive sleep
B. Recurrent binge eating episodes
C. Intense fear of gaining weight
D. Alcohol abuse
Correct Answer: C
Rationale: Anorexia nervosa centers on restrictive intake and intense fear of weight gain despite
being underweight. Recurrent binge episodes are characteristic of bulimia nervosa and binge
eating disorder .
, Question 8
Which personality disorder is most characterized by instability in relationships, identity
disturbance, and impulsivity?
A. Narcissistic
B. Borderline
C. Antisocial
D. Dependent
Correct Answer: B
Rationale: Borderline Personality Disorder involves emotional volatility, splitting, and fear of
abandonment, with instability in relationships and identity disturbance .
Question 9
In a patient presenting with new-onset confusion, which medical condition must be ruled out
before psychiatric diagnosis?
A. Schizophrenia
B. Delirium due to a medical cause
C. Cyclothymia
D. Somatic symptom disorder
Correct Answer: B
Rationale: Delirium is a medical emergency that presents acutely with fluctuating
consciousness. It must be ruled out before attributing new-onset confusion to a primary
psychiatric disorder. Delirium can be caused by infections, metabolic disturbances, medications,
and other medical conditions .
Question 10
What is the primary feature distinguishing delirium from dementia?
A. Chronic course
B. Gradual memory decline
C. Acute onset and fluctuating consciousness
D. Associated depressive symptoms
Correct Answer: C
EXAM ALL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
Section 1: Psychiatric Differential Diagnosis (Questions 1-25)
Question 1
A 24-year-old male presents with 3 weeks of decreased need for sleep, pressured speech,
grandiose delusions about being a billionaire, and risky sexual behavior. He has no history of
depression. Which medication is the FIRST-LINE treatment for acute stabilization?
A. Fluoxetine
B. Lithium
C. Haloperidol
D. Lamotrigine
Correct Answer: B
Rationale: Lithium is first-line for acute mania in bipolar I disorder without depressive history.
Fluoxetine (antidepressant) can worsen mania. Haloperidol may be used for severe agitation but
is not first-line monotherapy. Lamotrigine is for bipolar depression maintenance, not acute
mania .
Question 2
According to DSM-5-TR, what is the MINIMUM duration required to diagnose persistent
depressive disorder (dysthymia) in adults?
A. 3 months
B. 6 months
C. 2 years
D. 5 years
,Correct Answer: C
Rationale: DSM-5-TR requires depressed mood for most of the day, for more days than not, for
at least 2 years in adults (1 year in children/adolescents) to diagnose persistent depressive
disorder .
Question 3
Which symptom best differentiates PTSD from Acute Stress Disorder?
A. Flashbacks
B. Dissociation
C. Duration of symptoms
D. Nightmares
Correct Answer: C
Rationale: PTSD symptoms persist beyond one month, while Acute Stress Disorder is diagnosed
when symptoms occur within 1 month of trauma and last 3 days to 1 month. Both conditions
can present with flashbacks, dissociation, and nightmares .
Question 4
A 30-year-old patient presents with persistent worry about multiple life domains, irritability, and
sleep disturbance for 8 months. What is the most likely diagnosis?
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Adjustment Disorder
D. Social Anxiety Disorder
Correct Answer: B
Rationale: Generalized Anxiety Disorder (GAD) is characterized by chronic, excessive worry
lasting ≥6 months with associated symptoms like irritability and sleep disturbance. Panic
disorder involves discrete panic attacks; adjustment disorder occurs within 3 months of a
stressor .
Question 5
A patient presents with flat affect, social withdrawal, and impaired motivation for 6 months.
There are no psychotic symptoms. What is the most likely diagnosis?
,A. Schizophrenia
B. Schizoaffective Disorder
C. Major Depressive Disorder with psychotic features
D. Schizoid Personality Disorder
Correct Answer: D
Rationale: Long-standing social detachment, flat affect, and limited emotion indicate a
personality disorder rather than acute psychotic illness. Schizoid personality disorder is
characterized by social withdrawal and introversion without psychotic symptoms .
Question 6
A patient presents with chronic, excessive worry lasting ≥6 months with associated symptoms.
This presentation is most consistent with:
A. Panic Disorder
B. Generalized Anxiety Disorder
C. Adjustment Disorder
D. Social Anxiety Disorder
Correct Answer: B
Rationale: Generalized Anxiety Disorder (GAD) is characterized by chronic, excessive worry
lasting ≥6 months with associated symptoms like irritability and sleep disturbance .
Question 7
What is a key diagnostic criterion for anorexia nervosa?
A. Excessive sleep
B. Recurrent binge eating episodes
C. Intense fear of gaining weight
D. Alcohol abuse
Correct Answer: C
Rationale: Anorexia nervosa centers on restrictive intake and intense fear of weight gain despite
being underweight. Recurrent binge episodes are characteristic of bulimia nervosa and binge
eating disorder .
, Question 8
Which personality disorder is most characterized by instability in relationships, identity
disturbance, and impulsivity?
A. Narcissistic
B. Borderline
C. Antisocial
D. Dependent
Correct Answer: B
Rationale: Borderline Personality Disorder involves emotional volatility, splitting, and fear of
abandonment, with instability in relationships and identity disturbance .
Question 9
In a patient presenting with new-onset confusion, which medical condition must be ruled out
before psychiatric diagnosis?
A. Schizophrenia
B. Delirium due to a medical cause
C. Cyclothymia
D. Somatic symptom disorder
Correct Answer: B
Rationale: Delirium is a medical emergency that presents acutely with fluctuating
consciousness. It must be ruled out before attributing new-onset confusion to a primary
psychiatric disorder. Delirium can be caused by infections, metabolic disturbances, medications,
and other medical conditions .
Question 10
What is the primary feature distinguishing delirium from dementia?
A. Chronic course
B. Gradual memory decline
C. Acute onset and fluctuating consciousness
D. Associated depressive symptoms
Correct Answer: C
