NR547 DIFFERENTIAL DIAGNOSIS IN
PSYCHIATRIC-MENTAL HEALTH
ACROSS THE LIFESPAN EXAM PREP
1. A 45-year-old female presents with new-onset depressive symptoms and fatigue. Which
medical condition must be ruled out first due to its high prevalence in mimicking Major
Depressive Disorder (MDD)?
A. Systemic Lupus Erythematosus
B. Hyperparathyroidism
C. Hypothyroidism
D. Vitamin D deficiency
Answer: C
Conceptual Explanation: Hypothyroidism is a common medical mimic of depression,
causing lethargy, low mood, and weight gain. Thyroid function tests (TSH) are a standard
part of the initial psychiatric workup.
,2. What is the primary diagnostic differentiator between Bipolar I Disorder and Bipolar II
Disorder?
A. The presence of at least one major depressive episode
B. The duration of hypomanic symptoms
C. The severity of psychotic features in depression
D. The occurrence of at least one full manic episode
Answer: D
Conceptual Explanation: Bipolar I requires at least one manic episode (lasting at least 7
days or requiring hospitalization). Bipolar II requires a hypomanic episode AND a major
depressive episode, but never a full manic episode.
3. A patient reports experiencing auditory hallucinations and delusions for 7 months. Mood
symptoms have occurred for only 1 month of the total illness duration. What is the most
likely diagnosis?
A. Schizoaffective Disorder
B. Major Depressive Disorder with Psychotic Features
C. Schizophrenia
D. Brief Psychotic Disorder
Answer: C
, Conceptual Explanation: In Schizophrenia, mood symptoms must be present for a
minority of the total duration of the illness. If mood symptoms were present for the
majority, Schizoaffective Disorder would be considered.
4. In the Mental Status Examination (MSE), a patient who quickly jumps from one idea to
another with only thin logical connections is exhibiting:
A. Circumstantiality
B. Tangentiality
C. Flight of ideas
D. Loose associations
Answer: C
Conceptual Explanation: Flight of ideas involves rapid shifting between ideas where the
connection is understandable but the pace is accelerated, often seen in mania.
5. Which diagnosis should be considered for a 9-year-old child showing persistent irritability
and frequent, severe temper outbursts that are out of proportion to the situation?
A. Oppositional Defiant Disorder (ODD)
B. Attention-Deficit/Hyperactivity Disorder (ADHD)
C. Pediatric Bipolar Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
PSYCHIATRIC-MENTAL HEALTH
ACROSS THE LIFESPAN EXAM PREP
1. A 45-year-old female presents with new-onset depressive symptoms and fatigue. Which
medical condition must be ruled out first due to its high prevalence in mimicking Major
Depressive Disorder (MDD)?
A. Systemic Lupus Erythematosus
B. Hyperparathyroidism
C. Hypothyroidism
D. Vitamin D deficiency
Answer: C
Conceptual Explanation: Hypothyroidism is a common medical mimic of depression,
causing lethargy, low mood, and weight gain. Thyroid function tests (TSH) are a standard
part of the initial psychiatric workup.
,2. What is the primary diagnostic differentiator between Bipolar I Disorder and Bipolar II
Disorder?
A. The presence of at least one major depressive episode
B. The duration of hypomanic symptoms
C. The severity of psychotic features in depression
D. The occurrence of at least one full manic episode
Answer: D
Conceptual Explanation: Bipolar I requires at least one manic episode (lasting at least 7
days or requiring hospitalization). Bipolar II requires a hypomanic episode AND a major
depressive episode, but never a full manic episode.
3. A patient reports experiencing auditory hallucinations and delusions for 7 months. Mood
symptoms have occurred for only 1 month of the total illness duration. What is the most
likely diagnosis?
A. Schizoaffective Disorder
B. Major Depressive Disorder with Psychotic Features
C. Schizophrenia
D. Brief Psychotic Disorder
Answer: C
, Conceptual Explanation: In Schizophrenia, mood symptoms must be present for a
minority of the total duration of the illness. If mood symptoms were present for the
majority, Schizoaffective Disorder would be considered.
4. In the Mental Status Examination (MSE), a patient who quickly jumps from one idea to
another with only thin logical connections is exhibiting:
A. Circumstantiality
B. Tangentiality
C. Flight of ideas
D. Loose associations
Answer: C
Conceptual Explanation: Flight of ideas involves rapid shifting between ideas where the
connection is understandable but the pace is accelerated, often seen in mania.
5. Which diagnosis should be considered for a 9-year-old child showing persistent irritability
and frequent, severe temper outbursts that are out of proportion to the situation?
A. Oppositional Defiant Disorder (ODD)
B. Attention-Deficit/Hyperactivity Disorder (ADHD)
C. Pediatric Bipolar Disorder
D. Disruptive Mood Dysregulation Disorder (DMDD)
Answer: D
