NRNP 6635: PSYCHOPATHOLOGY AND
DIAGNOSTIC REASONING -
COMPREHENSIVE HIGH-LEVEL EXAM
1. A 26-year-old patient presents with symptoms of auditory hallucinations, social
withdrawal, and flattened affect that have persisted for exactly 4 months. According to the
DSM-5, what is the most appropriate diagnosis?
A. Schizophrenia
B. Schizoaffective Disorder
C. Brief Psychotic Disorder
D. Schizophreniform Disorder
Answer: D
Conceptual Explanation: Schizophreniform disorder is diagnosed when the symptoms of
schizophrenia are present for at least 1 month but less than 6 months. Since the patient has
had symptoms for 4 months, this is the correct diagnosis.
2. A patient taking both Fluoxetine and Tramadol presents with autonomic instability,
hyperreflexia, and myoclonus. Which condition should the clinician immediately suspect?
A. Neuroleptic Malignant Syndrome (NMS)
,B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. Tardive Dyskinesia
Answer: C
Conceptual Explanation: Serotonin Syndrome is characterized by hyperreflexia and
myoclonus, often resulting from a combination of serotonergic agents like SSRIs and
Tramadol. NMS is more likely to cause ‘lead-pipe’ rigidity rather than hyperreflexia.
3. Which dopaminergic pathway is primarily associated with the negative symptoms of
schizophrenia, such as cognitive impairment and social withdrawal?
A. Mesolimbic pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesocortical pathway
Answer: D
Conceptual Explanation: Hypofunction of the mesocortical pathway is linked to the
negative symptoms and cognitive deficits of schizophrenia, whereas hyperactivity in the
mesolimbic pathway causes positive symptoms.
, 4. A 35-year-old woman reports a history of at least one major depressive episode and at
least one hypomanic episode. She has never experienced a full manic episode. What is her
most likely diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Cyclothymic Disorder
D. Bipolar II Disorder
Answer: D
Conceptual Explanation: Bipolar II Disorder requires the occurrence of at least one major
depressive episode and at least one hypomanic episode, without any history of a full manic
episode.
5. A patient describes a chronic state of low mood that has lasted for over two years. They
report poor appetite, low energy, and low self-esteem but do not meet the full criteria for a
Major Depressive Episode. What is the diagnosis?
A. Adjustment Disorder with Depressed Mood
B. Major Depressive Disorder, Chronic
C. Persistent Depressive Disorder (Dysthymia)
D. Generalized Anxiety Disorder
Answer: C
DIAGNOSTIC REASONING -
COMPREHENSIVE HIGH-LEVEL EXAM
1. A 26-year-old patient presents with symptoms of auditory hallucinations, social
withdrawal, and flattened affect that have persisted for exactly 4 months. According to the
DSM-5, what is the most appropriate diagnosis?
A. Schizophrenia
B. Schizoaffective Disorder
C. Brief Psychotic Disorder
D. Schizophreniform Disorder
Answer: D
Conceptual Explanation: Schizophreniform disorder is diagnosed when the symptoms of
schizophrenia are present for at least 1 month but less than 6 months. Since the patient has
had symptoms for 4 months, this is the correct diagnosis.
2. A patient taking both Fluoxetine and Tramadol presents with autonomic instability,
hyperreflexia, and myoclonus. Which condition should the clinician immediately suspect?
A. Neuroleptic Malignant Syndrome (NMS)
,B. Anticholinergic Toxicity
C. Serotonin Syndrome
D. Tardive Dyskinesia
Answer: C
Conceptual Explanation: Serotonin Syndrome is characterized by hyperreflexia and
myoclonus, often resulting from a combination of serotonergic agents like SSRIs and
Tramadol. NMS is more likely to cause ‘lead-pipe’ rigidity rather than hyperreflexia.
3. Which dopaminergic pathway is primarily associated with the negative symptoms of
schizophrenia, such as cognitive impairment and social withdrawal?
A. Mesolimbic pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesocortical pathway
Answer: D
Conceptual Explanation: Hypofunction of the mesocortical pathway is linked to the
negative symptoms and cognitive deficits of schizophrenia, whereas hyperactivity in the
mesolimbic pathway causes positive symptoms.
, 4. A 35-year-old woman reports a history of at least one major depressive episode and at
least one hypomanic episode. She has never experienced a full manic episode. What is her
most likely diagnosis?
A. Bipolar I Disorder
B. Major Depressive Disorder
C. Cyclothymic Disorder
D. Bipolar II Disorder
Answer: D
Conceptual Explanation: Bipolar II Disorder requires the occurrence of at least one major
depressive episode and at least one hypomanic episode, without any history of a full manic
episode.
5. A patient describes a chronic state of low mood that has lasted for over two years. They
report poor appetite, low energy, and low self-esteem but do not meet the full criteria for a
Major Depressive Episode. What is the diagnosis?
A. Adjustment Disorder with Depressed Mood
B. Major Depressive Disorder, Chronic
C. Persistent Depressive Disorder (Dysthymia)
D. Generalized Anxiety Disorder
Answer: C
