NR.110.575
Differential Diagnosis of Mental
Disorders
Midterm Exam Review
(Questions & Solutions)
2025
1
,1. A 28-year-old woman presents with 3 weeks of low mood, anhedonia,
and hypersomnia. She reports feeling better in the afternoon and
overeating. Which specifier best fits her presentation?
A. Melancholic
B. Atypical
C. Catatonic
D. Seasonal
ANS: B
Rationale: Hypersomnia, hyperphagia, and mood reactivity are
hallmarks of atypical depression, not melancholic or catatonic features.
2. A 12-year-old boy exhibits constant fidgeting, difficulty sustaining
attention in all settings for 9 months. He denies mood swings. Which
diagnosis is most likely?
A. Cyclothymic disorder
B. ADHD, combined type
C. Oppositional defiant disorder
D. Pediatric bipolar disorder
ANS: B
Rationale: Pervasive inattention and hyperactivity across settings
over ≥6 months indicates ADHD; bipolar disorder requires episodic mood
changes.
3. A 45-year-old man reports recurrent panic attacks with palpitations
and derealization. He also describes persistent worry about having
another attack, lasting over a month. Which disorder fits best?
A. Generalized anxiety disorder
B. Panic disorder
C. Social anxiety disorder
D. Agoraphobia
2
, ANS: B
Rationale: Panic disorder is defined by unexpected panic attacks
followed by ≥1 month of persistent concern about additional attacks or
their consequences.
4. A 60-year-old patient with memory loss, apathy, and visual
hallucinations shows fluctuating attention over weeks. Which diagnosis is
most consistent?
A. Alzheimer’s disease
B. Major neurocognitive disorder with Lewy bodies
C. Vascular dementia
D. Parkinson’s disease dementia
ANS: B
Rationale: Cognitive fluctuations and visual hallucinations early in the
course suggest Lewy body dementia rather than Alzheimer’s.
5. A patient presents with chronic distrust, is reluctant to confide in
others, and misinterprets benign remarks as threatening but has no fixed
delusions. Which personality disorder?
A. Borderline
B. Paranoid
C. Schizoid
D. Schizotypal
ANS: B
Rationale: Paranoid personality disorder features pervasive distrust
and suspicion without overt psychotic delusions.
6. A 35-year-old exhibits a 2-week period of elevated mood, decreased
need for sleep, and grandiosity but no psychotic features, followed by 3
weeks of depression. Which is correct?
A. Bipolar I disorder
B. Bipolar II disorder
3
Differential Diagnosis of Mental
Disorders
Midterm Exam Review
(Questions & Solutions)
2025
1
,1. A 28-year-old woman presents with 3 weeks of low mood, anhedonia,
and hypersomnia. She reports feeling better in the afternoon and
overeating. Which specifier best fits her presentation?
A. Melancholic
B. Atypical
C. Catatonic
D. Seasonal
ANS: B
Rationale: Hypersomnia, hyperphagia, and mood reactivity are
hallmarks of atypical depression, not melancholic or catatonic features.
2. A 12-year-old boy exhibits constant fidgeting, difficulty sustaining
attention in all settings for 9 months. He denies mood swings. Which
diagnosis is most likely?
A. Cyclothymic disorder
B. ADHD, combined type
C. Oppositional defiant disorder
D. Pediatric bipolar disorder
ANS: B
Rationale: Pervasive inattention and hyperactivity across settings
over ≥6 months indicates ADHD; bipolar disorder requires episodic mood
changes.
3. A 45-year-old man reports recurrent panic attacks with palpitations
and derealization. He also describes persistent worry about having
another attack, lasting over a month. Which disorder fits best?
A. Generalized anxiety disorder
B. Panic disorder
C. Social anxiety disorder
D. Agoraphobia
2
, ANS: B
Rationale: Panic disorder is defined by unexpected panic attacks
followed by ≥1 month of persistent concern about additional attacks or
their consequences.
4. A 60-year-old patient with memory loss, apathy, and visual
hallucinations shows fluctuating attention over weeks. Which diagnosis is
most consistent?
A. Alzheimer’s disease
B. Major neurocognitive disorder with Lewy bodies
C. Vascular dementia
D. Parkinson’s disease dementia
ANS: B
Rationale: Cognitive fluctuations and visual hallucinations early in the
course suggest Lewy body dementia rather than Alzheimer’s.
5. A patient presents with chronic distrust, is reluctant to confide in
others, and misinterprets benign remarks as threatening but has no fixed
delusions. Which personality disorder?
A. Borderline
B. Paranoid
C. Schizoid
D. Schizotypal
ANS: B
Rationale: Paranoid personality disorder features pervasive distrust
and suspicion without overt psychotic delusions.
6. A 35-year-old exhibits a 2-week period of elevated mood, decreased
need for sleep, and grandiosity but no psychotic features, followed by 3
weeks of depression. Which is correct?
A. Bipolar I disorder
B. Bipolar II disorder
3
