ABPN American Board of Psychiatry and Neurology 2 — Questions and Answers
Question 1: Which neurotransmitter is most implicated in the pathophysiology of Parkinson disease?
- Dopamine (Correct answer)
- Serotonin
- Glutamate
- Acetylcholine
Correct answer: Dopamine
Parkinson disease results from degeneration of dopaminergic neurons in the substantia nigra.
Question 2: A patient presents with sudden right-sided weakness and expressive aphasia. Which arterial territory is most likely involved?
- Left middle cerebral artery (Correct answer)
- Right posterior cerebral artery
- Basilar artery
- Anterior spinal artery
Correct answer: Left middle cerebral artery
Broca (expressive) aphasia with right hemiparesis localizes to the left MCA territory.
Question 3: First-line pharmacotherapy for generalized anxiety disorder is typically which class?
- SSRIs (Correct answer)
- Benzodiazepines
- Antipsychotics
- Beta-blockers
Correct answer: SSRIs
SSRIs are first-line for GAD due to efficacy and lower dependence risk than benzodiazepines.
Question 4: Which finding is characteristic of neuroleptic malignant syndrome?
- Lead-pipe rigidity and hyperthermia (Correct answer)
- Flaccid paralysis and hypothermia
- Ataxia and nystagmus
- Resting tremor and bradykinesia
Correct answer: Lead-pipe rigidity and hyperthermia
NMS features muscular rigidity, hyperthermia, autonomic instability, and elevated CK.
Question 5: The EEG hallmark of absence seizures is:
- 3-Hz generalized spike-and-wave (Correct answer)
- Focal temporal spikes
- Burst suppression
- Triphasic waves
Correct answer: 3-Hz generalized spike-and-wave
Absence seizures classically produce 3-Hz generalized spike-and-wave discharges.
Question 6: Which medication requires regular white blood cell monitoring due to agranulocytosis risk?
- Clozapine (Correct answer)
- Risperidone
- Olanzapine
- Quetiapine
Correct answer: Clozapine
Clozapine can cause agranulocytosis, mandating routine ANC monitoring.
Question 7: A positive Babinski sign in an adult indicates a lesion of which pathway?
- Corticospinal tract (Correct answer)
- Dorsal columns
- Spinothalamic tract
- Cerebellar peduncles
Correct answer: Corticospinal tract
An extensor plantar response reflects upper motor neuron (corticospinal) dysfunction.
ABPN American Board of Psychiatry and Neurology 2
Which neurotransmitter is most implicated in the pathophysiology of Parkinson disease?