American Board of Psychiatry and Neurology ABPN Child and Adolescent Psychiatry 1 — Questions and Answers
Question 1: A 7-year-old boy has difficulty paying attention, frequently interrupts others, and cannot stay seated in class. His symptoms are present at home and school. What is the MOST likely diagnosis?
- Oppositional defiant disorder
- Autism spectrum disorder
- Attention-deficit/hyperactivity disorder (ADHD) (Correct answer)
- Anxiety disorder
Correct answer: Attention-deficit/hyperactivity disorder (ADHD)
ADHD requires symptoms of inattention and/or hyperactivity-impulsivity present in two or more settings before age 12, fitting this presentation.
Question 2: Which medication is FDA-approved as FIRST-LINE pharmacotherapy for ADHD in children aged 6 and older?
- Atomoxetine
- Methylphenidate (Correct answer)
- Clonidine
- Guanfacine
Correct answer: Methylphenidate
Stimulant medications including methylphenidate are first-line FDA-approved pharmacotherapy for ADHD due to superior efficacy over non-stimulant options.
Question 3: A 4-year-old child does not make eye contact, does not respond to his name, lacks joint attention, and engages in repetitive hand-flapping. What is the MOST likely diagnosis?
- Intellectual disability
- Selective mutism
- Autism spectrum disorder (ASD) (Correct answer)
- Reactive attachment disorder
Correct answer: Autism spectrum disorder (ASD)
Autism spectrum disorder is characterized by persistent deficits in social communication and restricted, repetitive behaviors presenting in early development.
Question 4: Which condition is characterized by sudden onset of severe OCD symptoms and motor or vocal tics in a child following group A streptococcal infection?
- Tourette disorder
- PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) (Correct answer)
- Sydenham chorea
- Pediatric acute-onset neuropsychiatric syndrome (PANS)
Correct answer: PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections)
PANDAS describes abrupt onset of OCD and/or tic disorders temporally associated with group A streptococcal (GAS) infections in prepubertal children.
Question 5: A 16-year-old girl refuses to eat, has lost 20% of her body weight, believes she is overweight despite being underweight, and has stopped menstruating. What is the MOST likely diagnosis?
- Bulimia nervosa
- Avoidant/restrictive food intake disorder
- Anorexia nervosa (Correct answer)
- Body dysmorphic disorder
Correct answer: Anorexia nervosa
Anorexia nervosa is characterized by restriction of energy intake, intense fear of gaining weight, and distorted body image, with serious medical complications.
Question 6: What is the recommended FIRST-LINE psychotherapy for separation anxiety disorder in children?
- Psychodynamic therapy
- Cognitive-behavioral therapy (CBT) (Correct answer)
- Play therapy
- Family systems therapy
Correct answer: Cognitive-behavioral therapy (CBT)
CBT with graduated exposure is the evidence-based first-line treatment for separation anxiety disorder and other childhood anxiety disorders.
American Board of Psychiatry and Neurology ABPN Child and Adolescent Psychiatry 1
A 7-year-old boy has difficulty paying attention, frequently interrupts others, and cannot stay seated in class.
His symptoms are present at home and school.
What is the MOST likely diagnosis?