American Board of Psychiatry and Neurology

Question 1

On average, how long does the active phase of schizophrenia last?

Accepted Answer

1 Month

Answer

The active phase of schizophrenia, characterized by prominent positive symptoms like delusions and hallucinations, must last for at least one month to meet diagnostic criteria according to the DSM-5. While the overall duration of the disorder is longer, the 'active phase' specifically refers to this period of acute symptom presentation. This duration helps differentiate schizophrenia from brief psychotic disorder, which is shorter.

Question 2

Which of the following DOES NOT indicate that a person has positive symptoms of schizophrenia?

Accepted Answer

Avolition

Answer

Positive symptoms of schizophrenia are those that add to or distort normal functions, such as delusions, hallucinations, and disorganized speech. Avolition, on the other hand, is a negative symptom, characterized by a decrease in motivated self-initiated purposeful activities. Negative symptoms represent a deficit or absence of normal functions, distinguishing them from the 'added' features of positive symptoms.

Question 3

Which receptors are inhibited by antipsychotics of the second generation?

Accepted Answer

D2 and 5HT2

Answer

Second-generation antipsychotics (SGAs), also known as atypical antipsychotics, primarily exert their therapeutic effects by blocking dopamine D2 receptors and serotonin 5-HT2A receptors. The D2 receptor antagonism helps reduce positive symptoms, while the 5-HT2A receptor antagonism is thought to contribute to their efficacy against negative and cognitive symptoms and a lower risk of extrapyramidal side effects compared to first-generation antipsychotics.

Question 4

Which combination of antipsychotics causes the most weight gain?

Accepted Answer

Olanzapine and Clozapine

Answer

Among the antipsychotic medications, olanzapine and clozapine are consistently associated with the highest risk of significant weight gain and metabolic side effects. This is due to their potent antagonism of various receptors, including histamine H1 and serotonin 5-HT2C receptors, which play roles in appetite regulation and metabolism. Clinicians must carefully monitor patients on these medications for metabolic changes.

Question 5

What condition is not usually associated with Neuroleptic Malignant Syndrome (NMS)?

Accepted Answer

Leukopenia

Answer

Neuroleptic Malignant Syndrome (NMS) is characterized by elevated fever, severe muscle rigidity, autonomic instability, and altered mental status. While NMS can cause leukocytosis (elevated white blood cell count) due to stress, leukopenia (low white blood cell count) is not typically associated with NMS itself. Leukopenia, specifically agranulocytosis, is a known serious side effect of clozapine, but not a feature of NMS.

American Board of Psychiatry and Neurology Practice Test

American Board of Psychiatry and Neurology Practice Test

American Board of Psychiatry and Neurology