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Psychiatry Flashcards

7 cards from real NBME practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 30-year-old man with no psychiatric history suddenly believes he is receiving special messages from the television. He also hears voices commenting on his actions. Symptoms have been present for 3 weeks. What is the most likely diagnosis?

    Answer: Schizophreniform disorder

    Schizophreniform disorder presents with schizophrenia-like symptoms lasting 1–6 months; duration less than 1 month is brief psychotic disorder.

  2. A 25-year-old woman reports chronic feelings of emptiness, frantic efforts to avoid abandonment, and a history of self-cutting when upset. She has had three suicide attempts. What personality disorder best fits?

    Answer: Borderline personality disorder

    Borderline personality disorder is defined by unstable mood, identity, and relationships, chronic emptiness, fear of abandonment, self-harm, and impulsivity.

  3. A 40-year-old woman presents with a 3-month history of believing her husband is being unfaithful despite no evidence. She is otherwise well-functioning. No hallucinations are present. Which diagnosis is most appropriate?

    Answer: Delusional disorder, jealous type

    Delusional disorder involves a non-bizarre delusion lasting at least 1 month with preserved functioning and no other psychotic symptoms.

  4. A 10-year-old boy is brought in for difficulty sitting still in class, frequently interrupting others, and losing homework assignments. His teacher reports similar behavior. Symptoms began before age 7. What is the best initial treatment?

    Answer: Methylphenidate

    Methylphenidate (a stimulant) is first-line pharmacotherapy for ADHD and improves attention and impulse control.

  5. A patient on clozapine develops a fever of 39.2°C, sore throat, and an absolute neutrophil count of 450/µL. What is the most appropriate action?

    Answer: Discontinue clozapine immediately

    Clozapine-induced agranulocytosis (ANC < 500/µL) requires immediate discontinuation and should never be rechallenged.

  6. A 72-year-old woman develops acute confusion, disorientation, and visual hallucinations 2 days after hip replacement surgery. Her symptoms fluctuate throughout the day. Which diagnosis is most likely?

    Answer: Delirium

    Delirium is characterized by acute onset, fluctuating course, inattention, and disturbance of consciousness, commonly occurring postoperatively.

  7. A 35-year-old soldier returning from combat has nightmares, flashbacks, avoidance of crowds, and hypervigilance for 3 months after witnessing deaths of fellow soldiers. What is the diagnosis?

    Answer: Post-traumatic stress disorder

    PTSD is diagnosed when intrusion, avoidance, negative cognitions/mood, and hyperarousal symptoms persist for more than 1 month after a traumatic event.