DIRECTIONS (Items 1-80): Each of the numbered items or incomplete
statements in this section is followed by answers or by completions of
the statement. Select the ONE lettered answer or completion - that is
BEST in each case and fill in the right or left the Questions.
1. A female patient comes to the doctor's office looking thin and
disheveled. The patient's hair is patchy, with hair completely lost
from the scalp in some places and the remainder in various stages of
growth. The scalp is normal, not showing atrophy nor scaring. When
asked why she came to see the doctor, the patient replies that she
really did not want to come, but only kept the appointment at the
insistence of her mother.
(A) Factitious disorder
(B) Trichotillomania
(C) Anorexia nervosa
(D) Major depression
(E) Alopecia totalis
2. Secondary, partial epileptic seizures accompanied by aura:
(A) Petit mal epilepsy
(B) Lenonox-Gastaut syndrome
(C) Sylvian epilepsy
(D) Temporal lobe epilepsy
(E) Juvenile myoclonic epilepsy
Items 3 and 4
A 58-year-old female physician is hospitalized with a fractured ankle
following a traffic accident. Four days after this hospital admission,
the notes from the nurse on the chart indicate tachycardia;
restlessness, sweating and actions attributed to fearfulness. During
an interview she reports being bothered by "vague shapes" which she
sees coming out of the walls.
3. Based on this information, a check of the woman's past history is
most likely to show evidence of:
(A) bipolar disorder
(B) schizophrenic episodes /
(C) chronic alcohol abuse
(D) borderline personality disorder
(E) post-traumatic stress disorder
4. Two weeks later, her acute symptoms have subsided. Although you
have never treated her before, during visits for morning rounds she
speaks with pleasure about the many years, she says, that you have
cared for her and her family, and especially how you once saved the
life of her child. The woman is now manifesting symptoms of:
(A) malingering/"
(B) pathological intoxication
(C) psychogenic fugue
(D) Munchausen's syndrome
(E) Korsakoff s syndrome
5. Epidemiologists investigating an outbreak of salmonella poisoning
at a local restaurant gathered evidence of what patrons had eaten and
who had become ill. The results of their investigation are presented
in the following table:
Egg Drop Soup
Raw Clams
Chicken Special
TOTAL
Healthy
24
12
45
81
Sick
10
28
11
48
TOTAL
34
40
56
130
Based on this data , what is the attack rate for those persons who ate
raw clams?
(A) 12 /28
(B) 28/ 130
(C) 28/40)
(D) 28 /48
(E) 28 / 12
Items 6 and 7
You have been treating a depressed anxious 47- year-old woman with
phenelzine. After four weeks of treatment she is sleeping better,
appetite is improving and her mood seems less despondent. However, one
evening she calls feeling "bad". Quite suddenly, she had developed
palpitations, sweating and a sharp pain at the back of her skull.
6. The woman is most likely suffering from:
(A) acute anxiety attack
(B) depressive somatization
(C) somatic delusions
(D) hypertensive crisis
(E) hyperventilation syndrome
7. Treatment would most likely include:
(A) Chlorpromazine
(B) Doxepin
(C) Buspirone
(D) Trazodone
(E) Alprazolam
8. Despite continuing public skepticism and even fear regarding its
use, electro-convulsive therapy (ECT) has been proven safe and
effective for treating a number of psychiatric conditions. Empirical
experience with ECT has shown that:
(A) only about 50% of patients on whom it is tried show any real
improvement
(B) even with current precautions, about 5% of patients experience
minor fractures
(C) treatments are followed by memory loss, which often lasts several
months
(D) effects are facilitated by a concomitant course of lorazepam
(E) usually requires 5 to 10 treatments for full efficacy
9. The best way to distinguish a delusion from a hallucination is on
the basis of:
(A) consensual validation
(B) perceptual experience
(C) grandiosity
(D) laboratory tests
(E) thematic appreciation test
15. Which term best describes the situation in which the physician
says to the patient, "You are very quiet today."?
(A) Reassurance
(B) Confrontation /
(C) Facilitation
(D) Close-ended statement
(E) Leading statement
16. Which of the following psychological tests would be most useful
for assessing if a five- year-old child had been sexually abused?
(A) Rorschach Test
(B) Thematic Apperception Test
(C) Sentence Completion Test
(D)California Psychological Inventory
(E) Draw-a-Person Test
17 and 18
HIV antibody testing, including initial and confirmatory test, is used
to screen the national blood supply. An enzyme immunoassay (EIA) is
applied first. Any blood unit that is reactive on the initial EIA is
discarded. However, blood donors are notified that they are "positive"
for the HN antibody only if an additional EIA and a confirmatory
Western Blot (WE) are also reactive.
17. To optimally protect the national blood supply, the EIA test must
have:
(A) high sensitivity
(B) high specificity
(C) high positive predictive value
(D)high negative predictive value
(E) high accuracy !
18. Minimizing the number of persons who are erroneously informed that
they are probably infected with HIV by the Western Blot confirmatory
test effects
(A) sensitivity and specificity
(B) sensitivity and positive predictive value
(C) specificity and positive predictive value
(D) positive predictive value and negative predictive value
(E) specificity and negative predictive value
19. On January 1, the number of cases of diagnosed multiple sclerosis
(MS) in an urban metropolitan area was 321. During .the calendar year,
seven of these persons / died from a variety of causes. Also during
the year, 15 cases of MS were newly diagnosed, and one of these died
in a motor vehicle crash. The point prevalence for MS at the end of
the year is:
(A) 14 / mid-year population x 100,000
(B) 15 / mid-year population x 100,000
(C) 328 / mid-year population x 100,000
(D) 329 / mid-year population x 100,000
(E) 336 / mid-year population x 100,000
20. A cohort of ischemic heart disease (IHD) incidence in relation to
habitual levels of physical activity (PA) was conducted. Based on the
following relative risks, as reported in the study results, what is
the most appropriate conclusion?
Level of Physical Activity
Relative Risk
Confidence Interval
Sedentary
1.00
NA
Low
.95
(.89 - 1.21)
Moderate
.86
(.73 - 1.09)
High
.64
(.49 - .87)
(A) The higher the level of PA, the higher the IHD risk
(B) All level of PA appear to have a significant protective effect
(C) High and moderate levels of PA appear to have a significant
protective effect
(D) Only high levels of PA appear to have a significant protective
effect
(E) A dose-response relationship is evident, but significance can not
be determined
21. Much of what is known about the brain chemistry associated with
sleep stems from recognition of the correlations between, sleep
effects and various pharmacological and psychiatric events. This
recent research has shown that:
(A) drugs that decrease brain dopamine / produce arousal and
wakefulness
(B) patients with Alzheimer's disease have reduced REM sleep time
(C) insomnia is often associated with the later stages of a depressive
episode
(D) manic episodes are often accompanied by periods of hypersomnia
(E) the initial REM episode is shorter than normal in depressed
patients
22. Which of the following would be the best choice to produce short
term, muscle-relaxing effects?
(A) Triazolam
(8) Alprazolam
(C) Lorazepam
(D) Diazepam
(E) Quazepam
23. His parents referred Jack, a 15-year-old male, to the clinic for
evaluation. During the interview, Jack seemed defiant and rebellious.
"Why don't people just leave me alone to do what I want to do?" he
asked. These constant demand for independence have cause him [0 stop
listening [0 his parents and occasionally being absent from school.
Jack's behavior:
(A) suggests that he should be turned over to the courts for
disposition
(B) can probably be controlled by stricter rules and punishments
(C) can be the expected behavior at this :.- stage of development
(D) is evidence of an identity crisis
(E) is usually accompanied by inner feelings of security, confidence
and masculinity
24. During a discussion of her relationship with her husband, a woman
breaks downs into tears, crying for several minutes. She reports that
she had been feeling terribly hurt by her husband's recent affair, but
had been unable to express it until that moment. The best description
of her behavior is:
(A) cathexis
(B) fixation resolution
(C) catharsis
(D) hysterical reaction
(E) transference
25. Each of the past 10 years has shown a decrease in the rate of
on-the-job deaths. Yet, job-related mortality remains high. The
incidence of accidental death is highest for which of the following
industries?
(A) Transportation
(B) Manufacturing
(C) Construction
(D) Agriculture
(E) Mining
26. A recent quality of care survey documented several important
parameters for defining key aspects of patient care. One key
parameter, mean length of stay, showed that the average stay of
persons discharged from the hospital in a given year is about 6 days.
This means that:
(A) half the patient stay longer and half less than six days
(B) the average length of stay of discharged patients on any given day
will center around six days
(C) the greatest proportion of patients discharged stayed in the
hospital eight days
(D) the total number of days of hospitalization provided during the
year, divided by the number of discharges, is six days
(E) the frequency distribution of discharges by length of stay is
symmetrical about a center of six days
27. A cat scratched Sally, a 3-year-old child, when aged one. Since
then, she has developed a phobia of small animals. The recommended
treatment is having small animals carried very gradually towards her
while she was listening to her favorite music. This procedure is best
described as:
(A) extinction of a classically conditioned response
(B) extinction of an operantly conditioned response
(C) competitive positive reinforcement
(D) chaining of emotional responses
(E) secondary reinforcement
28. A researcher interested in examining the differences in health
care in rural and urban areas collected information regarding the
number of elective surgeries for MEN and WOMEN in 50 rural and 50
urban randomly sampled communities. The results indicate a mean number
of elective surgeries in the city as 146 per 1,000 and 56 per 1,000 in
the rural areas. What statistical test should the researcher conduct
to take full advantage of this data?
(A) T-test
(B) Chi-square
(C) One way analysis of variance
(D) Two way analysis of variance
(E) Pearson correlation
29. Given that recent research has established concordance rates for
schizophrenia of 48% for monozygotic twins and 12% for dizygotic
twins, by means of the Inheritability Index compute the proportion of
schizophrenia that has agenetic basis?
(A) 10%
(B) 20%
(C) 30%
(D) 40%
(E) 60%
30. Sue, a 36-year-old, Hispanic woman has been brought to the clinic
by her daughter who states that her mother has "been getting
impossible to live with". The mother refuses to talk with the male
doctor, although she watches him very intently. The daughter explains
that her mother has been increasingly wary of men, and has
circumscribed her contacts with them. During an interview with a
female resident, Sue talks relatively freely and coherently, confiding
that, "We have to watch out for those men. All they want is one thing.
You have to always be on your guard." The best preliminary diagnosis
for this patient would be:
(A) paranoid personality disorder
(B) histrionic personality disorder
(C) adjustment disorder
(D) paranoid schizophrenia
(E) paranoid disorder
31. Studies as to the prevalence of schizophrenia show that
schizophrenia is more likely in:
(A) persons of moderate socio-economic status
(B) females
(C) immigrants
(D) rural areas
(E) children born in the summer months
32. In a test of associative learning, a woman is asked to memorize a
list of words and to choose a picture to match each word. If the woman
were normal, subsequent examination of the picture chosen should
remind her of the previously learned word. However, in the present
case, the woman has tremendous difficulty with the recall task. The
most likely cause for this dysfunction is a lesion of the:
(A) parietal lobe
(B) temporal lobe
(C) frontal lobe
(D) basal ganglia
(E) occipital lobe
33. To assess public attitudes towards AIDS in the community, one of
every ten houses in every city block are drawn at random, and all
persons aged 20 to 45 years normally residing in those houses are
included in the sample. However, the response rate differs from block
to block. To make up for this, additional houses are added until the
desired quota of responders is reached for each block. The sample is
thus made adequate in size, but has not been corrected for bias
primarily because:
(A) persons move from one part of the city to another
(B) repetitive contacts by the interviewers will increase interviewer
bias
(C) persons living in different parts of the city may react
differently to different interviewers
(D) non-respondents and wonders may react differently
(E) persons on one block may respond differently than persons on the
next.
36. Developmental psychologists have identified a number of factors
that are important for influencing the child's development. Research
has shown that the child's social development is most strongly
influenced by the:
(A) techniques of discipline used by the child's parents
(B) age when toilet training is initiated
(C) pervasive emotional tone expressed .by the parents
(D) cohesiveness of the marital unit
(E) number of siblings
37. Mr. Callahan, a 56-year-old white male, is brought to the local
clinic by his wife who reports with great concern that he has "become
difficult to understand." He has, by her report, become hyperactive,
excitable and irritable. Under examination, he talks a lot, in a
rapid, pressured manner, characterized by odd word choices. For
example, when asking for a "pen," he calls it a "writer," or uses
words that seem to be made up. In addition, he has trouble repeating
words back to the examiner. No muscle weaknesses are detected. Based
on this preliminary examination, the most likely diagnosis for Mr.
Callahan would be:
(A) Broca's aphasia
(B) schizophrenia, undifferentiated type
(C) transcortical aphasia
(D) Wernicke's aphasia
(E) general aprosodia
38. A 35-year-old woman is admitted for treatment of alcoholism and
possible pill use. Physical examination and labs are within normal
limits. Eight days following uneventful withdraw from alcohol, patient
develops anxiety, agitation, tremulousness, and insomnia. The most
likely explanation for this is:
(A) Diazepam dependency
(B) Codeine dependency
(C) Amitriptyline dependency
(D) Delirium tremens onset
(E) Hysterical reaction
39. George, age 8, achieved a score on the IQ test equivalent to
someone at age 11. The resulting IQ score for George is higher than
what percentage of the population?
(A) just over 84%
(B) just under 84%
(C) just over 97%
(D) just under 97%
(E) just under 68%
40. Users of the drug phencyclidine report unpredictable subjective
effects. The irregular variation of these effects tends to perpetuate
use of the drug. This is best described as an example of:
(A) classical conditioning
(B) operant conditioning
(C) tolerance
(D) habituation
(E) spontaneous recovery
Item 41
Soon after the outbreak of toxic shock syndrome, an epidemiological
study was conducted examining the relationship between the incidence
of toxic shock and the type of tampons used. The results of the study
are presented in the table below:
Toxic Shock Reported
No Toxic Shock Reported
Brand X
120
350
Other Brands
24
450
41. Based on this information, what is the relative chance of getting
toxic shock if a woman uses Brand X compared to the
Other Brands
(A) (24 / 120) / (450 / 350)
(B) (241 350) / (120 1 450)
(C) (120 x 450) / (24 / 350)
(D) (24 x 350) / (120 x 450)
(E) (120 x 450) / (24 x 350)
42. By means of an IQ test with the usual standard error of
measurement, Jack is assessed as having an IQ score of 90. Based on
this score we would most likely classify Jack as having what level of
intelligence?
(A) Superior
(B) Above average
(C) Average
(D) Borderline
(E) Mental defective
43. A community survey reveals that a certain disease has a higher
prevalence in whites than non-whites. This higher prevalence may
possibly be the result of:
(A) whites have more clinic visits than non-whites
(B) non-whites have a shorter disease span than do whites
(C) the disease has a higher incidence in non-whites than in whites
(0) the disease has a higher mortality rate in whites
(E) the disease has a higher attack rate in non-whites
44. A man in his mid-20s is brought into the emergency room by a
friend, who then leaves. The examination of the man shows rapid pulse
and dilated pupils. He complains of pain in his "gut," muscle spasms,
tremors, and generalized anxiety. The examination is interrupted by a
fit of vomiting. Treatment will most likely include:
(A) buspirone
(B) clonidine
(C) carbamazepine
(D) phenelzine
(E) amantadine
45. On which of the following tests is the students' performance
better, relative to his classmates?
(A) Student' score = 40, class mean = 30, standard deviation = 5
(B) Student score = 45, class mean = 35; - standard deviation = 4
(C) Student score = 50, class mean = 45, 4~t standard deviation = 4
(D) Student' score = 60, class mean = 52, - standard deviation = 5
(E) Student' score = 71, class mean = 65, standard deviation = 4
46. In terms of learning theory, neurotic symptoms are the result of:
(A) a compromise between forces engaged in unconscious conflict
(B) the _expression of repressed wishes
(C) sublimated instrumental responses
(D) inappropriate fear reactions
(E) developmental stage linked anxiety responses
47. Temporal lobe epilepsy is associated with:
(A) Increased sex drive and increased aggression
(B) Increased sex drive, but no effect on aggression
(C) Decreased sex drive and decreased aggression
(D) Decreased sex drive, but no effect on aggression
(E) No effect on sex drive, but increased aggression
Items 48 and 49
The population of Miami is approximately I 2,000,000 persons.
Hispanics comprise about 50% of the population; whites, 30%; and
blacks 20%. For the following questions, assume that I males comprise
half of the population within each racial category. Also assume that
the distribution of blood types is identical across all races:
type A = 30%; type B = 15%; type AB = 5%; type O = 50%.
48. Estimate the number of Miami residents with either blood type B or
blood type AB.
(A) 100,000
(B) 200,000
(C) 250,000
(D) 300,000
(E) 400, 000
49. What is the probability that an individual chosen at random from
Miami will be a black male with blood type 0?
(A) 5 %
(B) 10%
(C) 15%
(D) 20%
(E) 25%
50. Most common toxin:
(A) Lead
(B) Botulism
(C) Carbon tetrachloride
(D) Toluene
(E) Ethyl alcohol
51. A 48-year old male reports being impotent with his wife, while
capable of performing sexually with his mistress. This might best be
described as the defense mechanism of:
(A) Passive-aggressive behavior ,
(B) Blocking
(C) Reaction formation "'
(D) Introjection
(E) Somatization
52. Which of the following is most likely to be non-sedating, has low
abuse potential and is useful for alcohol detoxification?
(A) Diazepam
(B) Halazepam
(C) Triazolam
(D) Busiprone
(E) Clonazepam
53. Clyde is a 56-year old, black male who lives by himself in a small
room of a transient hotel, which he pays for with a monthly disability
check from the government. He is generally clean, although his clothes
are often tattered. As a man of regular habits, Clyde eats two meals a
day, always at the same small diner where he always sits in the same
booth. For breakfast he orders two strips of bacon, two eggs, two
pieces of white toast and two cups of coffee. His second meal is just
as regular: two bowls of soup, along with two cheese sandwiches, each
with two pickles. Clyde never throws anything out. His room is piled
high with newspapers and magazines he has collected over [he years,
arranged neatly in double stacks. His drawers are crammed full of
pieces of sting and matchbooks, which he also collects. He never goes
out without his two lucky charms. In conversation, Clyde is coherent,
although soft spoken, and given to both particular choices of words
and a tendency to say everything twice, which makes him difficult to
understand. The most likely diagnosis for Clyde would be:
(A) Schizoid personality disorder
(B) Schizotypal personality disorder
(C) Avoidant personality disorder
(D) Anti-social personality disorder
(E) Obsessive-compulsive personality disorder
54. The most common health problem in the United States is
(A) Cancer
(B) Heart disease
(C) Substance abuse
(D) Obesity
(E) Dental caries
55. In the case of a school phobia, the most appropriate management
would be:
(A) Keep the child in the same class in conjunction with parental
counseling
(B) Allow the child to remain at home until the problems causing the
school phobia can be identified and addressed
(C) Keep the child in the same class, but provide counseling to foster
better social skills to improve the child's relationships with peers
(D) Keep the child in the same class, and have a parent attend school
with the child, tapering off the parent's attendance until the child
is able to stay at school on his own
(E) Change the child's classroom setting within the school
56. Research on the effects of communicated appeals on subsequent
attitude change toward as life-threatening illness tells us that:
(A) There is a positive linear relationship between the degree of fear
arousal in the communication and the degree of change
(B) There is an inverse relationship between the degree of fear
arousal in the communication and the degree of change
(C) There is no consistent relationship between the degree of fear
arousal and the degree of change
(D) Moderately strong fear arousal tends to produce more attitude
change than either weak or very strong fear appeals
(E) Any level of fear arousal, if backed by strong intellectual
arguments tends to produce more attitude change than no fear arousal
at all
57. A 4-year-old boy's history and present behavior include an
inability to relate to other children or adults since infancy, failure
of the use of language, a preoccupation with maintaining sameness with
objects in his environment, and repetitive and stereotyped behaviors.
The most likely diagnosis for this child is:
(A) childhood schizophrenia
(B) dyslexia
(C) developmental delay, due to hearing impairment
(D) mental retardation
(E) pervasive developmental disorder
58. A 6-year old girl is brought by her father to see a physician at a
local '3:iTi15uratory care clinic. The father reports that the child
is nocturnally enuretic about 3 to 5 times a month. The physician's
best course of action is to:
(A) refer her to a psychiatrist
(B) investigate the family for any signs of sexual abuse
(C) tell the father that this behavior is normal and that she will
grow out of it
(D) collect a detailed history of the symptoms and ask about any
recent events in the child's life
(E) Prescribe a course of imipramine
59. A 36-year-old male is referred for evaluation complaining of
excessive sleepiness. He has come in for evaluation after falling
asleep at work. Upon questioning, he reports that his body sometimes
becomes paralyzed and that he occasionally suffers from both visual
and auditory hallucinations. The most likely diagnosis for this man
is:
(A) central sleep apnea
(B) narcolepsy
(C) idiopathic sleep disorder
(0) somnambulism
(E) conditioned poor sleep
60. A mother brings in her 16-year old son for evaluation, reporting
that he suffers from periods of brief loss of consciousness
accompanied by a twitching of the muscles of the face. The son
describes it as, "sort of like just phasing out, but then I come back
again." The EEG results show a three per second spike and slow wave
patterns. The best choice for pharmacological management would be:
(A) primidone
(B) carbamazepine
(C) diphenylhydantoin
(D) Phenobarbital
(E) ethosuximide
61. Which of the following age groups is most likely to be covered by
health insurance?
(A) Below 20 years of age
(B) 25 to 35 years of age
(C) 35 to 55 years of age
(D) 55 to 65 years of age
(E) 65 to 75 years of age
Items 66 and 67
62. A 36-year old male is brought into the emergency room by an
ambulance following an automobile accident. Upon examination, the man
is found to be suffering from a broken femur, several broken ribs and
internal injuries accompanied by bleeding in the abdominal cavity.
When the physician asks the patient how he is doing, the patient
replies, "I have some pain." The doctor responds, "Does it really hurt
a lot?" This question by the doctor is best described as an example
of:
(A) facilitation
(B) exploratory question
(C) responsive question
(D) reflection
(E) leading question
63. Because of the internal bleeding, the patient is losing a lot of
blood. The physician determines that surgery is required to stop the
loss of blood. When the patient is informed of this he refuses
consent, citing religious grounds. The collective opinion of the
medical staff is that without the surgery, the man's life is in
serious risk. What should the physician do?
(A) Try to contact the patient's family to obtain their permission
(B) Seek a court order permitting the surgical procedure
(C) Negotiate with the patient as to what alternative treatment he
might accept
(D) Call in the hospital legal staff for advice
(E) Do nothing, the patient has a right to refuse treatment
64. The air quality is assessed in two Midwestern cities, one in which
a government program has been instituted reducing the amount of carbon
monoxide emissions allowed, and one without the government program.
The rates of respiratory problems in both cities are recorded over a
five-year period. Given the design of this study, an appropriate one-
tailed null hypothesis would be:
(A) air quality is related to respiratory problems in both of the
cities under study
(B) air quality is related to respiratory problems in the city with
the government program, but not in the other city
(C) no evidence will be found for differences in air quality between
the two cities
(D) the rate of respiratory problems in the city with the government
program will not be any lower than that of the other city
(E) air quality will be inversely related to the rate of respiratory
problems in both cities.
65. The action of serotonin is most closely associated with the:
(A) nigrostriatal pathway
(B) raphe nuclei
(C) tuberoinfundibular system
(D) mesolimbic pathway
(E) locus ceruleus
66. The power of a statistical test can be increased by:
(A) increasing the chance of failing to reject a null hypothesis when
it is true
(B) decreasing the chance of rejecting a null hypothesis when it is
true
(C) increasing the chance of rejecting a null hypothesis when it is
true
(D) reducing the expected effect size
(E) increasing the number of independent variables
67. A middle-aged woman has had a series of four different jobs in
different hospitals in the area. She lost each of them due to hospital
budget cuts. Now she refuses to put forth any effort to seek a new
job, preferring to just stay at home and watch TV. "What's the use",
she says, "even if I could find another job, I would just lose it
again, so there is no reason to put myself through that. The best
description of this woman's behavior is:
(A) vocational aversion
(B) learned helplessness
(C) negative reinforcement
(D) implosion
(E) shaping
68. Memory impairment resulting from bilateral lesions of the medial
temporal lobe:
(A) has little apparent effect on skill- based memory
(8) is limited to one sensory modality
(C) affects both long and short term memory
(D) has no impact on events prior to the onset of amnesia
(E) is eased by increasing the time between exposure and retention to
facilitate consolidation
69. Destruction of the lateral hypothalamus in rats leads to:
(A) anorexia
(B) thirst
(C) hyperphagia
(D) increased aggressiveness
(E) apathy
70. Helen Drumand, age 70, has experienced a slow deterioration of her
cognitive abilities over the past several years. The loss has been
gradual, and her family is largely unaware of the decline. Her "people
skills" are still intact, but she has difficulty concentrating on the
crossword puzzles that she has always loved to do. Often, she forgets
conversations she has just had, but is able to remember events from
her youth with remarkable clarity. The most 11kely cause of Helen's
condition is:
(A) Pseudodementia
(B) Multi-infarct dementia
(C) Pick's disease
(D) Dementia of the Alzheimer's type
(E) Creutzfield- Jacob disease
71. A recent study tested the efficacy of a new medication delivery
system for offering relief t0 patients with gastric ulcers. Twenty-two
patients were given their usual medication in capsules coated with a
new, easier t0 digest coating, while 22 other patients were given
capsules using the old coating. Patients were followed over a one
month period and reported their degree of relief at one week
intervals. The data were analyzed t0 determine if the new coating
group reported a higher level of relief than the old coating group.
Analysis of this data produced a value of p = .024. Based on this
evidence we may safely conclude:
(A) the new coating offers a more effective medicine delivery system
than the old coating
(B) the new coating offers a clinically significant advantage over the
old coating
(C) patients were more likely t0 rake the -1: capsules with the new
coating
(D) most of the patients preferred the f new capsules
(E) it is likely that patients in the general population who are given
the new coating rather than the old coating will report relatively
greater relief from their symptoms.
72. A 32-year-old Irish male appears at the clinic complaining of "a
slight pain" on his left side. Upon examination, he is found to have
two broken ribs. When informed of this, the man insists that it can
not be that serious and asks only for some medication for the pain.
This is best characterized as the defense mechanism of:
(A) displacement
(B denial
(C) depression
(D) isolation
(E) reaction Formation
73. Recent studies based on a representative sample of adolescents
show that:
(A) teenagers generally do not trust their parents
(B) normal teenagers experience intense inner turmoil
(C) teenage rebellion is manifest as relatively minor disagreements
with parents regarding music and dress
(D) most teenagers reject their parents' core values
(E) rebellious behavior is most common during the later teenage years
74. A female, age 56, is brought to a community clinic by a neighbor.
The woman reports a loss of agility, and a slight bur persistent
tremor. During the interview, the patient seems apathetic and
forgetful. On the Beck Inventory she scores a 24. This patient is most
likely suffering from:
(A) simple schizophrenia
(B) dysthymia
(C) Alzheimer's Disease
(D) bipolar Disorder
(E) Parkinson's Disease
75. Research into the epidemiology and treatment of schizophrenia
tells us that:
(A) monozygotic twin studies report lower rates for females than males
(B) age of onset is generally later for males than females
(C) female patients respond better to neuroleptics better than do male
patients
(D) the generic contribution has been found to follow known Mendelian
patterns.
(E) the concordance rates for monozygotic twins only slightly more
than that of same-sex dizygotic twins.
76. Suggests good prognosis in schizophrenia:
(A) Catatonic features
(B) Family history of schizophrenia
(C) Negative symptoms
(D) Autistic behavior
(E) No known precipitating factors
77. A woman in her late 30's appeared at the local clinic. She
reported that she had recently quit smoking. However, since .then she
felt plagued by an uncontrollable fear that whenever she left her
house, it would burn down from a cigarette she left behind smoldering.
She was only able to come to the clinic by leaving her mother behind
with a fire extinguisher to watch the house. The most likely diagnosis
for this woman is:
(A) paranoid disorder
(8) hysterical personality disorder
(C) obsessive-compulsive personality disorder
(D) obsessive-compulsive anxiety disorder
(E) agoraphobia r\
78. The child has just learned to stand by himself without help. The
child is in which Eriksonian stage of development?
(A) Initiative vs. guilt
(B) Autonomy vs. shame
(C) Identity vs. role confusion
(D) Trust vs. mistrust
(E) Industry vs. inferiority
79. A child achieves the "laws of conservation" during the ages
corresponding to what Freudian stage?
(A) Latency
(B) Phallic
(C) Oral
(0) Genital
(E) Anal
80. An insomniac is instructed to take sleeping medication every
evening at 10:00 PM.. Eventually, the man goes to sleep every night
just after 10:00 without taking his medication. This is an example of:
(A) operant conditioning
(B) respondent conditioning
(C) intermittent reinforcement
(0) habituation
(E) shaping
DIRECTIONS (Items 81-96): Each of the numbered items or incomplete
statements in this section is negatively phrased, as indicated by a
capitalized word such as NOT, LEAST, or LEAST LIKELY. Select the ONE
lettered answer or completion that is BEST in each case and fill in
the circle containing the corresponding letter on the answer sheet.
81. A female patient continuing on a course of anti-psychotic
medication would be LEAST LIKELY to experience:
(A) orthostatic hypotension
(B) dental cavities
(C) amenorrhea
(D) weight loss
(E) breast enlargement
82. All of the following reasons might account for the differences
between rates of elective surgery for rural and urban settings,
EXCEPT:
(A) differences in pathologic conditions. in the populations
(B) variation in the number of surgeons per capita
(C) the relative availability of hospital beds in the urban setting
(D) distance required to be traveled t0 reach a health care facility
(E) lack of publicity as to the availability of procedures
83. Maternal cocaine use during pregnancy is LEAST LIKELY to be
associated with increased incidence of the following:
(A) Spontaneous abortion
(B) Microcephaly
(C) Premature labor
(D) Abruption placentae
(E) Fetal death
84. Which of the following drugs is LEAST LIKELY to produce psychotic
symptoms resembling schizophrenia?
(A) amphetamine
(B) methaqualone
(C) mescaline
(D) LSD
(E) phencyclidine
85. Which of the following does NOT occur before 12 months of age?
(A) separation anxiety
(B) cooperative play
(C) fear of a stranger
( D) social smile
(E) hand grasp
86. Years of research and observation have detailed a number of
mechanisms by which humans cope with the stresses and strains which
they encounter in their lives. Which of the following is NOT
considered a mechanism in response to stress?
(A) Avoid stressor
(B) getting Information
(C) Manifest anxiety
(D) Denigrate stressor
(E) Do the opposite of what one feels
87. Biofeedback is LEAST LIKELY to be effectively used in the
treatment in which of the following:
(A) Grand Mal Epilepsy
(B) Tension Headaches
(C) Orthostatic Hypotension
(0) Tourette's Syndrome
(E) Raynaud's Syndrome
88. Visual hallucinations are LEAST LIKELY to be a part of the
clinical picture of:
(A) alcohol withdrawal
(B) schizophrenia, disorganized type
(C) Alzheimer’s dementia
(D) narcolepsy
(E) temporal lobe epilepsy
89. Experience with psychopharmacological agents suggests that which
of the following statements is LEAST LIKELY to be true?
(A) The use of Imipramine results in impotence in about~% of all
individuals
(B) The incidence of impotence with phenelzine is higher than with
imipramine
(C) Lithium carbonate has been associated with the occurrence of
impotence
(D) Ejaculatory problems occur in, approximately 25% of phenelzine
users
(E) Impotence occurs in approximately 80% of patients treated with
high doses of chlorpromazine
90. Although there is considerable debate as to the relative effects
of nature vs. nurture on the development of homosexuality, certain
facts have been established. According to current research, which of
the following is NOT true?
(A) Alterations if prenatal hormones may play a role in determining
the tendency towards homosexuality
(B) There is a higher concordance among monozygotic than among
dizygotic twins
(C) Cross-gender behavior during childhood commonly occurs
(D) Most homosexual men report more women than men in the household as
they grew up
(E) Rates of homosexuality are higher for males than for women
91. Which of the following is NOT true concerning the successful use
of biofeedback?
(A) the patent must receive continuous information about the
physiologic activity.
(B) Thc physiologic activity must be detectable and measurable
(C) A patient's motivation is important
(D) It is used primarily to gain control
(E) It is used primarily to gain control over the central nervous
system
(F) A very large-amount of practice is required for successful mastery
Items 92 and 93
A 4-year-old child is scheduled to be hospitalized overnight for a
tonsillectomy. This will be the child's first experience staying away
from his home. The surgery is successful and the child returns home
with his parents
92. Which of the following reactions in the child would you anticipate
as LEAST LIKELY following the surgery?
(A) Speaking baby talk
(8) Thumb-sucking
(C) Separation anxiety
(0) Enuresis
(E) Encopresis
93. About a year later, the little boy begins to 5 experience
nightmares of a monster coming into his bedroom. The boy describes
details such as the monster. is going to "bite off' his nose and "eat
him up". As the family physician you should advise the parents that:
(A) the child shows initial signs of post- traumatic stress disorder
(B) a psychiatric consult is needed as a precaution
(C) a full neurological examination, including electroencephalography
should be performed
(D) these symptoms are frequent at his age and usually transitory
(E) these nightmares are early signs of oedipal anxiety and should be
addressed by talking over his anxieties with the child
94. Which of the following is NOT an example of the use of
biofeedback?
(A) Electric shock given to a person when antisocial behavior is
manifested
(B) Electronic display of skin temperature
(C) A physician telling the patient that as a result of a diet, the
patient's blood pressure is reduced
(D) Electro-convulsive therapy given to a depressed patient
(E) Tension headache treated with electromyogram
95. Sarah, 15-year old adolescent is referred for psychotherapy by her
school counselor because of behavior problems in school. Which of the
following is the LEAST LIKELY reason why Sarah might be resistant to
psychotherapy?
(A) She does not feel that her behavior is , a problem
(B) She does not want to be labeled as crazy
(C) She is not able to think in abstract terms
(D) Her behavior may be an integral part of her attempt to separate
from her parents
(E) She views the therapist as representing her parent's values
96. Which of the following would NOT be expected to elevate during the
early stages of nocturnal sleep?
(A) prolactin
(B) Thyroid-Stimulating Hormone
(C) serotonin
(0) Human Growth Hormone (HGH)
(E) melatonin
DIRECTIONS (Items 102-122): Each set of matching questions in this
section consists of a list of4-15 lettered options (some of which may
be in figures) followed by several numbered items. For each numbered
item, select the ONE lettered option that is most closely associated
with it and fill in the circle containing the corresponding letter on
the answer sheet.. Each lettered option may be selected once, more
than once, or not at all.
Items 102 and 103
(A) Sexual Sadism
(F) Dyspareunia
(K) Pedophilia
(B) Sexual Masochism
(G) Exhibitionism
(L) Premature ejaculation
(C) Trans-sexualism
(H) Frotteurism
(M) Impotence
(D) Transvestitism
(I) Fetishism
(N) Satyriasis
(E) Vaginismus
(J) Voyeurism
(0) Masturbation
102. Associated with pelvic pathology, genital surgery and childhood
abuse. Condition is aggravated if partner proceeds with intercourse.
103. Most common of type of sexual assault.
Items 104 and 105
(A) Acting out
(F) Intellectualization
(K) Regression
(B) Autism
(G) Introjection
(L) Repression
(C) Denial
(H) Isolation
(M) Splitting
(D) Displacement
(I) Projection
(N) Sublimation
(E) Dissociation
(J) Reaction formation
(0) Suppression
104. Persons who have been abused as children often become child
abusers themselves.
105. A female child, age 4, is observed being physically abused by her
mother. Metro authorities intervene in the situation, the child is
referred for evaluation and counseling. Throughout the initial
interview, the child says little and asks repeatedly to "go home".
When asked how she is treated at home, the girl says, "My mommy always
treats me nice and would never hurt me."
Items 106-108
Lesion of:
(A) Dominant parietal lobe
(H) Ventro-medial hypothalamus
(B) Non-dominant parietal lobe
(I) Lateral hypothalamus
(C) Dominant temporal lobe
(J) Amygdala
(D) Non-dominant temporal lobe
(K) Thalamus
(E) Dominant frontal lobe
(L) Basal ganglia
(F) Non-dominant frontal lobe
(M) Corpus callosum
(G) Occipital lobes
106. Patent show diminished response to painful stimuli administered
at multiple bodily sites.
107. When asked to copy a picture of geometric shapes, patient is able
to produce the right hand side exactly, but neglects to even draw the
left-hand side of the figure
108. Her daughter who is very concerned brings a woman to a local
clinic that, "something is just not right with Mom." Her daughter
reports that her mother has become dysphoric and increasingly
irritable. Particularly distressing to her is the fact although her
mother is considered my most to be a gifted singer, she is now unable
to carry a tune
Items 109 and 110
(A) Case report
(F) Cohort study
(B) Clinical case series
(G) Randomized clinical trial
(C) Cross-sectional study
(H) Double-blind randomized clinical trial
(E) Case-control study
(J) Nested case-control study
109. Longitudinal study tracking 1,000,000 American Cancer Society
volunteers, classified by smoking status at entry, to determine rates
of occurrence of chronic obstructive pulmonary disease, coronary heart
disease and a variety of cancers
110. Mailed survey of state physicians in a low HN -seroprevalence
state, regarding their knowledge, attitudes, ai1d clinical practice
skills for treating patients with AIDS
Item 111 to 113
(A) Factor analysis
(H) Chi-square
(B) Pooled t-test
(I) Regression
(C) Matched pairs t-test
(J) Fischer's exact test
(D) One way analysis of variance
(K) Odds ratio
(E) Two way analysis of variance
(L) Relative risk
(F) Pearson correlation
(M) Attributable risk
(G) Spearman correlation
Select the appropriate statistical test for examining associations or
differences between comparison groups.
111. Comparison of population means of serum cholesterol in the 16
cohorts of middle-aged men comprising the Alameda County Study.
112. Comparison of male and female systolic blood pressure
distributions for brothers and sisters'
113. Comparisons of HN status (positive or negative) for men from
three different risk factor groups: men who have a history of sex with
other men, injecting drug users and recent immigrants from Pattern II
nations.
Items 114 and 115
(A) Fixed Interval Reinforcement
(I) Biofeedback
(B) Positive Reinforcement
(J) Systematic Desensitization
(C) Variable Interval Reinforcement
(K) Operant conditioning
(D) Negative Reinforcement
(L) Classical conditioning
(E) Fixed Ratio Reinforcement
(M) Secondary Reinforcement
(F) Punishment
(N) Extinction
(G) Flooding
(0) Spontaneous recovery
(H) Observational Learning
114. When they were dating, a man and a woman talked on the phone at
least once every other day. Now, although their relationship ended
years ago, the man picks up the phone and calls this old girlfriend.
115. A woman sitting in a physician's office feels anxious and wonders
what the doctor will tell her. As she waits, she hears an old song on
the radio, a song her mother often sang to her as she went to sleep at
night. The woman suddenly feels calm and more relaxed.
Items 116 to 118
(A) Senile Dementia
(I) Adjustment Disorder
(B) Avoidant Personality Disorder
(J) Malingering
(C) Alcoholism
(K) Schizoid Personality Disorder
(D) Acute Delirium
(L) Cocaine Withdraw
(E) Major Depression
(M) Anti-social Personality Disorder
(F) Panic Disorder
(N) Cannabis Withdraw
(G) Paranoid Disorder
(0) Alcohol Withdraw
(H) Psychogenic Fugue
116. Mr. Verdalenra, age 55, is a successful businessman and the head
of a fast-growing company which he founded. Business is good. orders
are flooding in. None-the-less, he becomes convinced that the business
will fail and that he will soon lose all his material possessions.
Only family intervention
keeps him from selling the business at well below what it is worth.
117. Anxiety and insomnia lasting for several weeks.
118. An adolescent is referred for treatment after being arrested for
shoplifting for the second time in three weeks. During the same period
has been ticketed for five traffic violations and failed two exams at
school. Prior to this most recent episode, the patient had been a "B"
student with no prior history of legal troubles.
Items 119 and 120
(A) Projection
(F) Introjection
(K) Isolation
(B) Acting Out
(G) Regression
(L) Intellectualization
(C) Passive-aggressive
(H) Displacement
(M) Sublimation
(D) Splitting
(I) Dissociation
(N) Reaction formation
(E) Denial
(J) Rationalization
(O) Repression
119. A woman is regularly beaten by her husband. When questioned about
the continuing abuse, she admits that she is hurting, but defends him,
explaining that he is "under a lot of pressure", and that she is not
as supportive as she should be. "You have to see things from his
perspective,'" she says.
120. Extreme repetitive oscillation between contradictory
self-concepts.
Item 121
(A) Paranoid
(F) Anti-social
(K) Sadomasochistic
(B) Schizoid
(G) Borderline
(L) Self defeating
(C) Schizotypal
(H) Avoidant
(M) Sadistic
(D) Histrionic
(I) Dependent
(E) Narcissistic
(J) Passive-Aggressive
Which personality disorder best describes the following case?
121. His parents who express concern at his solitary lifestyle and
lack of close friends bring a 24-year old, white male into the clinic
for evaluation. During an evaluation interview the patient appears ill
at ease and avoids eye contact. When questioned, the patient reports
that he prefers to be by himself, and does not desire or enjoy close
relationships. "I just want to be left alone," he says.
Item 122
(A) Cross-sectional study
(H) Case-control study
(B) Historical cohort study
(I) Crossover study
(C) Aggregate case study
(J) Retrospective panel study
(D) Retrospective longitudinal study
(K) Randomized clinical trial
(E) Observational study
(L) Meta-analysis
(F) Quasi-experimental study
(M) Double blind study
(G) Non-randomized clinical trial
(N) Community study
Which choice is the best label for the type of study described?
122. A researcher identifies children with disruptive in-school
behavior patterns and then interviews the parents and the siblings of
the children looking for developmental consistencies. Results of these
interviews are compared to interviews of parents and siblings of
children who do not evidence the disruptive behavior patterns. |
