习题 1.A 50-year-old man is brought to the emergency room by the police because he was on the street screaming that the air was being poisoned.The man is very agitated,and requires restraint by the attendants.As you,the on-call physician,try to interview him, he tries to hit you and screams at you.Which of the following is the most appropriate first step in management? A.administer amobarbital by mouth B.give him an injection of haloperidol C.give him an injection of naloxone D.perform a physical examination E.reason with him that the air is not poisoned 2.A 35-year-old single woman complains of fatigue,insomnia,and depression. 1 If further history reveals that she had attempted suicide several times in the past, which of the following statements would be most useful? A.The patient is not a serious suicide risk B.The patient probably has antisocial personality disorder C.The patient should be evaluated for a psychotic disorder D.The risk of successful suicide is decreased E.The risk of successful suicide is increased 2 If the patient seems very sluggish in movement and speech,and takes an inordinate amount of time to answer a question,the patient is suffering from which of the following? A.hysteria B.pseudobulbar palsy C.psychomotor agitation D.psychomotor retardation E.restless leg syndrome 3.Your patient confides in you that she has been losing weight with loss of appetite, has been unable to concentrate,and has had difficulty sleeping through the night.She has also been thinking of the means of killing herself.Which of the following is the most likely diagnosis? A.borderline personality disorder B.factitious disorder C.generalized anxiety disorder D.hypochondriasis E.major depression
习题 1. A 50-year-old man is brought to the emergency room by the police because he was on the street screaming that the air was being poisoned. The man is very agitated, and requires restraint by the attendants. As you, the on-call physician, try to interview him, he tries to hit you and screams at you. Which of the following is the most appropriate first step in management? A. administer amobarbital by mouth B. give him an injection of haloperidol C. give him an injection of naloxone D. perform a physical examination E. reason with him that the air is not poisoned 2. A 35-year-old single woman complains of fatigue, insomnia, and depression. ① If further history reveals that she had attempted suicide several times in the past, which of the following statements would be most useful? A. The patient is not a serious suicide risk B. The patient probably has antisocial personality disorder C. The patient should be evaluated for a psychotic disorder D. The risk of successful suicide is decreased E. The risk of successful suicide is increased ② If the patient seems very sluggish in movement and speech, and takes an inordinate amount of time to answer a question, the patient is suffering from which of the following? A. hysteria B. pseudobulbar palsy C. psychomotor agitation D. psychomotor retardation E. restless leg syndrome 3. Your patient confides in you that she has been losing weight with loss of appetite, has been unable to concentrate, and has had difficulty sleeping through the night. She has also been thinking of the means of killing herself. Which of the following is the most likely diagnosis? A. borderline personality disorder B. factitious disorder C. generalized anxiety disorder D. hypochondriasis E. major depression
4.Which of the following is the most common type of substance dependency in the United States? A.alcohol B.cannabis C.cocaine D.heroin E.tobacco 5.Sara is a 15-year-old healthy female.With which of the following would one expect a girl of her age to spend a lot of time? A.a mixed group of peers B.adults C.animals D.furry toys E.older females 6.Which of the following has a triphasic abstinence syndrome,the first phase being the "crash"? A.alcohol B.barbiturates C.cannabis D.cocaine E.opiates 7.An elderly patient with multi-infarct dementia also suffers from urinary incontinence and ataxia.Which of the following therapeutic procedures may be considered for this type of patient? A.benzodiazepines B.electroconvulsive therapy C.megavitamin therapy D.urocholine E.ventriculo peritoneal shunt 8.Naloxone would be contraindicated in an apparently psychotic patient if one were to also discover which of the following? A.The patient had a psilocybin-induced psychosis B.The patient has hypertension C.The patient has just suffered a fracture D.The patient is a placebo responder E.The patient is an alcohol abuser 9.Unmyelinated C fibers are thought to carry which of the following pain sensations? A.aching B.burning C.dull D.gnawing E.pricking 10.Which of the following describes a possible adverse effect of long-term chronic treatment of schizophrenia with a phenothiazine such as fluphenazine? A.diarrhea,nausea,and vomiting B.reduced secretion of prolactin C.tardive dyskinesia D.Tourette syndrome
4. Which of the following is the most common type of substance dependency in the United States? A. alcohol B. cannabis C. cocaine D. heroin E. tobacco 5. Sara is a 15-year-old healthy female. With which of the following would one expect a girl of her age to spend a lot of time? A. a mixed group of peers B. adults C. animals D. furry toys E. older females 6. Which of the following has a triphasic abstinence syndrome, the first phase being the "crash"? A. alcohol B. barbiturates C. cannabis D. cocaine E. opiates 7. An elderly patient with multi-infarct dementia also suffers from urinary incontinence and ataxia. Which of the following therapeutic procedures may be considered for this type of patient? A. benzodiazepines B. electroconvulsive therapy C. megavitamin therapy D. urocholine E. ventriculo peritoneal shunt 8. Naloxone would be contraindicated in an apparently psychotic patient if one were to also discover which of the following? A. The patient had a psilocybin-induced psychosis B. The patient has hypertension C. The patient has just suffered a fracture D. The patient is a placebo responder E. The patient is an alcohol abuser 9. Unmyelinated C fibers are thought to carry which of the following pain sensations? A. aching B. burning C. dull D. gnawing E. pricking 10. Which of the following describes a possible adverse effect of long-term chronic treatment of schizophrenia with a phenothiazine such as fluphenazine? A. diarrhea, nausea, and vomiting B. reduced secretion of prolactin C. tardive dyskinesia D. Tourette syndrome
E.weight loss 11.A 17-year-old girl consults the doctor because she has not had her menses within the last 4 months.On questioning,she also describes being very sensitive to cold and being constipated.However,overall she feels well and does not see any need for treating these latter symptoms.Her weight is 34 kg (75lbs),her height 1.65 m(5 ft 4 in).A pregnancy test is negative.Results of a neurological examination are normal, and her axillary and pubic hair is normally developed.What is the most likely cause of her secondary amenorrhea? A.anorexia nervosa B.Celiac disease C.Crohn's disease D.diabetes insipidus E.panhypopituitarism 12.A 28-year-old woman is brought to the hospital because she had not come out of her room for 3 days,missing work.She would eat only when a tray was brought in. 1While you are trying to understand her,she suddenly stops talking,staring into space.She probably has which of the following? A.ambivalence B.delusion C.illusion D.negativism E.thought blocking 2 If the patient was observed in her room alone talking loudly and gesticulating,this is probably an example of which of the following? A.delusion B.hallucination C.compulsive behavior D.panic behavior E.schizophrenia 3 When the patient arrives,she is observed walking very slowly,and when you try to speak with her,she responds very slowly after a long latency.This may be an example of which of the following? A.autistic thinking B.circumstantiality C.folie a deux D.psychomotor retardation E.thought blocking 4 Further history reveals that the patient had her first psychiatric hospitalization at age 20 when she made a suicide attempt.Otherwise,she is known to be a rather cheerful person.She is gainfully employed,but there are times when she has shopping sprees running up enormous credit card debt.There seems to be no history of substance abuse.Family history reveals that her maternal grandmother had died in a
E. weight loss 11. A 17-year-old girl consults the doctor because she has not had her menses within the last 4 months. On questioning, she also describes being very sensitive to cold and being constipated. However, overall she feels well and does not see any need for treating these latter symptoms. Her weight is 34 kg (75lbs), her height 1.65 m (5 ft 4 in). A pregnancy test is negative. Results of a neurological examination are normal, and her axillary and pubic hair is normally developed. What is the most likely cause of her secondary amenorrhea? A. anorexia nervosa B. Celiac disease C. Crohn's disease D. diabetes insipidus E. panhypopituitarism 12. A 28-year-old woman is brought to the hospital because she had not come out of her room for 3 days, missing work. She would eat only when a tray was brought in. ①While you are trying to understand her, she suddenly stops talking, staring into space. She probably has which of the following? A. ambivalence B. delusion C. illusion D. negativism E. thought blocking ② If the patient was observed in her room alone talking loudly and gesticulating, this is probably an example of which of the following? A. delusion B. hallucination C. compulsive behavior D. panic behavior E.schizophrenia ③ When the patient arrives, she is observed walking very slowly, and when you try to speak with her, she responds very slowly after a long latency. This may be an example of which of the following? A. autistic thinking B. circumstantiality C. folie à deux D. psychomotor retardation E. thought blocking ④ Further history reveals that the patient had her first psychiatric hospitalization at age 20 when she made a suicide attempt. Otherwise, she is known to be a rather cheerful person. She is gainfully employed, but there are times when she has shopping sprees running up enormous credit card debt. There seems to be no history of substance abuse. Family history reveals that her maternal grandmother had died in a
state hospital.Which of the following is the most likely diagnosis for this patient? A.bipolar disorder B.delusional disorder C.folie a deux D.lewy body disease E.schizophrenia 5 Given the most likely diagnosis above,which of the following would be the drug of choice? E A.benztropine B.chlordiazepoxide C.fluoxetine D.tranylcypromine E valproic acid 13.Which of the following is true concerning factitious disorder? A.It is a form of psychosis B.It is an integral part of borderline personality C.It is an intentional antisocial act D.It is a sick-role addiction 14.A physician is treating a patient whom he suspects of factitious disorder.If the physician learns that the patient would have been incarcerated for a criminal offense if he had not been hospitalized,which of the following diagnoses becomes most likely? A.antisocial personality disorder B.borderline personality disorder C.malingering D.Munchausen syndrome E.sick-role addiction 15.A contaminated meat dish infected 12 members of a church congregation gathered for a potluck meal.If food poisoning is assumed to be due to enterotoxin produced by Clostridium perfringens,final confirmation will rest upon which of the following? A.demonstration of spores in suspected food B.enterotoxin production in food and neutralization by its antiserum C.growth of gram-positive bacilli in thioglycolate broth D.the presence of antibodies against C.perfringens in the patient's serum E.the presence of many gram-positive rods in food 16.Which of the following is the most treatable dementing disease? A.Alzheimer's disease B.Creutzfeldt-Jakob disease C.multi-infarct dementia D.Pick disease E.Wernicke syndrome 17.All patients who have trisomy of autosome 21 who survive to adulthood develop which one of the following conditions? A.Alzheimer's disease B.lewy body dementia C.multi-infarct dementia D.Pick disease E.secondary dementia
state hospital. Which of the following is the most likely diagnosis for this patient? A. bipolar disorder B. delusional disorder C. folie à deux D. lewy body disease E. schizophrenia ⑤ Given the most likely diagnosis above, which of the following would be the drug of choice? E A. benztropine B. chlordiazepoxide C. fluoxetine D. tranylcypromine E valproic acid 13. Which of the following is true concerning factitious disorder? A. It is a form of psychosis B. It is an integral part of borderline personality C. It is an intentional antisocial act D. It is a sick-role addiction 14. A physician is treating a patient whom he suspects of factitious disorder. If the physician learns that the patient would have been incarcerated for a criminal offense if he had not been hospitalized, which of the following diagnoses becomes most likely? A. antisocial personality disorder B. borderline personality disorder C. malingering D. Munchausen syndrome E.sick-role addiction 15. A contaminated meat dish infected 12 members of a church congregation gathered for a potluck meal. If food poisoning is assumed to be due to enterotoxin produced by Clostridium perfringens, final confirmation will rest upon which of the following? A. demonstration of spores in suspected food B. enterotoxin production in food and neutralization by its antiserum C. growth of gram-positive bacilli in thioglycolate broth D. the presence of antibodies against C. perfringens in the patient's serum E. the presence of many gram-positive rods in food 16. Which of the following is the most treatable dementing disease? A. Alzheimer's disease B. Creutzfeldt-Jakob disease C. multi-infarct dementia D. Pick disease E. Wernicke syndrome 17. All patients who have trisomy of autosome 21 who survive to adulthood develop which one of the following conditions? A. Alzheimer's disease B. lewy body dementia C. multi-infarct dementia D. Pick disease E.secondary dementia
18.Your patient seems very trusting of you,and when you try to explain laboratory results,she says,"Just tell me the good news."She seems to be quite impressionistic and friendly.If she turns out to have a newly diagnosed serious medical condition, which of the following is appropriate? A.Ask the patient if she would like to hear the bad news B.Tell the family about the diagnosis,and tell the patient she should discuss it with the family C.Tell the patient about the diagnosis in great detail D.Tell the patient about the diagnosis in very general terms,and ask if she would like more detail E.Withhold the information from the patient 19.Which of the following best defines a person's "personality"? A.characteristic means of relating with reality B.characteristic patterns of thought,behavior,and feelings C.defensive armamentarium D.ego E.ego and superego combined 20.A 9-year-old girl is brought into your office by her mother,who states that the daughter has been losing weight and having difficulty at school.The mother discovered some yellow-colored discharge on the child's underwear.On physical examination,you notice erythema of all parts of the patient's vulva and the vagina. There is some yellow discharge visible.Which of the following is the most likely diagnosis? A.Mullerian duct tumor B.Wolffian duct tumor C.Dermatitis D.Sexual abuse E.Straddle injury 21.The activity of which structure in the pons is suppressed by opioids, alpha-2-agonists,and gamma-aminobutyric acid (GABA),and produces most of the noradrenergic input to the brain? A.anterior Cingulate Gyrus B.locus ceruleus C.mammillary bodies D.nucleus pulposus E.nucleus solitaries 22.An 87-year-old man has been living alone.He has no chore worker or caregiver
18. Your patient seems very trusting of you, and when you try to explain laboratory results, she says, "Just tell me the good news." She seems to be quite impressionistic and friendly. If she turns out to have a newly diagnosed serious medical condition, which of the following is appropriate? A. Ask the patient if she would like to hear the bad news B. Tell the family about the diagnosis, and tell the patient she should discuss it with the family C. Tell the patient about the diagnosis in great detail D. Tell the patient about the diagnosis in very general terms, and ask if she would like more detail E. Withhold the information from the patient 19. Which of the following best defines a person's "personality"? A. characteristic means of relating with reality B. characteristic patterns of thought, behavior, and feelings C. defensive armamentarium D. ego E. ego and superego combined 20. A 9-year-old girl is brought into your office by her mother, who states that the daughter has been losing weight and having difficulty at school. The mother discovered some yellow-colored discharge on the child's underwear. On physical examination, you notice erythema of all parts of the patient's vulva and the vagina. There is some yellow discharge visible. Which of the following is the most likely diagnosis? A. Müllerian duct tumor B. Wolffian duct tumor C. Dermatitis D. Sexual abuse E. Straddle injury 21. The activity of which structure in the pons is suppressed by opioids, alpha-2-agonists, and gamma-aminobutyric acid (GABA), and produces most of the noradrenergic input to the brain? A. anterior Cingulate Gyrus B. locus ceruleus C. mammillary bodies D. nucleus pulposus E. nucleus solitaries 22. An 87-year-old man has been living alone. He has no chore worker or caregiver