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Free notes, MCQs, tables & flowcharts for USMLE Step 1 Psychiatry
A mother brings her 3-year-old son to the doctor because she is worried that he might be harming himself by constantly banging his head on the wall. He has been exhibiting this behavior for a few months. She is also worried because he has started to speak less than he used to and does not respond when his name is called. He seems aloof during playtime with other children and seems to have lost interest in most of his toys. What is the most likely diagnosis?
AAutism spectrum disorder
BAttention deficit hyperactivity disorder
CGeneralized anxiety disorder
DBipolar disorder
EObsessive-compulsive disorder
A 73-year-old man is brought to the physician by his daughter for evaluation of increasing forgetfulness during the past 6 months. The daughter reports that he recently got lost while walking home from the grocery store. He has also been more irritable recently. On mental status examination, he has a normal affect. He is oriented to person and place but cannot recall which month it is. He recalls memories from more than 20 years ago in great detail but cannot state his home address or the name of his recently born grandson. His gait is normal and there is no nystagmus. An MRI of the brain is shown. Which of the following is the most likely underlying cause of the radiologic findings?
ADemyelination of periventricular structures
BBleeding into the ventricular system
CObstruction of the foramen of Monro
DInflammation of the choroid plexus
EAtrophy of the cortex
A 7-year-old boy is brought to the physician because of repetitive, involuntary blinking, shrugging, and grunting for the past year. His mother states that his symptoms improve when he is physically active, while tiredness, boredom, and stress aggravate them. He has felt increasingly embarrassed by his symptoms in school, and his grades have been dropping from average levels. He has met all his developmental milestones. Vital signs are within normal limits. Mental status examination shows intact higher mental functioning and thought processes. Excessive blinking, grunting, and jerking of the shoulders and neck occur while at rest. The remainder of the examination shows no abnormalities. This patient's condition is most likely associated with which of the following findings?
AFeelings of persistent sadness and loss of interest
BDefiant and hostile behavior toward teachers and parents
CRecurrent episodes of intense fear
DChorea and hyperreflexia
EExcessive impulsivity and inattention
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