Neurodevelopmental disorders (ADHD, autism) Practice Questions

Question 1

A group of neurologists develop a new blood test for Alzheimer's. They are optimistic about the test, as they have found that for any given patient, the test repeatedly produces very similar results. However, they find that the new test results are not necessarily consistent with the gold standard of diagnosis. How would this new test most accurately be described?

Accepted Answer

Reliable

Answer

Valid and reliable

Answer

Valid

Answer

Biased

Answer

Neither valid nor reliable

Question 2

A 4-year-old boy is brought to the physician by his parents because of concerns about his behavior during the past year. His parents report that he often fails to answer when they call him and has regular unprovoked episodes of crying and screaming. At kindergarten, he can follow and participate in group activities, but does not follow his teacher's instructions when these are given to him directly. He is otherwise cheerful and maintains eye contact when spoken to but does not respond when engaged in play. He gets along well with friends and family. He started walking at the age of 11 months and can speak in two-to-three-word phrases. He often mispronounces words. Which of the following is the most likely diagnosis?

Accepted Answer

Hearing impairment

Answer

Selective mutism

Answer

Conduct disorder

Answer

Specific-learning disorder

Answer

Autistic spectrum disorder

Question 3

An 8-year-old boy is brought to the physician by his mother for a well-child examination at a clinic for low-income residents. Although her son's elementary school offers free afterschool programming, her son has not been interested in attending. Both the son's maternal and paternal grandmothers have major depressive disorder. The mother is curious about the benefits of afterschool programming and asks for the physician's input. Which of the following statements best addresses the potential benefits of afterschool programming for this child?

Accepted Answer

High-quality afterschool programming for low-income 8-year-olds may correlate with decreased ADHD risk in adults.

Answer

High-quality afterschool programming would decrease this patient's risk of developing major depressive disorder.

Answer

High-quality afterschool programming has a greater effect on reducing psychotic disorder risk in adults than bipolar disorder risk.

Answer

High-quality afterschool programming has a greater effect on reducing ADHD risk in adults than major depressive disorder risk.

Answer

The patient's family history of psychiatric illness prevents any potential benefits from afterschool programming.

Question 4

A 5-year-old boy is brought to the physician by his mother because he does not “listen to her” anymore. The mother also reports that her son cannot concentrate on any tasks lasting longer than just a few minutes. Teachers at his preschool report that the patient is more active compared to other preschoolers, frequently interrupts or bothers other children, and is very forgetful. Last year the patient was expelled from another preschool for hitting his teacher and his classmates when he did not get what he wanted and for being disruptive during classes. He was born at term via vaginal delivery and has been healthy except for 3 episodes of acute otitis media at the age of 2 years. He has met all developmental milestones. His mother has major depressive disorder and his father has Graves' disease. He appears healthy and well nourished. Examination shows that the patient does not seem to listen when spoken to directly. The remainder of the examination shows no abnormalities. Which of the following is the most appropriate next step in treatment?

Accepted Answer

Behavior therapy

Answer

Methylphenidate

Answer

Methimazole

Answer

Fluoxetine

Answer

Hearing aids

Question 5

A 10-year-old child is sent to the school psychologist in May because he refuses to comply with the class rules. His teacher says this has been going on since school started back in August. He gets upset at the teacher regularly when he is told to complete a homework assignment in class. Sometimes he refuses to complete them altogether. Several of his teachers have reported that he intentionally creates noises in class to interrupt the class. He tells the psychologist that the teacher and his classmates are at fault. What is the most appropriate treatment?

Accepted Answer

Cognitive-behavioral therapy

Answer

Interpersonal therapy

Answer

Administration of lithium

Answer

Motivational interviewing

Answer

Administration of clozapine

Question 6

A 3-year-old boy is brought in by his mother because she is concerned that he has been “acting differently recently”. She says he no longer seems interested in playing with his friends from preschool, and she has noticed that he has stopped making eye contact with others. In addition, she says he flaps his hands when excited or angry and only seems to enjoy playing with objects that he can place in rows or rigid patterns. Despite these behaviors, he is meeting his language goals for his age (single word use). The patient has no significant past medical history. He is at the 90th percentile for height and weight for his age. He is afebrile and his vital signs are within normal limits. A physical examination is unremarkable. Which of the following is the most likely diagnosis in this patient?

Accepted Answer

Autism spectrum disorder

Answer

Pervasive developmental disorder, not otherwise specified

Answer

Rett’s disorder

Answer

Childhood disintegrative disorder

Answer

Asperger’s disorder

Question 7

A 6-year-old boy presents to the pediatrician with his parents. He is fully vaccinated and met most developmental milestones. His fine motor milestones are delayed; at present, he cannot eat by himself and has difficulty in self-dressing. His intelligence quotient (IQ) is 65. He listens quietly while spoken to and engages in play with his classmates. He neither talks excessively nor remains mute, but engages in normal social conversation. There is no history of seizures and he is not on any long-term medical treatment. On his physical examination, his vital signs are stable. His height and weight are normal for his age and sex, but his occipitofrontal circumference is less than the 3rd percentile for his age and sex. His neurologic examination is also normal. Which of the following is the most likely diagnosis?

Accepted Answer

Intellectual disability

Answer

Attention deficit hyperactivity disorder

Answer

Autism

Answer

Obsessive-compulsive disorder

Answer

Tic disorder

Question 8

A 15-year-old boy is referred to a child psychologist because of worsening behavior and constant disruption in class. He has received multiple reprimands in the past 6 months for not doing the homework his teacher assigned, and he refuses to listen to the classroom instructions. Additionally, his teachers say he is very argumentative and blames other children for not letting him do his work. He was previously well behaved and one of the top students in his class. He denies any recent major life events or changes at home. His past medical history is noncontributory. His vital signs are all within normal limits. Which of the following is the most likely diagnosis?

Accepted Answer

Oppositional defiant disorder

Answer

Attention deficit hyperactivity disorder

Answer

Antisocial personality disorder

Answer

Conduct disorder

Answer

Major depressive disorder

Question 9

A 9-year-old boy is brought to a pediatric psychologist by his mother because of poor academic performance. The patient’s mother mentions that his academic performance was excellent in kindergarten and first grade, but his second and third-grade teachers complain that he is extremely talkative, does not complete schoolwork, and frequently makes careless mistakes. They also complain that he frequently looks at other students or outside the window during the class and is often lost during the lessons. At home, he is very talkative and disorganized. When the pediatrician asks the boy his name, he replies promptly. He was born at full term by spontaneous vaginal delivery. He is up-to-date on all vaccinations and has met all developmental milestones on time. A recent IQ test scored him at 95. His physical examination is completely normal. When he is asked to read from an age-appropriate children’s book, he reads it fluently and correctly. Which of the following is the most likely diagnosis in this patient?

Accepted Answer

Attention-deficit/hyperactivity disorder

Answer

Intellectual disability

Answer

Autism spectrum disorder

Answer

Dyslexia

Answer

Persistent depressive disorder

Question 10

True about Fragile X syndrome is

Accepted Answer

Males have IQ 20-40

Answer

10% Female carriers mentally retarded

Answer

Triple nucleotide CAG Sequence mutation

Answer

Gain of function mutation

Answer

Autosomal dominant inheritance pattern

Neurodevelopmental disorders (ADHD, autism)

Study Resources

Lessons

Questions

Flashcards

Lessons

ADHD subtypes and diagnostic criteria

Neurobiology of ADHD

Stimulant medications

Non-stimulant ADHD treatments

Autism spectrum disorder diagnostic criteria

Autism assessment tools

Early intervention in ASD

Applied behavior analysis

Intellectual disability classification

Learning disorders

Communication disorders

Motor disorders (tic disorders, stereotypic movement)

Transition to adult care

Practice Questions

Flashcards

About Neurodevelopmental disorders (ADHD, autism) for USMLE

Lessons in Neurodevelopmental disorders (ADHD, autism)

Master Neurodevelopmental disorders (ADHD, autism)