Schizophrenia Practice Questions

Question 1

A 29-year-old woman is brought to the physician by her father because of a change in her behavior over the past 8 months. The father says that his daughter has become increasingly withdrawn; she has not answered any phone calls or visited her family and friends. The patient says that she has to stay at home because a foreign intelligence service is monitoring her. She thinks that they are using a magnetic field to read her mind. Mental status exam shows disjointed and perseverative thinking. She is anxious and has a flat affect. Which of the following is the most likely diagnosis?

Accepted Answer

Schizophrenia

Answer

Delusional disorder

Answer

Paranoid personality disorder

Answer

Schizophreniform disorder

Answer

Schizoid personality disorder

Question 2

Two dizygotic twins present to the university clinic because they believe they are being poisoned through the school's cafeteria food. They have brought these concerns up in the past, but no other students or cafeteria staff support this belief. Both of them are average students with strong and weak subject areas as demonstrated by their course grade-books. They have no known medical conditions and are not known to abuse illicit substances. Which statement best describes the condition these patients have?

Accepted Answer

Can affect two or more closely related individuals.

Answer

A trial separation is likely to worsen symptoms.

Answer

The disorder is its own disease entity in DSM-5.

Answer

Antipsychotic medications are rarely beneficial.

Answer

Cognitive behavioral therapy is a good first-line.

Question 3

A 43-year-old woman presents for a routine checkup. She says she has been uncontrollably grimacing and smacking her lips for the past 2 months, and these symptoms have been getting progressively worse. Past medical history is significant for schizophrenia, managed medically with haloperidol. Which of the following is the most likely diagnosis in this patient?

Accepted Answer

Tardive dyskinesia

Answer

Oculogyric crisis

Answer

Trismus

Answer

Tourette’s syndrome

Answer

Torticollis

Question 4

A 20-year-old male is involuntarily admitted to the county psychiatric unit for psychotic behavior over the past three months. The patient's mother explained to the psychiatrist that her son had withdrawn from family and friends, appeared to have no emotions, and had delusions that he was working for the CIA. When he spoke, his sentences did not always seem to have any connection with each other. The mother finally decided to admit her son after he began stating that he "revealed too much information to her and was going to be eliminated by the CIA." Which of the following diagnoses best fits this patient's presentation?

Accepted Answer

Schizophreniform disorder

Answer

Schizophrenia

Answer

Brief psychotic disorder

Answer

Schizoid personality disorder

Answer

Schizotypal personality disorder

Question 5

A 34-year-old male presents to clinic today complaining that his medication has stopped working. He states despite being able to manage the side effects, a voice has returned again telling him to hurt his Mother. You prescribe him a drug which has shown improved efficacy in treating his disorder but requires frequent followup visits. One week later he returns with the following lab results: WBC : 2500 cells/mcL, Neutrophils : 55% and, Bands : 1%. What drug was this patient prescribed?

Accepted Answer

Clozapine

Answer

Lurasidone

Answer

Olanzapine

Answer

Chlorpromazine

Answer

Haloperidol

Question 6

A 22-year-old man is brought to the physician by his mother because of concerns about his recent behavior. Three months ago, the patient first reported hearing loud voices coming from the ceiling of his room. During this time, he has also become increasingly worried that visitors to the house were placing secret surveillance cameras. Mental status examination shows tangential speech with paranoid thoughts. Treatment for this patient's condition predominantly targets which of the following dopaminergic pathways?

Accepted Answer

Mesolimbic pathway

Answer

Mesocortical pathway

Answer

Thalamocortical pathway

Answer

Nigrostriatal pathway

Answer

Corticostriatal pathway

Question 7

A 24-year-old woman is brought to the hospital by her mother because she has "not been herself" for the past 3 months. The patient says she hears voices in her head. The mother said that when she is talking to her daughter she can’t seem to make out what she is saying; it is as if her thoughts are disorganized. When talking with the patient, you notice a lack of energy and an apathetic affect. Which of the following is the most likely diagnosis for this patient?

Accepted Answer

Schizophreniform disorder

Answer

Major depressive disorder

Answer

Schizophrenia

Answer

Brief psychotic disorder

Answer

Schizotypal disorder

Question 8

A 27-year-old man is brought to the emergency department from a homeless shelter because of bizarre behavior. He avoids contact with others and has complained to the supervising staff that he thinks people are reading his mind. Three days ago, he unplugged every electrical appliance on his floor of the shelter because he believed they were being used to transmit messages about him to others. The patient has schizophrenia and has been prescribed risperidone but has been unable to comply with his medications because of his unstable living situation. He is disheveled and malodorous. His thought process is disorganized and he does not make eye contact. Which of the following is the most appropriate long-term pharmacotherapy?

Accepted Answer

Intramuscular risperidone

Answer

Intravenous propranolol

Answer

Intramuscular benztropine

Answer

Oral haloperidol

Answer

Oral diazepam

Question 9

A 25-year-old woman is brought to a psychiatrist's office by her husband who states that he is worried about her recent behavior, as it has become more violent. The patient's husband states that his family drove across the country to visit them and that his wife 'threatened his parents with a knife' at dinner last night. Police had to be called to calm her down. He states that she has been acting 'really crazy' for the last 9 months, and the initial behavior that caused him alarm was her admission that his deceased sister was talking to her through a decorative piece of ceramic art in the living room. Initially, he thought she was joking, but soon realized her complaints of 'hearing ghosts' talking to her throughout the house were persisting and 'getting worse'. Over the past 9 months, she has experienced multiple periods of profound sadness, with persistent insomnia and an unintentional weight loss of 12 pounds over several months. She has been complaining of feeling 'worthless' and has had markedly diminished interest in activities for much of this time period. Her general hygiene has also suffered from her recent lack of motivation and she insists that the 'ghosts' are asking her to kill as many people as she can so they won't be alone in the house. Her husband is extremely concerned that she may harm herself or someone else. He states that she currently does not take any medications or illicit drugs as far as he knows. She does not smoke or drink alcohol. The patient herself does not make eye contact or want to speak to the psychiatrist, allowing her husband to speak on her behalf. Which of the following is the most likely diagnosis in this patient?

Accepted Answer

Schizoaffective disorder

Answer

Schizophreniform disorder

Answer

Schizophrenia

Answer

Delusional disorder

Answer

Brief psychotic disorder

Question 10

A 21-year-old man presents to an outpatient psychiatrist with chief complaints of fatigue and “hearing voices.” He describes multiple voices which sometimes call his name or say nonsensical things to him before he falls asleep at night. He occasionally awakes to see “strange people” in his room, which frighten him but then disappear. The patient is particularly worried by this because his uncle developed schizophrenia when he was in his 20s. The patient also thinks he had a seizure a few days ago, saying he suddenly fell to the ground without warning, though he remembers the episode and denied any abnormal movements during it. He is in his 3rd year of college and used to be a top student, but has been getting C and D grades over the last year, as he has had trouble concentrating and fallen asleep during exams numerous times. He denies changes in mood and has continued to sleep 8 hours per night and eat 3 meals per day recently. Which of the following medications will be most beneficial for this patient?

Accepted Answer

Modafinil

Answer

Haloperidol

Answer

Valproic acid

Answer

Risperidone

Answer

Levetiracetam

Schizophrenia

Study Resources

Lessons

Questions

Flashcards

Lessons

Diagnostic criteria and subtypes

Positive symptoms

Negative symptoms

Cognitive symptoms

Prodromal phase and early intervention

Neurobiological theories of schizophrenia

Genetics of schizophrenia

Neuroimaging findings

First-generation antipsychotics

Second-generation antipsychotics

Treatment-resistant schizophrenia

Psychosocial rehabilitation

Long-acting injectable antipsychotics

Practice Questions

Flashcards

About Schizophrenia for USMLE

Lessons in Schizophrenia

Master Schizophrenia