Somatic Symptom Disorders

Test 1 Question 11. You are talking to one of your colleagues from surgery. He tells you about a postoperative patient that he is covering who keeps complaining of pain. He tells you that the patient was originally on intramuscular meperidine and was switched to the same dose of oral meperidine just yesterday. The patient has been complaining constantly and is getting the nursing staff upset. What do you think is responsible for this situation?

Test 1 Question 56. A patient comes into your practice after referral from his primary care physician. He is convinced that he has cancer. He thinks that it hasn’t been found yet, but is convinced that it is there. He remains convinced despite a full workup with negative results. Despite further reassurance by his doctors, he remains convinced that he has cancer. Which is the most appropriate diagnosis?

Test 1 Question 81. Which one of the following is true regarding conversion disorder (functional neurological symptom disorder)?

Test 1 Question 122. Which one of the following disorders presents with the patient being preoccupied with having a given illness based on misinterpretation of bodily sensations?

Test 1 Question 145. A 75-year-old woman is referred to your practice by an internist for depression. On initial examination you discover that the patient has recently recovered from a heart attack. Which one of the following medications would be the best choice for this patient?

Test 2 Question 19. Which of the following would fall under the heading of Other Specified Somatic Symptom and Related Disorders?

Test 2 Question 134. Which one of the following is not an example of secondary gain?

Test 3 Question 82. A patient who is not malingering, but is believed to be producing the symptoms and signs of confusion or dementia involuntarily or unconsciously and believes that the symptoms are real, is thought to have which one of the following conditions?

Test 3 Question 109. A psychiatrist is consulted on a medical unit because there is a patient with a substance abuse history who is in need of pain control. Which one of the following answer choices would be the best way to treat this patient’s pain?

Test 3 Question 120. Which one of the following is not a feature of malingering?

Test 4 Question 23. A 29-year-old patient is admitted to the neurology unit for evaluation of seizures. Workup is negative and there has not been any seizure activity captured on electroencephalogram during his seizure episodes. Neurological examination is negative. The patient is noted to be very sad, and a psychiatric consult is called. Nurses have noted conflict between the patient and his wife during her visits. As the consultant, which one of the following would be the highest on your list of differential diagnoses?

Test 4 Question 73. Of the following disorders, which one has the best prognosis?

Test 5 Question 5. Which of the following must be present to meet Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5), criteria for somatic symptom disorder?

Test 5 Question 49. A depressed patient comes to you with brittle hair, weight gain, muscle weakness, dry skin, constipation, and cold intolerance. Which is the most appropriate next step in management?

Test 5 Question 97. Which of the following choices is a risk factor for developing conversion disorder (functional neurological symptom disorder)?

Test 5 Question 104. Which of the following is not one of the psychiatric symptoms that can result from adrenal insufficiency?

Test 5 Question 139. A new patient comes to you asking for help with depression. She states that she has had a very low mood recently and has been feeling overwhelmed. She has a 2-month-old daughter at home and keeping up with a new baby has been hard for her. She reports constant fatigue, listlessness, and weight loss. She states that her libido is down and she is very upset because she could not breastfeed her baby owing to lack of milk production. Her concentration is normal. She bursts into tears and states that she doesn’t think she can be a good mother. Which of the following would be the most appropriate next step in the management of this case?

Test 5 Question 141. Which one of the following is not a possible psychiatric manifestation of acute intermittent porphyria?

Test 6 Question 41. Which of the following is the most important factor in distinguishing somatic symptom disorder with predominant pain from chronic pain syndromes?

Test 6 Question 49. A man in his 30s is convinced that he has Lou Gehrig’s disease. Despite negative evaluations by several physicians he is still convinced that he has it. He comes to you convinced that the proper diagnosis has been missed. Your workup is negative but he remains convinced that he has the disease despite your efforts at reassurance. What is the most appropriate diagnosis?

Test 6 Question 144. Which of the following medical conditions can present with panic attacks, elevated blood pressure, flushing, and tremulousness?

1. Which of the following symptoms would push your differential diagnosis away from a conversion disorder (functional neurological symptom disorder) in Grace’s case? (Pick three of seven)

2. Which of the following etiological theories are believed to be possible contributors to Grace’s primary problem? (Pick three of six)

Vignette 19 Question 3. Which of the following statements about the epidemiology of Grace’s primary disorder are not true? (Pick three of six)

Vignette 19 Question 4. Which of the following facts are true about the course and prognosis of Grace’s primary disorder? (Pick three of six)

5. The only treatment maneuver for Grace’s primary disorder that seems to be able to decrease personal health care expenditure by about 50% is: