NR569 ACUTE CARE PRACTICUM
DIFFERENTIAL DIAGNOSIS MIDTERM 2026
ACTUAL SCRIPT QUESTIONS AND ANSWERS
100% CORRECT
◉ psychosis neurobiological factors: Neuroanatomy
Several areas of the brain are associated with the symptoms of
schizophrenia. When brain circuitry in the prefrontal cortex
malfunctions, patients may experience symptoms.
Match the brain area with malfunctioning circuitry with the
symptoms produced:
Area of brain:
Mesocortical and ventromedial prefrontal cortex
Dorsolateral
Orbitofrontal and connections to the amygdala
Symptoms:
aggressive, impulsive symptoms
negative and affective symptoms
,cognitive symptoms. Answer: Mesocortical and ventromedial
prefrontal cortex: negative and affective symptoms
Dorsolateral: cognitive symptoms
Orbitofrontal and connections to the amygdala: aggressive,
impulsive symptoms
◉ psychosis neurobiological factors: Neural networks. Answer:
Dopamine pathways explain the positive and negative symptoms
seen in schizophrenia and psychosis
-as well as the side effects associated with antipsychotic medications
◉ psychosis neurobiological factors: Neural signaling. Answer:
Dopamine Role in Psychosis
-leading hypothesis is that psychosis and schizophrenia are
associated with a dysfunction of the neurotransmitter dopamine
(DA)
• Traditionally, schizophrenia and psychosis symptoms have been
associated with a surplus of dopamine, since medications that block
dopamine, specifically D2, have been found to reduce the positive
symptoms of schizophrenia
-schizophrenia symptoms are related to "out of tune" dopamine
,-Dopamine dysfunctions are also involved in other conditions that
cause psychosis, such as severe depression, certain medical
disorders, and substance abuse
◉ Esme is a 22-year-old client who presents to the clinic with her
mother. Esme appears quiet and withdrawn with very little
emotional expression. Her mother reports that for the last couple of
years, Esme has gradually disengaged from all her friends. After
graduating from high school, she left for college but started hearing
voices telling her that she was ugly and stupid. She stopped
attending class or completing her work. When asked directly about
her symptoms, Esme provides very short, one-to-two-word
responses in a monotone voice.
Which of the following symptoms is Esme exhibiting? Select all that
apply.
anosognosia
alogia
avolition
asociality
blunted affect
depersonalization
catatonia
anhedonia
hallucinations
, delusions. Answer: alogia
avolition
asociality
blunted affect
hallucinations
Rationale:
Esme is experiencing the following symptoms of psychosis:
alogia: short answers, using few words to communicate
avolition: lack of initiative, withdrawal from work/school
asocialtiy: lack of relationships, reduced social interactions
blunted affect: decreased facial expressions and voice inflections
hallucinations: perceptual experiences in the absence of external
stimuli
Esme has not provided enough information to support the following
symptoms at this time:
anhedonia: inability to experience pleasure
anosognosia: functional inability to recognize illness
depersonalization: a perception that the body is floating, changing,
or detached
catatonia: lifeless, trance-like state with lack of response or
movement
DIFFERENTIAL DIAGNOSIS MIDTERM 2026
ACTUAL SCRIPT QUESTIONS AND ANSWERS
100% CORRECT
◉ psychosis neurobiological factors: Neuroanatomy
Several areas of the brain are associated with the symptoms of
schizophrenia. When brain circuitry in the prefrontal cortex
malfunctions, patients may experience symptoms.
Match the brain area with malfunctioning circuitry with the
symptoms produced:
Area of brain:
Mesocortical and ventromedial prefrontal cortex
Dorsolateral
Orbitofrontal and connections to the amygdala
Symptoms:
aggressive, impulsive symptoms
negative and affective symptoms
,cognitive symptoms. Answer: Mesocortical and ventromedial
prefrontal cortex: negative and affective symptoms
Dorsolateral: cognitive symptoms
Orbitofrontal and connections to the amygdala: aggressive,
impulsive symptoms
◉ psychosis neurobiological factors: Neural networks. Answer:
Dopamine pathways explain the positive and negative symptoms
seen in schizophrenia and psychosis
-as well as the side effects associated with antipsychotic medications
◉ psychosis neurobiological factors: Neural signaling. Answer:
Dopamine Role in Psychosis
-leading hypothesis is that psychosis and schizophrenia are
associated with a dysfunction of the neurotransmitter dopamine
(DA)
• Traditionally, schizophrenia and psychosis symptoms have been
associated with a surplus of dopamine, since medications that block
dopamine, specifically D2, have been found to reduce the positive
symptoms of schizophrenia
-schizophrenia symptoms are related to "out of tune" dopamine
,-Dopamine dysfunctions are also involved in other conditions that
cause psychosis, such as severe depression, certain medical
disorders, and substance abuse
◉ Esme is a 22-year-old client who presents to the clinic with her
mother. Esme appears quiet and withdrawn with very little
emotional expression. Her mother reports that for the last couple of
years, Esme has gradually disengaged from all her friends. After
graduating from high school, she left for college but started hearing
voices telling her that she was ugly and stupid. She stopped
attending class or completing her work. When asked directly about
her symptoms, Esme provides very short, one-to-two-word
responses in a monotone voice.
Which of the following symptoms is Esme exhibiting? Select all that
apply.
anosognosia
alogia
avolition
asociality
blunted affect
depersonalization
catatonia
anhedonia
hallucinations
, delusions. Answer: alogia
avolition
asociality
blunted affect
hallucinations
Rationale:
Esme is experiencing the following symptoms of psychosis:
alogia: short answers, using few words to communicate
avolition: lack of initiative, withdrawal from work/school
asocialtiy: lack of relationships, reduced social interactions
blunted affect: decreased facial expressions and voice inflections
hallucinations: perceptual experiences in the absence of external
stimuli
Esme has not provided enough information to support the following
symptoms at this time:
anhedonia: inability to experience pleasure
anosognosia: functional inability to recognize illness
depersonalization: a perception that the body is floating, changing,
or detached
catatonia: lifeless, trance-like state with lack of response or
movement
