NU 664 EXAM QUESTIONS WITH
CORRECT SOLUTIONS||100%
GUARANTEED PASS||UPDATED
2026/2027 SYLLABUS||ALREADY
GRADED A+||<<LATEST VESION>>
Obsessive and compulsive/Anxiety/trauma and stress related disorders - ANSWER
✓ Body Dysmorphic Disorder
ED
Trichotilomania
Hypochondriasis
OC Personality D/O
Tic or ST movement disorder
Obsessive and compulsive/Anxiety/trauma and stress related disorders basic
neuroscience (brain areas related to fear/anxiety) - ANSWER ✓ Lack of efficient
processing in OFC and lack of cognitive flexibility
Brain areas related to fear/anxiety include:
Cortico-striatao-thalamo-cortico (CSTC) pathway r/t obsessions
Amygdala - traumatic memories of the hippocampus can activate the amygdala
HPA axis - cortisol levels
Feelings of fear regulated by connections between amygdala and ACC and
amygdala and OFC
Obsessive and compulsive/Anxiety/trauma and stress related disorders
epidemiology - ANSWER ✓ Fairly consistent rates, lifetime prevalence in GO 2-
3% to 10% of outpatients in clinics
OCD the 4th most common d/o
Equal rates in adult men / women w/ mean age of onset about 20 years
More common among adolescent boys than girls
More common among singles than married ind
Less often among blacks than whites
,Obsessive and compulsive/Anxiety/trauma and stress related disorders onset,
progression - ANSWER ✓ Mean age of onset about 20 years
Most have onset before age 25, less have onset over age 35 years
Can occur in adol and childhood as early as age 2 years
High comorbidity with depression (about 67%)
Obsessive and compulsive/Anxiety/trauma and stress related disorders etiology -
ANSWER ✓ Biological factors: Serotonin more likely involved as SSRIs more
effective in tx; NE less involved although given clonidine's efficacy NE may be
partially involved as clonidine lowers NE amount released from PreS neurons.
Genetics: 3-5 fold higher probability if familial link
Obsessive and compulsive/Anxiety/trauma and stress related disorders
pharmacological treatment - ANSWER ✓ SSRIs, clomipramine, and if needed
augment with Depakote, lithium, tegretol
Buspar, Effexor, pindolol
Among children, sertraline + therapy more effective than either alone
CBT should be tried prior to initiation of meds
For children: FDA approved (at least 6 yrs), sertraline
Fluoxetine (at least 7)
Fluvoxamine (at least 8)
Clomipramine (at least 10) (first anti-dep studied and only TCA FDA approved for
tx of anxiety d/os in children, but not rec as first line due to SE profile as compared
to other SSRIs
Obsessive and compulsive/Anxiety/trauma and stress related disorders therapeutic
treatment - ANSWER ✓ Behavior therapy, exposure, desensitization, flooding,
aversion, thought stopping, implosion therapy, resolving underlying aggressive
impulses, ECT, DBS
Serotonin syndrome - ANSWER ✓ Migraines, myoclonus, agitation and
confusion on the mild side to hyperthermia, seizures, coma, cardiovascular
collapse, permanent hyperthermic brain damage and even death on the severe end
PANS - ANSWER ✓ a clinical diagnosis given to children who have a dramatic -
practically overnight - onset of neuropsychiatric symptoms including Obsessive
Compulsive Disorder (OCD) and/or eating disorder
,PANDAS - ANSWER ✓ Pediatric Autoimmune Neuropsychiatric Disorders
Associated with Streptococcal Infections; this is a subset of PANS
In Obsessive and compulsive/Anxiety/trauma and stress related disorders it is wise
to rule out - ANSWER ✓ underlying medical disorders and tx of comorbid
conditions - Hair pulling and skin picking. Substance induced, depressive d/o
Major and Minor Neurocognitive Disorders - ANSWER ✓ Significant decline
from previous level of performance in one or more cognitive domains (complex
attention, executive function, learning and memory, language, perceptual-motor, or
social cognition) based on:
a. Concern of the individual, a known informant, or clinician that has witnessed the
decline
b. A substantial impairment in cognitive performance documented by
neuropsychological testing
Specifiers of Major and Minor Neurocognitive Disorders - ANSWER ✓ a.
Without behavioral disturbances
b. With behavioral disturbances
i. Mild- difficulty with house work and managing money
ii. Moderate - difficulty feeding and dressing
iii. Severe- fully dependent
Other determinants of Major and Minor Neurocognitive Disorders - ANSWER ✓
The cognitive deficits interfere w/independence in everyday activities (i.e. paying
bills)
The cognitive deficits do not occur exclusively in the context of delirium or better
explained by another mental health d/o.
Etiology Major and Minor Neurocognitive Disorders - ANSWER ✓ HIV, Prions,
Parkinson's Disease, Huntington's Disease, Alzheimer's, Lew Body, Vascular,
trauma, medications
Mild neurocognitive Disorder - ANSWER ✓ Evidence of modest cognitive
decline from previous level of performance in one or more cognitive domains
(complex attention, executive function, learning and memory, language,
perceptual-motor, or social cognition) based on:
a. Concern of the individual, a known informant, or clinician that has witnessed the
decline
, b. A modest impairment in cognitive performance documented by
neuropsychological testing
With Mild neurocognitive Disorder - ANSWER ✓ The cognitive deficits do not
interfere w/independence in everyday activities (i.e. paying bills) but require
greater effort
The cognitive deficits do not occur exclusively in the context of delirium or better
explained by another mental health d/o.
Mild neurocognitive Disorder Specifiers - ANSWER ✓ a. Without behavioral
disturbances
b. With behavioral disturbances
Major and Minor Neurocognitive Disorders Due to Alzheimer's Diagnosis Criteria
- ANSWER ✓ 1. Criteria for major or mild neurocognitive disorder is met
2. Insidious onset and gradual progression in one or more cognitive domains
Specifiers of Major neurocognitive disorder, probable Alzheimer's - ANSWER ✓
i. Evidence of Alzheimer's genetic mutation via testing or family history and;
ii. Decline in memory and learning and at least one other cognitive domain and;
iii. Steadily progressive, gradual decline in cognition, w/o extended plateaus and;
iv. No evidence of other causative factor
Specifier of Mild neurocognitive disorder, probable Alzheimer's - ANSWER ✓ i.
Evidence of Alzheimer's genetic mutation via testing or family history
i. Decline in memory and learning and at least one other cognitive domain and;
ii. Steadily progressive, gradual decline in cognition, w/o extended plateaus and;
iii. No evidence of other causative factor
Genetic mutation of apolipoprotein E4 - ANSWER ✓ increases risk of
Alzheimer's
Assessment tools of Major and Minor Neurocognitive Disorders Due to
Alzheimer's - ANSWER ✓ Mini-Cog, Memory impairment screen, mini-mental
status exam, general practitioner assessment of cognition, activities of daily living,
functional activities questionnaire.
CORRECT SOLUTIONS||100%
GUARANTEED PASS||UPDATED
2026/2027 SYLLABUS||ALREADY
GRADED A+||<<LATEST VESION>>
Obsessive and compulsive/Anxiety/trauma and stress related disorders - ANSWER
✓ Body Dysmorphic Disorder
ED
Trichotilomania
Hypochondriasis
OC Personality D/O
Tic or ST movement disorder
Obsessive and compulsive/Anxiety/trauma and stress related disorders basic
neuroscience (brain areas related to fear/anxiety) - ANSWER ✓ Lack of efficient
processing in OFC and lack of cognitive flexibility
Brain areas related to fear/anxiety include:
Cortico-striatao-thalamo-cortico (CSTC) pathway r/t obsessions
Amygdala - traumatic memories of the hippocampus can activate the amygdala
HPA axis - cortisol levels
Feelings of fear regulated by connections between amygdala and ACC and
amygdala and OFC
Obsessive and compulsive/Anxiety/trauma and stress related disorders
epidemiology - ANSWER ✓ Fairly consistent rates, lifetime prevalence in GO 2-
3% to 10% of outpatients in clinics
OCD the 4th most common d/o
Equal rates in adult men / women w/ mean age of onset about 20 years
More common among adolescent boys than girls
More common among singles than married ind
Less often among blacks than whites
,Obsessive and compulsive/Anxiety/trauma and stress related disorders onset,
progression - ANSWER ✓ Mean age of onset about 20 years
Most have onset before age 25, less have onset over age 35 years
Can occur in adol and childhood as early as age 2 years
High comorbidity with depression (about 67%)
Obsessive and compulsive/Anxiety/trauma and stress related disorders etiology -
ANSWER ✓ Biological factors: Serotonin more likely involved as SSRIs more
effective in tx; NE less involved although given clonidine's efficacy NE may be
partially involved as clonidine lowers NE amount released from PreS neurons.
Genetics: 3-5 fold higher probability if familial link
Obsessive and compulsive/Anxiety/trauma and stress related disorders
pharmacological treatment - ANSWER ✓ SSRIs, clomipramine, and if needed
augment with Depakote, lithium, tegretol
Buspar, Effexor, pindolol
Among children, sertraline + therapy more effective than either alone
CBT should be tried prior to initiation of meds
For children: FDA approved (at least 6 yrs), sertraline
Fluoxetine (at least 7)
Fluvoxamine (at least 8)
Clomipramine (at least 10) (first anti-dep studied and only TCA FDA approved for
tx of anxiety d/os in children, but not rec as first line due to SE profile as compared
to other SSRIs
Obsessive and compulsive/Anxiety/trauma and stress related disorders therapeutic
treatment - ANSWER ✓ Behavior therapy, exposure, desensitization, flooding,
aversion, thought stopping, implosion therapy, resolving underlying aggressive
impulses, ECT, DBS
Serotonin syndrome - ANSWER ✓ Migraines, myoclonus, agitation and
confusion on the mild side to hyperthermia, seizures, coma, cardiovascular
collapse, permanent hyperthermic brain damage and even death on the severe end
PANS - ANSWER ✓ a clinical diagnosis given to children who have a dramatic -
practically overnight - onset of neuropsychiatric symptoms including Obsessive
Compulsive Disorder (OCD) and/or eating disorder
,PANDAS - ANSWER ✓ Pediatric Autoimmune Neuropsychiatric Disorders
Associated with Streptococcal Infections; this is a subset of PANS
In Obsessive and compulsive/Anxiety/trauma and stress related disorders it is wise
to rule out - ANSWER ✓ underlying medical disorders and tx of comorbid
conditions - Hair pulling and skin picking. Substance induced, depressive d/o
Major and Minor Neurocognitive Disorders - ANSWER ✓ Significant decline
from previous level of performance in one or more cognitive domains (complex
attention, executive function, learning and memory, language, perceptual-motor, or
social cognition) based on:
a. Concern of the individual, a known informant, or clinician that has witnessed the
decline
b. A substantial impairment in cognitive performance documented by
neuropsychological testing
Specifiers of Major and Minor Neurocognitive Disorders - ANSWER ✓ a.
Without behavioral disturbances
b. With behavioral disturbances
i. Mild- difficulty with house work and managing money
ii. Moderate - difficulty feeding and dressing
iii. Severe- fully dependent
Other determinants of Major and Minor Neurocognitive Disorders - ANSWER ✓
The cognitive deficits interfere w/independence in everyday activities (i.e. paying
bills)
The cognitive deficits do not occur exclusively in the context of delirium or better
explained by another mental health d/o.
Etiology Major and Minor Neurocognitive Disorders - ANSWER ✓ HIV, Prions,
Parkinson's Disease, Huntington's Disease, Alzheimer's, Lew Body, Vascular,
trauma, medications
Mild neurocognitive Disorder - ANSWER ✓ Evidence of modest cognitive
decline from previous level of performance in one or more cognitive domains
(complex attention, executive function, learning and memory, language,
perceptual-motor, or social cognition) based on:
a. Concern of the individual, a known informant, or clinician that has witnessed the
decline
, b. A modest impairment in cognitive performance documented by
neuropsychological testing
With Mild neurocognitive Disorder - ANSWER ✓ The cognitive deficits do not
interfere w/independence in everyday activities (i.e. paying bills) but require
greater effort
The cognitive deficits do not occur exclusively in the context of delirium or better
explained by another mental health d/o.
Mild neurocognitive Disorder Specifiers - ANSWER ✓ a. Without behavioral
disturbances
b. With behavioral disturbances
Major and Minor Neurocognitive Disorders Due to Alzheimer's Diagnosis Criteria
- ANSWER ✓ 1. Criteria for major or mild neurocognitive disorder is met
2. Insidious onset and gradual progression in one or more cognitive domains
Specifiers of Major neurocognitive disorder, probable Alzheimer's - ANSWER ✓
i. Evidence of Alzheimer's genetic mutation via testing or family history and;
ii. Decline in memory and learning and at least one other cognitive domain and;
iii. Steadily progressive, gradual decline in cognition, w/o extended plateaus and;
iv. No evidence of other causative factor
Specifier of Mild neurocognitive disorder, probable Alzheimer's - ANSWER ✓ i.
Evidence of Alzheimer's genetic mutation via testing or family history
i. Decline in memory and learning and at least one other cognitive domain and;
ii. Steadily progressive, gradual decline in cognition, w/o extended plateaus and;
iii. No evidence of other causative factor
Genetic mutation of apolipoprotein E4 - ANSWER ✓ increases risk of
Alzheimer's
Assessment tools of Major and Minor Neurocognitive Disorders Due to
Alzheimer's - ANSWER ✓ Mini-Cog, Memory impairment screen, mini-mental
status exam, general practitioner assessment of cognition, activities of daily living,
functional activities questionnaire.
