Child PRITE 2019 Questions & Answers

Which of the following acutely inhibits the release of glucocorticoids in the adrenal glands? a. GABA b. Cortisol c. Estrogen d. Serotonin e. Acetylcholine - ANSWERSa. GABA A teacher assigns the children in class to solve as many math problems as they can on their own in 20 minute period. Teacher makes a note of each student's progress, divides the class into groups to further work on the problems together, and provides help to each group when members are stuck. This strategy most directly makes use of which of the following educational concepts? a. Transfer of learning b. Collective socialization c. attunement to learning styles d. transformative learning theory e. zone of proximal development - ANSWERSe. zone of proximal development By age of 3 years, toddlers can typically perform which of the following tasks? a. tie shoelaces b. fasten buttons c. close a zipper d. manipulate scissors e. draw a person with realistic proportions - ANSWERSd. manipulate scissors An adolescent boy was engaged in therapy lasting 10 weeks. During this therapy the boy was able to relate to his test taking anxiety, chronic feeling of interpersonal inadequacy, and inaccurate sense of physical unattractiveness to an earlier relationship with his father who was often critical and harsh, and unpredictably embarrassed the boy in social settings. Which of the following therapies was most likely utilized? a. behavioral b. cognitive behavioral c. dialectical behavioral d. motivational interviewing e. short term psychodynamic - ANSWERSe. short term psychodynamic During psychiatric evaluation, which of the following methods would best help develop the therapeutic alliance between a psychiatric and a new immigrant patient and family? a. consulting with the immigrant family's traditional healers b. conducting the initial appointment with the identified patient only c. relying on previous clinical experiences with this immigrant population d. using a qualified interpreter who has proficiency in the family's language of origin e. maintaining consistent individualistic boundary practices across spectrum of cultures - ANSWERSd. using a qualified interpreter who has proficiency in family's language of origin Children typically demonstrate the most overt sexual interest and behavior during which of the following developmental stages? a. infancy b. toddlerhood c. preschool d. early school age e. late school age - ANSWERSc. preschool research on typical development has focused on acquisition of language as a foundation for cognitive and other areas of development. which of the following has been demonstrated to be most significantly related to language proficiency in preschoolers in the US? a. parental age b. geographical location c. socioeconomic status d. parental native language e. contact with other children - ANSWERSc. socioeconomic status youth who has been on long term risperidone treatment develops TD which continues despite initially reducing dose, and then sequential optimal trials of aripiprazole, olanzapine, quetiapine, each for sufficient duration and dose. Most appropriate next step is to start which of the following treatments? a. switch neuroleptic to clozapine b. add Vit E to neuroleptic use c. switch neuroleptic to fluphenazine d. add benztropine to neuroleptic use e. add botox injections to neuroleptic use - ANSWERSa. switch neuroleptic to clozapine 7 y.o. presents with speech difficulties. On exam, examples of child's speech include pronouncing "dat" for cat and "pay" for play. Parents report that this problem bothers their child and also results in child being bullied at school. The child has no hearing difficulties, and otherwise excels in academics. Which of the following is the most likely dx? a. stuttering b. normal development c. speech sound disorder d. childhood apraxia of speech e. social (pragmatic) communication disorder - ANSWERSc. speech sound disorder According to DSM, dx of premenstrual dysphoric disorder should be confirmed by... a. daily rating of severity of problems b. prospective symptom rating log over 2 months c. premenstrual tension syndrome rating scale d. visual analogue scales of premenstrual mood symptoms e. validated depression rating scale during week prior to menses - ANSWERSb. prospective symptom rating log over 2 months longitudinal, prospective study of a large group of healthy infants of mothers with postpartum depression finds that 3% of the study population meet criteria for a mood disorder by age 6 yrs, a proportion that increased to 6% by age 12. This measure of mood disorder occurrence among the children is best described as the... a. base rate b. odds ratio c. prevalence d. cumulative incidence e. positive predictive value - ANSWERSd. cumulative incidence Which of the following is the most important guide when arranging the infrastructure necessary to provide telepsychiatric consultation to a school? a. Rehabilitation act b. family educational rights and privacy act c. patient protection and affordable care act d. health information portability and accountability act e. individuals with disabilities education improvement act - ANSWERSb. family educational rights and privacy act An adolescent is referred for substance use treatment after being found unresponsive in the bathroom by a younger sibling at home. The adolescent relapsed and used substances 2 days prior to the visit with the psychiatrist. At the visit, the adolescent states, "I feel like such a failure". Using motivational interviewing approach, which of the following statements would be the next best response by a psychiatrist? a. "I wonder if your choice to use substances again may represent self sabotage" b. "you do not fully understand the negative consequences of your substance use" c. "this recent relapse is making you upset because you were trying so hard to stay sober" d. "this choice was more about peer pressure and you need to find a new group of friends" e. "let us try to view your recent relapse as a 1 time occurrence and move forward together" - ANSWERSc. "this recent relapse is making you upset because you were trying so hard to stay sober" An 8 yo with severe anxiety has benefited from weekly in person psychotherapy to date, but the long distance between the patient's home and clinic precludes continuing this treatment. Based on the available evidence, web based therapy for this child would most likely have the most beneficial effect if which of the following occurs? a. augmentation with pharmacotherapy b minimization of pictures and game play to avoid distraction c. multiple sessions are digitally recorded for viewing at home d. implementation with the support of a parent, caregiver or teacher e. utilization of text based input by the child to log events and feelings - ANSWERSd. implementation with the support of a parent, caregiver or teacher Which of the following non-pharmacological interventions for ADHD has been most consistently validated in treatment trials? a. neurofeedback b. social skills training c. behavioral parent training d. CBT e. removal of sugar and food additives from the diet - ANSWERSc. behavioral parent training Which of the following psychiatric d/o is most likely comorbid in an adolescent with diabetes? a. Bipolar d/o b. conduct d/o c. MDD d ODD e. ADHD - ANSWERSc. MDD which of the following psychiatric symptoms is most common in pediatric patients who have survived a brain tumor? a. anxiety b. psychosis c. impulsivity d. aggression e. self injurious behavior - ANSWERSa. anxiety Which of the following traumatic events is most commonly experienced by children and adolescents in the US? a. sexual abuse b. physical abuse c. natural disaster d. war related trauma e. death to a loved one - ANSWERSe. death to a loved one A 10 y.o. child's report card consists of all A's except for a C in math, the subject in which he has always had considerable difficulty. Which of the following assessment instruments would be most appropriate to help assess the child's academic deficit? a. wide range intelligence test b. stanford-binet intelligence scales c. leiter international performance scale d. wechsler intelligence scare for children e. woodcock-johnson tests of achievement - ANSWERSe. woodcock-johnson tests of achievement An outpatient clinic uses a newly developed screening tool to assess 100 children for autism. The tool correctly identifies 15 children with autism. However, 5 children w/ autism were missed, and 3 children were identified as having autism when they do not have it. What is the sensitivity of this newly developed tool? a. 5% b. 15% c. 20% d. 67% e. 75% - ANSWERSe. 75% The psychiatrist is considering using texting to communicate with several adolescent patients who prefer that method of communication. Which of the following represents an important professional standard regarding the use of texting with patients? a. AACAP has firmly opposed the use of text messaging with patients b. adolescents who are employed and pay for their own phone plan can provide the necessary consent to allow physicians to text message with them c. text messaging for scheduling purposes only is not considered clinical communication and therefore does fall under the purview of HIPAA d. physicians who choose to text message with patients should find a way to document and store records of the exchanges as part of the patient's medical record e. text messages are naturally encrypted and are considered secure electronic communication, as outline in HIPAA - ANSWERSd. physicians who choose to text message with patients should find a way to document and store records of the exchanges as part of the patient's medical record In youth with SUD, evidence suggests the chance for recovery in a peer support group is best optimized if the patient is peer matched along which parameter? a. age b. gender c. ethnicity d. substance of choice e. socioeconomic status - ANSWERSa. age Elevated release of neuropeptide Y in response to stress results in decreased psychological distress by modulating the release of which of the following? a. GABA b. serotonin c. dopamine d. glutamate e. norepinephrine - ANSWERSa. GABA Which of the following recommendations was made based on multimodal treatment of ADHD study at 6 to 8 yr follow up regarding the treatment of ADHD from childhood to adolescence? a. periodic drug holidays should be given to assess continued need and benefit b. the ADHD adolescents in treatment will normalize academically to the non ADHD adolescents c. maintain intensive medication management treatment through adolescence for continued benefit d. initial benefits of combined treatment of intensive therapy and medication management are maintained through adolescence e. adolescents have better adherence to medication management, thus other interventions for ADHD symptoms are not as necessary - ANSWERSa. periodic drug holidays should be given to assess continued need and benefit the classic triad of HIV related encephalopathy in children is characterized by pyramidal tract motor deficits, acquired microcephaly and: a. seizures b. blindness c. neoplasms d. developmental delays e. ADHD - ANSWERSd. developmental delays 10 yo boy has been preoccupied that he will develop leukemia since watching his younger brother succumb to the disease a year ago. The child is worried that he has all the same symptoms despite evidence to the contrary and reassurance from his parents and pediatrician. The child's friends have stopped associating with him because he only talks about how he will die soon and his parents are frustrated with his repeated requests for blood tests. which of the following is the most likely dx? a. illness anxiety disorder b. body dysmorphic disorder c. somatic symptom disorder d. OCD e. adjustment disorder with anxiety - ANSWERSa. illness anxiety disorder Which of the following medications has been shown to reduce weight gain associated with antipsychotic medication use? a. lithium b. clonidine c. metformin d. buproprion e. lamotrigine - ANSWERSc. metformin In a hypothetical study, 60% of adolescents with depression treated with SSRI met response rate criteria while those who received a placebo has response rate 35%. What is the number needed to treat for this study? a. 1 b. 4 c. 10 d. 40 e. 400 - ANSWERSb. 4 Which of the following compensatory biochemical changes that occur during dieting explains the plateau in weight loss? a. decreased leptin release b. decreased ghrelin release c. decreased neuropeptide Y release d. increased pro-opiomelanocortin release e. increased alpha-melanocyte stimulating hormone release - ANSWERSa. decreased leptin release When emailing or providing mental health information on electronic platforms, the most important reason for providing a disclaimer that the information does not constitute professional advice is to make which of the following professional issues clear? a. more involved care will require payment b. the limits of the physician's competence c. that there is no doctor-patient relationship d. transfer of responsibility for care to another provider e. the psychiatrist is providing only personal knowledge - ANSWERSc. that there is no doctor-patient relationship Spinal muscular atrophy is a chronic neurological d/o in children that primarily involves which of the following areas? a. anterior horn cells b. cranial nerve nuclei c. neuromuscular junctions d. efferent peripheral nerves e. afferent peripheral nerves - ANSWERSa. anterior horn cells A divorced mother brings her 14 yo child for an initial eval with the psychiatrist for depression. After interviewing the mother and then separately the child, the psychiatrist confirms dx of depression and finds no evidence of suicidality, SIB, or concern for safety. The child is amenable to treatment with antidepressant. The mother reports a shared custody arrangement with child's father, but the father "doesn't like medications". Which of the following is the psychiatrists best course of action? a. recommend family therapy to resolve the inter-parental dispute b. hospitalize the child and start an antidepressant as emergency treatment c. start antidepressant with the mother's consent as it is the child's best interest d. speak with the father and attempt to obtain his consent for starting the child on an antidepressant e. give a prescription for an antidepressant but tell the mother to discuss with the father whe - ANSWERSd. speak with the father and attempt to obtain his consent for starting the child on an antidepressant A child has a history of anger outbursts. The child and parents develop a plan for grocery that, if the child asks for a candy at the checkout stand, has a meltdown and is unable to stay calm, the child will lose video game play time for the next day. Which of the following terms best describes this strategy? a. time out b. token economy c. attending and ignoring d. praise and positive reinforcement e. antecedent-behavior-consequence - ANSWERSe. antecedent-behavior-consequence In application of DBT for adolescents, which of the following should be taught first? a. mindfulness b. self management c. distress tolerance d. emotion regulation e. interpersonal effectiveness - ANSWERSa. mindfulness A previously healthy child with a hx of ADHD and depression is medically admitted for vomiting, HA, increased ICP, hepatosplenomegaly, skin desquamation, and MSK/abdominal pain. Caregivers report use of cod liver oil for the child's depression and ADHD for last few years w/ steady increases in dosing due to lack of perceived effectiveness. The child has an otherwise normal diet and also prescribed melatonin and clonidine. Toxicity due to which of the following is the most likely of the patient's symptoms? a. lead b. clonidine c. Vitamin A d. melatonin e. omega 3 fatty acids - ANSWERSc. Vitamin A When an 8 yo XY male states that he is a boy, this meets definition of: a. cisgender b. alt gender c. third gender d. transgender e. non conforming gender - ANSWERSa. cisgender