Behavioral Medicine MCQs

A 23-year-old medical student comes to the emergency room with
increased heart rate, sweating, and shortness of breath. The student is
convinced that she is having an asthma attack and that she will suffocate.
The symptoms started suddenly during a car ride to school. The
student has had episodes such as this on at least three previous occasions
over the past 2 weeks. She has no history of asthma and, other
than an increased pulse rate, physical findings are unremarkable.

Which of the following disorders best fits this clinical picture?
(A) Hypochondriasis
(B) Obsessive-compulsive disorder
(C) Panic disorder
(D) Generalized anxiety disorder
(E) Acute stress disorder

A 35-year-old woman who was raped 5 years ago has recurrent vivid
memories of the incident accompanied by intense anxiety. These
memories frequently intrude during her daily activities, and nightmares
about the event often wake her. Her symptoms intensified when a
coworker was raped 2 months ago.
This patient’s symptoms most closely suggest

(A) post-traumatic stress disorder
(B) panic disorder
(C) adjustment disorder
(D) acute stress disorder
(E) malingering

A 45-year-old woman says that she frequently feels “nervous” and often
has an “upset stomach,” which includes heartburn, indigestion, and
diarrhea. She has had this problem since she was 25 years of age and
notes that other family members also are “tense and nervous.”
Which of the following disorders best fits this clinical picture?

(A) Hypochondriasis
(B) Obsessive-compulsive disorder
(C) Panic disorder
(D) Generalized anxiety disorder
(E) Acute stress disorder

A 28-year-old woman seeks facial reconstructive surgery for her
“sagging” eyelids. She rarely goes out in the daytime because
she believes that this characteristic makes her look “like a grandmother.”
On physical examination, her eyelids appear completely
normal.
Which disorder best fits this clinical picture?

(A) Post-traumatic stress disorder
(B) Hypochondriasis
(C) Obsessive-compulsive disorder
(D) Panic disorder
(E) Somatization disorder
(F) Generalized anxiety disorder
(G) Body dysmorphic disorder
(H) Conversion disorder
(I) Specific phobia
(J) Social phobia
(K) Adjustment disorder

A 29-year-old man experiences a sudden hemiparesis, but appears
unconcerned. He reports that just before the onset of paralysis, he saw
his girlfriend with another man. Physical examination fails to reveal
evidence of a medical problem.
Which disorder best fits this clinical picture?

(A) Post-traumatic stress disorder
(B) Hypochondriasis
(C) Obsessive-compulsive disorder
(D) Panic disorder
(E) Somatization disorder
(F) Generalized anxiety disorder
(G) Body dysmorphic disorder
(H) Conversion disorder
(I) Specific phobia
(J) Social phobia
(K) Adjustment disorder
(L) Masked depression

A 39-year-old woman takes her 6-year-old son to a physician’s office. She says
that the child often experiences episodes of breathing
problems and abdominal pain. The child’s medical record shows many office
visits and four abdominal surgical procedures, although no
abnormalities were ever found. Physical examination and laboratory studies are
unremarkable. When the doctor confronts the mother with
the suspicion that she is fabricating the illness in the child, the mother angrily
grabs the child and leaves the office immediately.
This clinical presentation is an example of

(A) factitious disorder
(B) conversion disorder
(C) factitious disorder by proxy
(D) somatization disorder
(E) somatoform pain disorder
(F) malingering

A 39-year-old woman takes her 6-year-old son to a physician’s office. She says that
the child often experiences episodes of breathing problems and abdominal pain. The
child’s medical record shows many office visits and four abdominal surgical
procedures, although no abnormalities were ever found. Physical examination and
laboratory studies are unremarkable. When the doctor confronts the mother with the
suspicion that she is fabricating the illness in the child, the mother angrily grabs the
child and leaves the office immediately.
In this situation, what is the first thing the physician should do?

(A) Take the child aside and ask him how he feels.
(B) Call a pediatric pulmonologist to determine the cause of the dyspnea.
(C) Call a pediatric gastroenterologist to determine the cause of the abdominal pain.
(D) Notify the appropriate state social service agency to report the physician’s
suspicions.
(E) Wait until the child’s next visit before taking any action.

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