Topics › System
Behavioral Health & Nervous Systems/Special Senses — Step 1 practice questions
284 questions in this area, with an explanation for every answer choice.
Three samples below, free and without an account.
How this shows up on Step 1
Neuroanatomy questions are localisation problems: a deficit is described and you name the lesion site. Psychiatry is tested through diagnostic criteria and time courses, so the durations that separate one diagnosis from another matter. Psychopharmacology appears throughout, usually as mechanism or side-effect profile.
Sample questions
Sample question 1
A 19-year-old woman of normal weight has recurrent episodes of eating large amounts of food with a sense of loss of control, followed by self-induced vomiting, with dental enamel erosion and parotid enlargement. Which of the following best describes this condition?
Explanations
A. Bulimia nervosa, in which patients are typically normal weight or overweight, distinguishing it from anorexia nervosa with its low body weight · correct
BULIMIA NERVOSA involves recurrent binge eating with a sense of loss of control followed by inappropriate COMPENSATORY behaviors — vomiting, laxatives, fasting, or excessive exercise — with self-evaluation unduly influenced by body shape. Patients are typically NORMAL weight or overweight, which is why it is frequently missed. Physical signs of purging include dental enamel erosion, parotid enlargement, Russell sign (knuckle calluses), and hypokalemic metabolic alkalosis. ANOREXIA nervosa requires significantly LOW body weight regardless of subtype, and BINGE EATING disorder involves binges WITHOUT compensatory behaviors.
B. Binge eating disorder, which includes compensatory behaviors
Binge eating disorder lacks compensatory behaviors.
C. Avoidant restrictive food intake disorder
ARFID involves restriction without body image disturbance.
D. Anorexia nervosa, binge-purge subtype, requiring low body weight
Anorexia nervosa requires significantly low weight.
E. Normal eating behavior
The pattern is clearly disordered with physical consequences.
Sample question 2
A 30-year-old man has bilateral hearing loss and tinnitus. MRI shows bilateral masses at the cerebellopontine angles, and he also has multiple meningiomas. Which of the following best describes the genetic basis of his condition?
Explanations
A. Mutation in the NF2 gene on chromosome 22 encoding merlin · correct
BILATERAL vestibular schwannomas are essentially pathognomonic for neurofibromatosis type 2, caused by mutation of the NF2 tumor suppressor on chromosome 22 encoding merlin. Patients also develop meningiomas, ependymomas, and juvenile cataracts. Mnemonic: NF2 — chromosome 22, two ears.
B. Mutation in TSC1 on chromosome 9
TSC1/TSC2 cause tuberous sclerosis.
C. Mutation in the VHL gene on chromosome 3
VHL causes hemangioblastomas and renal cell carcinoma.
D. Mutation in the RET proto-oncogene on chromosome 10
RET mutations cause MEN 2.
E. Mutation in the NF1 gene on chromosome 17 encoding neurofibromin
NF1 (chromosome 17) causes café-au-lait macules, axillary freckling, Lisch nodules, cutaneous neurofibromas, and optic gliomas.
Sample question 3
A patient taking an SSRI is started on a second serotonergic medication and develops agitation, hyperthermia, tremor, and hyperreflexia with clonus. Which of the following is the most appropriate immediate management?
Explanations
A. Add a third serotonergic medication
Adding another serotonergic medication would worsen, not treat, this condition.
B. Continue both medications and monitor without intervention
This is serotonin syndrome, a potentially life-threatening condition; simply monitoring without discontinuing the causative agents is inadequate.
C. No treatment is available for this condition
Effective supportive treatment approaches exist for serotonin syndrome.
D. Discontinue serotonergic agents and provide supportive care, including benzodiazepines and cyproheptadine if needed · correct
Serotonin syndrome management involves discontinuing all serotonergic agents, providing supportive care (cooling, benzodiazepines for agitation/rigidity), and using cyproheptadine (a serotonin antagonist) in more severe cases.
E. Administer more of the same medications at a higher dose
Increasing the causative medications would significantly worsen this dangerous condition.
Practice the rest
Build a quiz from this topic, or sit a full length exam under real conditions.
Start free
