A 5 year old boy is referred for evaluation because he is unable to sit still in school for more than a few seconds at a time. He pushes other children and yanks toys away from others. He interrupts, wanders around the classroom, or pokes his neighbors. This pattern of behavior has been observed since preschool and often has resulted in parents needing to come to the school to pick him up, and even being kicked out of one preschool class. His parents report that he has been “on the move” since he learned how to walk and always gets injured at home. The child’s language and motor development are normal.
The most likely diagnosis is:
a) Oppositional defiant disorder
b) ADHD, inattentive type
c) Mental retardation, mild
d) ADHD, combined type
e) Normal child development

A 15-year-old boy is arrested for shooting the owner of the store he tried to rob. He has been in the Department of Youth Services’ custody several times for a variety of crimes against property, possession of drugs, and assault and battery. He is cheerful and unconcerned during the arrest, more worried about not losing his leather jacket than about the fate of the man he has injured. What is his likely diagnosis?
a) Oppositional defiant disorder
b) Antisocial personality disorder
c) Narcissistic personality disorder
d) Conduct disorder
e) Substance abuse

A 7-year-old boy with leukemia is referred because of concerns for his mood. His parents report that he fluctuates between appearing depressed and acting angry. At times he plays quietly in his room, but at other times, he displays angry outbursts, often hitting his 4 year-old brother. Which of the following methods would be the most useful way to interview this child?
A) Sit quietly and allow the child to talk
B) Encourage the child to talk about whatever is on his mind
C)Provide toys and allow the child to play
D) Use the DISC (Diagnostic Interview Schedule for Children, Structured diagnostic interview)
E) Ask the child specific questions about how he feels about his disease

Which of the following types of psychotherapy is most effective for the treatment of bulimia nervosa in adolescents?
A) Cognitive-behavioral therapy
B) Family therapy
C) Psychoanalytic psychotherapy
D) Psychodynamic psychotherapy
E) Group therapy

A 4 –year-old boy is referred to you for evaluation because he has not started walking. He appears healthy and well cared for. He readily comes with you to the examination room. In your office, he notices a windup toy and immediately becomes engrossed in winding it up, watching it move around until it winds down, and winding it up again. After about 10 minutes, you attempt to take this toy from him and he comes extremely upset, making an insistent, piercing cry. What is the diagnosis?
A) Oppositional defiant disorder
B) Conduct disorder
C) Separation anxiety disorder
D) Autism spectrum disorder
E) Selective mutism

Which disorder is most frequently co-morbid with ADHD?
a) Reading disorder
b) Intellectual disability
c) Oppositional defiant disorder
d) Autism spectrum disorder
e) Anxiety disorder

A social worker makes a visit on a 3-year-old boy who has just been returned to his biological mother after spending three months in foster care for severe neglect. He initially appears shy and clings fearfully to his mom. Later on, he starts playing in a very destructive and disorganized way. When the mom tries to stop him from throwing blocks at her, he starts kicking and biting. Mom becomes enraged and starts shouting. Child’s diagnosis is likely…
A) Oppositional defiant disorder
B) ADHD
C) Reactive attachment disorder
D) PTSD
E) Depression

Based on pooled date from controlled clinical trials, which of the following medications has established the best risk-benefit ration for treatment of major depression in youth?
A) Venlafaxine (Effexor)
B) Fluoxetine (Prozac)
C) Paroxetine (paxil)
D) Citalopram (Celexa)
E)Fluvoxamine (Luvox)

A 6 month old girl is brought in by her grandmother for a routine visit. The physical examination is normal except that the baby has not gained weight as expected. As of earlier visits, the baby had been gaining weight appropriately. The grandmother reports that she likes to eat and is generally happy and playful. On further questioning, the grandmother describes chaotic mealtimes at home and sys that the baby drools more than usual. Which of the following eating disorders is the most likely diagnosis?
A) Anorexia nervosa
B) Bulimia nervosa
C) Pica
D) Rumination disorder
E)Avoidant/restrictive food intake disorder

Which of the following qualities is associated with a more favorable prognosis for children with autism?
A) Easily toilet trained
B) Organized in play
C) Interested in mechanical toys
D) Able to converse
E) Able to dance to a beat

A 5 year-old is being evaluated for ADHD. He has a past history of failure to thrive (FTT) and is still at the 15th percentile for weight and height. The evaluator notices that he has unusually small eyes with short palpebral fissures as well as a thin upper lip with a smooth philtrum. Which substance did his mother likely abuse during pregnancy?
a) Heroin
b) Nicotine
c) Cannabis
d) Alcohol
e) Cocaine

The mother of one of your 4-year-old patients calls and asks you for advice. She says that her son has been stealing toys from other children at school and bringing them home with him. Which suggestion is most appropriate?
A) The mom should return the toys herself and buy her son similar toys
B)The mom should tell her son that if he stops stealing, she will give him a reward each week.
C) The mom should point out to her son that he is stealing and punish him for it.
D) The mom should help her son return the toys.
e) The mom should ignore the entire situation because her son’s behavior is a part of a developmental phase that will pass.

A 17-year-old boy with a history of major depressive disorder comes to your office for a routine visit. When you walk into the examining room, you notice he is sitting slumped forward with his head bent down. He does not make eye contact and says nothing. You suspect a recurrence of depressive symptoms and are concerned for his risk for suicide. Which is true?
A) Rates of suicidal behavior are similar in adolescent girls and boys
B) More girls than boys commit suicide
C) Suicide is a considerable risk in depressed adolescents and should be specifically addressed during an interview.
D) A prior suicide attempt does not increase an adolescent’s risk of a subsequent one.
E) The adolescent suicide rate has remained stale over the past few decades.

A 15-year-old girl is brought to the doctor by her mom, who is concerned about her lack of apparent appetite. She is wearing baggy clothes, but her weight is in the 70th percentile for her height. She “does not eat much”, but she claims to have a voracious appetite. She is active in the school musical productions, and is very worried about “getting fat” and not getting the lead part. Her past medical history is unremarkable and although she started menstruation at age 13, she has not had her period for at least 5 months. Which of the following lab abnormalities is mostly likely to be present?
A) Decreased corticotropin-releasing hormone (CRH)
B) Hypercholesterolemia
C) Hyperglycemia
D) Hyperthyroidism
E) Leukocytosis

A 12-year-old boy is brought or evaluation because he is having problems being picked on at school. He has a sing-song voice, few friends, and only likes to talk about his bug collection. He has difficulty with transitions and trouble organizing himself. His IQ is 110 and he met all of his developmental milestones. He mostly likely has:
A) Social communication disorder
B) Autism spectrum disorder
C) Major depression
D) Obsessive compulsive disorder
E) Anxiety disorder

A 6-year-old boy with ADHD was started on methylphenidate 5mg twice daily. Parents report that he is able to focus better and seems to have more tolerance for frustration. They are concerned, though, because he is never hungry. Decreased appetite is a common side effect of methylphenidate. Another side effect of this medication is:
a) Night terrors
b) Choreiform movements
c) Insomnia
d) Cardiac Arrhythmias
e) Leukopenia

A 6-year-old child presents with a 3 year history of disruptive behaviors at home and school. His parents report that he also has difficulty paying attention and completing tasks. Other children find him intrusive and annoying. Over the last month, he has become more irritable. He often states, “I am no good” Which of the following comorbid conditions is the most likely explanation for the child’s recent behaviors?
A) Autism spectrum disorder
B) Social anxiety disorder /Social phobia
C) Depression
D) Schizophrenia
E) Oppositional defiant disorder

An 8-year-old boy with a history of major depression treated with fluoxetine (Prozac) is brought to the pediatric emergency department after running into the street in front of a car on the way home from school. The boy says that he wants to be dead and refuses to say more. The boy was not hit by the car, and physical and laboratory examinations are normal. Which of the following symptoms of MDD is seen more commonly in children than in adolescents?
A) Hypersomnia
B) Hopelessness
C) Psychomotor agitation
D) Weight changes
E) Drug abuse

A 17-year-old girl comes to your office for a routine visit. She states that she feels fine and offers no complaints. On exam, she weights 92lb and is 5ft 5in. One year earlier, her weight had been 125lb at the same height. After further discussion, you learn that she is terrified of gaining weight and think she looks fat and needs to lose more weight. She reports that she has not menstruated in the past 6 months. Which finding is consistent?
A) Sinus tachycardia
B) Increased resting energy expenditure/metabolism
C) Elevated serum estrogen levels in girls
D) Elevated serum testosterone levels in boys
E) Increased ventricular-brain ratio on brain imaging

A 4-year-old is diagnosed with Autism spectrum disorder, his pediatrician decides to obtain a blood sample to screen for which of the following disorders:
A) Downs syndrome
B) Fragile X
C) Huntington’s Disease
D) Cystic Fibrosis
E) Prader Willi

Stimulants such as methylphenidate effectively treat symptoms of ADHD in what percentage of patients?
a) 10%
b) 25%
c) 33%
d) 50%
e) 70%

A 9-year-old boy is mandated to attend fire prevention group after setting fire to a shed. He set on fire a small pile of dry leaves, then he poured gasoline on it. The fire went out of control & engulfed the shed. The boy’s mom reports that he had 4 other fire-setting incidents during the previous 6 months. Which is correct:
A) Fires started by kids rarely cause any damage
B) Children younger than 6 are not likely to experiment with fire
C) Girls and boys are equally at risk for pathological fire setting
D) Adolescent fire setting is usually done alone
E) Impulsivity and poor school performance are common in fire setters

Which of the following is the most common method by which adolescents successfully commit suicide?
A) Drug overdose
B) Stabbing or Cutting
C) Jumping from buildings
D) Hanging
E) Firearms

Which of the following tests would be most helpful in making the diagnosis of Rumination disorder?
A) Serum lead level
B) Calculation of the percentage of expected weight that the child’s weight is
C) 24 hr video monitoring
D) Complete blood count (CBC)
E) Esophageal PH measurement

As a part of summer band camp, a 15-year-old autistic female was marching down the street practicing for her school marching band. She suddenly fell to the ground and started shaking and urinated in her pants. The most likely explanation is:
A) It was likely hot outside and she had heat exhaustion or heat stroke
B) She wanted to avoid band practice
C) She had a seizure
D)She had a panic attack