Sample questions / Behavioral Health

Organ system

Behavioral Health questions for Step 1

Work through behavioral health vignettes that mix physiology, pathology and pharmacology, the way the exam does. Every explanation covers all five options.

Behavioral Science / DevelopmentEasy

Piaget conservation

A 4-year-old watches equal amounts of juice poured into a tall thin glass and a short wide glass, yet still insists the tall glass holds more.

This shows that the child does not yet understand which concept?

1. Object permanence
2. Centration
3. Conservation
4. Animism
5. Artificialism

EthicsEasy

Social media boundaries

A physician gets a LinkedIn connection request from a current patient, who says it is for professional networking.

What is the most appropriate response?

1. Accept but limit interaction to professional topics
2. Accept to avoid seeming rude
3. Decline and explain professional boundary policies
4. Ignore the request without explanation
5. Report the patient for inappropriate behavior

Behavioral ScienceEasy

Transition difficulties

A 5-year-old boy becomes aggressive only at transitions. He hits classmates when cleanup is announced and has tantrums when moving from playground to classroom, but behaves well otherwise.

Which intervention would help most?

1. Visual schedule and transition warnings
2. Removal of playground privileges
3. One-on-one aide assignment
4. Behavioral reward chart
5. Time-out after each aggressive incident

PsychiatryMedium

Schneider first-rank symptoms

A 22-year-old man believes his thoughts are broadcast, that a microchip controls his actions, and hears two voices talking about him. Symptoms have lasted 8 months with withdrawal.

Why were these 'first-rank symptoms' considered important?

1. They indicate genetic rather than environmental etiology
2. They were considered highly suggestive of schizophrenia when present in the absence of organic causes
3. They are pathognomonic for schizophrenia and exclude all other diagnoses
4. They indicate a more severe prognosis than other psychotic symptoms
5. They respond exclusively to typical antipsychotics

PharmacologyEasy

Thiazide and lithium

A 38-year-old woman on lithium has coarse tremor, ataxia and confusion after starting HCTZ; her level is 2.0.

What is the mechanism?

1. Inhibition of hepatic metabolism via CYP3A4
2. Increased proximal tubular reabsorption due to volume depletion
3. Displacement from plasma protein binding
4. Inhibition of renal excretion via organic anion transporters
5. Direct additive neurotoxicity

Other systems

Cardiovascular · Respiratory · Renal & Urinary · Gastrointestinal & Hepatobiliary · Nervous System · Endocrine · Reproductive · Hematology & Oncology · Musculoskeletal & Skin · Multisystem & General Principles ·