Sunday, 18 November 2012

Usmle Step 1 MCQ's # 5

Title: Usmle Step 1 MCQ's # 5
Subject: Behavioral Science

Q NO 5: A 19-year-old woman is brought to the emergency department by the police. She had run away from home alter another battle with her mother. She has been hospitalized several times for overdoses, and she has numerous scars on her wrists. The psychiatrist notes that all of her relationships have been stormy, and that she seems to regard people as either “all good” or “all bad.” She is admitted with a diagnosis of major depression because of the apparent depth of her depression, however, by the next morning, she is completely recovered and is “well” with no vegetative symptoms. Which of the following is the most likely diagnosis?

A. Antisocial personality disorder
B. Borderline personality disorder
C. Histrionic personality disorder
D. Narcissistic personality disorder
E. Passive-aggressive personality disorder

The correct answer is B. Borderline personality disorder is characterized by short term psychotic episodes (e.g., the depression noted in this case), self mutilation, “splitting” persons into the “good-bad” extremes on a continuum and markedly unstable interpersonal relationships.
The person with antisocial personality disorder (choice A) operates in opposition to society’s rule and customs. Criminal behavior is common.
The person with histrionic personality disorder (choice C) is flamboyant and seductive.
The person with narcissistic personality disorder (choice D) is impressed with himself and operates from a position of entitlement.
The person with passive-aggressive personality disorder (choice E) expresses his anger by passive means such as procrastination, chronic tardiness, and sabotaging productivity.

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