American Board of Psychiatry and Neurology Test Prep

Board certification is the stepping stone to becoming a medical professional.

When becoming a Board certified Psychiatrist or Neurologist, you must be able to make quick diagnoses, order laboratory tests, handle emergencies, and manage long term care with patients. This is not an easy task by any means and can make the ABPN board exam seem even more daunting. 

That’s where My Psych Board comes in!

ABPN Question Banks

ABPN style multiset and video vignettes

Our Question Bank is comprised of video vignettes, multiset vignettes, and multiple choice questions, which will help prepare you for your ABPN examination by honing each of the necessary skills needed to succeed in the field.

New questions are continually being added to the question banks, ensuring the most current and up to date information is being made available to you as you progress in your studies.

Topics

The ABPN Question Bank encompasses all the topics you need to master in order to become board certified. From Depression to Neurology, this Question Bank covers it all.

Samples of the questions we offer in our ABPN question bank- Click to see more!

Example Multiset Vignette- Click to see answer!

A 53-year-old male with a history of depression is admitted to the inpatient medical floor after presenting to the ER with altered mental status. Psychiatry is consulted due to some suspicion that he may have intentionally overdosed on one of his home medications. He appears slow in his movements and when the psychiatrist asks him, “What day is it today?” he stares back for a few minutes and ultimately responds with “…what day is it today, what day is it today”. On physical examination, the patient tends to initially push against movements but then allows the physician to guide him with mild resistance. The psychiatrist also notices that at various points during the interview and examination, the patient will hold a limb in a given position for longer than one would expect. A few hours later, the patient’s wife provides some additional collateral and notes that he was recently prescribed metoclopramide to treat nausea after a procedure.

Q1: Which of the following is correct regarding this patient’s most likely diagnosis?

A This patient likely has Major Depressive Disorder with Psychotic Features; once medically cleared, he should be started on an SSRI plus atypical antipsychotic

B Given the patient’s age and presenting symptoms, Delirium due to medical causes should be ruled out

C This patient should be administered the Bush-Francis Catatonia Rating Scale (BFCRS) and if he scores below 10, catatonia is likely

D Catatonia is unlikely as a mood disorder like Major Depressive Disorder (MDD) would not typically lead to these type of symptoms

E Catatonia can only occur in patients with a psychotic illness (i.e. Schizophrenia), and thus this patient’s history of MDD reduces the likelihood of catatonia

Example Multiset Vignette- Answer

Correct Answer – B Given the patient’s age and presenting symptoms, Delirium due to medical causes should be ruled out

Explanation:

This patient has a constellation of symptoms (echolalia, staring, odd posturing) that raise concern for catatonia, and further assessment will be helpful to rule out delirium due to medical causes (Choice B). There are no clear signs of psychosis, and use of an atypical antipsychotic could make catatonia worse (Choice A). Additionally, a psychotic disorder like schizophrenia is only one of the possible psychiatric conditions that can predispose to catatonia – in general, both mood and psychotic disorders can lead to catatonic symptoms (Choices D and E). While a BFCRS would be helpful, higher scores generally correlate to increased severity of catatonia (Choice C).

REF:

1-DiPalma JR. Metoclopramide: a dopamine receptor antagonist. Am Fam Physician. 1990 Mar;41(3):919-24. PMID: 2407079.

2-Van der Heijden, Tuinier S, Arts NJ, et al: Catatonia: disappeared or under-diagnosed? Psychopathology 2005; 38:3–8.

3-Sienaert P, Dhossche DM, Vancampfort D, De Hert M, Gazdag G. A clinical review of the treatment of catatonia. Front Psychiatry. 2014;5:181. Published 2014 Dec 9. doi:10.3389/fpsyt.2014.0018

Example Multiset Vignette Q2 Click to see answer!

A 53-year-old male with a history of depression is admitted to the inpatient medical floor after presenting to the ER with altered mental status. Psychiatry is consulted due to some suspicion that he may have intentionally overdosed on one of his home medications. He appears slow in his movements and when the psychiatrist asks him, “What day is it today?” he stares back for a few minutes and ultimately responds with “…what day is it today, what day is it today”. On physical examination, the patient tends to initially push against movements but then allows the physician to guide him with mild resistance. The psychiatrist also notices that at various points during the interview and examination, the patient will hold a limb in a given position for longer than one would expect. A few hours later, the patient’s wife provides some additional collateral and notes that he was recently prescribed metoclopramide to treat nausea after a procedure.

Q2: The on-call psychiatrist completes a Bush-Francis Catatonia Rating Scale. Which of the following is correct when considering the scoring of this patient’s symptoms?

A The patient should receive a score of “0” for echolalia

B The patient should receive a score of “3” for waxy flexibility

C There is clear evidence of “Gegenhalten” based on the reported findings thus far, and the patient would not score a “0” for this category

D The psychiatrist does not need to have vital sign information to have an accurate overall score on the BFCRS

E There is clear evidence for stereotypies based on the reported findings thus far

Example Multiset Vignette Q2 Answer

The BFCRS is a very useful tool in diagnosing the severity of catatonia. For this patient, there is evidence of echolalia (Choice A is incorrect), staring, and waxy flexibility (Choice B). Gegenhalten is not clear from the description; generally Gegenhalten is described as the involuntary resistance to passive movement, whereas this patient allows the examiner to move his arm without significant resistance (Choice C). There is not clear description of stereotyped movements (Choice E). Vital sign information is a part of the BFCRS and would contribute to the overall score (Choice D). Other elements of the BFCRS are not observed here, but a complete examination would help determine the overall severity of this patient’s catatonic symptoms.

REF:
1-DiPalma JR (1990). Metoclopramide: a dopamine receptor antagonist. Am Fam Physician. 41(3), 919-924
2-Van der Heijden, Tuinier S, Arts NJ, et al (2005). Catatonia: disappeared or under-diagnosed? Psychopathology, 38, 3-8.
3-Sienaert P, Dhossche DM, Vancampfort D, De Hert M, Gazdag G (2014). A clinical review of the treatment of catatonia. Front Psychiatry. 5,181

Example Single Response Multiple Choice Question

A 10-year-old male presents to the hospital for behavioral aggression at home. His parents report he has a history of intellectual disability and did not meet several developmental milestones. On exam, you notice frequent hand-flapping, poor eye contact, and difficulty focusing. His parents share that they are awaiting genetic results for possible fragile X syndrome. What is the genetic mechanism behind this disorder?

A Third copy of chromosome 18

B Trinucleotide expansion on X chromosome

C Trinucleotide expansion on chromosome 4

D Microdeletion on chromosome 15

E Point mutation on chromosome 11

Example Video Vignette

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