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Self-Assessment Questions

Psychiatry
Attention-Deficit/Hyperactivity Disorder: Review Questions

Joseph V. Penn, MD

Dr. Penn is the Director of Child and Adolescent Forensic Psychiatry, Rhode Island Hospital, and a Clinical Assistant Professor, Department of Psychiatry & Human Behavior, Division of Child and Adolescent Psychiatry, Brown University School of Medicine, Providence, RI.


Choose the single best answer for each question.

Questions 1 through 3 refer to the following case study.

A 7-year-old boy is brought to his physician because of a 1-year history of difficulty sustaining attention in school tasks, chores, or play activities. His parents say that he does not listen to them or his teacher and that he "can’t stay on track." The boy often loses toys, library books, and school assignments and is easily distracted by extraneous stimuli in the classroom. He fails to pay close attention to details and makes careless mistakes in his schoolwork. Evidence of clinically significant impairment in his social and academic functioning has been observed. In the doctor’s office, the boy makes good eye contact and exhibits no obvious behavioral problems.

1. Which of the following is the most likely diagnosis for this patient?
  1. Attention-deficit/hyperactivity disorder (ADHD), predominantly inattentive type
  2. ADHD, combined type
  3. Conduct disorder
  4. Oppositional defiant disorder
  5. Parent-child relational problem
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2. Which of the following criteria is necessary to confirm a diagnosis of ADHD in this child?

  1. Behavior such as enuresis, fire setting, and cruelty to animals
  2. Impairment observed in 2 or more settings
  3. Onset of symptoms before age 5 years
  4. Symptoms lasting at least 3 months
  5. Violation of rules or the rights of others
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  3. Which of the following most likely explains the patient’s lack of clinical signs and symptoms in the doctor’s office?
  1. Circadian cycle of symptoms
  2. Lack of rewards for appropriate behavior
  3. Novel setting
  4. Unstructured setting
  5. Volitional control by the patient
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4. Which of the following is the most commonly reported adverse effect of stimulant medications used to treat ADHD?

  1. Appetite suppression and sleep disturbance
  2. Headaches and growth suppression
  3. Irritability and tearfulness
  4. Lethargy and lowering of seizure threshold
  5. Tics and gastrointestinal discomfort
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5. Which of the following is the most likely cause of ADHD?

  1. Fetal alcohol syndrome
  2. Fragile X syndrome
  3. Low birth weight
  4. Thyroid disorders
  5. Unknown
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