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Question 1
Which laboratory finding is hallmark of refeeding syndrome?
Correct Answer:
Hypophosphatemia
Explanation:
When refeeding after a period of starvation, a surge of insulin drives phosphate into cells to support ATP production and other anabolic processes. This rapid intracellular shift causes a drop in circulating phosphate levels, making low serum phosphate the characteristic finding of refeeding syndrome. Severe hypophosphatemia can lead to energy failure in multiple organs, contributing to weakness, respiratory failure, cardiac dysfunction, hemolysis, and more. Other electrolyte changes can occur—potassium and magnesium also shift intracellularly, so hypokalemia and hypomagnesemia are common—but they are not the defining, hallmark finding. Hyponatremia can occur due to fluid shifts and other factors, but it is not the defining feature of refeeding syndrome.
Question 2
What is the most common physiological cause of erectile dysfunction?
Correct Answer:
Atherosclerosis
Explanation:
Erection relies on rapid arterial inflow to the penis and proper venous occlusion to trap that blood. The most common physiological problem that disrupts this process is atherosclerotic disease narrowing the penile arteries, which reduces arterial inflow and prevents the rise in penile blood pressure needed for an erection. This link to systemic vascular disease explains why ED is so often associated with aging and risk factors like smoking, high cholesterol, and hypertension. Diabetes is a strong risk factor and can worsen ED through vascular and nerve damage, but it’s not the single most common mechanism. Low testosterone can contribute to ED, but hormonal deficiency is a less frequent cause of the physiological dysfunction that prevents erection.
Question 3
Which feature best differentiates alcohol withdrawal delirium (delirium tremens) from alcohol hallucinosis?
Correct Answer:
Unstable vital signs such as hypertension and tachycardia
Explanation:
Delirium tremens is the severe alcohol withdrawal state that features delirium with autonomic hyperactivity. The strongest clue that sets it apart from alcohol hallucinosis is unstable vital signs, such as tachycardia, hypertension, and fever, reflecting a heightened physiological storm. In delirium tremens, this autonomic instability accompanies confused and fluctuating consciousness, agitation, and disorientation. By contrast, alcohol hallucinosis involves hallucinations—often auditory—while the patient’s sensorium remains clear and vitals remain relatively stable, without the marked autonomic signs. Timing after the last drink can overlap between these conditions, and hallucinations can occur in both, but the presence of significant autonomic instability is the key differentiator. Pupillary responses are not consistently helpful as differentiators.
Question 4
Night terrors occur during which sleep stage?
Correct Answer:
N3
Explanation:
Night terrors arise from deep non-REM sleep, the deepest stage often called slow-wave sleep. In this stage the brain shows large delta waves, and the sleeper is difficult to awaken, with abrupt episodes of intense fear, autonomic arousal, and confusion, usually with little or no memory of the event afterward. They tend to occur in the first part of the night. This contrasts with nightmares, which occur during REM sleep and typically involve vivid dream recall upon waking. Understanding that night terrors come from deep sleep helps explain why they feel so disruptive and are not the same as the dreams people remember from REM.
Question 5
ECT is indicated in which scenario according to the material?
Correct Answer:
Severe depressive episode with psychotic features
Explanation:
Electroconvulsive therapy is especially indicated when a depressive episode is severe and accompanied by psychotic features because this combination often requires a rapid, robust response that antidepressants alone may not achieve quickly enough. The presence of psychosis in a major depressive episode signals a more treatment-resistant course and higher risk, so ECT can produce quicker relief of both mood symptoms and psychotic symptoms, improving safety and function sooner. In contrast, a mild depressive episode is typically treated with psychotherapy and antidepressants, generalized anxiety disorder and simple phobia respond to targeted psychotherapies and pharmacologic options rather than ECT, and thus do not warrant this invasive, high-intensity intervention.
Question 1
Exam overview

About this Exam

The Dr. High Yield Psychiatry Practice Exam is an essential preparatory tool designed specifically for medical students and psychiatry residents.

It is tailored to help future physicians master high-yield concepts required for the NBME Psychiatry Shelf Exam, USMLE Step 2 CK, and COMLEX Level 2.

By condensing vast amounts of medical literature into digestible, frequently tested material, this practice exam serves as a bridge between foundational medical knowledge and clinical application.

It is the perfect resource for driven medical students who want to maximize their study efficiency and achieve top percentile scores on their clinical board exams.

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Additional Information

What the Course Entails and Exam Details

This comprehensive practice exam covers a wide array of critical psychiatric topics that consistently appear on standardized tests.

You will dive deep into the DSM-5 diagnostic criteria for major mental health conditions and behavioral disorders.

Core subjects include mood disorders, psychotic disorders, personality disorders, childhood behavioral issues, and substance abuse.

Additionally, the material places a heavy emphasis on psychopharmacology, ensuring you know exactly which medications to prescribe, their mechanisms of action, and their potential side effects.

It also thoroughly covers important therapeutic communication techniques, legal guidelines, and medical ethics related to behavioral health.


What to Expect in the Final Exam

When taking your actual psychiatry board or shelf exam, you can expect a rigorous, fast-paced multiple-choice format.

The questions are heavily vignette-based, meaning you must quickly accurately diagnose and manage patients based on detailed clinical scenarios.

Most official exams in this field consist of around 110 questions, with a strict time limit of two hours and forty-five minutes.

Passing score requirements vary by institution, but achieving a score in the 60th to 70th percentile is generally required to comfortably pass and progress.

You must remain focused, manage your time to about one minute per question, and adhere strictly to the non-disclosure rules of the testing body.


How to Study and Exam Centers

To succeed, you should integrate this practice exam with spaced repetition software and high-quality question banks like UWorld.

Review the detailed explanations for every practice question, paying close attention to why the incorrect answers are wrong.

Consistency is key, so aim to complete a set number of practice questions every single day leading up to your test date.

Your final, official exam will likely be administered through a secure online portal at your medical school or a highly regulated authorized testing facility.

In many cases, students take these standardized exams at a local Prometric testing center or Pearson VUE location under closely proctored conditions.


Job Opportunities from the Course

Successfully passing your psychiatry shelf and board exams opens the door to a highly rewarding career in mental healthcare.

You will be well on your way to becoming eligible to pursue several prestigious and fulfilling roles in the medical field.

These exciting job titles and career paths include:

  • Board-Certified Psychiatrist

  • Child and Adolescent Psychiatrist

  • Addiction Medicine Specialist

  • Forensic Psychiatrist

  • Geriatric Psychiatrist

  • Medical Educator or University Faculty

  • Clinical Researcher in Behavioral Health

  • Consultation-Liaison Psychiatrist

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