Most Commonly-Missed Shelf Exam Practice Questions

Question 1 of 7
Internal Medicine

A 7-year-old boy is being seen for a well-child checkup by his primary provider. During routine screening, his parents report that he has several hour episodes of being “wild” about once per week. They are unable to identify any particular trigger. When asked to elaborate further, his parents report that he keeps acting up until he gets their attention and ends up in a time out. He throws his toys around, hits his older sisters, and swears at his mother. His father is worried that his son has bipolar disorder, as his paternal grandmother was institutionalized with “manic depression.” Review of systems is significant for sleeping only five hours each night and then being full of energy the next day. The boy’s mental status exam is significant for irritability, labile affect, oppositionality, and distractibility. The provider tells the parents that the boy does not meet criteria for bipolar disorder. Which of the following is the most likely rationale for the provider’s decision?

A Atypical sleep pattern
BDiagnosis excluded due to age
CInsufficient duration of episodes
D Irritable rather than manic mood

Free Trial

Want to try out more NBME-formatted questions for free? Get free access to Blueprint’s Step 2 & Shelf Qbank for 14 days. No credit card required!

Full Access

Calling all over-achievers: Get Blueprint’s Step 2 & Shelf Qbank, including 3,500 questions across all 7 core clerkship specialties!

Powerful Content
Free For You

Find more tips and strategies for medical students to guide you along the road to residency.