AANP Mental Health 2 — Questions and Answers
Question 1: A patient with schizophrenia develops muscle rigidity, high fever, altered consciousness, and autonomic instability after starting haloperidol. What is this complication?
- Serotonin syndrome
- Neuroleptic malignant syndrome (NMS) (Correct answer)
- Tardive dyskinesia
- Acute dystonic reaction
Correct answer: Neuroleptic malignant syndrome (NMS)
NMS is a rare, life-threatening reaction to dopamine-blocking antipsychotics, characterized by the tetrad of fever, rigidity, altered consciousness, and autonomic instability.
Question 2: Which psychotherapy has the strongest evidence base for treating major depressive disorder?
- Psychodynamic therapy
- Cognitive behavioral therapy (CBT) (Correct answer)
- Supportive therapy
- Eye movement desensitization and reprocessing (EMDR)
Correct answer: Cognitive behavioral therapy (CBT)
CBT has the most robust evidence base for treating major depressive disorder, with multiple randomized controlled trials demonstrating efficacy comparable to antidepressants.
Question 3: A patient with generalized anxiety disorder (GAD) asks about non-benzodiazepine pharmacotherapy. Which agent is FDA-approved for GAD?
- Propranolol
- Buspirone (Correct answer)
- Diphenhydramine
- Hydroxyzine
Correct answer: Buspirone
Buspirone is FDA-approved for GAD, has no abuse potential, does not cause sedation acutely, and is effective for chronic anxiety but takes 2–4 weeks to work.
Question 4: A patient diagnosed with bipolar I disorder should be educated that untreated manic episodes last approximately how long?
- 1–3 days
- 3–7 days
- 1–3 months without treatment (Correct answer)
- 6–12 months
Correct answer: 1–3 months without treatment
Untreated manic episodes in bipolar I disorder typically last 3 months or longer; proper mood stabilizer therapy significantly shortens episode duration.
Question 5: Which class of medication is first-line for panic disorder with or without agoraphobia?
- Benzodiazepines
- SSRIs/SNRIs (Correct answer)
- Beta-blockers
- Anticonvulsants
Correct answer: SSRIs/SNRIs
SSRIs and SNRIs are first-line for panic disorder due to their efficacy, tolerability, and lack of dependence; benzodiazepines may be used short-term as adjuncts.
Question 6: The AUDIT-C questionnaire is used to screen for which behavioral health condition?
- Depression
- Substance use disorder (opioids)
- Hazardous or harmful alcohol use (Correct answer)
- Tobacco dependence
Correct answer: Hazardous or harmful alcohol use
The AUDIT-C (Alcohol Use Disorders Identification Test-Concise) is a validated 3-question screen for hazardous or harmful alcohol consumption in primary care.
AANP Mental Health 2
A patient with schizophrenia develops muscle rigidity, high fever, altered consciousness, and autonomic instability after starting haloperidol.
What is this complication?