APEA Mental Health in Primary Care

Question 1

A 34-year-old patient presents with 2 weeks of depressed mood, anhedonia, insomnia, fatigue, poor concentration, and feelings of worthlessness.
DSM-5 criteria require how many symptoms for a minimum of how many days to diagnose major depressive disorder?

Accepted Answer

5 or more symptoms for at least 14 days, including depressed mood or anhedonia

Answer

3 symptoms for 7 days

Answer

7 symptoms for 30 days

Answer

2 symptoms for any duration

Question 2

A 28-year-old patient is diagnosed with moderate major depressive disorder. First-line pharmacotherapy for MDD in primary care includes which class of medications?

Accepted Answer

Selective serotonin reuptake inhibitors (SSRIs) such as sertraline, escitalopram, and fluoxetine

Answer

Tricyclic antidepressants (TCAs) as the first choice due to highest efficacy

Answer

Monoamine oxidase inhibitors (MAOIs) for initial treatment

Answer

Antipsychotics as monotherapy for MDD

Question 3

Generalized anxiety disorder (GAD) is characterized by which core symptom that distinguishes it from other anxiety disorders?

Accepted Answer

Excessive, difficult-to-control worry about multiple areas of life occurring more days than not for 6 months or longer

Answer

Specific phobia triggers with avoidance behavior

Answer

Panic attacks with palpitations and fear of dying

Answer

Social anxiety focused specifically on performance situations

Question 4

A 25-year-old female presents with recurrent unexpected panic attacks including palpitations, diaphoresis, chest tightness, fear of dying, and paresthesias. She now avoids public places for fear of another attack. The most likely diagnosis is:

Accepted Answer

Panic disorder with agoraphobia

Answer

Generalized anxiety disorder

Answer

Specific phobia — claustrophobia

Answer

Social anxiety disorder

Question 5

When prescribing an SSRI for depression or anxiety in primary care, patients should be counseled that full therapeutic effects typically occur after:

Accepted Answer

4 to 6 weeks

Answer

24 to 48 hours

Answer

3 to 5 days

Answer

6 to 12 months

Question 6

A 22-year-old male patient screens positive on the PC-PTSD-5. Which exposure history is required to diagnose PTSD per DSM-5?

Accepted Answer

Direct exposure to, witnessing, or learning about actual or threatened death, serious injury, or sexual violence

Answer

Any significantly stressful life event including job loss or divorce

Answer

Repeated failure or academic disappointment

Answer

Physical illness requiring hospitalization