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

DSM-5 requires 5 or more of 9 symptoms for at least 2 weeks, with at least one being depressed mood or anhedonia. This patient meets criteria.

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

SSRIs are first-line pharmacotherapy for MDD due to their efficacy, tolerability, safety profile, and availability in generic form. TCAs and MAOIs are reserved for refractory cases.

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

GAD is characterized by excessive, uncontrollable worry across multiple domains for 6 or more months, distinguishing it from specific phobia (discrete triggers) or panic disorder (episodic attacks).

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

Recurrent unexpected panic attacks combined with avoidance of situations where escape might be difficult defines panic disorder with agoraphobia per DSM-5 criteria.

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

SSRIs typically require 4-6 weeks to achieve full therapeutic antidepressant or anxiolytic effects. Patients should be counseled to continue the medication for the full trial period before assessing efficacy.

APEA - Advanced Practice Education Associates Practice Test

APEA - Advanced Practice Education Associates Practice Test

APEA Mental Health in Primary Care