DO Psychiatry and Behavioral Medicine 2

Question 1

A 40-year-old woman with depression is started on fluoxetine. What is the primary mechanism of action of SSRIs?

Accepted Answer

Inhibition of serotonin reuptake at the presynaptic terminal

Answer

Inhibition of monoamine oxidase

Answer

Blockade of postsynaptic dopamine receptors

Answer

Stimulation of GABA-A receptors

Question 2

A patient on lithium for bipolar disorder presents with coarse tremor, confusion, ataxia, and nausea. His serum lithium level is 2.1 mEq/L. What is the most appropriate immediate management?

Accepted Answer

Discontinue lithium and provide supportive care with hydration

Answer

Increase the lithium dose to achieve therapeutic levels

Answer

Add a low-dose antipsychotic to control symptoms

Answer

Administer activated charcoal and a cathartic

Question 3

A 25-year-old woman presents with intense fear of abandonment, markedly unstable relationships alternating between idealization and devaluation, identity disturbance, recurrent self-harm, and severe emotional lability. What is the most likely diagnosis?

Accepted Answer

Borderline Personality Disorder

Answer

Histrionic Personality Disorder

Answer

Narcissistic Personality Disorder

Answer

Antisocial Personality Disorder

Question 4

A patient with alcohol use disorder is admitted for detoxification. During which timeframe after the last drink is the risk for alcohol withdrawal seizures highest?

Accepted Answer

24–48 hours after last drink

Answer

1–6 hours after last drink

Answer

6–24 hours after last drink

Answer

5–7 days after last drink

Question 5

A patient taking haloperidol develops hyperthermia (40.5°C), severe lead-pipe muscle rigidity, altered consciousness, and autonomic instability. CPK is markedly elevated. What is this condition?

Accepted Answer

Neuroleptic Malignant Syndrome

Answer

Serotonin Syndrome

Answer

Malignant Hyperthermia

Answer

Anticholinergic Toxicity

Question 6

An adult patient reports longstanding difficulty sustaining attention, frequent task-switching, forgetfulness, and disorganization present since childhood that impairs occupational functioning. What is the first-line pharmacological treatment for adult ADHD?

Accepted Answer

Amphetamine salts or methylphenidate

Answer

Bupropion

Answer

Atomoxetine

Answer

Modafinil

Question 7

A 55-year-old woman presents with excessive worry about multiple life domains occurring more days than not for 8 months, with associated muscle tension, fatigue, and irritability. What is the minimum duration of symptoms required to diagnose Generalized Anxiety Disorder?

Accepted Answer

6 months

Answer

2 weeks

Answer

1 month

Answer

1 year