DO Psychiatry and Behavioral Medicine 3

Question 1

A patient on an SSRI develops agitation, tremor, diaphoresis, hyperreflexia, and clonus within hours of adding tramadol. How does serotonin syndrome differ from Neuroleptic Malignant Syndrome?

Accepted Answer

Serotonin syndrome has rapid onset with clonus; NMS has slower onset with lead-pipe rigidity

Answer

Serotonin syndrome has rapid onset (within hours), features clonus and hyperreflexia, and is caused by serotonergic drugs; NMS has slower onset over days, lead-pipe rigidity, and is caused by antipsychotics.

Question 2

Electroconvulsive therapy (ECT) is most appropriately indicated in which clinical scenario?

Accepted Answer

Severe treatment-resistant depression with acute suicidality or when medications are contraindicated

Answer

ECT is indicated for severe treatment-resistant depression, acute suicidality, catatonia, psychotic depression, or when rapid response is essential and medications are refused or contraindicated.

Question 3

A physician uses motivational interviewing to help a patient with alcohol use disorder consider behavior change. Which principle best describes this therapeutic approach?

Accepted Answer

Eliciting and strengthening the patient's intrinsic motivation through a collaborative, patient-centered approach

Answer

Motivational interviewing uses a collaborative, empathetic approach to elicit intrinsic motivation for change by exploring ambivalence, working with the patient's own values rather than imposing external pressure.

Question 4

A 30-year-old woman develops sudden paralysis of her left arm following a traumatic car accident. Neurological examination and brain MRI are normal. She appears surprisingly unconcerned about the deficit. What is the most likely diagnosis?

Accepted Answer

Conversion Disorder (Functional Neurological Symptom Disorder)

Answer

Conversion Disorder presents with neurological symptoms incompatible with known neurological disease, often following psychological stress, and may include la belle indifférence (apparent unconcern).

Question 5

A 17-year-old girl with anorexia nervosa (BMI 14) is hospitalized for nutritional rehabilitation. Which electrolyte abnormality is the most dangerous complication of refeeding and must be closely monitored?

Accepted Answer

Hypophosphatemia

Answer

Refeeding syndrome causes rapid intracellular shift of phosphate with hypophosphatemia, which is the most dangerous complication and can lead to cardiac arrhythmias and respiratory failure.

DO - Doctor of Osteopathy Practice Test

DO - Doctor of Osteopathy Practice Test

DO Psychiatry and Behavioral Medicine 3