DO Psychiatry and Behavioral Medicine

Question 1

A 35-year-old woman presents with persistent sadness, anhedonia, insomnia, fatigue, difficulty concentrating, and feelings of worthlessness for 3 weeks. What is the minimum number of symptoms required to diagnose Major Depressive Disorder per DSM-5?

Accepted Answer

5 symptoms for at least 2 weeks

Answer

DSM-5 requires at least 5 of 9 specified symptoms present for at least 2 weeks, with depressed mood or anhedonia being mandatory.

Question 2

A 22-year-old man with schizophrenia has persistent auditory hallucinations and delusions despite adequate trials of two second-generation antipsychotics. Which medication is most appropriate for treatment-resistant schizophrenia?

Accepted Answer

Clozapine

Answer

Clozapine is the only FDA-approved medication for treatment-resistant schizophrenia, defined as failure of at least two adequate antipsychotic trials.

Question 3

Which feature best distinguishes Bipolar I disorder from Bipolar II disorder?

Accepted Answer

At least one full manic episode lasting 7 or more days

Answer

Bipolar I requires at least one full manic episode lasting ≥7 days (or any duration requiring hospitalization), while Bipolar II involves hypomania but never full mania.

Question 4

A 28-year-old woman reports recurrent, unexpected episodes of intense fear with palpitations, dyspnea, chest pain, and fear of dying peaking within 10 minutes. She now avoids crowded places. What is the most likely diagnosis?

Accepted Answer

Panic Disorder with Agoraphobia

Answer

Panic Disorder with Agoraphobia presents with recurrent unexpected panic attacks plus avoidance of situations where escape might be difficult if an attack occurs.

Question 5

A 32-year-old veteran presents with intrusive flashbacks, nightmares, hypervigilance, emotional numbing, and avoidance of combat-related stimuli persisting for 6 months post-deployment. What is the first-line pharmacological treatment?

Accepted Answer

Sertraline or paroxetine

Answer

SSRIs (sertraline and paroxetine) are the only FDA-approved medications for PTSD, and are recommended as first-line pharmacotherapy.

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DO Psychiatry and Behavioral Medicine