Family Practice Exam Mental Health 4 — Questions and Answers
Question 1: A 22-year-old college student reports recurrent binge eating followed by self-induced vomiting. Which electrolyte abnormality is most expected?
- Hyperkalemia
- Hyponatremia
- Hypokalemic metabolic alkalosis (Correct answer)
- Hyperchloremic metabolic acidosis
Correct answer: Hypokalemic metabolic alkalosis
Recurrent purging causes loss of hydrochloric acid and potassium, resulting in hypokalemic metabolic alkalosis.
Question 2: Which psychological therapy has the strongest evidence base for treating bulimia nervosa?
- Psychodynamic therapy
- Cognitive behavioral therapy (CBT) (Correct answer)
- Exposure and response prevention
- Dialectical behavior therapy (DBT)
Correct answer: Cognitive behavioral therapy (CBT)
CBT is the gold-standard psychotherapy for bulimia nervosa with the strongest evidence for reducing binge-purge cycles.
Question 3: A patient presents with an intense fear of gaining weight, BMI of 16, and absence of menstruation for 6 months. Which lab finding is most expected?
- Elevated FSH
- Low cortisol
- Elevated LH
- Low LH and FSH (Correct answer)
Correct answer: Low LH and FSH
Anorexia nervosa causes hypothalamic suppression, leading to low LH and FSH with resulting amenorrhea.
Question 4: Which of the following is a hallmark feature of borderline personality disorder?
- Pervasive distrust of others
- Identity disturbance and fear of abandonment (Correct answer)
- Grandiosity and lack of empathy
- Restricted emotional expression
Correct answer: Identity disturbance and fear of abandonment
Borderline personality disorder is characterized by unstable identity, intense fear of abandonment, and impulsive behaviors.
Question 5: A 50-year-old man presents with progressively worsening memory, personality changes, and myoclonus over 6 months. MRI shows cortical ribboning. The most likely diagnosis is:
- Alzheimer's disease
- Lewy body dementia
- Creutzfeldt-Jakob disease (Correct answer)
- Frontotemporal dementia
Correct answer: Creutzfeldt-Jakob disease
Rapidly progressive dementia with myoclonus and cortical ribboning on DWI MRI is classic for Creutzfeldt-Jakob disease (CJD).
Question 6: Which antidepressant is preferred for a depressed patient who also wants to quit smoking?
- Fluoxetine
- Bupropion (Correct answer)
- Amitriptyline
- Citalopram
Correct answer: Bupropion
Bupropion is FDA-approved for both major depressive disorder and smoking cessation.
Question 7: A 30-year-old woman reports chronic feelings of emptiness, recurrent suicidal gestures, and intense but unstable relationships. Which DSM-5 diagnosis best fits?
- Histrionic personality disorder
- Narcissistic personality disorder
- Borderline personality disorder (Correct answer)
- Dependent personality disorder
Correct answer: Borderline personality disorder
Chronic emptiness, suicidal gestures, and unstable intense relationships are core features of borderline personality disorder.
Family Practice Exam Mental Health 4
A 22-year-old college student reports recurrent binge eating followed by self-induced vomiting.
Which electrolyte abnormality is most expected?