MCCQE Common Psychiatric Disorders 2

Question 1

A 28-year-old woman presents with recurrent episodes of binge eating followed by self-induced vomiting, dental erosions, and parotid gland enlargement. Which electrolyte abnormality is most likely?

Accepted Answer

Hypokalemia

Answer

Repeated purging in bulimia nervosa causes loss of gastric acid, leading to hypokalemic, hypochloremic metabolic alkalosis.

Question 2

A 35-year-old man with schizophrenia develops high fever, muscle rigidity, diaphoresis, and altered consciousness after starting haloperidol. What is the most appropriate immediate management?

Accepted Answer

Discontinue antipsychotic and provide supportive care

Answer

Neuroleptic malignant syndrome (NMS) requires immediate discontinuation of the offending antipsychotic and aggressive supportive care including IV fluids and cooling.

Question 3

A 45-year-old with MDD has failed two adequate antidepressant trials. Which augmentation strategy has the strongest evidence base for treatment-resistant depression?

Accepted Answer

Adding lithium or atypical antipsychotic

Answer

Lithium augmentation and atypical antipsychotic augmentation (e.g., quetiapine, aripiprazole) have the best evidence for treatment-resistant depression.

Question 4

A 22-year-old college student fears being watched or judged in social situations, avoids classes, and has impaired daily functioning for over 6 months. What is the first-line pharmacological treatment?

Accepted Answer

Selective serotonin reuptake inhibitor (SSRI)

Answer

SSRIs (e.g., paroxetine, sertraline) are first-line pharmacotherapy for social anxiety disorder, with evidence for both acute and long-term treatment.

Question 5

A 60-year-old man presents with a 3-week history of depressed mood, anhedonia, psychomotor retardation, and 10 lb weight loss following his wife's death 2 months ago. Which finding most supports a diagnosis of MDD rather than normal bereavement?

Accepted Answer

Marked functional impairment and suicidal ideation

Answer

Marked functional impairment and suicidal ideation distinguish major depressive disorder from normal grief, which typically does not involve suicidality.

(MCCQE) Medical Council of Canada Qualifying Examination Practice Test

(MCCQE) Medical Council of Canada Qualifying Examination Practice Test

MCCQE Common Psychiatric Disorders 2