MCCQE Common Psychiatric Disorders 3

Question 1

A 40-year-old man presents with persistent worry about multiple life domains, muscle tension, irritability, and sleep disturbance for more than 6 months. What is the first-line psychotherapy?

Accepted Answer

Cognitive behavioural therapy (CBT)

Answer

CBT is the most evidence-based psychotherapy for generalized anxiety disorder, targeting maladaptive worry and avoidance behaviours.

Question 2

A 55-year-old woman on phenelzine for depression eats aged cheese and develops severe hypertensive crisis. What is the mechanism?

Accepted Answer

Tyramine-induced norepinephrine surge due to MAO inhibition

Answer

MAO inhibitors block tyramine breakdown; dietary tyramine triggers massive norepinephrine release from sympathetic terminals, causing hypertensive crisis.

Question 3

A 27-year-old woman presents after an argument with her partner. She describes intense fear of abandonment, unstable relationships, impulsive self-harm, and chronic feelings of emptiness. What is the most likely diagnosis?

Accepted Answer

Borderline personality disorder

Answer

Borderline personality disorder is characterized by fear of abandonment, unstable relationships, impulsivity, self-harm, and chronic emptiness.

Question 4

A 70-year-old man with no prior psychiatric history develops visual hallucinations, fluctuating cognition, and REM sleep behaviour disorder. Parkinsonism follows 6 months later. What is the most likely diagnosis?

Accepted Answer

Dementia with Lewy bodies

Answer

Dementia with Lewy bodies classically presents with visual hallucinations, fluctuating cognition, REM sleep behaviour disorder, and parkinsonism.

Question 5

A 30-year-old man with alcohol use disorder has his last drink 48 hours ago. He now presents with agitation, tremor, diaphoresis, tachycardia, and a witnessed tonic-clonic seizure. What is the most appropriate immediate treatment?

Accepted Answer

IV lorazepam

Answer

IV benzodiazepines (e.g., lorazepam, diazepam) are first-line treatment for alcohol withdrawal seizures and delirium tremens by enhancing GABA-A activity.

(MCCQE) Medical Council of Canada Qualifying Examination Practice Test

(MCCQE) Medical Council of Canada Qualifying Examination Practice Test

MCCQE Common Psychiatric Disorders 3