MD Psychiatry and Behavioral Science

Question 1

A 25-year-old man presents with auditory hallucinations, disorganized speech, and flat affect for 8 months. He has no history of substance abuse or medical illness. What is the most appropriate first-line pharmacological treatment?

Accepted Answer

Risperidone

Answer

Atypical antipsychotics such as risperidone are the first-line treatment for schizophrenia due to their efficacy and lower risk of extrapyramidal side effects compared to typical antipsychotics.

Question 2

According to DSM-5, how many total symptoms (including depressed mood or anhedonia) are required for a diagnosis of Major Depressive Disorder over a minimum 2-week period?

Accepted Answer

5

Answer

DSM-5 requires at least 5 of 9 symptoms (including depressed mood or anhedonia as one) present for at least 2 weeks, causing significant functional impairment.

Question 3

A patient taking lithium develops coarse tremor, confusion, and vomiting. His serum lithium level is 2.8 mEq/L. What is the most important immediate intervention?

Accepted Answer

Discontinue lithium and provide supportive care including possible hemodialysis

Answer

A lithium level above 2.0 mEq/L indicates severe toxicity requiring immediate discontinuation; hemodialysis is indicated for levels above 3.0 mEq/L or in severe clinical toxicity.

Question 4

A 32-year-old woman experiences recurrent unexpected panic attacks and has persistent worry about future attacks for 3 months. She avoids crowded places and public transportation. What is the most likely diagnosis?

Accepted Answer

Panic Disorder with Agoraphobia

Answer

Panic disorder is characterized by recurrent unexpected panic attacks with persistent concern about future attacks; when accompanied by avoidance of situations where escape would be difficult, agoraphobia is also diagnosed.

Question 5

Which of the following is a required DSM-5 criterion for a diagnosis of Post-Traumatic Stress Disorder (PTSD)?

Accepted Answer

Symptoms must be present for at least 1 month

Answer

DSM-5 requires that PTSD symptoms (intrusion, avoidance, negative cognitions/mood, and hyperarousal) persist for more than 1 month following traumatic exposure, distinguishing it from acute stress disorder.

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MD - Doctor of Medicine Practice Test

MD Psychiatry and Behavioral Science