NBOME Behavioral Health & Psychiatry

Question 1

According to DSM-5, which of the following is required for a diagnosis of Major Depressive Disorder?

Accepted Answer

At least 5 symptoms present for at least 2 weeks, including depressed mood or anhedonia

Answer

At least 3 symptoms present for at least 1 week, including psychosis

Answer

At least 5 symptoms present for at least 1 month, including insomnia

Answer

At least 7 symptoms present for at least 2 weeks, including suicidal ideation

Question 2

A 25-year-old presents with disorganized speech, auditory hallucinations, and flat affect persisting for 8 months without any mood episodes. What is the most likely diagnosis?

Accepted Answer

Schizophrenia

Answer

Schizoaffective disorder

Answer

Brief psychotic disorder

Answer

Schizophreniform disorder

Question 3

A 30-year-old woman has recurrent unexpected panic attacks with persistent worry about future attacks and avoidance behaviors for 3 months. Which feature would be INCONSISTENT with a panic disorder diagnosis?

Accepted Answer

Attacks triggered exclusively by social evaluation situations

Answer

Palpitations and diaphoresis during attacks

Answer

Fear of losing control

Answer

Derealization during attacks

Question 4

A patient on lithium presents with coarse tremor, confusion, and vomiting. His serum lithium level is 2.5 mEq/L. Which is the most appropriate immediate intervention?

Accepted Answer

Discontinue lithium immediately and provide supportive care with IV normal saline

Answer

Reduce the lithium dose by 50% and recheck level in 12 hours

Answer

Administer IV sodium bicarbonate to alkalinize the urine

Answer

Add a benzodiazepine to manage the tremor and agitation

Question 5

Which mechanism best explains the antidepressant effect of selective serotonin reuptake inhibitors (SSRIs)?

Accepted Answer

Blocking the serotonin transporter (SERT) at the presynaptic terminal

Answer

Blocking presynaptic dopamine D2 receptors

Answer

Irreversibly inhibiting monoamine oxidase A and B

Answer

Stimulating postsynaptic 5-HT1A autoreceptors directly

Question 6

Which feature most clearly distinguishes Bipolar I from Bipolar II disorder?

Accepted Answer

Bipolar I requires at least one full manic episode; Bipolar II involves only hypomania

Answer

Depressive episodes occur only in Bipolar II

Answer

Psychotic features are exclusive to Bipolar II

Answer

Mood episodes are shorter in duration in Bipolar I

Question 7

A combat veteran reports intrusive flashbacks, avoidance of war-related cues, negative cognitions about himself and the world, and hypervigilance persisting for 6 weeks following return from deployment. What is the minimum symptom duration required to diagnose PTSD per DSM-5?

Accepted Answer

More than 1 month

Answer

More than 3 months

Answer

More than 6 months

Answer

More than 2 weeks