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

DSM-5 requires ≥5 depressive symptoms for ≥2 weeks, with at least one being depressed mood or anhedonia (loss of interest).

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

Schizophrenia requires ≥2 characteristic symptoms for ≥6 months with active psychotic symptoms for ≥1 month and no prominent mood episodes.

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

Panic disorder involves unexpected (uncued) panic attacks; attacks triggered exclusively by social situations are more consistent with social anxiety disorder.

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

Lithium toxicity (level >2.0 mEq/L) with clinical symptoms requires immediate drug discontinuation; IV normal saline expands volume and promotes renal lithium clearance.

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

SSRIs block SERT, preventing serotonin reuptake into the presynaptic neuron and thereby increasing serotonin concentration in the synaptic cleft.

NBOME - National Board of Osteopathic Medical Examiners Practice Test

NBOME - National Board of Osteopathic Medical Examiners Practice Test

NBOME Behavioral Health & Psychiatry