PANRE Psychiatry 3 — Questions and Answers
Question 1: A 50-year-old male with alcohol use disorder has a last drink 36 hours ago and now has tremors, diaphoresis, and a seizure. What is the most appropriate pharmacotherapy?
- Haloperidol
- Lorazepam (Correct answer)
- Carbamazepine
- Phenytoin
Correct answer: Lorazepam
Benzodiazepines (lorazepam) are first-line for alcohol withdrawal seizures due to cross-tolerance with GABA receptors.
Question 2: Which cognitive distortion is most characteristic of generalized anxiety disorder?
- Catastrophizing (Correct answer)
- Splitting
- Ideas of reference
- Thought insertion
Correct answer: Catastrophizing
Catastrophizing—assuming worst-case outcomes—is a hallmark cognitive distortion in generalized anxiety disorder.
Question 3: A patient reports recurrent intrusive thoughts about harming her infant, accompanied by significant distress and avoidance. She does not want to act on these thoughts. What is the most likely diagnosis?
- Postpartum psychosis
- Infanticide risk requiring hospitalization
- Obsessive-compulsive disorder, postpartum onset (Correct answer)
- Postpartum depression with psychotic features
Correct answer: Obsessive-compulsive disorder, postpartum onset
Ego-dystonic, intrusive, and distressing thoughts with avoidance and no intent are characteristic of OCD, not psychosis.
Question 4: Which finding best differentiates delirium from dementia?
- Memory impairment
- Acute fluctuating course (Correct answer)
- Disorientation
- Functional decline
Correct answer: Acute fluctuating course
Delirium is distinguished by its acute onset and fluctuating level of consciousness, unlike the gradual decline in dementia.
Question 5: A 22-year-old college student has recurrent binge eating followed by self-induced vomiting twice weekly for 4 months. She is normal weight. What is the diagnosis?
- Anorexia nervosa, binge-purge subtype
- Bulimia nervosa (Correct answer)
- Binge eating disorder
- Purging disorder
Correct answer: Bulimia nervosa
Bulimia nervosa is defined by recurrent binge-purge cycles at least once weekly for 3 months in a person of normal or above-normal weight.
Question 6: Which medication is FDA-approved for the treatment of bulimia nervosa?
- Sertraline
- Fluoxetine (Correct answer)
- Topiramate
- Bupropion
Correct answer: Fluoxetine
Fluoxetine 60 mg/day is the only FDA-approved medication for bulimia nervosa.
Question 7: A patient describes feeling detached from their own body and mind, as if they are an outside observer, for several weeks. Which condition best describes this?
- Derealization disorder
- Depersonalization/derealization disorder (Correct answer)
- Dissociative amnesia
- Schizotypal personality disorder
Correct answer: Depersonalization/derealization disorder
Persistent depersonalization (detachment from self) with intact reality testing defines depersonalization/derealization disorder.
PANRE Psychiatry 3
A 50-year-old male with alcohol use disorder has a last drink 36 hours ago and now has tremors, diaphoresis, and a seizure.
What is the most appropriate pharmacotherapy?