PANRE Psychiatry 5

Question 1

A patient with schizophrenia on olanzapine gains 20 lbs over 6 months and develops fasting glucose of 126 mg/dL. What is the most appropriate next step?

Accepted Answer

Switch to aripiprazole or ziprasidone

Answer

Switching to a metabolically neutral antipsychotic (aripiprazole or ziprasidone) is preferred over adding medications for metabolic side effects.

Question 2

Which condition is characterized by at least 2 years of fluctuating hypomanic and depressive symptoms that do not meet criteria for full bipolar episodes?

Accepted Answer

Cyclothymic disorder

Answer

Cyclothymic disorder requires ≥2 years (1 year in children) of subsyndromal hypomanic and depressive periods.

Question 3

A patient reports that her neighbor has been poisoning her food for the past year. She is otherwise functional, with no hallucinations or disorganized speech. What is the most likely diagnosis?

Accepted Answer

Delusional disorder, persecutory type

Answer

Delusional disorder features a fixed non-bizarre or bizarre delusion for ≥1 month without prominent hallucinations or disorganization.

Question 4

Which medication requires a REMS program due to the risk of QTc prolongation and cardiac arrhythmia?

Accepted Answer

Clozapine

Answer

Clozapine has a REMS program primarily for agranulocytosis, but also requires monitoring for QTc effects.

Question 5

A 45-year-old man has persistent worry about multiple life domains, muscle tension, and restlessness for more than 6 months, causing work impairment. First-line treatment is:

Accepted Answer

Buspirone or SSRI/SNRI

Answer

SSRIs, SNRIs, and buspirone are first-line pharmacotherapy for GAD; benzodiazepines are avoided as monotherapy.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Psychiatry 5