SMLE Psychiatry 2

Question 1

A 17-year-old female presents with restricted eating, intense fear of gaining weight, and a BMI of 15 kg/m².
She perceives herself as overweight despite being underweight.
What is the most likely diagnosis?

Accepted Answer

Anorexia nervosa

Answer

Bulimia nervosa

Answer

Avoidant/restrictive food intake disorder

Answer

Body dysmorphic disorder

Question 2

A patient on lithium presents with tremor, polyuria, and a serum lithium level of 2.5 mEq/L. What is the immediate management?

Accepted Answer

Stop lithium, IV fluids, and monitor renal function

Answer

Increase lithium dose

Answer

Add a thiazide diuretic

Answer

Observation only

Question 3

A 35-year-old woman experiences recurrent, unexpected panic attacks with palpitations, shortness of breath, chest pain, and fear of dying. She now avoids crowded places. What is the most accurate diagnosis?

Accepted Answer

Panic disorder with agoraphobia

Answer

Generalised anxiety disorder

Answer

Social anxiety disorder

Answer

Specific phobia

Question 4

A veteran presents with flashbacks, nightmares, hypervigilance, and emotional numbing 3 months after a traumatic combat experience. He avoids anything related to the event. What is the diagnosis?

Accepted Answer

Post-traumatic stress disorder (PTSD)

Answer

Acute stress disorder

Answer

Adjustment disorder

Answer

Generalised anxiety disorder

Question 5

A 70-year-old man presents with progressive memory loss, difficulty with familiar tasks, word-finding difficulty, and getting lost in his own neighbourhood over the past year. MMSE score is 18/30. What is the most likely diagnosis?

Accepted Answer

Alzheimer disease

Answer

Delirium

Answer

Vascular dementia

Answer

Normal ageing

Question 6

What is the mechanism of action of SSRIs in treating depression?

Accepted Answer

Block serotonin reuptake at the presynaptic neuron

Answer

Increase dopamine synthesis

Answer

Block monoamine oxidase enzyme

Answer

Antagonise serotonin receptors