SMLE Psychiatry 6

Question 1

A 22-year-old university student presents with severe social anxiety, inability to attend classes or speak in groups, and avoidance of social situations for 2 years.
CBT has been partially effective.
What pharmacotherapy should be added?

Accepted Answer

SSRI (e.g., sertraline or paroxetine)

Answer

Benzodiazepine long-term

Answer

Antipsychotic medication

Answer

Buspirone

Question 2

A patient attempts suicide by hanging and is found unconscious. After medical stabilisation, what is the most important aspect of the initial psychiatric assessment?

Accepted Answer

Comprehensive suicide risk assessment including intent, plan, and protective factors

Answer

Prescribing antidepressant medication immediately

Answer

Discharging to outpatient care with follow-up

Answer

Obtaining a brain CT scan

Question 3

A patient with schizophrenia has been resistant to two adequate trials of different antipsychotics. What is the recommended next pharmacological step?

Accepted Answer

Start clozapine

Answer

Add a mood stabiliser

Answer

Combine two typical antipsychotics

Answer

Switch to a benzodiazepine

Question 4

A 30-year-old woman presents with episodes of depersonalisation, identity confusion, and amnesia for significant personal events. She has a history of severe childhood abuse. What is the most likely diagnosis?

Accepted Answer

Dissociative identity disorder

Answer

Borderline personality disorder

Answer

PTSD

Answer

Schizophrenia

Question 5

A 65-year-old patient with Parkinson disease develops visual hallucinations. Which antipsychotic is safest to use?

Accepted Answer

Quetiapine or pimavanserin

Answer

Haloperidol

Answer

Risperidone

Answer

Chlorpromazine

Question 6

What is the recommended duration of antidepressant treatment after a first episode of major depressive disorder in remission?

Accepted Answer

6-12 months after remission

Answer

Stop immediately after symptom resolution

Answer

4-6 months after remission

Answer

Lifelong treatment