SPEX Psychiatry 2

Question 1

A 35-year-old woman presents with recurrent, intrusive thoughts about harming her infant despite having no intent to act on them. She is distressed by these thoughts. What is the most likely diagnosis?

Accepted Answer

Postpartum OCD

Answer

Postpartum OCD is characterized by ego-dystonic intrusive thoughts (often about harming the baby) without intent, causing significant distress.

Question 2

Which antidepressant mechanism is most associated with serotonin syndrome when combined with linezolid?

Accepted Answer

Serotonin reuptake inhibition

Answer

Serotonin reuptake inhibitors (SSRIs/SNRIs) combined with linezolid (an MAO inhibitor) can precipitate serotonin syndrome due to excess serotonergic activity.

Question 3

A patient on clozapine develops fever, sore throat, and a WBC of 1,800/µL. What is the immediate management?

Accepted Answer

Discontinue clozapine immediately and hospitalize

Answer

Clozapine must be stopped immediately if agranulocytosis (ANC <500) or severe leukopenia occurs, as continuing risks fatal infections.

Question 4

According to DSM-5, persistent depressive disorder (dysthymia) requires a depressed mood for at least:

Accepted Answer

2 years

Answer

DSM-5 requires at least 2 years of depressed mood (1 year in children/adolescents) for a diagnosis of persistent depressive disorder.

Question 5

A 28-year-old man with schizophrenia develops muscle rigidity, hyperthermia (41°C), diaphoresis, and altered consciousness after starting haloperidol. Labs show elevated CPK. What is the diagnosis?

Accepted Answer

Neuroleptic malignant syndrome

Answer

Neuroleptic malignant syndrome presents with the tetrad of hyperthermia, rigidity, autonomic instability, and altered consciousness, with elevated CPK, following antipsychotic exposure.

SPEX Exam Practice Test

SPEX Exam Practice Test

SPEX Psychiatry 2