Which of the following medications is FDA approved for the treatment of attention-
deficit/hyperactivity disorder and relies on selective norepinephrine reuptake inhibition
for its efficacy?
Atomoxetine
Bupropion
Dexmethylphenidate
Guanfacine - Atomoxetine
selective norepinephrine reuptake inhibition
A 44-year-old man, previously diagnosed with panic disorder, presents to the clinic
stating that he is unwilling to continue taking medication for his panic disorder. He states
he cannot tolerate the side effects, does not want to take any more pills, and is very
open to other methods of treatment. Which of the following would be the best choice for
initial, non-pharmacologic treatment of his panic disorder?
Cognitive-behavioral therapy
Electroconvulsive therapy
Hypnotherapy
Repetitive transcranial magnetic stimulation - Cognitive Behavioral therapy
A 26-year-old woman presents to the outpatient family practice office complaining of
mood swings. She reports that she often feels intensely sad for a few hours followed by
significant anxiety or irritability. During the interview, she frequently remarks that she
feels she has lost herself and thinks that all people will abandon her at some point in her
life. She feels detached from herself and sometimes is just "going through the motions"
of her day. She reports that her friendships are usually very intense, and she typically
spends almost every day with a new friend. She states she likes to get to know
everything about them to try to avoid being left out when they make a new friend. At
times, she will impulsively engage in risky behavior like gambling or using substances to
try to keep friends. However, she reports that most friendships end in an angry outburst
when she senses they are about to abandon the friendsh - Borderline personality
disorder
Which one of the following helps establish the diagnosis of autism spectrum disorder?
Degree of intellectual disability
History of insufficient caregiving
Narrow range of interests
Short palpebral fissure length - Narrow range of interests
A 26-year-old man presents to your office for evaluation. His substance use screening
tool is positive. Vital signs include a blood pressure reading of 90/71 mm Hg and
respiratory rate of 10 breaths per minute. Physical exam reveals altered mental status
,and track marks on his arms. Which of the following additional findings would suggest a
diagnosis of opioid intoxication rather than stimulant intoxication?
Elevated temperature
Miosis
Mydriasis
Tremor - Miosis
After a thorough evaluation and physical exam, a 38-year-old woman is diagnosed with
cyclothymic disorder. Which of the following clinical characteristics must be present to
make this diagnosis?
Symptoms are concurrent with substance abuse
Symptoms are never gone for more than two consecutive months
Symptoms are present continually for two years
Symptoms do not cause serious psychosocial impairment - Symptoms are never gone
for more than two consecutive months
A 20-year-old previously healthy woman with a body mass index of 20 kg/m2 presents
to your office for her annual exam. She tells you that she is very concerned about her
weight and has been weighing herself daily. Vital signs reveal a blood pressure of 92/65
mm Hg and pulse of 102 bpm. Physical exam findings include bilateral parotid gland
enlargement, dental caries, and abrasions on the knuckles of her right hand. Which of
the following is the most likely diagnosis?
Anorexia nervosa
Bulimia nervosa
Major depressive disorder
Obsessive-compulsive disorder - Bulimia Nervosa
A 32-year-old woman presents for a complete physical examination. During the exam,
she says she has diminished interest in daily activities. Upon further questioning, she
also reports feelings of worthlessness, hypersomnia, fatigue, and the inability to
concentrate at work. These symptoms have been ongoing for the last month. She has
never had symptoms like this in the past. Which of the following would be the most
appropriate pharmacologic treatment at this time?
Amitriptyline
Bupropion
Sertraline
Tranylcypromine - Sertraline
A 23-year-old man presents to your clinic with concerns about low back pain and his
medication not working any more. He says that two years ago he had an injury at work
that resulted in ongoing back pain. Right after the accident, one of his medical providers
gave him a prescription for oxycodone, which helped at first, but then he noticed having
to take more than the prescribed amount in order to have the same relief of his pain
symptoms. His medical provider declined to continue prescribing oxycodone, so he
started to buy it off the street. Recently a friend of his offered him heroin, which he tried
once. This scared him because he liked it so much that he wanted to continue using it,
, but he knows that this can lead to serious problems. Which of the following is the most
appropriate therapy?
Buprenorphine/naloxone
Duloxetine
Extended release oxycodone
Gabapentin - Buprenorphine/naloxone
1st line long-term treatment with opioid agonist
A 25-year-old woman presents to the emergency department with complaints of
abdominal pain, vomiting, and diarrhea that has been present for five years. She states
that no one has been able to help her up to this point. She has numerous allergies to a
variety of medications. Physical exam reveals moist mucous membranes, multiple well-
healed incisions on her abdomen, and vital signs within normal limits. Which of the
following is the most likely diagnosis?
Borderline personality disorder
Conversion disorder
Factitious disorder
Malingering - Factitious Disorder
A 23-year-old man presents to the psychiatric emergency room involuntarily. The
patient is malodorous and disheveled. His affect is flat, and he is conversing with people
who are not present. Which of the following findings are most likely to be observed on
brain MRI?
Enlarged ventricles
Gray matter gain
Hyperintense ring-enhancing lesions
Mass effect - Enlarged ventricles
schizophrenia
A 20-year-old woman presents to the clinic complaining of stress. During the interview,
she taps her fingers repetitively on her leg in a specific pattern. When questioned, she
states she taps them because she has a "bad thought" about hurting someone, and
each time she thinks it, she has to tap her fingers in a specific manner to erase the
thought. Which of the following questions, if answered in the affirmative, would be most
likely to aid in the diagnosis of obsessive-compulsive disorder in this patient?
Do you feel the bad thought is put there by someone else?
Does the compulsive behavior cause you anxiety?
Does the compulsive behavior cause you social or occupational problems?
Does the thought of harming others bring you enjoyment? - Does the compulsive
behavior cause you social or occupational problems?
A 28-year-old woman presents with symptoms of depression. She states that she has
had mood swings during the past 2 years. Upon eliciting a history, she describes
multiple mild episodes of hypomanic symptoms and mild depression that have caused
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