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PRITE - Emergency Psychiatry Exam 2024/2025 Questions With Completed & Verified Solutions.
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PRITE - Emergency Psychiatry Exam 2024/2025 Questions With Completed & Verified Solutions.
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PRITE - Emergency PsychiatryC. Administer Benztropine 1mg IV now - Acute Dystonic reactions are managed with IM/IV
immediately - ANS A patient with a history of schizophrenia treated with haloperidol 5mg PO
BID presents to the emergency department with a complaint of being "unable to see." The
patient appears to be insignificant distress, with writhing and moaning, and also complains of
being "unable to stop looking up." Which of the following is the most appropriate treatment
intervention?
A. Add trihexyphenidyl 1mg PO BID
B. Administer Lorazepam 1mg IV now
C. Administer Benztropine 1mg IV now
D. Increase haloperidol to 10mg PO BID
E. Administer diphenhydramine 25mg PO now
C. Insist on further cardia monitoring in either the ED or ICU. - ANS A 32-year-old patient with a
history of treatment-resistant depression was brought to the emergency department (ED) by
family members after the patient overdosed on imipramine. The patient reported wanting to die,
but then changed her mind and called for help. The patient's regular psychiatrist had recently
added imipramine to the patient's partially effective regimen of fluoxetine 80 mg daily. The
patient is afebrile, blood pressure is 100/58 mm Hg and heart rate is 96 and regular. She is
vague about the details of the suicide attempt, but reports no longer feeling suicidal. The
medical resident recommends that the patient be admitted to a psychiatric unit. Requests for a
tricyclic antidepressant (TCA) blood level and an electrocardiogram (EKG) are deferred. The
medical resident asserts that the patient's combined imipramine and desipramine level of 750
ng/ml is not in the cardiotoxic range. Which of the following is the best course of action for the
psychiatrist to take?
A. Transfer the patient to a psychiatric unit for involuntary admission
B. Transfer the patient to a psychiatric inpatient unit but only on a voluntary basis.
C. Insist on further cardia monitoring in either the ED or ICU.
D. Urge the patient to see her psychiatrist within the next 24 to 48 hours.
E. Reassure the patient and family, and arrange follow-up with th patient's psychiatrist within the
next 10 to 14 days
D. Nifedipine - ANS A patient with a long history of treatment-resistant depression currently
stabilized on phenelzine presents to the emergency department with a complaint of sweating,
heart palpitations, and severe headache. On initial presentation, the blood pressure is 210/118
mm Hg. The patient recently took an over-the-counter medication to treat symptoms of an upper
respiratory infection. Which of the following is the most appropriate intervention?
A. Lorazepam
,B. Benztropine
C. Sumatriptan
D. Nifedipine
F. Lisinopril
B. Cognitive-behavioral therapy (CBT) - ANS Which of the following treatments has
demonstrated effectiveness in preventing future suicide attempts in adults with major depression
who had recently attempted suicide?
A. Electroconvulsive therapy (ECT)
B. Cognitive-behavioral therapy (CBT)
C. Supportive psychotherapy
D. Citalopram
E. Venlafaxine
D. Lysergic acid diethylamide (LSD) - ANS A I7-year-old patient is brought to the emergency
department by friends who report that the patient ingested a drug 2 hours previously. They
describe the patient's behavior after drug ingestion as relaxed and tranquil but talkative. Soon
after, the patient complained of drowsiness, dizziness, and nausea. On examination, the patient
has an impaired but labile level of consciousness. The drug screen is negative for
benzodiazepines, barbiturates, and opioids. The psychiatrist alerts the ED to the possibility of
imminent respiratory difficulty. Which of the following drugs most likely caused this condition?
A. Ketamine
B. Dimethyltryptamine (DMT)
C. Gamma-hydroxybutyrate (GHB)
D. Lysergic acid diethylamide (LSD)
E. MDMA
D. Electroencephalogram (EEG) - ANS A 32-year-old patient presents to the emergency
department with acute onset of paranoia, auditory hallucinations, and hypervigilance. On
examination, the patient is tachycardic and hypertensive, and demonstrates psychomotor
agitation and anxiety. The patient denies any past psychiatric or medical history. The review of
systems is significant for intermittent episodes of substernal chest pain. Which of the following
tests would be most helpful in developing a differential diagnosis?
A. Urine toxicology
B. Complete metabolic profile
C. Complete blood count (CBC)
D. Electroencephalogram (EEG)
E. Head computed tomography (CT) scan
B. Acute stress disorder - ANS A 28-year-old patient presents to the emergency department
after experiencing a sexual assault one week earlier. Although the patient cannot recall all
aspects of the event, she remembers feeling helpless, detached, and as if her surroundings
, were not real during the assault. For the past week, the patient has had difficulty sleeping due to
nightmares about the assault, and has not been able to talk about the event with any of her
friends. She is
also experiencing intermittent episodes of palpitations, shortness of breath, dizziness, and
nausea throughout the day. Which of the following is the most likely diagnosis?
A. Panic disorder
B. Acute stress disorder
C. GAD
D. Adjustment disorder with anxiety
E. PTSD
B. Physostigmine - stimulates Ach - ANS Which of the following drugs is most appropriate in the
emergency treatment of anticholinergic toxicity?
A. Chlorpromazine
B. Physostigmine
C. Haloperidol
D. Propranolol
E. Atropine
C. History of prior suicide attempt - ANS Which of the following factors carries the highest
standardized mortality ratio for suicide?
A. Family history of suicide
B. History of self-mutilation
C. History of prior suicide attempt
D. Presence of a substance use disorder
E. Current diagnosis of major depression
B. Dissociation - Across trauma types, traumatic dissociation has been identified as the largest
predictor of PTSD in a review of PTSD risk factors. It has also been identified as a predictor of
PTSD in a number of individual studie (Nöthling et al., 2015) - ANS A patient presents to the
emergency department after witnessing a tragic motor vehicle accident in which an individual
was killed. Presence of which of the following symptoms immediately following the event would
increase the patient's risk of ultimately developing posttraumatic stress disorder (PTSD)?
A. Depression
B. Dissociation
C. Intense fear
D. Low level of arousal
E. Inability to stop thinking about the incident
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