Psychiatry Flashcards
7 cards from real PANRE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Psychiatry flashcards as text
A patient with schizophrenia on olanzapine gains 20 lbs over 6 months and develops fasting glucose of 126 mg/dL. What is the most appropriate next step?
Answer: Switch to aripiprazole or ziprasidone
Switching to a metabolically neutral antipsychotic (aripiprazole or ziprasidone) is preferred over adding medications for metabolic side effects.
Which condition is characterized by at least 2 years of fluctuating hypomanic and depressive symptoms that do not meet criteria for full bipolar episodes?
Answer: Cyclothymic disorder
Cyclothymic disorder requires ≥2 years (1 year in children) of subsyndromal hypomanic and depressive periods.
A patient reports that her neighbor has been poisoning her food for the past year. She is otherwise functional, with no hallucinations or disorganized speech. What is the most likely diagnosis?
Answer: Delusional disorder, persecutory type
Delusional disorder features a fixed non-bizarre or bizarre delusion for ≥1 month without prominent hallucinations or disorganization.
Which medication requires a REMS program due to the risk of QTc prolongation and cardiac arrhythmia?
Answer: Clozapine
Clozapine has a REMS program primarily for agranulocytosis, but also requires monitoring for QTc effects.
A 45-year-old man has persistent worry about multiple life domains, muscle tension, and restlessness for more than 6 months, causing work impairment. First-line treatment is:
Answer: Buspirone or SSRI/SNRI
SSRIs, SNRIs, and buspirone are first-line pharmacotherapy for GAD; benzodiazepines are avoided as monotherapy.
Which of the following symptoms is NOT part of the DSM-5 criteria for major neurocognitive disorder (dementia)?
Answer: Acute onset over hours
Acute onset suggests delirium, not dementia; major NCD requires gradual onset and progressive decline.
A 16-year-old is brought in by parents for refusing to speak at school for 3 months, though he speaks normally at home. His school performance is declining. What is the diagnosis?
Answer: Selective mutism
Selective mutism is defined by consistent failure to speak in specific social situations despite speaking normally elsewhere.