psychiatry

Practice targeted AMC-style multiple-choice questions on psychiatry.

A 40-year-old patient with PTSD is started on sertraline but develops sexual dysfunction as a side effect. What is the next step in management?

A. Add bupropion.

B. Switch to paroxetine.

C. Continue sertraline and monitor.

D. Discontinue sertraline.

E. Reduce the dose of sertraline.

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A man tells his doctor that aliens on the television are commanding him to do things. This is an example of which of the following?

A. Thought broadcasting

B. Grandiosity

C. Auditory hallucination

D. Idea of reference

E. Delusion of persecution

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A nurse in the psychiatry ward discloses that she is involved in a relationship with an ex-patient. What is the most appropriate action to take?

A. Inform AHPRA immediately.

B. Notify the senior medical director.

C. Take note of the conversation for your records only.

D. Ask the nurse to end the relationship immediately.

E. Report the matter to the nurse supervisor.

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A 35-year-old man with PTSD is experiencing severe nightmares despite being on an SSRI. What medication can be added to target this symptom?

A. Prazosin

B. Gabapentin

C. Quetiapine

D. Clonidine

E. Trazodone

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A patient recently started on an antipsychotic medication and develops an inner sense of restlessness and an inability to sit still, constantly needing to move or change position. What is the most likely diagnosis for this side effect?

A. Tardive dyskinesia

B. Neuroleptic Malignant Syndrome

C. Parkinsonism

D. Akathisia

E. Dystonia

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A 28-year-old patient with autism spectrum disorder is prescribed risperidone for aggressive behavior. His parents report significant weight gain. What is the most appropriate next step?

A. Monitor and continue risperidone.

B. Add metformin.

C. Start a low-calorie diet.

D. Switch to aripiprazole.

E. Discontinue risperidone.

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A patient presents with a non-healing wound, appears to be removing her bandages, has frequent conflicts with colleagues, and recently left her job. Which of the following historical features would most strongly support a diagnosis of Borderline Personality Disorder in this patient?

A. Family history of anxiety disorder

B. Previous suicidal attempts

C. History of a single episode of depression.

D. Presence of delusions

E. Childhood history of specific phobia.

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A 9-year-old, diagnosed with ADHD, struggles with homework completion despite medication. His parents report significant family stress. What's the MOST appropriate next step?

A. Referral for family therapy

B. Increase the current medication dosage

C. Recommend individual cognitive behavioral therapy for the child

D. Implement a strict reward system at home

E. Switch to a different stimulant medication

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A 28-year-old patient with PTSD is undergoing therapy. The therapist uses exposure techniques to help the patient confront traumatic memories. What type of therapy is this?

A. Psychodynamic therapy

B. Cognitive behavioral therapy (CBT)

C. Supportive therapy

D. Dialectical behavior therapy (DBT)

E. Eye movement desensitization and reprocessing (EMDR)

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A 25-year-old woman with a history of sexual assault presents with intrusive thoughts, avoidance behaviors, and emotional numbness. She is diagnosed with PTSD. What is the first-line pharmacological treatment for this condition?

A. Selective serotonin reuptake inhibitors (SSRIs)

B. Benzodiazepines

C. Beta-blockers

D. Mood stabilizers

E. Antipsychotics

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A patient on 2 mg risperidone developed bilateral nipple discharge. What is the most appropriate management step?

A. Switch to quetiapine.

B. Change to amisulpride.

C. Increase risperidone.

D. Decrease risperidone.

E. Switch to clozapine.

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A 30-year-old veteran presents with recurrent nightmares, flashbacks of combat, and hypervigilance. He avoids crowded places and has difficulty sleeping. His symptoms have persisted for over 6 months and are affecting his daily functioning. What is the most likely diagnosis?

A. Major depressive disorder

B. Post-traumatic stress disorder (PTSD)

C. Generalized anxiety disorder

D. Schizophrenia

E. Bipolar disorder

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A lady stopped driving after being involved in an accident two years ago. She frequently experiences nightmares about the accident and has difficulty falling asleep. Her sister died a few months ago. What is the most likely diagnosis for her current symptoms?

A. Acute stress disorder

B. Grief reaction

C. Adjustment disorder

D. PTSD

E. Generalized Anxiety Disorder

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An elderly man presents with a 6-month history of memory decline, recurrent falls, visual hallucinations, agitation, and confusion. His wife reports he talks to people who are not visible. Which of the following clinical features is most helpful in diagnosing his condition?

A. Nystagmus

B. Parkinsonian gait/tremor

C. Ataxia

D. Aphasia

E. Hemiparesis

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A 40-year-old patient with schizophrenia is started on risperidone. His GP recommends regular monitoring. What parameters should be monitored?

A. Serum calcium

B. Thyroid function tests

C. Liver function tests

D. Vitamin D levels

E. Blood glucose and lipids

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A patient tells you that aliens on the television are commanding him to perform certain actions. What type of delusion is this most likely to be?

A. Grandiose delusion

B. Idea of reference

C. Thought broadcasting

D. Persecutory delusion

E. Somatic delusion

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A 30-year-old woman with bipolar disorder is prescribed risperidone for manic episodes. She develops tremors and rigidity. What is the most likely diagnosis?

A. Extrapyramidal symptoms (EPS)

B. Neuroleptic malignant syndrome

C. Tardive dyskinesia

D. Serotonin syndrome

E. Akathisia

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A 25-year-old man with schizophrenia is started on risperidone. After a few weeks, he develops gynecomastia and galactorrhea. What is the most likely cause of these symptoms?

A. Hyperprolactinemia

B. Diabetes insipidus

C. Hypothyroidism

D. Cushing syndrome

E. Adrenal insufficiency

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A 35-year-old patient with schizophrenia is on risperidone and develops QT prolongation on ECG. What is the next step?

A. Switch to clozapine.

B. Start a beta-blocker.

C. Discontinue risperidone.

D. Monitor ECG regularly.

E. Reduce the dose of risperidone.

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A man presents to his GP complaining of insomnia. He has a history of addiction but is currently doing well. His girlfriend recently left him, and he states he will kill her if he sees her again. What is the most appropriate initial management step?

A. Refer him for anger management.

B. Advise him that his feelings are normal and will improve with time.

C. Arrange for immediate psychiatric assessment.

D. Inform the police.

E. Prescribe diazepam for a short duration.

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A 32-year-old woman presents to her general practitioner six weeks postpartum with distressing obsessive thoughts about accidentally harming her newborn. She reports spending excessive time checking on the baby and cleaning the nursery, which interferes with her ability to rest and care for herself. She denies any intent to harm her child and feels ashamed of these thoughts. Her past medical history is unremarkable, and she has no history of psychiatric disorders. On examination, she appears anxious but is cooperative and oriented. Which of the following is the most appropriate initial management strategy for her condition?

A. Cognitive-behavioral therapy (CBT) with exposure and response prevention

B. Reassurance and monitoring without immediate intervention

C. Referral to a psychiatrist for further evaluation

D. Initiation of selective serotonin reuptake inhibitor (SSRI) therapy

E. Prescribing benzodiazepines for immediate anxiety relief

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psychiatry

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