PANCE psychiatry
(Smarty PANCE)
Exam
2026
Questions and Answers
(A+ Grade Guarantee)
,What is generalized anxiety Excessive anxiety and worry about a number of activities or
events that is present more days than not for ≥ 6 months
disorder (GAD)?
1. Severe anxiety/worry about MANY topics, events, tasks that
occur MOST days > 6 months
2. At least 3 symptoms:
● Muscle tension
● Fatigability
● Concentration difficulty
DSM-5 criteria for GAD? ● Restlessness
● Irritability
● Sleep disturbances
Mnemonic: Macbeth Frets Constantly Regarding Illicit Sins
● Muscle tension
● Fatigability
● Concentration difficulty
Mnemonic to remember the ● Restlessness
symptoms of of GAD? ● Irritability
● Sleep disturbances
Norepinephrine is increased in patients with generalized anxiety
Norepinephrine is _________ in disorder.
patients with generalized anxiety
disorder?
GABA and serotonin levels are decreased in patients with
GABA and serotonin levels are generalized anxiety disorder.
___________ in patients with
generalized anxiety disorder.
Cognitive behavioral therapy is the psychotherapy of choice for
What is the psychotherapy of patients with generalized anxiety disorder.
choice for patients with
generalized anxiety disorder?
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-
First line medication for the norepinephrine reuptake inhibitors (SNRIs) are the first-line
treatment of GAD? drug classes for generalized anxiety disorder.
Second line medications for the Buspirone and Tricyclic antidepressants are second-line
medications for generalized anxiety disorder
treatment of GAD?
Benzodiazepines (anxiolytics) in small to moderate doses may
This class of medications in also be effective, although sustained use may lead to physical
small to moderate doses may dependence.
also be effective, although
sustained use may lead to
physical dependence
Panic disorder is occurrence of repeated panic attacks typically
accompanied by fears about future attacks or changes in behavior
Describe panic disorder? to avoid situations that might predispose to attacks
1. > 1 panic attack that reoccurs w/o warning and >4 symptoms
DSM V criteria for panic
disorder? 2. At least a month or more of worry or avoidant behavior
2026
, Patients need to experience the abrupt onset of at least four of
the following 13 symptoms:
● pounding heart or fast heart rate
● chest pain or discomfort
● sweating
● trembling
● shortness of breath
● nausea
In order to be classified as panic ● dizziness
disorder patients need to ● chills
experience the abrupt onset of at ● numbness
least four of 13 symptoms. ● feelings of choking
What are they? ● feelings of being detached from oneself
● fear of losing control
● fear of dying
To be considered panic disorder one must experience: recurrent,
To diagnose panic disorder, how unexpected panic attacks with at least a month or more of worry
long must symptoms be present? or avoidant behavior
Patients with a panic disorder can’t predict where the panic attack
Patients with a panic will happen next, so it’s important to seek treatment before patients
disorder can’t predict where the develop avoidance, which is when they actively avoid the places
panic attack will happen next where a panic attack previously occurred.
and are likely to develop what?
This is called anticipatory anxiety
What is it called when a patient
experiences anxiety just
thinking about the possibility
of having a panic attack?
The fear of going into crowded Agoraphobia
spaces?
Selective serotonin reuptake inhibitors and SNRIs (venlafaxine)
What are the first-line agents for are the first-line agents for the management of panic disorder
the management of panic
disorder?
What can be Benzodiazepines and hydroxyzine
taken PRN for panic attacks?
Cognitive-behavioral therapy has been an effective type of
What has been an effective type psychotherapy for patients with panic disorder
of psychotherapy for patients
with panic disorder?
If panic disorder is very severe, anti-seizure medications may
If the panic disorder is very sometimes be prescribed
severe what class of medications
may sometimes be prescribed?
Phobias are extreme,
What are phobias? often unreasonable and irrational fears of something, which
could literally be anything
2026
, There are three main types of phobias:
1. Specific phobias
What are the three main types 2. Agoraphobia
of phobias? 3. Social phobia
Specific phobic disorders consist of persistent, unreasonable,
Define specific phobic intense fears (phobias) of specific situations, circumstances, or
disorders? objects
Persistent (>6 months) intense fear/anxiety of specific
Specific phobia DSM-V criteria? object/situation/place
Agoraphobia
A type of specific phobia, is an
exaggerated fear of public
spaces in which escape may be
difficult. It is associated with
panic disorder.
● Public transportation
● Open spaces
What places must people w/ ● Enclosed spaces
agoraphobia fear to make a ● Lines or crowds
formal diagnosis (need 2)? ● Outside home
Social Anxiety Disorder (Social Phobia)
A type of specific phobia
characterized by excessive fear
of embarrassment in social
situations such as public
speaking
Treatment of specific phobias is with systematic desensitization
Treatment of specific phobias? to the stimulus
Treatment for social anxiety In social anxiety disorder, patients can
take benzodiazepines or beta-blockers for infrequent anxiety-
disorder?
producing occasions.
Cognitive behavioral therapy and selective serotonin reuptake
Treatment for agoraphobia? inhibitors
Bipolar disorder is a mood disorder that is characterized by
episodes of mania, hypomania, and major depression. The
What is bipolar disorder? subtypes of bipolar disorder include bipolar I and bipolar II
Bipolar I
More manic with some
depression?
Hypomania with more Bipolar II (remember that bipolar II is depression > mania because
(profound) depression? depression is twice as big a word as mania)
2026
(Smarty PANCE)
Exam
2026
Questions and Answers
(A+ Grade Guarantee)
,What is generalized anxiety Excessive anxiety and worry about a number of activities or
events that is present more days than not for ≥ 6 months
disorder (GAD)?
1. Severe anxiety/worry about MANY topics, events, tasks that
occur MOST days > 6 months
2. At least 3 symptoms:
● Muscle tension
● Fatigability
● Concentration difficulty
DSM-5 criteria for GAD? ● Restlessness
● Irritability
● Sleep disturbances
Mnemonic: Macbeth Frets Constantly Regarding Illicit Sins
● Muscle tension
● Fatigability
● Concentration difficulty
Mnemonic to remember the ● Restlessness
symptoms of of GAD? ● Irritability
● Sleep disturbances
Norepinephrine is increased in patients with generalized anxiety
Norepinephrine is _________ in disorder.
patients with generalized anxiety
disorder?
GABA and serotonin levels are decreased in patients with
GABA and serotonin levels are generalized anxiety disorder.
___________ in patients with
generalized anxiety disorder.
Cognitive behavioral therapy is the psychotherapy of choice for
What is the psychotherapy of patients with generalized anxiety disorder.
choice for patients with
generalized anxiety disorder?
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-
First line medication for the norepinephrine reuptake inhibitors (SNRIs) are the first-line
treatment of GAD? drug classes for generalized anxiety disorder.
Second line medications for the Buspirone and Tricyclic antidepressants are second-line
medications for generalized anxiety disorder
treatment of GAD?
Benzodiazepines (anxiolytics) in small to moderate doses may
This class of medications in also be effective, although sustained use may lead to physical
small to moderate doses may dependence.
also be effective, although
sustained use may lead to
physical dependence
Panic disorder is occurrence of repeated panic attacks typically
accompanied by fears about future attacks or changes in behavior
Describe panic disorder? to avoid situations that might predispose to attacks
1. > 1 panic attack that reoccurs w/o warning and >4 symptoms
DSM V criteria for panic
disorder? 2. At least a month or more of worry or avoidant behavior
2026
, Patients need to experience the abrupt onset of at least four of
the following 13 symptoms:
● pounding heart or fast heart rate
● chest pain or discomfort
● sweating
● trembling
● shortness of breath
● nausea
In order to be classified as panic ● dizziness
disorder patients need to ● chills
experience the abrupt onset of at ● numbness
least four of 13 symptoms. ● feelings of choking
What are they? ● feelings of being detached from oneself
● fear of losing control
● fear of dying
To be considered panic disorder one must experience: recurrent,
To diagnose panic disorder, how unexpected panic attacks with at least a month or more of worry
long must symptoms be present? or avoidant behavior
Patients with a panic disorder can’t predict where the panic attack
Patients with a panic will happen next, so it’s important to seek treatment before patients
disorder can’t predict where the develop avoidance, which is when they actively avoid the places
panic attack will happen next where a panic attack previously occurred.
and are likely to develop what?
This is called anticipatory anxiety
What is it called when a patient
experiences anxiety just
thinking about the possibility
of having a panic attack?
The fear of going into crowded Agoraphobia
spaces?
Selective serotonin reuptake inhibitors and SNRIs (venlafaxine)
What are the first-line agents for are the first-line agents for the management of panic disorder
the management of panic
disorder?
What can be Benzodiazepines and hydroxyzine
taken PRN for panic attacks?
Cognitive-behavioral therapy has been an effective type of
What has been an effective type psychotherapy for patients with panic disorder
of psychotherapy for patients
with panic disorder?
If panic disorder is very severe, anti-seizure medications may
If the panic disorder is very sometimes be prescribed
severe what class of medications
may sometimes be prescribed?
Phobias are extreme,
What are phobias? often unreasonable and irrational fears of something, which
could literally be anything
2026
, There are three main types of phobias:
1. Specific phobias
What are the three main types 2. Agoraphobia
of phobias? 3. Social phobia
Specific phobic disorders consist of persistent, unreasonable,
Define specific phobic intense fears (phobias) of specific situations, circumstances, or
disorders? objects
Persistent (>6 months) intense fear/anxiety of specific
Specific phobia DSM-V criteria? object/situation/place
Agoraphobia
A type of specific phobia, is an
exaggerated fear of public
spaces in which escape may be
difficult. It is associated with
panic disorder.
● Public transportation
● Open spaces
What places must people w/ ● Enclosed spaces
agoraphobia fear to make a ● Lines or crowds
formal diagnosis (need 2)? ● Outside home
Social Anxiety Disorder (Social Phobia)
A type of specific phobia
characterized by excessive fear
of embarrassment in social
situations such as public
speaking
Treatment of specific phobias is with systematic desensitization
Treatment of specific phobias? to the stimulus
Treatment for social anxiety In social anxiety disorder, patients can
take benzodiazepines or beta-blockers for infrequent anxiety-
disorder?
producing occasions.
Cognitive behavioral therapy and selective serotonin reuptake
Treatment for agoraphobia? inhibitors
Bipolar disorder is a mood disorder that is characterized by
episodes of mania, hypomania, and major depression. The
What is bipolar disorder? subtypes of bipolar disorder include bipolar I and bipolar II
Bipolar I
More manic with some
depression?
Hypomania with more Bipolar II (remember that bipolar II is depression > mania because
(profound) depression? depression is twice as big a word as mania)
2026
