PA PSYCHIATRY EOR LATEST ACTUAL
EXAM 2 TEST BANK WITH REAL EXAM
QUESTIONS WITH 100% CORRECT
VERIFIED ANSWERS GRADED A+/ PSYCH
EOR PAEA LATEST EXAM NEW!!
Questions 1–25: Mood Disorders (Major Depressive Disorder, Bipolar)
1. A 28-year-old woman reports 6 weeks of depressed mood, loss of interest, fatigue,
poor concentration, and early morning awakening. She denies mania, psychosis, or
suicidal ideation. What is the most appropriate initial treatment?
A) Bupropion 150 mg BID
B) Escitalopram 10 mg daily
C) Venlafaxine 75 mg BID
D) Fluoxetine 20 mg BID
Correct ,,,ANSWER,,,: B – Escitalopram 10 mg daily (SSRI first-line; start low).
Bupropion is second-line. Venlafaxine may be used but not first. Fluoxetine 20 mg
BID is too high.
2. A 45-year-old male presents with 5 days of elevated mood, decreased need for
sleep (sleeps 3 hours but feels rested), grandiosity, and increased goal-directed
activity. He has no psychotic features. This episode meets criteria for:
A) Hypomanic episode
B) Manic episode
,C) Mixed episode
D) Cyclothymic disorder
Correct ,,,ANSWER,,,: B – Manic episode requires ≥1 week (or any duration if
hospitalized). Hypomania requires ≥4 days. This duration is 5 days, but still manic
because it's more than 4 days and meets severity (grandiosity, decreased sleep).
DSM-5: ≥1 week for mania, but 5 days with impairment could still be considered
manic if severe.
3. A patient with bipolar I disorder is currently depressed. Which medication is most
clearly associated with increased risk of switching to mania?
A) Lamotrigine
B) Quetiapine
C) Fluoxetine (monotherapy)
D) Lithium
Correct ,,,ANSWER,,,: C – Antidepressant monotherapy (especially SSRIs) in bipolar
depression can precipitate mania/hypomania or rapid cycling. Mood stabilizers or
atypical antipsychotics are preferred.
4. A 22-year-old college student reports feeling sad, worthless, and having difficulty
studying for 2 months. She denies suicidal ideation. Her TSH and CBC are normal.
She has never had a manic episode. What is the first-line pharmacotherapy?
A) Sertraline 25 mg daily
B) Amitriptyline 25 mg at bedtime
C) Phenelzine 15 mg TID
D) Lithium 300 mg BID
Correct ,,,ANSWER,,,: A – Sertraline 25 mg daily (SSRI). Amitriptyline (tricyclic) has
more side effects; MAOIs are third-line; lithium is for bipolar.
5. A 35-year-old woman has had persistent depressive symptoms for over 2 years,
but never meeting full MDD criteria. She reports poor appetite, low energy, and low
self-esteem. What is the diagnosis?
A) Major depressive disorder, moderate
,B) Persistent depressive disorder (dysthymia)
C) Adjustment disorder with depressed mood
D) Bipolar II disorder
Correct ,,,ANSWER,,,: B – Persistent depressive disorder requires depressed mood
for most of the day, more days than not, for ≥2 years (1 year in
children/adolescents).
6. Which of the following is a specifier for major depressive disorder?
A) With atypical features
B) With catatonia
C) With peripartum onset
D) All of the above
Correct ,,,ANSWER,,,: D – All are specifiers: atypical, catatonia, peripartum,
seasonal pattern, melancholic, anxious distress, mixed features, etc.
7. A 52-year-old male with bipolar I disorder is stable on lithium. He develops
polyuria and polydipsia. What is the most likely cause?
A) Lithium-induced diabetes mellitus
B) Lithium-induced nephrogenic diabetes insipidus
C) Syndrome of inappropriate antidiuretic hormone (SIADH)
D) Primary polydipsia
Correct ,,,ANSWER,,,: B – Lithium can cause nephrogenic diabetes insipidus (renal
resistance to ADH). Monitor urine specific gravity, serum sodium, and lithium levels.
8. A patient with MDD fails to improve after 6 weeks of sertraline 50 mg daily. What is
the next step?
A) Augment with lithium
B) Switch to venlafaxine 37.5 mg daily
C) Increase sertraline to 100-150 mg daily (max 200 mg)
D) Add aripiprazole 2 mg daily
Correct ,,,ANSWER,,,: C – First step for inadequate response to SSRI is to increase
, dose to maximum tolerated. Augmentation (e.g., aripiprazole) is considered after
dose optimization and possibly switching.
9. A 70-year-old man with depression and benign prostatic hyperplasia should avoid
which antidepressant due to risk of urinary retention?
A) Sertraline
B) Duloxetine
C) Bupropion
D) Amitriptyline
Correct ,,,ANSWER,,,: D – Amitriptyline (tricyclic) has anticholinergic effects,
causing urinary retention, constipation, blurred vision, confusion (especially in
elderly).
10. A 25-year-old woman reports premenstrual mood symptoms that cause
significant impairment. She has a history of MDD. Which SSRI is FDA-approved for
PMDD?
A) Paroxetine
B) Fluoxetine
C) Sertraline
D) All of the above
Correct ,,,ANSWER,,,: D – Fluoxetine, sertraline, and paroxetine are FDA-approved
for PMDD. Can be taken daily or only during luteal phase.
11. A 30-year-old woman is 2 weeks postpartum. She reports mood lability, crying
spells, insomnia despite exhaustion, and intermittent thoughts of harming her baby.
What is the most appropriate next step?
A) Reassure and schedule follow-up in 4 weeks
B) Start sertraline 25 mg daily and refer to psychiatry
C) Admit to inpatient psychiatric unit
D) Increase social support and monitor
Correct ,,,ANSWER,,,: C – Thoughts of harming baby with mood symptoms
EXAM 2 TEST BANK WITH REAL EXAM
QUESTIONS WITH 100% CORRECT
VERIFIED ANSWERS GRADED A+/ PSYCH
EOR PAEA LATEST EXAM NEW!!
Questions 1–25: Mood Disorders (Major Depressive Disorder, Bipolar)
1. A 28-year-old woman reports 6 weeks of depressed mood, loss of interest, fatigue,
poor concentration, and early morning awakening. She denies mania, psychosis, or
suicidal ideation. What is the most appropriate initial treatment?
A) Bupropion 150 mg BID
B) Escitalopram 10 mg daily
C) Venlafaxine 75 mg BID
D) Fluoxetine 20 mg BID
Correct ,,,ANSWER,,,: B – Escitalopram 10 mg daily (SSRI first-line; start low).
Bupropion is second-line. Venlafaxine may be used but not first. Fluoxetine 20 mg
BID is too high.
2. A 45-year-old male presents with 5 days of elevated mood, decreased need for
sleep (sleeps 3 hours but feels rested), grandiosity, and increased goal-directed
activity. He has no psychotic features. This episode meets criteria for:
A) Hypomanic episode
B) Manic episode
,C) Mixed episode
D) Cyclothymic disorder
Correct ,,,ANSWER,,,: B – Manic episode requires ≥1 week (or any duration if
hospitalized). Hypomania requires ≥4 days. This duration is 5 days, but still manic
because it's more than 4 days and meets severity (grandiosity, decreased sleep).
DSM-5: ≥1 week for mania, but 5 days with impairment could still be considered
manic if severe.
3. A patient with bipolar I disorder is currently depressed. Which medication is most
clearly associated with increased risk of switching to mania?
A) Lamotrigine
B) Quetiapine
C) Fluoxetine (monotherapy)
D) Lithium
Correct ,,,ANSWER,,,: C – Antidepressant monotherapy (especially SSRIs) in bipolar
depression can precipitate mania/hypomania or rapid cycling. Mood stabilizers or
atypical antipsychotics are preferred.
4. A 22-year-old college student reports feeling sad, worthless, and having difficulty
studying for 2 months. She denies suicidal ideation. Her TSH and CBC are normal.
She has never had a manic episode. What is the first-line pharmacotherapy?
A) Sertraline 25 mg daily
B) Amitriptyline 25 mg at bedtime
C) Phenelzine 15 mg TID
D) Lithium 300 mg BID
Correct ,,,ANSWER,,,: A – Sertraline 25 mg daily (SSRI). Amitriptyline (tricyclic) has
more side effects; MAOIs are third-line; lithium is for bipolar.
5. A 35-year-old woman has had persistent depressive symptoms for over 2 years,
but never meeting full MDD criteria. She reports poor appetite, low energy, and low
self-esteem. What is the diagnosis?
A) Major depressive disorder, moderate
,B) Persistent depressive disorder (dysthymia)
C) Adjustment disorder with depressed mood
D) Bipolar II disorder
Correct ,,,ANSWER,,,: B – Persistent depressive disorder requires depressed mood
for most of the day, more days than not, for ≥2 years (1 year in
children/adolescents).
6. Which of the following is a specifier for major depressive disorder?
A) With atypical features
B) With catatonia
C) With peripartum onset
D) All of the above
Correct ,,,ANSWER,,,: D – All are specifiers: atypical, catatonia, peripartum,
seasonal pattern, melancholic, anxious distress, mixed features, etc.
7. A 52-year-old male with bipolar I disorder is stable on lithium. He develops
polyuria and polydipsia. What is the most likely cause?
A) Lithium-induced diabetes mellitus
B) Lithium-induced nephrogenic diabetes insipidus
C) Syndrome of inappropriate antidiuretic hormone (SIADH)
D) Primary polydipsia
Correct ,,,ANSWER,,,: B – Lithium can cause nephrogenic diabetes insipidus (renal
resistance to ADH). Monitor urine specific gravity, serum sodium, and lithium levels.
8. A patient with MDD fails to improve after 6 weeks of sertraline 50 mg daily. What is
the next step?
A) Augment with lithium
B) Switch to venlafaxine 37.5 mg daily
C) Increase sertraline to 100-150 mg daily (max 200 mg)
D) Add aripiprazole 2 mg daily
Correct ,,,ANSWER,,,: C – First step for inadequate response to SSRI is to increase
, dose to maximum tolerated. Augmentation (e.g., aripiprazole) is considered after
dose optimization and possibly switching.
9. A 70-year-old man with depression and benign prostatic hyperplasia should avoid
which antidepressant due to risk of urinary retention?
A) Sertraline
B) Duloxetine
C) Bupropion
D) Amitriptyline
Correct ,,,ANSWER,,,: D – Amitriptyline (tricyclic) has anticholinergic effects,
causing urinary retention, constipation, blurred vision, confusion (especially in
elderly).
10. A 25-year-old woman reports premenstrual mood symptoms that cause
significant impairment. She has a history of MDD. Which SSRI is FDA-approved for
PMDD?
A) Paroxetine
B) Fluoxetine
C) Sertraline
D) All of the above
Correct ,,,ANSWER,,,: D – Fluoxetine, sertraline, and paroxetine are FDA-approved
for PMDD. Can be taken daily or only during luteal phase.
11. A 30-year-old woman is 2 weeks postpartum. She reports mood lability, crying
spells, insomnia despite exhaustion, and intermittent thoughts of harming her baby.
What is the most appropriate next step?
A) Reassure and schedule follow-up in 4 weeks
B) Start sertraline 25 mg daily and refer to psychiatry
C) Admit to inpatient psychiatric unit
D) Increase social support and monitor
Correct ,,,ANSWER,,,: C – Thoughts of harming baby with mood symptoms
