PA Psychiatry EOR (End of Rotation)
2025/2026 Latest Actual Exam - Test Bank
with Verified Answers
Category Topics Included
MDD (SIG-E-CAPS criteria), Bipolar I vs II, Hypomania vs
Mood Disorders Mania, Cyclothymia, Persistent depressive disorder,
PMDD, Atypical/Melancholic features, Mixed episodes
GAD (≥6 months criteria), Panic disorder (unexpected
Anxiety Disorders attacks), Social anxiety, PTSD (trauma + >1 month),
Acute stress disorder, Adjustment disorder, Agoraphobia
Schizophrenia (≥6 months), Schizoaffective, Brief
Psychotic Disorders psychotic disorder, Delusional disorder, Positive vs
Negative symptoms, Drug-induced psychosis
Alcohol (withdrawal, DTs, intoxication), Opioids
(withdrawal, intoxication), Cocaine (intoxication,
Substance Use
withdrawal, excited delirium), Benzodiazepines
(withdrawal), Cannabis, LSD (flashbacks), Stimulants
Borderline (DBT treatment), Antisocial, Histrionic,
Personality Disorders
Narcissistic, ODD (ADHD comorbidity)
Childhood OCD, ADHD (stimulants, ODD comorbidity),
Pediatric Psychiatry
PMDD
Alzheimer's dementia, Delirium vs Dementia vs
Geriatric Psychiatry
Depression, MMSE/MoCA screening
SSRIs (sertraline, fluoxetine, paroxetine), SNRIs
(duloxetine, venlafaxine), Bupropion, TCAs, Lithium
(monitoring, side effects), Valproate (monitoring),
Psychopharmacology
Antipsychotics (typical vs SGAs, EPS, metabolic, QTc,
prolactin, agranulocytosis), Benzodiazepines, Buspirone,
Trazodone
CBT (depression, anxiety, OCD, PTSD), DBT (BPD),
Therapeutic
Trauma-focused CBT (PTSD), Exposure therapy (OCD),
Interventions
CBT-I (insomnia)
, Category Topics Included
PHQ-9 (depression 0-27), GAD-7 (anxiety 0-21), AUDIT
Assessment Tools (alcohol), MMSE/MoCA (cognition), SUICIDE screening
(PHQ-9 item 9)
Depression + neuropathic pain (SNRI), Depression +
smoking cessation (bupropion), PTSD + substance use
(SSRI), Pregnancy (lamotrigine safe), Parkinson's (avoid
Medical Comorbidities typical antipsychotics), Seizure disorder (avoid
bupropion), Narrow-angle glaucoma (avoid TCAs),
Bulimia (avoid bupropion), QTc prolongation (avoid
ziprasidone)
Suicide risk assessment, Lithium levels (0.6-1.2), ANC for
clozapine (>1000), TSH for lithium, Liver enzymes/CBC
Safety & Monitoring
for valproate, ECG for ziprasidone, Sodium for SSRIs
(SIADH), Metabolic monitoring for olanzapine
Sexual dysfunction (SSRI), Weight gain (olanzapine,
lithium), QTc prolongation (ziprasidone, haloperidol), EPS
Side Effects & (haloperidol > risperidone > quetiapine),
Contraindications Hyperprolactinemia (risperidone), Agranulocytosis
(clozapine), Serotonin syndrome, NMS, Seizures
(bupropion), Orthostasis (TCAs)
Question 1
A 28-year-old female presents with 3 weeks of persistent sadness, decreased
interest in activities, fatigue, difficulty concentrating, and feelings of
worthlessness. She denies suicidal ideation. What is the MOST appropriate initial
diagnosis?
A. Bipolar I disorder
B. Major depressive disorder (MDD)
C. Generalized anxiety disorder
D. Persistent depressive disorder
Correct Answer: B
Rationale: Major depressive disorder (MDD) is diagnosed when a patient
has 5+ SIG-E-CAPS symptoms for ≥2 weeks: Sleep changes, Interest loss, Guilt,
,Energy loss, Concentration problems, Appetite changes, Psychomotor changes,
Suicidality. This patient has sadness (depressed mood), anhedonia (decreased
interest), fatigue (energy), concentration difficulty, and worthlessness (guilt) = 5
symptoms for 3 weeks. Bipolar I requires manic episode. GAD is anxiety >6
months. Persistent depressive is ≥2 years. PA must recognize MDD criteria.
Question 2
Which medication is the FIRST-LINE treatment for acute mania in bipolar
disorder?
A. Lamotrigine
B. Lithium or valproate
C. Fluoxetine
D. Sertraline
Correct Answer: B
Rationale: Lithium or valproate are FIRST-LINE for acute mania in bipolar
disorder. Lithium is classic mood stabilizer; valproate (divalproex) is effective for
acute mania. Lamotrigine is for bipolar depression. Fluoxetine and sertraline are
antidepressants (can worsen mania). Mood stabilizers are essential for bipolar;
antidepressants alone are contraindicated. PA must know bipolar treatment
hierarchy.
Question 3
A patient with schizophrenia is on clozapetine. Which laboratory test must be
monitored regularly?
A. Liver enzymes
B. White blood cell count with absolute neutrophil count (ANC)
C. Thyroid function
D. Creatinine
Correct Answer: B
Rationale: White blood cell count with absolute neutrophil count (ANC) must
be monitored for clozapetine due to risk of agranulocytosis (severe neutropenia).
Weekly ANC for first 6 months, then biweekly. Liver enzymes are for
, valproate. Thyroid is for lithium. Creatinine is renal function. Ag granulocytosis
is life-threatening; PA must monitor clozapetine closely.
Question 4
Which symptom is MOST characteristic of generalized anxiety disorder (GAD)?
A. Panic attacks
B. Excessive anxiety/worry >6 months about multiple events
C. Social avoidance
D. Flashbacks
Correct Answer: B
Rationale: GAD is characterized by excessive anxiety/worry >6 months about
multiple events (work, health, family) that is difficult to control. Associated with
restlessness, fatigue, concentration problems, irritability, muscle tension, sleep
disturbance. Panic attacks are panic disorder. Social avoidance is social
anxiety. Flashbacks are PTSD. PA must differentiate anxiety disorders.
Question 5
A 35-year-old male presents with hallucinations, delusions, and disorganized
thinking for 8 months. What is the MOST appropriate diagnosis?
A. Brief psychotic disorder
B. Schizophrenia
C. Schizoaffective disorder
D. Delusional disorder
Correct Answer: B
Rationale: Schizophrenia requires ≥6 months of continuous signs including 2+
of: delusions, hallucinations, disorganized speech, disorganized behavior, negative
symptoms. This patient has hallucinations, delusions, disorganized thinking for 8
months = schizophrenia. Brief psychotic is <1 month. Schizoaffective requires
mood episode. Delusional is only delusions (no hallucinations). PA must know
duration criteria.
2025/2026 Latest Actual Exam - Test Bank
with Verified Answers
Category Topics Included
MDD (SIG-E-CAPS criteria), Bipolar I vs II, Hypomania vs
Mood Disorders Mania, Cyclothymia, Persistent depressive disorder,
PMDD, Atypical/Melancholic features, Mixed episodes
GAD (≥6 months criteria), Panic disorder (unexpected
Anxiety Disorders attacks), Social anxiety, PTSD (trauma + >1 month),
Acute stress disorder, Adjustment disorder, Agoraphobia
Schizophrenia (≥6 months), Schizoaffective, Brief
Psychotic Disorders psychotic disorder, Delusional disorder, Positive vs
Negative symptoms, Drug-induced psychosis
Alcohol (withdrawal, DTs, intoxication), Opioids
(withdrawal, intoxication), Cocaine (intoxication,
Substance Use
withdrawal, excited delirium), Benzodiazepines
(withdrawal), Cannabis, LSD (flashbacks), Stimulants
Borderline (DBT treatment), Antisocial, Histrionic,
Personality Disorders
Narcissistic, ODD (ADHD comorbidity)
Childhood OCD, ADHD (stimulants, ODD comorbidity),
Pediatric Psychiatry
PMDD
Alzheimer's dementia, Delirium vs Dementia vs
Geriatric Psychiatry
Depression, MMSE/MoCA screening
SSRIs (sertraline, fluoxetine, paroxetine), SNRIs
(duloxetine, venlafaxine), Bupropion, TCAs, Lithium
(monitoring, side effects), Valproate (monitoring),
Psychopharmacology
Antipsychotics (typical vs SGAs, EPS, metabolic, QTc,
prolactin, agranulocytosis), Benzodiazepines, Buspirone,
Trazodone
CBT (depression, anxiety, OCD, PTSD), DBT (BPD),
Therapeutic
Trauma-focused CBT (PTSD), Exposure therapy (OCD),
Interventions
CBT-I (insomnia)
, Category Topics Included
PHQ-9 (depression 0-27), GAD-7 (anxiety 0-21), AUDIT
Assessment Tools (alcohol), MMSE/MoCA (cognition), SUICIDE screening
(PHQ-9 item 9)
Depression + neuropathic pain (SNRI), Depression +
smoking cessation (bupropion), PTSD + substance use
(SSRI), Pregnancy (lamotrigine safe), Parkinson's (avoid
Medical Comorbidities typical antipsychotics), Seizure disorder (avoid
bupropion), Narrow-angle glaucoma (avoid TCAs),
Bulimia (avoid bupropion), QTc prolongation (avoid
ziprasidone)
Suicide risk assessment, Lithium levels (0.6-1.2), ANC for
clozapine (>1000), TSH for lithium, Liver enzymes/CBC
Safety & Monitoring
for valproate, ECG for ziprasidone, Sodium for SSRIs
(SIADH), Metabolic monitoring for olanzapine
Sexual dysfunction (SSRI), Weight gain (olanzapine,
lithium), QTc prolongation (ziprasidone, haloperidol), EPS
Side Effects & (haloperidol > risperidone > quetiapine),
Contraindications Hyperprolactinemia (risperidone), Agranulocytosis
(clozapine), Serotonin syndrome, NMS, Seizures
(bupropion), Orthostasis (TCAs)
Question 1
A 28-year-old female presents with 3 weeks of persistent sadness, decreased
interest in activities, fatigue, difficulty concentrating, and feelings of
worthlessness. She denies suicidal ideation. What is the MOST appropriate initial
diagnosis?
A. Bipolar I disorder
B. Major depressive disorder (MDD)
C. Generalized anxiety disorder
D. Persistent depressive disorder
Correct Answer: B
Rationale: Major depressive disorder (MDD) is diagnosed when a patient
has 5+ SIG-E-CAPS symptoms for ≥2 weeks: Sleep changes, Interest loss, Guilt,
,Energy loss, Concentration problems, Appetite changes, Psychomotor changes,
Suicidality. This patient has sadness (depressed mood), anhedonia (decreased
interest), fatigue (energy), concentration difficulty, and worthlessness (guilt) = 5
symptoms for 3 weeks. Bipolar I requires manic episode. GAD is anxiety >6
months. Persistent depressive is ≥2 years. PA must recognize MDD criteria.
Question 2
Which medication is the FIRST-LINE treatment for acute mania in bipolar
disorder?
A. Lamotrigine
B. Lithium or valproate
C. Fluoxetine
D. Sertraline
Correct Answer: B
Rationale: Lithium or valproate are FIRST-LINE for acute mania in bipolar
disorder. Lithium is classic mood stabilizer; valproate (divalproex) is effective for
acute mania. Lamotrigine is for bipolar depression. Fluoxetine and sertraline are
antidepressants (can worsen mania). Mood stabilizers are essential for bipolar;
antidepressants alone are contraindicated. PA must know bipolar treatment
hierarchy.
Question 3
A patient with schizophrenia is on clozapetine. Which laboratory test must be
monitored regularly?
A. Liver enzymes
B. White blood cell count with absolute neutrophil count (ANC)
C. Thyroid function
D. Creatinine
Correct Answer: B
Rationale: White blood cell count with absolute neutrophil count (ANC) must
be monitored for clozapetine due to risk of agranulocytosis (severe neutropenia).
Weekly ANC for first 6 months, then biweekly. Liver enzymes are for
, valproate. Thyroid is for lithium. Creatinine is renal function. Ag granulocytosis
is life-threatening; PA must monitor clozapetine closely.
Question 4
Which symptom is MOST characteristic of generalized anxiety disorder (GAD)?
A. Panic attacks
B. Excessive anxiety/worry >6 months about multiple events
C. Social avoidance
D. Flashbacks
Correct Answer: B
Rationale: GAD is characterized by excessive anxiety/worry >6 months about
multiple events (work, health, family) that is difficult to control. Associated with
restlessness, fatigue, concentration problems, irritability, muscle tension, sleep
disturbance. Panic attacks are panic disorder. Social avoidance is social
anxiety. Flashbacks are PTSD. PA must differentiate anxiety disorders.
Question 5
A 35-year-old male presents with hallucinations, delusions, and disorganized
thinking for 8 months. What is the MOST appropriate diagnosis?
A. Brief psychotic disorder
B. Schizophrenia
C. Schizoaffective disorder
D. Delusional disorder
Correct Answer: B
Rationale: Schizophrenia requires ≥6 months of continuous signs including 2+
of: delusions, hallucinations, disorganized speech, disorganized behavior, negative
symptoms. This patient has hallucinations, delusions, disorganized thinking for 8
months = schizophrenia. Brief psychotic is <1 month. Schizoaffective requires
mood episode. Delusional is only delusions (no hallucinations). PA must know
duration criteria.
