USMLE Step 2 CK-Psychiatry Questions and Answers
2024 1.What is the dx criteria for Generalized Anxiety Disorder?: anxiety on most days (six or more months) and w/ three or more somatic sx (restlessness, fatigue, difficulty concentrating, irritability, muscle tension, disturbed sleep)
2.How is GAD tx?: Lifestyle changes psychotherapy
medication
-SSRIs
-Venlafaxine
-buspirone
-Benzos for immediate sx relief
3.How does OCD present?: Obsessions: persistent, unwanted, and intrusive ideas, thoughts, impulses, or images that lead to marked anxiety or distress and occur despite the patient's attempts to prevent them
Compulsions: repeated mental acts or behaviors that neutralize anxiety from obses- sions (e.g. handwashing, elaborate rituals for ordinary tasks, counting, excessive checking)
Pts recognize these behaviors as excessive and irrational products of their own minds. Wish to get rid of the obsessions and/or compulsions
4.How is OCD tx?: Pharmacotherapy
-SSRIs (first line) CBT
-exposure and desensitization relaxation techniques Pt education
5.How do panic attacks present?: Discrete periods of intense fear or discomfort in which at least 4 of the following sx develop abruptly and peak w/in 10 min:
-tachypnea
-chest pain
-palpitations
-diaphoresis
-nausea
-trembling
-dizziness
-fear of dying or "going crazy" USMLE Step 2 CK-Psychiatry Questions and Answers
2024 -depersonalization
-hot flashes
-perioral and/or acral paresthesias-->hyperventilation and low O2 sats USMLE Step 2 CK-Psychiatry Questions and Answers
2024
one or more months of concern about having additional attacks or significant behavior change as a result of the attacks--avoiding situations that may precipitate attacks
6.What other conditions should be considered when a pt presents w/ panic attack?: Angina
MI
arrhythmias hyperthyroidism Vita B12 deficiency pheochromocytoma
substance-induced anxiety generalized anxiety disorder PTSD
7.How are panic disorders treated?: CBT pharmacotherapy
-SSRIs
-TCAs
Benzos
-for immediate relief, but avoid long-term use
-taper as soon as long term tx is on board
8.What is the difference between OCD and OCPD?: OCD is ego-dystonic: rec- ognize the obsessions/compulsions and want to be rid of them
OCPD is ego-syntonic: do not recognize their behavior as problematic
9.What is a social phobia?: characterized by marked fear provoked by social or performance situations in which embarrassment may occur. It may be specific (e.g. public speaking, urinating in public) or general (e.g. social interaction) and often begins in adolescence
10.What is a specific phobia?: anxiety is provoked by exposure to a feared object or situation (e.g. animals, heights, airplanes). Most cases begin in childhood.
11.How are specific phobias tx?: CBT involving desensitization through incre- mental exposure to the feared object or situation and relaxation techniques. Supportive, family and insight-oriented psychotherapy
12.How are social phobias tx?: CBT SSRIs
Low dose benzos
B-blockers (for performance anxiety)
13.What is PTSD?: reexperiencing of the event (e.g. nightmares), avoidance of stimuli associated w/ the trauma, numbed responsiveness (e.g. detachment, anhe-
2024 1.What is the dx criteria for Generalized Anxiety Disorder?: anxiety on most days (six or more months) and w/ three or more somatic sx (restlessness, fatigue, difficulty concentrating, irritability, muscle tension, disturbed sleep)
2.How is GAD tx?: Lifestyle changes psychotherapy
medication
-SSRIs
-Venlafaxine
-buspirone
-Benzos for immediate sx relief
3.How does OCD present?: Obsessions: persistent, unwanted, and intrusive ideas, thoughts, impulses, or images that lead to marked anxiety or distress and occur despite the patient's attempts to prevent them
Compulsions: repeated mental acts or behaviors that neutralize anxiety from obses- sions (e.g. handwashing, elaborate rituals for ordinary tasks, counting, excessive checking)
Pts recognize these behaviors as excessive and irrational products of their own minds. Wish to get rid of the obsessions and/or compulsions
4.How is OCD tx?: Pharmacotherapy
-SSRIs (first line) CBT
-exposure and desensitization relaxation techniques Pt education
5.How do panic attacks present?: Discrete periods of intense fear or discomfort in which at least 4 of the following sx develop abruptly and peak w/in 10 min:
-tachypnea
-chest pain
-palpitations
-diaphoresis
-nausea
-trembling
-dizziness
-fear of dying or "going crazy" USMLE Step 2 CK-Psychiatry Questions and Answers
2024 -depersonalization
-hot flashes
-perioral and/or acral paresthesias-->hyperventilation and low O2 sats USMLE Step 2 CK-Psychiatry Questions and Answers
2024
one or more months of concern about having additional attacks or significant behavior change as a result of the attacks--avoiding situations that may precipitate attacks
6.What other conditions should be considered when a pt presents w/ panic attack?: Angina
MI
arrhythmias hyperthyroidism Vita B12 deficiency pheochromocytoma
substance-induced anxiety generalized anxiety disorder PTSD
7.How are panic disorders treated?: CBT pharmacotherapy
-SSRIs
-TCAs
Benzos
-for immediate relief, but avoid long-term use
-taper as soon as long term tx is on board
8.What is the difference between OCD and OCPD?: OCD is ego-dystonic: rec- ognize the obsessions/compulsions and want to be rid of them
OCPD is ego-syntonic: do not recognize their behavior as problematic
9.What is a social phobia?: characterized by marked fear provoked by social or performance situations in which embarrassment may occur. It may be specific (e.g. public speaking, urinating in public) or general (e.g. social interaction) and often begins in adolescence
10.What is a specific phobia?: anxiety is provoked by exposure to a feared object or situation (e.g. animals, heights, airplanes). Most cases begin in childhood.
11.How are specific phobias tx?: CBT involving desensitization through incre- mental exposure to the feared object or situation and relaxation techniques. Supportive, family and insight-oriented psychotherapy
12.How are social phobias tx?: CBT SSRIs
Low dose benzos
B-blockers (for performance anxiety)
13.What is PTSD?: reexperiencing of the event (e.g. nightmares), avoidance of stimuli associated w/ the trauma, numbed responsiveness (e.g. detachment, anhe-
