1. A 40-year-old widowed man describes feeling sad most of the day, decreased appetite, insomnia, fatigue, worthlessness. This matches the diagnosis of:
2. Depression is more common in which gender:
A. Males
B. Females
C. Equal between males and females
3. Depressed mood that occurs in a seasonal pattern would be most characteristic of:
A. Dysthymia
B. Bipolar disorder
C. Seasonal affective disorder
D. Premenstrual dysphoric disorder
4. Co-administration of bupropion is helpful for which side effect associated with SSRI use?
A. Sedation
B. Nausea
C. Sexual dysfunction
D. Weight gain
5. A 58-year-old male with 4 days of depressed mood, poor appetite, insomnia following the death of his wife. This meets criteria for:
A. Persistent depressive disorder
B. Major depressive disorder
C. Bipolar II disorder
D. Adjustment disorder with depressive features
6. Electroconvulsive therapy is indicated as a treatment option when depression has failed to respond adequately to:
A. One antidepressant
B. Two antidepressants
C. Psychotherapy alone
D. Lithium or antipsychotics as augmenting agents
7. All are first-line treatments for MDD EXCEPT:
A. SSRIs
B. TCAs
C. Monoamine oxidase inhibitors
D. Psychotherapy
8. Compared to other anti-depressants, venlafaxine has advantages in the treatment of:
A. OCD
B. Panic disorder
C. Social anxiety disorder
D. Generalized anxiety disorder
9. Monoamine oxidase inhibitors have which dangerous food/medication interaction risk:
10. A 24-year-old college student describes depressed mood over the past 2 years with distinct periods of elevated mood and decreased need for sleep. During her elevated phase, her thoughts are racing and she engages in risky behaviors. She meets criteria for:
11. A patient’s first manic episode occurred at age 30 after starting an antidepressant. She had no prior personal or family history of mania. This represents an instance of:
12. According to the cognitive model of depression, which type of thinking is considered a cognitive distortion:
A. Overgeneralization
B. Magnification
C. Categorical thinking
D. Mind reading
13. According to DSM-5 criteria, how many symptoms must be present daily for at least 2 weeks for a diagnosis of MDD:
A. 2
B. 4
C. 5
D. 7
14. MAOI augmentation therapy has been shown effective in treatment resistant depression when used with which medication:
A. Desipramine
B. Buspirone
C. Pindolol
D. Modafinil
15. Compared to venlafaxine, duloxetine has equivalent efficacy but increased risk of which side effect:
A. Weight loss
B. Somnolence
C. Nausea
D. Sexual dysfunction
16. SSRIs should be avoided in patients with current or recent diagnosis of:
A. PTSD
B. Bipolar disorder
C. Social anxiety disorder
D. Dysthymia
17. Which medication is considered first-line for treatment of MDD in pregnant patients:
A. Fluoxetine
B. Duloxetine
C. Bupropion
D. Sertraline
18. Psychomotor agitation, flight of ideas and grandiosity distinguish mania from:
A. Hypomania
B. Mixed episode
C. Depression
D. Bipolar depression
19. MAOI augmentation has been studied using irreversible nonselective MAOIs such as:
A. Selegiline
B. Tranylcypromine
C. Moclobemide
D. Isocarboxazid
20. Lithium augmentation has shown benefit when added to which class of antidepressants for treatment-resistant depression:
A. SSRIs
B. TCAs
C. SNRIs
D. MAOIs
21. A 32 year old female with depressed mood, excessive guilt, psychomotor slowing who denies distinct periods of mania. She likely has:
A. Bipolar II disorder
B. Dysthymic disorder
C. Major depressive disorder
D. Persistent depressive disorder
22. According to behavioral theories, depression results from a lack of:
A. Serotonin
B. Operant reward contingencies
C. Adequate REM sleep
D. Social support
23. MAOI augmentation has been demonstrated as efficacious for depression refractory to:
A. One antidepressant
B. Two antidepressants
C. ECT
D. TMS
24. This antidepressant acts primarily by enhancing serotonergic and adrenergic neurotransmission:
A. Paroxetine
B. Mirtazapine
C. Bupropion
D. Trazodone
25. Which of the following is used for augmentation but carries risk of QTc prolongation:
A. Lithium
B. Thyroid hormone
C. Pindolol
D. Buspirone
26. After 4 weeks at maximum doses, a patient on fluoxetine experiences recurring depressed mood and psychomotor agitation. The next appropriate step is to:
A. Switch to another SSRI
B. Augment with buspirone
C. Augment with lithium
D. Refer for ECT
27. Patients with melancholic features often respond best to:
A. SSRIs
B. Mirtazapine
C. Bupropion
D. TCAs
28. MAOI augmentation is considered when there has been an inadequate response to:
A. One failed AD trial
B. Two failed AD trials
C. ECT
D. TMS
29. Behavioral activation aims to address depression by increasing:
A. Activity level and pleasurable activities
B. Positive reinforcement of behaviors
C. Serotonergic neurotransmission
D. Relaxation and mindfulness skills
30. Drug interactions are a major limitation of which class of antidepressants:
A. SSRIs
B. TCAs
C. Mirtazapine
D. Bupropion
31. According to cognitive theory, which thinking pattern increases vulnerability to depression:
A. Overgeneralization
B. Personalization
C. Categorical thinking
D. Selective abstraction
32. Phototherapy works by acting on which biological system:
A. Serotonergic
B. Hypothalamic-pituitary-adrenal axis
C. Circadian rhythms
D. Melatonergic system
33. A 65 year old male presents with 4 week history of depressed mood, diminished interest, insomnia, fatigue. He denies distinct periods of elevated mood. He likely has:
A. Major depressive disorder
B. Persistent depressive disorder
C. Depressive disorder due to another medical condition
D. Adjustment disorder with depressive features
34. St John’s wort has been shown to be equally effective as which antidepressants for treatment of major depression:
A. SSRIs
B. SNRIs
C. TCAs
D. MAOIs
35. Lithium augmentation is recommended when there is inadequate response to:
A. One failed AD trial
B. Two failed AD trials
C. ECT
D. TMS
36. Psychological therapies with evidence for treatment of depression include:
A. CBT
B. IPT
C. Behavioral activation
D. All of the above
37. Neurovegetative symptoms of depression include:
A. Insomnia, psychomotor retardation, fatigue
B. Feeling keyed up, distractibility, pressured speech
C. Expansive mood, flight of ideas, excessive involvement in pleasurable activities
D. Irritability, low self-esteem, feelings of guilt
38. MAOI augmentation has advantage over other strategies in treatment resistant depression due to:
A. Rapid onset
B. Limited side effect burden
C. Lower cost
D. Superior efficacy
39. Which antidepressant has lowest risk of drug interactions:
A. Fluoxetine
B. Nortriptyline
C. Trazodone
D. Mirtazapine
40. According to Beck’s cognitive model of depression, which type of thinking contributes to and maintains depressive symptoms:
A. Overgeneralization
B. Magnification
C. Categorical thinking
D. Self-blame
41. Compared to unipolar depression, mixed features are more common in:
A. Delusional depression
B. Atypical depression
C. Psychotic depression
D. Bipolar depression
42. Duloxetine has shown superior efficacy over SSRIs in treating:
A. Social anxiety disorder
B. Generalized anxiety disorder
C. Fibromyalgia
D. Panic disorder
43. Lurasidone is an atypical antipsychotic with evidence for efficacy as an augmenting agent in treatment resistant depression. It works primarily by antagonism of:
A. Serotonin and norepinephrine
B. Dopamine and serotonin
C. Histamine and muscarinic cholinergic receptors
D. Alpha-1 adrenergic and histamine H1 receptors