FINAL- Psych

Question 1

Which brain region is involved in decision-making and is hypoactive in depression?

Answer 1

Prefrontal Cortex (PFC)

Question 2

What emotional functions are primarily regulated by the amygdala in depression?

Answer 2

Emotion processing, particularly fear and sadness

Question 3

Which brain area affects memory and concentration and shows reduced size in depression?

Answer 3

Hippocampus

Question 4

What role does the hypothalamus play in depression?

Answer 4

Regulates appetite and sleep; involved in neurovegetative symptoms like anhedonia

Question 5

What depression-related symptom is the basal ganglia linked to?

Answer 5

Psychomotor agitation or retardation

Question 6

What is the role of glial cells in depression?

Answer 6

Support neurons, stabilize glutamate, and produce BDNF

Question 7

What does BDNF do in the brain?

Answer 7

Promotes neuroplasticity and neurogenesis

Question 8

What effect do antidepressants have on BDNF?

Answer 8

Normalize BDNF levels and promote neuroplasticity

Question 9

What hormones are involved in HPA axis overactivation?

Answer 9

CRF (corticotropin releasing hormone) → ACTH → Cortisol

Question 10

What is the impact of excess cortisol on the brain?

Answer 10

Causes hippocampal atrophy and persistent HPA activation

Question 11

What labs are commonly ordered to rule out medical causes of depression?

Answer 11

TSH, B12, CBC (for anemia), urinalysis

Question 12

What are the core DSM-5 criteria for Major Depressive Disorder (MDD)?

Answer 12

At least 1 major depressive episode, no history of mania/hypomania, ≥5 symptoms including depressed mood or anhedonia for ≥2 weeks

Question 13

What mnemonic helps remember MDD criteria?

Answer 13

SIGECAPS(S): Sad mood, Interest loss, Guilt, Energy, Concentration, Appetite, Psychomotor, Sleep, Suicide

Question 14

What is considered full remission in MDD?

Answer 14

No symptoms for at least 2 months

Question 15

Which nutritional supplements have evidence for improving depression?

Answer 15

Folate (vitamin B9) and omega-3 fatty acids (650–1200 mg EPA + DHA daily)

Question 16

What should be done if there’s only 20% improvement in 4–6 weeks?

Answer 16

Consider maximizing the dose before switching medications

Question 17

How long should antidepressants be continued after symptom remission?

Answer 17

At least 6–12 months

Question 18

Why is bupropion contraindicated in eating disorders?

Answer 18

Increased seizure risk

Question 19

Which atypical antipsychotics are FDA-approved as adjuncts for treatment-resistant depression?

Answer 19

Aripiprazole and quetiapine

Question 20

What is Deplin (L-methylfolate) used for in depression?

Answer 20

Augmentation, especially in patients with folate deficiency

Question 21

Which agent is preferred for an overweight, hypersomnolent patient?

Answer 21

Bupropion (activating, weight-neutral)

Question 22

Which SSRI is best avoided in pregnancy?

Answer 22

Paroxetine (Paxil)

Question 23

What is the minimum duration of symptoms required for a diagnosis of Generalized Anxiety Disorder (GAD)?

Answer 23

≥6 months

Question 24

What are first-line treatments for GAD?

Answer 24

SSRIs such as escitalopram, paroxetine, sertraline

Question 25

Which medications are used to treat panic disorder?

Answer 25

SSRIs (fluoxetine, paroxetine), short-term benzodiazepines

Question 26

Which pharmacologic agents are used for severe social anxiety disorder?

Answer 26

SSRIs or SNRIs

Question 27

What is the difference between obsessions and compulsions in OCD?

Answer 27

Obsessions are intrusive thoughts; compulsions are repetitive behaviors to reduce anxiety

Question 28

What is the minimum time OCD symptoms must be present for diagnosis?

Answer 28

≥1 hour/day

Question 29

What is the first-line treatment for OCD?

Answer 29

CBT with exposure-response prevention and SSRIs

Question 30

What are the core features of PTSD?

Answer 30

Exposure to trauma, flashbacks, nightmares, avoidance, negative mood, hyperarousal

Question 31

What is the duration required for PTSD diagnosis?

Answer 31

Symptoms lasting >1 month post-trauma

Question 32

What medication helps with PTSD-related nightmares?

Answer 32

Prazosin

Question 33

What are symptoms of Adjustment Disorder?

Answer 33

Anxiety, depression, disturbance of conduct

Question 34

What is the preferred treatment for Adjustment Disorder?

Answer 34

Psychotherapy

Question 35

What does the PCL-5 measure?

Answer 35

PTSD symptoms

Question 36

What is the Yale-Brown scale used for?

Answer 36

OCD severity

Question 37

What characterizes Bipolar I Disorder?

Answer 37

At least one manic episode (elevated/irritable mood ≥1 week) ± depressive episodes

Question 38

What defines Bipolar II Disorder?

Answer 38

At least one hypomanic episode (≥4 days, not severe) + one major depressive episode

Question 39

What is Cyclothymic Disorder?

Answer 39

Numerous hypomanic and depressive symptoms ≥2 years, not meeting full criteria for either

Question 40

What neurobiological factors are associated with violence?

Answer 40

Low serotonin, frontal lobe trauma, impulsivity

Question 41

How is opioid use disorder treated?

Answer 41

Methadone, buprenorphine, naltrexone

Question 42

How does aging affect deep sleep?

Answer 42

Stage 4 deep sleep decreases with age and may be absent by age 75

Question 43

What are hallmark signs of narcolepsy?

Answer 43

Daytime sleep attacks, cataplexy, low CSF hypocretin-1, sleep-onset REM

Question 44

What comorbidities are associated with narcolepsy?

Answer 44

Obesity, mood disorders, anxiety, schizophrenia

Question 45

What is the key diagnostic test for sleep apnea and other sleep disorders?

Answer 45

Polysomnography (PSG)

Question 46

Name 5 types of circadian rhythm disorders.

Answer 46

Delayed, Advanced, Irregular, Non-24-Hour, Shift Work

Question 47

What are examples of Non-REM Arousal Parasomnias?

Answer 47

Sleepwalking and sleep terrors

Question 48

What is REM Sleep Behavior Disorder (RBD)?

Answer 48

Vocalizations or complex motor behaviors during REM sleep

Question 49

What is the first-line treatment for insomnia?

Answer 49

Cognitive Behavioral Therapy (CBT)

Question 50

Which hypnotic is FDA-approved for long-term use?

Answer 50

Eszopiclone (Lunesta)

Question 51

Which sedating antidepressants are used for sleep?

Answer 51

Trazodone, mirtazapine, doxepin

Question 52

What are the risks of trazodone?

Answer 52

Priapism and QTc prolongation

Question 53

What sleep disorders use stimulants as treatment?

Answer 53

Narcolepsy and hypersomnia

Question 54

What are examples of wake-promoting agents?

Answer 54

Modafinil (Provigil), Armodafinil (Nuvigil)

Question 55

What is sodium oxybate (Xyrem) used for?

Answer 55

Cataplexy and excessive daytime sleepiness in narcolepsy

Question 56

What pharmacologic options may be used adjunctively for OSA?

Answer 56

Modafinil or armodafinil

Question 57

What is the first-line treatment for Restless Legs Syndrome (RLS)?

Answer 57

Dopamine agonists like pramipexole and ropinirole

Question 58

How are non-REM parasomnias treated?

Answer 58

Safety, psychotherapy, benzodiazepines, antidepressants

Question 59

What medications are used for REM Sleep Behavior Disorder?

Answer 59

Clonazepam and safety measures

Question 60

What treats nightmare disorder?

Answer 60

Prazosin, clonidine, CBT, EMDR