Mental Health 10 Single Best Answer (SBA)
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1. A 30-year-old woman reports severe mood swings, irritability, and fatigue in the week before her period. Symptoms resolve completely after menstruation begins. What is the most appropriate first-line treatment?
Answer: Selective serotonin reuptake inhibitor (SSRI)
SSRIs address the severe mood and irritability symptoms in PMDD effectively, often with intermittent or continuous dosing strategies.
2. A 45-year-old man presents with a 6-month history of low mood, fatigue, and anhedonia. He denies suicidal ideation. What is the most likely diagnosis?
Answer: Major depressive disorder (MDD)
MDD requires at least two weeks of depressive symptoms; here he has 6 months of consistent low mood and anhedonia, meeting criteria.
3. What is the primary pathophysiological abnormality in anorexia nervosa?
Answer: Reduced caloric intake leading to metabolic and hormonal dysregulation
In anorexia nervosa, persistent undernutrition and weight loss lead to wide-ranging metabolic and endocrine disturbances.
4. A 22-year-old woman with bulimia nervosa has repeated episodes of vomiting. Blood tests show potassium 2.9 mmol/L. What is the most appropriate next step?
Answer: Prescribe potassium supplementation
In bulimia with hypokalaemia, urgent correction of potassium is vital to prevent arrhythmias. Psychological and pharmacological treatments follow.
5. What is the most common long-term complication of untreated binge eating disorder?
Answer: Obesity and related comorbidities
BED commonly leads to significant weight gain, increasing risk of type 2 diabetes, hypertension, and cardiovascular disease.
6. Which personality disorder is most strongly associated with self-harming behaviours?
Answer: Borderline personality disorder (BPD)
Recurrent self-harm or suicidal behaviour is a hallmark of borderline personality disorder.
7. A 35-year-old woman with bipolar disorder presents with severe agitation, pressured speech, and decreased need for sleep. What is the most appropriate initial management?
Answer: Administer intramuscular lorazepam
Lorazepam quickly reduces severe manic agitation. Mood stabilisers follow once the patient is calmer. Admission is often required, but sedation is first priority.
8. A 40-year-old man with GAD reports constant worry and insomnia. He declines medication. What is the most appropriate next step?
Answer: Offer cognitive behavioural therapy (CBT)
In GAD, CBT is a mainstay if patients refuse pharmacological options. It helps modify thought patterns and reduce worry.
9. Which of the following is a common side effect of SSRIs?
Answer: Sexual dysfunction
SSRIs commonly cause sexual side effects (decreased libido, difficulty achieving orgasm).
10. A 25-year-old woman with OCD refuses therapy and insists her rituals are necessary. She demonstrates capacity and is not at immediate risk. What is the most appropriate next step?
Answer: Respect her decision and provide psychoeducation
If a competent patient refuses treatment and poses no significant risk, respect her autonomy. Offer information and support.
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