ABFM KSA Behavioral Health Exam |
Questions and Correct Answers Rated
A+ | 100% Correct | 2026 Latest Guide
A 27-year-old female presents to your office because of frequent fatigue,
especially early in the work week, in addition to frequent gastrointestinal
distress and occasional chest pain and shortness of breath. She seems
jittery and asks for some medicine to help her with her nerves. This is the
third time you have seen her in the last 6 months with similar vague reports
of pain, and she was also recently seen in the emergency department for a
twisted ankle after falling down the stairs. You note a small laceration over
her left eye, which she attributes to walking into a door at night. She
noticeably avoids eye contact when she answers your questions. Physical
and laboratory findings were all normal at the two previous visits. Which
one of the following would be LEAST appropriate at this point?
The GAD-7
The PHQ-15
The Hurt, Insult, Threaten, and Scream (HITS) screen
calling law enforcement
prescribing SSRI
-Correct Answer-HITS screening
Given the history and nature of the symptoms and the lack of other medical
findings, further assessment for intimate partner violence (IPV) is indicated
,in this case, especially since there is evidence suggesting harm. IPV is
underreported, but it is estimated that as many as 30% of women may
have experienced IPV in their lifetime. Alcohol consumption, psychiatric
illness, a history of violent childhood relationships, and academic and
financial underachievement increase the risk of IPV. Several screening
tools for IPV are available, including the Hurt, Insult, Threaten, and Scream
(HITS) screen and the three-question Partner Violence Screen. While
screening has been shown to increase identification of at-risk women, it
has not been shown to decrease IPV. Nonetheless, given the prevalence of
IPV, the U.S. Preventive Services Task Force recommends screening all
women of child-bearing age (B recommendation). Family physicians should
know and inform patients of their state's rules for mandatory reporting of
IPV.The patient in this case has also described multiple vague symptoms.
Somatic symptoms and anxiety for at least 6 months could suggest
generalized anxiety disorder, and administering a screening tool such as
the GAD-7 or the Zung Anxiety Scale would be reasonable. The PHQ-15
can be used to further screen for somatic symptom disorder (somatization
disorder). In a 2009 study of patients 18-70 years old with unexplained
somatic complaints, frequent visits, or mental health problems, the PHQ-15
was 78% sensitive and 71% specific for detecting somatoform disorder in
patients with three or more somatic symptoms in the previous 4
weeks.Referral to a mental health professional for an anxiety disorder or
somatization disorder would be reasonable after a positive screen,
although famil
,A 75-year-old male sees you for routine follow-up of hypertension. He is
accompanied by his wife, who expresses concern that he sleeps
excessively, has lost interest in his hobbies, has a decreased appetite, and
complains often of various aches and pains. She also says that he has
recently started to have difficulties with short-term memory. He is adherent
to his medication regimen of lisinopril (Prinivil, Zestril) and
hydrochlorothiazide. On examination his blood pressure is 142/84 mm Hg.
Which one of the following would be LEAST clinically useful for evaluating
the patient's symptoms at this time?
A vitamin B12 level
Thyroid function testing
CT of the brain
The Cornell Scale for Depression in Dementia
-Correct Answer-CT of his brain
Depression is common in older adults. Data from the National Institute of
Mental Health in 2017 revealed that nearly 5% of individuals over age 50
had an episode of major depression in the previous 12 months. Several
different instruments have been studied for depression screening in adults,
including the PHQ-2, the Geriatric Depression Scale (GDS), and the
Cornell Scale for Depression in Dementia (CSDD). The GDS does not
assess for somatic issues, making it useful for screening older adults with
physical symptoms. The CSDD is preferred when the possibility of
dementia is a concern, as it retains its validity better than the GDS or PHQ-
2 in patients with dementia.Dementia and depression frequently occur
, together, and the differential diagnosis in an older patient may be difficult. In
individuals over the age of 65 cognitive impairment can cause depression.
Likewise, cognitive impairment due to an underlying dementia may cause
depressive symptoms, and determining the underlying cause is critical to
administering appropriate treatment. Patients with dementia often
underplay their cognitive impairment, whereas the cognitive problems
reported by elderly patients with depression are often out of proportion to
the findings on objective examination and testing. A key component of the
assessment is determining the temporal relationship between depression
and cognitive symptoms. The workup should also include assessment for
underlying causes of depression or memory impairment, such as thyroid
disorders, anemia, vitamin B12 deficiency, vascular disease, alcohol use,
and renal impairment. Additional information can be gained from family
members, and the psychosocial assessment should cover risk factors such
as the recent death of a loved one, lack of social support, and physical
disability.CT of the brain could s
A 28-year-old male asks if there is something he can take to decrease his
nervousness before he has to make a presentation at his workplace next
week. He has never given a public presentation and is worried about
sweating, blushing, and appearing incompetent. He has consistently
received good job performance reviews, although he prefers to work alone
or in small groups. He has declined opportunities to lead his division
despite encouragement from his supervisors. Additional questioning
reveals that he has avoided large groups and parties ever since high
school because he is concerned that he might say something
Questions and Correct Answers Rated
A+ | 100% Correct | 2026 Latest Guide
A 27-year-old female presents to your office because of frequent fatigue,
especially early in the work week, in addition to frequent gastrointestinal
distress and occasional chest pain and shortness of breath. She seems
jittery and asks for some medicine to help her with her nerves. This is the
third time you have seen her in the last 6 months with similar vague reports
of pain, and she was also recently seen in the emergency department for a
twisted ankle after falling down the stairs. You note a small laceration over
her left eye, which she attributes to walking into a door at night. She
noticeably avoids eye contact when she answers your questions. Physical
and laboratory findings were all normal at the two previous visits. Which
one of the following would be LEAST appropriate at this point?
The GAD-7
The PHQ-15
The Hurt, Insult, Threaten, and Scream (HITS) screen
calling law enforcement
prescribing SSRI
-Correct Answer-HITS screening
Given the history and nature of the symptoms and the lack of other medical
findings, further assessment for intimate partner violence (IPV) is indicated
,in this case, especially since there is evidence suggesting harm. IPV is
underreported, but it is estimated that as many as 30% of women may
have experienced IPV in their lifetime. Alcohol consumption, psychiatric
illness, a history of violent childhood relationships, and academic and
financial underachievement increase the risk of IPV. Several screening
tools for IPV are available, including the Hurt, Insult, Threaten, and Scream
(HITS) screen and the three-question Partner Violence Screen. While
screening has been shown to increase identification of at-risk women, it
has not been shown to decrease IPV. Nonetheless, given the prevalence of
IPV, the U.S. Preventive Services Task Force recommends screening all
women of child-bearing age (B recommendation). Family physicians should
know and inform patients of their state's rules for mandatory reporting of
IPV.The patient in this case has also described multiple vague symptoms.
Somatic symptoms and anxiety for at least 6 months could suggest
generalized anxiety disorder, and administering a screening tool such as
the GAD-7 or the Zung Anxiety Scale would be reasonable. The PHQ-15
can be used to further screen for somatic symptom disorder (somatization
disorder). In a 2009 study of patients 18-70 years old with unexplained
somatic complaints, frequent visits, or mental health problems, the PHQ-15
was 78% sensitive and 71% specific for detecting somatoform disorder in
patients with three or more somatic symptoms in the previous 4
weeks.Referral to a mental health professional for an anxiety disorder or
somatization disorder would be reasonable after a positive screen,
although famil
,A 75-year-old male sees you for routine follow-up of hypertension. He is
accompanied by his wife, who expresses concern that he sleeps
excessively, has lost interest in his hobbies, has a decreased appetite, and
complains often of various aches and pains. She also says that he has
recently started to have difficulties with short-term memory. He is adherent
to his medication regimen of lisinopril (Prinivil, Zestril) and
hydrochlorothiazide. On examination his blood pressure is 142/84 mm Hg.
Which one of the following would be LEAST clinically useful for evaluating
the patient's symptoms at this time?
A vitamin B12 level
Thyroid function testing
CT of the brain
The Cornell Scale for Depression in Dementia
-Correct Answer-CT of his brain
Depression is common in older adults. Data from the National Institute of
Mental Health in 2017 revealed that nearly 5% of individuals over age 50
had an episode of major depression in the previous 12 months. Several
different instruments have been studied for depression screening in adults,
including the PHQ-2, the Geriatric Depression Scale (GDS), and the
Cornell Scale for Depression in Dementia (CSDD). The GDS does not
assess for somatic issues, making it useful for screening older adults with
physical symptoms. The CSDD is preferred when the possibility of
dementia is a concern, as it retains its validity better than the GDS or PHQ-
2 in patients with dementia.Dementia and depression frequently occur
, together, and the differential diagnosis in an older patient may be difficult. In
individuals over the age of 65 cognitive impairment can cause depression.
Likewise, cognitive impairment due to an underlying dementia may cause
depressive symptoms, and determining the underlying cause is critical to
administering appropriate treatment. Patients with dementia often
underplay their cognitive impairment, whereas the cognitive problems
reported by elderly patients with depression are often out of proportion to
the findings on objective examination and testing. A key component of the
assessment is determining the temporal relationship between depression
and cognitive symptoms. The workup should also include assessment for
underlying causes of depression or memory impairment, such as thyroid
disorders, anemia, vitamin B12 deficiency, vascular disease, alcohol use,
and renal impairment. Additional information can be gained from family
members, and the psychosocial assessment should cover risk factors such
as the recent death of a loved one, lack of social support, and physical
disability.CT of the brain could s
A 28-year-old male asks if there is something he can take to decrease his
nervousness before he has to make a presentation at his workplace next
week. He has never given a public presentation and is worried about
sweating, blushing, and appearing incompetent. He has consistently
received good job performance reviews, although he prefers to work alone
or in small groups. He has declined opportunities to lead his division
despite encouragement from his supervisors. Additional questioning
reveals that he has avoided large groups and parties ever since high
school because he is concerned that he might say something
