MH 709 FINAL QUESTIONS
WITH ACCURATE ANSWERS
1. A comprehensive treatment plan for a patient experiencing a depressive
disorder would include what possible treatments? correct answer Lifestyle
changes: Good sleep practices, healthy diet, activity
Therapy, meds, TMS, ECT
1. A patient who has been stable for 2 years on lithium shares with you that she
wants to get pregnant. What are your recommendations? correct answer The
options to discuss with the patient include: 1. The possibility of discontinuing the
medication 2. The possibility of continuing to take the medication during
pregnancy. Some providers might consider a medication switch, which could also
be a part of option 1, if a discontinuation of medication wasn't successful, a new
medication could be initiated. A specific anomaly associated with Lithium is
Ebstein's anomaly, which is a defect that causes tricuspid insufficiency. A pregnant
woman taking lithium would need careful monitoring of lithium levels, symptoms
and the overall pregnancy. Lithium crosses the placenta and the fetus receives
100% of the drug. Dosage changes are expected in different trimesters.
1. A patient with a history of multiple suicide attempts would be considered what
level of risk? correct answer Chronic high risk.
1. Aside from Cognitive Behavioral Therapy (CBT), what is one primary non-
pharmacological treatment for Obsessive Compulsive Disorder and how does it
work? correct answer Exposure Response Prevention (ERP). Repeated exposure to
anxiety provoking stimuli without engaging in compulsive rituals gradually
desensitizes person to the anxiety over time.
, 1. Describe 3 key aspects of interacting with a patient in an outpatient setting who
demonstrates manipulative behavior? correct answer a. Establishing specific
parameters about frequency of non-appointment communication
b. Define and enforce professional boundaries
c. Clear and detailed communication in the EHR for covering/call staff
1. Describe the dysregulated HPA axis seen in chronic stress. correct answer
Stress-induced hypercortisolism leads to "burn out" of system with subsequent
chronic hypocortisolism. However, cortico-releasing factor continues to be
released, which stimulates further release of norepinephrine and leads to
anatomical changes and neurotransmitter abnormalities.
1. Describe the symptoms of Persistent Depressive Disorder. What does the term
"double depression" mean? correct answer Persistent Depressive Disorder (PDD)
is a chronic condition with depressed mood for most of the day for more days
than not, for a 2-year period. The term "double depression" refers to people who
have Persistent Depressive Disorder, then develop a Major depression also.
1. Describe the titration schedule of Prazosin. correct answer 1mg for two nights,
then increase by 2mg every 4 days up to 20mg until achieved effect.
1. Describe the two ends of the suicidal ideation continuum. correct answer From
fleeting and vague thoughts, to persistent and highly specific plans.
1. Describe the two ends of the suicidal risk continuum. correct answer From
vague and unrealistic thoughts, to specific and feasible plans.
1. Do signs of suicidal preparation, such as giving away possessions or hoarding
pills, truly increase risk of suicide? correct answer Yes.
WITH ACCURATE ANSWERS
1. A comprehensive treatment plan for a patient experiencing a depressive
disorder would include what possible treatments? correct answer Lifestyle
changes: Good sleep practices, healthy diet, activity
Therapy, meds, TMS, ECT
1. A patient who has been stable for 2 years on lithium shares with you that she
wants to get pregnant. What are your recommendations? correct answer The
options to discuss with the patient include: 1. The possibility of discontinuing the
medication 2. The possibility of continuing to take the medication during
pregnancy. Some providers might consider a medication switch, which could also
be a part of option 1, if a discontinuation of medication wasn't successful, a new
medication could be initiated. A specific anomaly associated with Lithium is
Ebstein's anomaly, which is a defect that causes tricuspid insufficiency. A pregnant
woman taking lithium would need careful monitoring of lithium levels, symptoms
and the overall pregnancy. Lithium crosses the placenta and the fetus receives
100% of the drug. Dosage changes are expected in different trimesters.
1. A patient with a history of multiple suicide attempts would be considered what
level of risk? correct answer Chronic high risk.
1. Aside from Cognitive Behavioral Therapy (CBT), what is one primary non-
pharmacological treatment for Obsessive Compulsive Disorder and how does it
work? correct answer Exposure Response Prevention (ERP). Repeated exposure to
anxiety provoking stimuli without engaging in compulsive rituals gradually
desensitizes person to the anxiety over time.
, 1. Describe 3 key aspects of interacting with a patient in an outpatient setting who
demonstrates manipulative behavior? correct answer a. Establishing specific
parameters about frequency of non-appointment communication
b. Define and enforce professional boundaries
c. Clear and detailed communication in the EHR for covering/call staff
1. Describe the dysregulated HPA axis seen in chronic stress. correct answer
Stress-induced hypercortisolism leads to "burn out" of system with subsequent
chronic hypocortisolism. However, cortico-releasing factor continues to be
released, which stimulates further release of norepinephrine and leads to
anatomical changes and neurotransmitter abnormalities.
1. Describe the symptoms of Persistent Depressive Disorder. What does the term
"double depression" mean? correct answer Persistent Depressive Disorder (PDD)
is a chronic condition with depressed mood for most of the day for more days
than not, for a 2-year period. The term "double depression" refers to people who
have Persistent Depressive Disorder, then develop a Major depression also.
1. Describe the titration schedule of Prazosin. correct answer 1mg for two nights,
then increase by 2mg every 4 days up to 20mg until achieved effect.
1. Describe the two ends of the suicidal ideation continuum. correct answer From
fleeting and vague thoughts, to persistent and highly specific plans.
1. Describe the two ends of the suicidal risk continuum. correct answer From
vague and unrealistic thoughts, to specific and feasible plans.
1. Do signs of suicidal preparation, such as giving away possessions or hoarding
pills, truly increase risk of suicide? correct answer Yes.
