PSYCHIATRY PA EOR 2026-2027 ACTUAL LATEST
EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+
MDD Criteria - ANSWERS-Must have at least five of the following symptoms (must include either
number I or number 2) for at least a 2-week period:
1. Depressed mood
2. Anhedonia (loss of interest in pleasurable activities)
3. Change in appetite or body weight (f or J,)
4. Feelings of worthlessness or excessive guilt
5. Insomnia or hypersomnia
6. Diminished concentration
7. Psychomotor agitation or retardation (ie, restlessness or slowness)
8. Fatigue or loss of energy
9. Recurrent thoughts of death or suicide
Manic episode criteria - ANSWERS-A period of abnormally and persistently elevated, expansive,
or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary) and
including at least three of the following (four if mood is irritable):
I. Distractibility
2. Inflated self-esteem or grandiosity
3. tin goal-directed activity (socially, at work, or sexually)
,4. J, need for sleep
5. Flight of ideas or racing thoughts
6. More talkative or pressured speech (rapid and uninterruptible)
7. Excessive involvement in pleasurable activities that have a high risk of negative consequences
(eg, shopping sprees, sexual indiscretions)
These symptoms cannot be due to substance use or medical conditions, and they must cause
social or occupational impairment. Seventy-five percent of manic patients have psychotic
symptoms.
Mania vs hypomania - ANSWERS-Mania: Lasts at least 7 days, Causes severe impairment in
social or occupational functioning, May necessitate hospitalization to prevent harm to self or
others, May have psychotic feature
Hypomania: Lasts at least 4 days, No marked impairment in social or occupational functioning,
Does not require hospitalization, No psychotic features
Bipolar 1 disorder criteria - ANSWERS-The only requirement for this diagnosis is the occurrence
of one manic or mixed episode - depression, dysthymia, and hypomania can happen between
episodes, but are not required for diagnosis
Bipolar 1 and 2 treatment - ANSWERS-Lithium
Anticonvulsants (carbamazepine or valproic acid) are also mood stabilizers. They are especially
useful for rapid cycling bipolar disorder and mixed episodes, although associated with T risk of
suicide.
Atypical antipsychotics (olanzapine, quetiapine, ziprasidone) are effective as both monotherapy
and adjunct therapy
Psychotherapy: Supportive psychotherapy, family therapy, group therapy (prolongs remission
once the acute manic episode has been controlled). • ECT: Works well in treatment of manic
episodes
,Lithium Side Effects - ANSWERS-Weight gain • Tremor • Gastrointestinal disturbances • Fatigue
• Cardiac arrhythmias • Seizures • Goiter/hypothyroidism • Leukocytosis (benign) • Como •
Polyuria (nephrogenic diabetes insipidus) • Polydipsia • Alopecia • Metallic taste
Bipolar 2 Criteria - ANSWERS-History of one or more major depressive episodes and at least one
hypomanic episode. Remember: If there has been a full manic episode even in the past, then
the diagnosis is not bipolar II disorder, but bipolar I.
Cyclothymic disorder - ANSWERS-Alternating periods of hypomania and periods with mild to
moderate depressive symptoms.
Chronic disorder - 1/3 of patients are eventually diagnosed with bipolar disorder
Cyclothymic disorder criteria - ANSWERS-• Numerous periods with hypomanic symptoms and
periods with depressive symptoms for at least 2 years.
• The person must never have been symptom free for > 2 months during those 2 years.
• No history of major depressive episode or manic episode.
Cyclothymic disorder treatment - ANSWERS-Same as bipolar disorder
Persistent depressive disorder (dysthymia) - ANSWERS-Chronic mild depression
Dysthymic disorder (DD) =
2 D's
2 years of depression
2 listed criteria
Never asymptomatic for > 2 months
Dysthymia Criteria - ANSWERS-l. Depressed mood for the majority of time most days for at least
2 years (in children or adolescents for at least I year)
, 2. At least two of the following: • Poor concentration or difficulty making decisions • Feelings of
hopelessness • Poor appetite or overeating • Insomnia or hypersomnia • Low energy or fatigue
• Low self-esteem
3. During the 2-year period: • The person has not been without the above symptoms for > 2
months at a time. • No major depressive episode. • The patient must never have had a manic or
hypomanic episode (this would make the diagnosis bipolar disorder or cyclothymic disorder,
respectively)
Cannot have psychotic features
Dysthymia treatment - ANSWERS-Cognitive therapy and insight-oriented psychotherapy are
most effective.
Antidepressant medications (SSRis, TCAs, or MAOis) are useful when used concurrently with
psychotherapy
Exhibitionistic disorder - ANSWERS-Exposure of one's genitalia to an unsuspecting individual,
with the additional requirement that the person has acted on these sexual urges with a
nonconsenting person or the sexual urges or fantasies have resulted in clinically significant
distress or functional impairment
Exhibitionistic disorder criteria - ANSWERS-A. Over a period of at least 6 months, recurrent and
intense sexual arousal from the exposure of one's genitals to an unsuspecting person, as
manifested by fantasies, urges, or behaviors.
B. The individual has acted on these sexual urges with a nonconsenting person, or the sexual
urges or fantasies cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning.
Exhibitionistic disorder treatment - ANSWERS-Psychotherapy, support groups, and SSRIs - First
line
Sometimes antiandrogen drugs - in order to lower testosterone and lower sexual desire
EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+
MDD Criteria - ANSWERS-Must have at least five of the following symptoms (must include either
number I or number 2) for at least a 2-week period:
1. Depressed mood
2. Anhedonia (loss of interest in pleasurable activities)
3. Change in appetite or body weight (f or J,)
4. Feelings of worthlessness or excessive guilt
5. Insomnia or hypersomnia
6. Diminished concentration
7. Psychomotor agitation or retardation (ie, restlessness or slowness)
8. Fatigue or loss of energy
9. Recurrent thoughts of death or suicide
Manic episode criteria - ANSWERS-A period of abnormally and persistently elevated, expansive,
or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary) and
including at least three of the following (four if mood is irritable):
I. Distractibility
2. Inflated self-esteem or grandiosity
3. tin goal-directed activity (socially, at work, or sexually)
,4. J, need for sleep
5. Flight of ideas or racing thoughts
6. More talkative or pressured speech (rapid and uninterruptible)
7. Excessive involvement in pleasurable activities that have a high risk of negative consequences
(eg, shopping sprees, sexual indiscretions)
These symptoms cannot be due to substance use or medical conditions, and they must cause
social or occupational impairment. Seventy-five percent of manic patients have psychotic
symptoms.
Mania vs hypomania - ANSWERS-Mania: Lasts at least 7 days, Causes severe impairment in
social or occupational functioning, May necessitate hospitalization to prevent harm to self or
others, May have psychotic feature
Hypomania: Lasts at least 4 days, No marked impairment in social or occupational functioning,
Does not require hospitalization, No psychotic features
Bipolar 1 disorder criteria - ANSWERS-The only requirement for this diagnosis is the occurrence
of one manic or mixed episode - depression, dysthymia, and hypomania can happen between
episodes, but are not required for diagnosis
Bipolar 1 and 2 treatment - ANSWERS-Lithium
Anticonvulsants (carbamazepine or valproic acid) are also mood stabilizers. They are especially
useful for rapid cycling bipolar disorder and mixed episodes, although associated with T risk of
suicide.
Atypical antipsychotics (olanzapine, quetiapine, ziprasidone) are effective as both monotherapy
and adjunct therapy
Psychotherapy: Supportive psychotherapy, family therapy, group therapy (prolongs remission
once the acute manic episode has been controlled). • ECT: Works well in treatment of manic
episodes
,Lithium Side Effects - ANSWERS-Weight gain • Tremor • Gastrointestinal disturbances • Fatigue
• Cardiac arrhythmias • Seizures • Goiter/hypothyroidism • Leukocytosis (benign) • Como •
Polyuria (nephrogenic diabetes insipidus) • Polydipsia • Alopecia • Metallic taste
Bipolar 2 Criteria - ANSWERS-History of one or more major depressive episodes and at least one
hypomanic episode. Remember: If there has been a full manic episode even in the past, then
the diagnosis is not bipolar II disorder, but bipolar I.
Cyclothymic disorder - ANSWERS-Alternating periods of hypomania and periods with mild to
moderate depressive symptoms.
Chronic disorder - 1/3 of patients are eventually diagnosed with bipolar disorder
Cyclothymic disorder criteria - ANSWERS-• Numerous periods with hypomanic symptoms and
periods with depressive symptoms for at least 2 years.
• The person must never have been symptom free for > 2 months during those 2 years.
• No history of major depressive episode or manic episode.
Cyclothymic disorder treatment - ANSWERS-Same as bipolar disorder
Persistent depressive disorder (dysthymia) - ANSWERS-Chronic mild depression
Dysthymic disorder (DD) =
2 D's
2 years of depression
2 listed criteria
Never asymptomatic for > 2 months
Dysthymia Criteria - ANSWERS-l. Depressed mood for the majority of time most days for at least
2 years (in children or adolescents for at least I year)
, 2. At least two of the following: • Poor concentration or difficulty making decisions • Feelings of
hopelessness • Poor appetite or overeating • Insomnia or hypersomnia • Low energy or fatigue
• Low self-esteem
3. During the 2-year period: • The person has not been without the above symptoms for > 2
months at a time. • No major depressive episode. • The patient must never have had a manic or
hypomanic episode (this would make the diagnosis bipolar disorder or cyclothymic disorder,
respectively)
Cannot have psychotic features
Dysthymia treatment - ANSWERS-Cognitive therapy and insight-oriented psychotherapy are
most effective.
Antidepressant medications (SSRis, TCAs, or MAOis) are useful when used concurrently with
psychotherapy
Exhibitionistic disorder - ANSWERS-Exposure of one's genitalia to an unsuspecting individual,
with the additional requirement that the person has acted on these sexual urges with a
nonconsenting person or the sexual urges or fantasies have resulted in clinically significant
distress or functional impairment
Exhibitionistic disorder criteria - ANSWERS-A. Over a period of at least 6 months, recurrent and
intense sexual arousal from the exposure of one's genitals to an unsuspecting person, as
manifested by fantasies, urges, or behaviors.
B. The individual has acted on these sexual urges with a nonconsenting person, or the sexual
urges or fantasies cause clinically significant distress or impairment in social, occupational, or
other important areas of functioning.
Exhibitionistic disorder treatment - ANSWERS-Psychotherapy, support groups, and SSRIs - First
line
Sometimes antiandrogen drugs - in order to lower testosterone and lower sexual desire
