NMS Q&A Family Medicine

Depression 291(A) It lasts on average as long as major depressiveepisodes not occurring in association withchildbirth.(B) It affects about 3% of new mothers.(C) It takes longer for a spontaneous remission tooccur than in major depressive episodes notassociated with childbirth.(D) The depression is more severe and suicideattempts are more common in postpartumdepression.(E) It is sometimes considered an adjustment disorderwith depressed mood.13 A 45-year-old male patient unknown to you has beenbrought in by his sister’s family, whom he has beenvisiting from out of town. He was observed to havewhat was described as a grand mal seizure. In inquiringabout his medications, you find he has beentreated with a medication for depression, the identityof which the patient cannot recall. He has history ofneither head trauma nor seizure disorder in the past.Which of the following is the most likely drug he mayhave been taking?(A) Fluoxetine (Prozac)(B) Amitriptyline (Elavil)(C) Trazodone (Desyrel)(D) Bupropion (Wellbutrin)(E) Phenelzine (Nardil)14 You are selecting an antidepressant for a 35-year-oldman. Which of the following antidepressants carriesthe highest incidence of the side effect of priapism?(A) Trazodone(B) Nefazodone(C) Escitalopram(D) Sertraline(E) Fluoxetine15 You are concerned about the potential for suicide inan 18-year-old patient you are treating for depression.Which of the following increases this patient’srisk for suicide?(A) The patient is felt to have dysrhythmic disorder.(B) The patient has a moderate bout of depressionthat improves after the patient has been onSSRIs for 1 month.(C) The patient fulfills criteria for a major depressiveepisode.(D) The patient is an African-American living in aninner-city environment.(E) The patient is frequently asked if he has suicidalthoughts or plans.16 Venlafaxine (Effexor) and duloxetine (Cymbalta) areboth serotonin and norepinephrine reuptake inhibitors.Which of the following possible advantages doesduloxetine have over other SSRIs and other antidepressantsin general?(A) In addition to antidepressant activity, it isanxiolytic.(B) It is, in addition, an antipsychotic drug.(C) It possesses analgesic properties.(D) It possesses nonselective beta-blocking properties.(E) It has antidiabetic properties.17 A 48-year-old depressed patient, during an interviewby his family doctor, reveals that his mood has beenprecipitated by his interpretation of his situation atwork. He assumes that an impending change in hisjob description is a sign of his failure in his sales ability.Thus, he feels he has hopelessly lost out in his chosenfield and feels it impossible to start over in a newdirection at his age. Since finding out about the comingchange, he has had difficulty in falling to sleepand is prone to frequent awakening; he is ultimatelyunable to complete a night’s sleep. The physicianengages him in a realistic discussion of the company’schanging fortunes and helps him to conclude that, ifanything, the change in job description within thecompany may be a vote of confidence in him, becausehe has not been asked to resign; that, in fact, thepatient’s interpretation of events has given rise to anegative value judgment. Which of the followingtherapeutic methods is being brought into play?(A) Cognitive therapy(B) Deep psychoanalytic therapy(C) Reiki therapy(D) Supportive therapy(E) Corporate engagement therapy