A 32-year-old female sees you for a health maintenance visit. She reports that she experiences severe anxiety when involved in social situations. She lives with her mother and dreads meeting unfamiliar people. At work, she remains in her cubicle throughout the day and avoids staff parties. She has a history of alcoholism in remission. She has otherwise been in good health and a physical examination is normal. Which one of the following would be a first-line treatment for this patient?

An 85-year-old female with advanced Alzheimer’s disease is brought to your office for treatment of agitation, aggressive behavior, and delusions. Behavioral and psychological interventions have had little success and the family is willing to try medications because they prefer to keep the patient at home. Which one of the following would most likely help control this patient’s symptoms?

A 42-year-old male with alcohol use disorder tells you that his last drink was 7 days ago and asks if there are any medications available to help him maintain abstinence from alcohol. He has no other medical or psychological problems. Which one of the following pharmacologic agents could help reduce this patient’s alcohol consumption and increase abstinence?

You see a 26-year-old male for the first time. He has had a history of major depression over the past 4–5 years. He currently does not take any medications. His psychiatric history reveals at least two episodes of mania, most recently 1 year ago when he was hospitalized during the episode. Which one of the following is CONTRAINDICATED as monotherapy in treating this patient’s depression at this time?

An 84-year-old female with severe dementia due to Alzheimer’s disease is a resident of a long-term care facility. She has been hitting the staff while receiving personal care and recently had an altercation with another resident. Behavioral interventions have been unsuccessful in managing her symptoms and you suggest to the patient’s family that she be started on low-dose risperidone (Risperdal). They ask about the appropriate use of the drug and the potential for side effects. Which one of the following would be appropriate advice?

A 40-year-old white female sees you for the first time. When providing a history she describes several problems, including anxiety, insomnia, fatigue, persistent depressed mood, and low libido. These symptoms have been present for several years and are worse prior to menses, although they also occur to some degree during menses and throughout the month. Her menstrual periods are regular for the most part. Based on this history, the most likely diagnosis is?

A 30-year-old female who gave birth to a healthy infant 3 months ago has had mildly depressed moods almost daily for the last 7 weeks. She takes very little joy in daily activities and interacting with her baby. She is exclusively breastfeeding and has difficulty sleeping. She says that she felt fine during the first month after the delivery, and has not experienced any homicidal or suicidal ideations. You rule out postpartum psychosis and bipolar disorder. Which one of the following would be most appropriate at this point?

A 45-year-old female sees you because of an increase in fibromyalgia pain. On examination, she has a BMI of 35.6 kg/m2 and normal vital signs except for a blood pressure of 156/91mm Hg. Her other medical problems include obstructive sleep apnea, type 2 diabetes Mellitus, hypertension, and generalized anxiety disorder. She smokes one pack of cigarettes daily and does not drink alcohol. She is currently taking metformin (Glucophage), 500 mg twice daily; lisinopril (Prinivil, Zestril), 10 mg daily; gabapentin (Neurontin), 300 mg 3 times daily; oxycodone (OxyContin), 10 mg every 6 hours; and lorazepam (Ativan), 1 mg 3 times daily. Which one of the following findings in this patient’s history greatly increases her risk of an accidental overdose?

Intensive behavioral intervention has more benefits than other treatment modalities in treating children who have been diagnosed with?

A 15-year-old female presents with a 3-month history of intermittent abdominal pain and headaches. She does not have any associated weight loss, fever, nausea, change in bowel habits, or other worrisome features. An examination is unremarkable. She does report being stressed at school and has a PHQ-2 score of 4. Which one of the following would be most appropriate at this point?

Which one of the following is the most appropriate psychotherapy for patients with obsessive-compulsive disorder?

A 38-year-old white female presents with abdominal pain and insists that she be referred for surgical evaluation. She has a history of multiple unexplained physical symptoms that began in her late teenage years. She is vague about past medical evaluations, but a review of her extensive medical record reveals multiple normal blood and imaging tests, several surgical procedures that have failed to alleviate her symptoms, and frequent requests for refills of narcotic analgesics. This patient’s history is most compatible with?

A 38-year-old female presents for follow-up of a second hospitalization in the past 3 months for acute hepatitis, thrombocytopenia, and alcohol withdrawal symptoms treated with benzodiazepines. She says that prior to her hospitalization a week ago she had been drinking a half pint of vodka daily. She reports that her drinking has gradually increased over the past 10 years but increased significantly 6 months ago after she lost her job at a bar and grill. She knows her alcohol consumption is causing damage to her liver and tells you that her aunt died of alcoholic cirrhosis this year. Despite this knowledge, she does not want to stop drinking at this time. She has looked into several alcohol cessation programs in the area but does not think that they are a good fit for her. She currently lives with her boyfriend who also uses alcohol and cocaine regularly. She is not currently speaking to her mother because they “don’t see eye to eye.” She tells you that she has not consumed alcohol since her discharge from the hospital 2 days ago. She reports that her abdominal pain, nausea, and vomiting have resolved and she is feeling well.  The most likely diagnosis is:

A 35-year-old female comes to your office for evaluation of a tremor. During the interview, you note jerking movements first in one hand and then the other, but when the patient is distracted the symptom resolves. Aside from the intermittent tremor, the neurologic examination is unremarkable. She does not drink caffeinated beverages and takes no medications. Which one of the following is the most likely diagnosis?

A 12-year-old male is brought to your office by his guardian. In the last 12 months, he was suspended from school multiple times for bullying and fighting. He kicks the family dog and goes out at night without permission. He ran away from home 2 weeks ago and he lies constantly. He skips school and does not care about his grades. Attention-deficit/hyperactivity disorder was previously ruled out. Two days ago he was grounded and retaliated by destroying his guardian’s computer. During the office visit, he says the school is “boring and stupid.”Which one of the following would be the most appropriate next step in managing this patient?

A 35-year-old male presents with depression that started when his wife asked him for a divorce last month. A depression screen is positive and he has some passive suicidal ideation. He does not have any prior history of suicide attempts or a specific plan. He does not have any health issues, a family history of mental health issues, or a history of adverse childhood events. You would be most concerned that the patient will die from suicide if he:

A 48-year-old male presents with psychogenic erectile dysfunction in conjunction with depression. You decide that treatment of his underlying mood disorder is the best initial step. Which one of the following antidepressants would be most appropriate?

A 34-year-old female has posttraumatic stress disorder that started 6 months ago after she was a victim of an armed robbery. She also has nightmares, anxiety, hypervigilance, and some paranoia and has been reexperiencing the robbery. She has been receiving psychotherapy but would now like to start a medication. Which one of the following would be the most appropriate medication to start?

You have assumed the care of a well-established patient in your practice whose medications include chronic alprazolam (Xanax) treatment for anxiety and codeine for chronic back pain following a work accident years earlier. His Prescription Drug Monitoring Program report shows a consistent pattern of filling the medications as prescribed. You order a urine immunoassay for opioids and benzodiazepines. The results are positive for opioids but negative for benzodiazepines. Which one of the following would be the most appropriate next step?