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Overall peer comparison
For Stahl’s Self-Assessments in Psychiatry: Multiple Choice Questions for Clinicians, second edition, the correct answer was selected 65% of the time.
Release/expiration dates
Released: May 1, 2015
CME Credit Expires: April 1, 2018
CME Posttest Study Guide
Optional posttests with CME credits are available for a fee (waived for NEI Members). For participant ease, each chapter has its own posttest and certificate. NOTE: the book as a whole is considered a single activity and credits earned must be totaled and submitted as such to other organizations. To receive a certificate of CME credit or participation, complete the chapter posttest and evaluation, available only online at neiglobal.com/CME (under “Book”). If a score of 70% or more is attained, you will be able to immediately print your certificate. If you have questions, call 888–535–5600, or email customerservice@neiglobal.com.
PLEASE NOTE: Posttests can only be submitted online. The posttest questions have been provided below solely as a study tool to prepare for your online submissions. Faxed/mailed copies of posttests cannot be processed and will be returned to the sender. If you do not have access to a computer, contact customer service at 888–535–5600.
Basic neuroscience
1. Agonists cause ligand-gated ion channels to:
A. Open wider
B. Open for a longer duration
C. Open more frequently
2. Communication between human CNS neurons at synapses is?
A. Chemical
B. Electrical
C. Both A and B
D. Neither A nor B
3. The direct role of transcription factors is to:
A. Cause neurotransmitter release
B. Influence gene expression
C. Synthesize enzymes
D. Trigger signal transduction cascades
Psychosis and schizophrenia
1. Based on thorough evaluation of a patient and his history, his care provider intends to begin treatment with a conventional antipsychotic but has not selected a particular agent yet. Which of the following is most true about conventional antipsychotics?
A. They are very similar in therapeutic profile but differ in side-effect profile
B. They are very similar in both therapeutic and side-effect profile
C. They differ in therapeutic profile but are similar in side-effect profile
D. They differ in both therapeutic and side-effect profile
2. A 37-year-old woman with schizophrenia has failed to respond to two sequential adequate trials of antipsychotic monotherapy (first olanzapine, then aripiprazole). Which of the following are evidence-based treatment strategies for a patient in this situation?
A. High dose of her current monotherapy (aripiprazole)
B. Augmentation of her current monotherapy with another atypical antipsychotic
C. Switch to clozapine
3. A 27-year-old male who has been treated with quetiapine for the last 8 weeks is now having his medication changed to aripiprazole. What is the recommended starting dose for aripiprazole?
A. Low dose
B. Middle dose
C. Full dose
4. A 34-year-old man who has been taking a conventional antipsychotic for 6 years has begun demonstrating extrapyramidal side effects (EPS), and his clinician elects to switch him to an atypical antipsychotic with serotonin 2A antagonism. The majority of atypical antipsychotics:
A. Have higher affinity for dopamine 2 receptors than for serotonin 2A receptors
B. Have higher affinity for serotonin 2A receptors than for dopamine 2 receptors
Unipolar depression
1. A 36-year-old man with major depressive disorder has lab work done to assess his levels of inflammatory markers. The results come back indicating elevated levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin 6 (IL-6). Elevated cytokine levels may indirectly lead to:
A. Excessive glutamate and reduced serotonin
B. Excessive glutamate and excessive serotonin
C. Reduced glutamate and reduced serotonin
D. Reduced glutamate and excessive serotonin
2. A 36-year-old patient has only partially responded to his second monotherapy with a first-line antidepressant. Which of the following has the best evidence of efficacy for augmenting antidepressants in patients with inadequate response?
A. Adding an atypical antipsychotic
B. Adding buspirone
C. Adding a stimulant
3. Margaret is a 42-year-old patient with untreated depression. She is reluctant to begin antidepressant treatment due to concerns about treatment-induced weight gain. Which of the following antidepressant treatments is associated with the greatest risk of weight gain?
A. Escitalopram
B. Fluoxetine
C. Mirtazapine
D. Vilazodone
4. A 38-year-old patient with depression presents with depressed mood, anhedonia, and loss of energy. These symptoms can be conceptualized as reflecting reduced positive affect and are hypothetically more likely to respond to agents that enhance:
A. Serotonin and possibly dopamine function
B. Dopamine and possibly norepinephrine function
C. Norepinephrine and possibly serotonin function
Bipolar disorder
1. A 28-year-old woman presents with a depressive episode. She has previously been hospitalized and treated for a manic episode but is not currently taking any medication. The agents with the strongest evidence of efficacy in bipolar depression are:
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