Which theory of depression was developed based on observing that patients who were being
treated for Hep C developed depressive symptoms?
A. The
... [Show More] monoamine theory
B. The inflammation theory
C. The HPA axis theory
D. The stress-diathesis theory ✔✔b. The inflammation theory
Which of the following health conditions have a high co-morbidity with depression?
A. Hypertension
B. Asthma
C. Diabetes mellitus
D. Cardiovascular disease
E. Celiac disease
F. Cognitive impairment
G. Obesity
H. Cancer ✔✔A. Hypertension
C. Diabetes Mellitus
D. Cardiovascular disease
F. Cognitive impairment
G. Obesity
H. Cancer
In the Cutler video on depression, he highlights that there are 200 different ways to meet the
diagnostic criteria for depression.
A. True
B. False ✔✔A. True
You have diagnosed a 53-year-old male with moderate MDD and he has declined psychotherapy
but has agreed to pharmacotherapy. He has diagnoses of Type 2 D.M. with a BMI of 32.1. Which
of the following antidepressants would provide a dual benefit for this patient?
A. Sertraline
B. Fluoxetine
C. Duloxetine
D. Mirtazapine ✔✔C. Duloxetine
Your patient was started on fluoxetine and after ten weeks of treatment his PhQ 9 score is 9. What
is your assessment of the efficacy of treatment based on this score?
A. The patient is in remission
B. The response is adequate but not in remission
C. The response is possibly inadequate
D. The response is inadequate ✔✔B. The response is adequate but not in remission
In the Star*D trial what percentage of patients treated for depression failed to respond to initial
pharmacotherapy?
A. 20%
B. 30%
C. 40%
D. 50% ✔✔D. 50%
In the Star D trial for patients that achieved remission what percentage relapsed after 4.4 months?
A. 25%
B. 33%
C. 42%
D. 53% ✔✔B. 33%
When should adjunctive therapy be considered in treating MDD? (select all that apply)
A. Already tried 3 or > antidepressants
B. Initial antidepressant well tolerated
C. Partial response (>50% improvement)
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference ✔✔B. Initial antidepressant well tolerated
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference
Rates of remission increased with each additional change in therapy, especially when switching.
A. True
B. False ✔✔B. False
You have diagnosed your patient with Major Depressive Disorder and after six weeks of being
treated with fluoxetine 20 mg there is no treatment response. According to the VA/DoD Guidelines
for treatment of MDD what is the next step?
A. Switch to another monotherapy either an antidepressant or psychotherapy.
B. Switch to a different antidepressant
C. Augment with a second antidepressant
D. Augment with a second medication or psychotherapy
A. A, C
B. B
C. C
D. A, D ✔✔D. A,D
Your patient has experienced her first episode of MDD and is in remission. How long should the
antidepressant be continued after remission has been achieved to reduce the risk of relapse?
A. 2 months
B. 4 months
C. 6 months
D. One year ✔✔C. 6 months
For patients that respond to treatment with pharmacotherapy but are at high risk for recurrent
depressive episodes, howe long should maintenance pharmacotherapy be continued?
A. At least 6 months
B. At least 12 months
C. At least 24 months
Indefinitely ✔✔B. At least 12 months
Having a patient sign a "no suicide contract" has demonstrated efficacy in reducing suicides among
those who sign these "contracts".
A. True
B. False ✔✔B. False
When de-escalating a patient what is the recommended closest distance that you should stand from
the patient?
A. 1 arm length
B. 2 arms length
C. six feet
D. 10 feet ✔✔2 arms length
In order to assess agitation in a patient the practitioner should:
A. Use past experiences with patients to compare to this patient
B. Use an objective scale such as the Behavioral Activity Rating Scales
C. Find the most experienced person with assessing agitation
D. Avoid jumping to conclusions and monitor the patient over time ✔✔B. Use an objective scale
such as the Behavioral Activity Rating Scales
You walk into the room of a patient in an acute care facility where you have been asked to consult
with due to the patient's bizarre behavior. The patient is a 6'5" former body builder who is pacing
the room, talking loudly and hurling verbal threats about wanting to hurt someone. You are fearful
as the last time you encountered a patient such as this you were assaulted and ended up needing
several stitches. Your decision would be to:
A. Talk in a calm, reassuring manner to the patient
B. Make eye contact so that the patient knows you are watching him
C. Leave the room to secure someone else to work with the patient
D. Leave the room to secure someone else to work with the patient ✔✔C. Leave the room to secure
someone else to work with the patient
Select the key components of de-escalation:
A. Hands should be visible and not clenched
B. Directly face the patient but stand at arm's length
C. Fold your arms
D. Provide an in-depth explanation of the problem as you see it
E. If the patient is delusional point out that this is faulty thinking
F. Introduce yourself and ask the patient his/her name and how they would like to be addressed
G. Have your back to the exit so the patient must go around you to leave the room.
H. Use clarifying sentences ✔✔A. Hands should be visible and not clenched
F. Introduce yourself and ask the patient his/her name and how they would like to be addressed
H. Use clarifying sentences
Your patient is extremely agitated and it is evident that the patient needs medication to calm him
down. Which of the following would be the least effective way to approach to this subject?
A. "When you were this worked up before we gave you a shot and it really helped so I have ordered
the same medicine for you"
B. "I need to protect you from hurting someone so I would like for you to take some medication
to help you stay in control."
C. "I am going to need to give you some medication to help you maintain control. Would you
prefer something by mouth or by a shot?"
D. "In order to protect yourself from injury I am going to need to give you some medication. What
has worked for you in the past or do you have a preference? " ✔✔A. "When you were this worked
up before we gave you a shot and it really helped so I have ordered the same medicine for you"
Which of the following statements are correct related to suicidality in the elderly?
A. Suicides increase with age and therefore are the highest risk for suicide
B. Attempts at suicide are more serious
C. More lethal than the younger population
D. Depression is easier to treat with lower relapse rates ✔✔A. Suicides increase with age and
therefore are the highest risk for suicide
B. Attempts at suicide are more serious
C. More lethal than the younger population [Show Less]