Mental Health

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Cannabis and Psychosis

Which one of the following is not a risk factor for developing psychosis associated with cannabis use?

  • Use of high potency tetrahydrocannabinol (a product with > 10% THC)
  • Frequent use
  • Female sex
  • History of a mental disorder (e.g., bipolar disorder, depression, anxiety)
Volume 41.1 - Question 15

Addictive Screen Use and Suicidal Behaviours

High and increasing addictive screen use trajectories in early adolescence are associated with suicidal behaviours.

  • True
  • False
Volume 41.1 - Question 5

Cannabis and Mental Health

In terms of mental health diagnoses, the most consistent effect from high doses of cannabidiol is some acute relief from anxiety.

  • True
  • False
Volume 40.5 - Question 12

Methylphenidate and Atomoxetine in Pregnancy

Pregnant women affected by ADHD who were receiving treatment with methylphenidate showed a significantly higher frequency of congenital anomalies or miscarriages compared to the general population.

  • True
  • False
Volume 40.5 - Question 5

Empathic Telephone Conversations

Layperson-delivered, empathy-focused telephone engagement can improve glycemic control for patients with diabetes.

  • True
  • False
Volume 40.4 - Question 17

Treatment Resistant Depression in Older Adults

A 72-year-old, retired immigrant engineer returns to your clinic with his wife to follow up on the efficacy of the second antidepressant prescribed for his depression. Symptoms first started about nine months ago. He started to see you seven months ago. He tried an SSRI at a therapeutic dose daily for three months and, when asked to rate his progress at that time, indicated an improvement in his symptoms of about 25%. After taking another SSRI at therapeutic dose daily for a little more than another three months, the couple reported that the second drug improved symptoms about 25%. You feel the patient meets the criteria for treatment resistant late life depression given his age. You inform them that the diagnosis is referred to as treatment-resistant late-life depression. The couple is not familiar with the diagnosis and risk factors.
Volume 40.21 - Question 5

Prenatal Cannabis Use and Maternal Pregnancy Outcomes

Prenatal cannabis use is associated with a greater risk of all the following except:

  • Excessive gestational weight gain
  • Gestational diabetes
  • Preeclampsia
  • Placental abruption
Volume 40.2 - Question 7

Management of Insomnia

Which one of the following statements about the management of insomnia is false?

  • Mindfulness-based therapy has more data to support its efficacy than cognitive behavioural therapy for insomnia (CBT-I).
  • Melatonin has been shown to have a small effect on sleep onset in adults.
  • Complex behaviours during sleep, such as driving, are a patient-reported side effect of benzodiazepine receptor agonists.
  • CBT-I used alone produces more sustained benefits than when used in combination with medication.
Volume 40.1 - Question 28

Weight Gain with Antidepressants

Which one of the following antidepressants is associated with lower six-month weight gain when compared with sertraline.

  • Escitalopram
  • Bupropion
  • Venlafaxine
  • Paroxetine
Volume 40.1 - Question 27

Trauma Informed Care in Serious Illness

Which one of the following statements about trauma informed care in serious illness is false?

  • A recommended screening question for trauma in serious illness is: “Have you ever experienced anything that makes seeing a health care provider difficult or scary to you?”.
  • Being trauma-informed means presuming all patients have a history of trauma.
  • The medical setting can trigger traumatic memories leading to hypervigilance.
  • The stressors of the acute medical setting can increase hospital length of stay.
Volume 40.1 - Question 18

Weight Training for Depression

Strength training is an effective treatment for depression.

  • True
  • False
Volume 39.6 - Question 26

The Twitchy Tongue - An Approach

Which one of the following statements about hyperkinetic movements of the tongue is false?

  • Epileptic conditions are a situation in which hyperkinetic movements of the tongue may be represented.
  • Cortical infarcts could be manifested as tongue tremors.
  • Tardive dyskinesia does not involve any parts of the tongue.
  • Isolated tongue tremor may be a presentation of idiopathic Parkinson’s disease.
Volume 39.6 - Question 25

Akathisia

Vitamin B6 has the best risk-benefit ratio for the treatment of antipsychotic drug-induced akathisia.

  • True
  • False
Volume 39.6 - Question 24

Depression Treatment

Which one of the following statements about treatment-resistant depression is false?

  • Augmentation by adding a second-generation antidepressant with a different mechanism of action may have some benefit.
  • Cannabis is recommended.
  • Augmentation with a second-generation antipsychotic may have some benefit.
  • Psilocybin may be helpful.
Volume 39.6 - Question 4

Treatment-Resistant Depression

Which one of the following statements about nonpharmacologic treatment strategies for treatment-resistant depression is false?

  • A structured exercise program may reduce the severity of depressive symptoms.
  • When used for years, B12 vitamins have shown some benefit by decreasing the risk of relapse.
  • Bright light therapy does not reduce depressive symptoms for those whose depression is not seasonal.
  • Repetitive transcranial magnetic stimulation may be helpful.
Volume 39.6 - Question 3

SSRI & Anticoagulants

Among patients with atrial fibrillation, concomitant use of SSRIs and oral anticoagulants (OACs) was associated with an increased risk of major bleeding compared with OAC use alone.  

  • True
  • False
Volume 39.5 - Question 22

Brexpiprazole in Alzheimer Disease

Brexpiprazole improves agitation scores in adults with Alzheimer disease and agitated behaviors. 

  • True
  • False
Volume 39.5 - Question 18

Esketamine and Post Partum Depression

For mothers with prenatal depression, a single low dose of esketamine after childbirth decreases major depressive episodes at 42 days post partum. 

  • True
  • False
Volume 39.5 - Question 9

Difficult-to-Treat Depression

Which one of the following statements about adjunctive medications in difficult-to-treat depression is false? 

  • Atypical antipsychotics are efficacious.   
  • Lithium is a recommended drug.   
  • Bupropion has mixed evidence for efficacy.   
  • Mirtazapine has been shown to be efficacious. 
Volume 39.4 - Question 19

Advance Care Planning and Huntington Disease

In patients with Huntington disease, engaging in advance care planning discussions does not cause untoward effects on suicidal thoughts and behaviours. 

  • True
  • False
Volume 39.4 - Question 18

Atrial Fibrillation and Psychological Distress

In patients with symptomatic atrial fibrillation, improvements of symptoms of anxiety and depression were improved with catheter ablation, but not with medical therapy. 

  • True
  • False
Volume 39.4 - Question 17

Pharmacological Intervention for Irritability, Aggression and Self Injury in Autism

At short term follow up (up to 6 months) which one of the following statements is false about pharmacological interventions for symptoms of irritability, aggression and self injury in autistic persons?  

  • Atypical antipsychotics probably reduce self injury.    
  • There is clear evidence that atypical antipsychotics reduce aggression.    
  • ADHD related medications may reduce irritability slightly.    
  • There is no clear evidence antidepressants reduce irritability.  
Volume 39.4 - Question 8

Peri-Partum Depression

Your next patient is a 26-year-old female patient. She gave birth to a healthy baby 4 months ago. She has an older 4-year-old son. The patient says that, for the past two months, she has been feeling sad, cries daily, has no energy and feels inadequate as a mother. She feels guilty that she is not as present for her older child and not as invested as her friends with their newborn children.
Volume 39.3 - Question 42

Treatment Resistant Depression in Older Adults

A 72-year-old, retired immigrant engineer returns to your clinic with his wife to follow up on the efficacy of the second antidepressant prescribed for his depression. Symptoms first started about nine months ago. He started to see you seven months ago. He tried an SSRI at a therapeutic dose daily for three months and, when asked to rate his progress at that time, indicated an improvement in his symptoms of about 25%. After taking another SSRI at therapeutic dose daily for a little more than another three months, the couple reported that the second drug improved symptoms about 25%. You feel the patient meets the criteria for treatment resistant late life depression given his age. You inform them that the diagnosis is referred to as treatment-resistant late-life depression. The couple is not familiar with the diagnosis and risk factors.
Volume 39.3 - Question 41

Inappropriate Sexual Behaviour in Long-Term Care

In the pharmacologic management of inappropriate sexual behaviour in long-term care residents with dementia, each of the following drugs, alone or in combination, could be considered as first-line agents except:

  • Sertraline
  • Finasteride
  • Aripiprazole
  • Estrogen
Volume 39.3 - Question 19

Autism Diagnosis

About one-third of children who receive a diagnosis of autism spectrum disorder (ASD) between 12-36 months of age no longer meet the diagnostic criteria for ASD at 5-7 years of age.

  • True
  • False
Volume 39.3 - Question 10

Esketamine Nasal Spray

In patients with treatment-resistant depression, esketamine nasal spray plus an SSRI or SNRI is superior to extended-release quetiapine plus an SSRI or SNRI with respect to remission at eight weeks.

  • True
  • False
Volume 39.3 - Question 6

Non-Drug Therapy for Depression

Which one of the following non-drug treatments for depression have been shown to be the most effective?

  • Electroconvulsive therapy
  • Transcranial magnetic stimulation
  • Deep brain stimulation
  • Interpersonal therapy
Volume 39.3 - Question 5

ADHD

Stimulant treatment for children with ADHD is associated with an increased risk of subsequent substance use.

  • True
  • False
Volume 39.3 - Question 4

Catatonia

Which one of the following statements about Catatonia is false?

  • It is a rare form of schizophrenia.
  • Episodes may recur periodically.
  • Remission with lorazepam challenges validates the diagnosis.
  • Electroconvulsive therapy is effective after insufficient response to benzodiazepine administration.
Volume 39.3 - Question 1

Brief Psychotic Episodes

Half of patients with a brief psychotic episode will only present with a single remitting event.

  • True
  • False
Volume 37.4 - Question 16

Drug Induced Akathisia

Which one of the following statements about acute drug induced akathisia is false?  

  • It develops soon after starting new medications or after dosage adjustments.   
  • It lasts less than six months.  
  • It generally resolves when the medicine triggering it is discontinued.  
  • Akathisia rarely occurs concurrently with akinesia.
Volume 36.1 - Question 23

Binge Eating Disorder 2

Lisdexamfetamine is an effective treatment in binge eating disorder.

  • True
  • False
Volume 38.2 - Question 14

Binge Eating Disorder 1

Which one of the following statements about binge eating disorder (BED) is false?

  • It has a female-to male ratio of approximately 5:1.
  • Most people with BED meet the criteria for another psychiatric disorder.
  • Less than 5% of those who meet the DSM-5 criteria for BED have received a diagnosis from a health care provider
  • Current research supports the efficacy and cost effectiveness of self-help interventions such as books and smartphone apps as the first step in treatment of BED.
Volume 38.2 - Question 13

Insomnia and Mindfulness-Based Interventions

Which one of the following is not an effective intervention for treatment of insomnia among people with common mental disorders?

  • Mindfulness-Based therapy for insomnia.
  • Internet mindfulness meditation intervention.
  • Mindfulness meditation.
  • Mindfulness-based touch therapy.
Volume 37.5 - Question 17

Body Dysmorphic Disorder

Which one of the following statements about body dysmorphic disorder (BDD) is false? 

  • The prevalence in people requesting cosmetic surgery is much higher than the general population. 
  • Dissatisfaction with their appearance results in a low quality of life. 
  • Nose, hair, skin, and lips are parts of the body most associated with BDD. 
  • They have a low risk of suicide. 
Volume 38.1 - Question 9

Antenatal Depression and Preterm Birth

An improved antenatal depression symptom trajectory, compared with worsened symptoms is associated with decreased odds of preterm birth for pregnant people referred for mental health care. 

  • True
  • False
Volume 39.1 - Question 17

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