MCQ Quiz: Psychiatric Illness

Psychiatric illnesses are complex medical conditions that affect a person’s thinking, feeling, mood, or behavior. Their management is a cornerstone of modern healthcare, requiring a deep understanding of neurobiology, pharmacology, and psychotherapy. This quiz will test your general knowledge on the assessment and treatment principles for several major psychiatric disorders, including depression, anxiety, and bipolar disorder

1. A patient describes a period of two weeks where they felt “down,” lost interest in activities they used to enjoy, had trouble sleeping, and felt worthless. This cluster of symptoms is most characteristic of:

• a. A manic episode
• b. A panic attack
• c. A major depressive episode
• d. A psychotic episode

Answer: c. A major depressive episode

2. Which class of medications is considered first-line pharmacotherapy for most anxiety and depressive disorders?

• a. Benzodiazepines
• b. Antipsychotics
• c. Selective Serotonin Reuptake Inhibitors (SSRIs)
• d. Mood stabilizers

Answer: c. Selective Serotonin Reuptake Inhibitors (SSRIs)

3. Bipolar I Disorder is characterized by the presence of at least one:

• a. Major depressive episode
• b. Manic episode
• c. Hypomanic episode
• d. Panic attack

Answer: b. Manic episode

4. A patient presents with an elevated mood, decreased need for sleep, racing thoughts, and excessive involvement in risky activities. These are hallmark symptoms of:

• a. Generalized Anxiety Disorder
• b. Schizophrenia
• c. A manic episode
• d. Major Depressive Disorder

Answer: c. A manic episode

5. Which of the following medications is a “gold standard” mood stabilizer used for the long-term management of bipolar disorder?

• a. Lorazepam
• b. Sertraline
• c. Haloperidol
• d. Lithium

Answer: d. Lithium

6. A patient experiences sudden, intense periods of fear accompanied by physical symptoms like a pounding heart, shortness of breath, and dizziness. This is characteristic of:

• a. Post-Traumatic Stress Disorder (PTSD)
• b. Obsessive-Compulsive Disorder (OCD)
• c. Panic Disorder
• d. Social Anxiety Disorder

Answer: c. Panic Disorder

7. Benzodiazepines like alprazolam are effective for anxiety but are generally not recommended for long-term use due to the risk of:

• a. Weight gain
• b. Dependence, tolerance, and withdrawal symptoms.
• c. Hypertension
• d. Liver damage

Answer: b. Dependence, tolerance, and withdrawal symptoms.

8. The “monoamine hypothesis” of depression suggests a deficiency in which neurotransmitters?

• a. Acetylcholine and GABA
• b. Serotonin, norepinephrine, and dopamine
• c. Glutamate
• d. Endorphins

Answer: b. Serotonin, norepinephrine, and dopamine

9. A critical counseling point for a patient starting an SSRI is that:

• a. The medication will provide immediate relief within hours.
• b. The full therapeutic effect may take 4-6 weeks to become apparent.
• c. They can stop taking the medication as soon as they feel better.
• d. The medication is not addictive and has no withdrawal effects.

Answer: b. The full therapeutic effect may take 4-6 weeks to become apparent.

10. A “black box warning” on all antidepressants highlights an increased risk of what in children, adolescents, and young adults?

• a. Suicidal thoughts and behaviors.
• b. Weight gain.
• c. Severe sedation.
• d. Seizures.

Answer: a. Suicidal thoughts and behaviors.

11. Which of the following is NOT primarily considered a psychiatric illness?

• a. Schizophrenia
• b. Bipolar Disorder
• c. Parkinson’s Disease
• d. Major Depressive Disorder

Answer: c. Parkinson’s Disease

12. The primary goal of managing a chronic psychiatric illness like bipolar disorder or schizophrenia is:

• a. A complete cure.
• b. To manage symptoms, prevent relapse, and improve quality of life.
• c. To use the highest possible dose of medication.
• d. To rely on psychotherapy alone.

Answer: b. To manage symptoms, prevent relapse, and improve quality of life.

13. Non-pharmacologic therapy, such as Cognitive Behavioral Therapy (CBT), is an evidence-based and critical component of treatment for many psychiatric illnesses.

• a. True
• b. False

Answer: a. True

14. A patient taking lithium must be counseled on the importance of maintaining consistent:

• a. Sleep patterns.
• b. Exercise levels.
• c. Salt and fluid intake.
• d. Caffeine intake.

Answer: c. Salt and fluid intake.

15. Which of the following is considered a “positive” symptom of schizophrenia?

• a. Avolition (lack of motivation)
• b. Affective flattening
• c. Alogia (poverty of speech)
• d. A delusion

Answer: d. A delusion

16. The primary mechanism of action of SSRIs is:

• a. Blocking the reuptake of serotonin from the synapse.
• b. Blocking dopamine D2 receptors.
• c. Enhancing the effect of GABA.
• d. Inhibiting the enzyme monoamine oxidase.

Answer: a. Blocking the reuptake of serotonin.

17. “Anhedonia,” a common symptom of depression, is defined as:

• a. A decreased need for sleep.
• b. A loss of interest or pleasure in activities.
• c. A feeling of worthlessness.
• d. An increase in goal-directed activity.

Answer: b. A loss of interest or pleasure in activities.

18. A key difference between Bipolar I and Bipolar II disorder is that Bipolar II disorder is characterized by:

• a. The absence of any depressive episodes.
• b. The presence of mania.
• c. The presence of hypomania and at least one major depressive episode.
• d. A less severe overall course.

Answer: c. The presence of hypomania and at least one major depressive episode.

19. A pharmacist’s role in the care of patients with psychiatric illness includes:

• a. Promoting medication adherence.
• b. Counseling on potential side effects.
• c. Helping to reduce the stigma associated with mental illness.
• d. All of the above.

Answer: d. All of the above.

20. Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonergic activity. The risk is highest when an SSRI is combined with:

• a. An NSAID like ibuprofen.
• b. A statin like atorvastatin.
• c. An MAO inhibitor or the herbal supplement St. John’s Wort.
• d. Acetaminophen.

Answer: c. An MAO inhibitor or the herbal supplement St. John’s Wort.

21. Obsessions are _____, while compulsions are ______.

• a. repetitive behaviors, recurrent thoughts
• b. recurrent and persistent thoughts, repetitive behaviors or mental acts
• c. enjoyable thoughts, unwanted behaviors
• d. logical thoughts, illogical behaviors

Answer: b. recurrent and persistent thoughts, repetitive behaviors or mental acts

22. Which of the following is a symptom of Generalized Anxiety Disorder (GAD)?

• a. A specific phobia of spiders.
• b. Recurrent, unexpected panic attacks.
• c. Excessive, uncontrollable worry about multiple life domains for at least 6 months.
• d. A flashback to a traumatic event.

Answer: c. Excessive, uncontrollable worry about multiple life domains for at least 6 months.

23. “Akathesia” is a side effect of some antipsychotic medications characterized by:

• a. A severe muscle spasm.
• b. A feeling of inner restlessness and an inability to sit still.
• c. A shuffling gait and tremor.
• d. Involuntary facial movements.

Answer: b. A feeling of inner restlessness and an inability to sit still.

24. The management of psychiatric illness requires a patient-centered and collaborative approach.

• a. True
• b. False

Answer: a. True

25. A key aspect of managing any psychiatric illness is:

• a. Regular monitoring of symptoms and side effects.
• b. A strong therapeutic alliance.
• c. Patient and family education.
• d. All of the above.

Answer: d. All of the above.

26. Which of the following is NOT a first-line treatment for PTSD?

• a. Trauma-focused psychotherapy (e.g., CPT, PE).
• b. SSRIs or SNRIs.
• c. Benzodiazepines for chronic management.
• d. Prazosin for nightmares.

Answer: c. Benzodiazepines for chronic management.

27. The term “affect” in a mental status exam refers to:

• a. The patient’s self-reported mood.
• b. The clinician’s objective observation of the patient’s emotional expression.
• c. The patient’s level of intelligence.
• d. The patient’s insight into their illness.

Answer: b. The clinician’s objective observation of the patient’s emotional expression.

28. Using an antidepressant as monotherapy in a patient with bipolar disorder can precipitate:

• a. A depressive episode.
• b. A switch into mania or hypomania.
• c. A psychotic episode.
• d. It is a safe and effective first-line treatment.

Answer: b. A switch into mania or hypomania.

29. What is a key counseling point when a patient is discontinuing an SSRI?

• a. The medication can be stopped abruptly without issue.
• b. The dose should be tapered slowly to avoid discontinuation symptoms.
• c. The patient will immediately feel depressed again.
• d. They should start an MAOI the next day.

Answer: b. The dose should be tapered slowly to avoid discontinuation symptoms.

30. The stigma surrounding psychiatric illness is a major barrier to patients seeking and receiving care.

• a. True
• b. False

Answer: a. True

31. A patient on lithium must have their blood levels monitored regularly due to:

• a. The drug’s high cost.
• b. Its narrow therapeutic index.
• c. Its lack of efficacy.
• d. The need to increase the dose every week.

Answer: b. Its narrow therapeutic index.

32. The primary goal of managing a patient with schizophrenia is:

• a. To cure the disease.
• b. To manage symptoms and improve social and occupational functioning.
• c. To use the highest possible dose of an antipsychotic.
• d. To focus only on positive symptoms.

Answer: b. To manage symptoms and improve social and occupational functioning.

33. Which of the following is a common comorbidity with many psychiatric illnesses?

• a. Substance use disorders
• b. Cardiovascular disease
• c. Diabetes
• d. All of the above

Answer: d. All of the above

34. A pharmacist’s role in mental health care is limited to dispensing.

• a. True
• b. False

Answer: b. False

35. A “delusion” is a disorder of ______, while a “hallucination” is a disorder of ______.

• a. perception, thought
• b. thought, perception
• c. mood, affect
• d. affect, mood

Answer: b. thought, perception

36. For many anxiety disorders, _____ is considered as effective, if not more effective, than medication in the long term.

• a. a healthy diet
• b. regular exercise
• c. Cognitive Behavioral Therapy (CBT)
• d. a multivitamin

Answer: c. Cognitive Behavioral Therapy (CBT)

37. Which medication class used to treat depression also has an indication for smoking cessation?

• a. SSRIs
• b. TCAs
• c. Bupropion
• d. Mirtazapine

Answer: c. Bupropion

38. It is important to screen for suicidal ideation in any patient with a major psychiatric illness.

• a. True
• b. False

Answer: a. True

39. A pharmacist who provides care in an empathetic and non-judgmental manner is helping to:

• a. Build a therapeutic alliance.
• b. Reduce stigma.
• c. Improve patient adherence.
• d. All of the above.

Answer: d. All of the above.

40. The management of a psychiatric illness is often a lifelong process.

• a. True
• b. False

Answer: a. True

41. Which of the following is a symptom of a panic attack?

• a. Palpitations
• b. Fear of dying or losing control
• c. Shortness of breath
• d. All of the above

Answer: d. All of the above

42. The term “polypharmacy” refers to the use of multiple medications and is a major concern in patients with psychiatric illness.

• a. True
• b. False

Answer: a. True

43. Which of the following is NOT a primary domain of symptoms in schizophrenia?

• a. Positive symptoms
• b. Negative symptoms
• c. Manic symptoms
• d. Cognitive symptoms

Answer: c. Manic symptoms

44. A patient taking an MAOI must be counseled to avoid tyramine-rich foods to prevent:

• a. A hypertensive crisis.
• b. Serotonin syndrome.
• c. A severe drop in blood pressure.
• d. Liver failure.

Answer: a. A hypertensive crisis.

45. The choice of a specific antidepressant is often based on:

• a. The patient’s symptom profile.
• b. The drug’s side effect profile.
• c. The patient’s previous response or family history of response.
• d. All of the above.

Answer: d. All of the above.

46. A patient is considered “treatment-resistant” if they have not responded to an adequate trial of:

• a. One medication.
• b. Two or more different medications.
• c. Psychotherapy.
• d. A non-pharmacologic treatment.

Answer: b. Two or more different medications.

47. A pharmacist can play a key role in identifying drug-induced psychiatric symptoms.

• a. True
• b. False

Answer: a. True

48. A patient is prescribed a long-acting injectable antipsychotic. This formulation is primarily designed to improve:

• a. Efficacy
• b. Adherence
• c. Side effect profile
• d. Cost

Answer: b. Adherence

49. The overall management of psychiatric illness requires a comprehensive approach that includes medication, therapy, and social support.

• a. True
• b. False

Answer: a. True

50. The ultimate goal of learning about psychiatric illness is to:

• a. Be able to provide competent, safe, and compassionate care to a vulnerable patient population.
• b. Diagnose all psychiatric conditions.
• c. Prescribe psychotropic medications.
• d. Memorize all the diagnostic criteria from the DSM-5.

Answer: a. Be able to provide competent, safe, and compassionate care to a vulnerable patient population.