Depression Practice Questions

Question 1

Which of the following neuroanatomical areas is/are considered to be involved in the etiology of depression?

Accepted Answer

All of the options

Answer

Striatum

Answer

Amygdala

Answer

Hippocampus

Question 2

A 38-year-old professor with depression requests you to prescribe an antidepressant that would be least likely to cause sexual dysfunction. Which of the following drugs would you prescribe?

Accepted Answer

Bupropion

Answer

Venlafaxine

Answer

Fluoxetine

Answer

Escitalopram

Question 3

All are required to diagnose major depression except?

Accepted Answer

Nihilistic ideas

Answer

Depressed mood

Answer

Decreased concentration

Answer

Insomnia

Question 4

A 33-year-old man visits his psychiatrist with feelings of sadness on most days of the week for the past 4 weeks. He says that he is unable to participate in his daily activities and finds it hard to get out of bed on most days. If he has nothing scheduled for the day, he sometimes sleeps for 10–12 hours at a stretch. He has also noticed that on certain days, his legs feel heavy and he finds it difficult to walk, as though there are bricks tied to his feet. However, he is still able to attend social events and also enjoys playing with his children when he comes home from work. Other than these simple pleasures, he has lost interest in most of the activities he previously enjoyed. Another troubling fact is that he had gained weight over the past month, mainly because he eats so much when overcome by these feelings of depression. His is prescribed a medication to treat his symptoms. Which of the following is the mechanism of action of the drug he was most likely prescribed?

Accepted Answer

Inhibit the uptake of serotonin and norepinephrine at the presynaptic cleft

Answer

Activates the γ-aminobutyric acid receptors

Answer

Works as an antagonist at the dopamine and serotonin receptors

Answer

Non-selectively inhibits monoamine oxidase A and B

Answer

Stimulates the release of norepinephrine and dopamine in the presynaptic cleft

Question 5

A 60-year-old woman with treatment-resistant depression has been referred for electroconvulsive therapy (ECT) after failing adequate trials of four different antidepressants including augmentation strategies. She has severe depression with psychomotor retardation, significant weight loss, and pervasive guilt. Her family is concerned about potential cognitive side effects of ECT. They ask about factors that might be modified to minimise cognitive adverse effects while maintaining treatment efficacy. Which modification would most effectively reduce cognitive side effects while preserving antidepressant efficacy?

Accepted Answer

Using unilateral electrode placement on the non-dominant hemisphere rather than bilateral placement

Answer

Reducing the electrical dose to just above seizure threshold regardless of electrode placement

Answer

Extending the interval between treatments from twice weekly to once weekly throughout the course

Answer

Using ultra-brief pulse width stimulation with bilateral electrode placement

Answer

Limiting the total number of ECT sessions to a maximum of 6 treatments

Question 6

A 52-year-old man presents with a 1-month history of a depressed mood. He says that he has been “feeling low” on most days of the week. He also says he has been having difficulty sleeping, feelings of being worthless, difficulty performing at work, and decreased interest in reading books (his hobby). He has no significant past medical history. The patient denies any history of smoking, alcohol use, or recreational drug use. A review of systems is significant for a 7% unintentional weight gain over the past month. The patient is afebrile and his vital signs are within normal limits. A physical examination is unremarkable. The patient is prescribed sertraline 50 mg daily. On follow-up 4 weeks later, the patient says he is slightly improved but is still not feeling 100%. Which of the following is the best next step in the management of this patient?

Accepted Answer

Continue sertraline

Answer

Switch to a different SSRI

Answer

Add buspirone

Answer

Switch to an MAOI

Answer

Add aripiprazole

Question 7

A 27-year-old man presents to his physician for a checkup. At presentation, he complains of anxiety and persistent mood changes. The patient's comorbidities include chronic gastritis treated with Helicobacter pylori eradication therapy, and chronic pyelonephritis with stage 1 chronic kidney disease. His grandfather who was a heavy smoker just passed away due to metastatic lung cancer. The patient has an 8-year-history of smoking, and he is concerned about consequences of his habit. He says that he tried to quit several times with nicotine patches, but he is unsuccessful because of the unpleasant symptoms and returning anxiety. Moreover, his tobacco use increased for the past 12 months due to increased anxiety due to his job and family problems, which could not be relieved by previous consumption levels. He still wants to stop smoking due to the health concerns. The patient's vital signs and physical examination are unremarkable. The physician considers prescribing the patient a partial nicotine agonist, and conducts a further testing to see whether the patient is eligible for this medication. Which of the following tests is required to be performed prior to prescribing this medication to the presented patient?

Accepted Answer

9-item patient health questionnaire

Answer

Echocardiography

Answer

Creatinine assessment

Answer

Esophagogastroduodenoscopy

Answer

Mini mental state examination

Question 8

A 50-year-old woman presents to her family physician 6 months after the death of her husband, who died following a car accident. She is crying inconsolably and reports that she no longer enjoys doing the things she and her husband once did together. She feels guilty for the time she wasted arguing with him in the past. She finds herself sleeping on most mornings, but still lacks the energy and concentration needed at work. The physical examination is normal. Based on a well-known hypothesis, which of the following combinations of neurotransmitter abnormalities most likely exist in this patient?

Accepted Answer

↓ Norepinephrine, ↓ Serotonin, ↓ Dopamine

Answer

↑ Norepinephrine, ↑ Serotonin, ↑ Dopamine

Answer

Normal Norepinephrine, ↓ Serotonin, Normal Dopamine

Answer

Normal Norepinephrine, Normal Serotonin, ↑ Dopamine

Answer

Normal Norepinephrine, Normal Serotonin, ↓ Dopamine

Question 9

A 43-year-old woman is brought to the physician by her daughter because she has been intermittently crying for 6 hours and does not want to get out of bed. Her symptoms started after she was fired yesterday from her job of 20 years. She says she feels sad and does not understand what she will do with her life now. She uses an over-the-counter inhaler as needed for exercise-induced asthma, and recently started oral isotretinoin for acne. She used to smoke a pack of cigarettes per day, but for the last year she has decreased to 2 cigarettes daily. She appears sad and very upset. Her temperature is 37°C (98.6°F), pulse is 110/min, respirations are 20/min, and blood pressure is 140/80 mm Hg. Physical examination shows no other abnormalities. On mental status examination, she is oriented to person, place, and time. She maintains eye contact and follows instructions. She denies suicidal ideation. Which of the following is the most likely explanation for this finding?

Accepted Answer

Normal stress reaction

Answer

Drug-related depression

Answer

Acute stress disorder

Answer

Adjustment disorder

Answer

Major depressive disorder

Question 10

A 22-year-old female presents to your clinic for evaluation of "skin problems." She complains of severe acne and "spots" all over her face that have persisted for the last 8 years, despite innumerable creams and lotions. She reports spending several hours every morning using make-up just to go outside. She wishes to learn about cosmetic procedures or surgeries that could solve her problem. While you perceive her concern for her skin to be genuine, upon examination, you note a healthy-appearing, well-nourished female with a normal complexion, minimal acne and sparse freckles on the nasal bridge. You calculate her BMI to be 21. In addition to making a diagnosis, this patient should be screened for which other disorder?

Accepted Answer

Major depressive disorder

Answer

Anorexia

Answer

Malingering

Answer

Munchausen's syndrome

Answer

Trichotillomania

Depression

Study Resources

Lessons

Questions

Flashcards

Lessons

Major depressive disorder diagnostic criteria

Neurobiological basis of depression

Genetic and environmental risk factors

Depression with melancholic features

Depression with atypical features

Depression with psychotic features

Seasonal affective disorder

Postpartum depression

Treatment-resistant depression

Pharmacotherapy for depression

Psychotherapy approaches for depression

ECT and neuromodulation therapies

Suicide risk assessment and management

Practice Questions

Flashcards

About Depression for USMLE

Lessons in Depression

Master Depression