Medicine
Geriatrics & Psychiatry
Which vitamin should be given early to a malnourished patient with alcohol dependence?
A. Vitamin K as the only priority
B. Biotin only
C. Thiamine
D. Vitamin E only
Correct Answer: C
Thiamine deficiency can cause Wernicke encephalopathy and should be treated promptly in at-risk patients.
Medicine
Geriatrics & Psychiatry
Which complication or major adverse outcome is particularly associated with Alcohol withdrawal?
A. Self-harm, neglect or functional deterioration
B. Withdrawal seizures or delirium tremens
C. Functional impairment and comorbid depression
D. Hip fracture with loss of independence
Correct Answer: B
Severe withdrawal can cause seizures, severe autonomic instability and delirium tremens.
Medicine
Geriatrics & Psychiatry
A patient is diagnosed with Alcohol withdrawal. Which is the most appropriate management principle?
A. Use symptom-guided benzodiazepine therapy and give thiamine with supportive monitoring
B. Use an appropriate mood stabilizer and/or antipsychotic; hospitalize when severe risk or inability to care for self is present
C. Use antipsychotic therapy together with psychosocial interventions and adherence support
D. Use cognitive behavioral therapy and/or an appropriate first-line antidepressant when symptoms are persistent
Correct Answer: A
Benzodiazepines reduce seizure and delirium-tremens risk; thiamine helps prevent or treat Wernicke encephalopathy.
Medicine
Geriatrics & Psychiatry
In a patient with suspected Alcohol withdrawal, which investigation or diagnostic approach is most appropriate at this stage?
A. Clinical psychiatric assessment including direct suicide-risk evaluation
B. Clinical assessment including substance or medication causes and immediate risk
C. Clinical psychiatric assessment with screening for medical, neurologic and substance-induced causes
D. Clinical severity assessment with evaluation for electrolyte abnormalities, liver disease and coexisting illness
Correct Answer: D
Withdrawal is primarily clinical; assessment guides medication intensity and identifies complications.
Medicine
Geriatrics & Psychiatry
A patient develops tremor, autonomic hyperactivity, agitation and insomnia after abruptly stopping heavy chronic alcohol use. What is the most likely diagnosis?
A. Alzheimer-type major neurocognitive disorder
B. Major depressive disorder
C. Alcohol withdrawal
D. Acute mania in bipolar disorder
Correct Answer: C
Autonomic and neuropsychiatric symptoms after cessation of heavy alcohol use are typical of withdrawal.
Medicine
Geriatrics & Psychiatry
Which medication group is generally not preferred as the sole long-term first-line treatment for GAD because of dependence risk?
A. SSRIs
B. Benzodiazepines
C. SNRIs
D. Evidence-based psychotherapy
Correct Answer: B
Benzodiazepines may have selected short-term uses but carry tolerance, dependence and falls or cognitive risks, especially in older adults.
Medicine
Geriatrics & Psychiatry
Which complication or major adverse outcome is particularly associated with Generalized anxiety disorder?
A. Functional impairment and comorbid depression
B. Hip fracture with loss of independence
C. Functional decline and increased mortality
D. Loss of independent activities of daily living
Correct Answer: A
Chronic anxiety can significantly impair work, sleep and relationships and commonly coexists with depression.
Medicine
Geriatrics & Psychiatry
A patient is diagnosed with Generalized anxiety disorder. Which is the most appropriate management principle?
A. Use symptom-guided benzodiazepine therapy and give thiamine with supportive monitoring
B. Deprescribe high-risk medicines where possible and implement individualized strength, balance and environmental interventions
C. Treat the cause and use nonpharmacologic orientation, sleep, mobility and sensory-support measures
D. Use cognitive behavioral therapy and/or an appropriate first-line antidepressant when symptoms are persistent
Correct Answer: D
CBT and serotonergic antidepressants are common first-line long-term treatments.
Medicine
Geriatrics & Psychiatry
In a patient with suspected Generalized anxiety disorder, which investigation or diagnostic approach is most appropriate at this stage?
A. Clinical psychiatric assessment with screening for medical, neurologic and substance-induced causes
B. Clinical severity assessment with evaluation for electrolyte abnormalities, liver disease and coexisting illness
C. Clinical assessment while excluding substance effects, thyroid disease and other medical mimics
D. Multifactorial falls assessment including medicines, orthostatic vitals, gait, vision and home hazards
Correct Answer: C
Anxiety disorders are diagnosed clinically after considering alternative causes.
Medicine
Geriatrics & Psychiatry
A patient has excessive difficult-to-control worry across several domains for months with restlessness and muscle tension. What is the most likely diagnosis?
A. Acute mania in bipolar disorder
B. Generalized anxiety disorder
C. Schizophrenia-spectrum psychosis
D. Alcohol withdrawal
Correct Answer: B
Persistent generalized worry with physical and cognitive symptoms and functional impact is consistent with GAD.
Medicine
Geriatrics & Psychiatry
Which is a positive symptom of schizophrenia?
A. Auditory hallucinations
B. Avolition
C. Flattened affect
D. Social withdrawal
Correct Answer: A
Hallucinations and delusions are positive symptoms; avolition and flattened affect are negative symptoms.
Medicine
Geriatrics & Psychiatry
Which complication or major adverse outcome is particularly associated with Schizophrenia-spectrum psychosis?
A. Loss of independent activities of daily living
B. Suicide
C. Severe financial, social or safety-related harm
D. Self-harm, neglect or functional deterioration
Correct Answer: D
Untreated psychosis may cause major impairment, poor self-care and safety risks.
Medicine
Geriatrics & Psychiatry
A patient is diagnosed with Schizophrenia-spectrum psychosis. Which is the most appropriate management principle?
A. Treat the cause and use nonpharmacologic orientation, sleep, mobility and sensory-support measures
B. Use supportive care, safety planning, caregiver support and appropriate cognitive-symptom therapy when indicated
C. Use antipsychotic therapy together with psychosocial interventions and adherence support
D. Use evidence-based psychotherapy and/or antidepressant treatment according to severity and patient factors
Correct Answer: C
Antipsychotics are central for positive symptoms, while comprehensive care addresses function, cognition and relapse prevention.
Medicine
Geriatrics & Psychiatry
In a patient with suspected Schizophrenia-spectrum psychosis, which investigation or diagnostic approach is most appropriate at this stage?
A. Multifactorial falls assessment including medicines, orthostatic vitals, gait, vision and home hazards
B. Clinical psychiatric assessment with screening for medical, neurologic and substance-induced causes
C. Focused clinical assessment plus evaluation for reversible precipitants
D. Cognitive assessment, functional history and evaluation for reversible contributors
Correct Answer: B
No single laboratory test diagnoses schizophrenia; assessment must rule out secondary psychosis.
Medicine
Geriatrics & Psychiatry
A patient has persistent delusions, auditory hallucinations, disorganized thought and social or occupational decline. What is the most likely diagnosis?
A. Schizophrenia-spectrum psychosis
B. Alcohol withdrawal
C. Falls related to polypharmacy and frailty
D. Delirium
Correct Answer: A
Persistent psychotic symptoms with functional deterioration suggest a schizophrenia-spectrum disorder after exclusions.
Medicine
Geriatrics & Psychiatry
Which symptom strongly supports mania rather than uncomplicated anxiety?
A. Worry about multiple daily issues
B. Tension headache
C. Fear of public speaking only
D. Decreased need for sleep without feeling tired
Correct Answer: D
A reduced need for sleep is a classic manic symptom and differs from insomnia with daytime fatigue.
Medicine
Geriatrics & Psychiatry
Which complication or major adverse outcome is particularly associated with Acute mania in bipolar disorder?
A. Self-harm, neglect or functional deterioration
B. Functional impairment and comorbid depression
C. Severe financial, social or safety-related harm
D. Withdrawal seizures or delirium tremens
Correct Answer: C
Impaired judgment and risk-taking during mania can produce major psychosocial and physical consequences.
Medicine
Geriatrics & Psychiatry
A patient is diagnosed with Acute mania in bipolar disorder. Which is the most appropriate management principle?
A. Use evidence-based psychotherapy and/or antidepressant treatment according to severity and patient factors
B. Use an appropriate mood stabilizer and/or antipsychotic; hospitalize when severe risk or inability to care for self is present
C. Use antipsychotic therapy together with psychosocial interventions and adherence support
D. Use cognitive behavioral therapy and/or an appropriate first-line antidepressant when symptoms are persistent
Correct Answer: B
Acute mania often needs rapid pharmacologic stabilization and sometimes inpatient care.
Medicine
Geriatrics & Psychiatry
In a patient with suspected Acute mania in bipolar disorder, which investigation or diagnostic approach is most appropriate at this stage?
A. Clinical assessment including substance or medication causes and immediate risk
B. Cognitive assessment, functional history and evaluation for reversible contributors
C. Clinical psychiatric assessment including direct suicide-risk evaluation
D. Clinical psychiatric assessment with screening for medical, neurologic and substance-induced causes
Correct Answer: A
Mania is diagnosed clinically; medical and substance-related mimics must be excluded.
Medicine
Geriatrics & Psychiatry
A patient has decreased need for sleep, pressured speech, grandiosity, increased goal-directed activity and risky behavior. What is the most likely diagnosis?
A. Delirium
B. Alzheimer-type major neurocognitive disorder
C. Major depressive disorder
D. Acute mania in bipolar disorder
Correct Answer: D
A sustained period of elevated or irritable mood with increased energy and functional disturbance is characteristic of mania.