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Featured Article Review Questions

  Recognizing and Treating Posttraumatic Stress Disorder: A Guide for the Primary Care Physician

Ruth E. Levine, MD

Dr. Levine is the Director of Medical Student Education and an Associate Professor of Psychiatry and Behavioral Sciences and of Internal Medicine, The University of Texas Medical Branch, Galveston, TX.

The questions below are based on the September 2002 cover article, “Recognizing and Treating Posttraumatic Stress Disorder: A Guide for the Primary Care Physician.”

Choose the single best answer for each question.


1. A 22-year-old woman is brought to the emergency department for evaluation after being involved in an automobile accident in which her friend was killed. Several days later, she goes to her physician in marked distress. She states that she often cannot sleep and cannot stop thinking about the accident. At the same time, she reports feelings of numbness and of being "in a daze," as well as an inability to recall aspects of the accident. She reports that when she does fall asleep, she frequently has nightmares. She is extremely anxious and says she does not know what to do. Which is the following is the most likely diagnosis?
  1. Normal reaction to trauma
  2. Acute stress disorder
  3. Adjustment disorder with anxiety
  4. Posttraumatic stress disorder (PTSD), acute
  5. PTSD, delayed onset
Click here to compare your answer.


2. What percentage of persons exposed to a traumatic event will likely develop PTSD?

  1. Less than 10%
  2. 10% to 20%
  3. 30% to 40%
  4. 50% to 60%
  5. More than 60%
Click here to compare your answer.


3. A 34-year-old man reports frequent episodes of chest pain, shortness of breath, and diaphoresis associated with feelings of high anxiety during a visit to his family physician. The patient says that he is veteran of the Gulf War and has been increasingly troubled by memories of and nightmares about his combat experiences ever since attending a reunion with fellow veterans in June of 2001; symptoms intensified after the events of September 11, 2001. He experiences anxiety whenever he hears news about the war in Afghanistan and has canceled his newspaper subscription and discarded his television as a result. He does not understand why he is only recently troubled by memories from 10 years ago and wonders if there is something physically wrong with him. A detailed evaluation, including a cardiac work-up, reveals no evidence of any medical illness. Which of the following diagnoses is most likely?

  1. Normal reaction to trauma
  2. Acute stress disorder
  3. Adjustment disorder with anxiety
  4. PTSD, acute
  5. PTSD, delayed onset
Click here to compare your answer.

4. Which of the following psychotherapies has been shown to be most efficacious in treating PTSD?
  1. Cognitive behavioral therapy
  2. Eye movement desensitization and reprocessing
  3. Imagery rehearsal therapy
  4. Psychodynamic psychotherapy
  5. Psychoanalysis
Click here to compare your answer.


5. Which of the following drug classes is recommended for use as first-line treatment for PTSD?

  1. Anticonvulsant agents
  2. Benzodiazapines
  3. Monoamine oxidase inhibitors
  4. Selective serotonin reuptake inhibitors
  5. Tricyclic antidepressant agents
Click here to compare your answer.


6. Which of the following drug classes should be avoided as a first-line treatment for PTSD because of the potential of worsening a patientıs symptoms of dissociation and disinhibition?

  1. Anticonvulsants
  2. Benzodiazepines
  3. beta-Blockers
  4. Monoamine oxidase inhibitors
  5. Neuroleptic agents
Click here to compare your answer.




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