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Self-Assessment Questions

Psychiatry

Evaluation and Treatment of Obsessive-Compulsive Disorder: Review Questions

William R. Marchand, MD
Dr.Marchand is an assistant professor of clinical psychiatry, University of Utah, Salt Lake City, UT.



Choose the single best answer for each question.

1. A 45-year-old man reports concerns about obsessive thinking over the past 3 months. He describes unpleasant ruminations about being worthless because of not achieving goals he set for his life. He feels these are meaningful thoughts but painful and disturbing. He also reports feeling sad over the same time period and states that he has low energy and difficulty sleeping. He denies worry about everyday problems. What is this patient’s most likely diagnosis?
  1. Delusional disorder
  2. Generalized anxiety disorder
  3. Major depression
  4. Obsessive-compulsive disorder (OCD)
  5. Posttraumatic stress disorder
Click here to compare your answer.


2. Which of the following would be the most appropriate first-line agent for OCD uncomplicated by any comorbid psychiatric disorders?

  1. Buspirone
  2. Clomipramine
  3. Fluvoxamine
  4. Haloperidol
  5. Risperidone
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3. A 35-year-old woman with OCD presents to her psychiatrist. She has been taking clomipramine 75 mg/d for 3 weeks and states that there has been no improvement in her symptoms. Which of the following would be the most appropriate treatment recommendation for this patient?

  1. Augment with lithium
  2. Augment with trazodone
  3. Change to another tricyclic antidepressant
  4. Change to sertraline
  5. Gradually titrate clomipramine to 250 mg/d and continue the trial
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4. A 55-year-old man presents to his primary care physician accompanied by his spouse. His wife is concerned that he may have OCD. She states that he sometimes is unsure if he has locked the door when leaving the house and walks back to check it. The patient agrees with his wife’s statement but does not see it as a problem. They both agree that it does not interfere with his life. However, his wife is annoyed by the behavior and feels it is unnecessary. He denies any other repetitive behaviors or obsessive thoughts. No additional psychiatric symptoms are reported. What is the most likely diagnosis for this patient?
  1. Anxiety disorder not otherwise specified
  2. Generalized anxiety disorder
  3. No psychiatric diagnosis
  4. Obsessive-compulsive personality disorder
  5. OCD
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5. Which of the following conditions should always be considered in the differential diagnosis of a patient with suspected OCD?

  1. Delirium
  2. Depersonalization disorder
  3. Malingering
  4. Neuroleptic-induced parkinsonism
  5. Tourette’s disorder
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