Psychiatry Posttraumatic Stress Disorder: Review Questions Ruth E. Levine, MD Dr. Levine is Associate Professor and Director of Undergraduate Education, Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, and a member of the Hospital Physician Editorial Board. Choose the single best answer for each question.
	Questions 1 through 3 refer to the following case study. A 20-year-old female college student was raped 10 days ago. Since the rape, she has experienced high levels of anxiety, persistent and vivid nightmares about the rape, and a reluctance to leave her home. She has stopped attending her classes and has lost interest in many of the activities she once enjoyed. She startles at even the slightest noise and alternates between feelings of irritability and numbness. Often, she feels like she is "in a daze." She reports difficulty in talking about the rape, stating that she honestly cannot remember much of what happened. 1. Which of the following disorders is she most likely experiencing? Acute stress disorder Adjustment disorder with mixed emotional features Bipolar II disorder Major depression Posttraumatic stress disorder (PTSD) Click here to compare your answer.		2. If this patient continued to experience these symptoms 6 months after the rape, which of the following treatments would be considered optimal? Cognitive behavioral therapy alone Cognitive behavioral therapy in combination with an antidepressant Trauma-focused psychodynamic therapy alone Trauma-focused psychodynamic therapy in combination with an anxiolytic An antidepressant in combination with an anxiolytic Click here to compare your answer. 3. If a medication is deemed necessary, which of the following would be a first-line choice? Alprazolam Bupropion Buspirone Lithium Sertraline Click here to compare your answer. 4. Brain magnetic resonance imaging studies of patients with PTSD have revealed atrophy in which of the following areas of the brain? Amygdala Frontal lobes Hippocampus Hypothalamus Reticular formation Click here to compare your answer.
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