A 28-Year-Old Man Comes to the Office Due to Persistent

question 86

Multiple Choice

A 28-year-old man comes to the office due to persistent fatigue.  For the past several weeks, he has been having trouble sleeping and is frequently late for work as he has difficulty getting out of bed.  At work, his mind wanders, and his supervisor has commented that the quality of his work has deteriorated.  The patient says, "I've been feeling down and don't feel like doing anything.  My appetite is poor.  I no longer go out with my friends and haven't gone to the gym in weeks."  The patient has no significant medical or psychiatric history.  He has 1 or 2 alcoholic drinks several days a week but does not use illicit drugs.  Routine laboratory evaluation, including thyroid function tests and serum B₁₂ level, is normal.  Physical examination is unremarkable.  Mental status examination shows a cooperative man with sad affect.  No delusions are elicited.  The patient says he sometimes wishes he could "go to sleep and not wake up," but has no suicidal intent or plan.  First-line pharmacotherapy for this patient most likely involves a drug with which of the following mechanisms of action?

• A)Antagonism of dopamine D2 receptors
• B)Antagonism of serotonin 5-HT2 receptors
• C)Inhibition of sodium channels
• D)Inhibition of the serotonin transporter
• E)Inhibition of monoamine oxidase
• F)Potentiation of the effects of endogenous GABA

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Definitions:

Knowledge

Facts, information, and skills acquired through experience or education; the theoretical or practical understanding of a subject.

Connectionist Model

A theoretical approach in cognitive science that argues mental phenomena can be described by artificial neural networks or activities of interconnected nodes, simulating the way neurons work in the brain.

Letters

Written symbols or characters that are used to create words in various alphabets.

Word-Superiority Effect

A phenomenon where words are more easily recognized and processed than individual letters or non-words in reading and perception tasks.