Behavioral Science & Ethics USMLE Step 1 Practice Question
A 38-year-old man presents with a 6-week history of depressed mood, poor concentration, and insomnia. He reports that his mood has been persistently low for the past 4 years following a breakup, with only brief periods of normal mood lasting 2-3 weeks. He denies significant changes in appetite or weight and reports adequate energy levels. He does not use alcohol or illicit drugs. Mental status examination confirms depressed mood with restricted affect. Urine drug screen is negative. Which of the following is the most appropriate initial management?
Answer choices
- ASertraline monotherapy with reassessment in 2 weeks
- BCognitive behavioral therapy alone with close psychiatric follow-up
- CCombination sertraline and cognitive behavioral therapy with follow-up in 4 weeksCorrect answer
- DBupropion monotherapy due to his preserved energy levels
- EParoxetine monotherapy given the chronicity of symptoms
- FCognitive behavioral therapy plus benzodiazepine for symptom relief
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.