Questions

Just like the actual exam

Aligned with the American Board of Psychiatry and Neurology format. Authored & peer-reviewed by faculty, clinicians, and program directors.

Each question is written to resemble the format and topics on the exam, meaning you won’t see any negatively phrased questions, no “all of the following except,” no “A and B”…you know what we mean. Most importantly, all questions include selective distractors (incorrect answer choices), which will help you think critically.

  • Must address important content
  • Must be well structured

Question

A 62-year-old woman presents to the emergency room with acute onset of disorientation, akathisias, flushing, low-grade fever, hypertension, diaphoresis, tachycardia, and myoclonus. Her medications include citalopram, hydrochlorothiazide, metformin, and transdermal selegiline. What pharmacological intervention would be most effective in addition to admitting this woman to the hospital?

A Bromocriptine
B Cyproheptadine
C Dantrolene
D Physostigmine

This woman is suffering from serotonin syndrome due to a drug-drug interaction between selegiline and citalopram. Serotonin syndrome is a potentially life-threatening condition characterized by altered level of consciousness, autonomic instability, and neuromuscular abnormalities such as myoclonus, hyperreflexia, nystagmus, akathisia, and muscle rigidity. The differential diagnoses could include neuroleptic malignant syndrome, malignant hyperthermia, anticholinergic toxicity, sympathomimetic intoxication, and sedative-hypnotic withdrawal. Treatment of serotonin syndrome includes discontinuation of the offending agents, supportive therapy, and use of the nonspecific serotonin antagonist cyproheptadine.

Use of bromocriptine (A) and dantrolene (C) is indicated in neuroleptic malignant syndrome. However, bromocriptine can worsen serotonin syndrome. Though typically thought of as a dopamine agonist, it also has serotonin agonist properties. Though anticholinergic toxicity can be reversed with physostigmine (D), it has no role in treating serotonin syndrome.


Explanations

Written with a purpose

Understanding why an answer choice is incorrect is just as important as knowing why one is correct. That’s why every Rosh Review question includes detailed explanations for the correct and incorrect answer choices. These comprehensive summaries link the most important components of a topic—from risk factors to diagnostics and treatment—giving you the context to build relationships between them.

  • Created for optimal learning and recall
  • Help reinforce your knowledge
  • Focus on the essential information

Illustrations

Created to enhance learning

Custom illustrations and tables help further clarify the core concepts. When information is presented visually, you can focus on meaning, easily reorganize and group similar ideas, and make better use of your memory.

serotonin syndrome

Powerful Analytics

Track progress, performance, & predictions

Your personal analytics allow you to see your progress at all times, so you can create an efficient and effective learning strategy and stay on pace with your plan.

Focus your learning

Deep insights to determine your strengths and weaknesses so you can spend your time on the subjects that matter.

Compare with your peers (chart)

Compare with your peers

Discover how your answer choices align with those selected by learners across the country.

Find out your probability of passing

Using data generated by previous users, your Qbank gives a prediction of how likely you are to pass your exam.


One Step Further

Taking your learning to the next level

After each explanation is a straightforward question with a simple, memorizable answer that reinforces the corresponding topic.

  • Strengthens your knowledge
  • Stands alone from the main explanation so you’re not rereading content

Q: What other class of medications is helpful in managing serotonin syndrome?

REVEAL ANSWER

A: Benzodiazepines.

Serotonin Syndrome

  • Patient with a history of taking multiple medications that increase the amount of serotonin
  • PE will show mental status changes, autonomic instability, and neuromuscular abnormalities
  • Treatment is benzodiazepines, cyproheptadine, removing the offending agent(s)

Rapid Review

Keeping things simple

These bulleted reviews focus on condensed, high-yield concepts about the main topic, from patient presentation to preferred management.

  • Cover the fundamentals in one list
  • Allow you to quickly scan the must-know information
Thank you for preparing me for my certification exam. What kind of sorcery are you doing? I got the exact score you predicted I would get. Creepy but good!

FAQs

Get a little more clarification

Do you offer a free trial?
Absolutely! You can try out a number of sample questions in the actual app by creating a free account (no billing information required—we promise). You will get a fully functional account, forever, with a limited number of questions. If you love it, you can easily purchase a full content subscription. You won't be charged at any point during your trial until you make a purchase.
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Phone...laptop...tablet...yep! You can access your subscription from as many locations and as many devices as you want and have. However, we recommend starting and completing exams on a single device.Keep in mind that sharing accounts is not allowed, so simultaneous logins are not allowed. Any abuse of the Terms & Conditions will result in cancellation of your account.Please download the mobile app from the Apple Store or Google Play Store.
How do you decide which topics to cover?
Every question in your Qbank is based on topics found in the most recent version of your specialty’s practice model. As you review each question, the category that correlates with the material being tested will appear on the screen. If it’s not in the model, it won’t be on the exam.

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