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PTSD — MCCQE Part 1 MCQ

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ModeratePTSD/TraumaPTSDMCCQE Part 1

A 32-year-old veteran has recurrent nightmares about combat 6 months ago, hypervigilance, exaggerated startle, emotional numbness, avoidance. Uses alcohol nightly for sleep. Most appropriate initial treatment?

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Correct answer: B — Trauma-focused CBT (CPT or prolonged exposure)

PTSD: trauma-focused CBT (CPT or PE) is first-line. Benzodiazepines CONTRAINDICATED in PTSD (impair fear extinction, worsen outcomes). If pharmacotherapy needed: SSRIs or venlafaxine. Address comorbid alcohol use.

Reference: CANMAT/Canadian PTSD Guidelines