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100+ Free AOBNP Neurology & Psychiatry Practice Questions

Pass your AOBNP Neurology and Psychiatry Primary Certifying Examination exam on the first try — instant access, no signup required.

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~75-90% Pass Rate
100+ Questions
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Question 1
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Which is the most appropriate treatment for moderate-to-severe Alzheimer disease?

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B
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to track
2026 Statistics

Key Facts: AOBNP Neurology & Psychiatry Exam

$1,650

Application + Exam Fee

AOBNP 2026

$1,200

Reexamination Fee

AOBNP 2026

$175/yr

Longitudinal Assessment Fee

AOBNP 2026

30 MCQs

Annual Longitudinal Questions

AOA Learning Portal

Remote

Online Remote-Proctored Delivery

AOBNP

300-500 hrs

Typical Study Time

Residency graduates

AOBNP is the AOA pathway for DO board certification in Neurology and Psychiatry, with combined-track eligibility for physicians completing both residencies. The 2026 application+exam fee is $1,650 (with a $1,200 retake fee) and the longitudinal assessment runs through the AOA Learning Portal at $175/yr starting January 2026. The Written Exam is single-best-answer MCQ delivered annually via remote proctored testing, with pass rates historically ~75-90% across tracks.

Sample AOBNP Neurology & Psychiatry Practice Questions

Try these sample questions to test your AOBNP Neurology & Psychiatry exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 28-year-old woman presents with 3 weeks of depressed mood, anhedonia, decreased sleep, low energy, poor concentration, weight loss, and passive suicidal ideation without plan. She has no manic history. Which is the most appropriate first-line pharmacologic treatment?
A.Sertraline
B.Olanzapine
C.Lithium
D.Methylphenidate
Explanation: Per DSM-5-TR, she meets criteria for major depressive disorder. SSRIs (sertraline, escitalopram, fluoxetine) are first-line because of efficacy and tolerability. Reassess in 4-6 weeks; therapeutic dose typically reached in 2-4 weeks with response in 4-8 weeks.
2A 32-year-old man has a 1-week episode of decreased need for sleep, racing thoughts, increased goal-directed activity, grandiosity, and impulsive spending. He was admitted for safety. Which is the most appropriate maintenance therapy?
A.Sertraline alone
B.Lithium or valproate; consider atypical antipsychotic
C.Diazepam alone
D.Methylphenidate
Explanation: Bipolar I disorder requires mood stabilizer maintenance. Lithium (target 0.6-1.2 mEq/L) and valproate are first-line, often combined with an atypical antipsychotic during acute mania. SSRIs alone can precipitate mania.
3Which laboratory test is most important to obtain before starting lithium therapy?
A.Serum creatinine, TSH, electrolytes, pregnancy test, ECG in older patients
B.Liver function tests only
C.CBC only
D.Cortisol level
Explanation: Baseline labs before lithium include renal function (creatinine), thyroid function (TSH), electrolytes, pregnancy test (Ebstein anomaly risk), and ECG in older adults or those with cardiac history. Monitor lithium level 5 days after each dose change.
4A 22-year-old college student presents with 9 months of social withdrawal, auditory hallucinations of derogatory voices, persecutory delusions, and disorganized speech. No substance use. What is the most likely diagnosis?
A.Brief psychotic disorder
B.Schizophreniform disorder
C.Schizophrenia
D.Major depressive disorder with psychotic features
Explanation: Schizophrenia requires >=2 of 5 criterion A symptoms (delusions, hallucinations, disorganized speech, grossly disorganized/catatonic behavior, negative symptoms) with continuous disturbance >=6 months and >=1 month of active-phase symptoms.
5A patient on haloperidol develops high fever 40 C, severe muscle rigidity, altered mental status, autonomic instability, and elevated CK 12,000. What is the most likely diagnosis and treatment?
A.Serotonin syndrome; cyproheptadine
B.Neuroleptic malignant syndrome; stop antipsychotic, supportive care, dantrolene or bromocriptine
C.Malignant hyperthermia; dantrolene only
D.Catatonia; lorazepam
Explanation: NMS classically presents as fever, lead-pipe rigidity, AMS, autonomic dysfunction, and very elevated CK after antipsychotics. Treatment: stop the offending agent, aggressive cooling/IV fluids, dantrolene (1-2.5 mg/kg) or bromocriptine, and ICU care.
6Which laboratory monitoring is required for clozapine therapy?
A.TSH monthly
B.ANC weekly for the first 6 months, then biweekly, then monthly; monitor for agranulocytosis
C.Liver function tests yearly
D.Lithium level
Explanation: Clozapine requires strict ANC monitoring: weekly for the first 6 months, every 2 weeks for the next 6 months, then monthly. Discontinue if ANC <1,000/uL. Also monitor for myocarditis (early), metabolic syndrome, and seizures.
7A 35-year-old presents with sudden onset of intense fear, palpitations, sweating, shortness of breath, and a sense of impending doom lasting 15 minutes. Episodes have recurred over 3 months and he avoids public places. What is the most likely diagnosis?
A.Panic disorder with agoraphobia
B.GAD
C.PTSD
D.OCD
Explanation: Recurrent unexpected panic attacks plus 1 month of persistent worry or maladaptive behavior change defines panic disorder. Agoraphobia is fear of >=2 situations where escape is difficult. First-line: SSRI and CBT.
8A 40-year-old veteran reports recurrent intrusive memories of combat, nightmares, hypervigilance, irritability, and avoidance of crowded places for the past 8 months. Which evidence-based therapy is first-line?
A.Trauma-focused CBT (prolonged exposure or cognitive processing therapy) and SSRI
B.Benzodiazepines daily
C.Cognitive remediation
D.Antipsychotic monotherapy
Explanation: PTSD first-line treatment is trauma-focused psychotherapy (prolonged exposure, cognitive processing therapy, EMDR) and SSRI (sertraline or paroxetine are FDA-approved). Benzodiazepines should be avoided.
9Which antidepressant is most likely to cause sexual dysfunction?
A.Bupropion
B.Mirtazapine
C.Sertraline (SSRI)
D.Vilazodone
Explanation: SSRIs are most associated with sexual dysfunction (decreased libido, anorgasmia, erectile dysfunction). Bupropion and mirtazapine have the lowest sexual side-effect profile; vilazodone also has lower rates.
10A patient with chronic alcohol use is brought in 8 hours after his last drink. He has tremor, diaphoresis, tachycardia 110, BP 160/95, and is anxious. CIWA-Ar score is 18. What is the most appropriate management?
A.Discharge with reassurance
B.Long-acting benzodiazepine (e.g., chlordiazepoxide) on symptom-triggered or fixed schedule, plus thiamine, folate, multivitamins
C.Naltrexone immediately
D.Disulfiram now
Explanation: Moderate-to-severe alcohol withdrawal (CIWA >=8-10) is treated with benzodiazepines (chlordiazepoxide, diazepam, lorazepam) on a symptom-triggered or fixed-dose protocol, plus thiamine before glucose, folate, and supportive care. Monitor for DT progression.

About the AOBNP Neurology & Psychiatry Exam

The AOBNP administers AOA board certification in Neurology and in Psychiatry (with combined-track eligibility for candidates completing dual training). The Written Exam is delivered annually via remote proctored testing and covers core neurology and psychiatry content as well as osteopathic principles. After passing the Written, candidates complete an Oral/Clinical Exam component. Continuous certification from January 2026 is administered through the AOA Learning Portal with 30 untimed MCQs per calendar year ($175 annual fee).

Questions

100 scored questions

Time Limit

Remote-proctored Written Exam (multi-section, single day per AOBNP schedule)

Passing Score

Criterion-referenced scaled standard set by AOBNP (typical AOA scale ~500/800)

Exam Fee

$1,650 (application $350 + exam $1,300); retake $1,200 (American Osteopathic Board of Neurology and Psychiatry (AOBNP))

AOBNP Neurology & Psychiatry Exam Content Outline

20%

Mood and Anxiety Disorders

DSM-5-TR MDD criteria (>=5 SIGECAPS over 2 weeks), bipolar I (>=1 manic) vs bipolar II (>=1 hypomanic + MDE), antidepressant first-line (SSRIs sertraline/escitalopram), bipolar maintenance (lithium - therapeutic 0.6-1.2 mEq/L, lamotrigine for depression, valproate, atypicals), ECT for refractory or catatonic depression, suicide risk stratification.

12%

Psychotic Disorders

Schizophrenia criteria (positive: hallucinations/delusions; negative: avolition/alogia; cognitive symptoms; >=6 months duration with >=1 month active phase), schizoaffective, delusional disorder, atypical antipsychotic monitoring (metabolic syndrome, QTc), clozapine indications (treatment-resistant, suicide risk) with ANC monitoring weekly, neuroleptic malignant syndrome (dantrolene, bromocriptine).

10%

Substance Use Disorders

Alcohol use disorder severity, withdrawal CIWA-Ar (benzodiazepines, thiamine before glucose), MAT for AUD (naltrexone, acamprosate, disulfiram), opioid use disorder (buprenorphine - start when COWS >=12, methadone, naltrexone), stimulant/cocaine (no FDA-approved MAT), benzo withdrawal (long-acting taper), nicotine (varenicline, bupropion, NRT).

8%

Child/Adolescent and Geriatric Psychiatry

ADHD (DSM-5-TR <=12 yo onset for symptoms, stimulants methylphenidate/amphetamine first-line, atomoxetine/guanfacine alternatives), autism (early intervention, ABA), eating disorders (anorexia BMI <17.5, bulimia compensatory behaviors, refeeding syndrome with low phos/Mg/K), geriatric depression (low-dose sertraline, avoid TCA/anticholinergic), dementia BPSD (non-pharm first, atypicals with black-box warning).

10%

Cerebrovascular Disease

Acute ischemic stroke (NIHSS, IV alteplase within 4.5 h, BP <185/110; thrombectomy 0-24 h for large vessel occlusion with imaging mismatch), ICH (BP control SBP ~140, reverse anticoagulation, neurosurg consult), SAH (CT then LP if early CT negative; nimodipine, aneurysm coiling/clipping), secondary prevention (antiplatelet, statin, BP control, AF anticoagulation CHA2DS2-VASc).

8%

Seizures and Epilepsy

Generalized vs focal classification, status epilepticus (lorazepam 4 mg IV x 2, then levetiracetam 60 mg/kg or fosphenytoin 20 mg PE/kg or valproate 40 mg/kg), absence (ethosuximide first-line), JME (valproate, lamotrigine), focal (levetiracetam, oxcarbazepine), pregnancy (avoid valproate - neural tube defects, lamotrigine safer), SUDEP risk.

6%

Headache and Pain Disorders

Migraine acute (triptans, NSAIDs, gepants - ubrogepant/rimegepant), preventive (propranolol, topiramate, amitriptyline, CGRP mAbs - erenumab/galcanezumab/fremanezumab/eptinezumab), tension-type (NSAIDs, OMT), cluster (high-flow O2, sumatriptan SC, verapamil prevention), red flags (SAH thunderclap, GCA, IIH papilledema, trigeminal neuralgia carbamazepine).

8%

Neuromuscular and Movement Disorders

Parkinson disease (levodopa-carbidopa, DA agonists, MAO-B inhibitors, DBS for advanced), essential tremor (propranolol, primidone), myasthenia gravis (pyridostigmine, immunosuppressants, IVIG/plasmapheresis for crisis, thymectomy), GBS (IVIG or plasmapheresis, watch for autonomic instability), ALS (riluzole, edaravone), MS (DMTs - ocrelizumab, natalizumab, fingolimod).

8%

Dementia and Cognitive Disorders

Alzheimer disease (cholinesterase inhibitors - donepezil, rivastigmine, galantamine; memantine moderate-severe; anti-amyloid mAbs - lecanemab/donanemab with MRI monitoring for ARIA), vascular dementia (BP/lipid/glucose control), Lewy body dementia (sensitive to antipsychotics, REM behavior disorder), FTD (behavioral variant, primary progressive aphasia), NPH (wet/wacky/wobbly, shunting).

10%

OMM and Cross-Cutting (Ethics, Capacity, Civil Commitment)

Suboccipital release for tension headache, cervical muscle energy for cervicogenic headache, lumbar OMT for low back pain in depression/anxiety somatization, decision-making capacity (understanding, appreciation, reasoning, communication), informed consent, civil commitment criteria (danger to self/others/grave disability), confidentiality and HIPAA exceptions, Tarasoff duty to warn.

How to Pass the AOBNP Neurology & Psychiatry Exam

What You Need to Know

  • Passing score: Criterion-referenced scaled standard set by AOBNP (typical AOA scale ~500/800)
  • Exam length: 100 questions
  • Time limit: Remote-proctored Written Exam (multi-section, single day per AOBNP schedule)
  • Exam fee: $1,650 (application $350 + exam $1,300); retake $1,200

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

AOBNP Neurology & Psychiatry Study Tips from Top Performers

1Memorize DSM-5-TR core criteria: MDD (>=5 SIGECAPS over 2 weeks including depressed mood or anhedonia), bipolar I (>=1 manic episode lasting >=7 days), bipolar II (>=1 hypomanic + MDE), GAD (excessive worry >=6 months, 3+ symptoms), PTSD (>=1 month, intrusion/avoidance/negative cognition/arousal), and schizophrenia (>=2 of 5 criteria A symptoms for 1 month, total 6 months).
2Drill psychotropic monitoring: lithium (level 0.6-1.2, TSH/Cr, signs of toxicity tremor/ataxia/seizures), valproate (LFTs, CBC, pregnancy contraindicated for neural tube defects), lamotrigine (slow titration to avoid SJS), clozapine (ANC weekly first 6 months, agranulocytosis, myocarditis), atypicals (metabolic syndrome, EPS, NMS criteria - fever/rigidity/AMS/autonomic instability).
3For acute stroke, internalize: tPA window 4.5 h with BP <185/110, exclude hemorrhage, NIHSS 4-22 typically; thrombectomy 0-24 h for LVO using DAWN/DEFUSE-3 imaging mismatch criteria; secondary prevention with antiplatelet + statin + BP <130/80; AF stroke uses anticoagulation per CHA2DS2-VASc.
4Master status epilepticus algorithm: lorazepam 4 mg IV every 5-10 min (up to 8 mg total), then second-line levetiracetam 60 mg/kg OR fosphenytoin 20 mg PE/kg OR valproate 40 mg/kg (per ESETT trial, roughly equivalent), then anesthetic infusion (propofol, midazolam, pentobarbital) for refractory cases.
5Practice OMM cross-cutting scenarios: suboccipital release for chronic tension-type headache with cervical somatic dysfunction, cervical muscle energy for cervicogenic headache, lumbar HVLA/muscle energy for chronic low back pain in patients with comorbid depression or anxiety, recognizing somatic dysfunction in chronic pain syndromes, and integrating OMT with pharmacologic and psychotherapeutic management.

Frequently Asked Questions

Who is eligible for the AOBNP Primary Certifying Examination?

Candidates must be DO graduates (or MDs with approved equivalency) who have completed an ACGME-accredited Neurology or Psychiatry residency (formerly AOA-approved). For combined-track eligibility, candidates must complete both training programs and meet AOBNP's combined case and training requirements. Unrestricted US medical license and program director attestation of clinical competence are required.

How is the AOBNP Written Exam structured?

Both the Neurology and Psychiatry Written Exams are offered annually via a remote proctored online platform. The exams use single-best-answer multiple-choice questions and are administered as a multi-section assessment per AOBNP's schedule. After passing the Written, candidates complete an Oral/Clinical component for full certification.

What does the AOBNP exam cost?

The 2026 application fee is $350 and the initial examination fee is $1,300, totaling $1,650 due with the completed application. Re-examination is $1,200. For continuous certification beginning in 2026, the longitudinal assessment annual fee is $175 (with a $50 late fee after October 16); registration opens August 1 and closes November 30.

How does the AOA Learning Portal longitudinal assessment work?

Starting January 2026, the Neurology and Psychiatry longitudinal assessment runs through the AOA Learning Portal LMS. Diplomates answer 30 untimed multiple-choice questions per calendar year for ongoing certification. The assessment replaces the traditional 10-year recertification exam for participating diplomates and is one component of the broader OCC framework.

What topics are tested on the AOBNP Written Exam?

Psychiatry content includes mood and anxiety disorders, psychotic disorders, substance use, child/adolescent and geriatric psychiatry, personality disorders, and consultation-liaison topics. Neurology content includes cerebrovascular disease, seizures, headache, dementia, movement and neuromuscular disorders, demyelinating disease, neuro-oncology, and neuro-ophthalmology. Cross-cutting topics include osteopathic principles, ethics, capacity/civil commitment, and OMM application to neuro-psychiatric conditions.

How long should I study for the AOBNP Written Exam?

Most residency graduates report 300-500 hours of dedicated study over 4-8 months. A typical plan allocates ~30% to mood/anxiety and psychotic disorders (psychiatry track) or stroke and seizures (neurology track), with proportional time on substance use, child/geriatric, dementia, movement disorders, neuromuscular, headache, and cross-cutting OMM/ethics topics.

What is the pass rate for the AOBNP exam?

AOBNP publishes annual pass-rate statistics on its certification site. First-attempt pass rates for US-trained residency graduates have historically ranged about 75-90% across the Neurology and Psychiatry tracks, with retakers performing lower. Completing a structured board review, drilling DSM-5-TR criteria and AAN/APA guidelines, and timed mixed-content question sets correlate with success.

Does the AOBNP exam test osteopathic content?

Yes. AOBNP examinations include osteopathic principles and OMM application as part of the cross-cutting content. Expect questions on suboccipital release for tension headache, cervical muscle energy for cervicogenic headache, lumbar OMT for low back pain (often comorbid with depression/anxiety), and integration of osteopathic principles into the holistic care of neurologic and psychiatric patients.