Med Student Finals Category: Psychiatry

MSFinals-5564

A 16-year-old boy with Tourette’s syndrome is brought to the GP by his father as he is concerned about some unusual behaviors he has observed. During the appointment, you discover that he has been extremely anxious about his upcoming driving test. He feels compelled to check the locks on all the doors in the house repeatedly before leaving, as otherwise, he becomes more anxious about the test.

What signs or symptoms would suggest a diagnosis of psychosis rather than obsessive-compulsive disorder?

MSFinals-5580

A 70-year-old man contacts his primary care physician for guidance. He lost his wife to cancer and has been a widower for 6 months. The patient has a supportive family and is not experiencing clinical depression, but he was very emotional after his wife’s passing. He occasionally feels indifferent and disheartened, but this has improved significantly over time. However, he has heard his late wife speaking to him on several occasions over the last 2 weeks. He also believed he saw her once while shopping with a friend, but he acknowledges that this is impossible. What is the most appropriate course of action for management?

MSFinals-5565

A 32-year-old male visits his primary care physician complaining of new and concerning symptoms. He has a medical history of schizophrenia, which was diagnosed at the age of eighteen and is currently managed with olanzapine. He has not undergone any surgical procedures and is generally in good health.
What are the symptoms he is likely to be experiencing?

MSFinals-5566

In clozapine-treated patients, what is the treatment for hypersalivation?

MSFinals-5567

A 35-year-old woman presents to her general practitioner complaining of a backache that has persisted for the last two weeks. The doctor diagnoses her with a muscle strain and recommends rest with paracetamol for pain as needed. The patient requested narcotic pain medicine, but the doctor refused to prescribe the drug because she thought a medicine of that strength was unnecessary. The patient left the examination room angrily and yelled at the reception staff on her way out.
Which of the following defence mechanisms was the patient demonstrating?

MSFinals-5568

A 27-year-old man is brought to the emergency department by police after being found naked in the street and shouting about the government’s plan to infect the population with a virus through the water supply. He is not known to secondary care services and a drug screen is negative. The psychiatry liaison team admits him under Section 2 of the Mental Health Act for assessment of a first psychosis. What is the most significant risk factor for this patient’s condition?

MSFinals-5569

A 20-year-old man with moderate learning difficulty visits your clinic with his father. His father complains that he has trouble sleeping at night and frequently wakes up, disrupting his own sleep and causing him to be excessively drowsy during the day. He frequently takes a nap in the late afternoon, which is impacting his ability to participate in local community services. They have already attempted conventional sleep hygiene recommendations. Given the history of learning difficulty, what would be the most appropriate medication to assist with his sleep problems?

MSFinals-5554

A 21-year-old woman is brought to her General Practitioner for follow-up 1 week after being attacked and raped by an acquaintance on her university campus. Immediately after the episode, she was seen in the Emergency Department for her injuries and evidence gathering, interviewed by the police and discharged home. Today she reports difficulty sleeping and flashbacks about the event. She has had difficulty concentrating at university and feels anxious that ‘something bad’ might happen to her again.
Which one of the following is the most likely diagnosis?

MSFinals-5555

As you explore non-pharmacological treatments for different mental health conditions during your psychiatry rotation, you come across electroconvulsive therapy (ECT). Which of the following mental health conditions can be treated and managed using ECT?

MSFinals-5556

A 36-year-old woman comes to her General Practitioner (GP) complaining of mood changes eight days after giving birth. She expresses that she does not want the baby and believes that it is dying. She feels like crying constantly. She experiences auditory and visual hallucinations that tell her to harm herself. Apart from this, she has no significant medical history.
What is the diagnosis for this patient?