MSFinals-5557
A 56-year-old man without medical history is beginning treatment with tranylcypromine for his depression. What foods should he be cautioned against consuming?
Med Student Finals Category: Psychiatry
MSFinals-5542
A 26-year-old man is brought to his GP by his father as he is worried that his son has become socially withdrawn since puberty. Despite being regularly invited, he doesn’t participate in after-work events. His father recently became concerned when his son stated that he doesn’t need or want any friends. The patient has no significant medical history, denies alcohol dependence, and has recently been promoted at work. During the consultation, he remains with his arms folded and does not engage. There is no evidence of affection towards his father when he expresses his concern. What is the most likely diagnosis for this patient?
MSFinals-5558
Sophie is a 25-year-old woman who was diagnosed with generalised anxiety disorder 8 months ago. She has been taking sertraline for 5 months but feels that her symptoms have not improved much. Sophie wants to switch to a different medication. What is the most suitable drug to start?
MSFinals-5543
A 30-year-old woman is brought to the Emergency Department after attempting to end her life by jumping from a height. On examination, she is conscious and has significant bruising over the occiput region. She reports that her parents are recently divorced and it has caused significant strain on her current relationship and as a result, is failing to do well at work. She has no significant medical history, apart from an incident when she was 17 where she was admitted to the hospital after intentionally taking too many paracetamol.
Which of the following from the patient’s history is most associated with an increased risk of repeated attempts of self-harm/suicide?
MSFinals-5559
You speak to the husband of a patient with depression who was recently discharged from a psychiatry ward after a suicide attempt. He was switched from sertraline to venlafaxine. His husband says his mood is okay but over the last 2 weeks, he became erratic and was not sleeping. He spoke fast about a ‘handsome inheritance’ he got but was gambling away their savings saying he was going to save the world. When confronted he became angry and accused him of trying to ‘steal his energy’. You suspect he’s developed mania and refer him to the crisis psychiatry team.
What do you anticipate will be the subsequent step in management?
MSFinals-5544
A 58-year-old woman with a long history of bipolar disorder visits the mental health clinic. She reports experiencing an uncomfortable sensation of inner restlessness for several months, and her husband observes that she frequently moves her arms and legs.
What symptom is the woman experiencing?
MSFinals-5560
A 60-year-old patient with a history of bipolar disorder visits your GP clinic for routine blood tests. Despite feeling completely fine, he wants to check his health status. Upon clinical examination, there are no signs of splenomegaly or lymphadenopathy.
The following are the results:
– Hb 140 g/L Male: (135-180) Female: (115 – 160)
– Platelets 160 * 109/L (150 – 400)
– WBC 14 * 109/L (4.0 – 11.0)
– Na+ 144 mmol/L (135 – 145)
– K+ 4.7 mmol/L (3.5 – 5.0)
– Urea 5.4 mmol/L (2.0 – 7.0)
– Creatinine 114 µmol/L (55 – 120)
– Thyroid stimulating hormone (TSH) 5.2 mU/L (0.5-5.5)
– Free thyroxine (T4) 9.5 pmol/L (9.0 – 18)
– Lithium level 0.75 mmol/L (0.6 – 1.2)
What advice would you give to this patient?
MSFinals-5545
A 37-year-old man presents with intrusive images of a violent altercation he witnessed a couple of months ago. He says he cannot concentrate because of it and has been avoiding going to the area where it happened. What should be your first line in management?
MSFinals-5561
A 28-year-old woman is brought to the Emergency Department after taking an overdose of paracetamol due to a recent breakup with her partner. She expresses remorse for her actions, denies any suicidal thoughts, and requests to be discharged. Her parents and a friend arrive at the hospital soon after. Paracetamol levels at 4 hours are below the treatment limit.
What should be the next course of action in managing her case?
MSFinals-5546
A 35-year-old patient is about to be discharged from hospital with a course of diazepam to help with anxiety symptoms.
Which feature of the history is the most important to ask about?