A 50-year-old male with schizophrenia is being evaluated by his psychiatrist. During the consultation, the psychiatrist observes that the patient appears disinterested and unresponsive when discussing recent and upcoming events in his life, such as his upcoming trip to Hawaii and his recent separation from his spouse.
What is the most appropriate term to describe the abnormality exhibited by the patient?
A 28-year-old patient presents with sudden paralysis in their right leg and left arm, four weeks after being involved in a car accident. Despite being discharged from the hospital without injuries, they woke up this morning unable to move these limbs. There is no pain, but the paralysis is causing significant distress. On examination, there are no visible injuries, normal tone, and intact sensation in all four limbs. All reflexes are normal, but power in the affected limbs is MRC 0/5, while the contralateral limbs are MRC 5/5. Hoover’s sign is positive on the affected leg, and there are no abnormalities in the cranial nerve exam. What is the likely diagnosis?
A 47-year-old man visits his General Practitioner with worsening anxiety. He describes one of his symptoms as feeling severely nauseous and even vomiting every time he smells a particular perfume. What theory of learning explains this?
A 25-year-old man with Down syndrome is brought to see the General Practitioner (GP) by his mother to discuss his acne. His mother takes care of all his medications, as he cannot understand the instructions. He lives with his parents and depends on them to do all his cooking and washing. He does not work but attends a day centre a few days per week, where he enjoys craft activities and has a number of close friends. The staff report he is always very polite and interacts well with everyone at the centre. His mother says he is unable to be left alone in the house and cannot go out on his own without the support of another adult.
Which one of the following conditions does he have?
A 9-year-old girl is brought to see the General Practitioner (GP) by her father, who is concerned about her behaviour at home and school. Over the past 18 months, her father has noted problems with inattention, hyperactivity and impulsivity. Teachers have also been raising similar issues about her behaviour in school. Her symptoms are affecting her performance in school and her relationship at home with her parents and siblings.
Which one of the following conditions is she most likely to be diagnosed with?
A 4-year-old boy is brought to the General Practitioner (GP) by his parents due to concerns raised by his nursery. Although he is meeting his developmental milestones, he seems to struggle with social interaction and play with other children.
The parents report that he was born via normal vaginal delivery at term and has met all of his speech and motor milestones. However, they have noticed that he is different from his older siblings as he has never made any friends or engaged in any imaginative play. He prefers to play alone and becomes upset if anyone touches his toys. He insists on following the same routine every day, including eating the same meals and taking the same route to nursery. He struggles during weekends and holidays when his routine is disrupted.
Which of the following diagnoses would be most consistent with the signs and symptoms observed in this child?
A 30-year-old man without known psychiatric history is admitted to the psychiatry ward, after presenting to the emergency department with delusions and homicidal ideations.
Following a negative drugs screen, antipsychotic treatment is initiated with haloperidol.
The patient is reviewed 3-hours after the initiation of treatment and is noted to have a sustained upward deviation of both eyes. When asked, he reports that his eyes are extremely painful.
What is the most appropriate initial management option based on the likely diagnosis?
A 25-year-old woman returns to your clinic complaining of constant feelings of sadness, loss of appetite, insomnia, and a lack of enjoyment in anything. Despite making lifestyle changes and setting small goals, she still feels hopeless and requests medication. You decide to prescribe sertraline. What drug should be avoided in patients taking an SSRI?
A 67-year-old man presents to the hospital in a confused state. He is unable to explain his condition but insists that he was admitted for 10 days last month despite records showing his last admission to be 7 months ago. He cannot recall which secondary school he attended and, after being on the ward for a week, he does not recognize his primary doctor’s face. The patient has a medical history of hypertension, ischemic stroke, and alcoholic liver disease.
Upon examination, the patient has normal tone, upgoing plantar reflexes on the right, and a broad-based gait. There are bilateral cranial nerve 6 (CN 6) palsies associated with nystagmus.
What is the probable diagnosis for this patient?
Samantha, a 35-year-old woman, arrives at the emergency department complaining of severe, sharp pain on her left side that radiates to her lower abdomen and groin. The pain comes and goes in waves and has been ongoing for 10 hours. She also reports an increased frequency of urination and a burning sensation while urinating. A urine dip reveals haematuria but no signs of infection. You request the following blood tests:
Calcium 3.3 mmol/L (2.1-2.6)
Corrected Calcium 3.4 mmol/L (2.1-2.6)
Phosphate 0.6 mmol/L (0.8-1.4)
Magnesium 0.8 mmol/L (0.7-1.0)
Thyroid stimulating hormone (TSH) 4.9 mU/L (0.5-5.5)
Free thyroxine (T4) 9.5 pmol/L (9.0 – 18)
Parathyroid hormone 85 pg/mL (10-65 )
Which medication’s long-term use is responsible for Samantha’s condition?