Med Student Finals Category: Psychiatry

MSFinals-5487

A 32-year-old man comes to you seeking help as he feels like he is not himself lately. He has been struggling since his divorce 8 months ago. For the past 5 weeks, he has been experiencing low moods for most of the day, particularly in the mornings when he wakes up early. He has lost interest in his usual hobbies, including going to the gym. He has not been to any of his regular workout classes. He has had thoughts of taking a bottle of pills to end it all, but he knows he won’t do it because he has a supportive family. He has no significant medical or psychiatric history.

Which of the following treatments would be the most appropriate?

MSFinals-5488

A 28-year-old man with a history of moderate depression presents to his GP after being prescribed a new medication by his psychiatrist. He reports experiencing a significant increase in appetite and subsequent weight gain, as well as constant fatigue and difficulty concentrating at work.
What medication is most likely responsible for these symptoms?

MSFinals-5489

A very thin 20-year-old woman is referred for evaluation of weight loss. Anorexia nervosa is suspected, but various screening tests are conducted to confirm the diagnosis. Which of the following findings would support the diagnosis of anorexia nervosa?

MSFinals-5458

A 28-year-old female arrives at the emergency department with her husband who is worried about her unusual behavior. The patient discloses that her sister passed away in a car accident recently and the funeral was held last week. She expresses her deep love and closeness with her sister and admits to feeling very sad. The psychiatrist confirms this sentiment with the husband. However, while recounting the events of her sister’s death and funeral, she begins to smile and laugh, describing the events in a cheerful tone. What is the most appropriate term to describe the patient’s abnormal behavior?

MSFinals-5474

A 21-year-old woman is admitted to the psychiatric ward. She has been awake for 4 days and is convinced that she will become the next big pop star by recording 3 albums simultaneously. When asked about her emotions, she immediately talks about her music projects, providing intricate details about each album, her plans for distribution, and her future as a famous musician. She then mentions that her mood has been fantastic because of these topics. When the conversation shifts, she continues to respond in a similar fashion. What term best describes this patient’s presentation?

MSFinals-5459

Which of the following symptoms may suggest mania instead of hypomania?

MSFinals-5475

A 27-year-old man dressed in casual attire has been admitted to the psychiatric intensive care unit. He is asked why he was admitted and he responds ‘It all started at my workplace, everyone is so busy making money, I’ve been busy too. I’m investing in stocks, trying to make some extra cash, I keep a record of it in my notebook, I love writing, I write all the time because I’m trying to find a cure for Alzheimer’s’. The speech is rapid and has a sense of urgency and when being asked further questions he demonstrates the same behaviour.

What best describes this patient’s behaviour?

MSFinals-5460

A 29-year-old man with bipolar disorder presents at the psychiatric outpatients clinic. He has been stable on lamotrigine for the past six months but is now reporting symptoms of elevated mood. How can you differentiate between symptoms of mania and hypomania in this case?

MSFinals-5461

You are asked to obtain consent from a pediatric patient for electroconvulsive therapy (ECT).

Which of the following is not a risk associated with ECT?

MSFinals-5462

A 40-year-old woman is being evaluated in the Psychiatry Clinic following her third suicide attempt in the past two years. She had cut her wrist at home and was brought to the hospital after her sister found her unconscious. She was successfully resuscitated, received a blood transfusion, and was discharged after a few days in hospital. She has been diagnosed with bipolar disorder since her teenage years and works in retail. She is currently single after having had unsuccessful relationships in the past. She consumes a moderate amount of alcohol and smokes around ten cigarettes a day. She is currently taking lithium for her mental illness. She is otherwise healthy and does not suffer from any medical conditions. What will be included in her long-term risk management plan?