A 25-year-old man has been admitted to the psychiatric ward due to concerns from his GP about experiencing symptoms of psychosis. The psychiatric team is contemplating a diagnosis of schizophrenia. What aspect of his medical history would be most indicative of this diagnosis?
A 35-year-old male with a history of agoraphobia for the past 3 months presents for a telemedicine consultation to discuss his current issues. He reports feeling unable to leave his home due to a fear of contamination and illness. He explains that he feels the outside world is too dirty and that he will become sick and die if he leaves his house. He also reports washing his hands six times with soap and water after touching anything, which has resulted in his hands becoming dry, cracked, and erythematosus. He has lost his job as a result of missing deadlines and not being able to complete his work due to his compulsive hand washing behavior. Despite his awareness of the negative impact of his behavior, he feels unable to stop himself from washing his hands exactly six times every time.
During the telemedicine consultation, his mental state examination is unremarkable. However, upon requesting to see his hands over the video conversation, it is noted that they appear dry, cracked, and erythematosus.
What is the most appropriate management strategy for this patient?
A 30-year-old bipolar woman has been readmitted to the hospital after attempting to harm herself. She is currently stable. What form of psychotherapy would be most appropriate in this case?
A 14-year-old male comes to his pediatrician’s office with his father. His father is worried about his son’s recent behavior. He explains that his son has been repeatedly checking the locks on the doors and windows in their house, causing him to be late for school. This behavior has been going on for a few weeks now.
What is the best initial approach to managing this condition?
A 25-year-old trans woman visits her primary care physician after experiencing a sexual assault by a coworker at her workplace two weeks ago. She has been suffering from persistent flashbacks, nightmares, and dissociation since the incident, which has affected her sleep and caused her to take a two-week leave from work. What would be the optimal initial treatment for her likely diagnosis, if it were readily accessible?
A 33-year-old woman who has never given birth before comes for her first prenatal visit at 29 weeks gestation. She is currently taking fluoxetine and lactulose and is concerned about the potential risks to her baby. What is a possible danger of using fluoxetine during the third trimester of pregnancy?
A 49-year-old man is brought to the emergency department after being found wandering the streets in an agitated state. His medical history includes hepatic steatosis, hypertension, and asthma, and he regularly takes amlodipine and Symbicort. He drinks up to 1 liter of vodka daily and has smoked for 30 years. He has not been seen by his family for 2-3 days before these events. His vital signs are heart rate 111 beats per minute, blood pressure 170/94 mmHg, respiratory rate 23 /min, oxygen saturations 97% on air, and temperature 37.2ºC. He is tremulous, diaphoretic, and agitated. Shortly after examination, he has a self-terminating seizure lasting 30 seconds. Blood tests and a CT head are performed, with the latter being reported as normal. What is the best medication choice to prevent further seizures?
A 31-year-old woman comes to you with complaints of worsening low mood and uncontrollable behaviors. She reports feeling distressed and finds relief only by repeating a certain phrase in her mind. She has no significant medical history and is in good physical health.
What is the symptom being described in this case?
A 54-year-old woman visited her primary care physician complaining of persistent polydipsia and swollen legs for the past few months. She reported having a medical history of chronic obstructive pulmonary disease (COPD), schizophrenia, and hypertension. Her current medications include tiotropium inhaler, ipratropium bromide inhaler, olanzapine, and nifedipine. She had previously taken bendroflumethiazide, which was discontinued two years ago, and had a 5-day course of 30mg oral prednisolone six months ago due to a COPD exacerbation. Her fasting blood tests revealed:
Fasting plasma glucose 7 mmol/L (3.9-5.4)
Random plasma glucose 12 mmol/L (<7.8)
Which medication is likely responsible for her abnormal blood results?
A woman in her early thirties is considering pregnancy while taking paroxetine. She is concerned about any potential negative effects on her pregnancy. What guidance should you provide?