Med Student Finals Category: Psychiatry

MSFinals-5473

A 60-year-old man is admitted from the angiography suite after the cardiologist discovered severe triple vessel disease. He awaits transfer to a tertiary hospital for a coronary artery bypass graft. After 48 hours of admission, you receive a call to see him as he has become confused, sweaty, tremulous, and agitated.

Upon reviewing his record, you note a history of asthma, variceal bleed, and cirrhosis secondary to alcohol excess. His observations show a pyrexia at 37.9ºC, heart rate of 105 bpm, and blood pressure 175/98 mmHg. What would be the most appropriate immediate intervention given the likely diagnosis?

MSFinals-5442

A 25-year-old female complains of headache, weakness, and pains in her arms and legs. She reports feeling like her symptoms are worsening. She has no significant medical history except for a miscarriage two years ago.

Upon examination, her neurological and musculoskeletal functions appear normal, and there are no alarming signs in her headache history. Her GP conducts a comprehensive blood test, which yields normal results.

What is the most probable diagnosis for this patient?

MSFinals-5443

A 40-year old man is deeply concerned that a mole on his arm may be cancerous. He has consulted with a dermatologist who has assured him that it is a benign pigmented nevus, but the patient remains convinced that he will develop skin cancer. What is the term for neurotic anxiety related to a serious medical condition that cannot be alleviated by medical reassurance, assuming there are no other significant psychiatric disorders present?

MSFinals-5445

A 35-year-old man who is an accountant presents with complaints of fainting spells, dizziness, palpitations and pressure in his chest. He experiences these symptoms for 5-10 minutes during which he becomes anxious about fainting and dying. He takes a longer route to work to avoid crossing busy streets as he fears getting hit by a car if he faints. He avoids public speaking and works late into the night from home, which exacerbates his symptoms. What is the probable diagnosis?

MSFinals-5446

A 23-year-old woman is brought to the Emergency Department by her friend. The friend reports that she has been acting strangely and unable to focus on one task at a time. He has observed over the past few days that she has been walking around in the early hours of the morning and not sleeping. He is particularly concerned that she has been returning home with multiple bags of expensive shopping every day for the past three days.

The patient denies experiencing any hallucinations but reports feeling fantastic and having an increased appetite. She has no prior medical history and is not taking any medications.

What is the most probable cause of this patient’s presentation?

MSFinals-5447

A 42-year-old woman visits her GP with her husband, reporting that she has been experiencing a racing heart for the past year. She also feels sweaty and sometimes has difficulty breathing. Despite seeing a cardiologist, no abnormalities were found in her heart. The patient admits to worrying about various things, which has affected her relationships with her loved ones. She also suffers from insomnia 3-4 nights a week. The patient has no significant medical history, but her cousin has a history of depression. On examination, the patient’s heart rate is 89 bpm, and her palms are sweaty. Blood tests show no abnormalities, including normal thyroid function and calcium levels. Which neuroendocrine axis is involved in the patient’s condition?

MSFinals-5448

A 32-year-old woman has come to her doctor for a medication review. She was diagnosed with bipolar disorder 10 months ago and has been taking olanzapine 10 mg once daily and lithium carbonate 600mg twice daily. While her psychological symptoms have improved, she has been feeling more fatigued in the past few weeks. Additionally, she has noticed a decrease in appetite and has experienced bouts of constipation. What is the most probable cause of her symptoms?

MSFinals-5449

A 16-year-old male comes in for a psychiatric check-up for his depression and reports frequently losing his train of thought, attributing it to the government stealing his ideas. What is the symptom he is displaying?

MSFinals-5450

An 85-year-old man with early-stage dementia is brought to see the General Practitioner (GP) by his daughter to discuss appointing a Lasting Power of Attorney.
Which one of the following statements is true regarding the Mental Capacity Act (MCA)?