A 25-year-old female has been discharged from hospital after being diagnosed with schizophrenia. She is now being seen in the GP clinic and is concerned about her prognosis. Prior to her illness, she was a high-functioning accountant. Her symptoms began gradually and mainly involved auditory hallucinations and persecutory delusions, which are currently under control. What factor in her case suggests a poor prognosis?
You are part of the mental health team assessing a 65-year-old woman in the emergency department who has presented with an intentional paracetamol overdose. She is a retired teacher and a devout Christian. She lives alone in a house and her two adult daughters live in a different state. When you ask her, she says that she regrets taking the paracetamol, but is not sure if she would try to do it again.
What factor decreases her likelihood of carrying out another attempt in the future?
A 28-year-old man is brought to the Emergency Department by ambulance after his partner reported he ingested multiple tablets of paracetamol after an argument. The patient is currently medically stable and can give a history to the attending emergency physician. He reports that he regrets taking the tablets and that this is the first time he has committed such an act. He claims that he acted in a moment of anger after the argument and never planned for this to happen. He suffers from moderate depression which has been managed by his general practitioner with sertraline. He consumes a moderate amount of alcohol and denies any abuse of recreational drugs. He has no family history of mental illness.
Which one of the following is an important dynamic risk factor to consider when managing this patient?
Sarah is a 20-year-old woman who has just started her first year at university. She is described by others as quite a reserved character. She has one friend but prefers solitary activities and has few interests. Sarah has never had a boyfriend and does not seem to be interested in companionship. When she is praised or criticised by others, she remains indifferent to their comments. There is no history of low mood or hallucinations.
What is the most probable diagnosis for Sarah’s condition?
A 25-year-old man arrives at the emergency department following his fifth suicide attempt in the past two years. He was discovered by his ex-girlfriend, who ended their relationship the day before due to his intense mood swings and overwhelmingly negative emotions. He has no communication with his family and appears unkempt. When questioned, he expresses feelings of worthlessness and a belief that everyone will eventually leave him. What is the probable diagnosis?
A 76-year-old man visits his doctor with his wife, who is concerned about his recent memory decline and difficulty concentrating. She also notes that he has become incontinent of urine and is walking with smaller steps. The patient’s medical history includes a myocardial infarction one year ago, as well as hypertension and diabetes. There is no family history of similar symptoms. What is the probable diagnosis?
A 45-year-old man with a history of schizophrenia no longer reports hallucinations or delusions. However, he spends many hours doing nothing, has trouble reading a book or watching a film and rarely speaks spontaneously or fluently. His grooming is poor and he is socially withdrawn.
What is a positron emission tomography (PET) scan most likely to show?
A 25-year-old female presents to the emergency department with palpitations. Her ECG reveals first-degree heart block, tall P-waves, and flattened T-waves. Upon arterial blood gas analysis, her results are as follows: pH 7.55 (normal range 7.35-7.45), HCO3- 30 mmol/L (normal range 22-26 mmol/L), pCO2 5.8kPa (normal range 4.5-6kPa), p02 11kPa (normal range 10-14kPa), and Chloride 85mmol/L (normal range 95-108mmol/L). What is the underlying cause of her presentation?
Sarah, a 15-year-old girl is brought to the GP by her father as Sarah has not had her first period. She is 1.50m tall and weighs 40 Kg. Her heart rate is 60 beats per minute. Blood pressure is 120/90 mmHg. She has not developed any secondary sexual characteristics. There is a strong family history of eating disorder. You suspect that the delayed puberty may be due to anorexia nervosa.
What evidence supports the diagnosis of anorexia nervosa in Sarah?
A 67-year-old Indigenous male with a lengthy history of heavy alcohol use is hospitalized after experiencing a seizure upon stopping alcohol consumption. The physician observes that the patient is experiencing memory difficulties, as evidenced by his detailed recollection of events from the previous day in the hospital that are completely different from what actually occurred. The patient does not appear to have any intention of deceiving the doctor.
What is the most appropriate term to describe the patient’s abnormality?