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 His grooming is poor and he is socially withdrawn.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?
A 39-year-old male has been taking olanzapine for the last 3 years. After experiencing an episode of tardive dyskinesia, he researched the potential side-effects of the medication. What is the most probable biochemical side-effect that this patient may experience?
A 45-year-old patient with a history of rheumatoid arthritis is currently taking sulfasalazine, paracetamol, and ibuprofen for their condition. They have been experiencing low mood and have tried non-pharmaceutical interventions with little success. The patient now reports that their depressive symptoms are worsening, prompting the GP to consider starting them on an antidepressant. Which antidepressant would pose the highest risk of causing a GI bleed in this patient, necessitating the use of a proton pump inhibitor as a precaution?
You are asked to assess a 76-year-old man who was admitted to the ward yesterday with agitation and distressing hallucinations believed to be caused by delirium from a urinary tract infection (UTI). The nursing staff is concerned that he is now exhibiting rigid movements and hand tremors, in addition to being very confused. The patient’s wife mentions that he had previously experienced confusion, sleep disturbances, visual hallucinations, and abnormal movements. Which medication is most likely responsible for the patient’s decline?
A 32-year-old with a long standing history of schizophrenia presents to the emergency department in status epilepticus. After receiving treatment, he informs the physician that he has been experiencing frequent seizures lately.
Which medication is the most probable cause of his seizures?
A 35-year-old female comes to your clinic with concerns that her husband is cheating on her. They have been married for 10 years and have always been faithful to each other. She is a stay-at-home mom and her husband works long hours. You wonder about the likelihood of her claims being true.
What is the medical term for this type of delusional jealousy?
A 95-year-old man without past medical history presents with increasing forgetfulness. His son is concerned that over the last six weeks his father has been forgetting his grandchildren’s names and stories from his upbringing. The patient reports a loss of appetite, sometimes forgetting if he has eaten, is not getting good quality sleep and is frustrated with his son for taking him to the doctors. He sometimes sees and hears his recently deceased wife.
Based on these symptoms, what is the most probable diagnosis for this patient?