A 50-year-old woman arrives at the emergency department complaining of palpitations, dizziness, and lightheadedness. Upon conducting an ECG, torsades de pointes is observed. Which medication is the most probable cause of the cardiac anomaly?
A 24-year-old man is brought into the emergency department by his friends. They report that for the past 6 days, he has not slept or eaten, and he believes that aliens are communicating with him through his phone.
During the examination, he speaks rapidly and loudly. When asked about his condition, he describes in detail what the aliens have been telling him, including the frequency and duration of the calls, as well as the tone and pitch of their voices. He also expresses feelings of anxiety and paranoia.
What type of thought disorder is present in this man?
A 30-year-old female with a diagnosis of bipolar disorder visits her doctor to discuss a headache. She starts explaining her issue with the following statement:
I came here to talk about this headache, but I can’t stop thinking about the dream I had last night where I was flying over a rainbow. It’s funny because I haven’t eaten pizza in a week, and I really miss it.
What sign of thought disorder is evident in the patient’s speech?
A 78-year-old man is admitted with new-onset confusion. He is usually independent and enjoys gardening in his spare time. When he didn’t show up for his weekly gardening club meeting, a friend went to his house. The friend noticed that the patient appeared disoriented and was speaking nonsensically, prompting them to call for medical assistance.
What distinguishes delirium from dementia?
A 35-year-old homeless man is brought to the hospital as he reports seeing an ‘ocean of bees’ surrounding him. He is unable to provide a detailed medical history due to his extreme anxiety and confusion, constantly yelling about the ‘deafening buzzing.’ His heart rate is 140 beats per minute and his breathing rate is 23 breaths per minute. Reviewing his records, it is noted that he has been admitted to the emergency department multiple times due to alcohol intoxication.
What is the initial treatment for his condition?
A 27-year-old woman is admitted to the psychiatric ward. She appears lethargic. When asked about her emotions, she responds, ‘Let me start by telling you about my recent job interview. It went well, but I’m still waiting to hear back. I really need this job to pay off my student loans and start saving for a house. I’ve been feeling stressed about money lately.’ She continues to talk about her financial situation.
Upon further questioning, she exhibits similar behavior and speaks slowly throughout.
How would you describe her behavior?
A patient in their 50s is brought to the acute mental health unit by the police after being found on the street shouting at people. They have no known past medical history.
On examination, they are poorly dressed. When asked about their mood, they begin by asking what colour the sky is, then begin to talk about their strong dislike for cheese, followed by wanting to break the table lamp they own at home. Throughout the consultation, they speak slowly.
What term best describes this patient’s presentation?
A 30-year-old woman visits her GP complaining of feeling down. She finds it difficult to work with her colleagues and believes they are not performing up to par. Consequently, she declines to delegate tasks and has become exhausted.
Upon further inquiry, she adheres to a strict daily routine and tries to avoid deviating from it as much as possible. If she fails to follow this plan, she becomes anxious and spends her free time catching up on tasks.
What is the most suitable course of action in managing her probable diagnosis?
A 38-year-old man presents to the Emergency Department complaining of epigastric pain. The patient reports that he developed acute abdominal pain 2 hours prior to presentation after eating a cheeseburger. The patient otherwise has no significant past medical history. He does not take any medications and denies smoking, alcohol consumption and drug use. He has been recently been released from prison and has not got stable living and has had to sleep outside since his release.
On examination, the patient has normal vital signs. His abdominal examination demonstrates normoactive bowel sounds, no tenderness to palpation in the epigastrium and no guarding or rebound tenderness. Rectal exam for stool occult blood is negative and a chest X-ray does not reveal free air under the diaphragm. A right upper quadrant ultrasound does not demonstrate stones. The doctor recommends antacids. When the doctor tells the patient that he is safe for discharge, the patient insists that he must be admitted to hospital for further tests.
Which of the following is the most likely diagnosis?
A 32-year-old female presents to her primary care physician with her sister. The sister is worried that the patient may have a personality disorder due to her lack of interest in socializing and her preference for being alone. Upon further discussion, the patient admits to having no desire for romantic relationships, being unemployed, and lacking motivation to work. She denies any self-harm or suicidal thoughts and has no history of legal issues. During the consultation, she displays a flat and emotionless facial expression. What personality disorder is most likely present in this patient?