MSFinals-5387
A middle-aged man presents with persecutory delusions and auditory hallucinations. His expression appears to have a reduced affect. He has disorganised speech and thinking.
What is the most probable diagnosis for this patient?
Med Student Finals Category: Psychiatry
MSFinals-5388
A mother brings her 8-year-old son to see the general practitioner (GP) as she is very concerned about his school performance. His teacher has reported that he is being highly disruptive in the classroom.
Which of the following sets of behaviours fit best with a diagnosis of attention deficit/hyperactivity disorder (ADHD)?
MSFinals-5389
A 28-year-old male with bipolar disorder is currently under the care of his psychiatrist as an outpatient. During the review, the psychiatrist observes that the patient’s speech mostly follows a logical sequence, but at times, the patient uses a seemingly inappropriate series of rhyming words. For instance, when asked about his activities the previous day, he responded, I went for a run, had some fun, saw the sun, and then I was done.
What is the most appropriate term to describe the speech abnormality exhibited by the patient?
MSFinals-5390
A 26-year-old male comes to his doctor’s office at the request of his friends. Upon examination, he discloses that he thinks everyone can hear his thoughts, as if he were a radio station, and that he hears voices commenting on his actions. The doctor observes that he has a blunted affect, alogia, and avolition. Additionally, the doctor notes that the patient repeats the final word of any inquiry posed to him.
What term describes this phenomenon?
MSFinals-5391
You’re on an acute take ward and you are asked to see a patient by your foundation doctor. The foundation doctor is concerned about this patient as he is uncertain of the next step in management and investigation.
The patient is a 46-year-old male who has been admitted with excess tearing. He has a past medical history of allergic rhinitis. He uses nasal saline rinses several times a day. His father recently died of lung cancer with brain metastases.
This patient has had extensive investigations in multiple other hospitals due to his concerns of a cancer diagnosis causing his excessively watery eyes. He has had three CT orbits in the last 12 months which have been reported as normal. On ophthalmic examination, he has some crusting and erythema of his lid margins, but it is a normal examination otherwise. The patient remains convinced that a cancer diagnosis still can’t be excluded.
What is the reason for this patient’s presentation?
MSFinals-5392
A 20-year-old woman presents to her General Practitioner (GP) with a 2-year history of restricting food intake and self-induced vomiting. She attends her GP for the first time with her sibling reporting a recent worsening of her symptoms. The GP suspects anorexia nervosa.
Which is the most appropriate investigation to determine whether the patient requires urgent hospital admission?
MSFinals-5377
A 32-year-old woman presents to her GP with complaints of feeling extremely anxious, avoiding going out, and experiencing disturbed sleep. Her symptoms have resulted in the breakdown of her relationship. She reports that her symptoms began to worsen after she was sexually assaulted 2 years ago. She experiences flashbacks of the assault when she is in a confined space with someone, even if there is no physical contact. The GP decides to refer her for cognitive behavioural therapy and the patient also expresses interest in trying medication. Which of the following medications would be recommended for the management of this patient?
MSFinals-5378
You are requested to assess a patient with generalized anxiety disorder (GAD) who has been on sertraline for the past 6 months. They have previously attempted citalopram with minimal improvement. The patient complains of persistent anxiety, chest tightness, and palpitations and wishes to explore a different medication. What would be the most suitable medication to recommend for this patient?
MSFinals-5379
A 28-year-old man presents with symptoms of low mood. He discloses that he has been struggling with motivation, insomnia, and loss of interest in social activities since losing his job two years ago. He denies any suicidal ideation or intent. On the PHQ 9, he scores 9, indicating mild-moderate depression. What is the recommended initial treatment?
MSFinals-5364
A 42-year-old man comes to the Emergency Department claiming that he is infested with fleas. He reports feeling extremely itchy and is requesting treatment. This is his fourth visit in the past year for this issue. The patient has no notable medical history and denies using any illicit drugs. He drinks 12 units of alcohol per week and is employed full-time as a teacher.
What is the probable diagnosis?