A 67-year-old male who has been on long term chlorpromazine presents with repetitive eye blinking. He is concerned about the cause of this symptom and reports being unable to control it. He has no visual disturbance and is otherwise in good health. Upon examination, he has a normal facial and ocular appearance except for excessive rapid blinking. What is the probable reason for his symptoms?
A 25-year-old man is worried about several recent incidents related to his sleep. He reports experiencing paralysis upon waking up and occasionally when falling asleep, accompanied by what he describes as ‘hallucinations’ such as seeing another person in the room. These episodes are causing him increasing anxiety. What is the probable diagnosis?
A 40-year-old man with schizophrenia has been taking clozapine for five years and has been stable during that time. During his latest check-up, it was discovered that his clozapine levels were higher than recommended, resulting in a reduction in his dosage.
What is the most probable cause of an increase in clozapine blood levels?
Which of the following interventions is most likely to be beneficial for a patient with early-onset schizophrenia?
A 25-year-old male presents in clinic, insisting that you diagnose his colon issues. He describes experiencing vague sensations of incomplete stool passage and is worried that he may have a tumor causing obstruction. He reports regular bowel movements and denies any episodes of diarrhea or constipation. There is no history of blood in his stool, unintentional weight loss, or loss of appetite. He has no family history of cancer. After discussing your negative findings, he abruptly leaves the office, stating, You’re just like the other four doctors I’ve seen, all incompetent and willing to let me die.
What is the most accurate description of his gastrointestinal (GI) symptoms?
A 19-year-old long-distance runner who is currently preparing for a regional marathon seeks an appointment with the team doctor due to an unusual sensation in her legs. She reports feeling numbness below her knee. During the examination, the doctor observes sensory loss below the left knee in a non-dermatomal distribution. The team doctor suspects a non-organic cause of her symptoms. What type of disorder is this an example of?
You are a junior doctor working at an inpatient psychiatry unit. You have been asked to assess a patient by the nursing staff as they are currently occupied by a distressed patient and relative. The patient you’ve been asked to review has known schizophrenia and wishes to leave the unit. However, following consultation with the patient, you are concerned they are exhibiting features of an acute psychotic episode.
Which section of the Mental Health Act (2007) could be used to detain the patient?
A 26-year-old man presents to your clinic six months after he was assaulted on his way home from work. He was mugged and punched in the stomach by his attacker before he fled. Six months later, the patient continues to have severe and incapacitating periumbilical pain where he was punched. He denies any gastrointestinal symptoms or any other issues. Previous investigations and imaging have been unremarkable for any underlying anatomical, neurological or vascular abnormality.
What is the most appropriate description of the patient’s current complaints during the clinic visit?
A 42-year-old man visits his doctor’s office and reports that his partner of many years passed away recently. He shares that when he woke up this morning, he believed he was lying next to her and heard her voice calling his name. Despite knowing that this is impossible, it has caused him considerable anguish. He is concerned that he may be losing his mind. He has no other significant psychiatric history.
What is the probable diagnosis?
A 17-year-old male student spontaneously disrobed while watching a film. He saw wavy lines on the screen and then reported a brief episode of mental blankness, followed soon after by a headache and extreme fatigue.
What is the most likely diagnosis?