A 32-year-old female is initiated on haloperidol for treatment-resistant schizophrenia. She visits her primary care physician with a complaint of neck pain and limited neck movement for the past 24 hours. Upon examination, she displays normal vital signs except for a mild tachycardia of 105 and neck stiffness with restricted range of motion. Her neck is involuntarily flexed towards the right. Her facial movements are normal. What is the probable diagnosis?
A 45-year-old woman who is currently an informal inpatient at a mental health hospital is being evaluated for electroconvulsive therapy (ECT), a treatment she has never undergone before. What is an appropriate indication for ECT?
A 32-year-old woman presents to her GP with a complaint of severe dyspareunia and loss of libido that has been ongoing for the past year. She has already been evaluated by a gynaecologist and discharged as all her tests were normal. She has undergone a pelvic ultrasound, laparoscopy, and blood tests for LH/FSH and TFTs, as well as low vaginal and endocervical swabs. She reports no symptoms of depression or anxiety and maintains a healthy lifestyle with regular exercise, good sleep, and a balanced diet. She denies any substance abuse. What is the most appropriate course of action?
A 38-year-old woman and her 14-year-old daughter are apprehended after being caught trying to destroy a statue in the town square. When asked why, they both explain how the statue comes to life and terrorizes them at night, breaking things in their house, whispering violent thoughts in their minds and urging them to kill themselves. The police officer brings them to the Emergency Department where you evaluate them. The mother is a well-known psychiatric patient, but the daughter has never been seen before.
Which of the following is most likely to acutely reverse the psychosis in at least one of the patients?
A 30-year-old woman presents to you with complaints of feeling down and fatigued. She struggles to fall asleep at night and has difficulty getting up in the morning. Despite her love for exercise, she lacks motivation and finds it hard to engage in physical activity.
What is the duration of her symptoms that would warrant a diagnosis of a depressive episode?
A 65-year-old-male presents to his GP with a chief complaint of forgetfulness over the past 3 months. He reports difficulty recalling minor details such as where he parked his car and the names of acquaintances. He is a retired accountant and reports feeling bored and unstimulated. He also reports difficulty falling asleep at night. His MMSE score is 27 out of 30. When asked to spell WORLD backwards, he hesitates before correctly spelling the word. His medical history includes hyperlipidemia and osteoarthritis. What is the most likely diagnosis?
Samantha is a 38-year-old female who has come to the crisis team with suicidal thoughts. Upon further inquiry, Samantha also reveals experiencing low mood, lack of energy, early morning awakenings, and difficulty concentrating. She reports that these symptoms are persistent, but she has both good and bad days. Samantha has no prior psychiatric history. What medication would be the most suitable to initiate treatment for Samantha?
A man has been hospitalised for severe psychiatric disease. The patient is unable to form new memories and, as such, is stuck in 1992, believing that the Gulf War is ongoing. He has been hospitalised since 1993. He is unaware of his memory problem and confabulates his story when you try to point out the discrepancies between his stories and reality. He is able to remember everything up until 1992 without any problem.
Which of the following is the most likely aetiology of his disorder?
A 40-year-old Afro-Caribbean male has been diagnosed with schizophrenia for 3 years. To address his history of non-compliance, he has been prescribed a monthly 250 mg depo injection of zuclopenthixol. What is a typical side effect of this type of antipsychotic medication?
A 35-year-old male with a history of daily alcohol consumption for the last five years is admitted to the hospital emergency room. He is experiencing acute visual hallucinations, seeing spiders all around him, and is unable to recognize his family members. He is also exhibiting aggressive behavior and tremors. The patient had stopped drinking alcohol for two days prior to admission. On examination, he has a blood pressure of 170/100 mmHg, tremors, increased psychomotor activity, fearful affect, hallucinatory behavior, disorientation, impaired judgment, and insight. What is the most likely diagnosis?