Sophie is a 25-year-old woman who was diagnosed with generalised anxiety disorder 8 months ago. She has been taking sertraline for 5 months but feels that her symptoms have not improved much. Sophie wants to switch to a different medication. What is the most suitable drug to start?
You speak to the husband of a patient with depression who was recently discharged from a psychiatry ward after a suicide attempt. He was switched from sertraline to venlafaxine. His husband says his mood is okay but over the last 2 weeks, he became erratic and was not sleeping. He spoke fast about a ‘handsome inheritance’ he got but was gambling away their savings saying he was going to save the world. When confronted he became angry and accused him of trying to ‘steal his energy’. You suspect he’s developed mania and refer him to the crisis psychiatry team.
What do you anticipate will be the subsequent step in management?
A 60-year-old patient with a history of bipolar disorder visits your GP clinic for routine blood tests. Despite feeling completely fine, he wants to check his health status. Upon clinical examination, there are no signs of splenomegaly or lymphadenopathy.
The following are the results:
– Hb 140 g/L Male: (135-180) Female: (115 – 160)
– Platelets 160 * 109/L (150 – 400)
– WBC 14 * 109/L (4.0 – 11.0)
– Na+ 144 mmol/L (135 – 145)
– K+ 4.7 mmol/L (3.5 – 5.0)
– Urea 5.4 mmol/L (2.0 – 7.0)
– Creatinine 114 µmol/L (55 – 120)
– Thyroid stimulating hormone (TSH) 5.2 mU/L (0.5-5.5)
– Free thyroxine (T4) 9.5 pmol/L (9.0 – 18)
– Lithium level 0.75 mmol/L (0.6 – 1.2)
What advice would you give to this patient?
A 28-year-old woman is brought to the Emergency Department after taking an overdose of paracetamol due to a recent breakup with her partner. She expresses remorse for her actions, denies any suicidal thoughts, and requests to be discharged. Her parents and a friend arrive at the hospital soon after. Paracetamol levels at 4 hours are below the treatment limit.
What should be the next course of action in managing her case?
A 42-year-old male arrives at the emergency department with recently developed symptoms. He has a complicated medical history, including depression, schizophrenia, asthma, and rheumatoid arthritis. He had an episode one hour ago where his left eye moved upwards and inward, and he began blinking repeatedly. The episode lasted for three minutes, and he did not lose consciousness. He is currently experiencing severe neck pain. However, he is feeling fine at the moment. Which medication is the most probable cause of his symptoms?
A 50-year-old woman presents with complaints of lower back pain, constipation, headaches, low mood, and difficulty concentrating. Which medication is most likely responsible for her symptoms?
A 32-year-old man visits his General Practitioner (GP) for an annual mental health review. He was diagnosed with schizophrenia eight years ago. He has been on medication since diagnosis and takes this daily without any side-effects. He has regular contact with the community mental health team. He is working part-time as a shop assistant, which he enjoys. He has a good appetite, sleeps well and exercises regularly.
What is true regarding the treatment of schizophrenia in a 32-year-old man who has been diagnosed with the condition for eight years and is currently on medication without any side-effects, has regular contact with the community mental health team, works part-time, and has good appetite, sleep, and exercise habits?
A 21-year-old student has been diagnosed with schizophrenia.
What is the most frequent type of hallucination experienced in schizophrenia?
A 47-year-old man is prescribed haloperidol, a first-generation antipsychotic, for an acute psychotic episode. He had previously been on olanzapine, a second-generation antipsychotic, but discontinued it due to adverse reactions. What adverse effect is he more prone to encounter with this new medication in comparison to olanzapine?
A 65-year-old male has been admitted to the in-patient psychiatric unit. Upon review this morning, he appears to be a poor historian, providing minimal answers and insisting that he is deceased and does not belong in a hospital meant for the living. What is the specific name of this delusional disorder and with which condition is it typically linked?