A 32-year-old Welsh Guard returning from operational duty overseas has been suffering from nightmares and intrusive memories of his military experiences for the past 6 months. He avoids anything that reminds him of his tour of duty and is emotionally detached. He has trouble sleeping, concentrating, and is easily startled by loud noises. Additionally, he has been abusing alcohol. What is the probable diagnosis?
A 25-year-old man comes to the emergency department after being diagnosed with migraines by his primary care physician. He reports experiencing headaches on the right side of his head that last for approximately 6 hours and are triggered by work-related stress. He frequently experiences nausea during these episodes, which subside when he rests in a quiet environment. The patient has a history of depression and is currently taking sertraline. He has no known allergies. During the examination, the physician becomes worried about a medication that the patient has recently started taking for his symptoms.
Which medication is the physician most likely concerned about in this patient?
A 30-year-old woman is brought to your office by her brother. He is concerned about her lack of close friends and her eccentric behavior, speech, and beliefs. The patient believes she has psychic abilities and is fascinated with the paranormal. Her brother reports that she has displayed these behaviors since childhood, but he is only seeking help now as he is moving to another state and worries about how she will manage alone with their parents. What personality disorder might this patient have?
A 25-year-old woman who is a law student has severe anxiety about public speaking and in informal social settings. She avoids situations where she might have to enter into conversations with strangers. She reports that she thinks others are frustrated by her inability in casual social interactions and that she ‘feels stupid and awkward’. Her social problems are also affecting her academic performance. She is considering leaving university for a less stressful environment.
Which is the most appropriate form of psychotherapy for this woman?
What is the mechanism of action of venlafaxine for elderly patients?
A 25-year-old woman with a diagnosis of obsessive-compulsive disorder has been undergoing cognitive behavioural therapy and taking fluoxetine, but her symptoms persist. Her doctor decides to prescribe clomipramine, but warns her of potential side effects. What is the most likely side effect she may experience as a result of taking clomipramine?
A 28-year-old woman is admitted to the psychiatric ward under section 2 of the mental health act for suspected bipolar disorder. She has a 4-month history of manic episodes and has been experiencing delusions of grandeur. She started lithium 3 weeks ago. She has no other medical conditions and takes no other medications.
Today, staff on the ward raised concerns due to her abnormal behaviour. She was found in the common room dancing and singing loudly, despite it being late at night. It is reported that she has been like this for the last hour. Her observations are normal. She has not responded to attempts to engage her in conversation or to calm her down.
What is the most appropriate description of her current presentation?
A 40-year-old woman was admitted to the psychiatric ward with paranoid delusions, auditory hallucinations and violent behaviour. There was no past medical history. She was diagnosed with schizophrenia and given intramuscular haloperidol regularly. Four days later, she became febrile and confused. The haloperidol was stopped, but 2 days later, she developed marked rigidity, sweating and drowsiness. She had a variable blood pressure and pulse rate. Creatine phosphokinase was markedly raised.
What is the most likely diagnosis?
A 32-year-old woman confides in you that she experienced childhood sexual abuse. Which one of the following features is not a characteristic feature of post-traumatic stress disorder?
A 60-year-old female with depression is seen by her psychiatrist. She reports that her antidepressants are not improving her depressed mood. She expresses a sense of detachment from her surroundings, including her loved ones.
What is the most appropriate term to describe the patient’s abnormality?