Archives: Medical Student Finals

MSFinals-5516

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?

MSFinals-5517

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?

MSFinals-5518

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?

MSFinals-5519

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?

MSFinals-5520

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?

MSFinals-5521

A 28-year-old patient presents to her doctor with symptoms of low mood and anhedonia. She has previously undergone cognitive behavioural therapy and art therapy, but with limited success. The doctor prescribes citalopram and refers her for additional talk therapy.
What medication should be avoided while taking citalopram?

MSFinals-5522

A 35-year-old woman is seeking help at the Psychiatry Clinic upon referral from her General Practitioner. The patient is experiencing persistent low mood for the past two months and finds it difficult to get out of bed to go to work at times. She used to enjoy playing tennis, but now she does not find pleasure in any sports. Additionally, she has lost interest in food and lacks the motivation to go out and meet her friends. The patient also reports waking up early in the morning and having difficulty falling back asleep. She lives alone and has been divorced for two years. She smokes and drinks moderate amounts of alcohol.
What is the most affected aspect of pleasure in this patient?

MSFinals-5501

You have been referred a 14-year-old girl who appears very upset by her parents’ ongoing divorce. She has begun to engage in self-injurious behaviour by banging her head against walls at times of stress. Her intelligence quotient (IQ) has been assessed by her school as 62.

With which of the following is this score most consistent?

MSFinals-5502

A 27-year-old woman visits her General Practitioner for a follow-up appointment after being diagnosed with depression. She is currently undergoing treatment with citalopram and has started a course of cognitive behavioural therapy (CBT).
What is used to assess the effectiveness of treatment in patients with depression?