A 29-year-old man with bipolar disorder presents at the psychiatric outpatients clinic. He has been stable on lamotrigine for the past six months but is now reporting symptoms of elevated mood. How can you differentiate between symptoms of mania and hypomania in this case?
You are asked to obtain consent from a pediatric patient for electroconvulsive therapy (ECT).
Which of the following is not a risk associated with ECT?
A 40-year-old woman is being evaluated in the Psychiatry Clinic following her third suicide attempt in the past two years. She had cut her wrist at home and was brought to the hospital after her sister found her unconscious. She was successfully resuscitated, received a blood transfusion, and was discharged after a few days in hospital. She has been diagnosed with bipolar disorder since her teenage years and works in retail. She is currently single after having had unsuccessful relationships in the past. She consumes a moderate amount of alcohol and smokes around ten cigarettes a day. She is currently taking lithium for her mental illness. She is otherwise healthy and does not suffer from any medical conditions. What will be included in her long-term risk management plan?
A 30-year-old bipolar woman has been readmitted to the hospital after attempting to harm herself. She is currently stable. What form of psychotherapy would be most appropriate in this case?
A 14-year-old male comes to his pediatrician’s office with his father. His father is worried about his son’s recent behavior. He explains that his son has been repeatedly checking the locks on the doors and windows in their house, causing him to be late for school. This behavior has been going on for a few weeks now.
What is the best initial approach to managing this condition?
A 25-year-old trans woman visits her primary care physician after experiencing a sexual assault by a coworker at her workplace two weeks ago. She has been suffering from persistent flashbacks, nightmares, and dissociation since the incident, which has affected her sleep and caused her to take a two-week leave from work. What would be the optimal initial treatment for her likely diagnosis, if it were readily accessible?
A 33-year-old woman who has never given birth before comes for her first prenatal visit at 29 weeks gestation. She is currently taking fluoxetine and lactulose and is concerned about the potential risks to her baby. What is a possible danger of using fluoxetine during the third trimester of pregnancy?
A 49-year-old man is brought to the emergency department after being found wandering the streets in an agitated state. His medical history includes hepatic steatosis, hypertension, and asthma, and he regularly takes amlodipine and Symbicort. He drinks up to 1 liter of vodka daily and has smoked for 30 years. He has not been seen by his family for 2-3 days before these events. His vital signs are heart rate 111 beats per minute, blood pressure 170/94 mmHg, respiratory rate 23 /min, oxygen saturations 97% on air, and temperature 37.2ºC. He is tremulous, diaphoretic, and agitated. Shortly after examination, he has a self-terminating seizure lasting 30 seconds. Blood tests and a CT head are performed, with the latter being reported as normal. What is the best medication choice to prevent further seizures?
A 31-year-old woman comes to you with complaints of worsening low mood and uncontrollable behaviors. She reports feeling distressed and finds relief only by repeating a certain phrase in her mind. She has no significant medical history and is in good physical health.
What is the symptom being described in this case?
A 54-year-old woman visited her primary care physician complaining of persistent polydipsia and swollen legs for the past few months. She reported having a medical history of chronic obstructive pulmonary disease (COPD), schizophrenia, and hypertension. Her current medications include tiotropium inhaler, ipratropium bromide inhaler, olanzapine, and nifedipine. She had previously taken bendroflumethiazide, which was discontinued two years ago, and had a 5-day course of 30mg oral prednisolone six months ago due to a COPD exacerbation. Her fasting blood tests revealed:
Fasting plasma glucose 7 mmol/L (3.9-5.4)
Random plasma glucose 12 mmol/L (<7.8)
Which medication is likely responsible for her abnormal blood results?