A 35-year-old man who is an accountant presents with complaints of fainting spells, dizziness, palpitations and pressure in his chest. He experiences these symptoms for 5-10 minutes during which he becomes anxious about fainting and dying. He takes a longer route to work to avoid crossing busy streets as he fears getting hit by a car if he faints. He avoids public speaking and works late into the night from home, which exacerbates his symptoms. What is the probable diagnosis?
A 23-year-old woman is brought to the Emergency Department by her friend. The friend reports that she has been acting strangely and unable to focus on one task at a time. He has observed over the past few days that she has been walking around in the early hours of the morning and not sleeping. He is particularly concerned that she has been returning home with multiple bags of expensive shopping every day for the past three days.
The patient denies experiencing any hallucinations but reports feeling fantastic and having an increased appetite. She has no prior medical history and is not taking any medications.
What is the most probable cause of this patient’s presentation?
A 42-year-old woman visits her GP with her husband, reporting that she has been experiencing a racing heart for the past year. She also feels sweaty and sometimes has difficulty breathing. Despite seeing a cardiologist, no abnormalities were found in her heart. The patient admits to worrying about various things, which has affected her relationships with her loved ones. She also suffers from insomnia 3-4 nights a week. The patient has no significant medical history, but her cousin has a history of depression. On examination, the patient’s heart rate is 89 bpm, and her palms are sweaty. Blood tests show no abnormalities, including normal thyroid function and calcium levels. Which neuroendocrine axis is involved in the patient’s condition?
A 32-year-old woman has come to her doctor for a medication review. She was diagnosed with bipolar disorder 10 months ago and has been taking olanzapine 10 mg once daily and lithium carbonate 600mg twice daily. While her psychological symptoms have improved, she has been feeling more fatigued in the past few weeks. Additionally, she has noticed a decrease in appetite and has experienced bouts of constipation. What is the most probable cause of her symptoms?
A 20-year old man with suspected schizophrenia is reviewed in clinic. During the consultation the patient informs you that there is a plot to destroy the world and that he has been chosen as a saviour.
Which of the following terms most appropriately describes this patient’s belief?
A 25-year-old woman goes to her GP to discuss symptoms she believes are related to a diagnosis of obsessive-compulsive disorder (OCD). She has been struggling with these symptoms for a few years, but they have worsened in recent months since she started working as a janitor. She experiences intrusive and persistent thoughts about germs, which lead her to repeatedly wash her hands, clothes, and clean her home. Her partner is worried about her, and they argue when he tries to encourage her to resist the urge to clean, as this exacerbates her anxiety symptoms. Which medication is approved for treating OCD?
A 28-year-old man visits the police station complaining about his wife. He tells the police she regularly physically beats their 5-year-old daughter with a belt and that she often slaps the girl. The woman is arrested by the police for hitting and brutally beating her 5-year-old daughter. When the woman is asked why she does this, she responds that, ‘This is how my mother treated me, it’s how women should act’.
Which of the following types of learning behaviour in the woman does this represent?
A 42-year-old woman is seen in the clinic after a recent visit to the psychiatrist who recommended an increase in her lithium dose for better symptom control. Her renal function is stable and you prescribe the recommended dose increase. When should her levels be re-checked?
Samantha is a 35-year-old female who is receiving treatment for bipolar disorder on the psychiatric ward. She has been taking lithium for the past 3 weeks and the doctor needs to check if her levels have stabilised by taking bloods. Samantha’s last dose of lithium was at 9am this morning and it is currently 12pm. What is the appropriate time for the doctor to take her bloods?
Electroconvulsive Therapy (ECT) is recommended by NICE for which clinical conditions?