Archives: Medical Student Finals

MSFinals-5371

A 42-year-old woman visits the clinic with her husband, who is worried about her recent change in behavior. For the past two weeks, she has been acting out of character, spending large amounts of money on credit cards and wearing bold makeup and clothes that she wouldn’t normally choose. She has also been experiencing insomnia, often staying up late at night to work on important projects that she can’t disclose to her husband. The patient has a history of depression, and her mother was hospitalized for mental illness. What is the most probable diagnosis for this patient?

MSFinals-5372

Barbara, a 75-year-old recently widowed woman, visits your medical practice with her son, who is concerned about his mother’s memory. Over the past few months, she has been forgetting appointments and conversations that they had just a few days ago, requiring frequent reminders to recall recent events. When you speak with Barbara, she mentions that she has lost her appetite and is waking up earlier than usual. She denies experiencing any hallucinations or issues with movement.
After administering a mini mental state exam, Barbara scores 23, and you observe that she is having difficulty focusing on your questions, often responding with I don’t know.
What is the most probable diagnosis?

MSFinals-5373

A 22-year-old college student presents with insomnia, anxiety, and flashbacks. She experienced a traumatic event two weeks ago when a young man demanded her phone and purse while she was walking home from a party. She was alone and feared for her safety. Since then, she has been struggling with nightmares and flashbacks, which have disrupted her sleep. She has also been avoiding going out alone. She is seeking medication to help her sleep. What is her response?

MSFinals-5374

You are asked to see a 50-year-old woman who reports feeling down for several months. Upon further questioning, you discover that she has lost interest in activities she previously enjoyed, such as hiking and going to the theater. She has also been experiencing fatigue, causing her to miss work, and has had occasional thoughts of not wanting to be alive, although she denies any intention of harming herself. In the past month, her symptoms have worsened, with episodes of anxiety occurring at least once a week. These episodes last around five minutes and are characterized by hyperventilation, nausea, and a fear of having a heart attack. No physical abnormalities have been found. What is the most likely diagnosis?

MSFinals-5375

A 20-year-old individual presents with obsessive thoughts about causing harm to others since moving away from home to attend college. They are particularly anxious about using the shared kitchen in their dormitory and tend to prepare and eat meals during the night to avoid contact with their roommates. After completing a Yale-Brown Obsessive Compulsive Scale (Y-BOCS), they are diagnosed with mild OCD. What treatment option would be most suitable for this individual?

MSFinals-5376

A 28-year-old woman contacts her doctor seeking guidance on stopping all of her medications abruptly. She has a medical history of asthma, depression, and occasional tennis elbow pain, for which she takes a salbutamol inhaler, citalopram, and paracetamol, respectively. What is the most probable outcome if she discontinues her medications suddenly?

MSFinals-5377

A 32-year-old woman presents to her GP with complaints of feeling extremely anxious, avoiding going out, and experiencing disturbed sleep. Her symptoms have resulted in the breakdown of her relationship. She reports that her symptoms began to worsen after she was sexually assaulted 2 years ago. She experiences flashbacks of the assault when she is in a confined space with someone, even if there is no physical contact. The GP decides to refer her for cognitive behavioural therapy and the patient also expresses interest in trying medication. Which of the following medications would be recommended for the management of this patient?

MSFinals-5378

You are requested to assess a patient with generalized anxiety disorder (GAD) who has been on sertraline for the past 6 months. They have previously attempted citalopram with minimal improvement. The patient complains of persistent anxiety, chest tightness, and palpitations and wishes to explore a different medication. What would be the most suitable medication to recommend for this patient?

MSFinals-5379

A 28-year-old man presents with symptoms of low mood. He discloses that he has been struggling with motivation, insomnia, and loss of interest in social activities since losing his job two years ago. He denies any suicidal ideation or intent. On the PHQ 9, he scores 9, indicating mild-moderate depression. What is the recommended initial treatment?

MSFinals-5380

A mother brings her 10-year-old daughter who was recently diagnosed with attention-deficit/hyperactivity disorder (ADHD).
She is visiting the clinic as she is still having difficulty managing her daughter’s disruptive and challenging behavior, despite receiving group-based support and environmental modifications.
What is the primary treatment option for managing ADHD?