Archives: Medical Student Finals

MSFinals-5381

A 35-year-old unemployed man visits his GP seeking assistance with his heroin addiction. He has been using heroin for more than a year after a friend suggested trying the drug after a night out. As a result, he has frequently used heroin. He has lost his job, ended his long-term relationship, and is currently sleeping on his friend’s couch.

A few months ago, he attempted to quit because he wanted to turn his life around, but he found the withdrawal symptoms too difficult to handle and ended up using heroin again. He is eager to try and quit drugs, but he feels he cannot do it without some form of assistance.

Which of the following can be used for substitution therapy in opioid-dependent patients?

MSFinals-5349

A 29-year-old woman arrives at the Emergency Department in a state of distress. She admits to having lost a significant amount of money through gambling and then taking 4 packets of paracetamol. This is not the first time she has engaged in such behavior. She discloses that her partner of 3 years has been offered a job overseas and is considering accepting it. Despite her initial heartbreak, they had a major argument and she now claims to be indifferent about whether he stays or goes.

What is the most appropriate course of action based on the probable diagnosis?

MSFinals-5351

Sarah, a 44-year-old taxi driver, visits her GP 4 months after being involved in a car accident. During the consultation, the GP takes a thorough psychiatric history. Sarah is unable to recall the specifics of the accident, but the thought of driving her car causes her to feel anxious. Consequently, she avoids driving whenever possible, which worries her as it may impact her income.

Further investigation by the GP reveals that Sarah has been compulsively buying clothes and electronics online. Additionally, she has been relying on her sister and son to help with household tasks such as cooking and cleaning due to a lack of motivation. Sarah’s sister has also noted that she has been crossing busy roads recklessly on several occasions.

Which aspect of Sarah’s history provides the strongest indication of a PTSD diagnosis?

MSFinals-5352

A 27-year-old is brought to the on-call psychiatry team at a hospital after being found wandering aimlessly on the streets. The patient had a breakdown in a local convenience store where they were caught stealing cigarettes and had a violent outburst when confronted by the store clerk. When asked about their behavior, they state that they do not care about the consequences of their actions and that they have stolen many times before. They also admit to enjoying hurting others in the past and have a history of animal cruelty. Although they report self-harming in the past, there are no visible scars.

Which of the following characteristics would be more indicative of a diagnosis of antisocial personality disorder rather than borderline personality disorder?

MSFinals-5353

A 9-year-old patient is brought to the general practitioner by his parents because he has been disruptive at school. His teachers report that he does not pay attention in class, bullies other classmates and takes their food during lunchtime without their permission. One teacher also reported that the patient was seen hurting the class hamster.
What is the most probable diagnosis for this patient?

MSFinals-5354

A 78-year-old man with known dementia is admitted to hospital for treatment of a community acquired pneumonia. Unfortunately, he was not accompanied by a family member and the history provided by the patient seems confused. Upon arrival of the daughter, she confirms that her father has been confusing real events with those from his imagination. Through this process he appears to be able to maintain a superficial conversation despite significant cognitive impairment.
Which of the following describes this phenomenon?

MSFinals-5355

You are about to prescribe fluoxetine, a selective serotonin reuptake inhibitor (SSRI) to a 50-year-old man who has just started a new relationship. He asks about common side-effects.
Which of the below is a common side-effect that it would be most important to council this patient about?

MSFinals-5356

A 30-year-old man visits his GP for a medication review. He began taking citalopram four months ago to treat his depression, and he now feels that his symptoms have significantly improved. He believes that he has returned to his usual self and no longer requires the antidepressant medication. What advice should the GP provide to minimize the risk of relapse?

MSFinals-5357

A 35-year-old woman is brought to the psychiatry clinic by her spouse. The spouse reports that the patient has been displaying abnormal behaviour, such as staying up all night, talking rapidly, excessive shopping, and claiming she will become a millionaire by investing in cryptocurrency.

The patient has a history of depression and is currently taking sertraline. During the mental state examination, the patient exhibits signs of overly familiar behaviour, pressured speech, and flight of ideas.

What is the best medication to treat this condition?

MSFinals-5358

A 44-year-old man is being evaluated on the psychiatric ward due to a worsening of his mental health condition. Upon admission, the patient was diagnosed with a major depressive disorder accompanied by hallucinations.
Lately, the patient has been persistently expressing the belief that he is deceased. Consequently, he has ceased eating and displays obvious signs of self-neglect. The patient has no known medical conditions other than his mental health problems.
What is the name of the syndrome that this patient is experiencing?