Archives: Medical Student Finals

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?

MSFinals-5359

A 30-year-old man is brought to his psychiatrist by his sister. His sister is worried that her brother firmly believes that he is a superhero, despite having no evidence or abilities to support this belief.

Upon assessment, the man appears physically healthy. There are no signs of delusions, disorientation, or unusual speech patterns. However, he maintains an unyielding conviction that Beyonce is in live with him.

What is the appropriate diagnosis for this condition?

MSFinals-5360

A 35-year-old woman has been diagnosed with paranoid schizophrenia and prescribed clozapine for the past three months. She is due for a review appointment and has had regular blood tests. What is the primary abnormality she is at risk for?

MSFinals-5361

A 70-year-old homeless man is admitted to the hospital for osteomyelitis resulting from a diabetic foot ulcer. During his stay, it becomes evident that he is experiencing significant memory impairment. Despite being asked about the events of the day, he tells a believable story that is entirely different from what actually occurred. There is no indication that he is intentionally deceiving the medical staff. He is also unaware of his memory impairment and denies having any issues with his memory. According to his family, this memory impairment has been present for the past 5-6 months. He has a history of excessive alcohol consumption spanning 45 years. What is the most probable cause of his memory deficits?

MSFinals-5362

A 65-year-old man is brought to the doctors by his son. Three weeks ago his wife passed away from metastatic breast cancer. He reports feeling sad and tearful every day, but his son is worried because he keeps getting into arguments with him over small things and bringing up past family issues. The son also mentions that his father has mentioned hearing his wife’s voice and even cooked a meal for her once. Despite this, he has started going for walks with his friends again and is determined to get his life back on track. What is the most probable diagnosis?

MSFinals-5363

A 28-year-old man has been admitted to the psychiatric ward under section 2 of the mental health act for suspected first-episode psychosis. During his mental state examination, burns are observed on his arms and he claims that insects are burrowing into his skin. He suggests that the burns are caused by bleach. The evaluating psychiatrist could not detect any insects, and when questioned, the patient became agitated and insisted that his skin was infested. What is the most probable disorder being described?

MSFinals-5344

A 17-year-old boy visits his doctor complaining of low mood. He has been experiencing this for the past 5 weeks along with fatigue, anhedonia, and oversleeping. The doctor orders a set of blood tests and his PHQ-9 score indicates moderate depression. The patient has no medical history. He is not interested in cognitive behavioural therapy and wants to begin medication. What is the best medication for him to start with?

MSFinals-5345

A 42-year-old man is brought to the Emergency Department by his friends. He holds a senior trading job in an investment bank and has a history of recurrent admissions following cocaine intoxication. They are worried because he recently sent a memo to everyone on the trading floor suggesting that he is now the lead, he has the mental capacity to beat anyone to a higher profit and he should be chairman of the group. In fact, he has been performing poorly and has missed recent performance targets.
Which of the following is the most likely diagnosis?

MSFinals-5346

A 29-year-old woman presents with dry, eczematous hands. She reports being a very hygienic person, but since the onset of the COVID-19 pandemic, she has been washing her hands excessively – up to 60 times a day. She is aware that this is causing her skin to become dry and irritated, but her anxiety about contracting the virus is too great to stop. She works in a hospital and is worried about her colleagues noticing her frequent hand washing. You suspect she may have obsessive-compulsive disorder and decide to refer her to the community mental health team. What treatment options are likely to be offered to her?