A 22-year-old female with paranoid schizophrenia is currently admitted as an inpatient and receiving treatment with antipsychotic medication under section 3 of the Mental Health Act. She has recently reported experiencing breast tenderness and enlargement. As the current antipsychotic regimen is not being well-tolerated, what would be the most suitable alternative antipsychotic medication to minimize these side effects?
A 32-year-old woman presents to her GP for her 6-week postnatal check-up. She mentions feeling mildly depressed at times but denies any issues with her eating or sleeping habits. She is managing well with taking care of her baby and has a strong support system from her loved ones. She is currently breastfeeding.
What would be the most suitable course of action for her management?
A 29-year-old man is admitted to a medical ward for treatment of an abscess in his leg. He has a history of intravenous heroin use and reports that he is beginning to experience symptoms of opioid withdrawal. What is the most appropriate course of action for this patient?
A patient who has been attending your GP surgery with a worsening depressive episode on a background of known depression presents with occasional suicidal thoughts and is finding it difficult to cope with some daily activities despite use of psychological therapies and regular consultation with the GP. You agree to trial use of an antidepressant.
Which of the following would be the most appropriate choice for a patient in their 60s?
A 27-year-old man is brought to the hospital by his sister after he spent all of his savings on buying expensive gifts for strangers on the street, claiming that he is here to spread love and happiness. He insists that he is the chosen one to bring joy to the world and will do anything to achieve it. He is very restless, and the doctor cannot communicate with him to gather a medical history. His sister confirms that he has a known diagnosis of bipolar disorder and is currently on medication. For the past few days, the patient has not slept much and has been up all night planning his mission to spread love. There is no evidence of any overdose, but his sister says that he may have missed his medication while on a trip last week. The doctor decides to keep the patient in the hospital under a Section until tomorrow morning when an approved mental health professional can evaluate him.
For how long can the patient be detained under the Section used?
A 35-year-old male contacts his GP at 2PM to schedule his blood tests following a recent visit to his psychiatrist. The psychiatrist has raised his lithium dosage and requested that the GP arrange for lithium levels to be checked at the appropriate time after taking the medication. The patient took his first increased dose of lithium at 10AM (4 hours ago).
In how many hours should the GP schedule the blood test to be taken?
A 50-year-old man with schizophrenia who is on chlorpromazine experiences a bilateral resting tremor. Which side effect of antipsychotic medication does this exemplify?
A 30-year-old woman, with a history of hearing voices, was brought to the Emergency Department by her family. She described the voices as telling her to kill her father as ‘he has the devil in him’. She also reported noting her intelligence being tapped through the Internet by a higher power. This has been going on for the past 6 months. Her family denies either depression or manic episodes. The patient was admitted to an inpatient Psychiatry Unit and started on haloperidol for her symptoms, after an evaluation and diagnosis of schizophrenia. Twelve hours after initiation of therapy, the patient started to have stiffness in the neck muscles and spine. Physical examination revealed muscular spasms in the neck and spine, a temperature of 37.2 °C, blood pressure 125/70 mmHg and a pulse of 80 bpm.
What is the most likely diagnosis?
A 56-year-old man presents to the community mental health team with a history of obsessive-compulsive disorder (OCD). He reports obsessive thoughts about his family members being in danger and admits to calling his wife and daughters 3-4 times an hour to ensure their safety. Despite undergoing cognitive behaviour therapy (CBT) with exposure and response prevention (ERP), he still experiences distressing symptoms. The patient has a medical history of hypertension, hypercholesterolaemia, unstable angina, and pre-diabetes. What would be the most appropriate course of action for managing this man’s OCD?
Sarah is a 35-year-old married woman with two children. She comes to you in distress and expresses suicidal thoughts, stating that she has considered taking an overdose. She has no history of self-harm or suicide attempts, and no psychiatric background. Despite having a loving family and enjoying her job, she is struggling. What is a risk factor for suicide in this case?