Anyone done Psychiatry? Case studies - please help!

[bargaindoctor]

Anyone done psychiatry here? Here are 10 psychiatric case studies from some past papers. Would love to hear someone who has done psychiatry answer them. These are british as you may tell from some terminology. I'm sure it's a breeze for those of you who know your stuff.

Question 1
A 54-year-old married woman is admitted for varicose vein surgery. On admission she says she has longstanding ‘problems with her legs’ and is noted to be mildly ataxic and slightly dysarthric. Two days post-operatively she has a grand mal seizure. She has been investigated neurologically in the past three months with no abnormality found.
a) What are the main diagnostic possibilities here? (3)
b) What other features would you seek? (3)
c) What is your immediate management plan? (4)

Question 2
A 27-year-old married woman becomes sleepless and over excited four days post partum while in the maternity unit. You are the psychiatrist on call. When you see her she is shouting loudly; her speech is pressurised and hard to follow but she seems to think she is the Virgin Mary; she is rushing up and down the ward clutching the baby in her arms.
a) What do you think might be wrong with her? (2)
b) What would be your immediate plan of action? (4)
c) Once the immediate situation has been resolved what outstanding issues
do you think would be important? (4)

Question 3
You are asked by colleagues in paediatrics to assess an unsupported mother who is staying in the children’s ward with her 3 year old son who is failing to thrive. The staff think, although they have no proof, that she is interfering with the child’s feeding regime.
a) what diagnostic possibilities do you see here? (3 marks)
b) how would you differentiate between these? (7)

Question 4
You are a GP. A 30 year old woman comes to see you to say that her 58 year old mother has been admitted to a psychiatric ward following an overdose. ECT has been mentioned as a possible treatment for her mother. She does not know what to think about this but friends have told her it is old fashioned and barbaric. How would you advise her:
a) upon the range of severity and possible consequences of depressive illness; (3 marks)
b) the possible treatments for depressive illness; (4)
c) her own and her mother’s rights in respect of confidentiality and consent to
treatment. (3)

Question 5
A 52-year-old woman with depression and a history of pulmonary embolus, on
Warfarin, wants to take St John’s Wort. Do you envisage any problems with this, and if so, what ? (2)
A woman with hypertension treated with diuretics has a second episode of mania having had one major episode of depression in the past. She asks about mood stabilisers and whether these would help her and which would be the most suitable. What would you tell her? (3)
A 50- year-old man with schizophrenia has been treated with thioridazine for years and has found the particular side effects of the trifluoperazine to which he was changed difficult to tolerate. He wishes to change to a more modern drug but has a history of angina and maturity onset diabetes and some ischaemic changes on ECG. He wants to know what the pros and cons of the different antipsychotic options are. What would you tell him? (5)

Question 6
You are an SHO in psychiatry and at 11pm are called by the casualty officer to see two medical students who have presented. One has brought his friend (the patient) who returned to their flat four days previously after the summer holidays. Initially he just seemed quieter than usual but over the last 48 hours has been talking about being under threat by international terrorists, keeping the flat in darkness and refusing to go to bed in case he is harmed while asleep. The patient says he is giving no information to you or anyone else and behaves in a watchful but calm manner.
What is the differential diagnosis? (4)
What are your immediate plans for management? (6)

Question 7
Reduction in rates of suicide and self-harm is a major priority.
a) Give one intervention that you know has been put into practice and has
reduced death rates by at least one method. (2)
b) Give three other interventions which could realistically be suggested
and indicate how you think they would work. (8)

Question 8
You are a G.P. A 30-year old married woman comes into your surgery with facial bruising. Six months ago she had a black eye which she attributed to walking into a clothesline. You ask her about the situation and after some delay she tells you that both injuries were actually the result of her husband punching her.
a) What questions do you think you should ask her? (3)
b) What diagnostic possibility in the husband would give you particular
cause for concern? (2)
c) How would you manage this situation? (3)
d) If your enquiries lead you to believe that there is a significant risk of serious
harm coming to this woman what should you do? (2)

Question 9
Summarise the evidence that the following groups of drugs which may be used recreationally may precipitate psychotic illness:
(a) alcohol (2)
(b) opiates/benzodiazepines (2)
(c) stimulants (amphetamines and cocaine) (2)
(d) dance drugs (e.g. ecstasy, ketamine) (2)
(e) cannabis (2)

Question 10
You are a psychiatrist. You are asked by a GP colleague to advise a female patient aged 45 who has consulted him about issues relating to Alzheimer’s disease in her own family. Her mother aged 72 has been hospitalised for one year with the disorder. She can no longer communicate and requires assistance with all areas of activity. Her mother’s sister died from Alzheimer’s aged 73, two years ago. The woman wishes to know if:
a) Cognitive enhancers would help her mother and how should her need for these be assessed (3)
b) What the risks are to herself and if any genetic or other testing would help (3)
c) If it would be useful for her to take cognitive enhancers on a prophylactic
basis now (2)
d) If her own two children aged 8 and 10 could have any form of genetic or
other predictive testing (2)

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[AF_PedsBoy]

Do your own homework, loser!

 

[ThinkFast007]

Anyone done psychiatry here? Here are 10 psychiatric case studies from some past papers. Would love to hear someone who has done psychiatry answer them. These are british as you may tell from some terminology. I'm sure it's a breeze for those of you who know your stuff.

Question 1
A 54-year-old married woman is admitted for varicose vein surgery. On admission she says she has longstanding ‘problems with her legs’ and is noted to be mildly ataxic and slightly dysarthric. Two days post-operatively she has a grand mal seizure. She has been investigated neurologically in the past three months with no abnormality found.
a) What are the main diagnostic possibilities here? (3)
b) What other features would you seek? (3)
c) What is your immediate management plan? (4)

Question 2
A 27-year-old married woman becomes sleepless and over excited four days post partum while in the maternity unit. You are the psychiatrist on call. When you see her she is shouting loudly; her speech is pressurised and hard to follow but she seems to think she is the Virgin Mary; she is rushing up and down the ward clutching the baby in her arms.
a) What do you think might be wrong with her? (2)
b) What would be your immediate plan of action? (4)
c) Once the immediate situation has been resolved what outstanding issues
do you think would be important? (4)

Question 3
You are asked by colleagues in paediatrics to assess an unsupported mother who is staying in the children’s ward with her 3 year old son who is failing to thrive. The staff think, although they have no proof, that she is interfering with the child’s feeding regime.
a) what diagnostic possibilities do you see here? (3 marks)
b) how would you differentiate between these? (7)

Question 4
You are a GP. A 30 year old woman comes to see you to say that her 58 year old mother has been admitted to a psychiatric ward following an overdose. ECT has been mentioned as a possible treatment for her mother. She does not know what to think about this but friends have told her it is old fashioned and barbaric. How would you advise her:
a) upon the range of severity and possible consequences of depressive illness; (3 marks)
b) the possible treatments for depressive illness; (4)
c) her own and her mother’s rights in respect of confidentiality and consent to
treatment. (3)

Question 5
A 52-year-old woman with depression and a history of pulmonary embolus, on
Warfarin, wants to take St John’s Wort. Do you envisage any problems with this, and if so, what ? (2)
A woman with hypertension treated with diuretics has a second episode of mania having had one major episode of depression in the past. She asks about mood stabilisers and whether these would help her and which would be the most suitable. What would you tell her? (3)
A 50- year-old man with schizophrenia has been treated with thioridazine for years and has found the particular side effects of the trifluoperazine to which he was changed difficult to tolerate. He wishes to change to a more modern drug but has a history of angina and maturity onset diabetes and some ischaemic changes on ECG. He wants to know what the pros and cons of the different antipsychotic options are. What would you tell him? (5)

Question 6
You are an SHO in psychiatry and at 11pm are called by the casualty officer to see two medical students who have presented. One has brought his friend (the patient) who returned to their flat four days previously after the summer holidays. Initially he just seemed quieter than usual but over the last 48 hours has been talking about being under threat by international terrorists, keeping the flat in darkness and refusing to go to bed in case he is harmed while asleep. The patient says he is giving no information to you or anyone else and behaves in a watchful but calm manner.
What is the differential diagnosis? (4)
What are your immediate plans for management? (6)

Question 7
Reduction in rates of suicide and self-harm is a major priority.
a) Give one intervention that you know has been put into practice and has
reduced death rates by at least one method. (2)
b) Give three other interventions which could realistically be suggested
and indicate how you think they would work. (8)

Question 8
You are a G.P. A 30-year old married woman comes into your surgery with facial bruising. Six months ago she had a black eye which she attributed to walking into a clothesline. You ask her about the situation and after some delay she tells you that both injuries were actually the result of her husband punching her.
a) What questions do you think you should ask her? (3)
b) What diagnostic possibility in the husband would give you particular
cause for concern? (2)
c) How would you manage this situation? (3)
d) If your enquiries lead you to believe that there is a significant risk of serious
harm coming to this woman what should you do? (2)

Question 9
Summarise the evidence that the following groups of drugs which may be used recreationally may precipitate psychotic illness:
(a) alcohol (2)
(b) opiates/benzodiazepines (2)
(c) stimulants (amphetamines and cocaine) (2)
(d) dance drugs (e.g. ecstasy, ketamine) (2)
(e) cannabis (2)

Question 10
You are a psychiatrist. You are asked by a GP colleague to advise a female patient aged 45 who has consulted him about issues relating to Alzheimer’s disease in her own family. Her mother aged 72 has been hospitalised for one year with the disorder. She can no longer communicate and requires assistance with all areas of activity. Her mother’s sister died from Alzheimer’s aged 73, two years ago. The woman wishes to know if:
a) Cognitive enhancers would help her mother and how should her need for these be assessed (3)
b) What the risks are to herself and if any genetic or other testing would help (3)
c) If it would be useful for her to take cognitive enhancers on a prophylactic
basis now (2)
d) If her own two children aged 8 and 10 could have any form of genetic or
other predictive testing (2)

hey i dont know where you've gotten these questions from...but in american schools we dont have these types of schools...it's usually multiple choice (shelf exam). Unless of course you have an oral exam/in house exam, then you have these open ended types of q's...