Ok, did form 1 today. Well, these ones i can't seem to understand. So, some help would be appreciated.
1) a 55 year old woman is brought to the emergency department by her parents because of strange behavior for 3 months. She insist that her father and next door neighbor want to steal money from her. She also said that there were fumes that her neighbors were blowing under her door causing headaches and skin tone changes. She has called the radio station for the same. Other than this she has no problems and insist that she is normal. Mental status shows no incoherence, loose associations, hallucinations. She is oriented to time, place, person.
1) Schizophreniform
2) Paranoid.
3) shizo
4) MDD
5) Delusional
2) A 47 year old man comes to the physician because of 4 weeks of depression, lack of energy, poor concentration, daytime sleepiness. He started a program for weight loss 6 weeks ago, consisitng of diet and exercise, and had a 5.9(13kg) weight loss.He has HTn and was switched to water pill from propranolol. no h/o psych illness. He is 180cm tall and now weights 97kg. Bim is 30. Bp 1135/90. Mental status shows depressed mood and poor concentration. What is the diagnosis?
1) adjustement disorder with depressed moon
2) Dysthymic
3) MDD
4) mood disorder to to medical condition
5) substance induced
3) A 67 year old with parkinson is bought by his wife. She said, "he has become increasingly withdrawn and tearful during the past 3 weeks. He has had poor energy and decreased sleep for 2 months." Current medications is Cari-levadopa and pramipexole. He has had a 6.kg weight loss in 3 months. He is 5ft 3 inches tall and now weights 90lbs. Resting tremor and hand bradykinesia have increased since last visit. On examination he has flat affect and downcast gaze, speech is slow and soft. When asked about the crying spells he said, "Who wouldn't be sad with the damn disease I got?" He doesn't want to go anywhere because he doesn't want people to see him with his tremor. Most likely diagnosis
1) Adjustement with depressed moos
2) Normal reaction to medical condition
3) MDD
4) Dysthymic
5) D/t carbi-levadopa
4) a 13 year old girl is brought by her mother because she has not started menstruation yet. The patient has MDD which was treated with fluoxetine for 8months. Not sexually active and physical examination is normal. Sexual development is at tanner stage 2. Mental status shows mild depression and anxiety. What do you do next?
1) Discuss normal pubertal development
2) reassessment by her psychiatrist
3) Prolactin measurement
4) discontinue fluoxetine
5) begin benzo
5) a 10 month old was at a day care. he came back and was crying and refused to put weight on his leg. An x ray was done and showed a spiral fracture of the femur. What is the likely diagnosis
1) Osteogeneis Imperfecta
2) child abuse
both of these can lead to spiral fracture, I am guessing child abuse as if it was the other, there would be other signs as well? like sclera and teeth?
6) A 37 year old girl has had repeated attempts to commit suicide. she has a 6 year history for MDD with multiple anti depressants. She said, " there is no hope and she is helpless" tox screens are negative. What will you find in the patient?
P.S can you tell me where I can see the other finding listed.
a) dec concentration of 5-HIA in spinal fluid
b) delayed REM on polysomnography
c0 enlarged lateral ventricles
d( increased sensitivity to lactate infusion
serology positive for HLA-DR2
7) if a patient is on haloperidol and has blunted affect. they want to know how to decrease their chances of getting tar dative dyskinesis
1) lower halo dose
2) switch to aripiprazole
3) switch to carbamazepine
4) lorazepam to the regime
5) add citalopram to the regime
6) maintain current regime
8) a 47yo woman is admitted to the hospital because of a 12 hr history of tremors and confusion. she has a history of alcoholism and last consumed alcohol 24 hours ago. she has no other history of serious illness. she does not smoke cigarettes or use illicit drugs. on admission, she is agitated, diaphoretic, orientnted to person but not to time or place. vitamin B1 , folic acid, and three doses of diazepam are administered intravenously. 35 min later, respiratory compromise develops. patient is intubated, mechanical ventilation is started . 2 hr later, she remains agitated. she is pulling at her peripheral intravenous and urethral catheters and picking at her blankets. pulse 140/min, bp160/100, neurologic exam show tremor of upper and lower extremities and hyperreflexia bilaterally. next step pharmacotherapy?
1) add flumazenil
2) add haloperidol
3) add phenytoin
4) Add bento
5) Add B1
1) a 55 year old woman is brought to the emergency department by her parents because of strange behavior for 3 months. She insist that her father and next door neighbor want to steal money from her. She also said that there were fumes that her neighbors were blowing under her door causing headaches and skin tone changes. She has called the radio station for the same. Other than this she has no problems and insist that she is normal. Mental status shows no incoherence, loose associations, hallucinations. She is oriented to time, place, person.
1) Schizophreniform
2) Paranoid.
3) shizo
4) MDD
5) Delusional
2) A 47 year old man comes to the physician because of 4 weeks of depression, lack of energy, poor concentration, daytime sleepiness. He started a program for weight loss 6 weeks ago, consisitng of diet and exercise, and had a 5.9(13kg) weight loss.He has HTn and was switched to water pill from propranolol. no h/o psych illness. He is 180cm tall and now weights 97kg. Bim is 30. Bp 1135/90. Mental status shows depressed mood and poor concentration. What is the diagnosis?
1) adjustement disorder with depressed moon
2) Dysthymic
3) MDD
4) mood disorder to to medical condition
5) substance induced
3) A 67 year old with parkinson is bought by his wife. She said, "he has become increasingly withdrawn and tearful during the past 3 weeks. He has had poor energy and decreased sleep for 2 months." Current medications is Cari-levadopa and pramipexole. He has had a 6.kg weight loss in 3 months. He is 5ft 3 inches tall and now weights 90lbs. Resting tremor and hand bradykinesia have increased since last visit. On examination he has flat affect and downcast gaze, speech is slow and soft. When asked about the crying spells he said, "Who wouldn't be sad with the damn disease I got?" He doesn't want to go anywhere because he doesn't want people to see him with his tremor. Most likely diagnosis
1) Adjustement with depressed moos
2) Normal reaction to medical condition
3) MDD
4) Dysthymic
5) D/t carbi-levadopa
4) a 13 year old girl is brought by her mother because she has not started menstruation yet. The patient has MDD which was treated with fluoxetine for 8months. Not sexually active and physical examination is normal. Sexual development is at tanner stage 2. Mental status shows mild depression and anxiety. What do you do next?
1) Discuss normal pubertal development
2) reassessment by her psychiatrist
3) Prolactin measurement
4) discontinue fluoxetine
5) begin benzo
5) a 10 month old was at a day care. he came back and was crying and refused to put weight on his leg. An x ray was done and showed a spiral fracture of the femur. What is the likely diagnosis
1) Osteogeneis Imperfecta
2) child abuse
both of these can lead to spiral fracture, I am guessing child abuse as if it was the other, there would be other signs as well? like sclera and teeth?
6) A 37 year old girl has had repeated attempts to commit suicide. she has a 6 year history for MDD with multiple anti depressants. She said, " there is no hope and she is helpless" tox screens are negative. What will you find in the patient?
P.S can you tell me where I can see the other finding listed.
a) dec concentration of 5-HIA in spinal fluid
b) delayed REM on polysomnography
c0 enlarged lateral ventricles
d( increased sensitivity to lactate infusion
serology positive for HLA-DR2
7) if a patient is on haloperidol and has blunted affect. they want to know how to decrease their chances of getting tar dative dyskinesis
1) lower halo dose
2) switch to aripiprazole
3) switch to carbamazepine
4) lorazepam to the regime
5) add citalopram to the regime
6) maintain current regime
8) a 47yo woman is admitted to the hospital because of a 12 hr history of tremors and confusion. she has a history of alcoholism and last consumed alcohol 24 hours ago. she has no other history of serious illness. she does not smoke cigarettes or use illicit drugs. on admission, she is agitated, diaphoretic, orientnted to person but not to time or place. vitamin B1 , folic acid, and three doses of diazepam are administered intravenously. 35 min later, respiratory compromise develops. patient is intubated, mechanical ventilation is started . 2 hr later, she remains agitated. she is pulling at her peripheral intravenous and urethral catheters and picking at her blankets. pulse 140/min, bp160/100, neurologic exam show tremor of upper and lower extremities and hyperreflexia bilaterally. next step pharmacotherapy?
1) add flumazenil
2) add haloperidol
3) add phenytoin
4) Add bento
5) Add B1
