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Apatient reports that, on his way to the hospital, he saw a man feeding two squirrels in the park. He says that this means his future will be decided in 2 weeks. This man, he believes, is deliberately out to alarm him (the patient). One of the squirrels is scheming with the man; the other is innocent and trusting. Which of the following terms best describes what this man is experiencing?
A young mother seeks psychiatric help because she is unable to remember events surrounding her 3- year-old son's death after being struck by a car 2 months ago. She is worried that maybe she did something that put him at risk. Except for this brief time period, she is able to recall other events both before and after the tragedy. Given the information above, which of the following is the most likely diagnosis?
A young mother seeks psychiatric help because she is unable to remember events surrounding her 3- year-old son's death after being struck by a car 2 months ago. She is worried that maybe she did something that put him at risk. Except for this brief time period, she is able to recall other events both before and after the tragedy. Of the following treatments, which is the most appropriate to help this patient regain her memory?
A 44-year-old man presents with fears that his mathematical abilities have been slowly sucked out of his brain for the last 4 years. He believes an "alien force disguised as a human being" is responsible. To avoid contacting this being, he has isolated himself in a room in a boarding house. His wife divorced him and left with their children. After 10 years teaching math at a local high school, he resigned about 3 years ago. He supports himself by "collecting cans." His affect is blunted. His appearance is disheveled, unshaven, and unwashed. Which of the following is the most likely diagnosis?
A 44-year-old man presents with fears that his mathematical abilities have been slowly sucked out of his brain for the last 4 years. He believes an "alien force disguised as a human being" is responsible. To avoid contacting this being, he has isolated himself in a room in a boarding house. His wife divorced him and left with their children. After 10 years teaching math at a local high school, he resigned about 3 years ago. He supports himself by "collecting cans." His affect is blunted. His appearance is disheveled, unshaven, and unwashed. Which of the following hypotheses is the leading hypothesis to explain the patient's psychotic symptoms?
A 44-year-old man presents with fears that his mathematical abilities have been slowly sucked out of his brain for the last 4 years. He believes an "alien force disguised as a human being" is responsible. To avoid contacting this being, he has isolated himself in a room in a boarding house. His wife divorced him and left with their children. After 10 years teaching math at a local high school, he resigned about 3 years ago. He supports himself by "collecting cans." His affect is blunted. His appearance is disheveled, unshaven, and unwashed. Considering the information learned thus far, which of the following would be an appropriate first-line treatment for this patient? thiamine
A 17-year-old girl is brought in by her parents because of their concerns about her weight loss. She is petite, and a normal weight for someone her height is 100 lbs, but she weighs 78 lbs. She reports menstrual irregularity. The patient believes she is obese. She does not believe she has a problem. Her mother reports that she found laxatives on her daughter's nightstand, and heard her vomiting in the bathroom yesterday after dinner. Which of the following is the most likely diagnosis?
A 17-year-old girl is brought in by her parents because of their concerns about her weight loss. She is petite, and a normal weight for someone her height is 100 lbs, but she weighs 78 lbs. She reports menstrual irregularity. The patient believes she is obese. She does not believe she has a problem. Her mother reports that she found laxatives on her daughter's nightstand, and heard her vomiting in the bathroom yesterday after dinner. Which of the following is the best initial treatment?
A 70-year-old man is brought to his primary care doctor by the man's son. According to his son, who had not seen his father for about a year, the father seemed to have some personality changes. He was no longer interested in his hobbies and seemed apathetic. He seemed to forget easily, and he repeatedly asked the same already answered questions. On at least two occasions, the father wandered out of the house and was found by neighbors, who thought he was confused. Considering the information learned thus far, which of the following medications would be the most appropriate treatment here?
A 25-year-old male graduate student presents at a university hospital emergency department complaining of a sudden onset of a pounding in his chest, a feeling of choking, and shortness of breath. He reports that things somehow suddenly seem unreal, and he is afraid he is dying of a heart attack. An electrocardiogram (ECG) shows normal sinus rhythm and no abnormalities If this patient continues to experience similar episodes over the next 2 months, with substantial apprehension about the episodes, which of the following drugs would be most appropriate for the treatment of this patient's condition?
A70-year-old woman was brought to the emergency department following her involvement in a minor car accident. She had sustained no injuries but was very upset and was, therefore, referred to a psychiatrist. After speaking at length about her part in the accident and sharing her reactions, she still remained tremulous, anxious, and tearful. She has no history of addiction. You decide to use an anxiolytic to help her. Which of the following is the best choice?
Which of the following delusions would most likely be observed in a psychotically depressed person?
You are called to the ICU to see a 65-year-old female who is 2 days status post hip surgery. The medical team is concerned because the patient is having visual hallucinations and did not sleep last night. She scored 21/30 on a Mini-Mental Status Examination (MMSE) with 5 points off for disorientation and 2 off for both concentration and shortterm memory. The patient is restrained because she pulled out her IV last night. Records indicate she has no previous psychiatric history and that her cognitive functioning presurgery was normal. Which of the following is the most likely axis I diagnosis?
You are called to the ICU to see a 65-year-old female who is 2 days status post hip surgery. The medical team is concerned because the patient is having visual hallucinations and did not sleep last night. She scored 21/30 on a Mini-Mental Status Examination (MMSE) with 5 points off for disorientation and 2 off for both concentration and shortterm memory. The patient is restrained because she pulled out her IV last night. Records indicate she has no previous psychiatric history and that her cognitive functioning presurgery was normal. Which of the following is not a predisposing factor for the above condition?
A 56-year-old man with a dual diagnosis of schizophrenia and alcohol dependency was arrested for "driving under the influence." After 2 days in jail, he was noted to be acting agitated and "crazy," claiming that the guards were going to kill him that night. When questioned about his profuse sweating, he claimed that he had just come in from his job working in the heat and humidity. He was distracted by various noises, claiming that these were made by people watching him and waiting for him. He appeared to watch things that seemed to be moving on the walls. On further examination, it was noted that he was very tremulous, unable to follow an object with his eyes only, and quite ataxic. The working diagnosis at this point is most likely which of the following?
A 56-year-old man with a dual diagnosis of schizophrenia and alcohol dependency was arrested for "driving under the influence." After 2 days in jail, he was noted to be acting agitated and "crazy," claiming that the guards were going to kill him that night. When questioned about his profuse sweating, he claimed that he had just come in from his job working in the heat and humidity. He was distracted by various noises, claiming that these were made by people watching him and waiting for him. He appeared to watch things that seemed to be moving on the walls. On further examination, it was noted that he was very tremulous, unable to follow an object with his eyes only, and quite ataxic. Which of the following benzodiazepines can reliably be given intramuscularly to this patient to help control his symptoms?
A 25-year-old woman presents with a recurrent depression, and says she has taken many antidepressant medications from several different classes of drugs in the past. Which of the following atypical antidepressants is a presynaptic alpha-2 receptor noradrenergic antagonist and a 5-HT2 and 5-HT3 receptor serotonergic antagonist?
A 60-year-old man disappears from his home and travels 100 miles to a small town, where he opens a small grocery store using a different name. Six weeks later, he awakens in some agitation, uses his original name, and asks to know where he is. He wishes to return to his home. Which of the following is the most likely diagnosis?
A 35-year-old woman comes into the ER after cutting her wrists for the 10th time. She did this after her boyfriend of 2 weeks left her yesterday. She reports a history of unstable interpersonal relationships, chronic feelings of emptiness, impulsive sexual relationships, and problems with her sense of identity. Which of the following is the most likely axis II diagnosis?
A 35-year-old woman comes into the ER after cutting her wrists for the 10th time. She did this after her boyfriend of 2 weeks left her yesterday. She reports a history of unstable interpersonal relationships, chronic feelings of emptiness, impulsive sexual relationships, and problems with her sense of identity. The one psychotherapeutic technique to avoid would be: