2015 October Flashcards
A 37 years old, treatment resistant schizophrenic patient is on 500 mg of clozapine. He develops an epileptic fit at night and shows residual psychotic symptoms. a) What are the likely effects that you expect when you combine the following medicines with clozapine: 1) Risperdal 2) Topiramate 3) Olanzapine 4) Sodium valproate 5) Lamotrigine b) Enumerate any four scales to monitor progress of improvement
A
.2 A 66 years old patient has had feeling of sadness for the last 10 years, associated with lack of interest irritability, poor concentration, disturbed sleep, low appetite. Occasionally he also has difficulty in recalling names of familiar person. For the last few days he has developed hyperactivity with episodes of laughter and agitation. Sometimes he claims to be Lord of the Village and at other times he says he is the candidate for presidency. On History, it was revealed that he was the son of a famous tribesman and now his family has worse social and financial conditions. He believes other people of his tribe are against him and they want to harm him. Mental state examination also reveals suicidal ideation.
a) What is your provisional diagnosis according to ICD-10 with code?
b) Enlist any 3 differentials that you consider?
c) What therapeutic intervention you can do for this case?
A
A 9 years old boy has been brought to you by his mother with history of irritability and overactive behaviour. He is markedly restless in the class room and fails to focus on the lessons He frequently forgets things in School, doesn’t sit for more than half an hour to watch TV unlike his younger brother. During the interview the child is unable to stand still andrefuses to answer any questions
a) What is the most likely diagnosis?
b) Enlist the areas of assessment in this case?
c) What are the common co-morbid psychiatric conditions in this disorder?
d) What are various pharmacological options for treatment?
A
A 67 years old male patient is brought to psychiatric OPD with the complaints of insidious onset of forgetfulness, visual hallucinations, frequent falls and variations in attention and alertness. On physical examination patient is found to have tremors, rigidity and difficulty initiating movement.
a) What is your provisional diagnosis? Give points in the favor of your diagnosis in three lines,
b) What will be your differential diagnosis?
c) How will you investigate this case?
d) How will you proceed with pharmacological management according to recent international guidelines?
A
0 Mr X is an 18 years old single, school fallout who has been caught following a failed attempt by him to blow himself up in a busy Street. During his summary trial in a military court, he openly expressed his desire to repeat the action, and stated that he is “on a holy mission”. The police reports that the individual has been extensively interrogated. The court approaches you for an opinion on the subject. a) In the light of current evidence and references on the is likely view that you will form on the mental health of bomber?
b) What are the key psycho social risk factors that you will look at in this individual?
A
