Psychiatric Flashcards
A 15-year-old girl is brought to the emergency department by her mother after
experiencing a first-time seizure. The thin-appearing girl has a heart rate of 55/min, signs
suggestive of dehydration, and fi ne, velvety hair covering her arms and legs. The
physician calculates her body mass index to be 16.4 kg/m². When the patient’s mother
leaves the room for a moment, the patient admits to the physician that she has been
feeling depressed recently and that for the past week she has been self-medicating with
normal daily doses of one of her friend’s antidepressant medications. What
antidepressant is the patient most likely taking?
(A) Amitriptyline
(B) Bupropion
(C) Fluoxetine
(D) Mirtazapine
(E) Selegiline
(B) Bupropion
A 45-year-old man presents to a marriage counselor at his wife’s prompting. He has been
married for 10 years and believes that his wife has been unfaithful for the entire
marriage, despite her protests to the contrary. He says that everyone is always betraying
him, and he has a litany of slights, insults, and injuries that have been perpetrated against
him. He is very defensive with the counselor and reads an attack in almost every
statement. This patient most likely has which of the following personality disorders?
(A) Antisocial
(B) Avoidant
(C) Obsessive-compulsive
(D) Paranoid
(E) Schizoid
(D) Paranoid
A 20-year-old man is seen by a physician for the third time in 3 months. At the first visit
he was brought to the emergency department by his mother after swallowing toilet bowel
cleaner. He told the doctor that he took the cleaning product to “cleanse his body from
the aliens” that had “forced their entry” and “possessed” him. Today the patient appears
unclean and disheveled, and his mother reports that he has become progressively
withdrawn and expressionless. Four months ago, the patient witnessed the gruesome
death of his father in a drive-by shooting incident. Prior to this incident, he had a normal
and healthy life. Which of the following is the most likely diagnosis?
(A) Factitious disorder
(B) Schizoaffective disorder
(C) Schizophrenia
(D) Schizophreniform disorder
(E) Shared delusional disorder
(D) Schizophreniform disorder
A 42-year-old schizophrenic woman visits her psychiatrist because her caregiver has
noticed that she has recently developed involuntary, stereotyped facial grimacing and
repetitive thrusting of the tongue. The patient began haloperidol therapy 6 months prior
to the visit. Both the patient and her psychiatrist conclude that the patient continues to
require treatment for her psychotic symptoms, so the psychiatrist writes a prescription
for a different medication. The new medication still has antipsychotic properties but is
less frequently reported to contribute to oromotor symptoms. What is a serious adverse
effect of the new medication most likely prescribed by the psychiatrist?
(A) Agranulocytosis
(B) Anorgasmia
(C) Diabetes insipidus
(D) Hypertension
(E) Respiratory depression
(A) Agranulocytosis
