Behavioral Sciences Question Set 2

A 27-year-old male is brought to the emergency department by the police after he was found running around in the park naked. The patient has a two-year history of feeling depressed and during this time he has lost 15 pounds. He feels a lack of energy and focus. He often has trouble staying asleep and wakes up very early in the morning. He says the running commentary in his head also does not help with his sleep situation. The police have known this patient for that past 2 years from previous encounters to wander around aimlessly. His behavior, although odd until now did not warrant being taken into custody. On further questioning, the patient admits that for the last 3 weeks his mood has improved and he is no longer depressed but still has an annoying voice commenting on his every move. What is the most likely diagnosis?

A 20-year-old woman is brought into the emergency department by her mother after she recently lost her father from lung cancer a week ago. The patient says she hears voices in her head. These voices have conversations about her and how she should have been the one to die. She has since then not been able to concentrate at work and was forced to take a leave of absence for the following two weeks. She has no other history medical or psychiatric illness. She denies recent use of any medication. What is the patient's most likely diagnosis?

A 22-year-old male is brought to the emergency department by his father because his son is having bizarre thoughts. The patient says that he is being haunted by aliens from outer space. The father is worried as his son has had these symptoms for the past 7 months and lately, it seems to be getting worse. He has become more self-obsessed and does not seem to pay any interest in his previously favorite activities. He has no plans to harm himself or others but spends a lot of time and energy building "defenses" in and around his room as he is absolutely sure the aliens will come to get him soon. Which of the following is correct regarding the patient’s symptom?

A 50-year-old male presents to the clinic as he experiences abnormal odor on several occasions. He says that he smells burnt rubber even though there is no such thing around him. This has been intermittent for the past six months. During this period he had occasional nose bleeds. He works as a high school teacher. Although his work gets a little stressful around the exam season, he says he is able to cope well. He still gets a good amount of sleep and does not need to take a nap during the day. He exercises three times a week and eats a healthy diet. Family history is unremarkable. He does not smoke or drink alcohol and denies use of any medication. Physical examination reveals unilateral nasal obstruction with some dried blood in the nasal passage. What is the most likely diagnosis?

A 40-year-old male is brought into the emergency room by paramedics after having seizure-like activity at home 30 minutes back. His accompanying wife states that he had no such episodes in the past and that her husband has always been healthy. Social history reveals a sedentary lifestyle and regular alcohol consumption, even on weeknights. This weekend he was out with his friends celebrating a hometown football game victory. The wife describes a single episode of seizure involving all the limbs that became rigid for a while and then relaxed. She also notice muscle spasm when she tried to hold his arms. He was confused after he recovered for almost 15 minutes. The patient's last drink was almost 48 hours ago. Vital signs show a blood pressure of 148/86 mmHg with a heart rate of 102 / minute. Physical examination reveals an anxious male with tremors. Which type of hallucination is this patient likely to experience?

A 44-year old male is brought to the clinic by his wife insisting that her husband is acting strange lately. He is a dentist by profession and has no known medical condition. For the past 6 weeks, he is insisting to listen to the 6 pm news on the radio. He is adamant that the anchor is making explicit references to his life in the newscast. Apart from this, his wife states that her husband is fine and does everything as usual. He and his wife deny use of any prescribed medication or illicit drug use by the patient. He is a non-smoker and drinks alcohol only on social occasions. Physical examination and routine laboratory investigations are normal. What is the most likely diagnosis?

A 35-year old female is brought to the inpatient psychiatric unit by the police after he was found violating the conditions of her restraining order by parking on the side street of her ‘lover’s’ home every night for the past week. Her ‘lover’, a famous hometown celebrity, has adamantly denied any relationship with the patient over the past 6 months. The patient insists that ever since he signed a copy of his album at a local signing, she knew they are in love. Despite him having his own wife and children, the patient insists that he is in love with her and goes to his house to meet in secret. Physical examination of the patient is insignificant. Urine toxicology report is negative. Which of the following statements best describes this patient’s condition?

Two dizygotic twins are sent to the university clinic for their unusual resentment towards their professors. The patients were seen by various faculty members over the past few months and their concerns addressed, but they continue to express an unshakable view of being targeted by the school. Both of them are average students with some strong subject areas and weak subject areas as demonstrated by their course grade-book. They have no known medical conditions and are not known to abuse illicit substances. None of their peers share the same concerns. Which statement best describes the condition that these patients have?

A 35-year old woman who was recently involved in a motor vehicle accident presents to the clinic for her follow-up visit. She was in the front passenger seat when the vehicle swerved off the road and struck two pedestrians. She was restrained by her seatbelt and did not suffer any significant physical injury. Since then she has already had one outpatient visit and was found to be recovering well. She is here today upon the request of her family members who insist that she has not come to terms with the incident. They have noted that she has significant distress while riding her car. However, she does not seem particularly worried and she cannot remember much of the details from the event. On mini-mental examination she is able to form new memory. Which statement is true regarding this patient’s condition?

A 45-year old male patient is referred to the outpatient psychiatry clinic as he does not feel good. He was diagnosed with pancreatic cancer recently. Since then he has not been able to go to work. Over the past several weeks he has had significant unintentional weight-loss and several bouts of epigastric pain. He lost his father to some form of cancer when he was 10-years old. After a complete history and physical examination, the patient is diagnosed with major depressive disorder, provisional. Which one of the following statements regarding the patient’s psychiatric condition is true?