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A 24-year-old male presents to the emergency department with agitation, palpitations, profuse sweating, and dilated pupils. He admits to the recreational use of a white powder purchased online, which he identifies as “meow-meow”, also known as mephedrone. His heart rate is 130 beats per minute, blood pressure is 150/95 mmHg, and he appears paranoid with frequent repetitive movements. Blood and urine tests are sent for routine analysis and tox screen. Management of this patient should include
A 53-year-old man presents with complaints of progressive left lower extremity weakness over the last two months. Neurological examination shows normal reflexes, sensory function, and no clear signs of upper motor neuron lesion. You decide to perform the Hoover test. Which of the following describes the correct interpretation of this test?
In criminal law, an attorney is examining various case scenarios to determine the most appropriate legal categorization. Which of the following would most accurately be classified as an indictable offence?
A 34-year-old female with a history of epilepsy presents to your clinic. She reports episodes of unusual behavior that her family has observed. According to the family, she seems to be ‘out of touch with reality’ during these episodes, where she repetitively carries out complex activities, such as preparing meals or changing clothes, with no apparent awareness or recollection of these events. Her family is concerned about these episodes, which seem to last for several minutes and often occur early in the morning. You suspect she is experiencing episodes of automatism. What is the most likely diagnosis?
A 14-year-old boy is brought to your clinic by his parents. They report that their son is persistently disobedient and shows aggression towards other children and animals. He has no close friends and does not seem to care about the rights or feelings of others. He often engages in risky behaviors without considering the potential harm to himself or others. He frequently misses school without permission and has been caught stealing on multiple occasions. This pattern of behavior has been ongoing for the past year and has significantly impacted his social and academic functioning. What is the most likely diagnosis?
A 10-year-old boy is referred to your clinic by his school. According to his teachers, he has been frequently disruptive in class, often leaving his seat, talking excessively, and interrupting others. His grades have been steadily declining. At home, his parents report that he often disobeys rules, is physically aggressive towards his younger sister, and lacks remorse for his actions. These behaviors have been persistent for more than 6 months. He has a few close friends but his relationships are often strained due to his impulsivity and aggression. Which of the following is the most likely diagnosis?
A 5-year-old boy is brought to your clinic by his parents. They report that their son has developed an unusual behavior of biting his fingers and lips, causing self-inflicted wounds. On physical examination, you note orange-colored crystals in his diapers. Additionally, he has a swollen and painful big toe, which is unusual for his age. He has also been exhibiting some mild developmental delays. His lab work shows elevated serum uric acid levels. Which of the following is the most likely diagnosis?
A 2-year-old boy is brought to your clinic by his parents for a developmental evaluation. They report that he avoids eye contact, exhibits repetitive behaviors, and has a delayed speech. Physical examination reveals a large head circumference, long face, large ears, and a prominent forehead and chin. His family history is notable for a paternal uncle with a learning disability. What is the most likely diagnosis?
A 4-year-old girl is brought to your clinic by her parents due to concerns about her developmental milestones. They mention she frequently hugs herself, especially when she is upset or excited. She also has difficulties with speech and sleeps poorly, often waking up in the middle of the night. On physical examination, you note a broad square-shaped face, prominent jaw, deep-set eyes, and a flat midface. Her developmental assessment reveals mild intellectual disability. What is the most likely diagnosis?
A 5-year-old boy is brought to the clinic by his parents, who are concerned about his excessive eating and weight gain over the past year. They mention he never seems satisfied, always seeking food and having temper tantrums if not allowed to eat. His birth history is significant for neonatal hypotonia and feeding difficulties requiring tube feeding for the first few months of life. Physical examination reveals obesity, almond-shaped eyes, and small hands and feet. Additionally, the patient seems to have mild intellectual disability. What is the most likely diagnosis?
A 35-year-old woman presents to the clinic with symptoms suggestive of rheumatoid arthritis (RA). She tests positive on an anti-cyclic citrullinated peptide (anti-CCP) test. You know that the sensitivity of the test is 80% and the specificity is 85%. Given that the prevalence of RA in the general population is 1%, what are her post-test odds of having rheumatoid arthritis after a positive test?
Dr. Alice, a young resident, is conducting a study on the frequency of various symptoms in patients diagnosed with fibromyalgia in her hospital. She collected data from 200 patients over six months. She wants to present this data in a visual manner to her colleagues in a department meeting. The symptoms included are fatigue, unrefreshing sleep, cognitive difficulties, headaches, irritable bowel syndrome, and depression. Which of the following methods would be the most appropriate way to present her data?
Dr. John, a clinical researcher, is designing a clinical trial to compare the efficacy of a new antihypertensive medication against a commonly used medication. He is mindful of potential biases that could affect the validity of his study. He decides to assign participants to either the experimental group or the control group randomly. This approach primarily helps to reduce which of the following types of bias?
A 45-year-old man with a history of schizophrenia presents to the psychiatric clinic with new complaints of restlessness and a constant urge to move. He reports feeling “jittery” and unable to sit still, often pacing around his room. His antipsychotic medication regimen was increased two months ago. His vitals and physical examination findings are otherwise unremarkable. Given the patient’s presentation and history, what would be the most appropriate next step in management?
A 55-year-old woman with a history of treatment-resistant schizophrenia has been managed successfully on clozapine for the past year. However, she has recently been experiencing troublesome hypersalivation, particularly at night. She has no dysphagia, cough, or other respiratory symptoms. Her oral hygiene is good, and dental examination is normal. Which of the following is the best medication to add to her current regimen to manage her symptoms?
A 9-year-old boy is brought to the clinic by his parents, who report concerns about his social interactions and behavior. The boy often appears absorbed in his own world, repeatedly lining up his toys in a precise order and becoming extremely upset if the order is disrupted. He also exhibits exceptional skill and attention to detail when drawing intricate objects like a clock. His speech development was delayed, and although he now has an extensive vocabulary, he often uses language in a formal and old-fashioned way. He struggles to understand others’ feelings and perspectives, and has little interest in playdates. This child’s particular attention to detail at the expense of understanding the bigger picture aligns with which concept in autism spectrum disorders?
A 12-year-old boy presents to the clinic with his parents who report his repetitive behaviors and fixations. They describe that he washes his hands numerous times in a day, sometimes until they become red and raw. He also has a rigid routine and insists on specific patterns in daily life, like stepping only on certain tiles or arranging his toys in a very particular way. He becomes extremely upset if these routines are interrupted. He has good academic performance and no other significant medical history. His symptoms have been causing him significant distress and affecting his social interactions. According to the NICE guidelines, what would be an appropriate pharmacological treatment for his condition?
A 35-year-old woman presents to the emergency department with agitation, diaphoresis, and tremor. Her husband reports that she has been taking fluoxetine for depression and recently started taking an over-the-counter cough medicine containing dextromethorphan. On examination, she has dilated pupils, increased bowel sounds, and inducible clonus at her ankles. Her deep tendon reflexes are brisk. Her temperature is 38.5°C (101.3°F), blood pressure is 155/95 mm Hg, and heart rate is 120 beats/min. What is the most likely diagnosis?
A 45-year-old man with a history of depression is brought to the emergency department with confusion, agitation, and tremor. His wife mentions that he was recently prescribed a new medication by his psychiatrist but is unsure of its name. On examination, he is diaphoretic with dilated pupils, his deep tendon reflexes are hyperactive, and he has inducible clonus at his ankles. His vital signs reveal a temperature of 39°C (102.2°F), a heart rate of 130 beats/min, and a blood pressure of 160/100 mmHg. The most likely diagnosis is serotonin syndrome. Which of the following is the most appropriate next step in managing this patient’s condition?
A 30-year-old man is brought to the emergency department following a motor vehicle accident. On arrival, he is conscious but disoriented and has difficulty remembering events before and after the accident. His Glasgow Coma Scale score is 14, and a CT scan of his head shows no intracranial hemorrhage or fractures. Over the next 24 hours, he remains disoriented and amnesic for the events surrounding the accident. Based on the patient’s presentation, which of the following factors is the best predictor of long-term cognitive impairment following this head injury?
A 7-year-old boy is brought to the pediatric clinic by his parents who are concerned about his behavior at school and home. He has trouble paying attention, is easily distracted, often makes careless mistakes in his homework, and finds it difficult to sit still during class. He is also impulsive and frequently interrupts others. His teachers have noticed these behaviors, which have persisted for the past year and have affected his academic performance. His parents report similar issues at home. There is no history of a significant head injury, seizures, or other neurological conditions. His development milestones have been normal. He sleeps well and has a good appetite. His older brother has a similar diagnosis. Assuming that this boy’s symptoms are consistent with attention-deficit/hyperactivity disorder (ADHD), what is the likelihood of a genetic contribution to his condition?
A 60-year-old woman with a history of recurrent severe depression, unresponsive to multiple trials of antidepressants and psychotherapy, receives a series of electroconvulsive therapy (ECT) treatments. After completion of the treatment series, she reports difficulty remembering certain events that occurred before her ECT. Over the next few months, her memory for recent events slowly improves, but she still has gaps in her memory for the period just before and during the ECT treatments. What type of memory loss is this patient experiencing?
A 55-year-old man with a history of chronic alcohol abuse is brought to the psychiatric clinic by his daughter. She reports that over the past few months, he has been increasingly forgetful, frequently repeating the same stories and asking the same questions. He also appears to be creating new, often implausible, stories about events that did not happen. His physical examination reveals mild ataxia and nystagmus. Neurological examination, including a Mini-Mental State Examination (MMSE), reveals significant deficits in both anterograde and retrograde memory but relative preservation of other cognitive abilities. What is the most likely diagnosis?
A 53-year-old man with a history of chronic alcohol use is diagnosed with Korsakoff’s syndrome after presenting with severe memory impairment and confabulation. His family is concerned about his progressive cognitive decline. Physical examination reveals a broad-based gait, nystagmus, and impaired coordination. Laboratory tests show a low serum thiamine level. Which of the following is the most appropriate management plan for this patient?
A 46-year-old woman presents to the neurology clinic with a 6-month history of progressively worsening unsteady gait. She reports frequent falls and has developed a change in her speech, which her family describes as “broken” or “staccato-like”. On examination, she exhibits dysmetria on finger-to-nose testing, a broad-based gait, and her speech is noted to be irregular with varying emphasis on syllables. MRI of the brain reveals atrophy of the cerebellum. Based on her clinical features and imaging findings, what is the most likely diagnosis?
A 70-year-old man with no prior medical history is brought in by his son, who reports that over the last year, his father has had progressively worsening memory problems, having difficulties remembering recent events. A cognitive assessment is performed, which suggests a decline from the patient’s previous level of functioning. You are considering the diagnosis of a neurodegenerative disease. You would like to establish the patient’s premorbid level of intelligence. Which of the following tests would be most appropriate?
A 65-year-old man presents to the clinic with a six-month history of behavioral changes and difficulty remembering words. According to his wife, he has become increasingly apathetic and socially withdrawn. She also notes that he frequently struggles to find the right words during conversation and often forgets the names of common items. His physical examination is unremarkable, and his neurological examination reveals no motor or sensory deficits. A brain MRI shows frontal and anterior temporal lobe atrophy. What is the most likely diagnosis?
A 6-month-old boy presents to the pediatrician for his well-child visit. His parents have noticed that he has lighter skin and eyes than his siblings and frequently has a rash on his cheeks and arms. The rash is erythematous and pruritic with weepy crusting, consistent with eczema. They also mention that he does not seem to be reaching developmental milestones as quickly as his older siblings did. Initial laboratory testing reveals elevated phenylalanine levels in his blood. What is the most likely diagnosis for this child?
A 22-year-old man presents to the clinic with concerns about drug use. He has been experimenting with various recreational substances over the past year and is concerned about developing a dependency. He has been using marijuana, cocaine, LSD, and heroin but wants to minimize the risk of physical and psychological dependence. Which of the following substances is least likely to cause both physical and psychological dependence?
A 12-year-old boy presents to your clinic with his parents, who are concerned about their son’s erratic and intense mood swings. They describe periods when he is overly happy, talks fast, and is hyperactive, followed by periods when he is irritable, has low energy, and withdraws from social activities. On further questioning, it is revealed that the boy also has difficulty focusing on tasks, is easily distracted, and is impulsive in school. These symptoms are causing significant distress and impairment in his life. Based on this information, which of the following comorbidities is the most likely in this patient?
A 13-year-old girl presents to the school counselor with distressing symptoms of low mood, sleep problems, and poor concentration. She confides in the counselor that she has been the subject of repeated bullying at school. Her grades have been slipping, and she is increasingly reluctant to attend school. As a counselor, you decide to develop a comprehensive anti-bullying program for the school. According to current guidelines and research, which of the following strategies would be most effective in preventing bullying in schools?
The principal of a large university campus is increasingly concerned about the rising rates of student suicides. In collaboration with mental health professionals, they are considering implementing several strategies to address this serious issue. Which of the following strategies would be considered a universal intervention to prevent suicide?
A psychiatrist is working in a mental health clinic with a large population of patients on second-generation antipsychotics. Aware of the risk of antipsychotic-associated diabetes, the psychiatrist is considering several strategies to mitigate this risk. Which of the following strategies would be considered a selective intervention to prevent antipsychotic-associated diabetes?
Dr. Jane, a psychiatrist, is treating a 35-year-old patient with major depressive disorder. The patient has a history of non-adherence to medication due to concerns about side effects and discontinuation symptoms. Dr. Jane considers prescribing a selective serotonin reuptake inhibitor (SSRI) and is looking for one that would cause the least discontinuation symptoms if the patient were to stop taking it abruptly. Which SSRI would be the most appropriate choice in this scenario?
Dr. Henry, a psychiatrist, is managing a 60-year-old patient with a depressive disorder. The patient also has a chronic issue with hyponatremia and is currently stable on an appropriate treatment regime for the same. However, the patient’s depression remains uncontrolled. Dr. Henry is considering the introduction of an antidepressant with minimal risk of exacerbating the patient’s hyponatremia. Which of the following would be the most appropriate choice in this scenario?
A psychiatrist is managing a 28-year-old pregnant woman in her second trimester who is presenting with symptoms of a mixed affective episode. This patient has a history of bipolar disorder and requires treatment to manage her current episode. The psychiatrist needs to consider a drug that is relatively safe in pregnancy. Which of the following medications would be the most appropriate choice in this scenario?
Dr. Alex, a psychologist, is conducting therapy with a 45-year-old client who recently experienced a traumatic event. In discussing this event, the client tends to analyze every detail of the trauma objectively and rationally, with a clear focus on the facts and an absence of emotional response. Dr. Alex recognizes this as a specific neurotic defense mechanism. Which of the following is the client demonstrating?
In a seminar, Dr. Andrew presents a study comparing the efficacy of two different antipsychotic drugs. He uses a particular type of plot to visually present the heterogeneity of treatment effects across the different study sites involved in the trial. This type of plot allows for the visualization of confidence intervals, standard errors, and effect sizes from different sites. Which of the following types of plots is Dr. Andrew likely using?
Dr. Thompson, a psychiatric researcher, is analyzing the data from multiple studies comparing the effectiveness of two different types of psychotherapy for major depressive disorder. To help assess the heterogeneity between the studies, Dr. Thompson utilizes a specific statistical tool. Which of the following tools is Dr. Thompson likely using?
Dr. Robertson, a psychiatrist, is screening a 50-year-old male patient for alcohol misuse using the CAGE questionnaire. The questionnaire consists of four questions. Based on previous research, if the cutoff for a positive screen is at answering ‘yes’ to 3 questions, the sensitivity is 0.36. What does this imply about the CAGE questionnaire in this context?
Dr. Evans, a psychiatrist in the UK, is conducting a population health study on alcohol use. She decides to use the CAGE questionnaire as a screening tool in her study. If she wants her study to reflect the point prevalence of alcohol misuse in the UK population, what should she take into consideration while interpreting the results of the CAGE questionnaire?
Dr. Johnson is conducting a research study to investigate the long-term effects of a specific medication on cardiovascular health. She recruits a group of 500 participants who have been taking the medication for at least five years and a comparison group of 500 individuals who have never taken the medication. Dr. Johnson plans to follow both groups over the next ten years to assess the incidence of cardiovascular events. What type of study design is Dr. Johnson utilizing in this research?
Dr. Parker is conducting a meta-analysis to pool data from several studies examining the effectiveness of a specific intervention for post-traumatic stress disorder (PTSD). To analyze the data, Dr. Parker decides to use a statistical model that assumes uncertainty is present and varies across studies. Which of the following models is Dr. Parker most likely employing?
Dr. Adams is analyzing a dataset of pain scores from a clinical trial investigating the effectiveness of two different treatments for chronic pain. He wants to describe the central tendency of the pain scores to provide a representative measure. Which of the following statistical measures is Dr. Adams most likely to use?
Dr. Anderson is examining a dataset of sleep duration in a sample of patients with insomnia. After analyzing the data, she observes that the distribution of sleep durations is negatively skewed. In this context, which of the following relationships is likely to be true?
Dr. Roberts, a primary care physician, is considering leaving his current clinic to join another healthcare facility. As he weighs his options, he contemplates the potential implications of this decision. One concept that Dr. Roberts considers is the opportunity cost associated with the move. What does the term “opportunity cost” refer to in this context?
Dr. Johnson is conducting a cost-effectiveness analysis of two different treatment options for a specific medical condition. In his analysis, he considers not only the direct monetary costs but also the broader impact of the treatments on patients’ well-being and quality of life. One aspect that Dr. Johnson evaluates is the intangible cost associated with each treatment. What does the term “intangible cost” refer to in this context?
Dr. Rodriguez is developing a new questionnaire to assess symptoms of anxiety in children and adolescents. To determine the validity of the questionnaire, she decides to compare the scores obtained from her questionnaire with those obtained from a well-established and widely used anxiety assessment tool. Which type of validity is Dr. Rodriguez primarily evaluating in this scenario?
A 48-year-old woman with a past medical history of hypertension and hyperlipidemia is part of a clinical study where a new diagnostic tool is being tested for predicting the development of Type 2 diabetes. This tool assesses several variables such as BMI, diet, physical activity, family history of diabetes, and several novel genetic markers. The objective of the study is to determine if this tool can predict the onset of Type 2 diabetes in the next 5 years with significant accuracy. Which of the following best describes the type of validity the investigators are assessing in this scenario?
A team of clinical researchers is developing a new psychometric questionnaire aimed at assessing stress levels among medical students. The questionnaire incorporates items regarding academic performance, interpersonal relationships, health behaviors, and financial concerns. The team is keen to ensure that the questionnaire effectively encompasses the breadth of factors that contribute to stress in this population. Which type of validity is primarily being evaluated in this scenario?
A randomized controlled trial (RCT) is underway to study the effects of a new medication for the treatment of moderate-to-severe asthma. The researchers recruited 500 participants initially, and 250 participants were assigned randomly to each arm of the study: the experimental group and the placebo group. At the end of the trial, 210 participants completed the study in the experimental group and 225 participants in the placebo group. The researchers are asked to present their results using a Consort diagram. Which of the following best describes the attrition rate in the experimental group?
A new randomized controlled trial is being conducted to assess the effectiveness of a new intervention for chronic kidney disease. At the end of the study, the lead investigator is asked to create a CONSORT diagram. Which of the following best represents the primary purpose of this diagram?
A research group is investigating the effect of diet type on body mass index (BMI) among adults in a particular region. They categorize the participants into three groups based on their self-reported primary diet: vegetarian, pescatarian, and omnivore. The sample consists of 100 vegetarians, 80 pescatarians, and 120 omnivores. The BMI data is non-normally distributed. To compare the BMI across the three diet types, which statistical test would be the most appropriate?
A team of researchers is conducting a study to compare the effects of two different physical therapy interventions on functional mobility in patients with chronic stroke. They randomly assign 100 patients to two treatment groups (50 per group). At baseline, they note a significant difference in the Berg Balance Scale (BBS) scores between the two groups. At the end of the study, they wish to compare the final BBS scores between the two groups, while controlling for the baseline scores. Which statistical test would be the most appropriate to use in this scenario?
A research team is studying the effects of a new drug on blood pressure reduction. They conduct a study involving 200 participants, with 100 participants assigned to the experimental group (new drug) and 100 participants to the control group (placebo). The participants in each group have no significant difference in their baseline characteristics. After six weeks, the research team measures the participants’ systolic blood pressure. Which statistical test should the researchers use to compare the mean systolic blood pressure between the two groups at the end of the study?
A group of oncologists is investigating the potential association between exposure to a specific environmental toxin and the development of a rare type of cancer. They collect data on 20 individuals: 8 with exposure to the toxin who developed the cancer, 2 with exposure to the toxin who did not develop the cancer, 4 without exposure who developed the cancer, and 6 without exposure who did not develop the cancer. Which statistical test would be most appropriate for the researchers to use in determining if there is a significant association between exposure to the toxin and the development of this rare cancer?
A 32-year-old man presents to the emergency department with severe agitation, anxiety, and sweating. He admits to using heroin for the last 7 years but states he has been trying to stop. His last dose was three days ago. His physical examination reveals an increased heart rate, dilated pupils, and diffuse muscle aches. Which of the following is the most likely explanation for the patient’s symptoms?
A 27-year-old woman with a history of heroin use disorder presents to your clinic requesting help to manage her withdrawal symptoms and maintain long-term abstinence. She is motivated and ready to change her behavior. She has tried to quit several times in the past but suffered relapses due to severe withdrawal symptoms. Her physical examination and lab results are within normal limits. Which of the following treatment options would be most appropriate for the long-term management of this patient’s heroin withdrawal?
A 50-year-old man presents to your office with a history of major depressive disorder which has been managed with various selective serotonin reuptake inhibitors (SSRIs) over the past five years. However, he continues to experience symptoms. The patient is considering switching to a different class of antidepressants and has found a recent study comparing SSRIs and SNRIs. In the study’s results, both adjusted and unadjusted hazard ratios are presented. In the adjusted analysis, Venlafaxine (an SNRI) is used as a comparator. The patient asks why the adjusted hazard ratio for Venlafaxine is 1. What is the most likely explanation for this?
A 70-year-old man is brought to your clinic by his daughter, who is concerned about his increasing difficulty with walking and balance over the last year. He has a history of falls, difficulty with eye movements, especially in the downward gaze, and recently, changes in personality and cognitive function. Physical examination reveals stiffness in the neck and axial body regions with reduced facial expression. Neurologic examination also reveals slow, dysmetric saccades and almost complete loss of voluntary vertical gaze. Which of the following conditions is most likely responsible for this patient’s symptoms?
You are a psychiatrist reviewing a recently published clinical trial that compared the effectiveness of two different therapies in preventing relapse in patients with bipolar disorder. Therapy A consisted of pharmacological treatment only, while Therapy B combined pharmacological treatment with cognitive-behavioral therapy (CBT). The study used a Cox proportional hazards model to compare the two therapies and reported a hazard ratio (HR) of 0.60 for Therapy B relative to Therapy A. How should you interpret this hazard ratio in the context of this study?
A 30-year-old woman, G2P1, with a history of bipolar disorder has been stable on lithium treatment throughout her pregnancy. She has just delivered a healthy baby and you are discussing her postpartum medication management. The patient expresses a desire to breastfeed. Considering the physiological changes that occur postpartum and the pharmacokinetics of lithium, how should her lithium dose be adjusted after delivery?
A 32-year-old woman, G1P1, with bipolar disorder has been stable on lithium treatment (900 mg/day) throughout her pregnancy. She has just delivered a healthy baby girl and is considering breastfeeding. Given her history and the physiological changes that occur postpartum, you decide to adjust her lithium dose. One week after delivery, you reduce her lithium dose to 400 mg/day and plan to recheck her serum lithium levels. What is the most appropriate reason for this adjustment?
A 45-year-old woman with a history of major depressive disorder and generalized anxiety disorder presents to your office. Recently, she has been experiencing increased pain due to rheumatoid arthritis. She describes her pain as unbearable and states that “it’s ruining my life. I can’t do anything anymore. I’m sure it’s only going to get worse.” The patient’s rheumatologist reports that her arthritis is relatively well-controlled with her current medication. The patient’s presentation is suggestive of which cognitive distortion?
You are a psychiatrist providing systemic family therapy to a family of four: a 16-year-old daughter, her divorced parents, and her maternal grandmother. The daughter was referred to you after an episode of self-harm and her parents are worried about her increasingly withdrawn behavior and poor school performance. The parents often argue in the sessions, blaming each other for their daughter’s issues, while the grandmother remains quiet. You decide to use hypothesizing to encourage the family to consider different perspectives. Which of the following interventions most accurately reflects the use of hypothesizing in systemic family therapy?
A 64-year-old woman, with a history of heavy alcohol use, is brought to the clinic by her daughter. The daughter states that her mother has been increasingly forgetful, repeats the same stories, and often appears confused. The patient does not remember conversations held just a few hours ago and forgets about appointments and activities she used to enjoy. Her past medical history includes an episode of Wernicke’s encephalopathy, which was treated. On examination, the patient denies having any problems with memory and appears comfortable. On cognitive testing, she is able to perform serial sevens and spell “world” backward without difficulty. Which of the following neuropsychological tests is most likely to be within the normal range for this patient?
A 22-year-old woman presents to the clinic with complaints of recurrent episodes of binge eating followed by self-induced vomiting over the past six months. She expresses a feeling of loss of control during the binge-eating episodes and extreme concern about her body weight and shape. Her BMI is 22. You decide to follow the NICE guidelines for treating this patient. Which of the following is the most appropriate first-line treatment?
A 17-year-old girl is brought to the clinic by her parents due to a significant weight loss over the past 10 months. They report that she has become increasingly preoccupied with her weight and has been eating minimal amounts. On examination, her BMI is 15.5 kg/m^2, and she has dry skin, hair loss, and cold intolerance. She expresses a fear of gaining weight and distorted body image. Lab results show a low serum potassium level. Which of the following is the most dangerous and immediate complication this patient is at risk of developing?
A 30-year-old man presents to the emergency department appearing anxious and restless. He confesses to having been using cocaine heavily for the past few years but stopped abruptly two days ago. He reports fatigue, unpleasant dreams, and intense cravings for the drug. He is agitated and has difficulty concentrating. His vital signs are within normal limits and physical examination is unremarkable. Which of the following is a typical feature of cocaine withdrawal that the patient is most likely to develop over the next week?
A pharmaceutical company has recently introduced two new generic antidepressants, Drug A and Drug B, which have shown equivalent efficacy and safety profiles to the well-established brand-name drug, Drug C. As a psychiatrist, you are trying to determine which medication would be the most finanially affordable and clinically effective for your patients. What kind of study design would be most appropriate to assess this?
A 45-year-old hospital technician has been under your psychiatric care for the past year for major depressive disorder. Despite ongoing treatment, she has been experiencing significant chronic pain related to her condition, which has led to frequent absences from work. Her reduced productivity and absences are causing significant financial losses for the hospital. In the context of health economics, what type of cost does her absence from work represent?
A team of healthcare economists is evaluating a new cognitive-behavioral group therapy program for individuals with Generalized Anxiety Disorder (GAD) in a community mental health clinic. The program cost £250,000 to implement and run over a year. An analysis of the program’s effects estimates that the program led to 500 fewer hospital admissions, with an average cost of £700 per admission. In addition, participants collectively took 100 fewer sick leave days from work, with an estimated productivity loss of £200 per day. When calculating the cost-benefit ratio for this program, for every pound that is spent on the program what is the return?
A 26-year-old man is brought to the emergency department by his friends who report that he suddenly stopped talking while they were in conversation, stared blankly ahead, and started fumbling with his hands in an aimless, repetitive manner. He did not respond to their questions during this episode. After a few minutes, he gradually returned to his normal self but appeared confused and could not recall the event. He has a history of similar episodes since childhood. His medical records indicate a diagnosis of epilepsy. Which of the following best describes the duration of the type of seizure this patient likely experienced?
A 15-year-old girl is brought to the clinic by her parents who are concerned about her rapid weight loss and avoidance of food. She appears cachectic and states that she sees herself as overweight even though she is noticeably underweight. She reports frequent dizziness and feeling cold all the time. On examination, her BMI is calculated to be 14 kg/m^2. Which of the following statements best describes the appropriateness of hospitalisation in this case?
A 10-year-old boy is brought to the clinic by his parents who are concerned about changes in his behavior. They report that six months ago he was involved in a bicycle accident, resulting in a moderate traumatic brain injury (TBI). Since then, he has been increasingly defiant, displaying aggressive behaviors, and having frequent temper tantrums. His school performance has significantly dropped and his teacher reported several incidents of him bullying his classmates. His past medical history is unremarkable and he was previously described as a quiet and diligent student. Based on the information provided, which of the following is the most likely diagnosis for the child’s recent behavioral changes?
A 17-year-old individual, assigned female at birth, comes to the clinic accompanied by their parents. They express a persistent discomfort with their assigned gender and express a strong identification as a male. They have a desire to transition and live as their identified gender. The patient reports feeling depressed and anxious most of the time. They also reveal recurrent thoughts of self-harm and suicide over the past month. They have a history of self-imposed social isolation, bullying at school, and poor academic performance. Based on the given clinical scenario, which of the following comorbid conditions is most likely present?
A couple visits your clinic expressing their concern about potential genetic factors that might increase the risk of autism in their future children. They have no family history of autism, but the mother has a history of Fragile X syndrome and the father has a history of tuberous sclerosis. Among the following genetic conditions, which is LEAST likely to be associated with an increased risk of autism?
A 12-year-old boy is brought to your clinic by his mother who is concerned about his behavioral problems at school. He has a history of ADHD, and recently has developed multiple motor and vocal tics. His academic performance has been suffering, and he has been experiencing difficulties in his social interactions due to these new symptoms. The patient’s mother is worried about the potential side effects of stimulant medications, especially exacerbation of tics. Which of the following medication options would be most appropriate for this patient’s management?
A 27-year-old woman comes to the clinic with a lifelong history of feeling inadequate and being overly sensitive to what others think of her. She states that she avoids social situations because she is terrified of criticism or disapproval. She has had few friends in her life because she fears that people will find her dull and uninteresting. She tends to misinterpret neutral or constructive comments as negative ones. While she desires affection and acceptance, she tends to avoid close relationships due to her fear of rejection. Given this information, which diagnosis is most likely?
A 32-year-old male is admitted to the hospital with a three-week history of mutism, immobility, refusal to eat, and stupor. His condition has deteriorated over the past week, with the development of high fever, tachycardia, elevated blood pressure, and excessive sweating. His past medical history is notable for schizophrenia. Despite initial treatment with benzodiazepines, his condition does not improve significantly. What should be the next step in the management of this patient’s condition?
A 28-year-old woman is brought to your clinic by her parents. They report that over the past month she has stopped talking, eating and responds minimally or not at all to her surroundings. They also note that she has been sad and tearful for several months prior to this and has expressed feelings of worthlessness and hopelessness. She has a past medical history of recurrent depressive disorder. What is the first line treatment for this patient’s current condition, as per Maudsley guidelines?
A 6-year-old boy is brought to your clinic by his mother. She reports that he was diagnosed with Fragile X syndrome as an infant. She also mentions that he has trouble interacting with other children, tends to avoid eye contact, and has repetitive behaviors. He also gets easily agitated and has demonstrated developmental delays, particularly with language and learning skills. Which of the following symptoms is most commonly seen in children with Fragile X syndrome?
A 55-year-old man with a history of bipolar disorder has been experiencing a severe depressive episode. He has not responded to medication changes and his psychiatrist is considering electroconvulsive therapy (ECT). The patient also has a history of epilepsy, which is currently well-controlled with antiepileptic medication. Which of the following medications, if the patient is taking, could potentially reduce the seizure threshold and complicate the ECT procedure?
A 40-year-old woman with a history of bipolar disorder is under your care. She has experienced recurrent episodes of mania and depression and you are considering lithium as a possible treatment option. However, you are aware of certain conditions that can contraindicate its use. Which of the following conditions is a contraindication to lithium treatment?
A 60-year-old man with a history of hypertension presents to your clinic three months following an intracerebral bleed. He has been struggling with feelings of sadness, loss of interest in previously enjoyed activities, and has difficulty sleeping. After a thorough assessment, you diagnose him with major depressive disorder. Taking his recent intracerebral bleed into consideration, which of the following antidepressants would be the preferred choice for this patient?
A 25-year-old man diagnosed with schizophrenia is being seen in your clinic. His father is a university professor, and the family has a comfortable socioeconomic status. You are aware of various epidemiological factors related to schizophrenia. Which of the following statements is TRUE regarding schizophrenia?
A 52-year-old man with a long history of alcohol abuse is brought to your clinic by his daughter, who reports that he has been increasingly forgetful and confused. A MRI scan is performed to assess possible brain damage related to his alcohol use. Which of the following findings is most likely to be observed in this patient?
A 27-year-old woman with Emotionally Unstable Personality Disorder (EUPD) presents to your clinic expressing frequent suicidal ideation. She has a history of multiple suicide attempts but has never completed suicide. Based on her diagnosis, what is the approximate lifetime risk of completed suicide for individuals with EUPD?
A 32-year-old man is brought to your clinic by his brother, who found him trying to start a fire in their backyard. He has a previous history of starting fires without clear motives. He also has a prolonged history of excessive alcohol consumption and related problems. Considering the psychopathological underpinnings of such behaviors, which of the following disorders is MOST likely associated with his arson behaviors?
A 70-year-old man presents to your clinic with complaints of bradykinesia, tremors, and rigidity that have developed over the past month. His family has noticed that his gait has become slow and shuffling. He has been on haloperidol for chronic schizophrenia for many years. Considering his symptoms and medication history, which of the following treatments would be the most appropriate for his current movement issues?
A 45-year-old woman with a history of tobacco use disorder has been seeing you in the clinic for smoking cessation. She successfully quit smoking a year ago and has managed to abstain since then. She uses a combination of nicotine replacement therapy, cognitive-behavioral therapy, and ongoing counseling to help her maintain her abstinence. According to Prochaska and DiClemente’s Stages of Change model, which stage best describes her current status?
A 40-year-old man presents to your clinic expressing a desire to quit smoking. He acknowledges that his smoking habit is harmful to his health, and he has started reducing the number of cigarettes he smokes each day. He also began reading self-help books about smoking cessation and is planning to attend a local smoking cessation support group next week. According to Prochaska and DiClemente’s Stages of Change model, which stage best describes his current status?
A 50-year-old woman presents to your clinic for her annual physical examination. During the exam, she discloses that she smokes a pack of cigarettes a day and has done so for the past 20 years. When you discuss the risks of smoking and suggest quitting, she dismisses your concerns and states that she enjoys smoking and has no plans to quit. According to Prochaska and DiClemente’s Stages of Change model, which stage best describes her current status?
Dr. Smith is conducting a study to assess the cost-effectiveness of two different treatment options for major depressive disorder: psychotherapy and antidepressant medication. He wants to ensure that his study’s findings are robust and not due to the specific assumptions he has made about the costs and effectiveness of the treatments. Which type of analysis should Dr. Smith perform to assess how changes in the assumptions he made about costs and outcomes would affect the results of his study?
Dr. Jones is a researcher examining the effectiveness of various antidepressant medications in the treatment of major depressive disorder. She has collected data from multiple randomized controlled trials, each comparing different pairs of medications. To incorporate all available comparisons into a single analysis and estimate the comparative effectiveness of each medication relative to the others, which type of analysis should Dr. Jones employ?
A 35-year-old woman presents to your clinic for grief counseling after the tragic loss of her 7-year-old child in a car accident. In the months following her child’s death, she has dedicated herself to promoting car safety for children. She established a local nonprofit organization to provide car seats to families who can’t afford them and started a public awareness campaign on the importance of seatbelt use. According to psychoanalytic theory, which defense mechanism is she primarily using to cope with her grief?
A 28-year-old man presents to the clinic with a history of impulsive behavior and violent outbursts. He reports that he has always had a short temper but recently decided that he needed to find a healthier way to manage his anger. He has started taking a kickboxing class, which he reports has significantly helped him control his aggressive impulses. He expresses a sense of accomplishment from this newfound discipline. According to psychoanalytic theory, which defense mechanism is this patient primarily using to manage his anger?
A 52-year-old man with schizophrenia is seen in your clinic for a medication review. The patient has a history of orthostatic hypotension and has reported episodes of dizziness and light-headedness in the past when standing up. Given this patient’s history, which of the following antipsychotic medications is preferred due to its relatively lower risk of causing orthostatic hypotension?
A 78-year-old man presents to your clinic accompanied by his daughter. She reports that over the past year, her father has shown increasing forgetfulness and has trouble remembering recent events. She is worried that he might be developing dementia. However, she also notes that he has been able to perform his daily activities, such as cooking, cleaning, and managing his finances, without any difficulty. Based on this information, which of the following is the most likely diagnosis?
Dr. Smith is a new psychiatrist appointed as the clinical lead at a community mental health hospital. One of his first responsibilities is to conduct a quality improvement project in the hospital. He decides to carry out an audit to ensure that clinical practice in the management of bipolar disorder aligns with the latest NICE guidelines. Which of the following steps is not a part of the clinical audit process?
Dr. Evans, a consultant psychiatrist at a NHS hospital, has noticed an increase in the readmission rates of patients with schizophrenia. He proposes a Quality Improvement (QI) project to address this issue, aiming to reduce readmission rates by enhancing the discharge planning process. Which of the following steps would NOT typically be involved in conducting a QI project in this context?
Dr. Thompson, a forensic psychiatrist, is evaluating a 35-year-old man who has a history of violent behavior and has been charged with assault. He is asked to provide an opinion on the risk of future violent behavior by the individual. Which of the following factors is most strongly associated with an increased risk of future violent behavior in this individual?
Dr. Patel, a forensic psychiatrist, is assessing a 40-year-old man with a history of violent offenses for risk of future violent behavior. She decides to use the Violence Risk Appraisal Guide (VRAG) to aid in her assessment. Which of the following statements about the VRAG is NOT correct?
Dr. Smith is a psychiatrist who is treating a 50-year-old patient with schizophrenia. Recently, the patient has developed tardive dyskinesia (TD), characterized by involuntary movements of the tongue and lower face. The patient’s TD symptoms are significantly affecting his quality of life, and Dr. Smith is considering the next step in management. Which of the following is true about the treatment of tardive dyskinesia?
Dr. Walker, a forensic psychiatrist, is conducting a risk assessment on a 30-year-old male who has been convicted of a violent offence. She’s utilizing various risk assessment tools to determine the likelihood of the individual reoffending. In the context of risk assessment, which of the following is a true statement about dynamic risk factors?
Dr. Johnson, a child psychiatrist, is working with a local school district that has a high proportion of low-income families. The school district is implementing various supports including subsidized meal programs, after-school tutoring, and linking families with social services. In the context of public health approaches to prevention, these actions can be best described as which type of prevention?
Dr. Marshall, a psychiatric researcher, has conducted a study on the average age of onset for major depressive disorder (MDD) in a sample of 500 patients from a population of 10,000. He calculated a mean onset age of 35 in his sample. He is now interested in inferring the mean onset age in the population from his sample data. Which of the following statistical terms best describes the variability of the sample mean around the population mean?
Dr. Greene is conducting a study on anxiety levels in her patients. She uses a standardized anxiety assessment scale that ranges from 0 (no anxiety) to 100 (extreme anxiety). In her sample of 200 patients, the mean score was 50. She is also interested in understanding the dispersion or variability in scores. Which of the following statistical measures would best allow Dr. Greene to understand the average amount by which individual scores deviate from the mean?
Dr. Davis is conducting an epidemiological study examining the association between smoking and lung cancer. He finds that smokers in his study have a 15% incidence rate of developing lung cancer, while non-smokers have a 3% incidence rate. Which of the following statistical measures best represents the ratio of the probability of the event occurring in the exposed group versus the non-exposed group?
Dr. Lopez is conducting a clinical study on the survival time of patients following a specific surgical procedure for a particular cancer. She needs a statistical method to estimate the survival function and visualize the data to consider censoring. Which of the following is the most appropriate tool for this purpose?
Which of the following statistical measures is NOT represented in a Box-and-Whisker plot?
A post-graduate student is analyzing a large dataset and wants to graphically represent the frequency distribution of a variable that is both continuous and normally distributed. They also want to visually assess the symmetry and skewness of the data. Which of the following graphical representations should be used for this purpose?
A postgraduate student is examining a dataset and is trying to understand the strength and direction of the linear relationship between two variables. They calculate a correlation coefficient and find it to be -0.8. Which of the following best describes this finding?
A recent double-blind, randomized control trial was conducted to compare the efficacy of Venlafaxine, Aripiprazole, and a placebo in the treatment of Major Depressive Disorder. The primary outcome was a reduction in the Hamilton Depression Rating Scale (HDRS) after 12 weeks of treatment. As a postgraduate student conducting a secondary analysis of this data, which of the following statistical approaches would be most suitable to compare the efficacy of these three groups?
A clinical trial is being designed to compare the efficacy of three different antipsychotics on the reduction of PANSS (Positive and Negative Syndrome Scale) scores in patients with Schizophrenia over a six-month period. The primary outcome will be the change in PANSS score from baseline to 6 months. What would be an appropriate statistical test for the primary outcome analysis?
A researcher conducted a study to determine the association between smoking status (categorized as ‘current smoker’, ‘former smoker’ and ‘never smoker’) and the development of chronic obstructive pulmonary disease (COPD). The researcher collected data from 500 participants and categorized them into the aforementioned groups. What would be the most appropriate statistical test to determine the association between these variables?
Dr. Patel is a psychiatrist conducting research on the association between long-term antidepressant use and the development of type 2 diabetes. She is using a large cohort of 50,000 patients who have been followed for 10 years. However, due to financial and time constraints, she decides to select only a subset of 500 individuals who developed diabetes (cases) and matches them with 1,500 patients who did not develop diabetes (controls) from the same cohort. What type of study design is Dr. Patel utilizing for her research?
Dr. Andrews is a psychiatrist studying the association between excessive Internet use and the rare condition of Internet Gaming Disorder (IGD) in adolescents. Given the infrequent occurrence of IGD, he decides to identify a group of adolescents diagnosed with IGD (cases) and matches them with a group of adolescents without IGD (controls). He then collects data on their Internet use habits. What is the primary strength of Dr. Andrews’ chosen study design?
Dr. Sullivan is a psychiatrist conducting a study on the long-term impact of child maltreatment on the development of depression in adulthood. She identifies a group of children who have experienced maltreatment and a matched group who have not, and plans to follow both groups into adulthood to observe the incidence of depression. However, she is aware that there are certain limitations to her chosen study design. Which of the following is a potential weakness of Dr. Sullivan’s cohort study?
Dr. Vargas is a psychiatrist researching the effectiveness of a new antipsychotic drug (Drug X) in preventing relapse in patients with schizophrenia. In her study, the control group receives the standard treatment, while the experimental group receives Drug X. After one year, she finds that 20% of patients in the control group and 10% of patients in the experimental group have experienced a relapse. What is the Absolute Risk Reduction (ARR) in her study?
Dr. Johansson has been investigating a new antidepressant, Drug Y, in a randomized clinical trial. After 3 months of treatment, it is observed that 40% of patients in the placebo group still have a depressive episode compared to 20% in the Drug Y group. What is the Number Needed to Treat (NNT) in this trial?
A 50-year-old man, known to be a notorious drug trafficker in his community, has recently started donating large sums of money to various local charities. In understanding his behavior from a psychological perspective, which defense mechanism is this individual most likely exhibiting?
You are a child psychiatrist evaluating a 1-year-old child with a cleft palate and delayed developmental milestones. The features presented are most consistent with which of the following syndromes?
A new antipsychotic medication has been introduced into the market. You have been appointed to evaluate initial reports of side effects associated with this drug. Which of the following study designs would be most appropriate to use initially in this situation?
Dr. White is interested in researching the association between depression severity and blood lithium levels among patients with bipolar disorder. Which of the following study designs would be most appropriate to use in this situation?
Dr. Johnson is conducting a study to assess the effectiveness of trainee general practitioners in managing medical issues in patients with schizophrenia. Which of the following study designs would be most suitable to use in this situation?
A 28-year-old woman comes to your clinic, concerned about the possibility of her child inheriting Down syndrome. She mentions that her older brother has Down syndrome. Both her parents are phenotypically normal. Which type of Down syndrome, if present in her brother, could have been transmitted equally by either of her parents?
A large psychiatric hospital has recently implemented a new MRI-based diagnostic test for Alzheimer’s disease, and has hired two radiologists, Dr. Smith and Dr. Brown, to interpret the scans. A sample of 100 scans was selected and each radiologist independently reviewed the scans and made a diagnosis. The hospital wants to determine the level of agreement between Dr. Smith and Dr. Brown’s diagnostic interpretations. Which statistical measure should be used to evaluate this?
Dr. Kumar, a psychiatrist at a large hospital, has developed a new self-report measure to assess depressive symptoms. She decides to validate her new measure by comparing patients’ scores on the new measure with their scores on the widely-used and well-validated Beck Depression Inventory (BDI). What type of validity is Dr. Kumar specifically trying to establish for her new measure?
Dr. Thompson has developed a new self-report test to assess the risk of suicide among psychiatric patients. In a study, she administered the test to a group of patients and followed them up over several years to determine if their test scores were associated with subsequent suicide attempts. Which type of validity is Dr. Thompson specifically examining in this study?
In a meta-analysis examining the efficacy of different antidepressant medications, researchers noticed significant variability in the effect sizes across the included studies. They decided to use a statistical tool to visually assess the presence of outliers and the influence of individual studies on the overall results. Which plot would be most appropriate for this purpose?
A group of researchers conducted a meta-analysis investigating the efficacy of different psychotherapeutic interventions for post-traumatic stress disorder (PTSD). They wanted to assess the level of heterogeneity among the included studies. Which of the following statements is true regarding the use of Galbraith plot and forest plot in checking heterogeneity?
In psychiatric practice, there are legal and ethical considerations regarding the provision of care and the rights of patients. Which legal case is associated with this concept of and highlights the issue of involuntary psychiatric detention without legal safeguards?
A 45-year-old woman with a history of breast cancer is currently taking Tamoxifen, a selective estrogen receptor modulator, as part of her adjuvant therapy. She presents to her psychiatrist with symptoms of depression and asks for a medication to help alleviate her symptoms. Which of the following medications should be avoided due to potential drug interactions with Tamoxifen?
In a clinical trial comparing the efficacy of two different psychotherapy interventions for patients with social anxiety disorder, researchers aim to allocate participants to the treatment groups in a manner that ensures equal distribution of important baseline characteristics. Which of the following methods would be most appropriate to achieve this goal?
A 40-year-old woman, who recently completed detoxification for alcohol use disorder, is seeking a medication to help maintain her abstinence. She is currently taking Tramadol for chronic back pain and has a history of ischemic heart disease. Which medication would be most suitable for her?
A 33-year-old man presents to your clinic complaining of severe, treatment-resistant depression. He has tried multiple SSRI and SNRI antidepressants with little success. You consider recommending a medication with effects on GABA and NMDA receptors. Which drug from the following list is known to antagonize NMDA receptors and has demonstrated effectiveness in treating treatment-resistant depression?
A 52-year-old homeless man with a history of chronic alcohol use is found by emergency services showing signs of confusion, unstable gait, and double vision, suggesting Wernicke’s encephalopathy. In the process of managing his condition, you decide to administer both thiamine and glucose. In which order should these be administered?
A 45-year-old woman presents to your clinic stating that her partner has recently left her. She has a history of chronic back pain, which has significantly worsened since her partner’s departure. She states she feels helpless in managing her pain. She has not experienced fatigue, hypersensitivity to touch, or diffuse pain in other regions. There are no significant findings on physical examination or imaging studies that explain her symptoms. Based on her presentation, which diagnosis seems most plausible?
A 45-year-old woman presents to your clinic with a 6-month history of widespread body pain, poor sleep, and fatigue. Physical examination reveals multiple tender points throughout her body. The pain interferes with her daily activities, and she describes it as a constant dull ache. Lab tests, including complete blood count, erythrocyte sedimentation rate, and thyroid function, are normal. Which of the following is the most likely diagnosis?
A 35-year-old man presents with a 6-month history of severe disabling fatigue that has not improved with rest and has significantly impacted his work and personal life. He also reports unrefreshing sleep, poor concentration, and frequent headaches. All possible medical and psychiatric causes for his symptoms have been excluded. According to the National Institute for Health and Care Excellence (NICE) criteria for Chronic Fatigue Syndrome (CFS) in the UK, which additional symptom should be present for a diagnosis of CFS?
A 24-year-old man presents to the emergency department. He reports feeling low lately and admits to experimenting with recreational drugs. In the past two hours, he has experienced two episodes of seizures, profuse sweating, muscular rigidity, and tachycardia. He also exhibits increased agitation and paranoia. Based on his symptoms, which substance did he most likely use?
A 3-day-old neonate is presented in the neonatal ward. The baby appears jittery, shows signs of shaking, excessive crying, and difficulty feeding. The mother has a history of substance misuse during pregnancy. Which of the following substances, when used by the mother during pregnancy, is most likely responsible for these symptoms?
A 35-year-old man with epilepsy is brought to the A&E due to symptomatic hyponatremia, which is believed to be induced by his carbamazepine therapy. His medical history also reveals a recent diagnosis of depression. Considering his current medical condition and medications, which antidepressant would be the best choice for his treatment?
A 75-year-old man presents with an 8-month history of memory issues. His general practitioner suspects Alzheimer’s disease. However, which of the following clinical features would make you consider an alternative diagnosis?
A 45-year-old woman is diagnosed with recurrent depressive disorder. In the context of this primary diagnosis, which of the following disorders cannot be diagnosed comorbidly according to the DSM-5 criteria?
A 20-year-old woman with a history of Bulimia Nervosa presents to the clinic for an initial appointment. Recent lab results show mild hypokalemia. Given this patient’s history and lab findings, which of the following ECG changes would you most likely expect to see?
A 20-year-old woman with a history of Bulimia Nervosa presents to the clinic for a follow-up appointment. Recent lab results show severe hypokalemia. Given this patient’s history and lab findings, which of the following ECG changes would you most likely expect to see?
A 35-year-old man with schizophrenia was recently started on clozapine. He presents to the clinic reporting chest pain, and his ECG reveals saddle-shaped ST segment elevations. Which of the following is the most likely diagnosis?
A 55-year-old woman with a history of major depressive disorder has been receiving treatment with citalopram. During her latest visit, an ECG is performed. Which of the following ECG changes is most likely associated with the use of citalopram?