Behavioral Sciences Question Set 1

A 24-year-old graduate student is brought to the physician by his mother. She says that ever since his son started graduate school he is not behaving as himself. He has been very anxious for the past six months and is always preoccupied with the thought that his professor, without a doubt, is out to get him. He also seems to behave very oddly at times, wearing his winter jacket in the midday sun, wanders aimlessly when out with the family to a nearby mall. What is the most likely diagnosis?

A 29-year-old male is brought to the emergency department by a concerned neighbor. The patient appears disheveled, has a flat affect and gives evidence of auditory hallucinations. He is alert and oriented to time, person and place and has an intact long term and short term memory. His neighbor says that he never really knew the patient that well and that he mostly kept everything to himself. They have been neighbors for the past 3 years at an apartment close to the hospital. What worried the neighbor was a sudden change in the patient's behavior since last week. He suddenly seemed interested in attending all the local council meetings and social gatherings. He is very talkative at these events and boasts highly of himself and starts suggesting changes that the committee could make with his help. He gets very agitated when they deny accepting his suggestions. Which of the following is a predictor of good prognosis for this patient's condition?

A 45-year-old male visits a psychiatrist with his wife asking for help with their ongoing family problem. The husband has been trying to convince his family that his wife is cheating on him. The couple have been married for 20 years and for the last 2 months the patient is fully convinced that his wife is cheating on him. He has hired numerous private investigators, who deny any such evidence for an extramarital affair. This persistent belief has begun to stress both sides of the family. The spouse has never in the past nor currently shown any evidence of infidelity. He is still able to hold a steady job and provide for his two children. Which of the following statements below is a diagnostic criterion for the above condition?

A 30-year-old male who is a patient at a local clinic comes in with a complaint of a "stiff neck." The patient is known to be sporadic with his follow-up but was last seen recently for his regular depot injection. He initially presented with complaints of paranoid delusions and auditory hallucinations that lasted for 7 months. It caused significant social and financial deterioration. He was brought into the clinic by his elder brother who later moved back to the states to be with his family. Because of the lack of social support and patient’s tendency to be noncompliant with his medications he was placed on a specific drug to mitigate this. Which of the following medications is responsible for the patient's movement disorder?

A 45-year-old obese male visits the clinic after minimal improvement in his symptoms. The patient was first brought into the clinic by his wife who complained of her husband becoming more and more stressed from suspected phishing attacks that he believed to be through emails he was receiving. Although he has the best commercially available comprehensive antivirus software installed in his computer and even had several people from technical support run diagnostics, he is convinced that these attacks are targeting him. He used to work as a janitor at a local high school and does not have much in the name of savings and has no one in particular that would wish his harm. Recently, he has become less interested in going out and having fun. He is withdrawn and less expressive of his feelings. He was started on a medication and then switched to a second drug when he did not respond to the first one. Which of the following in indicated in this patient?

A 60-year-old female on a conventional antipsychotic medication with good compliance and regular follow-up presents to the clinic with complaints of unwanted tongue movements. The changes were first noted by her daughter who is also her caregiver. It started a week ago and seems to be getting worse. On physical examination, the patient is found to have involuntary and non-rhythmic repetitive movements of the tongue. What is the next best step in her management?

A 40-year-old male known schizophrenic patient presents to the clinic with the complaint of seeing halos around bright lights for the past month. He did not initially have much response to atypical antipsychotic medications but responded well to low-potency typical antipsychotics. He has been compliant with his medication and has regular follow-up visits. He otherwise has no other complaints and his visual acuity is unchanged since his last visit. What is the best next step in the management of this patient?

A 40-year-old male accountant is brought to the physician by his wife. She complains of her husband talking strangely for the past 6 months. She has taken him to multiple physicians during this time, but her husband did not comply to their treatment. She says he keeps things to himself, stays alone and rarely spends time with her or the kids. When asked how he was doing, he responds in a clear manner with "I am fine, pine, dine doc." When further questioned about what brought him in today, he continues “nope, pope, dope doc.” Physical examination reveals no sensorimotor loss or visual field defects. Which of the following best describes the patient's condition?