Exam (elaborations)
PSYCH EOR - smarty pance (1)
PSYCH EOR - smarty pance (1)
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PSYCH EOR - smarty pancePatient will present as → a 27-year-old man accompanied by his girlfriend. In the
office, he seems to be running from topic to topic without a clear message. His
speech is pressured. The patient's girlfriend reports that he took steroids recently for
a bad sinus infection and since he started them, his behavior has been abnormal.
After discontinuing the medication, he has still been having symptoms. He has not
had a normal night of sleep for the past ten days, and he just bought a new sports
car though he has no need for one or the money to afford it. She also reports that
she has caught him with multiple other women in the past few days, though they
were in a committed relationship. The physical exam is benign and the patient's vital
signs are within normal limits - CORRECT ANSWER-bipolar I disorder
Patient will present as → a 19-year-old male who has had bouts of sadness for a
course of 1 year in which he says that often he cannot even get out of bed so he tells
his parents he is ill. Jim states that he recently felt so energized that he could not
keep his thoughts straight and jumped from one idea to another. During this
energized state, he did become irritable and others stated that he was louder than
usual and wondered if he took something that increased his energy. During the week
of high energy, he maxed out two of his credit cards and is not sure how he will pay
them off before he goes to school in the fall. It was only a week later that he became
so depressed that he did not find any pleasure in anything he did, was so tired he did
not want to get out of bed which has continued to be a struggle today - CORRECT
ANSWER-Bipolar II disorder
Patient will present as → a 24-year-old male with c/o episodes of depression
alternating with times of increased energy, restlessness, and decreased sleep for 2
years. - CORRECT ANSWER-cyclothymic disorder
Patient will present as →a 33-year-old woman complaining of fatigue and decreased
interest in "the things that used to make me happy." She is sleeping less and eating
less, and she says that she is forcing herself to eat "because I know I have to eat
something." She finds herself spending less time with her kids and husband as she
retreats to her room. She feels guilty that she lacks the energy and enthusiasm she
used to have - CORRECT ANSWER-major depressive disorder
Patient will present as → a 35-year-old female with a complaint of worry which she
cannot control for the last year. She tells you that her symptoms daily consisting of
sleep disturbances, difficulty concentrating, and irritability. She reports her symptoms
started around age 17 but have worsened. - CORRECT ANSWER-GAD
Patient will present as → a 26-year-old first-year PA student with a medical history
significant for GERD comes to your office because of frequent episodes of
palpitations. The palpitations are sudden in onset and are accompanied by sweating
, and a sense that she is going to "pass out." The episodes typically last no more than
10 minutes, and although the patient feels as if she may pass out, she never has.
The episodes first appeared when she started PA school and have increased in
frequency to the point where she is afraid to attend lectures out of fear of having an
"attack." - CORRECT ANSWER-panic disorder
Patient case presentation → a lab technician calls to tell you that a 22-year-old man
you have sent for a blood draw is very anxious. He says he is terrified of having his
blood drawn and almost faints at the sight of the needle. - CORRECT
ANSWER-specific phobia
Patient will present as → a 69-year-old female who presents to the emergency
department with sudden, severe onset epigastric pain that began while she was
watching television. On physical exam is an unkempt female with pain upon
palpation of the epigastric region. Labs are drawn and the patient has an elevated
amylase and lipase. The patient is made NPO, an NG tube is placed, and the patient
is given IV fluids. The patient is noted to be experiencing hallucinations. On her
second hospital day, the patient has a seizure - CORRECT ANSWER-alcohol related
disorders
Patient will present as → a 17-year-old male is brought to your office by his parents
due to his behavior - increased appetite, lack of motivation, and paranoia. When
interviewing the patient, the physician notes a slowed speech and conjunctival
injection!!!! - CORRECT ANSWER-cannabis related disorder
Patient will present as → a 24-year-old who was brought into the ED and has
attempted to assault a nurse several times. He is extremely aggressive and
becomes enraged when sudden movements or loud sounds are made. The patient is
escorted to a dimly lit, quiet exam room where he becomes much calmer. On
physical exam, the patient is agitated and has nystagmus. His blood pressure in the
ED is 180/100 mmHg. - CORRECT ANSWER-hallucinogen disorder
- PCP
Patient will present as → a 23-year-old male is brought into the ED by his friends at
1 a.m. They are afraid that he is going to hurt himself. They say that he has "been
freaking out" and seeing things that are not there. At one point, he tried to ride a bike
off the roof of a house. On exam, you see a young man who appears to be in a
panic. His gait is abnormal, he has diffuse tremors and his pupils are dilated -
CORRECT ANSWER-hallucinogen disorder
- LSD
A young child from low socioeconomic background arrives in the ED with a
headache, loss of appetite, rhinorrhea, injected sclera, dizziness, photophobia, or a
cough - CORRECT ANSWER-inhalant related disorder
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