Passmed Psychiatry – Practice Test 2

PBQ

A 32-year old gentleman with a diagnosis of schizophrenia is admitted to your care because of worsening auditory hallucinations and persecutory delusions.

He has been on oral haloperidol for the past two months with no significant improvement in symptoms. He has previously been on aripiprazole, quetiapine and olanzapine.

He has been unemployed for the past eight years and is dependent on his parents.

History from the parents reveals that while patient is able to perform basic self care, most of his needs are provided to him by his parents. His mother repeatedly states that she does not agree to have him work even after he has improved in the ward as ‘her baby is sick and she will provide for him’.

Q1. What is the main problem that you can identify in this patient? Give two (2) reasons for your answer.

Q2. List two (2) other problems that you can identify in this patient.

Q3. Give three (3) investigations that you would do to investigate for the possible cause of the problem in Q1, and give your reason for each.

Q4. How will you manage the problem in Q1?

Q5. How will you manage the problems in Q2?


OSCE 1

The parents of the patient in the PBQ above agree to the new medication that you have suggested. Psychoeducate the parents about the the new treatment.


OSCE 2

You receive a 23-year old medical student who recently went to Syria to provide relief work under an NGO. Since returning from the war-torn nation, she has been exhibiting symptoms suggestive of post-traumatic stress disorder (PTSD). Elicit the symptoms of PTSD in this patient.

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