Quiz 07/29/2022

A 37-year-old retired nurse is being evaluated in the emergency room for excessive diarrhea. She has been in the emergency department multiple times in the past for similar complaints and diagnostic testing has repeatedly been unremarkable. While casually talking to the nursing staff, the patient accidentally knocks over her purse and several bottles of laxatives fall out. Which of the following is the most likely diagnosis?

A 65-year-old man with a history of severe depression is bought to the clinic by his wife after losing 15 pounds in the last month. The patient states that he believes that his stomach and intestines have been removed and that he died several weeks ago. Which of the following is the most likely diagnosis?

Which of the following drug-mechanism pairs is incorrect?

Which of the following medications is the most effective in the management of PTSD-associated nightmares?

A 24-year-old man comes to the emergency room with severe left-hand pain after a fall at home. The patient refuses to allow the nurse or doctor to do a physical exam. A hand X-ray is unremarkable. She insists that all she needs is a note for two weeks of paid leave from her job. Which of the following is the most likely diagnosis?

A 31-year-old male comes to the clinic for evaluation of recurrent nightmares after returning from a tour of duty with the military two months ago. He is unable to concentrate on his new desk job and flinches every time he hears a door close. While once an avid bowler, he no longer goes to the bowling alley because the sounds of the pins falling remind him of bomb explosions. Which of the following is the most likely diagnosis?

Which of the following is the mechanism of action of prazosin?

A 28-year-old patient who you just diagnosed with non-epileptic spells admits to insomnia, low energy, increased appetite, loss of interest in activities he used to enjoy, and difficulty concentrating. Additionally, he endorses periods of pressured speech, racing thoughts, easy distractibility, and delusions of grandeur. Despite these symptoms, he continues to fulfill the duties of his high-paying job. In addition to non-epileptic spells, he also carries a diagnosis of which of the following?

Which of the following is not a risk factor for suicide?

A 33-year-old woman with a past medical history of depression is brought to the clinic by her husband because of atypical behavior. For the past three weeks, her thoughts have become progressively more disorganized. She is also having auditory hallucinations. Similar behavior has been seen intermittently over the past five years. Despite having a history of depression, her husband says the depression has been well controlled for the last three months. Which of the following is the most likely diagnosis?

A 68-year-old male presents with complaints of insomnia for 2 years. On further questioning, he also endorses a 2 years period of feelings of guilt about his sleeping, considerably low appetite (current BMI = 17), and low energy. He used to enjoy checkers but has lost interest in most activities these days. He denies suicidal ideation. He has previously declined medications to help with this, but he says he is ready to try something. Which of the following medications is most appropriate?

A 34-year-old male presents with personality changes that started after a motor vehicle accident-related traumatic brain injury. His family has noticed that since the accident, the patient no longer actively seeks out hobbies that he once enjoyed. He will often forget to eat meals unless prompted, even if the food is placed in front of him. Which of the following medications would most likely help with his behavior?

An 8-year-old male is seen in the clinic for difficulty paying attention at school and at home for the past 9 months. His mother reports that his elementary school teacher has called the home multiple times because the patient will often run around the classroom during assignments and frequently interrupts classmates. The mother states that at home, the patient has difficulty sitting still long enough to finish his dinner and homework. This patient’s condition is best treated with a medication that has what action?

An 80-year-old woman with a history of Parkinson’s disease that is well controlled with carbidopa-levodopa presents with her husband for evaluation of delusions. Her husband states that the patient believes that she is being consistently monitored by the FBI and will avoid eating certain foods for fear of being poisoned. She is also constantly worried that her husband will leave her for a younger woman. Which of the following medications would be the most appropriate FDA-approved treatment for these symptoms?

Which of the following medications used in the management of attention deficit hyperactivity disorder (ADHD) can worsen comorbid Tourette syndrome if present?

A 19-year-old female with a past medical history of anorexia and insomnia presents with major depressive disorder. Which of the following medications is the most appropriate at this time?

A 27-year-old woman comes into the clinic with the chief complaint of low energy and depressed mood. Ever since her mother died 3 years ago, she has felt fatigued and does not want to socialize with friends or family. She has had a poor appetite and has lost over 15 pounds in the past year. Additionally, she dropped out of college earlier this year due to difficulty concentrating on her studies. Which of the following is the most appropriate diagnosis?

An 83-year-old man with a history of Parkinson’s disease is brought to the office with worsening hallucinations. She says that she sees things around the house and is starting to get paranoid that their neighbors are spying on them. Which of the following medications would help this patient’s symptoms?

A 25-year-old woman with no significant medical history comes to the clinic for a routine physical exam. During the interview, she states that she is in a relationship with a famous singer for the last three months. She says his song lyrics are about her and his social media contains hidden messages that only she understands. The singer recently filed for a restraining order, but the patient says that’s “just for show.” She works at a local coffee shop and just recently got a promotion to manager. She denies any drug or alcohol use and takes no medications. Which of the following is the most likely diagnosis?

A 19-year-old boy presents with his mother for complaints of frequent eye blinking and shoulder-shrugging spells occurring multiple times a day. He also has frequent episodes of humming a three-note tune randomly throughout the day. He has had these problems since he was 17. He had an MRI brain and EEG that were negative. He takes no medications. The symptoms do not impact his activities of daily living, but he does feel embarrassed by the symptoms. He went to cognitive behavioral therapy for this for a year and has not seen a benefit. Which of the following is a first-line medication for this patient?