1.

A 25year old woman is brought to the emergency ward by her neighbors who reported her to be
banging on their doors and screaming in the stairwell. Upon examining the patient’s apartment
the police found the place to be dirty, with rotting garbage and food in the kitchen. On the
examination patient explains that she has been defending herself against aliens who want to use
her as a specimen for trials. The patient’s family reports that for the past year or so she has
seemed increasingly odd, dissociating herself from family activities.

Questions:

1. What is the likely preferred diagnosis?

2. What information in the case supports the diagnosis?

3. What is the likely differential diagnosis?

4. What treatment options are available?

5. What is the prognosis in the case?

2. A 19-year-old man is brought to the physician by his parents after he called them from college,
terrified that the Mafia was after him. He reports that he has eaten nothing for the past six
weeks other than canned beans because “they are into everything—I can’t be too careful.” He is
convinced that the Mafia has put cameras in his dormitory room and that they are watching his
every move. He occasionally hears the voices of two men talking about him when no one is
around. His roommate states that for the past six months the patient has been increasingly
withdrawn and suspicious.

Questions:

1. What is the likely preferred diagnosis?

2. What information in the case supports the diagnosis?

3. What is the likely differential diagnosis?

4. What treatment options are available?

5. What is the prognosis in the case?

 3. A 65-year-old widow has been brought to the GP because she has “not been taking care of
herself for last few week.” Lately, she wakes up earlier than she normally does and sits around
all day “doing nothing.” She has stopped attending her Thursday bingo meetings and says that
there’s not much for her in her life now. She experiences feeling of worthlessness, low energy
and shows signs of psychomotor retardation.

Questions:

1. What is the likely preferred diagnosis?

2. What information in the case supports the diagnosis?

3. What is the likely differential diagnosis?

4. What treatment options are available?

5. What is the prognosis in the case?

4. A 23-year-old woman arrives at the emergency room complaining that she had been seized by
an overwhelming fear, associated with shortness of breath and a pounding heart. These
symptoms lasted for approximately 20 minutes, and while she was experiencing them, she
feared that she was dying or going crazy. The patient has had four similar episodes during the
past month, and she has been worrying that they will continue to recur.

Questions:
1. What is the likely preferred diagnosis?
2. What information in the case supports the diagnosis?
3. What is the likely differential diagnosis?
4. What treatment options are available?
5. What is the prognosis in the case?

5. A 25 year-old woman presents to the clinic with a 9 day history of insomnia and increased
energy. Her father is concerned because she has been talking rapidly and loudly. The patient has
been going on shopping, acting in an uncharacteristically sexy manner and drawing attention to
 herself by falsely claiming to be a pop star. Patient speaks very quickly and his speech moves
from one topic to another. He uses many rhyming words without meaning.

Questions:

1. What is the likely preferred diagnosis?

2. What information in the case supports the diagnosis?

3. What is the likely differential diagnosis?

4. What treatment options are available?

5. What is the prognosis in the case?

6. A 19-year-old woman who is a college student is brought to the clinic by her roommate because
she has been acting strangely during the past six months. During the past month, the patient has
been describing how another person's thoughts have been entering into her mind. The patient's
grades have been slipping, and she does not talk as much as she did previously. The roommate
says that when the patient does talk, she strays from the topic and is hard to follow. During the
interview, the patient says a television reporter told her that the government had a special
message for her and she should listen to the radio for further instructions. Which of the
following conditions is the most likely cause of this patient's symptoms?

Questions:
1. What is the likely preferred diagnosis?
2. What information in the case supports the diagnosis?
3. What is the likely differential diagnosis?
4. What treatment options are available?
5. What is the prognosis in the case?

7. A 37-year-old man comes to the office after he experienced what he says was a nervous
breakdown. The patient says that after he recently declared bankruptcy, losing his home and his
business, he became very depressed. During this time, he began to hear voices telling him that
he was useless and should kill himself. The patient says his symptoms stopped after
approximately one week. He has had no similar episodes. Medical history includes no psychiatric
 conditions. Physical examination shows no abnormalities, and results of laboratory studies are
within normal limits. Which of the following is the most likely diagnosis?

Questions:

1. What is the likely preferred diagnosis?

2. What information in the case supports the diagnosis?

3. What is the likely differential diagnosis?

4. What treatment options are available?

5. What is the prognosis in the case?