Mood Disorders — MCQs

An 81-year-old woman presents to your office accompanied by her husband. She has been doing well except for occasional word finding difficulty. Her husband is concerned that her memory is worsening over the past year. Recently, she got lost twice on her way home from her daughter’s house, was unable to remember her neighbor’s name, and could not pay the bills like she usually did. She has a history of hypertension and arthritis. She has no significant family history. Her medications include a daily multivitamin, hydrochlorothiazide, and ibuprofen as needed. Physical exam is unremarkable. Which of the following is associated with an increased risk of this patient’s disease?

A 24-year-old woman comes to her physician because of fatigue. She has been coming to the office multiple times a month for various minor problems over the past six months. During the appointments, she insists on a first name basis and flirts with her physician. She always dresses very fashionably. When his assistant enters the room, she tends to start fidgeting and interrupt their conversation. When the physician tells her politely that her behavior is inappropriate, she begins to cry, complaining that no one understands her and that if people only listened to her, she would not be so exhausted. She then quickly gathers herself and states that she will just have to keep looking for a physician who can help her, although she has doubts she will ever find the right physician. She does not have a history of self harm or suicidal ideation. Which of the following is the most likely diagnosis?

A 25-year-old woman presents to her primary care physician with a chief complaint of diffuse muscle aches and pains. She states that she has trouble doing everyday tasks such as showering, cooking, and cleaning due to the pain. The patient has a past medical history of anxiety and bulimia nervosa and is currently not taking any medications. Upon further questioning, the patient states that her symptoms started last week when her boyfriend left her for another individual. The patient was quite upset, as she states she always had tended to all his needs and never argued with him. Since he has left, she has been unable to decide what she should do with herself during the day. The patient has been living with her mother for the past day and states that has helped greatly, as her mother helps her plan her days and gives her chores to do. Regardless, the patient states that her pain persists. The physician sets up a referral for the patient to work with a psychiatrist. Upon hearing this, the patient becomes visually bothered and questions if the physician is actually trying to help her. Which of the following personality disorder does this patient most likely suffer from?

A 19-year-old woman comes to the physician because of a 2-day history of difficulty sleeping. She worries that the lack of sleep will ruin her career prospects as a model. She has been coming to the physician multiple times over the past year for minor problems. She is dressed very extravagantly and flirts with the receptionist. When she is asked to sit down in the waiting room, she begins to cry and says that no one listens to her. When she is called to the examination room, she moves close to the physician, repeatedly intends to touch his cheek, and makes inappropriate comments. She does not have a history of self-harm or suicidal ideation. Which of the following is the most likely diagnosis?

A 14-year-old male is brought to your psychiatric clinic after he was caught stealing his peers’ belongings multiple times by his teacher. He is a straight-A student with many friends and is an outstanding football player. He describes his family as very loving and gets along with his older siblings. He also states that he has no ill will towards anyone he stole from in class. Although never caught, he admits that he would often steal things in stores or locker rooms when no one was looking in order to satisfy an intense impulse. Which of the following is the best diagnosis for this patient?

A 35-year-old woman is brought to the emergency department by her coworkers after a sudden onset of vision loss. She is a lawyer and lost 3 cases in the past week. Yesterday, she experienced weakness and paralysis of her left wrist. Past medical history is significant for acid reflux. Physical examination reveals 2/4 in reflexes and 5/5 in muscular strength in all extremities. She appears indifferent to her current situation and presents with a flat affect. Slurring of words is absent. CT without contrast and MRI of the brain are unremarkable. Which of the following is the most likely diagnosis?

A 25-year-old woman with a history of moderate persistent asthma presents to the emergency department with tachypnea, shortness of breath, and cough. She also mentions that she has recently started to notice red flecks in the sputum that she coughs up. The vital signs include: temperature 36.7°C (98.0°F), blood pressure 126/74 mm Hg, heart rate 74/min, and respiratory rate 26/min. Her physical examination is significant for moderate bilateral wheezes and poor air movement. The forced expiratory volume-1 (FEV-1) is less than 50% of the predicted value, and she is found to have a concurrent upper respiratory tract infection. She is given oxygen, albuterol, and corticosteroids for her exacerbation, and she starts to feel better after a few hours of monitoring in the emergency department. She is ultimately discharged home on a 14-day prednisone taper. Which of the following is a side effect she could experience on this short course of steroids?

A 27-year-old woman is brought to the physician by her parents because they are concerned about her mood. They say that she has “not been herself” since the death of her friend, who was killed 3 weeks ago when the fighter jet he piloted was shot down overseas. She says that since the incident, she feels sad and alone. She reports having repeated nightmares about her friend's death. Her appetite has decreased, but she is still eating regularly and is otherwise able to take care of herself. She does not leave her home for any social activities and avoids visits from friends. She went back to work after taking 1 week off after the incident. Her vital signs are within normal limits. Physical examination shows no abnormalities. On mental status examination, she appears sad, has a full range of affect, and is cooperative. In addition to taking measures to evaluate this patient's anxiety, which of the following is the most appropriate statement by the physician at this time?

A 34-year-old female presents to a counselor at the urging of her parents because they are concerned that she might be depressed. After recently breaking up with her long-term boyfriend, she moved back in with her parents because she could not handle making decisions alone. Soon after their breakup, she started going on 5–7 dates a week. She has been unemployed for 3 years, as her boyfriend took care of all the bills. In the past year, she thought of looking for a job but never felt confident enough to start the process. Her mom arranges her doctor's appointments and handles her car maintenance. She describes feeling uneasy when she is alone. She has hypothyroidism treated with levothyroxine. She does not smoke or drink alcohol. Vital signs are normal. Mental status exam shows a neutral affect. Neurologic examination shows no focal findings. Which of the following is the most likely diagnosis?

A 71-year-old woman comes to her doctor because she is having trouble staying awake in the evening. Over the past year, she has noticed that she gets tired unusually early in the evenings and has trouble staying awake through dinner. She also experiences increased daytime sleepiness, fatigue, and difficulty concentrating. She typically goes to bed around 9 PM and gets out of bed between 2 and 3 AM. She does not have any trouble falling asleep. She takes 30-minute to 1-hour daytime naps approximately 3 times per week. She has no history of severe illness and does not take any medication. Which of the following is the most likely diagnosis?